One more great reason to be in Dental School 2K4

[Tempress81]

Just read in US News magazine (annual best grad schools in the country issue) that 20,000 practicing dentists are retiring within the next couple of years and yall know what this means...more room for us. And well...the demand for dentists is supposedly at an all time high which leads me to believe that residency positions aren't as cut throat as people make them out to be. So to all of you orthos and oms and pedo wannabe's, congratulations on a brighter future.

UMDNJ-Dental School
Class of 2008

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Members don't see this ad.

 

[aphistis]

Not to rain on your parade, but the retiring dentists thing isn't breaking news. It still leaves us in a pretty comfortable position, though!

 

[Dr.BadVibes]

I dont think its a brighter future for them.....like Bill said, this news isnt breaking, yet applications for specialities are through the roof....face it, OMS and ortho are always gonna be tough to get into....it aint getting any easier...

 

[ItsGavinC]

And well...the demand for dentists is supposedly at an all time high which leads me to believe that residency positions aren't as cut throat as people make them out to be. So to all of you orthos and oms and pedo wannabe's, congratulations on a brighter future.

UMDNJ-Dental School
Class of 2008

Residency programs don't offer spots based on demand. So, they won't be offering additional places in their programs just because the nation needs more specialists.

We wish it were true.

 

[Dr.SpongeBobDDS]

If the residency programs did expand their spots all the new specialists graduated in the first few years would likely bring fees down until earnings were about on par with GPs. Then nobody'd want to specialize anyway.

 

[antidentite]

the number of graduating dentists has declined rapidly in the past 20 years while the number retiring has increased. this is not as great as it seems. In 1980, 460 dentists graduated dental school in illinois, in 2002 110 graduated dental school. this all sounds great in regards to a supply and demand type of relationship, but throw in the responsibility of dentists as an independent community to take care of the oral health of the all in the nation who are in need of care and there is a problem that arises. you can't just look at this from a financial perspective because when you look at the whole picture you can perdict that the current situation is temporary and there may be a dental crisis that iresults in much less income, not more, in the future for us. according to the surgeon generals report "healthy people 2010" oral health is directly linked to systemic health. first time this has been recognized by the government and everyone of us is happy. this leads to the following situation: oral health is linked to systemic health, dentists are in charge of providing this oral health to the whole nation, dentists are not capable of performing this duty due to low numbers due in part to shortages of money at dental schools preventing increase in class sizes, the government will have to intervene. add to this a likely democratic policy making government in the near future and there is no doubt this situation could result in an almost socialist type of dental health care system for this country, the government is going to have to intervene in this dental shortage crisis by offering lots of money to increase enrollment. since we could not address this problem by ourselves they will intentionally oversaturate the market, like what happened during the 60's, with an added benefit to them of drastically decreasing the cost of services, by the same supply and demand relationship we graduating dentists are happy to embrace at the moment with favorable conditions. the point is, the dental community has been inefective in providing the necessary oral health to the country. we are not getting the job done ourselves and it is just a matter of time before the government jumps in to right the ship. this is an embarassment for the dental community, and although it looks good for our pocketbooks at them moment, this is a ticking time bomb that most likely will explode during our peak profit years. does any one else agree with me in that this is a bad thing? it contradicts what we as a community claim to hold most important " oral health of the nation" and it will only lead to less income for us in the future if we can not adress the problem ourselves.

 

[busupshot83]

dentists are not capable of performing this duty due to low numbers due in part to shortages of money at dental schools preventing increase in class sizes, the government will have to intervene.

If this statement is true, another possible solution could be opening more dental schools. This would work in increasing the amount of graduating dentists, thus meeting the severe shortages. The question is: how true is this statement?

 

[UBTom]

That has indeed been happening-- Two new dental schools just opened up in the past few years, UNLV and Arizona. I wouldn't be surprised if there are more coming.

As far as government interference goes: The dentists as a whole are not powerless to oppose policies that will be detrimental to the profession (both practitioners and patients)-- The ADA boasts a 75% membership rate of all practicing dentists in the U.S., and has recently won several important cases against insurance companies seeking to limit patient access to care or impose unfair limits on dentist compensation.

Organized dentistry does look after the profession and I urge every dentist to join the ADA, state and local dental societies.

HTH.

 

[antidentite]

I agree the ADA is a wonderful thing. But, even if 100% of dentists were members of the ADA, how does this fix the problem? Every year that number of dentists which comprise the 100% membership becomes smaller, while the disparity in the need for dentists and supply for them becomes greater. This relationship weakens the credibility of the ADA to claim to have members capable of providing all the needed services. I don't think it is viable as a community to deny that there is a dental crisis that trickes down to even the schools that are open presently. there are not even enough willing dentists to fill the numerous vacant faculty spots at these schools. how can we accept more students and open more schools with out faculty. i very much respect the ADA and am sure they are attempting all they can to address this problem. i just personally feel that there will not be a turnaround in time. My only point being is that this shortage of dentists does not reflect our profession favorably nor does it look good for our pocketbooks in the future if all continues as is and we shouldn't be bragging about the current situation as though it is something we are proud of. One solution is to allow private interest groups to pay for dental schools demanding services out of their graduates in the future like OCE has done in jacksonville, colorado, and now las vegas with ortho residents. personally i would rather the government have to save us instead of having private interests suit and ties making money off our work and diminishing our field to little more than a "trade service" instead of a legitimate branch of healthcare.

 

[drPheta]

Don't forget about the rumored Hawaii dental school

 

[kato999]

antidentite,

you have some really good points but some of your concerns i think are a little presumptious

i really don't think the "problem" is a total shortage of dentists, it's an location access problem. if the gov't steps in, hopefully it will be to provide incentives for dentists to practice in rural or low income areas, not to simply increase the number of dentists. most people who actually want to see the dentist usually won't have a problem making an appointment. the problem is getting them to see the dentist.

i am just a dental student, this is just what some other dentists have told me.

 

[ItsGavinC]

I don't think location and numbers are even the crux of the problem. Even if those were filled to that there was a 1:1 ratio of dentists/patients, I'm sure that 25% of the population still would NOT visit the dentist (and that number may actually be much higher).

My point is that when all is said and done, dentist are still NOT responsible for the oral health care of our nation. That is a farce that far too many people buy into. We have the responsibility to serve, to educate, to inform, to provide services, etc. But at the end of the day the people must have the desire to obtain our services.

Does it *really* do much good to coerce patients into visiting our offices where we perform several restorations if they never brush or floss after that, nor make return visits? That is the #1 gripe about medicare/medicaid patients. It isn't the low fee schedule/reimbursement problems, but rather the fact that dentists know (and the patients know!) that the work they are doing will not be respected and that the patient's oral health will NOT significantly change in the long-term. You can't fix that with greater dentist/patient ratios.

 

[kato999]

exactly

 

[antidentite]

"We have the responsibility to serve, to educate, to inform, to provide services, etc. But at the end of the day the people must have the desire to obtain our services."

now i think we have gone off on a tangent here that may not apply to the issue first addressed, but these comments are intricately related and not two separate entities. You agree that we have the "responsibility to educate and inform our patients." I feel this is directly linked to their desire to obtain our services. It is not separate as you claim. That is the whole purpose of us educating and informing. It is our responsibilty to improve the oral health of this country, and one means of doing that is to educate and inform the population which leads to an increased desire to obtain our services. Also, you can not ignore that there is an access to care problem with regards to dentistry and that this is a reason that people do not visit the dentist. This access to care can manifest itself not just in that there is not a dentist within 100 miles like in some rural areas, but a person could have a dentist two blocks away but not have access to care due to cost of services which brings us back to the original topic of supply and demand.

i liked kato999 comments and agree to much of what he said. there is a definite demograhic component and increased incentives to go to rural areas is a good idea. but if competition was high enough in cities and suburbs, people would move there to practice anyway. if trends continue like they are now there will be not only a shortage of dentists in rural communities, but also in suburbs and cities where costs will be driven up as a result of the demand and only the wealthy will afford services. some argue that this is already happening today.

 

[groundhog]

If the government is moved to correct a perceived economic imbalance in oral health care services which is deemed to overly favor service providers, it might happen as follows. The Feds will fund a massive increase in GPR/AEGD PGY programs in return for the States' willingness to grant borderless licensure to those who complete the PGY programs. Graduates of foreign dental schools will be encouraged to help fill up the resulting huge increase in PGY slots. Think not? Just ask some of your physician friends.

An old addage applies under antidentite's scenario..."if you are being ran out of town, get out front and make it a parade." Be proactive not reactive.

 

[Dr.SpongeBobDDS]

I am eternally skeptical. I tend to look at those predictions with a grain - no, a shaker - of salt. Many of those predictions don't fully take into account the increasing efficiency of individual dentists, the decreasing caries rate, the fact that most dentists don't retire at the magical age of 62 and keep working for several more years, and the fact that most dentists don't even work a full 40 hrs/week but probably would if the price was right.

How many dentists do you know who are NOT accepting new patients? I have lived in dentally and medically "underserved" areas all my life and there has never been a problem with getting in to see a dentist or physician. It's just that people in these areas don't seek out care as often as some government formula says they should. The area can't support enough doctors and gets marked as "underserved" in spite of the fact that everyone who wants care gets it.

It doesn't matter how many dentists you flood the country with, they are still going to congregate around the areas where there are people who WANT to be taken care of. If the government really wanted to help "underserved" communities the best way would be through promotion and education on the importance of good oral health. As the dental IQ increased, so would the demand for services; there would be no shortage of dentists fighting tooth and nail to set up in these places where teeth had been neglected for so long. Can you imagine the draw there would be to locate your practice in a place where you could expect to do endo, C&B, exos and removable prosth on almost every patient that walked through your door? It would be like the pre-flouridation glory days all over again.

We need to think outside the demographic formulas and address the root of the problem - ignorance about the importance of oral health. The problem is not on the supply side; it is a lack of demand. More dentists is not an answer to anything.

 

[mike3kgt]

I am eternally skeptical. I tend to look at those predictions with a grain - no, a shaker - of salt. Many of those predictions don't fully take into account the increasing efficiency of individual dentists, the decreasing caries rate, the fact that most dentists don't retire at the magical age of 62 and keep working for several more years, and the fact that most dentists don't even work a full 40 hrs/week but probably would if the price was right.

How many dentists do you know who are NOT accepting new patients? I have lived in dentally and medically "underserved" areas all my life and there has never been a problem with getting in to see a dentist or physician. It's just that people in these areas don't seek out care as often as some government formula says they should. The area can't support enough doctors and gets marked as "underserved" in spite of the fact that everyone who wants care gets it.

It doesn't matter how many dentists you flood the country with, they are still going to congregate around the areas where there are people who WANT to be taken care of. If the government really wanted to help "underserved" communities the best way would be through promotion and education on the importance of good oral health. As the dental IQ increased, so would the demand for services; there would be no shortage of dentists fighting tooth and nail to set up in these places where teeth had been neglected for so long. Can you imagine the draw there would be to locate your practice in a place where you could expect to do endo, C&B, exos and removable prosth on almost every patient that walked through your door? It would be like the pre-flouridation glory days all over again.

We need to think outside the demographic formulas and address the root of the problem - ignorance about the importance of oral health. The problem is not on the supply side; it is a lack of demand. More dentists is not an answer to anything.

So I have a question then because I am confused and need outside thoughts. I see myself wanting to know that oral health matters, that periodontal health is linked to cardiovascular health, and we, as dentists, provide a service that is critical to overall systemic health. I see research propagating these ideas along with the push of government and school officials fighting to re-categorize "dentist" to "oral physician."

So I ask the question, is this bad for our profession? I see all of the problems associated with medicine and the potential problems adding the label of 'physician' may provide. Are we equal? I am confident that the push for knowledge and understanding is critical to advancement of the field. I am not confident, however, that the future of having stronger ties will result in a more prosperous dental community. If oral health is critical to systemic health and dentists are responsible for the oral health of all Americans and we are unable to perform it, government action will surely take place. There is talk about the 'hygiene practitioner' and 'private interest advanced education' occurring in dentistry. So I ask the question, "is advancing the field and knowledge necessarily good?"

Then again, I am a conservative and a realist, but I see what has occurred in medicine. The problem lies in the fact that public perception of healthcare is that we are 100% perfect. No errors should occur, a doctor should know everything about your health, and if errors occur, you are obligated to sue the doctor. I have spoken to friends in business who said if they shot for 100% perfection in, let's say, security management, they would lose their shirts because it's near impossible to get perfection in just about anything without losing money. It?s all about opportunity costs. So the thought of public perception of us as ?just dentists? may be alright with me. I do, however, know that ADA membership and political action is good for the community. The lawyers know this; they contribute to political causes via money and efforts, but doctors are ?known for deep pockets but short arms.?

Some philosophical ideas. Any comments are appreciated.
-Mike

 

[Tempress81]

So I ask the question, is this bad for our profession? I see all of the problems associated with medicine and the potential problems adding the label of 'physician' may provide. Are we equal?

The best i've heard yet, but don't let a med student hear you say that

 

[jk5177]

These social issues are intricate. Reading through the threads, the following are my gathered facts:

* Dentists are retiring, so they don't retire within the next couple years, they retire in the next few years.
* A demand for instructors in dental school. I've came across similar observations from ADA publications.
* The patients willingness, or awareness of dental health plays a more significant role than the number of dentist, dentistry professors. It doesn't matter how many dentist exists, if the patient doesn't care for its dental hygiene, nothing else matters.
* Government in the past, has try to fix the medical field problem by jacking up the medical school enrollment (Nixon in the 70's), encouraged influx of foreign medical students, and all the complexities has led to the current health care dilemma.
* Dental care is more of a privilege than a right, and this is different than the medical field, where people can argue differently.
* Dental procedures has less risk than medical procedures. The malpractice insurance is less.
* Less lawyers are involved in dentistry.

Gathering these facts, there will be a demand for dentistry, and whether if the government will step in is the question at hand, and I'm not expert in politics. What does this demand for dentistry will mean for dentist is the question at hand.

I don't know. In the long run, if the demand for dentistry does increase, perhaps there will be other solutions other than government stepping in. Such as... dentist working longer hours, more general dentist as oppose to specialties, more instructors may occur, ADA promoting better dental health. All these can factor into the solution to the increase in demand for dentistry. To say that government will simply step in and screw the dental field like what it did to the medical field is... (seems to me) requires more assumptions. In addition, government still has to tackle the health care mess, before they can deal with other health fields.

These are my 2 cents. I would love attacks to my post, so I can understand better. Please pull my analysis apart like the way you would pull a molar.

 

[koobpheej]

an important point to remember is that whihle we as dentists/future dentists know and fully understand the link between oral health and total health, most of the world's non-dentists either do not understand this link or do not appreciate its importance. i think this results in a much slower public response to dental shortages.
In addition, dental health is rarely life threatening. there are certainly health concerns and quality of life concerns, but somebody with dental problems is not in immediate trouble. the focus of public/ social medicine is on the dramatic, life threatening stuff, dental stuff is not breaking news material. besides, allopathic medicine in general is more reactive than preventative, whereas dentistry is more preventative than reactive (obviously not always true). the public does not appreciate the importance of oral health.
there will certainly be a public reaction to dental shortages, but i really think that it will be significantly less dramatic than what has happened to MD/DO's.

 

[aphistis]

an important point to remember is that whihle we as dentists/future dentists know and fully understand the link between oral health and total health, most of the world's non-dentists either do not understand this link or do not appreciate its importance. i think this results in a much slower public response to dental shortages.
In addition, dental health is rarely life threatening. there are certainly health concerns and quality of life concerns, but somebody with dental problems is not in immediate trouble. the focus of public/ social medicine is on the dramatic, life threatening stuff, dental stuff is not breaking news material. besides, allopathic medicine in general is more reactive than preventative, whereas dentistry is more preventative than reactive (obviously not always true). the public does not appreciate the importance of oral health.
there will certainly be a public reaction to dental shortages, but i really think that it will be significantly less dramatic than what has happened to MD/DO's.

There are a some good letters/articles in this month's JADA on this very topic, talking about how the public & medical community are waking up to the importance of oral health. I'm personally hoping for continued growth of that recognition, but for dentistry to maintain its separate administrative identity from medicine. If I wanted the kind of hassle medicine is going through, I would've gone to med school.

 

[Bickle]

There are a some good letters/articles in this month's JADA on this very topic, talking about how the public & medical community are waking up to the importance of oral health. I'm personally hoping for continued growth of that recognition, but for dentistry to maintain its separate administrative identity from medicine. If I wanted the kind of hassle medicine is going through, I would've gone to med school.

Off Topic, what does APHISTIS mean?

 

[aphistis]

Off Topic, what does APHISTIS mean?

S'ok, I get asked that a lot. I use Aphistis for pretty much anything I do on the internet. Way back my freshman year of high school, I wrote a short story right around the time I started spending a lot of time on the internet. Aphistis was the main dude's name, and since "Bill Johnson" isn't exactly a distinctive name, it makes a nice, identifiable internet name. Sorry, it's not the sexiest story.