Nice weather, affordable cost of living and resources from local dental organizations are some of the answers dentists gave when asked about the best parts of practicing in their states, while payer overreach, low reimbursements and corporate dentistry were the worst parts.
Five dentists recently spoke with Becker's to share the best and worst parts of practicing in their respective states.
Editor's note: Responses were lightly edited for clarity and length.
Jeffrey Cohen, DMD. The Cosmetic Dentist (West Palm Beach, Fla.): It's the old story of work hard, play ferociously. You can work hard during the week and then on the weekends, it's like being away at a resort. I don't know if there are any significant financial advantages to being in Florida other than there is no city or state income tax. It doesn't matter where you practice, you can be successful anywhere. It's just that I have to like living in this area. It's not any worse here than it is anywhere else.
Misako Hirota, DMD. Private practice (National City, Calif.): I think the worst part of being a dentist in California is not exclusive to this state. I believe it is the overarching influence of dental insurance [companies] to override the diagnosis and treatment by a dentist for their patients. Most claims are reviewed by non-dental personnel that do not have the dental education and ability to distinguish between necessary treatment and the plan's guidelines, which are most often based on the bottom line, not the patient's well-being.
California has very specific requirements regarding who can diagnose treatment and yet insurers are able to sidestep this requirement by stating the insurance's guidelines. When a pregnant patient presents to the office and I believe a resin composite in the posterior teeth is indicated, the insurance will downgrade the procedure to an amalgam, even though literature discourages this for pregnant women. They downgrade the procedure, not based on current practices but for monetary reasons and if you are in network, they forbid the practitioner from collecting the difference in fee. They routinely deny treatments that could save a patient's tooth over the cheaper alternative of extraction. While this may be a short-term solution, in the long run, the patient suffers from the inability to masticate properly and [it] causes movement of teeth, super-eruption of opposing teeth, etc. Insurance is a billion-dollar business.
What I think is the best part of being a dentist in California is the CDA's Practice Support Center and the resources it offers to members of the organization.
Huzefa Kapadia, DDS. Kapadia Dental Care (Waterford, Mich.) and Detroit Sterling Dental: Best part: I love not working weekends and I get done between 4-5 p.m.
Worst: Dealing with unreasonable and difficult patients can add a lot of stress to your life. Learning to read patients before treatment is key.
Natalie Stewart, DMD. Mason (Ohio) Elite Dentistry: Despite having two dental schools, there seem to be plenty of patients to go around. Since Ohio is by no means a destination state, being a dentist affords a great lifestyle at a reasonable cost of living.
The worst part about being a dentist in the state is if you do have to work for an office in network with or participate with state insurance yourself, the reimbursement rates are poor. There are few providers who are in network and many children suffer because Cincinnati Children's and the health departments can only handle so many patients. At one point, I was receiving a percentage of collections as an associate and regularly was paid less per hour than my assistant due to low reimbursements.
Owen Waldman, DMD. Waldman Dental Group (Scottsdale, Ariz.): I feel the best part about being a dentist in Arizona is living here and the beautiful lifestyle we enjoy. In addition, I think overall we have a good dental board here which doesn't seem to jump to conclusions based on random complaints, but actually looks into the facts to make sure there is merit and have reasonable [continuing education] licensing requirements. I hope that continues as it always has.
The worst part is the big increase in corporate dentistry-type offices over the past several years and its continuing influx, which, in my opinion, isn't good for dentistry and patient care as a whole.