Dental Therapists

[doctor.doctor]

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Thoughts on dental therapists? Will they have full prescription rights and do everything essentially a general dentist does?

 

[Cthuluhoop]

Corporate dental offices' are probably watering at the mouth over the thought of a dental MLP in most states. From what I've researched, they're being pitched as a solution to the "access to care issue", however in the states that they are currently utilized in, they are not working in the areas that need dental providers. Instead they're in the cities and areas already saturated with dentist.
I'm unsure of their prescription rights, but if they gain traction here in the states, I'm sure they'll get it

 

[2TH MVR]

Wonder if DTs will have similar responsibilities as PAs (Physician's Assts)? PAs can administer and prescribe drugs, digital rectal exam (ask me how I know lol) etc. etc.

Here's my opinion. DTs would exist to fill the void of areas without any local dentists. Dentists are decidedly against DTs for turf reasons. It's common nature. Dentists say there is not a lack of dentists in the underserved areas. Well ....there is .... at least in my state. Arizona. Plenty of Native American patients in rural areas. In the past and present .... the state has had to hire these outside, PRIVATE-FOR-PROFIT companies with their mobile dental units, dentist and asst. My friend (dentist) works for such a company. Their company services alot of these rural patients. From what my friend describes .... the dentistry is very 3rd world. He described to me "toothbrush prophy", numerous extractions, stainless steel crowns regardless of age, etc. etc.. I get it. Can't perform high end dentistry. His employer and others have been investigated numerous times for billing fraud and poor treatment practices.

The point I'm making is that a DT that actually lives in the rural area may be a better option for the local patients than unscrupulous for-profit companies that have questionable ethics.

 

[deleted942432]

Don't see anything wrong with it. If you can't keep up with your competition, then you only have yourself to blame.

 

[321931]

Don't see anything wrong with it. If you can't keep up with your competition, then you only have yourself to blame.

You will learn that, you, as a solo practitioner really can't keep up with the competition. When some of the insurance companies have market caps of 200+ billion dollars with lobbyists in the gov...how can YOU compete? You can't. You are the mercy of whatever changes they make.

So when dental therapists are introduced with way less schooling then you, and instead of hiring- you- a dentist in 300k+ of debt for 50$ an hour, and can instead, hire a dental therapist for 20$ an hour... that also means that insurance companies could potentially trim down reimbursements across the board.

You can compete against the guy next door, but you cannot compete against wall street.

So what's my answer to the question? Just adapt to DT. Perhaps hire them and make use of them. There's always a positive to a negative.

I do think long term they will affect dentists negatively but what can you do?

 

[deleted942432]

You will learn that, you, as a solo practitioner really can't keep up with the competition. When some of the insurance companies have market caps of 200+ billion dollars with lobbyists in the gov...how can YOU compete? You can't. You are the mercy of whatever changes they make.

So when dental therapists are introduced with way less schooling then you, and instead of hiring- you- a dentist in 300k+ of debt for 50$ an hour, and can instead, hire a dental therapist for 20$ an hour... that also means that insurance companies could potentially trim down reimbursements across the board.

You can compete against the guy next door, but you cannot compete against wall street.

They said the same thing about PA. Worst case, the whole industry goes down. Either way, we can't control what happen, so just go with the flow.

 

[AppalachianDentalBoy]

They said the same thing about PA. Worst case, the whole industry goes down. Either way, we can't control what happen, so just go with the flow.

The income of the PCP MD is decreasing while the PA's and NP's has been steadily increasing. Their scope of practice and ability to practice solo increases every year while also providing poorer care outcomes. The public doesn't know the difference and is being charged the same so the only people benefiting are the insurance agencies and corporations who employ them.

The only way for dentists to possibly benefit is to employ them. Unfortunately that will come at the detriment of patient care.

 

[deleted942432]

The income of the PCP MD is decreasing while the PA's and NP's has been steadily increasing. Their scope of practice and ability to practice solo increases every year while also providing poorer care outcomes. The public doesn't know the difference and is being charged the same so the only people benefiting are the insurance agencies and corporations who employ them.

The only way for dentists to possibly benefit is to employ them. Unfortunately that will come at the detriment of patient care.

Hey look at the bright side, at least this will force schools to lower their tuition to compete with these DT programs.

 

[knewstance]

In my opinion, DT's will be the same as dentists, wanting to live in big cities and suburban areas (same places there are already lots of dentists) and there will be little/no noticeable difference in providing access to care in rural areas. Patients will be receiving lower quality care due to a less educated and lower qualified provider. Overall DT's are not a positive thing for dental care, patients, and obviously for dentists.

Hey look at the bright side, at least this will force schools to lower their tuition to compete with these DT programs.

If that were to happen, we wouldn't see any changes for several years once DTs really start to gain traction - minimum 5+ years assuming laws went into action today.

 

[Cthuluhoop]

In my opinion, DT's will be the same as dentists, wanting to live in big cities and suburban areas (same places there are already lots of dentists) and there will be little/no noticeable difference in providing access to care in rural areas. Patients will be receiving lower quality care due to a less educated and lower qualified provider. Overall DT's are not a positive thing for dental care, patients, and obviously for dentists.

Yup, that's what's already happening in the states they are active in. Instead of going to the underserved areas, they're cramming into the cities that already have too many dentists.

Hey look at the bright side, at least this will force schools to lower their tuition to compete with these DT programs.

Definitely won't happen. You're becoming a doctor as a dentist, that alone sells many people on the profession.

 

[deleted942432]

Definitely won't happen. You're becoming a doctor as a dentist, that alone sells many people on the profession.

a chiropractor is also a doctor, but i don't see too many people gunning for that field. I guarantee you if dentists avg salary drop below 100k, then schools will lose a big chunk of their applicants. They would have no choice but to drop their tuition to keep up with the market.

 

[Cthuluhoop]

a chiropractor is also a doctor, but i don't see too many people gunning for that field. I guarantee you if dentists avg salary drop below 100k, then schools will lose a big chunk of their applicants. They would have no choice but to drop their tuition to keep up with the market.

While I do agree with you that should be happening, it's really not. People right now are taking loans of $400k+ for a starting salary of $90k-$120k in most desirable areas of the country pre-tax. After student loan repayment, taxes and expenses you're barely taking home anything if you go to an expensive dental school.

Schools have made the illusion to future applicants that they will be making $200k+ easily and will be rolling in money no matter the cost of schooling. During the financial aid presentations at a school I interviewed at, he showed us pictures of foreign cars, a massive house, and a boat that dentist friends of his had to show us how great we'll be doing. Then I interviewed at one of the most expensive schools in the country and they didn't even talk about finances other than a very brief discussion about cost of attendance. Most students are so gung-ho for this career that they don't really consider finances until it's too late it seems

 

[2TH MVR]

So when dental therapists are introduced with way less schooling then you, and instead of hiring- you- a dentist in 300k+ of debt for 50$ an hour, and can instead, hire a dental therapist for 20$ an hour... that also means that insurance companies could potentially trim down reimbursements across the board.

?

It's all capitalism. Similar scenario. Aspen Dental hires GPs (read: way less schooling than an Orthodontist) to perform orthodontic treatment using aligners. They can pay these GPs less than an orthodontist thereby offering a service at a lower cost which ultimately means ins. co. readjust their reimbursements lower.
Isn't life great?

 

[Likkriue]

What a mess, most will stay in the major cities. Who are we kidding lol.

 

[REACHOn]

If they do not gain enough positive traction (They aren't, the majority actually disagree with the concept of DT on DentalTown. The main supporters are very vocal about it though.) they will probably focus on gaining positive traction with another audience. They look for those that will purely benefit for it. What they say can contain a bit of truth. If they train thousands of dental therapist, a few will stay rural, but the majority will not and they will show statistics of how dental therapist are beneficial to rural areas. The numbers may not lie, but people do. The older generation has pretty much left the dental occupation in a rough state (ADEA conference and lobby for us!).

 

[AppalachianDentalBoy]

If they do not gain enough positive traction (They aren't, the majority actually disagree with the concept of DT on DentalTown. The main supporters are very vocal about it though.) they will probably focus on gaining positive traction with another audience. .

Sadly you're right. Dentists aren't the ones who get to make the decision, politicians are.

 

[knewstance]

The older generation has pretty much left the dental occupation in a rough state

Can you explain this a little more? I'm not sure what you are trying to say.

 

[Blueshirts]

Sadly you're right. Dentists aren't the ones who get to make the decision, politicians are.

They don't know any better that's why you lobby them. What's the solution for us to reach rural communities though? Would government dollars even be enough of an incentive?

 

[REACHOn]

Can you explain this a little more? I'm not sure what you are trying to say.

I guess I'll take the bait. There's 2 sides to everything and I won't be baited into going back and forth if anyone has another opinion. I'll just listen 🙂 Take it for what it's worth. The state of our occupation was built on the older generation's decision and actions. The support of corporations, dental therapists, increase in dental product prices, increase in school tuition are all attributed to an extent through the actions or lack of actions from the older generation. There are some positive things that were brought into modern dentistry but the general view seems to be that dentistry has been heading towards what pharmacy has become. Maybe I am too focused on the negatives, but the majority of my decisions were made from reading many forums off SDN, Dental Town and talking with present day dentists. Hopefully, the politician will fight for us and show some positive results.

or just tell the newer generation like me to suck it buttercups and do it work! Yes SIR!

 

[ChewyDrop]

No, they will never.

 

[knewstance]

I guess I'll take the bait. There's 2 sides to everything and I won't be baited into going back and forth if anyone has another opinion. I'll just listen 🙂 Take it for what it's worth. The state of our occupation was built on the older generation's decision and actions. The support of corporations, dental therapists, increase in dental product prices, increase in school tuition are all attributed to an extent through the actions or lack of actions from the older generation. There are some positive things that were brought into modern dentistry but the general view seems to be that dentistry has been heading towards what pharmacy has become. Maybe I am too focused on the negatives, but the majority of my decisions were made from reading many forums off SDN, Dental Town and talking with present day dentists. Hopefully, the politician will fight for us and show some positive results.

or just tell the newer generation like me to suck it buttercups and do it work! Yes SIR!

No bait here, I just wasn't sure what you were referring to in your statement. Thanks for the explanation on your viewpoint. I can see where you can arrive at that conclusion.

I like to hope the outlook is more positive for our profession than I make it out to be in my head/read on forums. I guess I'll be able to address that a little bit better as I gain my own experiences.

 

[2TH MVR]

I guess I'll take the bait. There's 2 sides to everything and I won't be baited into going back and forth if anyone has another opinion. I'll just listen 🙂 Take it for what it's worth. The state of our occupation was built on the older generation's decision and actions. The support of corporations, dental therapists, increase in dental product prices, increase in school tuition are all attributed to an extent through the actions or lack of actions from the older generation. There are some positive things that were brought into modern dentistry but the general view seems to be that dentistry has been heading towards what pharmacy has become. Maybe I am too focused on the negatives, but the majority of my decisions were made from reading many forums off SDN, Dental Town and talking with present day dentists. Hopefully, the politician will fight for us and show some positive results.

or just tell the newer generation like me to suck it buttercups and do it work! Yes SIR!

Well ... since you took the bait. 🙂

Definitely can understand your reasoning. Unfortunately .... nothing is simple. Not sure how much power organized dentistry has over deep pocketed Corps. Everyone cheers for technology allowing lesser trained dentists to perform "extra, super GP" procedures .... well this makes it easier for Corps, Ins Cos to manipulate pricing by hiring lesser trained dentists. Save money on procedures leads to a lower "Reasonable and Customary" fee pricing by Ins Cos.

Dental Therapists. Just a turf war. Dentists don't want more competition. Society sees dentists as rich doctors, so fighting DT is going to be difficult.

Millennials have definitely re-shaped the capitalistic markets and this has affected dentistry also. I'm not picking on Millennials 🙂🙂🙂, but Boomers didn't buy something (i.e education) unless they could AFFORD it. Simple economics. Boomers are shaking their collective heads when ever they see Care Credit, Govt backed Student loans, Govt backed mortgages, Corp pt Lending loans at double digit interest %, Payday loans, etc. etc. etc.

Everything seems online now. You want to buy something? Online. You want straight, poorly performing, will not last alignment, and will probably cause TMJ ...get online DSC. General dentistry is not immune to this online direction. Amazon dental is just around the corner. Problem with online is NO SERVICE. It's cheap, but you get what you paid for. Boomers were not responsible for the low quality, no service online environment that we are in.

EVERYONE had or has a part in this. No need to blame one generation over another.

 

[REACHOn]

Thanks for your opinion as it was very insightful. I know it's much better to live without blaming the past and to focus on improving the present for a better future. My opinion is something I just formulated through reading certain posts and it doesn't mean much (not a politician 😛) nor is it expressed beyond the masquerade provided by the web 🙂 Amazon dental haha there better not be a future Ebay dental.

@knewstance maybe I'm just so focused and more attentive to the negative things. I also hope there will be a more positive outlook for our profession in the near future. No false positive outlook provided by people/groups with certain agendas, but real positivity.

 

[Blueshirts]

Their seems to be a a common thread linking some of the issues stated already, which is government intervention

 

[321931]

Honestly, we can point fingers to everyone in this. However, I blame capitalism in this. The wealth gap, capitalism and greed has basically divided this nation into the haves and have nots. If you in the haves camp, it ain't that bad.

And nothing is going to change this, until the whole system collapses- which it won't. The system should of honestly collapsed in 2008, but was bailed out by the government. When you have the general population hooked on credit card debt- the appearance that one can afford a truck/car/house on debt debt debt, cheap entertainment, and food... you won't have a change.

So just chill and relax. Adapt to amazon dental, costco dental, and go with the flow. We are still the best country in the world, and that won't change.

 

[971565]

Honestly, we can point fingers to everyone in this. However, I blame capitalism in this. The wealth gap, capitalism and greed has basically divided this nation into the haves and have nots. If you in the haves camp, it ain't that bad.

And nothing is going to change this, until the whole system collapses- which it won't. The system should of honestly collapsed in 2008, but was bailed out by the government. When you have the general population hooked on credit card debt- the appearance that one can afford a truck/car/house on debt debt debt, cheap entertainment, and food... you won't have a change.

So just chill and relax. Adapt to amazon dental, costco dental, and go with the flow. We are still the best country in the world, and that won't change.

Capitalism is still the best system. It's when you begin to introduce too many social services and give government too much power, that is when it begins causing problems... and debt accumulation begins.

 

[hellopeople]

Boomers didn't buy something (i.e education) unless they could AFFORD it. Simple economics.

You would have if you were born a couple decades later.

 

[907914]

You will learn that, you, as a solo practitioner really can't keep up with the competition. When some of the insurance companies have market caps of 200+ billion dollars with lobbyists in the gov...how can YOU compete? You can't. You are the mercy of whatever changes they make.

So when dental therapists are introduced with way less schooling then you, and instead of hiring- you- a dentist in 300k+ of debt for 50$ an hour, and can instead, hire a dental therapist for 20$ an hour... that also means that insurance companies could potentially trim down reimbursements across the board.

You can compete against the guy next door, but you cannot compete against wall street.

So what's my answer to the question? Just adapt to DT. Perhaps hire them and make use of them. There's always a positive to a negative.

I do think long term they will affect dentists negatively but what can you do?

Just hopping over here from the pre-MD forum....that $50 an hour kills me. Are dentists really paid that little?! work in a low-level ancillary services poaition for a urology clinic for $26 an hour and I know several RNs making north of $40 an hour.....again, do dentists really only make $50 an hour?!?

 

[Likkriue]

Just hopping over here from the pre-MD forum....that $50 an hour kills me. Are dentists really paid that little?! work in a low-level ancillary services poaition for a urology clinic for $26 an hour and I know several RNs making north of $40 an hour.....again, do dentists really only make $50 an hour?!?

Probably closer to $70 an hour. Or about 550 a day. But yes it’s nothing. CNRAs get paid almost double that as a midlevel provider.
I know everyone wants to talk about how we work less hours, but let’s be real here, most of us graduating that aren’t legacy’s are going to have to work way more than established dentists who already paid off their debts and own practices 19 years ago.

This is because Insurance company’s haven’t raised reimbursements for the past 10 years and we do nothing about it. Very sad honestly.

 

[knewstance]

This is because Insurance company’s haven’t raised reimbursements for the past 10 years and we do nothing about it. Very sad honestly.

Is there anything that even can be done about this?

 

[AppalachianDentalBoy]

Is there anything that even can be done about this?

Don't take insurance or have your patients pay you more than what their insurance pays you. You don't have to take insurance, you'll have a harder time getting patients but you'll be much better off.

 

[Likkriue]

Don't take insurance or have your patients pay you more than what their insurance pays you. You don't have to take insurance, you'll have a harder time getting patients but you'll be much better off.

Good luck convincing someone who has 500k dental school debt and another 500k practice debt to hang tight and be patient lol. They’ll take anybody with a heartbeat to make that 30$ filling reimbursement.

 

[907914]

Good luck convincing someone who has 500k dental school debt and another 500k practice debt to hang tight and be patient lol. They’ll take anybody with a heartbeat to make that 30$ filling reimbursement.

How the heck is a filling only $30 when a bag of saline is like $300?!? Either medicine grossly overcharges, dentistry grossly undercharges, or both.

 

[AppalachianDentalBoy]

Good luck convincing someone who has 500k dental school debt and another 500k practice debt to hang tight and be patient lol. They’ll take anybody with a heartbeat to make that 30$ filling reimbursement.

Better to make the same doing less work. More patients doesn't mean more money.
You're exaggerating grossly. I'd rather not break my back for a $30 filling, is that what medicaid pays?

How the heck is a filling only $30 when a bag of saline is like $300?!? Either medicine grossly overcharges, dentistry grossly undercharges, or both.

Fillings are 200+ depending on size and surfaces. At a corp a dentist would make 25-30% of that so $50-60 for that hour of work, if they can fill more in the hour then that is decent money. Owners make more from the filling 50% ish depending on overhead. Way money in crowns and root canals than fillings.

Medicine grossly over charges too but that's besides the point.
Good thing Bernie will fix it give us medicare for all! /s

 

[Cthuluhoop]

Don't take insurance or have your patients pay you more than what their insurance pays you. You don't have to take insurance, you'll have a harder time getting patients but you'll be much better off.

I think this is easier for us to say at this point in our lives before dental school and when we're relatively young.

But when you're nearly 30, have countless more expenses than we have now and potentially a spouse and children, things will most likely change when you actually need money

 

[knewstance]

Don't take insurance or have your patients pay you more than what their insurance pays you. You don't have to take insurance, you'll have a harder time getting patients but you'll be much better off.

I was more referring to getting insurance companies to increased their reimbursement rates. Obviously, you set your own fee if you don't take insurance.

 

[Likkriue]

Better to make the same doing less work. More patients doesn't mean more money.
You're exaggerating grossly. I'd rather not break my back for a $30 filling, is that what medicaid pays?



Fillings are 200+ depending on size and surfaces. At a corp a dentist would make 25-30% of that so $50-60 for that hour of work, if they can fill more in the hour then that is decent money. Owners make more from the filling 50% ish depending on overhead. Way money in crowns and root canals than fillings.

Medicine grossly over charges too but that's besides the point.
Good thing Bernie will fix it give us medicare for all! /s

Yes I’m exaggerating somewhat, I think 1 filling amalgam is about 90 bucks from Medicaid, however factor in overhead and you get pretty close to about 54 bucks. Just saying reimbursements are going down every year and we all knows what will happen if we get Medicare for all.

 

[321931]

Don't take insurance or have your patients pay you more than what their insurance pays you. You don't have to take insurance, you'll have a harder time getting patients but you'll be much better off.

Fee For Service is a dying breed. In the 90's/00's, dentists used to have insurance companies come into their office and beg for them to sign up.

Today, WE beg to sign up in-network with insurance companies and to expedite the process to be in network...because patients leave us if we are out of network.

Fast forward into the near future, we have insurance companies putting clauses on going out of network- for example, if you have insurance company- in network you have 2000 max and no waiting period, out of network you have 1000 max and you have a 1 year waiting period to start any dentistry.

Don't kid yourself, that you will be the one guy not taking insurance because you are somewhat better then the other million dentists out there- because you probably won't be. Now if you are one of the rare gems that don't take insurance and survive without it- yes you will be much better off...but sitting around in an empty office on 500k practice loans, 500k student loans, and 500k house loan, and 40k car payment....you are better off signing up for HMO, PPO, and even Medicaid to have any living body in the dental chair. FFS/OON tend to be older mature practices that have established getting something like 700k-1mil collections and slowly dropping insurance and implementing a payment plan system...but that comes way way way later in life...and even then it might not be feasible depending on your demographics.

 

[AppalachianDentalBoy]

Fee For Service is a dying breed. In the 90's/00's, dentists used to have insurance companies come into their office and beg for them to sign up.

Today, WE beg to sign up in-network with insurance companies and to expedite the process to be in network...because patients leave us if we are out of network.

Fast forward into the near future, we have insurance companies putting clauses on going out of network- for example, if you have insurance company- in network you have 2000 max and no waiting period, out of network you have 1000 max and you have a 1 year waiting period to start any dentistry.

Don't kid yourself, that you will be the one guy not taking insurance because you are somewhat better then the other million dentists out there- because you probably won't be. Now if you are one of the rare gems that don't take insurance and survive without it- yes you will be much better off...but sitting around in an empty office on 500k practice loans, 500k student loans, and 500k house loan, and 40k car payment....you are better off signing up for HMO, PPO, and even Medicaid to have any living body in the dental chair. FFS/OON tend to be older mature practices that have established getting something like 700k-1mil collections and slowly dropping insurance and implementing a payment plan system...but that comes way way way later in life...and even then it might not be feasible depending on your demographics.

@Rainee I'd like to PM you but you have that option turned off. I have some questions for you that you'd probably be more comfortable answering via pm instead of on this thread.

I know several dentists who purchased FFS practices from retiring docs. One is in a suburb of a major city the others are rural. I understand starting a FFS practice would be difficult but you don't think purchasing one and continuing to run it in the same matter is sustainable? The least wealthy among them is the suburbanite but he also works the least. Their practices are thriving and have a long waitlist of patients.

 

[321931]

@Rainee I'd like to PM you but you have that option turned off. I have some questions for you that you'd probably be more comfortable answering via pm instead of on this thread.

I know several dentists who purchased FFS practices from retiring docs. One is in a suburb of a major city the others are rural. I understand starting a FFS practice would be difficult but you don't think purchasing one and continuing to run it in the same matter is sustainable? The least wealthy among them is the suburbanite but he also works the least. Their practices are thriving and have a long waitlist of patients.

FFS practice purchases are difficult to transition well. If it works out- great, if it doesn't then you are stuck with no recourse.

When you purchase a practice, you buy goodwill which is basically an intangible asset that is given a price- the patient base. When you buy a heavy PPO practice, most of these patients are retained because you are also in network and as long as you are a decent person, they will stick around. I take alot of insurance, and some of these plans- if the patients change dentists would have to go over to the next town over to find a dentist in network. People don't want to drive and change their routine. They will stick around. Humans are a creature of habit, why would they change?

When you purchase a FFS practice, these patients basically have an option to go to ANY dentist in the area. Doesn't matter where, they are welcome to any dental practice. As long as you can transition the practice well, then you will be fine.

IMO, the safest to transition practices to FFS are heavy insurance practices that slowly build trust and rapport and drop insurance plans as they mature and grow. If I saw you as a patient for 5-10 years under PPO #1, and in 10 years say hey appalachian we are changing our practice and dropping your plan, but we have a great payment alternative, then you *might* stick around.

I always look towards the future and what I see is the fact is that dentistry is a commodity and the only ones that really have any purchasing power are the boomers who are slowly retiring. These guys are getting on medicare advantage plans as they retire...have fixed incomes...and will want to minimize their expenditures. Your millieniel patient isn't going to fork up 1000$ cash for a crown when they are deep in debt with car payments, house payments and student loans. They will go on insurance and pay the minimum. Same with Gen X. Grandma who is getting social security isn't going to fork up 1000$ for a crown either.

The areas where I see FFS working well are old retirement communities- who are extremely wealthy, but as stated, things are changing and when patients hear about their friend paying 300$ out of pocket for their crown versus 1000$ cash, they wisen up and go on insurance.

With that all being said. Insurance practices aren't that bad. I'm 99% insurance and do just fine. I don't plan on dropping insurance. Cash patients give me a headache because they are high maintenance. These are just my opinions, if you can make FFS work...then hats off to ya. That's great work in this day and age.

 

[ysrebob]

My office is FFS and does not accept assignment of benefits: patients pay up front for services and then are reimbursed by their insurance... so we're about as arms-length from insurance as you can get. Even so, the majority of our patients have dental insurance, and as those plans start to add clauses that more heavily penalize going out-of-network, if I stay the course I will lose almost all those patients. Being FFS doesn't really insulate you from changes in dental insurance at all. Rainee is absolutely right about the future of dental insurance, which is away from PPO towards EPO; these patients will not stay in a FFS office. Depending on how hard I want to be working at that point, I will either capitulate and go in-network or stay the course and slow down and let my practice shrink. Other FFS docs will be making the same choices. We will all still be dentists and the sky will not fall, though it may be a little less rosy.

Back to the subject of the thread. The likely effect of midlevel dental therapists on our profession is Economics 101. They will expand the supply of labor. Prices (reimbursements) will go down. The value of YOUR labor as a dentist will fall, potentially by a lot. A fundamentally much greater threat to our profession than either insurance changes or proliferation of corps, in my opinion.



Edit to add: these two issues are related tho... it is the very modest increase in the supply of dentists over the past decade (with new schools and larger class sizes) that has given insurance companies elbow room to hold down reimbursements and move people into more restrictive plans. Midlevels would take that to a new "level."

 

[Thiscrazyputa]

Early action sought on dental-therapist bill

BOSTON — Rep. William “Smitty” Pignatelli has not seen his dentist in five years. Though he said he makes two trips to the dentist’s office each year, Pignatelli said the on…

www.lowellsun.com

With a good chance to pass, looks like that Tufts & BU tuition will be much harder to swallow 😱

 

[Blueshirts]

Early action sought on dental-therapist bill

BOSTON — Rep. William “Smitty” Pignatelli has not seen his dentist in five years. Though he said he makes two trips to the dentist’s office each year, Pignatelli said the on…

www.lowellsun.com

With a good chance to pass, looks like that Tufts & BU tuition will be much harder to swallow 😱

Great logic. Rep. Hasn't seen his dentist in 5 years, he should crack a tooth and haggle with his hygenist to fix it. Claims that they will say 'hundreds of thousands of dollars', yes a big number that leads to the conclusion of immediate economic intervention.