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Georgia has healthy supply of dentists but low demand for care, survey says


Dr. Tourial
Atlanta—Georgia has more than enough dentists to serve patients in the Peach State, but many residents aren't taking advantage of the large supply of dentists to access needed care, according to the state dental association and an independent survey.

Only 19 out of 4,044 dentists who are actively practicing in Georgia—or 0.5 percent of the total—say they cannot accept new patients.

The vast majority maintain that while their practices are busy, they can still accept newcomers.

This is according to a workforce census conducted in 2012 by the Georgia Health Policy Center and Market Decisions Inc. and commissioned by the Georgia Dental Association. Surveyors interviewed dentists in private practice, federally qualified health centers and public health departments.

"The GDA believes this census demonstrates there is not a shortage of dentists who can provide care," said GDA President Sidney Tourial in a news release. "The word shortage suggests there is more demand for dental care than an available supply.

"If 43 percent of our public health districts report that they aren't busy because patients don't show up for appointments, and only 19 private practice dentists cannot take new patients, it appears that there is not a lack of dentists in Georgia. There is a lack of demand."

Among the findings:

• more than 3,300 dentists reported that while their practices are busy, they are still accepting new patients;

• thirty-one dentists reported their practices were struggling, and 309 said they have a need for more patients;

• patients of record can get an appointment in about five days, a new patient can schedule an appointment within six days and patients can be seen almost immediately for emergencies; 

• fifteen FQHCs offer dental service and four of those report patients can be seen with no wait;

• of the 159 counties in Georgia, 16 do not have a dentist, and no patient has to drive more than 22.9 miles to see one.

GDA leaders are pleased they now have the statistics to back up what they've been saying for years.


Dr. Torbush
The ADA supported part of the census through its State Public Affairs program, which helps state societies develop their legislative agendas and public affairs initiatives.

"It represents an independent assessment of the dental workforce capability in our state," said Dr. Edward Green, member of the GDA's Patient Protection Task Force.

"There are always intuitive feelings whether we are adequate or not but to have an in-depth look at where we really are is important."

In 2010, the GDA published "Georgia's Oral Health Status, Access to and Utilization of Oral Health Care Services," which detailed research supporting the premise that patients don't access dental care for a number of reasons: oral health literacy, economic constraints, transportation, lack of an adequate safety net, underfunded
government programs and workforce, among others. But the state dental society still wanted the numbers to back up these theories, and they were prepared for the data to go either way.

"If the census revealed a shortage of dentists in the state, we could then address that issue," said Dr. Douglas Torbush, GDA vice president. "If, however, the census revealed that a shortage did not exist, this information could be used to support our long-held contention that there was not a shortage of dentists in the state. Either way the results turned out, we felt that we needed the correct information to provide relevant answers to the issues that were facing our state."


Dr. Green
Now that the GDA has the information, the obvious question is what to do with it. Leaders say the primary goal is to use the statistics to develop strategies for how to remove barriers to care.

"Anything we can do to increase the literacy of these patients and have them seek care, not just on an emergency basis but to find a dental home, is important," Dr. Green said.

GDA leaders also want legislators to take note of the census and use its information when making decisions related to dental care or workforce in Georgia.

"We're not saying that the system doesn't have some problems that need to be dealt with, but let's deal with them on dentistry's terms," said Dr. Ty Ivey, chair of the Patient Protection Task Force. "Let's deal with it with somebody who understands the dental health profession and how to deliver great care to patients that will stand the test of time."

Dr. Ivey encourages other states to use this census as a model to conduct their own surveys to assess their state's situation.  The GDA has a number of patient education and policy initiatives in the works that leaders hope will address access to care barriers.

The GDA is helping develop a patient education and referral to community resources program for patients who visit emergency rooms with dental problems. State dental leaders are also pushing state legislators to pass a bill that would provide incentives for practitioners who practice in underserved areas.

Leaders encourage state legislators to fund the Medicaid and PeachCare for Kids dental programs adequately and make it easier for dentists to participate.

The GDA is also working with the Georgia Healthcare Association to initiate a nursing home staff training program so they can assist caring for residents' oral health.

The GDA held its first Mission of Mercy in 2011, donating $1.7 million in care to nearly 2,200 people. The two-day, 100-chair event will be held again in June.

GDA member dentists also participate in Give Kids A Smile each year.

"The general public and our elected legislators should realize that dental care can be provided to our citizens," Dr. Torbush said. "The dentists of Georgia want to provide this needed care. The public needs to understand the importance and acknowledge the role that proper dental care has in their overall oral health."

At the national level, the most recent data available from the ADA Health Policy Resources Center confirms that dentists are finding themselves less and less busy.

The percent of general practice dentists reporting that they are not busy enough and can see more patients increased from 20 percent in 2007 to 39 percent in 2011, based on dentists surveyed across the country.

A similar increase was seen among specialist dentists.

Wait times for appointments also decreased steadily during the past decade from an average of 10 days in 2001 to five days in 2011, according to HPRC. The decline started well before the recent economic downturn.

"This data clearly indicates that at the national level there is significant capacity within the dental care delivery system to treat more patients and suggests that additional providers may not be needed," said Marko Vujicic, Ph.D., managing vice president of HPRC.

"Instead, policymakers ought to focus more attention on reforms targeted at harnessing this excess capacity to treat the underserved."

Dr. Vujicic said such reforms include expanding dental benefits to adults within Medicaid programs, significantly increasing oral health literacy outreach efforts, streamlining Medicaid administrative inefficiencies and raising reimbursement levels closer to market rates.

To view the entire GDA Dental Workforce Census report, go to the website.