Butterflies or Just Flies?
The structure of dentistry in the United States is undergoing a transformation that will have lasting impact on both the practice and the laboratory. It is not possible to know which forces impacting the industry will play the largest role in reshaping dentistry, nor is it possible to predict how that final structure will look and operate. What is known is that the US is comprised of a populous that is exponentially growing in number, rapidly aging, increasingly diverse, and less middle class.
We know that those most challenged financially or inhabiting the rural areas of the country are the least likely to afford or have access to dental care, a trend exacerbated by the rising cost for dental treatment and the continued scarcity of independent dental practices in the more remote locations, choosing instead to set up shop in more populated and affluent urban and suburban areas.
We also know that a free-fall economy has had a negative impact on the industry and intensified dentistry’s ongoing struggle to regain a foothold and find financial stability. We know that the shift of shouldering the financial burden for dental care from employers and insurance companies to patient out-of-pocket is altering patients’ perception of value and creating a frugality about where and how expendable income is allocated. In turn, the changing patient perceptions of healthcare in general, and dentistry in particular, is affecting a shift from a trusted dentist-patient relationship to a more impersonal consumer-dental services vendorship—a shift that has contributed to a decline in dental care utilization and demand among adults. This fact has some theorists predicting the slow demise of private dental care over the next decades and the rise of big-box dentistry. Even more disconcerting and a deeper unknown that may have longer-term consequences is the impact that the Affordable Care Act may have on the dental industry for years to come. Millions of the formerly uninsured—as well as those once covered by employer-based medical/dental plans but who are now dropped as the company folds their health coverage—will be enrolling in insurance-based medical healthcare plans that do not currently include dental coverage for adults.
The convergence of these economic, governmental, social, and insurance-based forces have not gone unnoticed by the American Dental Association (ADA). In May 2013 the ADA brought together a group of distinguished external thought leaders in Chicago to distill, synthesize, and interpret data compiled from a research study that the ADA commissioned from an outside consultant group. The objective of the “Intelligence Fair” was to identify the most pressing environmental factors impacting dentistry and guide the ADA in formulating a strategic plan for the future. The ADA published a summary of its findings and analysis titled “A Profession in Transition: Key Forces Reshaping the Dental Landscape”. I urge everyone to log on to www.ada.org/escan.aspx and read the entire document. A 10,000-foot macro view of the industry may help business owners strategically plan for 2014 and beyond.