The idea of the greater good has a long yet punctuated history, teeming with diverging meanings. How is this philosophy of collective purpose illustrated by DSOs? What would the world of philanthropic dentistry look like without DSOs?
Millions live in places where there is little or no access to care. These areas, both urban and rural, could be considered nonoptimal practice locations due to poverty and a lack of insurance, with a reliance on Medicaid. In addition to providing affordable dental care services and convenience, the emergence of DSOs is, in part, based on serving areas which are underserved. Practically speaking, many solo practitioners may not be able to enter that space. They have bills and student loans to pay off. They may be more inclined to locate their office somewhere they live, somewhere patients have good insurance or can pay for services out of pocket.
Inside Philanthropy’s website says that, “There are huge gaps in access to dental care in the United States. Only about half of all Americans have dental insurance, and obstacles to care are particularly high in minority and vulnerable communities. In October , nearly 5,000 areas in the country were designated as Dental Health Professional Shortage Areas—spots where there are 5,000 or more people per dentist.”
A 2014 study by the Federal Reserve found that a quarter of Americans went without the dental care they needed because they couldn’t afford it (see graphic below.) According to NPR.org, “For those in rural areas, the problem is far worse. A 2015 report by the Pew Charitable Trusts found that people in rural areas are poorer and less likely to have dental insurance than their urban counterparts. They’re also less likely to have fluoridated water, and more likely to live in an area where dentists are in short supply. Those dentists that are there probably don’t take Medicaid, government health insurance for the poor.”
We know that oral health is closely tied to overall health. Providing dental care not only makes people healthier, it can also make them more financially secure. That’s because, very simply, bad teeth can make it hard to get a job.
Dentists want to give back. The desire to serve the underserved is important them. The International Dental Journal orchestrated a global inquiry into dental student perceptions about philanthropy, global dentistry, and international student exchanges. A 22-question, YES/NO survey was distributed to 3,487 dental students at eight schools in seven countries in 2016. The questions probed students about their school’s commitment to enhance their education by promoting global dentistry, volunteerism, and philanthropy. “In total, 2,371 students (67.9%) completed the survey. Cultural diversity was seen as an important component of dental education by 72.8% of the students, with two-thirds (66.9%) acknowledging that their training provided preparation for understanding the oral health care needs of disparate peoples. A high proportion (87.9%) agreed that volunteerism and philanthropy are important qualities of a well-rounded dentist, but only about one-third felt that their school supported these behaviours (36.2%) or demonstrated a commitment to promote global dentistry (35.5%). In addition, 87.4% felt that dental schools are morally bound to improve oral health care in marginalised global communities and should provide students with international exchange missions (91%), which would enhance their cultural competency (88.9%) and encourage their participation in charitable missions after graduation (67.6%).”
DSOs have recognized the oral health needs of the underserved and are addressing it. In doing so, DSOs have the resources and opportunity to give back in high volume. After all, there is strength in numbers. There is a long list of free dentistry events, service days, mission trips, and community outreach programs provided by DSO teams for school children, veterans, and other economically disadvantaged people within the United States and across its borders. These events benefit upwards of hundreds, or even thousands, of people due to the sheer numbers of dental volunteers involved. Could a solo practitioner organize events and coordinate these complex logistical efforts, including staffing, equipment, space, geography, and marketing it to the needy community? Could they efficiently and effectively service the same amount of people that a free DSO event does? Would they be so inclined to divert focus, time, and energy away from their practice and navigate the logistics of a charitable clinic in an area they may be very unfamiliar with? More than likely, solo practitioners are more focused on building their practice and paying their bills, including school loans. There are only so many hours in a week. Solo practitioners need to spend time doing paperwork and administrative tasks which most DSO dentists do not have to do. Of course, solo practitioners can and do supply some charitable dental care, but can they reach the mass audience of desperate recipients as well as DSOs can? Without the DSO’s charitable efforts, where would all these people go for the necessary dental care?
Written by Beth Miller, contributing writer, GDN