PRIVATE DELIVERY SYSTEMS

Most dental services are provided in private dental practices owned and staffed by a single dentist. Approximately 92 percent of professionally active dentists work in this private practice model (ADA, 2009a). (See Box 3-1 in Chapter 3 for a description of types of dentists.) About 60 percent of private practice dentists are solo dentists (Wendling, 2010). Thirteen percent of private practice dentists are employees, and 3 percent function as independent contractors (ADA, 2009d). Private practices tend to be located in areas that have the population to support them; thus, there are more practices located in urban areas than rural areas, and more practices are located in high-income than low-income areas (ADA, 2009a; Solomon, 2007; Wall and Brown, 2007).

Staffing

Independent dentists usually employ one or more individuals in the private practice setting, with an average of 4.8 total staff members per dentist (ADA, 2009b). On average, the independent dentist employs 1.3 dental hygienists per dentist and 1.8 chairside assistants per dentist. Nearly 90 percent of independent dentists employ at least one full-time person, and 68 percent employ at least one person who only works part-time. The majority of these dentists employ chairside assistants (94 percent of dentists), secretaries/receptionists (91 percent), and dental hygienists (68 percent). Some independent dentists employ office managers (31 percent), financial coordinators (16 percent), and other personnel such as sterilization assistants and laboratory technicians. However, dental assistants often perform many of these duties.

Workload

Independent dentists work about 47.5 weeks annually and 35.9 hours per week. These dentists spend about 90 percent of their work hours treating patients (ADA, 2009a). In a survey by the American Dental Association (ADA) of the perceived workload of independent dentists, about 20 percent stated they were “not busy enough, could have treated more patients” (ADA, 2009a). Independent general practitioners have an average of 1,871 active patients1 (for single dentist practices) (ADA, 2009a). Independent general practitioners spend about 51 minutes per patient, and their patients have about 3.3 visits per year. Independent specialists spend slightly less time per patient (42 minutes), and the typical patient visits

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1 Active patients are commonly defined as those treated within the previous 2 years.



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