As DSOs continue to grow, the future of private practice becomes more uncertain.
Two dentists connected with Becker's to answer, "What will private practice look like 10 years from now?"
Note: Responses have been lightly edited for length and clarity.
Matt Carlston, DMD. Vice President of Marketing and Partner Recruitment at Comfort Dental: It is predicted that the trend of private ownership will continue to diminish. I agree with this assessment. In traveling to various recruitment events, the trend of DSO recruiting young dentists is seeming to increase. It appears to have become much more of a challenge to differentiate between the different DSO groups and private practices. DSOs have deep pockets. They can engage young dentists on levels that most private practices can't. It is very rare that we will see any solo doctor attempting to recruit young docs to their practices. Even when this does occur, it is usually done by a third party.
As dentists continue to retire from their private practices, they are met with few buyers that are not already connected to several different practices. In my experience, young doctors simply aren't prepared to undertake private ownership. Even if they wanted to purchase a practice, they have much educational debt. The number of young doctors that work for DSOs upon leaving dental school continues to increase. In my travels to over 30 dental schools these past few years, I have seen that most institutions neglect the business side of dentistry. They have so many students and limited time to teach them what they need to know. New doctors become intimidated by this side of dentistry. Most don't know what overhead is, how to order supplies, how to manage staff or meet a payroll, etc. So instead of trying to learn how, they take a job. They become an employee and give the responsibility to somebody else. Thus they are not compensated well enough to consider buying a private practice. So private practice will continue to shrink. The longer they remain in a DSO organization, the smaller the opportunity for them to be in a private practice.
DSOs also may offer the latest technology to many young dentists. Technology is important. For some procedures it makes dentistry more predictable and easier for the patient, which should always be our primary goal. Young doctors tend to fall in love with the latest and greatest [technology] when in reality they should be more concerned in how to properly remove decay, how to remove a tooth, and a whole list of bread and butter procedures that they have minimal exposure to while in school. Technology costs money. If new doctors want the latest dental technology, they need to absorb even more debt. This can be a recipe for disaster for the reasons listed above and many others. Many private practices are located in rural areas as well. A myth in dentistry is go where you want and you'll be successful. While this may be true for a few, the majority of doctors find this not to be the case.
Louis Cooper, DDS. Pediatric Dentist. (Rye, N.Y.): The signs of what private practice will look like are already present and visible. Some of the areas that I foresee the greatest impact are the following:
Technology: The digital world and advances in technology are having a major influence on all aspects of our lives, and dentistry is no exception. It is presently being used in digital radiography, digital impressions, creating in-office restorations, 3D printing, virtual reality and other applications. These areas will be refined and many additional developed to improve the practice of dentistry for doctors and the service to their patients.
Dental materials: The development of new materials will make it easier to restore tooth structure in a more minimally invasive and aesthetic way. Implants will continue to increase in use with its application expanded.
Workforce: There will be more women practicing dentistry, doctors will retire later, dental schools will produce more graduates and there will be a greater supply of dentists.
The relationship between dentistry and medicine: There will be a further appreciation of the role oral health has on overall health. This will initiate a closer working relationship between medicine and dentistry that in the end will benefit the patient.
Prevention: There will be a continued appreciation and implementation of new ways to prevent dental disease. The establishment of a dental home for children at age 1 will be more accepted within the professional community. This will form the basis for better oral health that will last the child a lifetime.
Teledentistry: The popularity that it achieved over the last few years will increase and become a significant tool in the care of patients and overcoming the barriers to oral health services.
Private Practice: With the growth of DSOs and the corporate model, the days of private practice may become a thing of the past. Owner or employee? We shall see.