Estimating determinants of dentist productivity: new evidence

Abstract

Objectives Productivity (output per unit of input) is a major driver of dental service capacity. This study uses 2006-2007 data to update available knowledge on dentist productivity. Methods In 2006-2007 the authors surveyed 1,604 Oregon general dentists regarding. hours worked, practice size, payment and patient mix, prices, dentist visits, and dentist characteristics. Effects of practice inputs and other independent variables on productivity were estimated by multiple regression and path analysis. Results The survey response rate was 55.2 percent. Dentists responding to the productivity-related questions were similar to dentists in the overall sampling frame and nationwide. Visits per week are significantly positively related to dentist hours worked, number of assistants, hygienists, and number of operatories. Dentist ownership status, years of experience, and % Medicaid patients are significantly positively related to practice output. The contributions of dentist chairside time and assistants to additional output are smaller for owners, but the number of additional dentist visits enabled by more hygienists is larger for owners. Conclusion As in earlier studies of dental productivity, the key determinant of dentist output is the dentist’s own chairside time. The incremental contributions of dentist time, auxiliaries, and operatories to production of dentist visits have not changed substantially over the past three decades. Future studies should focus on ultimate measures of output -- oral health -- and should develop more precise measures of the practice’s actual utilization of auxiliaries, their skill and use of technology.

Leading determinants of efficient dental care delivery

“…The latest work published by Conrad et al . is consistent with previously published work and showed that dentist productivity is influenced by dentist hours worked, number of assistants, number of operatories, number of hygienists, practice ownership, and the dentist's years of experience. Furthermore, Conrad et al .…”

“…This allowed us to construct models with excellent explanatory power and to substantiate the work by Lam et al (2), which demonstrated that the dental assistant-to-provider ratio was the most significant factor affecting a dental clinic's productivity. We achieved a better model fit than Conrad et al (10), possibly because they evaluated the outcome variable of dentist visits per week, whereas we were able to focus on a clinics' total practice output, measured in relative value units. The strength of using relative value units as an output measure is that it reflects the time and complexity of the procedures being completed.…”

“…We achieved a better model fit than Conrad et al . , possibly because they evaluated the outcome variable of dentist visits per week, whereas we were able to focus on a clinics' total practice output, measured in relative value units. The strength of using relative value units as an output measure is that it reflects the time and complexity of the procedures being completed.…”

“…Furthermore, Conrad et al . recommend that future studies include a primary outcome in terms of contribution to oral health, involve a measure of dental auxiliaries' skill level, evaluate the utilization of dental technology, and take into account the patient mix (demography and oral health). Our study addresses some of those variables.…”

“…The latest work published by Conrad et al (10) is consistent with previously published work (11,12) and showed that dentist productivity is influenced by dentist hours worked, number of assistants, number of operatories, number of hygienists, practice ownership, and the dentist's years of experience. Furthermore, Conrad et al (10) recommend that future studies include a primary outcome in terms of contribution to oral health, involve a measure of dental auxiliaries' skill level, evaluate the utilization of dental technology, and take into account the patient mix (demography and oral health). Our study addresses some of those variables.…”