Currently, many healthcare analysts predict a shortage of doctors in California, fueled by an influx of patients from enrollment in the Affordable Care Act. On March 26, the UCLA Center for Health Policy Research released a report that California is currently impacted by a shortage of dentists that is expected to worsen.
The report notes that in 2012 in California, an increase in the number of dentists occurred and the state boasts more licensed dentists (35,000 plus) than any other state; however, the number of those licensed to practice in California who opted to reside or work out of state increased by 6% between 2008 and 2012. The reason more new dentists are opting to practice out of state is likely due to a lingering recession, the elimination of Medicaid (MediCal) dental reimbursements and a preponderance of established dentists in wealthier, populated areas. “Good access to dental care depends on having a robust supply of new dentists in California,” explained study author Nadereh Pourat, PhD, director of research at the UCLA center. She added, “We need a new generation of dentists to replace the many dentists who are close to retirement.”
The report notes that the out-of-state migration is primarily occurring among new dentists. In 2012, 86% of those licensed within the previous five years practiced in the state, marking a 10% decrease from 2008. Furthermore, new dentists in 2012 comprised a smaller share of California’s overall supply. Just as more women are entering the dental field, more are embarking on a dental career. The report notes that in 2012 women comprised almost 50% of all newly licensed dentists in California. Another factor impacting the supply of dentists is age. Almost 25% of actively licensed dentists in California have been practicing for 30 years or more; thus, they are close to retirement age. Northern and Sierra counties had the highest proportion of dentists nearing retirement: 40%.
Another trend noted by the report is that more new dentists are specializing rather than practicing general dentistry. Thus, it may be harder to obtain basic dental care than treatment for periodontal (gum) disease. Overall, in 2012, 13% of newly licensed and actively practicing dentists in California noted that they were specialists, marking a 6% increase since 2008.
Of all regions, the San Joaquin Valley accrued the highest percentage of new dentists; they represent 15% of the total dentist population. Despite patients in the San Joaquin Valley having the highest percentage of newly licensed dentists, they still have the lowest ratio of dentists to patients in the state: with 2.4 dentists for every 5,000 individuals. In contrast, Greater Bay Area residents enjoy the highest dentist-to-patient ratio: 5.1 per 5,000. The state average is 3.9 per 5,000. “There is a lopsided distribution of dentists,” Dr. Pourat explained, “They cluster in areas like San Francisco and Southern California, but don’t settle in rural and underserved areas. Many areas of the state don’t have enough dentists.”
The report notes that economic conditions in California are likely to improve; however, it is extremely important to motivate new dentists to practice in underserved areas such as the San Joaquin Valley and the Northern and Sierra counties. In addition is recommends that options such as assistance with dental school loan repayment, small business loans, and higher Medicaid reimbursement rates be considered. These moves would provide incentives for dentists to practice in the state.