The Assault on Private Practice

Persevere against the triple threat challenging private practitioners today

It’s hard enough for dentists out there already. There are a host of very real challenges that practitioners face being in private practice today: staying up to date on the latest technology, keeping clinical skills honed, meeting your business goals, managing the dental team, marketing… the list seems never ending. It’s a heavy load for today’s dentists to carry.

The unfortunate reality is that current industry trends, including ever-lower insurance reimbursement rates, the rise of corporate dentistry and the overall lackluster economy pose three relatively new and increasingly imposing challenges for private practice dentists above and beyond the usual trials and travails.

The Insurance Reimbursement Bust

The insurance companies have effectively declared war on the private dental practitioner. Reimbursement rates are falling across the board. Insurance company executives have suggested that dentists “could start working five days a week” to make up for lost revenue from these deep cuts to their reimbursement rates. The mere suggestion that doing more volume can somehow make up for a loss on each procedure is preposterous; a negative multiplied by infinity is still a negative.

This standoff pits dental insurance companies against small business owners trying to care for patients and make a decent living. It’s clear that insurance companies either don’t know or don’t care about everything that comprises a dentist’s work week. The insurance company executives might be surprised to learn, for example, that clinical hours make up only a fraction of the hours a private practitioner spends working in the practice.

Corporate Dentistry

This lack of understanding of the day-to-day responsibilities of a private dental practitioner is quite possibly the byproduct of the rise of another type of assault upon the private practice of dentistry: high-volume dental chains operated by corporations known as dental management companies, or DMSO’s. Dentists within these organizations are often salaried employees who have limited business or management responsibilities. As a result, nearly all of these dentists’ time can be clinical time. The operational business functions, which are incredibly time-consuming in a private practice, are all provided by the corporation. Dental practices that are a part of a DMSO or chain can often be run with fewer staff members – and lower overhead as a result.

The Economy

This brings us to the final threat: the economy. Patients continue to feel the economic crunch, and whether that’s merely perception or their actual reality is almost irrelevant. The result of this squeeze is that patients are waiting longer in between dental hygiene visits – stretching out recall intervals and constantly “rescheduling”. Comprehensive treatment plans are often put on the back burner. Emergencies due to increased procrastination are becoming more and more prevalent; rather than patients taking a preventive approach, they’re seemingly crossing their fingers and hoping that a few years of dental neglect during hard times won’t come back to haunt them.

But the reality is that even in these tough economic times, many patients actually want a higher standard of care. Patients are beginning to understand, expect and budget for expenses like dental implants that were seen as a luxury item only a decade ago, even when the economy was booming. And the most surprising statistic about today’s economy is that while it has led to an overall sense of frugality when it comes to luxuries like expensive cars and vacations, the savings rate in the U.S. is actually at an all-time high, so people for once actually have the money to spend on dentistry.