Medicare in Oral and Maxillofacial Surgery Part 2: Academic Surgeons and Cancer Surgeons Are Reimbursed Less.

PURPOSE: The purpose was to evaluate predictors of reimbursement of oral and maxillofacial surgery services in the Medicare population. MATERIALS AND METHODS: This was a cross-sectional study of Medicare Physician and Other Supplier Aggregate Data from 2015. Clinicians were included if they were confirmed to be oral and maxillofacial surgeons (OMSs) by National Provider Identifier data. The primary outcome variable of this study was the proportion reimbursed (actual payment amount divided by charge amount). Predictor variables included type of practice (private vs academic), scope (cancer vs non-cancer), number of Medicare beneficiaries seen, number of unique Current Procedural Terminology (CPT) codes billed, and total amount charged. Descriptive statistics and regression analyses were calculated, with P < .05 considered significant. RESULTS: The initial search revealed 952 providers categorized as performing maxillofacial surgery, with 894 confirmed to be OMSs (144 academic and 750 private practice). Of 894 OMSs, 39 were cancer surgeons and 855 were non-cancer surgeons. Academic OMSs saw more complex patients than OMSs in private practice (P < .0001). Academic surgeons (n = 144) charged an average of $116,876.92 to Medicare, with a mean payment amount of $22,219.62. Private practice surgeons (n = 750) submitted an average charge of $27,812.56, with average reimbursement of $9,472.76. Multiple linear regression showed that academia, cancer surgeons, number of unique CPT codes, higher Hierarchal Condition Category scores, and total submitted charge amount were negative predictors of the proportion of reimbursement. CONCLUSIONS: Roughly 10% of OMSs participate in and bill for Medicare. Factors associated with a lower reimbursement proportion include being in academia, treating head and neck cancer, billing more unique CPT codes, seeing sicker patients, and having larger total submitted charges. As third-party private insurers often follow fee schedules and rates set by the Centers for Medicare & Medicaid Services, this observed effect also should be evaluated in claims data of other insurers.

Pediatric Dentistry Academic Workforce Survey.

Purpose: The purposes of this paper were to: (1) assess the current status of the pediatric dentistry academic workforce; (2) compare current findings with a similar survey completed in 2006; and (3) explore factors influencing the faculty workforce in pediatric dentistry. Methods: In 2016, 144 pediatric dentistry faculty members completed a web-based survey regarding workforce issues. Questions were asked regarding: (1) faculty demographics; (2) academic job history; (3) academic career longevity and possible change motivators; and (4) private practice participation. Results: A slight increase in the number of female pediatric dentistry educators was noted, since 2006. The precipitous drop in pediatric dentistry educators within the first five years of their academic careers, noted in 2006, seems to have improved somewhat, with more respondents indicating that they had been in their academic careers between five and 10 years than previously. However, a concerning number of faculty vacancies remain unfilled. Conclusions: Survey results indicate that pediatric dentistry's academic workforce challenges are consistent with the well-documented national shortage of dental faculty members. The most notable changes since the 2006 survey are the slight increase in female faculty members and a possible trend toward slightly younger faculty members and slightly longer faculty retention.

Challenges in clinical teaching investigated: Towards sustainable staff recruitment and retention in dentistry.

PURPOSE: The study was conducted to identify possible factors and potential barriers that affect the retention and recruitment of clinical teaching staff at the Faculty of Dentistry, University of Otago, New Zealand. METHODOLOGY: A short questionnaire survey was distributed to 47 clinical teaching staff to understand the retention strategies and barriers. The collected quantitative and qualitative data were analysed and presented. FINDINGS: The response rate was 96%, with an equal distribution of female and male clinicians. The majority of participants were European New Zealanders. Themes influencing retention strategies were the necessity of formal teaching skills, clinical teaching as a career pathway, pay progression, lack of support and heavy workload. PRACTICAL IMPLICATIONS: Results suggested that generally the respondents to this survey were motivated to give back to their profession through engaging in dental clinical teaching. This study identified that lack of a career development and minimal pay progression are major factors impacting on the retention of clinical teaching staff.

Current State of Dental Education: Executive Summary.

This executive summary for Section 1 of the "Advancing Dental Education in the 21st Century" project provides a composite picture of information from 12 background articles on the current state of dental education in the United States. The summary includes the following topics: the current status of the dental curriculum, the implications of student debt and dental school finances, the expansion of enrollment, student diversity, pre- and postdoctoral education, safety net status of dental school clinics, and trends in faculty.

Compensation and Position Characteristics of Dental Hygiene Program Directors.

Purpose: The purpose of this study was to collect information about dental hygiene program directors (PD) in order to create a comprehensive position profile for the profession and add to the current literature regarding employment trends and compensation in dental hygiene education. Information gained through this study addresses a gap in the literature and could be utilized by current and future educators considering a dental hygiene program director role or for recruitment purposes.Methods: An electronic survey, consisting of 38 items addressing areas including job characteristics, requirements, compensation, and anticipated retirement, was sent to PDs of all the Commission on Dental Accreditation (CODA) accredited dental hygiene programs in the United States (n=314). Descriptive and inferential statistics were used to analyze the data. ANOVA analyses were used to determine whether significant differences existed regarding salary and compensation, contact hours, total working hours, contract characteristics, and job expectations.Results: Directors from 122 programs responded yielding a response rate of 39%. Seventy-one percent of respondents were aged 50-59 years and 46% reported having held the program director position for 3 years or less. Thirty-five percent of participants plan to retire from their program director position in the next five years. In regards to compensation, 47% of respondents indicated making between $60,000 and $79,999 and 3% reported earning less than $40,000 while 4% indicated salaries over $100,000. Total number of teaching years and highest degree held demonstrated a positive impact on adjusted monthly salary. PDs employed in university settings were significantly more likely to have ongoing requirements for scholarly activity; those employed in settings associated with a dental school had a longer average contract length than directors in other institutions. Potential dental hygiene PDs should expect an average workweek of 40-50 hours, with the majority of the time spent on administrative duties. Additional responsibilities include teaching, scholarly activity, and committee work.Conclusion: A position profile detailing the range of employment expectations for dental hygiene PDs has been created and can serve as a guide to inform and recruit potential program directors.