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Blog — Wisdom Truth

The purpose of this blog is to help guide dental student so they can navigate the "Dental World".

About Dr. Dickinson

Migration of mid-level providers?

As we have discussed, using the banner of access to care, outside foundations and other groups are aligning with state based coalitions to put pressure on legislators to address the issue (in their words, ‘solve the access to care problem’) of access to oral health care via the establishment of training programs for ‘mid-level’ providers- in this instance ‘training up’ dental hygienists to fill these positions.

Financial Trends in Dentistry

As suspected, the US economy continues to effect the micro economy of the profession of dentistry.  Trends that we have been observing since prior to the official start of the recession continue to concern us and effect the bottom line of practices.  We do continue to see an uptick in usage of dental services by our older populations and those under 20 years of age.  Most of those kids are under some type of government financed care (Medicaid, etc.).

Dental Service Organizations: A Private-Sector Solution to a Public Health Problem


Across the country today, Medicaid requires states to provide dental coverage for children. Yet Medicaid’s reimbursement rates have been, and continue to be, too low to adequately compensate traditional dental practices. This leads to significant health problems, where simple cavities become severe infections which can even prove fatal in extreme circumstances.

Coordinated Care Organizations - How might it affect you in your practice?

"Oregon has tried to tackle rising costs by focusing on Medicaid which serves 550.000 people in the state and is expected to grow by 200.000 under the Affordable Care Act’s Medicaid expansion that starts next year.  Governor John Kitzhaber last year spearheaded a new model of delivering services under Medicaid.

Fee-for-service vs. insurance. What should I do?

“One of the major decisions you will be making during your career is ‘do I take these plans or not’ and ‘which ones should I take?’.  Linda Miles has a good ‘take’ on this subject and this is worth 15 minutes of your time.

Also, in the near future, the ADA will be offering a service that will allow you to evaluate the different plans and their effect on your bottom line.  This is another good reason why you should be a VDA and ADA member.

A Rapid Transformation...

As we discussed, even locally in Richmond and in the state, we are seeing a fairly rapid transition from small physician owned practices to a multi-specialty ‘group’ type practice being owned by large hospital chains.  My guess is around 70% of the existing physicians are working for a corporate entity in some form or fashion.  As the author suggests (see article link below), one day they may be on salary, instead of being paid by procedure codes.  Are there implications for dentistry?  I would think so, albeit at a much slower pace, due to the difference in

Discount Programs

As we discussed, we are seeing more of these type programs for self-employed folks, those without dental insurance at their work place and small companies that would like to offer some type of dental program.
Would they bring more patients to your office?  Probably so – but at a cost to your bottom line.  As with all discount programs (and that includes the traditional benefit plans which ask you to discount your fees also), you have to look carefully at these programs and how they will affect your bottom line.

Dental Spending Growth Slows…

The rate of growth of dental spending has also slowed in recent years. Between 1990 and 2002, per capita dental spending grew by 3.9 percent per year after adjusting for inflation, a rate that fell to 1.8 percent between 2002 and 2008. Since 2008, the per capita dental expenditure growth rate declined 0.3 percent while overall health spending grew by 1.6 percent.

The Trend Continues...

As you can see, the trend toward consolidation continues- not good or bad, just is the new paradigm.  Interestingly, the ‘buyer’ is in Canada also (remember Heartland’s buyout of probably around $1.3B to a Canadian teacher’s pension fund).  It’s the ‘return on investment’ these funds are seeking.