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Letters: Preparing dental students for changing environment

September 01, 2014 Dr. Valachovic is correct in highlighting the issue of properly preparing dental students for a changing dental health care environment ("From Bungalow To Big Box," July 14 ADA News) Corporate dentistry and dental support organizations have changed the face of dental health care delivery. But it is not the end to the traditional setting. As much as was pointed out that DSOs have an "efficient business model gives them a distinct economic advantage," the traditional setting is truly better for the dentist and the patient by maintaining a long-term relationship of care.

There is an efficient business model available for the private dentist accepting PPOs that places the private practice on or near even footing with the DSO. Dental students need to be taught in dental school how to make a living and have a private practice in the competitive PPO climate. It is possible to have a 32-hour work week, decent income and long-term patient relations and still accept PPO reimbursement rates. Dental students need to be taught how to achieve independence with and work with the PPOs, and not just look to dentistry as a job with a paycheck.

I disagree that DSOs "have an advantage in the marketplace for talent." The new dentist still needs to hone well-learned skills. Where better than under the wing of a senior practitioner? Someone who will guide the new dentist in their care for the patient, teach business/practice management skills and proper insurance billing.

Dr. Valachovic is correct in stating that the private practice is not for the new dentist who does not want to work hard in an entrepreneurial setting with long-term patient care. It does take hard work and effort to make any entrepreneurial business endeavor successful. The rewards are much greater than an extra week vacation, a short work week or just wanting an 8-5 job. It is through the long-term care of our patients that we have enabled many dentists to have a quality of life, truly enjoy their professional careers and have control of their lives. Over the years, we get to know our patients and their needs and provide care that is patient-centered and not procedure/profit centered. There is also the benefit of building a future that you can control. When you are self-employed you tend to think of ways to always improve your business (in dentistry that is the care of our patients) to make your business and yourself grow.  

Merely teaching codes of ethics and applicable laws is not enough. We must teach dental students the "why" to be ethical and to maintain their careers within the standard of care by putting the patient first and not corporate shareholder profit.

Not all DSOs are profiteers. Many, and I would like to think most, are an excellent alternative vehicle for delivery of dental care. However, I believe the patient will be best served by dentists educated and trained to keep the patient the focus of their endeavors.

Joseph P. Graskemper, D.D.S., J.D.
Associate Clinical Professor
Stonybrook School of Dental Medicine
Bellport, New York