The following editorial appeared in the May 2012 print edition of Carolina Journal:
North Carolina ranks 47th nationally in the number of dentists per capita, and a bill before this year’s short session of the General Assembly could make matters worse.
Senate Bill 655 would set into law restrictive regulations controlling the financing and operation of dental practices, while adding others. The backers of the bill include the North Carolina Dental Society and some current practitioners who say “corporate dentistry” (whatever that is) will drive small practices out of business. The bill passed the Senate last year and could go before the House in May.
Opponents say the bill would unravel existing dental practices operated by “dental service organizations” — businesses that resemble managed-care medical companies — and make it even tougher for patients to find dentists.
The opponents of S.B. 655 have the better argument. Bills like S.B. 655 limit competition, protect incumbent practitioners, and harm consumers, who care more about being able to see a dentist they trust than they do about who sends the bills to their insurance company.
A recent dental school graduate may need more than a license from the state’s Board of Dental Examiners to practice in North Carolina. Unless the graduate goes to work for an existing dentist, opening an independent practice can require roughly $500,000 in cash (or credit) to secure a location and the necessary equipment.
That’s where DSOs step in. These companies enter into a business partnership with a dentist; the DSO might purchase equipment, lease office space, arrange advertising, and provide back-office services such a payroll and billing. The dentist and the staff take care of patients.
An example of this, cited in a report by WRAL.com, is Kinston-based Affordable Care, which runs 182 Affordable Dentures offices in 38 states. A dentist owns each Affordable Dentures location, but as Affordable Care CEO Doug Brown told WRAL.com, “We do the accounting, the marketing, manage their payroll, provide the capital. We do the things [dentists] don’t want to do.”
Many established dentists and the state’s dental board don’t like this. They claim the DSOs can place investors’ profits over the quality of care. They also say dentists become de facto employees of the DSOs, which they say can push dentists to give better treatment to patients with insurance coverage or force them to work longer hours than they would if they “really” owned their practices.
The dental board and other regulatory agencies should prevent such shenanigans, and DSO officials who spoke to WRAL.com called those charges hogwash.
Meantime, Alliance for Access to Dental Care, a group opposing the measure, has found 31 provisions of S.B. 655 that would make regulations controlling dental management groups more restrictive in North Carolina than they are in neighboring states.
In fact, Affordable Care’s Brown said his company might stop doing business in the state if S.B. 655 or something like it became law.
State officials should remove barriers preventing entrepreneurs from providing services to consumers. By all accounts, S.B. 655 would erect unnecessary new ones.