The proliferation of DSOs and economic conditions in the U.S. are among the biggest concerns dental leaders have regarding the industry moving forward.
Here, 11 leaders answer the question: "What worries you about dentistry today?"
Editor's note: Responses were lightly edited for clarity and length.
Omer Anniso, DDS. La Costa Dental Group (Encinitas, Calif.): The biggest concern I have about our profession today is the financial pressures our new graduates are going to be faced with as they enter the workforce. The incredible debt that these young professionals will have on their shoulders I believe will affect their ability to focus on the path that they desire along with a genuine focus on patient care.
Catherine Cech, DMD (Manchester, Vt.): There are not enough auxiliary personnel. This is causing practices to close their doors.
Andy Droel, DDS. Droel Family Dentistry (Lino Lakes, Minn.): There is a pervasive and significant lack of available assistants and hygienists. Dentists and dental office owners cannot readily recruit and train more assistants; this is something that depends upon outside entities like colleges and vocational schools. Unfortunately, educational institutions are not expanding their programs nearly enough to address the situation and I anticipate no apparent end to these shortages.
Dennis Flanagan, DDS. Groton/Windham Dental Group (Groton, Conn.): DSOs are consuming dentistry. We need dentist MBAs to run these DSOs. Now many are run by high school graduates and there is now concern for human patients.
Rich Gilbert, DMD. Pelican Landing Dental (Bonita Springs, Fla.): The death of the 4/5 Op Solo-practitioner model and what fills that void. With rising wages, supply costs, lab costs and rent, this model already is failing. Will established corporate DSO dentistry completely fill that void, or will owner providers link up in group models, and if so, what percentage of market share will these new group practice models have?
Daniel Kazachkov, DMD. Dental Arts of Westwood (Mass.): DSOs are decreasing quality of care and insurance companies are trying to avoid payments. Staffing costs are beyond what I’ve ever seen and employee work isn’t what it used to be.
Bradford Mclaughlin, DDS. Tend (New York City): My concern right now is that my younger patients often can only afford what is covered by insurance (sometimes not even the co-pay), and insurances are not keeping up with the times on reimbursement to dentists or covering modern standard-of-care procedures. Dental health will naturally get worse as a result without changes.
Chip Mercer, DDS. Fielder Park Dental (Arlington, Texas): My main concern for dentistry right now is the horrendous economic conditions we have and how they affect our patients, their ability to pay for services and our employees' abilities to survive financially due to the high inflation, which is outpacing revenue.
John Merrill, DDS. NorthStar Dentistry for Adults (Huntersville, N.C.): Dentistry has little to worry about versus the powers that now control medicine: big pharma, government and larger hospital systems controlling virtually every aspect of patient care. Dentistry still enjoys a lot of autonomy, and the fact that insurance is paying relatively less each year places more choice and responsibility where it should be: between the doctor and patient. What concerns me is the amount of debt new graduates are carrying and the stress and lack of options open to them as economics become the main topic of their career options.
Richard Nguyen, DMD. In-House Dental Care (Huntington Beach, Calif.): The increase in DSOs. Dentistry is becoming more like hospitals, as they have the capital to expand and dominate the local market. They are very organized and very aggressive in their treatment diagnosis. A lot of young dentists are pushed to the limit with regards to their treatment plan because they are scared to lose their jobs and are not able to pay their large dental school loan. Dentistry is becoming more of a factory instead of the old-school personal touch.
Dipty Parikh, DDS (San Carlos, Calif.): The biggest concern that I have about dentistry are the DSOs. I believe dentistry is heading down the same path as the medical industry where they have all these big hospitals like Kaiser, PAMF/Sutter health and patients' concerns are neglected. The doctors are losing the human touch and it's all becoming a business with the health costs rising exponentially. I see the DSOs buying up small dental offices and making them into large franchises and eventually if nothing is done about it, even basic services like cleaning and X-rays will be expensive for most people.