Navigating Career Decisions in Dental Service Organizations: Practical Advice for Students, Residents, and Educators.

The dental practice market continues to experience unprecedented changes, including the increasing presence and influence of dental service organizations (DSOs)-corporate entities that provide support and practice management for group practices in such areas as financial operations, human resources, marketing, and legal services. At the same time, increasing percentages of new dental graduates are choosing to pursue an initial career path in corporate dental practices. As a result, new graduates and others making a transition into private practice are likely to encounter complicated, multifaceted variables related to associateship opportunities. Experts in dental education are articulating a need for more instruction in practice management, particularly related to DSOs. Accordingly, this Perspectives article discusses issues in five broad categories focused on vetting career decisions in DSOs: business systems; the dental team and patients; clinical dentistry; compensation and professional development; and ownership positions. In addition to explaining the importance of these areas, the authors provide specific questions prospective associates should ask in considering these career options. These considerations should be useful for students and specialists who are preparing for their dental careers and for the educators who help to guide them.

Prerequisites in behavioral science and business: opportunities for dental education.

There is increasing pressure on recent dental school graduates to understand and successfully utilize patient management and business management strategies to run a productive dental office. Dental schools are faced with the dilemma to either add more credit hours in their already crowded curriculum or adjust predental school requirements. All fifty-nine U.S. dental schools were assessed online to determine admission requirements in the areas of behavioral science and business education. Results show that only 11.9 percent of the schools require prerequisite course work in behavioral science and no school requires prerequisite course work in business. However, 64.4 percent and 30.5 percent of schools encouraged or recommended prerequisite course work in behavioral science and business, respectively. We suggest that the dental education community involve key stakeholders to discuss the incorporation of prerequisite course work in behavioral science and business. Additional courses in these disciplines would provide dental students better backgrounds from which the dental curriculum could build a more advanced and applied perspective to better prepare students for practice.

Impact of drug abuse/dependence on dentists.

Drug abuse and dependence are important and complex health problems, and understanding these issues is important for dental patient management. At the same time, dentists, like their patients, could abuse alcohol and other illicit drugs, which would jeopardize their ability to provide optimum dental care. This article reviews important aspects of drug abuse and dependence, risk factors for dentists, the impact of drug abuse on the dental profession, and various treatment options.

Oral health outcomes in an adult dental population: the impact of payment systems.

This study compared the effect of payment systems on recall visits and oral health outcomes for four patient payer groups. The authors reviewed recall audit data obtained over a 4-year period. Dental payer groups in the study population differed with respect to dental outcomes. Patients who had recall visits at 1 year or longer had worse outcomes than patients seen more frequently. A Medicaid subgroup with the greatest number of risk factors displayed improved oral health outcomes when seen on a more frequent recall schedule. Study findings suggest that, given the increased risks to maintaining oral health, patients being supported by public-funded programs would benefit from more frequent recalls. Such an emphasis would appear to provide the opportunity to improve outcomes in disadvantaged populations and increase the quality of care offered.

Strategic management and organizational behavior in dental education: reflections on key issues in an environment of change.

With issues such as shrinking revenue, access to care, faculty workloads, and graying faculty, dental schools are faced with difficult challenges that fall to dental school deans to manage. Do dental school deans have the organizational skill sets and ethical frameworks necessary to address the challenges now facing dental schools? The purpose of this article is to pose questions and suggestions regarding some of the key issues in dental colleges today and to stimulate discussion in the dental community about needed changes in dental education.

The state of the art in evaluating the performance of assistant and associate deans as seen by deans and assistant and associate deans.

This study explores the little-understood process of evaluating the performance of assistant and associate deans at dental colleges in the United States and Canada. Specifically, this research aimed to identify the methods, processes, and outcomes related to the performance appraisals of assistant/associate deans. Both deans and assistant/associate deans were surveyed. Forty-four of sixty-six deans (66.7 percent) and 227 of 315 assistant/associate deans (72.1 percent) completed surveys with both close-ended and open-ended questions. In addition, ten individuals from each group were interviewed. Results indicate that 75-89 percent of assistant/associate deans are formally evaluated, although as many as 27 percent may lack formal job descriptions. Some recommended best practices for performance appraisal are being used in a majority of colleges. Examples of these best practices are having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for assistant/associate deans. Still, there is much room to improve appraisals by incorporating other recommended practices. Relatively high levels of overall satisfaction were reported by both assistant/associate deans and deans for the process and outcomes of appraisals. Assistant/associate deans rated the value of appraisals to overall development lower than did deans. Qualitative data revealed definite opinions about what constitutes effective and ineffective appraisals, including the use of goal-setting, timeliness, and necessary commitment. Several critical issues related to the results are discussed: differences in perspectives on performance reviews, the importance of informal feedback and job descriptions, the influence of an assistant/associate deans' lack of tenure, and the length of service of deans. Lastly, recommendations for enhancing performance evaluations are offered.

The state of the art in evaluating the performance of department chairs and division heads.

This study explores the little understood process of evaluating the performance of department chairs/division heads in dental schools. Specifically, this research aimed to elucidate the methods, processes, and outcomes related to the job performance of department chairs/division heads. Forty-three deans and 306 chairs completed surveys with both close-ended and open-ended questions. In addition, ten deans and ten chairs were interviewed. Results indicate that 80 to 90 percent of department chairs are formally evaluated, although as many as 50 percent may lack job descriptions. Recommended best practices for performance appraisal--such as having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for chairs--are being used in most schools. Still, there is much room to improve appraisals by incorporating other recommended practices. Overall high levels of satisfaction were reported by both chairs and deans for the process and outcomes of appraisals. Qualitative data showed some convergence of opinions about appraisals with the notable exception of informal feedback. We explore some implications of these results, especially as they relate to improving performance appraisals.

A survey of endodontic residents' attitudes about a career in dental education.

There is an increasing demand for qualified educators throughout American dental schools. A survey designed to identify reasons for interest or lack of interest in education as a career was sent to all first and second year endodontic residents enrolled in the United States in 1999. Seventy-four percent of the 392 students responded (224 men and 65 women). The survey results were analyzed using descriptive statistics and Chi-square tests. Ninety-three percent of the respondents reported an interest in teaching on a part time basis, and of those, 51% were willing to teach 1.5 days/week, but only 16% were willing to teach more than 1.5 days/week. The survey included a list of eight potential reasons for not being interested in a career in education and respondents were asked to mark their top three. Low salaries for teachers was the most frequently chosen reason (70%), 51% listed educational debt, and 31% listed desire to be their own boss or lack of interest in research. Students were also asked to choose the top three reasons for interest in dental education from a list of seven reasons. Enjoyment of clinical teaching was the most frequently selected reason (41%): 32% included enjoying working with others in the field and 24% listed enjoyment of the university atmosphere.