NINTH DISTRICT
Dr . Aaron Merski
Having begun my dental career in 2018 , I am relatively new to the field and can only speak to my personal experience thus far . I was fortunate enough to have the opportunity to join the private practice world directly out of school , which I subsequently took ownership of in 2022 . Located in Erie , our practice is in a dentally underserved area where many of the dentists are retiring and not being replaced by the next generation . Erie is a blue-collar town with the majority of patients relying heavily on dental insurance to receive treatment . Instead of switching to a fee-for-service model , I decided to continue carrying most insurances and do my best to serve Erie ’ s needs – that is where the challenge comes in .
I have noticed that dental insurance companies are slowly strangling the private practices and catering to large Dental Support Organizations ( DSOs ) and corporate chains by lowballing reimbursements and no longer renegotiating . These groups have dozens , hundreds , or even thousands of locations nationwide , and therefore have much stronger bargaining power compared to a little shop like mine . Why is this a problem ? These groups are strongly focused on the bottom-line collection numbers , whether they are owned by providers or not . When this happens , employed doctors are pressured to see an unmanageable number of daily patients which negatively affects the quality of care . Corporate dentists are pushed to hit monthly collection goals before receiving additional compensation and are more likely to rush through treatment and suggest excessive treatment to do so . For example - a new patient of mine paid nearly $ 2,000 to have a “ deep cleaning ” done at a chain and took out a loan to do so ! Patients are paying more out of pocket and insurances are reimbursing chains at higher rates for lesser quality work , which sounds like a lose-lose to me . That is , unless you own a dozen dental chains of course .
I fear that dentistry is following in the footsteps of medicine where , soon , insurance companies will be purchasing DSOs and essentially have full ownership of treatment from start to finish . Insurances will dictate their own fees to reimburse themselves , their doctors ’ salaries , and the amount of treatment those doctors will have to provide . If so , patient care will continue to decline . It is my hope that our national , state and local organizations can continue combating this trend , and not fall wayside to future political or financial pressures ahead .
This is not a self-pity opinion piece , but rather an alarm bell for new grads and future retirees . Those fresh out of school : don ’ t be afraid to work corporate for a few years and get that experience under your belt – just don ’ t stay trapped forever ! Those retiring , resist the temptation of selling out to a chain , and reach out to your new dentists to carry on your legacy instead . I have yet to meet a doctor who regrets switching to private practice – the future of quality patient care depends on it .
Still being early in my career , I haven ’ t been around long enough to see all the effects organized dentistry has had . I know for a fact that PDA helped get our local offices back open during the COVID-19 pandemic , which allowed patients access to the crucial care they needed . As far as challenges go , keeping young members interested , enrolling and actively participating has proven difficult , at least in our local area . For me personally , getting to know my local colleagues has been an invaluable tool to network , learn , and ultimately help shape dental care in our region .
On a broader scale , I would like to see national and state organizations showcase what they ’ ve accomplished in a more direct manner . Many dentists have paid dues to the American Dental Association and PDA their entire career , spending tens of thousands of dollars , and ask what return did I get on my investment ? What have these associations accomplished legislature-wise , what have they done to improve and protect dentistry as a field ? Although things may be accomplished behind the scenes , it is important to make it known and easily understood . This will help build trust in such organizations and hopefully promote future stability and growth .
Organized dentistry is our last remaining tool to stand up and combat the future deterioration of our field . Its job is not only to protect the dental profession , but more importantly the quality of care that patients receive . Those in elected positions must remember it ’ s more than handshakes and meetings around the country – your decisions impact the future of dentistry for all generations to come !
MAY / JUNE 2024 | PENNSYLVANIA DENTAL JOURNAL 17