In my presentations to dental societies in the U.S. and abroad, when I discuss the imminent changes in the future of dentistry — such as dental therapists, massive infusions of investment capital, AI, blockchain, robotics, and other future changes, there is invariably a heated response. “Only a dentist can do diagnosis and treatment planning. Only a dentist can deliver dental care!”
Dentists are behaving like Luddites. In fact, dentists are the top Luddites in the healthcare industry.
A Luddite is a term used (usually pejoratively) to describe people who oppose the introduction of new technology. The idea that new technology leads to job losses has persisted and is deeply embedded in the nearly all business cultures, despite the fact that economists are almost universally united in stating that new technology will not increase the long-term unemployment rate. It’s been shown over and over by many economists that new technology does not, in fact, cause unemployment.
Jobs Lost, Jobs Gained
Sure, rapid technological change may cause some short-term temporary unemployment or changes in job duties. However, economic theory suggests that jobs lost or changed, as a result of technological change, will be created in different and new industries or in different ways.
According to economists and business pundits, if workers are threatened with job losses or job changes as a result of new technology, the solution is not to stop technological change, but to overcome the failure in removing labor market inflexibilities. The solution is education and retraining to help the unemployed or under-employed to find new or different jobs.
What I see is the major shift for dentists is moving from solo care delivery to team care delivery. Dentists will be captains of the dental-care team, while management, HR and administrative functions will move to a resource center.
Dentists will also be part of a multi-disciplinary team, much more integrated with medicine (physicians, hospitals, urgent care centers, pharmacy). The dentists’ responsibility as part of a multi-disciplinary team is the team will be graded on chronic disease management. The team will be measured and paid based on health outcomes.
A Shift in Dentistry
A new world awaits dentists and it is coming fast.
The future cannot be stopped. It doesn’t care about job security, threats to income, alterations in clinical care delivery, or type of practice required to deliver new technologies and collaborative care. The future doesn’t care that dentists are anchored to what they already have and don’t want it to change.
Dentists have been enjoying a monopoly in dentistry. They have been the monarchs of dentistry, ruling over how dental care is chosen and delivered. But the future in dentistry is impervious to cries and exclamations, to resistance, to the fighting that dentists engage in to preserve their unquestioned position in dentistry.
Until this time, the only real technology breakthroughs have been in patient administration and more sophisticated gear in the operatory. But the dentist has remained independent, mostly isolated, making all the clinical and management decisions. Most of that will come to pass.
AI will diagnose and treatment plan. Blockchain will eliminate the whole preauthorization and claims process. Midlevel providers and dental therapists will open the floodgates for treatment for people who previously did not have access, forcing prices downward for dentistry. The infusion of venture capital will press harder for greater consolidation. DSOs will continue to grow exponentially. Solo practice will continue to shrink in numbers. Robot-assisted surgeries will place implants faster and cheaper, with better results. Dentists will be required to work jointly with medicine.
And what are dentists doing to prepare for this future? What are dentists doing to redesign themselves to succeed in an industry dominated by technology and multi-disciplinary teams? What are dentists doing to learn how to collaboratively with medical doctors and hospitals?
Looking to the Future
I suggest what dentists and their political and professional organizations consider is first how to shift the mindset of what it means to be a dentist. When you have such a longstanding history and structure, the momentum of the past carries a lot of weight. But when you look at the impact of technology and medicine, and how it will powerfully change the market and the entire healthcare industry, it is clearly adapt or perish.
My recommendation is dentists should stop being Luddites and become creative thinkers about who they need to be in the future to succeed. As A.N. Turner wrote in his book Breaking the Feedback Loop, “You must change your life.” Dentists, I believe, should heed his advice. Dentists have to understand the world we live in and how our relationships are being totally reshaped by the digital age and the demand for collaboration.
For the incoming and younger dentists, this will not be a large gap to close. But for those dentists with 10 to 20 years remaining in their practice careers, the technology and the collaborative gap will be wide and deep. In my view, dentists and their dental organizations need to transform — transform what it means to be a dentist and what dentists do.
Transformation is being able to think and act beyond your past and your given identity. It would take dentists fully appreciating what the future holds. It would take dentists learning how to work as partners, as part of a healthcare team. That is a tall order, especially for dentists.