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Unraveling

Since the start of the year, I’ve noticed an increased amount of open appointment times in my dental office’s schedule. This isn’t just limited to the hygiene schedule but is also affecting the doctor’s schedule. With many years of collective experience among myself and my colleagues, we’ve found ourselves exchanging puzzled remarks like, “I can’t remember it ever being this quiet.” We’ve engaged in discussions, brainstorming potential reasons for the unexpected gaps and last-minute cancellations:

  • Have we inadvertently changed our approach when booking appointments with our patients?
  • Has there been any indication of patients sharing negative feedback with any member of the team?
  • Has there been a shift in our office ethos or a perceived decline in our standard of care?
  • Have our fees seen a significant hike?

Surprisingly, the answer to all these questions has been a resounding “no.” So, what then could explain the uncharacteristic slowdown in our schedule?

Driven by our collective frustration, I embarked on a quest for answers and discovered that our predicament isn’t unique. Many dental offices, like ours, are grappling with the challenge of maintaining a full schedule.

It appears that 2024 has been forecasted as a particularly challenging year for dental practices, attributed to various factors. 

Staffing Challenges

Dental offices, like many others, have not been spared from the effects of staffing shortages, and my office has certainly experienced the consequences of this. Throughout the COVID-19 pandemic, dental offices faced closures and non-emergency dental treatments were deemed nonessential by the U.S. government. Subsequently, each state determined its timeline for reopening, resulting in a staggered return of dental professionals to the workforce. However, not all dental personnel resumed their careers once clinics and operatories reopened.

Studies have examined various reasons for this phenomenon, with dental professionals citing burnout, early retirement, concerns about illness, and family obligations such as childcare as primary reasons for delaying their return to the operatory. Four years after the peak of the COVID-19 pandemic, hesitancy persists among dental workers, contributing to a continued shortage of personnel. 

Since 2020, my office has faced challenges in returning to the full capacity we once maintained. We’ve experienced the departure of a few team members, and filling these positions has proven difficult due to a shortage of applicants. Consequently, our patients have noticed a revolving door of faces at each appointment, leading to some uncertainty and comments about the changes.

Perhaps our office has lost the trust and integrity we once held, built over years of close relationships between patients and providers. Because of this, our main objective for this year is to attract new patients and essentially begin anew in establishing these trusted relationships.

Financial Constraints on Patient 

The economic challenges of this year are evident. With high interest rates, an overpriced housing market, record-high car payments, and rising college tuition, patients are feeling the financial strain. As disposable income decreases, people may prioritize essential expenses over elective procedures like dental treatments. Routine exams and preventive care may be deferred, and the apprehension of potential costly procedures can prevent individuals from addressing minor dental issues before they worsen.  

In my dental office, while our hygiene schedule remains consistently full on certain days, the availability in the doctor’s schedule fluctuates significantly. I’ve observed a decline in case acceptance compared to previous times when it was relatively easy to transition a patient from the hygiene chair to the doctor’s operatory for restorative work upon the discovery of decay during routine x-rays. While some patients openly acknowledge the financial strain, others depart without providing a specific reason. This situation prompts me to contemplate whether the financial burden is more widespread among my patient base than I initially perceived.

Insurance Coverage Reductions

Another financial challenge patients may face is layoffs. In March 2024, U.S.-based employers announced 90,309 job cuts, marking a 7% increase from the 84,638 cuts announced in February 2024. This figure is nearly identical to the 89,703 cuts announced in the same month last year. According to a report from Challenger, Gray & Christmas, Inc., this is the highest monthly total since 102,943 cuts occurred in January 2023.

Upon losing their job, patients lose their dental insurance coverage and often require third-party financing or payment plans. If their current dental office, like my own, does not offer these options, patients may seek coverage assistance elsewhere.

Tela Dentistry

Thanks to advancements in teledentistry, patients no longer have to physically visit the dental office for certain consultations or services. From a patient’s point of view, why take time off work or endure the hassle of commuting to the dental office when a dentist is just a video call away?

The COVID-19 pandemic changed so much about the way we live and take care of ourselves. People around the world adapted to the restrictions of lockdowns with work-from-home setups, grocery delivery and telehealth visits with their doctors. When I joined the dental profession in 2014, I never anticipated needing to contend with virtual hygienists. While patients still must physically attend the dental office for preventive and restorative care, the availability of “teledentistry” for consultations, emergencies, sharing pictures and dental imaging, or follow-ups in some offices may discourage patients from choosing ours, which lacks this option.  Integrating some form of teledentistry into our practice is another objective we aim to implement.

The slowdown experienced by dental offices during bad economic times in 2024 is a multifaceted issue influenced by various economic, social, and healthcare factors. Understanding these dynamics is crucial for dental practitioners to develop strategies that enable them to weather economic downturns while continuing to provide essential oral healthcare services to their communities.

By researching and understanding the hesitancy our patients may be experiencing, we as an office can improve our ability to provide them with the services and assistance they need to maintain overall dental and systemic health. 

Work Cited

Dahm, Tracee. “The Dental Staffing Shortage: Whom It Really Hurts.” Dr. Bicuspid, 27 Feb. 2024, www.drbicuspid.com/dental-practice/office-management/staff-shortages/article/15664944/the-dental-staffing-shortage-whom-it-really-hurts.

The Dental CFO. “The Biggest Challenges Dentists Face in 2024.” The Dental CFO, 13 Apr. 2024, www.thedentalcfo.com/blog/the-biggest-challenges-dentists-face-in-2024.

Graham, Brianna. “The Pros and Cons of Teledentistry.” ZocDoc, 9 Jan. 2023, www.zocdoc.com/blog/the-pros-and-cons-of-teledentistry/.

Josh Gosnell. “Adapting To Economic Uncertainty: Pivoting Your Dental Practice For Sustainability.” Adit, 18 Jan. 2024, adit.com/adapting-to-economic-uncertainty-pivoting-your-dental-practice-for-sustainability. 

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