(by Alan Stern, DDS )

A Vexing Problem

Last week at the Greater New York Dental Meeting , I met a few Dental Hygienists who expressed some serious discontent with their salaries, working conditions, and (what they saw as) the attitudes of their employers.   Knowing that there are three sides to every story, that the stress of the past three years has caused some serious mental health and employment tumult, and that rising cost and the demand for lower fees / reimbursements has twisted my brain inside out. A few things seem very clear:

We must begin to think “Both-And”

That’s also the title of the book by Wendy Smith and Marianne Lewis I just finished reading.

There are more than two right answers for almost any issue. Aside from simple things like 2+2=4, there  are also many truths and beliefs in the world, and that holds very true for our PROFESSION. And when we try to fight for our truths and beliefs, a winner and a loser will emerge. Now more than ever, we cannot have losers in Dentistry because now more than ever, WE NEED EACH OTHER!

Reconciling (seemingly) conflicting beliefs is possible, but will require some courage, humility, vulnerability, transparency, and , most of all, desire to come together rather than complain and argue that it’s my way or the highway

Safe Spaces and Sense of Purpose are Essential

The first step in getting us together will be very simple- uniting behind a mission and allowing for open and honest expression, both  as ladies and gentlemen AND as PROFESSIONALS. If a Dental Practice is going to cater to the underserved- a very noble mission- the members of that PROFESSIONAL community need to unite about that wonderful endeavor. Everyone has to realize that things will need to be done a certain way for a certain reason. Everyone has to figure out how to make the practice generate the dollars it needs to take care of everyone and what each person needs to do in order to make that happen. IF a practice is Fee for Service, other challenges will need ot be addressed in the same way- in a safe space with a clear sense of mission. Most importantly, everyone working in a practice needs to share the values that practice espouses. If someone does not, they need to find a practice whose values are more congruent with theirs.

Blind spots , defensiveness, and hidden opportunity

We all have blind spots. We all have confirmation bias, based on our unique life experiences. The members of our PROFESSIONAL community can both see things that we don’t see and open our eyes to  different ways of doing what we do. In a world that is changing rapidly, it would be very helpful to both cling to our core values and  try different ways of doing business or practicing. In a changing world comes new opportunity for those who can flex without trashing their core values

The 800 pound gorilla in the room

From my observation, third party payers have disrupted the Dental World. They have almost become the masters of their customers’ destiny and certainly are having a serious impact on our effectiveness as leaders, employers, and as PRACTITIONERS. I think my discontented hygienists may be collateral damage of the forces that are pressing PRACTITIONERS to work harder, faster, and leaner. In that process, we all can become emotionally hijacked and forget that we all need each other and that we ALL need to help one another serve the mission of Dentistry. That includes, without a doubt, paying, appreciating, and loving the people who surround us! It is time to take our PROFESSION back!

HOWEVER….

Like it or not, Dentistry is expensive. Like it or not, some people cannot or will not pay us what we are worth. Like it or not, some people WILL pay us IF we give them the value they seek. Like it or not, third party payers ARE at the table and are not going anywhere for the foreseeable future. And, like it or not, some people and practices are either forced to or choose to serve or be served by third party payers. And this will compel Dentists , Hygienists, Assistants, and Administrators to choose the niche they wish to serve and to work hard to maintain their missions.

It’s Both – And

I would challenge all of us to see how we can reconcile a fair fee with serving people as best we can, earning a good living while being paid with gratitude in a fee for service PRACTICE. Is it possible to maintain a PPO/Medicaid/or other non-FFS practice that is choked for cash by third party payers (TPPs) year after year as inflation takes its toll and profits of TPPs increase?? That’s not a rhetorical question, by the way! Is it possible for PRACTITIONERS and third-party payers to struggle to find a both- and solution before the entire dental PROFESSION collapses into a world of managed misery providing mediocre care for people who no longer trust us and increased job dissatisfaction? What’s that going to do for the people who put their trust in us? How can a Community Member show up and give their all if they’re not making a sustainable salary AND how can they expect a great salary if they are not actively and enthusiastically working towards the greater good of the practice, their fellow Community Members, and those they serve? We need to passionately face these paradoxes bravely and honestly. We need to practice in a way that’s congruent with our values, skills, and happiness. And we need to find Community members (read Employers and employees) who espouse the same values as we do if we are to work our way out of the many paradoxes, conflicts, and stressors we face.

Let’s work together as best we can!

Written by Alan Stern, DDS