Recruiting New Dentists in Iowa: A guide for your community to be successful
Chapter 1: Determining Community Readiness and Need
When looking at community infrastructure, easily accessible healthcare is one of the top quality-of-place attributes a community needs to be vibrant and remain viable. A strong healthcare infrastructure is important in a community for a number of reasons, including economic development, employer recruitment of workforce and health of population.
A strong healthcare infrastructure helps retain and attract businesses and companies. Furthermore, access to local and quality healthcare results in a healthier population, thus a stronger and more viable workforce. Local access also leads to less time off from work related to the treatment of employee and family healthcare needs. Moreover, strong existing healthcare services prevent additional retail leakage out of the community.
A dental practice is part of a strong healthcare infrastructure as well as a small local business and employer. It provides good paying jobs to people who often live in the community and is likely to support local community organizations and initiatives. According to the American Dental Association, one dentist can have an average annual economic impact of $1.6 million on the community. For these reasons, retaining and recruiting a dental workforce should be a community-wide effort. Once there is community buy-in and an initial “task force” has been started, this guide may be used to direct the recruitment process. The strategies outlined throughout have been used by some Iowa communities to successfully recruit new dentists and are likely to benefit your community as well.
For a community that already has existing dental providers, it is ideal to recruit a new provider before a current provider retires and a void is created. Recruitment efforts should also happen when there is a known and documented need in the community due to population growth or lack of dental providers due to attrition. Dentists and communities may need to begin the recruitment process as early as five years in advance of a retirement. It takes time to recruit a new dentist, and importantly, to negotiate and consummate a final contract deal.
The first step to knowing when to recruit dental providers is to conduct a community dental assets and needs assessment. An assessment should be done every few years as part of a bigger community healthcare strategic plan. The following steps address what to include within the assessment.
Step one in undertaking this assessment is approaching the current community assets related to providing healthcare, especially related to dental care. As part of the assessment, individual dental providers in the community and the surrounding area should be contacted to gather their perception of the current and future dental care landscape. The information the providers share will help the developing task force to know if they should be planning for future recruitment or actively recruiting. It can also help determine what type of clinic (if applicable) the community might need.
The task force should ask that a retiring dentist or one interested in a practice transition consider some questions. This will assist in creating the needs assessment and an action plan timeline and may include:
- What is the office’s patient load – busy, over busy, accepting new patients?
- What types of patients do they serve – self-pay only, Medicaid-enrolled, elderly, underserved, special needs, very young?
- Do they wish to expand their practice? If so, what positions will be added – administrative, dental assistants, dental hygienists, dentists and/or dental specialists?
- Do they have a practice transition plan with a timeline?
- Do they have an idea of when they would like to or plan to retire?
- Are there any other issues they may be facing?
This information should be respected and treated confidentially as it can be considered proprietary. The first time a dentist is approached, they may not be ready to disclose this information. However, the conversation can serve to build a trusted relationship and spur the dentist to think about the future of the business and community need.
Since recruitment is a community effort, communities should use existing resources for determining need. For instance, the I-Smile Coordinator and the I-Smile Silver Coordinator for the area are good resources. I-Smile Coordinators are dental hygienists who help coordinate dental care for children; I-Smile Silver Coordinators are dental hygienists whose focus is the elderly population. Both should already have a sense of the level of need in the community and most likely have a relationship with the majority of local dental care providers. This existing relationship between a coordinator and dentist may offer an opportunity to conduct the above conversation. (To find the I-Smile Coordinator and I-Smile Silver Coordinator, if available, in your area, refer to the Appendix for links to the program websites.)
County public health entities, hospital emergency rooms, and medical clinics may also have information regarding the number of clients or patients they see seeking care for oral health concerns and problems.
The second step in determining a community need is identifying the current dental providers in and around the region and their potential retirement timeline. It is suggested that an average of one dentist to every 2,500 patients is optimal for a practice. If there are five dentists in a community of 10,000, 30 or fewer miles away, a prospective dentist may not believe practicing in a neighboring community is sustainable. However, if a number of current providers plan on retiring within the next five years, recruitment efforts should be undertaken to maintain the current service level in the future. The OIPO can assist in identifying where and how many dentists are practicing in the community and area.
A GIS (Geographic Information System) service area analysis is another tool that can be used to identify the number of possible patients in differing service areas, by a distance of 10 to 30 miles from the community as well as identify the location of existing dental offices, clinics and centers. City or county offices in a community often use a GIS and may be able to assist you.
Once a need has been determined, it is important to build community support. The following chapter includes recommendations for communities and providers to increase their rate of success.