Navigating Your Practice

As I saw footage of the floodwaters in Yellowstone, and observed the power of the raging rivers, I was reminded of our UDA past president, Greg Gatrell, and his passion for running rivers, and navigating turbulent waters. Greg has spent a lot of time on many rivers and has become proficient in navigating the various obstacles and challenges the river throws his way. The new graduates from our two Utah dental schools will also undoubtedly face some occasional rough waters through their upcoming careers, and I think they may be ready to navigate those waters.

I recently had opportunities of participating in activities at each of the two dental schools which we have in Utah. At Roseman University’s College of Dental Medicine I attended a ribbon cutting and toured their new clinical facilities. At the University of Utah School of Dentistry, I attended the graduation ceremony for the 2022 graduating class of dental students. I was impressed with what I saw and heard and am confident that dentistry is improving and that we are receiving well trained and prepared new dentists who will strengthen our profession in years to come. Kudos to the dental schools, and thanks to the educators for a job well done!

One other thing I observed was, that in spite of these two dental schools being located in our state, the vast majority of graduates are leaving Utah to pursue their professional lives somewhere else. Didn’t they like it here? Or do they have families elsewhere? Do they feel that Utah doesn’t have as much to offer as other areas of the country? Or do they feel that the local economy and effects of inflation make it easier to make a go of it and provide for their families somewhere else? There is no one answer for everyone’s individual choice in the matter. The influencing factors may be many and vary widely. But perhaps one common factor influencing the choice of where to practice might be Utah’s history of income for dentists in our state being lower than that of dentists practicing elsewhere. A big part of the reason for that comes down to something I’ve heard and witnessed over and over and over again in the more than thirty years I’ve been practicing in the state, and that’s how dentists deal with and participate in various dental benefit plans.

We all feel the pains and frustrations of dealing with “dental insurance” in Utah, and that is the last time I will refer to benefit plans in this article as “insurance”, as it is not “insurance” in the true definition of the word. I wish I had a better answer and solid solution to our woes other than what the association has been preaching over the years. Carefully analyzing benefit plans with their various levels of compensation and participation is a cumbersome task for any office, but it’s currently a necessary burden, if we are looking out for the health and well-being of a practice. The ADA has reopened its concierge service which will help guide a practitioner through the process of evaluation of a particular plan to see if it’s wise to accept and participate, or not. I believe if we keep communication open with our colleagues, we can also learn of successes and failures of others in dealing with our challenges and learn things which can help us make the hard decisions and choices of accepting plans, rejecting plans, or renegotiating plans.

Dental benefit plan reimbursements to dentists in Utah are dismally low, especially as we see the reimbursements given in other states, including our closest neighbors. You know this. Nationally, Utah has ranked among the lowest 2-5 in plan reimbursements, and why? The reason Utah has the lowest reimbursement rates has been shown by the Health Policy Institute of the ADA to be due to the high numbers of dental providers on each plan. It’s a supply and demand situation. Utah has many providers signed up on PPO plans, therefore the dental benefit plans do not need to increase payment to attract providers. The high numbers of willing dentists to take cuts in reimbursements is why reimbursement rates are declining rather than keeping up with the escalating cost of living, overhead increases or inflation. Sadly, voicing complaints to plan providers, and even providing them with logical evidence of needed changes has been shown over the years to simply not work in an effort to increase reimbursement to a fair and just compensation across the board. It seems that as long as there is an adequate supply of plan participants, the plan providers feel no demand to increase their payout. Effective actions will hopefully speak louder than words. But again, it is up to each individual to make that decision to decline participation or stop participation in a particular plan which is unhealthy for, harmful to, or just plain bad for the practice.

Be wise and educated in making your practice decisions. Benefit plans come with many levels of participation and variations in different areas. It may be easier and less stressful to not sign up for a plan than to cancel participation in a plan. A plan that works in Washington may be terrible in Tremonton. Or a plan that’s successful in Sandy may be miserable in Moab. Learn the pros and cons for your area and practice. Use the resources offered through the ADA to assist in your decision making. We are grateful to all of you who have chosen to practice in our great state, and for your support and participation in organized dentistry. Together we can be stronger in our efforts to help each other, and to help and serve our patients and communities. We wish our new dentist graduates, and all our more seasoned dentists the greatest success as you navigate the waters of your career!

Dr Kay Christensen UDA President