Why Don't Hospitals Hire Dentists

[KSDental]

I was wondering why hospitals don't hire dentists. The only exception is oral surgeons, who usually handle trauma cases. It would seem natural for hospitals to have "oral health" departments since the oral cavity is part of the body.

There seems to be a lot of separation between the medical and dental professions. I see far more podiatrists and optometrists at hospitals than dentists. Will this change with so many connections between oral and systemic health being made?

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[Doc Smile]

I was wondering why hospitals don't hire dentists. The only exception is oral surgeons, who usually handle trauma cases. It would seem natural for hospitals to have "oral health" departments since the oral cavity is part of the body.

There seems to be a lot of separation between the medical and dental professions. I see far more podiatrists and optometrists at hospitals than dentists. Will this change with so many connections between oral and systemic health being made?

There are many hospitals that have a hospital dentistry department. Or, to save money, have a dentist on call they send emergency patients to. Mostly it is bureaucracy - the government and dentistry don't get along so the hospital cant really make a profit on it.

At least, that is my understanding of it

 

[mike3kgt]

Mostly it is bureaucracy - the government and dentistry don't get along so the hospital cant really make a profit on it.

For pre-dents: This is a good thing BTW.

 

[KSDental]

For pre-dents: This is a good thing BTW.

I think it has its pros and cons. With less government and hospital support, dentists have to be more business savvy than other healthcare providers. This can be a con for people that aren't good with the business side. Our business skills can be hampered by factors that we don't always have control over. Focusing on profit also takes time away from focusing on clinical skills.

Additionally, less government support contributes to a large undeserved population. There is a large population of patients that dentists would see if medicaid and other government programs reimbursed more.

 

[mike3kgt]

Additionally, less government support contributes to a large undeserved population. There is a large population of patients that dentists would see if medicaid and other government programs reimbursed more.

There is also a large population of dentists who wouldn't see medicaid and other government program patients if they reimbursed 10x more. This is mostly due to increased liability, government control, auditing concerns, and entitled patients.

 

[SeattleRDH]

There is also a large population of dentists who wouldn't see medicaid and other government program patients if they reimbursed 10x more. This is mostly due to increased liability, government control, auditing concerns, and entitled patients.

Sad but true. Medicaid patients are the most likely patients to no-show their appts. And the paperwork is a headache!!!

 

[DrJeff]

There is also a large population of dentists who wouldn't see medicaid and other government program patients if they reimbursed 10x more. This is mostly due to increased liability, government control, auditing concerns, and entitled patients.

Sad but true. Medicaid patients are the most likely patients to no-show their appts. And the paperwork is a headache!!!

Far too much truth in these statements. The government has helped create a group of patients that not only expect everything for nothing, but in many cases also expects to be picked up, brought to their appointment and then brought home. What's next?? Will we as oral healthcare providers be expected to goto their homes every night to brush their teeth for them??

Just because many on medicaid may not be financially as "functional" as others, doesn't mean that they're not functional in general.

Back to the original topic. Why don't hospitals employ dentists?? Pretty simple past stereotypes. When you think of going to the dentist, you don't think of going to a hospital! Plus, from a financial side of things, most dentists tend to find out that they'll do better on their own, rather than being an employee of a hospital. Full disclosure note here. My office is literally 100 yards down the street from the hospital in the town where I practice. Between my partner and I we have HUNDREDS of employees of the hospital as our patients. A few years ago there was some loose discussion about our practice being bought out by the hospital and us becoming employees of the hospital. The economics for US just weren't there.

 

[KSDental]

Far too much truth in these statements. The government has helped create a group of patients that not only expect everything for nothing, but in many cases also expects to be picked up, brought to their appointment and then brought home. What's next?? Will we as oral healthcare providers be expected to goto their homes every night to brush their teeth for them??

Just because many on medicaid may not be financially as "functional" as others, doesn't mean that they're not functional in general.

Back to the original topic. Why don't hospitals employ dentists?? Pretty simple past stereotypes. When you think of going to the dentist, you don't think of going to a hospital! Plus, from a financial side of things, most dentists tend to find out that they'll do better on their own, rather than being an employee of a hospital. Full disclosure note here. My office is literally 100 yards down the street from the hospital in the town where I practice. Between my partner and I we have HUNDREDS of employees of the hospital as our patients. A few years ago there was some loose discussion about our practice being bought out by the hospital and us becoming employees of the hospital. The economics for US just weren't there.

What if a dentist doesn't care about the salary though? What if they just want the name recognition, job security, and benefits that other healthcare providers (physicians, podiatrists, optometrists, etc.) have when working for a hospital? Are there opportunities for dentists that fit this description? Starting a practice is a risky investment, especially for a new dentist. Associateships usually don't last long and corporate dentistry may be too profit-driven for some.

The best option for dentists that fit the preceding description appears to be, to work for the government. There's nothing wrong with that option. It just seems like more, less business-minded dentists would want to work for hospitals as well.

 

[DrJeff]

What if a dentist doesn't care about the salary though? What if they just want the name recognition, job security, and benefits that other healthcare providers (physicians, podiatrists, optometrists, etc.) have when working for a hospital? Are there opportunities for dentists that fit this description? Starting a practice is a risky investment, especially for a new dentist. Associateships usually don't last long and corporate dentistry may be too profit-driven for some.

The best option for dentists that fit the preceding description appears to be, to work for the government. There's nothing wrong with that option. It just seems like more, less business-minded dentists would want to work for hospitals as well.

Its the profit factor. If a hospital for various reasons doesn't see spending the money to start and market and maintain a PROFITABLE dental department, then in all likelyhood they're not going to do it. Sure there are SOME hospitals that do have dental departments (they tend to be hospital with an attached either dental school or general dentistry residency program) but there just aren't a high percentage of free standing, unaffiliated hospitals that have full time dental departments that actually run as a prcatice rather than just a part time, consulation service because of the economics of it

 

[omaralt]

What if a dentist doesn't care about the salary though? What if they just want the name recognition, job security, and benefits that other healthcare providers (physicians, podiatrists, optometrists, etc.) have when working for a hospital? Are there opportunities for dentists that fit this description? Starting a practice is a risky investment, especially for a new dentist. Associateships usually don't last long and corporate dentistry may be too profit-driven for some.

The best option for dentists that fit the preceding description appears to be, to work for the government. There's nothing wrong with that option. It just seems like more, less business-minded dentists would want to work for hospitals as well.

in that case go work for the VA. i have a friend who works for the VA and he makes ~$120K/yr with great benefits, vacation, no stress, etc. he enjoys it. just not my cup of tea

 

[KSDental]

Its the profit factor. If a hospital for various reasons doesn't see spending the money to start and market and maintain a PROFITABLE dental department, then in all likelyhood they're not going to do it. Sure there are SOME hospitals that do have dental departments (they tend to be hospital with an attached either dental school or general dentistry residency program) but there just aren't a high percentage of free standing, unaffiliated hospitals that have full time dental departments that actually run as a prcatice rather than just a part time, consulation service because of the economics of it

Thanks. Now I understand.

 

[DrJeff]

Thanks. Now I understand.

Profit, inspite of what some folks may want you to belive isn't a taboo subject, and frankly if a business doesn't turn one, they won't be in business very long. So bottomline, that's what its really all about in the end, and this goes for private practice, hospital dentistry, and even public service dentistry. Is once all the bills are paid, is the practice turning a profit (even public service dentistry situations if they're gov't subsidized need to turn a profit - basically have their expenses be equal to or less than the subsidy they get).

If you're in a private practice situation then what's left AFTER you pay all the bills is yours, since as the business owner, you're the LAST one to get paid 😱

 

[yappy]

Are OS dentists employed by hospital systems?

 

[DrJeff]

Are OS dentists employed by hospital systems?

Some yes, some no. You might have a larger hospital that will have an OS department and employ OS's fulltime. But in many hospitals, what happens is that you'll have OS's that are on staff, but have a primary private practice as the source of their income. Then if they have a case where they need the facilities of a hospital OR, they can book a patient at that hospital, but function like an independent contractor in a sense where the patient will receive a bill from the hospital for the services that the hospital provides and a secondary bill from the OS (often just a direct insurance company reimbursement check unless its a pure cosmetics case and/or a patient without insurance). The OS's that are on staff, but not fulltime employees of the hospital then tend to have a rotating call schedule with the hospital where if there's a trauma case and/or other typical OS related emergency then the on-call OS will handle the case (sometimes in the hospital in the case of say a trauma or large facial swelling, or sometimes maybe in their own private office depending on the situation), again the billing is like I mentioned above in situations like this.

The simple reality is that MOST hospitals in this country don't have the day to day dental or OS volume to financially justify a fulltime, salaried dental or OS department and the assocaited staff that would be needed to support it