Greatest Misconceptions
I have 5 kids. As you can imagine, they all have their own personalities and quirks. I’ve been told it’s what makes each kid special. I have three daughters and two sons. My youngest son is very particular about what he eats. He is currently nine years old and he has never tried meat of any kind. No chicken, beef, fish, hot dog, pepperoni, hamburger, etc. His diet mostly consists of cheese. Cheese pizza, grilled cheese sandwiches, cheese quesadillas, cheese sticks, and he’ll mix in an Eggo waffle with peanut butter and honey for breakfast. I often wonder when he will break down and try a protein of any kind. I also have a daughter who’s personality quirk is going to help me make my point today. We had a new Mexican restaurant open in town last week. I mentioned the other night that we should go there for dinner and check it out. Her immediate response was that we shouldn’t go because it was gross. I asked her how she could possibly know that. Her response, “Lyla went the other day and he said it was gross.” Lyla is my daughter’s best friend. They are sophomores in high school this year. I quickly asked her how she could possibly know if it was gross without having tried it herself. She, of course, had no response for that question, but she knew that it was gross and she wasn’t willing to find out for herself if that was true or not. She was more than happy to take her bestie’s word for it and move forward without the Taco Brothers in her life.
This got me thinking. Do dental students, new grads, and younger dentists completely write off rural dentistry without actually knowing what it is? I think that answer is a resounding YES. In my mind there are three misconceptions about rural dentistry that I feel like prevent dentists from considering rural opportunities. The first is that all rural opportunities consist of working in underserved areas. When I was in school I equated the term “underserved” with “Medicaid” or “state assistance.” If you were being lured into working in an underserved area it was because no dentist wanted to go there because they couldn’t make any money. When I was coming out of school an agency that was recruiting me was the Indian Health Services. There are numerous Native American reservations throughout Arizona that are underserved with respect to dentistry. The IHS would hire you as a contracted dentist, pay you a salary, and you would work on the reservation for the length of your contract. This didn’t sound like a very desirable job to me. Indian reservations in Arizona are pretty desolate places. I feel like rural dentistry gets the same bad rep that IHS gets, but the IHS jobs have earned their reputation, rural dentistry hasn’t. The definition of “underserved,” to me, is that there are not enough dentists to service the community in which they practice. I’ll give you a couple of examples. I have 2 offices that are the ONLY dental offices in their respective counties. The ratio of dentists to patients in those offices are 1:26,000 and 1:13,000. This is the definition of underserved. In both of those offices I’m only in network with Delta Dental. Everything else is either cash or out of network insurance, no Medicaid. Truth be told, you should be salivating over a practice that is in an underserved area. That means more patients, more dentistry, more money.
The second great misconception is that people in small towns can’t pay for dentistry. They’re just a bunch of hillbillies in overalls who don’t have 2 nickels to rub together. Now, I’ve had plenty of hillbillies in overalls in my chairs over the years that don’t have 2 nickels to rub together, but I’ve also had some pull wads of cash out of that pocket in the front of their overalls and pay for big treatment. In almost every small community there are plenty of people who can pay for treatment. In all three of the communities my offices are in there are doctors, lawyers, engineers, and professionals of every kind that can afford insurance and afford treatment. Where you would be surprised is the guy who’s a farmer, plumber, electrician, and the like who own their own businesses. It’s the same situation as dentistry. When you’re the only plumber in town, you’re busier than you want to be, but with that comes profit. Now, I’m a very conservative dentist. I don’t do anything unless I have to. One reason is that I just don’t have time. If I treatment planned every crack, stained spot, or possible cavity I wouldn’t be able to get people in for months, especially emergencies. Secondly, I don’t want to take people’s money unless I know I doing something they need. That attitude has proven to play very well in a rural setting. People don’t want to feel like they are being taken advantage of. Once they trust you as a dentist, they will willingly part ways with their money for treatment that they need, not treatment they feel like is being sold to them.
The third misconception is that you’ll only do fillings and extractions in rural settings because that’s all people want, or will pay for. I have found the opposite to be true. I’ll use implants as an example. I started placing implants 11 years ago, when I moved to Colorado. I practiced in Colorado for 7 years. I have practiced in Kentucky for 4 years. In the 4 years I’ve been in Kentucky I have placed at least twice, if not three times, the number of implants than I did in Colorado, and for a higher price. In Colorado I charged $1995 for an implant/abutment/crown. In Kentucky I charge roughly $3250 for the same treatment. If I wanted to, I could keep myself plenty busy with molar endo. I hate molar endo, so I don’t do it, but there is plenty to go around. I have done multiple veneer cases, denture stabilization cases, multiple units of crown and bridge cases, etc. I have patients asking for implants constantly. The greater your catalog of procedures, the more you’ll be able to do, the more money you can make. These services aren’t just reserved for the big city hotshots who plaster themselves all over social media. Small town, rural patients want and appreciate these services as well.
I hope thais helps to clear up some misconceptions about practicing in a rural setting. I would venture to say that if you were able to poll some rural dentists they would be able to tell you the same thing. Rural dentistry is profitable and offers a wide variety of procedures to patients who can pay for them.