Factors Associated with the Economic Sustainability of the Registered Dental Hygienist in Alternative Practice

Sara L Coppola; Danielle Furgeson; Margherita Fontana; Janet S. Kinney; Anne E. Gwozdek

Abstract

Purpose: The purpose of this study was to investigate key factors associated with the economic sustainability of the Registered Dental Hygienist in Alternative Practice (RDHAP).

Methods: An invitation to participate in a 38-question electronic survey was sent via postal mail to 440 RDHAP licentiate addressees obtained through the Dental Hygiene Committee of California (DHCC). Legal restrictions did not allow for obtaining the RDHAP licentiate email addresses from the DHCC. The survey was disseminated via email to the 254 RDHAPs who were members of the California Dental Hygienists' Association. Additional invitations to participate were made via flyer distribution at an RDHAP symposium, and on RDHAP only social media sites.

Results: The response rate was an estimated 16%. While 44% of the RDHAPs reported some employment in a traditional dental practice, given the opportunity, 61% of these respondents indicated that they would practice exclusively as an RDHAP. With regard to practice strategic planning and alliances, 31% felt that dentists lacked knowledge of the RDHAP, and 25% indicated dentists were resistant to this workforce model. Regarding RDHAP practice staffing patterns, 75% indicated not having any employees. When asked about business systems, 64% had solo, portable practices and 16% had standalone practices. Economic sustainability challenges included practice business/equipment expenses (29%), insurance/reimbursement issues (21%), patient flow (19%) and RDHAP visibility (14%).

Conclusions: RDHAP practices face challenges including the need for strategic planning and intra- and inter-professional alliances, efficient and effective patient flow, optimal staffing patterns and effective business systems. Focus on enhancing RDHAP visibility within the dental and medical communities should be a priority. In addition, further research should explore RDHAPs aligning with community-based clinics, Federally Qualified Health Centers and Dental Support Organizations (DSOs) with a commitment to disease prevention in addition to the financial resources and staff to manage practice business systems.

Footnotes

Sara L. Coppola, RDH, RDHAP, MS, is a graduate of the Master of Science in Dental Hygiene program, University of Michigan School of Dentistry, Ann Arbor, MI, and is currently a faculty member at West Los Angeles College, Health Sciences Division, Department of Dental Hygiene, Culver City, CA.
Danielle Furgeson, RDH, MS, DHSc, is a clinical assistant professor and director of the dental hygiene graduate program, Department of Periodontics and Oral Medicine; Margherita Fontana, DDS, PhD, is a professor in the Department of Cariology, Restorative Sciences, and Endodontics; Janet S. Kinney, RDH, MS, is director of dental hygiene and a clinical associate professor in the Department of Periodontics and Oral Medicine; Anne E. Gwozdek, RDH, MA, is a retired clinical assistant professor in the Department of Periodontics and Oral Medicine; all at the University of Michigan School of Dentistry, Ann Arbor, MI.
This manuscript supports the NDHRA priority area Population level: Access to care (vulnerable populations)