THE STORY NEVER TOLD

It is clearly evident that change is upon the dental industry. The shift creates a new model for patient care, a new environment for dentists, a different reality for doctors in the transitioning stage of their career. With a different economic reality for graduating dentists, and a high speed evolution of technology that is shifting the standard of care for procedures, the timing is right for the shift. These changes and more have set the stage and environment for a tipping point in the industry.  The emergence and growth of a sector of the industry has energized the Dental Service Organization (DSO) industry.

The industry has had less than an accepting response the DSOs. Fearing the impact of the competition to the traditional private practice business model has brought dentists to declare war on DSOs.  Knowing that going toe to toe with the DSO industry on competitive business is an unfair fight, they have taken the offensive by looking to challenge the credibility and to regulate the DSO model. The story that they tell charges dental practices supported by DSOs as surrendering clinical quality to corporate interests that violate the laws and professional standards. Anti-DSO forces have positioned the DSO sector to a battle of profit vs. patient care. Major media has been receptive to this news worthy claim and published articles and stories that feed this fire. Alliances in the political arena have also been tapped to write legislature to regulate the DSO model out of the industry. In a nut shell, the opposition to DSO sector has defined the DSOs. The DSO industry has been demonized.

Is there another perspective? Is the perception a reality? Should we fear and regulate the DSO industry to extinction? Is there a story that has not been told?

The pro-DSO story to –date has not been told. Understandably, the individual DSO companies have been reluctant to directly pick a fight with the larger dental community. Perhaps the hope has been that the community would see the advantages of the model as a strong alternative to private solo practice and accept the changes. The American Dental Association has chosen to stay out of this fight publically. The Dental Group Practice Association (DGPA) is young and to this point has been in a reactive posture playing defense.

At the present time, there are number of threats that challenge the industry. There is a real dental care crisis in America. There is an emerging shortage of dentists that is only getting worse as dentists of the Baby Boom generation retire and too few dentists are graduating to fill the gap. There are regions in desperate need of dentists. There are populations that need care. The DSO companies uniquely can compete with these challenges by having the financial abilities to develop practices in these regions and offer a true market-based solution to the crisis. This compelling story has not been told.

The kill-DSO campaigns have been told by the efforts of well-established dentists protecting their comfortable existence. This is only a segment of the dental community.  What about the younger emerging dentists with mountains of debt and an interest in having a different work life balance? The balance that allows them to put 100% focus on the medicine without the juggling of all the complex process and realities of management, ownership, entrepreneurial risks, legal liabilities, human resource demands, third party insurance negotiations, increase scrutiny on health care, accounts receivable management, and more. Taking the time to learn up to date practices that are not educated in dental schools rather than the time it takes to run and operate their private business. What about the dentists that thrive in an environment that allows them to earn a comfortable living in a model that gives flexibility to taking time for family life with the support to work a schedule that suites there interests?  There are many dentists looking to slow down and begin a transition phase. The DSO model allows them to benefit from the equity they have built over many years of work and unable to find an associate to navigate the “traditional” transition model.  These dentists often feel a huge sense of relief and ability to practice with less stress as they slow down. Those stories have not been told.

The truth is that history is on the side of the DSO model. New models of health care delivery have been challenged by doctors before but have been well received by patients and ultimately prevailed. Competition drives innovation and price containment in all industries. The DSO model creates competition and patient (consumer) choice in their dental care. It allows patients to more effectively utilize benefits that their employers provide.  The Federal Trade Commission that characterized efforts to slow the growth of DSOs in North Carolina as anti-competitive. The FTC report a study finding that “corporate” involvement in health care delivery actually improves coverage and lowers costs.  That is a good thing that certainly the editors of Bloomberg News and member of congress should embrace.  Once again, this is a story that has not been told.

DSOs have legions of satisfied patients and dentists to help tell their story. DSO companies have practices in remote locations, where patients have been otherwise unable to seek care. DSO companies have countless examples of dentists that have had support in continuing their medical and dental educations to offer the most cutting edge high quality care for their patients. There are thousands of patients that have had positive life changing experiences in DSO practices. The industry has the opportunity to deal with the emerging crisis that is present. The DSO sector has numerous advantages that benefit the patients, the doctors, the staff, the industry, and the human population. This is the story that has not been told. I believe that the industry at its core, understands these advantages. The anti-DSO naysayers will lose the fight. The shift has reached its tipping point and the dental industry is better for it. With that reality, is the need to ensure that standards are clearly outlined, that quality regulations are in place and that all practicing dentists whether in solo practice or in a DSO, maintain the highest level of patient quality and establish an accreditation process that certifies this. That is another topic for another article.