As a longtime member of the N.C. Dental Society, I have received a barrage of mass emailings lately from our dental leadership urging support for Senate Bill 655 (which carries the short title “Dentistry Management Arrangements”). While there are merits to the bill, there’s a possibility that its passage could further worsen many North Carolinians’ already dire access to dental care.
I certainly am concerned when I see such statements as “Out-of-state corporations are trying to take over dentistry in North Carolina” expressed in bold, large lettering at the top of fliers from the Dental Society, or that “quality dental care” will suffer under corporate management. Where is the foundation for such statements? Is there credible data showing quality of care suffers more in states allowing corporate management than in those that do not?
Stories of abuses are certainly not limited to corporately managed practices, nor is the provision of services based on maximum profit so limited. Is there data demonstrating greater prevalence of these things in corporate versus private management?
As a dentist who treats primarily Medicaid, low-income and indigent patients in his private practice and who founded and built the N.C. Missions of Mercy free dental-care program, I am very attuned to the dental access crisis we have in this state. I have no ties to corporate dentistry and am not necessarily in disagreement with all of SB 655. However, one of the downsides of this bill is that it could force closure of some viable, high-quality dental practices now providing for the under-served of the state, and keep out others that may do the same. With a dental manpower shortage so severe as to rank 47th in the nation, we can ill afford to take away quality providers for our citizens.
Would the loss of these clinics be of greater harm to our citizenry than problems presented by corporate management? Have this question and others been thoroughly, openly and honestly considered?
The society’s executive director has said that it would not oppose consideration of a study of dental “midlevels,” another potential means to improve our dental manpower. However, the dental leadership worked behind the scenes to block establishment of exactly such an information-gathering study, as they proudly note in a list of legislative “accomplishments.” Could this same thing be happening in regard to statements the leadership makes about SB 655? Hopefully not.
The select committee on dentistry in the state House now considering the issue is not the answer. The representative who chairs the committee, Dr. Bert Jones of Rockingham County, is himself a dentist and member of the Dental Society. I have received numerous requests from that organization urging financial support for Jones.
The process through which dental policy is established is in dire need of revamping. Our state’s dental laws are among the most restrictive in the nation. Coincidentally or not, there are fewer than five states with greater dental manpower shortages.
Before we add yet another layer of restrictions, I urge lawmakers to take a step back and either defeat or table SB 655 until such time as we can establish an overall plan to vastly reduce or eliminate dental access problems without diminishing quality of care. We then need to make rational and objective decisions that will fit with that plan. We already have a law prohibiting corporate ownership of dental practices. This can protect us for the time being. If our Dental Society leadership takes issue with this approach, that should tell us all something.
Steven D. Slott, D.D.S, practices dentistry in Burlington.
