Many practitioners express concerns over the "state of dentistry" in five to seven years.
Penny Elliott Anderson, Senior Editor
For a lot of dentists participating in our 1995 Practice Survey, 1994 was a very good year and 1995 is looking even better. For others, vagaries of the local economy, increasing overhead costs and the "managed-care shuffle" were among the major elements contributing to a down year. In fact, even many of those who had a good year in 1994 expressed their concerns about the "state of dentistry" in five to seven years.
What follows are just a few of the many comments we received from practitioners taking part in our survey, listed by state:
Maine-"Practice did not grow much despite spending $12,000 for a management consultant. I see growth of 10 percent for 1995. My major practice concern is overhead."
New Hampshire-"New part-time associate. Goal is $1 million gross production in `95."
"Did worse than `93 ... Foresee: not enough patients; many have moved South and West for work."
Massachusetts-"1993 disaster. Improved in 1994. Looks better in 1995. Taxes (local, state and federal, fees, etc.) are killers."
"My practice has increased in new patients and retention of new patients. I foresee a great future as long as my staff and I are willing to change and grow as dentistry directs."
"1995 was best income-to-overhead year since 1989! Biggest concern-keeping overhead down as production maximizes and levels."
Connecticut-"1994 was a terrible year; worst in five years. 1995 will hopefully be better, but the Northeast economy is still sinking."
"Holding on. No fee increases for the past two years has caused a marked increase in overhead percentage."
New York-"No growth. If no growth in `95, then part-time associate must go."
"Major practice concern: Managed care, PPOs taking the profit out of providing care and decreasing quality of care as a result."
"1995 will continue downtrend in restorative dentistry unless `sold by pressure.` Practice concern is that dentistry will become a salaried position in an HMO/closed-panel insurance company."
"My first year in rural practice was superb; 1995 is, so far, even better."
New Jersey-"1993 was terrible. 1994 was good. 1995 is even better. I will not be encouraging my children to go into health care."
"Excellent growth, but as I go up the ladder of success, controlling costs becomes imperative. I am an optimist, but a realist. Gets tougher each year to grow."
Pennsylvania-"1994 average year. Bad weather in Northeast affected practice. 1995 starting out with record production!"
"Steady growth last four years, regrettably becoming too busy... Tell the young graduates to head to the rural areas-a wonderful way to practice dentistry!" ii
"Practice decreased, and my area of patient draw is aging rapidly and dying off. Young people must leave this area to find employment opportunities. I`m concerned about the increased threat of `managed care` (`miscare`)."
Ohio-"My major concern is the dishonesty in dentistry. We don`t need more marketing strategies. We need ethics, not greed."
iiIndiana-"Rising costs de-manding rising fees for an ever-more-resistant public. The highest factor of fees is-and should be-staff compensation, but the rising costs will eventually reach an `overload` to patients."
"Major concern is dentistry being priced out of the average person`s ability to pay."
iiIllinois-"Increased production even during six-month remodeling. I could use more patients-no capitation, little PPO; dropped all capitation three years ago."
"...Major concern-organized dentistry`s lack of an aggressive, proactive marketing campaign to make patients aware of dental-care needs and a strong fight to preserve fee-for-service dental care."
"We did well; hope it will continue. Looking for associate."
Michigan-"Practice growth is great. I hope the economy holds. Too many managed groups are being formed. I would like an associate in the future. Many don`t want to work."
"Approximately 30 percent increase over 1993. Continued growth at least 5 percent each year. I will bring in associate soon. Practice concerns: management of employees."
Minnesota-"Future`s so bright I gotta wear shades; love my job, growing at 20-30 percent a year. I`m rather new in the profession-six years. Why would anyone join a capitation plan?"
Nebraska-"Started regular staff meetings and bonus system in late 1993-increased gross over 20 percent! Dad`s astounded at how much improvement took place. I expect some improvement for 1995; won`t be much, however."
Maryland-"Very well in `94 as a result of extensive changes in business and management practices. Practice concerns are due to layoffs in patients` work."
Virginia-"Good year for rural area; `95 is improved due to improved employment climate. Maintaining income by controlling costs is a concern.
South Carolina-"Practice grew significantly. Expect 20-30 percent growth in `95. . . Main concern-dentists burying their heads in the sand, not learning the `business,` signing contracts out of fear."
Florida-"Practice was great! My daughter is coming in with me and it`s going to be fun. Twenty-nine years and I can`t wait to get to work..."
"Working late hours (after 5 p.m.) has highly increased revenues for 1994."
Kentucky-"Practice continues to improve yearly. Intraoral camera improved communication of needs to patients. Pankey philosophy drives success. Look forward to practice success despite capitation around me!"
"Doing very well by focusing on service, service, service."
Tennessee-"It has taken eight years, but stress levels are finally low enough to tolerate and net income is high enough that I`m not going to go into another field (at least not for seven-eight years!)."
Mississippi-"OK for first year in private, solo practice after five years in government service (public health). I`m not netting an income yet, but if you think the government is bad in private practice, try working for them! Concern is making a living."
Arkansas-"Great in `94. My major concern is finding a good partner for `96."
Oklahoma-"1994 gross up slightly. 1995 not much better. Too much OSHA expenses and poorly-motivated pool of employee applicants. Business down."
"1994 great year! Buyout of older dentist had perfect result with detailed planning. No capitation or PPO. It can work if you work at it."
Texas-"We had more growth this year than in past 10 years. "
"1994 excellent. Future-HMO city. Hope to be retired before dentistry goes down the drain in next five-seven years."
"We took on our associate in June 1994. I expect at least a 20 percent increase in 1995."
Colorado-"My major concern is third-party interven- tion- PPO, HMO, OSHA, Medicaid. Second concern is lack of quality postgraduate education and its expense."
"I would not want 100 percent capitation, but the minor amount that I do sure does helps the profit margin by filling in the empty appointment holes."
Arizona-"Growing about 10 percent per year steady. Patients more demanding than ever due to misinformation by media."
Utah-"Bringing in a partner. Working more hours and days than I want."
Washington- "Production and collections up 10 percent. We continue to see new patients. What will the bureaucrats do to us next? How do you know when to retire?"
California-"Practice gross production decreased 1 percent. The previous year, it had increased 15 percent and the year before that, it increased 13.5 percent. I see this due to lower reimbursement in plans more so than the loss of patients to competing plans."
"... Staff salaries too high; may cut back on staff."
"Tough-everything went up expense-wise, but production was down and my income was down about 15 percent!"
"Managed care and poor economy leads to lack of money for patients to spend on care."
"Better-we have avoided all managed care and we are prospering."
Hawaii-"My main concern is the rising overhead costs against the decreasing insurance-allowable fees and services. What I see for the future is working harder next year for the same salary."