1968 survey of dental practice. IV. Professional expenses
B ureau o f Eco nom ic R esearch and S ta tis tic s
In 1967 the mean professional expenses of non salaried dentists in the United States were $21,65 1, an increase of 31.1% over the preceding three years. This indicates a steeper increase in the trend of rising professional expenses than occurred dur ing the previous three-year period. In 1961 pro fessional expenses were rising less than 5% a year; by 1964 the annual rate of increase was less than 8 %; however, in 1967 expenses were rising at the rate of slightly more than 1 0 % a year.
Major ex p en se categories The four leading expense categories accounted for nearly 78% of total expenses in 1967. As shown in Table 18, they are: Salaries including com-
missions (30.2% of total expenses); Commercial dental laboratory charges (22.3%); Office rent and utilities (12.9% ); and Dental supplies, drugs, and so on (12.4%). As a percentage of total expenses these four items were not significantly higher in 1967 than in recent surveys, but salaries and com mercial dental laboratory charges constituted an increased share of total expenses while the last two items showed slight declines in their percentage relative to total expenses. It is recognized that the steady increase in average gross income has com pensated for the overall 31.1% rise in average pro fessional expenses that occurred between 1964 and 1967. As an illustration of relative trends among ex pense items, there was a 40.3% increase in mean salaries paid ($6,534 in 1967 compared with $4,658 in 1964). This substantial average gain is the result of two factors: more employees per dentist and higher salaries per employee. Regionally, mean salaries paid to employees ranged from $5,172 in the Northwest to $8,851 in the Far West.
Table 18 ■ Mean professional expenses of nonsalaried dentists by region, 1967.
New Middle South South Item England East east west Central Office rent and utilities $2,244 $2,568 $2,724 $2,881 $2,582 Salaries (including commis sions) 6,376 5,713 6,510 6,136 5,653 Fringe benefits (not in 135 cluded in salaries) 229 215 229 219 Insurance related todental practice 371 319 314 327 299 Depreciation on dental and office equipment 1,033 1,247 1,445 1,136 1,051 Travel to dental meetings, society dues, journals, 641 license fees, and soon 410 438 664 605 Commercial dental laboratory charges 3,887 4,728 4,870 4,271 4,512 Dental supplies, drugs, and soon ( not equipment or office supplies) 2,242 2,647 2,181 2,818 2,759 All other overhead (laundry, office supplies, postage, collection expense, office maintenance, and soon) 2,503 2,066 2,304 2,234 2,123 19,162 19,392 21,420 20,933 19,952 Total
% of % of total gross expenses income 12.9 6.0 30.2 14.1 1.2 0.5 1.7 0.8 5.5 2.6
North west $2,069 5,172 189 305 871
Far West $3,462 8,851 482 478 1,381
United States $2,791 6,534 252 369 1,201
608 3,423
753 5,550
608 4,830
2.8 22.3
1.3 10.4
2,550
3,006
2,686
12.4
5.8
2,214 17,401
3,001 26,964
2,380 21,651
11.0 100.0
5.1 46.6 1043
'
Table 19 ■ Professional expenses of nonsalaried dentists in 1967 as a percentage of total expenses and as a per centage of gross income, by region. M iddle East
New England
Item O ffice ren t and utilities S a la rie s (in clu d in g com m issio ns) Frin g e benefits (n o t in clud ed in sa larie s ) In su ra n c e related to d ental practice D epreciatio n on dental and office equipm ent T rave l to d ental meetings, society du es, journals, licen se fees, and so on C o m m ercial dental lab o rato ry ch arg es D ental sup plies, drugs, and s o o n (no t equipm ent or office su p p lie s) All o ther o verh ea d (la u n d ry , office supplies, postage, collection expense, office m ain tenance, and so o n ) Total
% of ex penses
% of g ross incom e
1 1.7
5.3
13.2
3 3 .3
1 5.2
1.2
0 .5
1.5 5.4
% of % of ex gross penses income
So u th w e st
So utheast
Northw est
Central
% of ex penses
% of gross incom e
5.8
12.7
6 .0
1 3 .8
6 .6
13.0
5 .8
2 9.5
12.9
3 0.4
14.3
2 9 .3
14.0
2 8.3
1.1
0 .5
0 .6
0 .3
1.1
0.5
1.1
0.7
1.9
0 .8
1.5
0.7
1.5
0.7
1.6
2.5
5.4
2 .4
5.8
2.7
6 .9
3.3
5.7
% of % of % of ex gross ex penses •income p enses
2.1
1.0
2.3
1.0
3.1
1.5
2.9
1.4
3.2
2 0.3
9 .2
2 4.4
10.7
22.7
10.7
2 0 .4
9 .8
22.6
11.4
5 .2
11.6
5.1
12.4
5.8
13.4
6 .4
13.1
6 .0
10.6
4 .7
10.8
5.1
10.7
100 .0
4 5 .6
1 00 .0
4 3 .9
100 .0
4 7.1
100 .0
Commercial dental laboratory charges increased 39.2%, from $3,469 in 1964 to $4,830 in 1967. Regionally, these expenses ranged from 19.7% of total expenses in the Northwest to 24.4% in the Middle East.
% of % of gross ex income p enses
% of ex penses
% of gross incom e
11.9
5 .3
1 2.8
6 .3
12.7
29.7
13.3
3 2 .8
16.1
0 .5
1.1
0 .5
1.8
0 .9
0.7
1.8
0 .8
1.8
0.9
2.6
5.0
2 .2
5.1
2.5
1.4
3.5
1.6
2.8
1.4
10.1
19.7
8.8
2 0.6
10.1
13.8
6 .2
14.6
6 .5
11.2
5.5
5.1
10.7
4 .8
12.7
5.7
11.1
5.5
4 7 .8
1 0 0 .0
4 4 .8
100 .0
4 4 .7 " 100 .0
4 9 .2
.
professional expenses have remained in the neigh borhood of 45.0 to 45.6% of gross income. In 1967 this ratio was slightly higher. The 1967 profession al expenses of self-employed dentists were 46.6% of gross income nationally (Table 18). Regionally, expenses as a percentage of gross income ranged from 43.9% in the Middle East to 49.2% in the Far West (Table 19). The four leading expense categories totaled 36.3% of gross income. The Central region had the lowest ratio of mean salaries to gross income (12.7%) and the Far West was highest (16.1%). Mean commercial dental laboratory charges ranged from 8.8% of gross income (Northwest) to
Expenses in relation to gross income While expenses have been steadily rising, the data indicate a comparative stability in the relation ship between costs and gross income. In the pre vious three surveys taken in the past ten years,
Table 20 ■ Percentage distribution of nonsalaried dentists according to percentage of 1966 gross charges uncollected, by region. % un collected 0 1 2 3 4 5 6 7 8 9 10 11-15 16-20 21-25 26Total M edian
1044 ■ JADA, Vol. 78, May 1969
Far W est
% of gross incom e
New England
M iddle East
So uth east
So u th west
6 .3 18.1 23.8 6.9 3 .8 15.0 1.2 1.9 2.5 0 .6 11.2 3.8 3.1 0 .6 1.2
10.8 3 2 .4 19.9 7.0 3.7 13.9 0.7 0 .7 1.0 0 .6 5.7 2 .0 0.7 0 .6 0.3
3.9 17.0 17.3 9.9 5.8 15.5 3.1 2.6 4.2 0.8 11.3 4.2 3.1 0.0 1.3
9 .5 13.1 14.6 10.9 6.6 2 1 .2 2.9 0.7 5.1 0 .0 6.6 4 .4 0.7 1.5 2.2
10.0 2 3.4 16.7 12.3 6.0 14.6 2.5 1.6 2.3 0 .4 6.6 1.5 1.2 0 .6 0 .3
100 .0
100.0
100.0
100.0
100.0
2.8
1.9
3 .8
3.8
2.0
C en tral
N o rth west
Far W est
U nited States
7.7 16.4 19.0 9.0 6.3 18.0 2.4 1.6 3.2 0 .5 9 .8 2.6 1.9 1.1 0 .5
8.7 2 2.6 18.6 9 .4 5.4 15.4 2.1 1.5 2 .6 0.5 7.8 2.5 1.6 0.6 0.7
100.0
1 00 .0
100 .0
2.7
3.3
2.5
9.4 15.7 , 23.6 8.7 7.9 13.4 4.7 1.6 3.9 0 .0 6.3 1.6 1.6 0.0 1.6
Table 21 ■ Percentage distribution of nonsalaried den tists buying dental equipment in 1967, according to amount spent. % of dentists
A m ount spent $
200— 400 — 600— 800 — 1,0 00 — 1,2 00 — 1 ,4 00 — 1 ,6 00 — 1 ,8 00 — 2 ,0 0 0 — 3 ,0 0 0 4 ,0 0 0 — 5 ,0 0 0 6 ,0 0 0 — 7 ,0 0 0 — 8 ,0 0 0 — 9 ,0 0 0 — 1 0 ,0 0 0 -
2.5 9.9 13.2 6.8 7.8 8.7 4.1 4.4 1.4 1.4 9.4 5.9 3.6 4.6 3.6 2.1 2.7 1.2 6.7
199 3 99 599 799 9 99 1,1 99 1,399 1,5 99 1,799 1,999 2 ,9 99 3 ,9 99 4 ,9 9 9 5 ,9 99 6 ,9 9 9 7 ,9 99 8 ,9 9 9 9 ,9 99
100 .0
Total
■ Percentage of nonsalaried dentists who purchased dental equipment in 1967, and the mean cost of equipment purchased by ail nonsalaried den tists, by region.
Table 22
Region
_______ M ean expenditures New Used Total
% buying eq uipm ent
New England M iddle East So utheast Southw est C en tral N orthw est Far W e st
51.1 4 7 .8 4 8.6 51.1 52.0 5 4.7 51.1
$ 1 ,4 3 4 2 ,0 97 1,4 60 1 ,4 74 1,301 1,129 1,679
$170 93 102 143 129 219 89
$ 1 ,6 0 4 1 ,1 90 1,5 62 1,6 17 1,4 30 1,3 48 1 ,7 68
United States
5 0.3
1,3 39
118
1 ,457
Table 23
■ Percentage of nonsalaried dentists who purchased dental equipment in 1967, and the mean cost of equipm ent purchased by all nonsalaried dentists, by age.
Age
% buying equipm ent
M ean cost of equipm ent
- 29 30 — 34 35-39 4 0 — 44 45 — 49 50 — 54 55 — 59 60-64 65-69 70 - 74 75 -
7 1.8 60.6 54.0 5 2.6 5 2.5 4 3 .6 4 0.2 3 3.3 2 3.7 2 5.0 3 0.8
$ 4 ,0 4 0 2 ,1 33 1,454 1 ,4 99 1,634 8 75 8 64 403 155 250 423
All ages
50.3
1,457
10.7% (Middle East and Southeast). Office rent and utilities averaged 6.0% of gross income nation ally. Close behind, averaging 5.8%, were dental supplies, drugs, and so on. Regional variation in
both of these categories was less than 1% of gross income above or below the national average. It is estimated that nonsalaried dentists paid $385 million to commercial dental laboratories — 10.4% of their total gross income of $3.7 billion. The estimate for dental supplies and drugs is $215 million. For “insurance related to dental practice,” dentists paid about $30 million.
Uncollected gross charges Nonsalaried dentists were asked to record the per centage of their 1966 gross charges uncollected at the time the questionnaire was completed in May 1968. It was assumed that this figure would be a close approximation to the percentage of charges uncollectible. The median percentage of 1966 gross charges remaining uncollected, both nationally and by region, was approximately the same as the corre sponding figures reported three years earlier. As shown in Table 20, the national average was 2.5% , and the variation by region was from 1.9% (Middle East) to 3.8% (Southeast and Southwest). There was a small increase in the percentage of dentists who could not collect 10% or more of their gross receipts. The Middle East region had the most favorable collection experience in this category, while New England and the Southeast ranked highest in percent of dentists reporting un collected receipts of 10% and more.
Purchase of equipment Approximately half of the dentists in the survey purchased equipment in 1967. Table 21 shows the percentage distribution of dentists who pur chased equipment according to the amount spent. In Tables 22 and 23 the means shown are based on all dentists replying to the question, including those who did not buy equipment. The national average expenditure when all nonsalaried dentists are included was $1,467. Nearly all equipment (92.5% on the average) was purchased new. The mean expenditure for those who purchased equipment may be obtained by dividing the fig ures in the right hand columns (Tables 22 and 23) by the percent buying equipment, and moving the decimal point of the quotient two places to the right. Thus, the mean equipment expenditure for dentists buying equipment was $2,897. REPORTS OF COUNCILS AND BUREAUS ■ 1045