Dental Practice Classifications and Landscape – 2018
Private Practice – 57% (Solo practices with a maximum of two dentists operating simultaneously)
Public Practice – 10% (spurred on by the expansion of community health centers, Medicaid, CHP (child health plus) and other federal and state subsidies.
Institutional – 5%
DSO/MSO and Regional Group Practices (including small practices with two or more locations operating simultaneously) – 28%.
*I predict that by the end of 2019 Group Practice will be at 34% reducing Solo practices to 51%.
I have invested dozens of hours of study, to better understand the dental market place and trends. I have read numerous research papers, articles and proprietary studies from DSO’s and other organizations to get at the truth. I have even researched the footnotes of those documents to understand the impact or consequences this data will have on our once cottage industry.
To my dismay, the information that our institutions and organizations are using to forecast group practice and public dentistry is flawed. The intent of these organizations is righteous and their information is valuable but it isn’t precise. Many of these outlets are using old census data and are extrapolating data from surveys sponsored by industry organizations, dental companies and media outlets.
While this is a widespread practice and usually leads to reasonable conclusions, I believe this is not the case when discussing our dental landscape in 2018. Online surveys are not very accurate because they pull from followers or customers that may share certain beliefs or affiliations. In addition, online surveys tend to require the survey taker to select from the answers provided, even if the survey taker is not in 100% agreement. This effects accuracy. Another variable is the classifications of the terms “Group Practice” and “Public Dentistry” which can vary from one organization to the next.
Dentists and practice owners need to know the truth about trends that can impact their business and exit strategy. While manufacturers and distributors seek the truth, they are handicapped because of their preconceived notions of the marketplace. Case in point. Most manufacturers and distributors believe that a small group practice is comprised of three or more facilities operating simultaneously. If these entities were to change the classification from three simultaneously operating dental facilities to two, and if they included super solo practices, it could stress their capabilities, resources and profitability.
*One location with 6 or more providers (3 -general, 2- specialists and three or four hygienists) is a group practice. There are hundreds of these offices in every state throughout the USA but as of right now, they are not measured in these studies.
*Dentists who own two multi-specialty practices operating simultaneously, with associates and hygienists in each facility, are small group practices. Interestingly, they were called small group practices in the nineties but do not qualify in most of these studies today!
*Community health centers and the public dentistry sector has grown exponentially. However, these studies fail to acknowledge the private/public activity. Hundreds of dental practices that accept Medicaid or other state or federal assistance are indeed, providing public dentistry. Currently, no study that I have read includes this activity in their analysis. I understand the challenge in acquiring those statistics but they provide healthcare that is subsidized by local, state or federal dollars so they need to be accounted for.