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MyView: Why Medicaid is part of my business model

September 15, 2014

By Michael Donohoo, D.D.S.

Photo of Dr. Donohoo
Michael Donohoo, D.D.S.
As a small business owner, I appreciate the necessity of managing a busy practice. Gone are the days that a dentist can simply open a practice and expect to be successful. The profit margins are being squeezed by value conscious consumers, insurance companies and state and federal governments. Most dentists are small business people, with economic decisions to make and payroll obligations to meet.

My community involvement with oral health promotion and helping the underserved has routinely been part of my business model. While that may not make sense to everyone, it has to my business partner and me for nearly 30 years.

The state where I practice has a Medicaid system whose reimbursement rates are near the lowest in the country. I understand why some practitioners refuse to partake in the system, using the business standpoint as the rationale. Colleagues have told me that if lawmakers want the underserved to be treated, then the programs should be adequately funded. The business side of me agrees.

But helping the underserved is actually good for "business." Community partners see you actively trying to be part of a solution and want to help. Treating kids on Medicaid is an important way to show the world that you care about the oral health of the public while it provides an avenue to fulfill your professional obligation.

At a time when many dentists have excess time in their schedules, it is a great opportunity to provide care and increase the bottom line by keeping staff busy and chairs productive without much increase in office overhead.  

Another advantage of participating is that it is easier to make change happen by being a part of something rather than an outsider. Partnering with others in your community to find the group of people that you want to help makes them much more likely to appreciate your efforts and work to place oral health at a higher priority in state budgets.  

It is critical that the Medicaid program work effectively so that charitable programs can help those that fall through the cracks. In Wisconsin, too, many of our charitable events are caring for those that already have Medicaid coverage.  

From my standpoint, helping a child with a toothache, decreasing someone's fear of the dentist, educating someone about nutrition and good oral health practice and transforming them into lifelong healthy people is
important work and gives me great satisfaction. The one day per week that we devote to the underserved can be the best part of my professional service because the patients and their families are so appreciative and I am truly making a difference in their lives.

I participate in Give Kids A Smile, Donated Dental Services, an emergency department referral program, our state and local oral health coalition and a Boys and Girls Club grant program. However, I think my Medicaid participation gives better access and care to society at large because I have an ongoing relationship with patients.

I can promise you that I won't stop advocating for better Medicaid reimbursement rates, lower administrative burdens and a better Medicaid system. I believe fixing the Medicaid program has the best chance of actually solving the access to care crisis that exists and my involvement in the system hopefully gives me greater leverage to change it.

Dr. Donohoo is a past president of the Wisconsin Dental Association and past chair of the American Dental Political Action Committee. He is a private practice dentist in Milwaukee.