Where Do Pediatric Dental Residents Intend to Practice? Exploring the Influence of Loan Repayment Programs and Other Factors

Abstract

The high cost of dental education and consequent loan burdens contribute to the shortage of pediatric dental providers in rural areas (RAs). Economic incentives are meant to recruit practitioners to RAs. The aim of this study was to assess the ability of government subsidized loan repayment programs (GSLRPs) to recruit pediatric specialists to practice in RAs. A 26‐item questionnaire was emailed to all 921 pediatric dental residents across the U.S. in 2015 for a cross‐sectional study of factors influencing their choice of practice location. The instrument included information about GSLRPs, enabling the study to serve as a quasi‐experiment on the level of funding needed to make GSLRPs effective. A total of 169 residents responded, for an 18% response rate; 74% of respondents were women and 86% had student loan debt. Among the respondents, 40.6% said they would like to practice in RAs, but only 4.1% actually intended to do so. Over one‐third initially reported interest in GSLRPs for practicing in RAs. However, after being informed that the average GSLRP is $30,000 annually, one‐third of those lost interest. Although 14.2% said no amount would convince them to consider practice in an RA, over half (53.3%) indicated willingness to consider it if the GSLRP were $40,000‐$60,000. These results suggest that current GSLRP levels are insufficient to induce pediatric dentists to practice in RAs.

How Phantom Networks, Provider Qualities, and Poverty Sway Medicaid Dental Care Access: A Geospatial Analysis of Manhattan

“…The literature on location decisions in the medical marketplace supports the notion that physicians and dentists generally choose to establish their practices in more affluent areas [ 105 , 106 , 107 , 108 , 109 , 110 ]. This location behavior may serve to attract private patients to offset the low reimbursement rates of Medicaid [ 28 ], hence counterbalancing costly student loan debt [ 111 , 112 ]. Location decisions may be financially motivated rather than needs-based, thus leading to an inequitable distribution of health providers.…”

Longitudinal assessment of a Dental and Medical Student Service program in Appalachia: Successes and lessons learned

“…17 The amount of funding provided to dental recipients ($50,000) may also contribute to the increased interest in rural practice, falling within the range observed as appealing in previously published work. 6 Future program evaluation that matches samples of applicants and awardees may delineate the influence of actual and perceived rural background, rurality of rotation site location, and program participation, including scholarship amount, on retention of dental providers in the state.…”

“…In a study examining pediatric dental residents, researchers concluded that provision of service scholarships of at least $40,000-$60,000 are likely needed for effective recruitment of pediatric dental residents to rural locations. 6 In Georgia, it was found that a medical scholarship's effect on recruitment and retention in rural locations increased when the repayment amount was increased to three times the amount of the original scholarship in lieu of completing the service obligation, and information about and applications for the scholarship were presented during a medical job fair. 7 Service scholarships were found to be important for provider community choice and possible retention in the community.…”