Dr. Raul Garcia
Is your oral health care affected by the type of dental practice you visit? That’s what Professor and Chair of Boston University Henry M. Goldman School of Dental Medicine’s Department of Health Policy & Health Services Research Dr. Raul Garcia explored in his October 2014 guest editorial in The Journal of the American Dental Association (JADA).The article was written on behalf of the Santa Fe Group, a not-for-profit organization of international scholars interested in improving oral health.
The editorial, titled The Restructuring of Dental Practice: Dentists as Employees or Owners, looks at the trend of dental practitioners in the United States today as they transition from owning their own practices to working for someone in a larger group practice model.
Large group practices in which dentists are employees are on the rise while smaller private practices in which dentists are owners are on the decline. The editorial explores why this may be taking place and discusses how changing socioeconomic, racial, and demographic trends may have led to disparities in access to oral health care, particularly in populations that have a higher risk and prevalence of oral health disease.
With a greater number of new dentists entering the workforce than retiring, and the vast majority of new dentists leaving school with mammoth debt loads, it may no longer be feasible for recent graduates to buy private practices of their own. New dentists entering the marketplace are being drawn in greater numbers to dental service organizations (DSOs). As a result of their increased buying power, these large DSOs are often able to offer lower prices than private practitioners and are able to accept more types of insurance, thus widening their potential patient base.
Garcia notes that these new mega-offices are not necessarily competing for patients against private practitioners; they are often vying for potential patients who are not already utilizing dental services, thereby creating new patients and expanding the market to those with unmet dental care needs.
“When all is said and done, what matters most is our patients’ oral and overall health,” Dr. Garcia said. “As a profession, we collectively need to ensure that the management and ownership structures of dental practices always serve our patients’ and the public’s best interests.”
Dean Jeffrey W. Hutter said, “Dr. Garcia makes several important observations about the changing nature of dental practices.” He continued, “As we continue to train our nation’s future practitioners, we must constantly be striving to make policy decisions that are in the best interest of our patients.”
The October 2014 edition of JADA, where Dr. Garcia’s editorial is featured, is available by request to JADA.