Dr. Kevin Coughlin: Good afternoon. You’re listening to Ascent Radio. This is Ascent-Dental-Solutions, with a focus on knowledge, consultation, development and training. Today’s podcast is brought to you by Stand Up and Be Heard, and a special thanks to Mr. Doug Foresta and that company. Without his expertise and knowledge, this podcast could not be put on.
Today, we have a special guest. That special guest is Dr. David Preble, ADA Practice Institute partner.
Although this is close to our 60th podcast, I personally feel that dental associations, and in particular, the American Dental Association, has perhaps more value than ever right now with the changes that are going on in our profession. I’m hoping that Dr. Preble can provide insight and knowledge to our almost 7,000 listeners.
David, thank you so much for taking time from your busy schedule. I just wanted to say thanks so much for sharing your knowledge and expertise and also your help in working with the American Dental Association. One of the first things, Dave, I wanted to ask you is right now, can you give the listeners an idea of about the average percentage of dentists that are participating in the American Dental Association?
Dr. Preble: Sure, Kevin. We have about a 63 percent market share of dentists. And that’s basically representing more than a 161,000 licensed dentists from all 50 states, the District of Columbia and Puerto Rico.
Kevin: Obviously, we’d love to see 100 percent of the practicing dentists being members. Are there particular areas that you think we could improve that number from 63 percent to higher? Are there things that the American Dental Association is working on, you in particular, to perhaps expand that base that’s already present?
Dr. Preble: As you said, we certainly want to and we are trying very hard to do that. What we are doing is trying to figure out that real value proposition for dentists at all stages of their careers. So both the young dentists, the millennials that are actually becoming now 50 percent of the dentists in the country, as well as the dentists in their mid-career and later career all get something that they want from the American Dental Association. We don’t just figure it out on our own, we try to ask them what it is that you want from us, and try to deliver that.
The ADA provides a broad range of services from legislative and regulatory advocacy, practice-based advocacy with third-party payers and governmental agencies, continuing education, peer review, scientific research, the development of dentistry policies and standards, as well as, practice management tools and resources. And we feel that all of these things are part of what dentists expect from the American Dental Association, but each individual decides for themselves whether or not it’s enough for them to actually join.
Kevin: I can tell you with my experience in Ascent Dental Solutions that there is basically those three broad categories that you touched on that individual who is just starting practice, who is recently graduated, their wants and needs are in a particular direction. And the ADA, in my opinion, is a tremendous asset to provide basically free information and knowledge to guide those new graduates through some of the trials and tribulations of either starting a practice, joining a practice, and determining do they compete with managed service organizations, do they consider joining managed service organizations, do they even know the difference?
And then you have that second group which have been probably practicing for 8 to 15 to 20 years and they are dealing with the practice management issues, the regulation issues, the day-to-day issues that perhaps their practice isn’t growing and doing as well as they’d hoped for a variety of reasons. And once again, the ADA has an enormous amount of asset to help that group.
Finally, the last group are those individuals more in the twilight of their career. Are they in a position to retire financially? Is their clinical practice in a position to pass on to another individual or group? Again, the ADA is there with knowledge, information and expertise.
When we look at these different areas, I know through previous conversations with you, you mentioned that there were probably three main areas or topics or issues that you thought were important to the dental profession. Would you like to touch base on those areas?
Dr. Preble: Sure. But before I do that, I’d like to come back in on what you said, because you really put it very well, those three different kind of stages of a career. Following graduation, a new dentist can really benefit from the services like our Career Center, which we are building to be even better and better, that really helps dentists make more informed and better decisions about where they want to practice, how they want to practice. Networking opportunities offered through the local and state dental societies, which are an integral part of the ADA, and practice development resources, even licensure guidance, loan refinancing options. We have this wonderful student loan refinancing programs that’s better than anything else that’s on the market and it’s saving young dentists thousands and thousands of dollars. Plus, of course, volunteer opportunities, continuing education, etc.
Then those dentists in that mid-career part, they can have ADA tools and resources to answer these third-party payer questions, accessed online scientific resources, etc. Then as they get into the later part of their career, we have practice transition information, insurance and what’s management options, answers to financial questions and then lots of opportunities for mentoring even new dentists. So there really is something for everyone.
But back to your question about these major areas that we keep seeing dentists say, “This is what we need help with. How can you help us?” There is the third-party payer reimbursement issues, whether they be public programs or private programs. This is something that is constantly in the dentists’ mind because this is the lifeblood of how they make their living. Along with that, there are lots of increasing regulatory burdens that we are seeing happen from governmental agencies, and even in the third-party payer private world, more regulation and how easy it is to do business. Those are the two big ones.
Of course, practice management itself, the business of doing practice is a big part of what dentists look for from the ADA. Because in dental school, we learn a lot about the art and science of actually treating patients and caring for patients, we don’t learn a lot about running a business. And that’s information that they really need and look to the ADA to give them in the most cost effective way. They can get all sorts of information from high-priced consultants, but when you are an ADA member, you get all that information for free. So it really is, I think, a good benefit.
Kevin: I think it’s not only good, it’s a tremendous benefit. And for listeners out there, I’m not here just tooting an organization. I firmly believe there is no real skin in the game, per se, with the American Dental Association. If you hire a Kevin Coughlin, I may have alternative motives that are specific to your wants and needs. The ADA is representing the profession and I think the profession comes first many times over the individual and hopefully, there can be a nice marriage and both benefit from it.
We talked a little while back about managed service organizations and dental service organizations. For some of our long time listeners, I define the managed service organization as equity-backed, venture capital-backed. This doesn’t mean good or bad, it just means that there are outside parties investing large sums of money to get a return on their investment. Whereas a dental service organization is generally run and owned primarily by practicing dentists, who also have skin in the game to make a profit and a return on their investment, but ultimately, they are the clinicians providing day-to-day care, services and expertise.
Does the ADA see any particular trends? Do they see that these MSOs and DSOs, are growing? Because based on the Health Policy Institute and other research that I’ve been able to do for previous podcast, that seems to be on the rise.
Dr. Preble: It is on the rise. First and foremost, I wanted to make sure that the listeners understand that the ADA supports ADA members and dentists to have the freedom to choose whatever practice model they decide. We are not judging whether one practice model is better than the other.
But that being said, the ADA does feel very firmly both in its policy and what we tell others is we support this conviction that the health interests of patients are best protected when dental practices and the facilities for the delivery of dental care are not only owned, but controlled by a dentist. We think this is just the best interest of the public. So there aren’t those conflicts of interests between the making of money and the care and delivery of the patient.
We do understand that dentists, some choose to not want to do the management end of practice. They would prefer to just do the care part. And having DSOs or any other type of support organization that does the business part of them for that, if that is the way they choose to do that, that’s okay. But all of those dentists agree, whether they work in a DSO environment or not, that they should have control over patient care. That’s the bottom line. It’s not just ownership on paper, but its control over how patients are treated. That’s what’s important.
Kevin: And I would concur 100 percent with that, Dave. Is there programs out there that the ADA has that can educate those dentists that are interested in learning more about MSOs and DSOs? Are there programs out there that the ADA may be able to review potential contracts, working relationships to determine whether one group may be stepping out of bounds? Are there any programs like that that the ADA has to offer to its members?
Dr. Preble: I don’t think that we’re going into that specific a detail. We have resources on the Center for Professional Success that help dentists, again, whatever stage they are in their career. Although, the Health Policy Institute research has shown that the large rise in the dentists that work in DSOs is in the younger cohort. So those younger dentists, there are resources there for them to say, “These are the things that you should evaluate in your contract. Are these things that you are comfortable doing and not comfortable doing? Are these the things you are comfortable agreeing to and not agreeing to?”
We don’t get into very specifics of evaluating particular contracts for the dentists, they’d have to hire their own legal counsel to do that. We don’t have the resources to do that for every dentist here at the ADA. But we do give them the broad ideas of what you should be looking for, what you should make decisions on your own about, what you are comfortable with and what you are not comfortable with.
Kevin: David, I want to thank you so much for your time. I want to give another plug for the American Dental Association. Your representation of what the American Dental Association is, I really think that 100 percent of our members should be members. I know I personally have been a member since 1983. I’ve had my ups and downs, I’ve had some agreements and disagreements, but in the end, the mission statement to represent the dental profession and dentists, I think, goes without saying. Your expertise, your knowledge is greatly appreciated, and especially spending your valuable time on this podcast to educate our listeners I think is terrific.
For the thousands of listeners that have been paying attention to Ascent Dental Solutions, strongly think about the American Dental Association. As competition becomes greater, financial risks become greater, educational debt. The American Dental Association has programs and options all at almost no charge to its members, granted we do pay a membership fee. But I really think it’s one of the organizations that we should be promoting and can offer much needed information to us.
We’ve been listening to Dr. David Preble. David, for some of the listeners who might not be as familiar with the ADA, is there an 800 number, a website? Is there a way that questions could be answered or information could be ascertained?
Dr. Preble: Sure. The home source of cause if just www.ada.org. That’s the easiest way to get to the home base of all the information. If dentists are looking for a specifically practice management type information and information about third-party payers and things like that, we have the Center for Professional Success, which is www.success.ada.org. Those two sources should get anybody started on a host of information.
Kevin: Thank you again so much, and thank you to the listeners. You’ve been listening to Ascent-Dental-Solutions. My name is Dr. Kevin Coughlin, with a focus on development, knowledge, training and education. Our guest today was Dr. David Preble, the ADA Practice Institute Head since 2013. Thank you so much.
Dr. Preble: Thank you, Kevin.