Looking for the green shoots
Economic experts are forecasting dramatic improvements in the Irish economy, but is the dental economy on the up as well?
Last month, new European Commission figures predicted Ireland would become the fastest growing economy in the European Union this year.
The commission forecasted a 4.6 per cent growth in GDP for 2014 and updated its prediction of growth for 2015 to 3.6 per cent, up from 3 per cent just six months ago. But what does this mean for dentistry? Do these figures have any bearing on how dentists up and down the country are coping with the economic situation?
A mixed picture
Barry Crowley is a dentist at the Lodge Dental Practice in Togher Cross, Cork. He graduated from UCC in the midst of the recession in 2009 and spent his first year on the now defunct VT scheme.
Barry explained that, of the 12 dentists who entered the VT year in 2009, only four stayed in Ireland. The rest left to find work in the UK. “Colleagues who went abroad and are thinking of coming home are very tentative. They are always asking if things are picking up, but they are still unsure whether to make the move back,” he said.
Asked if the green shoots are being seen, he said: “The shoots can be seen some days but other days it seems this recession will never end. If I only had a Euro for every time I’ve heard someone say: ‘I’ll get them done if I win the lotto.’
“We’ve all probably gotten used to telling patients to put away a bit of money every week and we’ll see you in a few weeks for that cleaning/filling/RCT.”
Looking to the future, Barry said that he believes the reintroduction of a free scale and polish would help the profession and their patients. He said: “A lot of the public think that they don’t need to go for a checkup if they don’t have any symptoms, and they probably feel the dentist is only looking to get money out of them. At least if they get a free scale and polish they feel the benefit from their visit. It will get patients back into the practice.”
A low priority
A dentist working in general practice in Co Tippperary explained how the recession has affected his business. He said: “The economic downturn of the past few years has simply resulted in a lower volume of patients. The overall reduction in disposable income has also seen many patients treat dentistry as a luxury. When you couple this with the already low priority dentistry is generally given by the average patient, it’s a recipe for dental disasters.”
He also explained that it has affected the type of problems he is dealing with on a daily basis. “Increasingly I’m seeing patients in pain with broken restorations and teeth,” he said. “Due to the ongoing neglect through lack of attendance, the regular extraction is now becoming a surgical extraction.
“The previous amalgam replacement is becoming a precariously large restoration with the increased risk of root therapy being required. And replacement dressings seem to be the order of the day.
“The costs of running the practice have also increased. I am fearful that the new regulations expected in the Dentist Act will add further expense, which I will find almost impossible to absorb.”
Note of caution
Dr Stephen Murray, principal orthodontist at Swords Orthodontics, explained that his practice coped during the recession by staying competitive, not just on prices but in all aspects of their service. However, he is unsure as to whether the green shoots are showing just yet.
He said: “I don’t see a genuine recovery yet, but I have colleagues in other parts of the country that believe they do. Then again, I have colleagues that didn’t see a recession.
“When I do see a ‘recovery’ I wouldn’t be inclined to believe it for some time, as I don’t see a solid base for it. And what’s more, the appearance of a recovery is likely to lead to increased operating costs in terms of rent, salaries, loan payments and utilities – all of which have a habit of being a lot slower to go down compared to their ability to increase.
“So an unsustained recovery could be more harmful than prolonged recession – more so if a dentist starts getting into more debt to enhance their practice, domestic life, or property portfolio.”
Dentist from Co. Dublin
“Irish dentistry was ripe for a crash to be honest. A fair number of practices closed their doors – mainly the older practitioner working on his own and who really had not kept up to date.
“Those practices that have survived the economic crash are much leaner, much more progressive, are selling their services better and have reduced their fees by something in the region of 30 per cent. In some cases they have reduced them by 40 per cent but these practice prices were ridiculously high in the first place.
“I think prices have now stabilised though, value for money is still crucially important and the communication between patient and dentist has dramatically improved, and not before time. The days of people just opening up a cheque book and not considering the numbers are over and done with. All expenditure is carefully considered these days.”