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Professional Courtesy: Don’t Worry, Do Dentistry by Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

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by Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

Dentists are worrywarts by nature. Every mouth that opens may contain a problem that we cannot fix, or at the very least, something that will cause our neck to hurt. I think it starts in dental school when we are worried about our grades, clinical skills, clinical requirements and the list continues. Once we graduate from dental school, we worry about where to work, when to start a practice and worst of all: was dentistry the right choice?

Here are a few big issues that often get more attention than they deserve:

Dental Health Aid Therapists

This strange title is often described as the dental version of a physician’s assistant in medicine. The threat that worries many dentists is the fear that these DHAT will invade the suburbs and do our work for half the fee. If you live in an area where your patients lack basic appreciation for your care, skill and judgment, it’s time to pack the house and move. The DHAT are a cross between a hygienist and a really smart dental assistant; their geographical target is anyplace where a dentist is unwilling to practice. Their socioeconomic target is a population of patients that are uninsured, receiving some form of Medicaid or too poor to afford routine care. If DHAT are keeping you up at night, consider a move to Alaska or start accepting your state’s version of Medicaid.

Independent Hygiene

This is a concept that never really got off the ground, in my opinion, and yet I have seen dentists wring their hands over the possibility of a hygienist opening their own office down the proverbial street. I say, go ahead. First, if I extracted the hygiene portion of my practice and tried to make it a business, it would be very tough. The overhead could be very low as in some of the independent practices in Colorado, but the uncertainty and marketing requirements would be a big hill to climb when generations of patients have been raised on the one-stop shopping model of dentistry.

Second, dentists worry that without hygiene their practices will suffer financially, but I’m here to say that your general dentistry practice would immediately become a specialist office. Your overhead would be lower with fewer employees and your time would be 100 percent focused on the procedures that currently pay your bills. Just because the hygienist moved down the street doesn’t mean the patients will stop getting cavities, cracked teeth and tooth loss from periodontal disease.

Corporate Dentistry

I think this worry exists for many dentists because they believe that so-called corporate dentistry is something new. They worry that one day there will be a dental office next to the McDonald’s on every corner in America. That’s already a reality where I live in Arizona but not worry worthy in my opinion. I would recommend that you read: Painless Parker: A Dental Renegade’s Fight to Make Advertising “Ethical” by Arden G. Christen and Peter M. Pronych, or at least read my column in the November 2013 issue of Dentaltown Magazine to understand why corporate dentistry is nearly as old as our profession. I believe the difference today is two-fold: you have big money that is moving the business of dentistry from cottage industry to Wall Street, and new graduates with such crushing levels of debt that they can’t afford to finance a practice purchase right out of school. Rest assured, you can be competitive because dentistry is a local service and you are not constrained by a massive group of middle management that must be paid but cannot produce dentistry. Corporate dentistry and mega-group practices will not disappear. It is simply a different business model.

If any of these issues have been getting under your skin, I sincerely hope you will sleep better tonight knowing that you are still a very valuable member of society. On the other hand, if you vehemently disagree with any of my opinions, please share your comments online. After all, discussion and debate are our goals. You can follow me on Twitter: @ddsTom.

Dentaltown Magazine
September 2025
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