Executive Outlook: Bills supporting DSOs will address dental access issues

Jeffrey Sulitzer, DMD, joins us as an Executive Outlook guest columnist. Dr. Sulitzer has been a licensed, practicing dentist since 1985 and is currently the Chief Clinical Officer for Gentle Dental, a DSO which has been serving dental patients in Washington State for over 30 years.

The State Legislature is considering whether to update Washington’s dental statute, written in 1935, to allow for more choices in the way dentists can set up their practices. This update is long overdue, especially given our state’s shortage of dental professionals. It will remove once and for all any question as to whether dentists like myself can contract with third party vendors for non-clinical services and support – allowing us to spend more time on patient care.

Dr. Jeffrey Sulitzer

Dr. Jeffrey Sulitzer

Dentists in nearly 150 practices in Washington State, serving more than 325,000 patients, have already made this choice. We are licensed professionals who are obligated by law, by regulation, and by creed to do what is best for our patients. We have chosen to contract with dental support organizations (DSOs) to handle some of the administrative burdens of supporting a practice, like I.T., equipment leasing, inventory management, office furnishings, and more. Others have chosen alternate practice models as well, including franchises and HMOs.

We enjoy spending most of our time at the office with our patients, being available to them during extended hours and weekends, and offering them modern services and convenient locations. Some of us have chosen this model to have flexible work hours, or to bypass the steep costs of opening a solo practice (dental school graduates finish school today with an average $245,000 in student loan debt).

Despite the obvious benefits to dentists and their patients, our state’s dental association has opposed the DSO-supported practice model, and prior efforts to modernize our state’s dental statute. The association should reverse course and embrace it immediately – to support the hundreds of dentists who have already chosen this model, to make our state more attractive to new dentists entering the profession, and to help resolve our dental professional shortage.

The bills being considered in Olympia – HB 2517 and SB 6275 – would:
• Prohibit a corporation from engaging in the clinical practice of dentistry;
• Permit dentists to contract with third party vendors to provide real property, furnishings, inventory, goods or nonclinical services to dentists;
• Ensure that only dentists can hire other dentists and dental hygienists in dental practices; and
• Clarify that DSOs and other models such as franchises and HMOs may continue to provide non-clinical support services in Washington, as they have done for over 30 years.

Alaska and Oregon, and many other states, have already taken a similar step. It is understandable that some dentists in Washington might worry about competition from an increasingly popular practice model – but in a state where there is a shortage of dentists to begin with, it is hardly the right time to be opposing measures that could make this a more attractive place to set up a practice. As long as the sanctity of the dentist-patient relationship is protected, as it is with these bills, everyone should be on board.