Economic and management considerations in the practice of team dentistry

In dentistry the accelerating pace of change is clear to all. Today's graduates accept the fact that equipment, facilities, materials, and work methods are undergoing constant development and improvement. They are aware of changing trends in methods of practice. They anticipate the possibility of larger, more complex private group practices or HMO's, providing economies of scale and greater opportunities for specialization. Several factors indicate the latter trend. In the coming years, government health programs may make routine dental care available to, and able to be demanded by, many more patients. Even without increased demand for his services, the dentist will want to utilize his time more effectively and/or efficiently. Courses are being offered in dental schools that emphasize the virtues and the values of group practice as opposed to 'solo' practice. Students are being taught to work with expanded duty dental auxiliaries (EDDA) in addition to the more traditional dental assistants, hygienists, etc. The typical solo practitioner of the future will employ a sizeable team of workers of various skills; certainly group practices will require a large supporting staff. As the size and complexity of a practice increase, management problems become more significant and more difficult. The Case Western Reserve School of Dentistry is engaged in a U.S. Public Health program of training EDDA's and teaching dental students to work with them. Organizational problems that arose, specifically in the scheduling of patients, dental students, and EDDA's in the clinic led to the formation of a collaborative team of investigators from the School of Dentistry and the Department of Operations Research in the CWRU School of Management. The authors point out some areas of modern dentistry, the growing complexity of which requires managerial assistance of the type that Operations Research can provide.