ADA.org: Future of Dentistry Full Report

FUTURE OFDENTISTRY

rose at about 2.0% annually. Dentists' productivity
actually declined by 0.13% annually because the
over-abundance of dentists compared to demand for
dental care made it difficult for dentists to stay busy.
During the period from 1991 to 1998, dental out-
put continued to grow more quickly than the popu-
lation. However, the growth in dentists' productiv-
ity had recovered from its stagnant period during
the 1980s to expand at 1.05% annually. Its contri-
bution to output was equal to that of the increase in
the number of dentists.
Thus, there are two ways to increase dental serv-
ices: one through increases in the number of dentists and
the other through increases in existing dentists' produc-
tivity. The two methods are related. If an over-abun-
dance of dentists compared to demand occurs, produc-
tivity is retarded, slowing the increase in dental output.
As the dental market tightens, dentists stay busy and
productivity is enhanced. Improvements in technology

enhance productivity, but the full impact of technical
change will also be affected by market conditions.
Appropriate use of staff and office space can
enhance dentists' productivity (Beazoglou et al,
2001). The type of analysis described next will dis-
cuss these issues. This analysis is different from the
previous discussion of dentists' productivity per
hour. It is like a recipe for efficient production of
dental services given the various factors (such as
number of staff, staff hours, office space, etc.) that
contribute to changes in dentists' productivity.
However, the analysis does not indicate which fac-
tor is more important in a fundamental sense. Of
course, the inputs of dentists are critical because
dental services cannot be produced without dentists.
Although this productivity analysis does not meas-
ure the productive effect of expanded duties for
allied dental personnel, it is valuable because it does

indicate, given the existing number of allied person-

nel (across all general practitioner dental practices),

the effect on dentist output if the number of allied

personnel were to be changed – assuming all other

factors remain constant.

Several factors contribute to changes in dentists' pro-

ductivity (Beazoglou et al, 2001). Table 3.5 shows the

percentage increase in dental output per hour from a

10% change in each of these factors separately, holding

the other factors constant. For example, a 10% increase

in dentist hours would increase dental output by 2.92%

while an increase of 10% in dental hygienist hours

would increase output by the almost equal amount of

2.74%. If more than one factor is changed their contri-

butions are additive. Thus, 10% increases in both den-

tal hygienists and dental assistants hours would increase

dental output by 4.02%. These productivity enhance-

ments can be realized by increasing the staff hours of

these personnel. Moreover, these increases can be real-

ized with the current scope of duties

for these personnel, as they exist in

the various states.

Increasing the number of dentists'

hours by producing more dentists

may not be the most cost-effective

way to increase productivity and sub-

sequently dental services. Interest-

ingly, once other factors are held con-

stant, neither gender nor age is a sig-

nificant factor in productivity. Female

dentists are just as productive as male

dentists. Also, older and younger

dentists can produce at the same rate.

National Dental Workforce Projections

To develop a national dental workforce policy,

one must understand the productive capacity of the

dental workforce. One dental workforce objective

could be to keep the productive capacity of the den-

tal workforce constant in relation to the United

States population in 2020 compared to 2000.

In 2000:

u United States population was 281,421,906;

u Active private practitioners numbered 153,431; and,

u Dentists-per-100,000-population ratio was 54.5.

Clinical Dental Practice and Management

Annual Growth Rates in the U.S. Population,

Dental Output, and Output per Dentist, 1960-1998

Source: Beazoglou et al, 2 001.

1.18%

5.01

3.95

1.0 2 %

2 .95

1.31

0.9 6 %

1.8 4

• 0.13

0.98%

1.80

1.05

1960 - 98 1960 - 74

TABLE 3. 4

197 4- 91 1991 - 98

U.S. Population

Dental Output

Output per Dentist