Getting Patients into the Chair
Although more people today appear to understand the importance of taking care of their teeth, economic, cultural and demographic issues continue to restrict patients from access to dental care
By Laura Thill
It’s not a bad time to be a dentist. In fact, people today appear to be more aware of the importance of oral healthcare than in the past. Better education, warnings about tobacco, an increased focus on attractive teeth and advancements in technology all have contributed to a change in people’s attitude toward oral health, according to Gary Price, CEO, Dental Trade Alliance (Arlington, Va.). "Still, there are challenges because of the weakening economy, rising unemployment and a growing senior adult population," he says. "And, we haven’t figured out what to do with the millions who can’t afford care.
"The issue of the supply of oral care providers is larger than shortages in rural areas," he continues. "We learned last year that care is not available for everyone even within a few hundred yards of the U.S. Capitol. Just because there is a practitioner doesn’t mean there is access. Part of the problem is money. People who don’t have it don’t go to the dentist. Another part of the problem is the lack of culturally sensitive education about oral health." In spite of the "thousands of hours of donated time, materials and equipment to provide screenings and care across the country, [this is] a band-aid for a larger problem."
However, organizations such as the Dental Trade Alliance Foundation are working to provide individuals with better access to dental care. And in spite of a slow economy, business-smart dentists continue to attract patients. "Obviously our industry is not immune to the negative effects of events in the economy, but the oral care market is less affected than the automobile or travel and leisure industries," says Price. "Patients may opt to continue to receive less expensive or temporary procedures in a tough economy. [Many] continue to receive their regular oral checkups. In tough economic times, oral healthcare professionals tend to work with their patients on payment schedules and advise them on lower-cost procedures." So, while cosmetic dentistry tends to have slowed down, preventive checkups are holding up, he adds.
Reaching out
How, then, do oral healthcare professionals reach those individuals with less access to dental care? The DTA Foundation addresses this in a number of ways. "The Foundation’s goal is to provide greater access to oral healthcare [by focusing on] how it can help make dentists more productive so that they can see more patients," says Kevin Thomas, executive director of the Dental Trade Alliance Foundation. Today, many dentists have moved from rural areas to cities, he adds. In addition, there has been a trend for dentists to cut back their hours, especially as they try to balance family with their careers. And, as more foreign students receive their dental training in the United States, more may opt to return to their home countries at some point, he notes.
In some parts of the country, it is becoming increasingly difficult for dentists to sell their practice, continues Thomas. "Some dentists feel, why purchase a practice when they can hang up a shingle?"
In response to the combination of the scarcity of dentists in rural areas and the lower economic status of many people who reside there, the DTA Foundation has begun targeting pediatricians to screen young patients who require dental checkups. "We look at the medical profession to identify children," says Thomas. "Instead of looking past the teeth to the tonsils, we [encourage them] to look more closely at the teeth." In fact, the Foundation has funded programs in Mississippi and Minnesota, among other states, to motivate pediatricians to "focus more on oral healthcare, identify issues and encourage patients to go to the dentist," he says. "Doctors now can receive online or formal training on providing fluoride varnishes and getting reimbursed." So, through grants, the Foundation worked with one Minneapolis, Minn.-based pediatrician, Dr. Amos Deinard, to train medical doctors in rural parts of the state to evaluate children’s teeth and refer them to a dentist.
Another such program is a fluoride treatment program in North Carolina, which the Foundation helped fund to reach out to rural Appalachian children. Smart Smiles, a three-year pilot program, was implemented in response to the high percentage of pre-school-age children who were not receiving dental care. Smart Smiles has focused on training medical personnel to apply fluoride varnishes. "We are seeing results starting to move along," says Thomas. Programs such as this one focus on ‘trying to put the mouth and body back together," he says. "Total body health includes oral health."
Thomas estimates the Dental Trade Alliance Foundation has given $500,000 in grants since it was started in the early 2000s. "We look to fund programs that are promising," he says. "We gave Dr. Deinard $18,000 and his program garnered close to $500,000 in additional grants."
Rural vs. urban
The focus on rural dentistry is forcing some city-based distributor reps to explore how these customers differ from their urban counterparts. There are definitely differences to consider when working with rural vs. urban dentists, notes Scott Boldt, a sales rep with Midwest Dental (Wichita Falls, Texas). "Dentists in rural areas want a handshake and a hello," he explains. "They enjoy a conservative practice and appreciate conservative advice. Rural dentists oftentimes are strong figures in the community and cannot walk through a Wal-Mart without seeing several of their patients."
By comparison, "dentists in urban areas have to keep up with the Joneses," he continues. "Patient perception is particularly important in these areas. A dated office can give the patient the wrong impression of the quality of dentistry a dentist provides. [As a distributor rep], it is important for me to keep urban practices mindful of the latest technology."
But, whether they are working with rural or urban dentists, distributor reps have to coach their customers on ways to market themselves more aggressively. "I get the feeling from economists that the economy will be in a downturn for a while, and that dentists should think creatively for the next year or two," says Bolt. In fact, "dentists should no longer expect to hang a sign in front of their office and anticipate people will show up. They must actively recruit patients."
"Dentists haven’t had to have this mindset in the past," adds Thomas. "Even two years ago, dentists could wake up Monday morning and patients would be at their office in need of work (e.g., repairing a broken crown.). [In the present economy], patients are seeking less expensive options, and dentists have to learn to ask them for more business." Meanwhile, now is "a great time for preventive dentistry," he says. "People’s mindset today is to stop something before it gets worse."
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