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SOLO GENERAL PRACTITIONERS AND SPECIALISTS
TRENDS
SOLO GENERAL PRACTITIONERS AND SPECIALISTS L. JACKSON BROWN, D.D.S., PH.D.; VICKIE LAZAR, M.A., M.S.
A
B
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R
A
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A solo practitioner is the sole owner of and the only dentist in a dental practice and also is the most common type of dental practitioner in the United States. The authors provide a brief look at solo general practitioners’ and specialists’ characteristics, including employment status, number of employees, time spent in the office, number of patient visits per week, gross billings, net income and practice expenses.
The ADA’s Survey Center conducts an annual, random survey of
about 5 percent of U.S. dentists in private practice. The results are published annually in a series of documents titled “Survey of Dental Practice,” which is a comprehensive source of information for practice characteristics. Results from the “Survey of Dental Practice” for the years 1990 through 1995 show that more than 90 percent of private practitioners own their practices, which are either sole proprietorships or partnerships. About 70 percent of private practitioners are solo practitioners. Although the number of private practitioners in the United States rose 27.1 percent between 1982 and 1995, from 116,208 to 141,396,1 the percentage of solo practices has remained fairly constant, near 70 percent. Solo dentists do not typically practice alone in their offices. In 1995, they employed an average 4.7 full- or part-time nondentist staff members. The average age of solo dentists is 48 years, which is 2.5 years older than dentists who practice in nonsolo practices. Solo dentists spent an average of 37.3 hours per week in their dental offices in 1995 and an average of 33.5 of those hours treating patients. Nonsolo dentists spend an average of 36.5 hours per week in their dental offices and an average of 32.9 of those hours treating patients. Solo dentists reported an average of 62.0 patient visits per week in 1995, not counting visits to the dental hygienist, while nonsolo dentists reported an average of 60.8 patient visits per week. The following brief overview of solo general practitioners and specialists was written using data gathered from the “Survey of Dental Practice” for the years 1990 through 1995; 1995 is the most recent year for which data are available. CHARACTERISTICS OF SOLO GENERAL PRACTITIONERS
In 1995, 70.5 percent of general practitioners in private practice were solo dentists. Solo general practitioners who responded to the 1995 “Survey of Dental Practice” were an average of 48 years old. Male solo general practitioners who responded to the survey were an average of 48.5 years old, while female solo general practitioners were an average of 40.6 years old. JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
1155
TRENDS
80 72.3
71.5
70.7
72.0
71.2
67.0
PERCENTAGE
70 60 50 40
33.0 27.7
30
29.3
28.8
28.5
28.0
20 10 0
1990
1991
1992
1993
1994
1995
YEAR Unincorporated
Incorporated
AVERAGE NUMBER OF PATIENT VISITS PER WEEK
Figure 1. Employment status of solo general practitioners, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
80 70 60
55.8
56.2
55.1
55.8
54.7
55.3
1990
1991
1992
1993
1994
1995
50 40 30 20 10 0
YEAR
Figure 2. Average number of patient visits per week, excluding dental hygienist visits, for solo general practitioners, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
Employment status. As shown in Figure 1, most solo general practitioners were in unincorporated practices during the period of 1990 through 1995. The percentage of solo general practitioners in unincorporated practices dropped 1156
from a steady 70.7 to 72.3 percent in the period of 1990 through 1994 to 67.0 percent in 1995. The percentage of solo general practitioners in incorporated practices rose from a steady 27.7 to 29.3 percent in the period of 1990 through 1994
to 33.0 percent in 1995. Employees. The percentage of solo general practitioners who did not employ any staff members dropped from 3.9 percent in 1990 to 2.7 percent in 1995. The percentage of solo general practitioners who did not employ any chairside assistants during this period dropped from 13.8 percent in 1990 to 7.5 percent in 1995. One-third or more of solo general practitioners consistently reported not employing any dental hygienists during the period of 1990 through 1995. In 1995, nearly 10 percent of solo general practitioners did not employ any secretaries or receptionists, compared with 17.8 percent who did not do so in 1990. Office time. Solo general practitioners spent an average of 48.1 weeks per year in their primary practices in 1995. Of the average 37.4 hours per week they spent in their primary practices, 33.7 hours (90.1 percent) were spent treating patients. Only 13.1 percent of solo general practitioners worked part-time (less than 32 hours per week) in 1995. The average number of hours worked per week remained consistent during the six-year period of 1990 through 1995. In 1990, solo general practitioners spent an average of 37.6 hours per week in the office and 33.9 hours per week treating patients. Patient visits. The average number of patient visits per week, excluding dental hygienist visits, for solo general practitioners also remained stable during the period of 1990 through 1995 (Figure 2). In 1995, the average number of patient visits per week, excluding dental hygienist visits, was 55.3 among solo general practition-
JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
TRENDS
GROSS BILLINGS AND NET INCOME ($)
400,000 350,000
330,840
300,000 250,000
306,190
295,580 270,760
255,690
244,180
200,000 150,000 100,000
102,810
91,940
87,980
84,320
115,690
111,000
50,000 0
1990
1991
1992
1993
1994
1995
YEAR Nominal Gross Billings
Nominal Net Income
Figure 3. Average nominal total primary practice gross billings and net income, for solo general practitioners, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
80 70
PERCENTAGE
ers, while the average number of patient visits per week, excluding dental hygienist visits, was 55.8 in 1990. The average number of patient visits per year, excluding dental hygienist visits, was 2,672.8 among solo general practitioners in 1995. Solo general practitioners treated an average of 1.5 patients per hour, excluding dental hygienist visits in 1995, and a typical patient visited a solo general practitioner an average of 3.2 times per year during this period. Gross billings. Gross billings are the total amount of fees charged by the entire primary practice for dental care provided during a year. Solo general practitioners’ average nominal total gross billings grew from $244,180 in 1990 to $330,840 in 1995 (Figure 3)—an increase of 35.5 percent. In 1995, solo general practitioners’ average nominal total gross billings were exceeded in the following U.S. census regions: New England ($331,420), South Atlantic ($348,830), West South Central ($346,480), Mountain ($407,100) and Pacific ($374,010). During the period of 1990 through 1995, the average annual increase in nominal total gross billings was approximately 5.2 percent. After adjusting for inflation using 1995 U.S. dollars as a base, the increase of solo general practitioners’ real total gross billings during this period was more modest than the increase of their nominal total gross billings. Solo general practitioners’ average real (base = 1995) total gross billings increased 16.2 percent, from $284,721 in 1990 to $330,840 in 1995. During this six-year period, solo general practitioners’ average annual increase in real (base = 1995) total
60 53.7
52.2 50
47.8
51.9
51.6 48.4
46.3
48.1
50.9 49.1
50.6
49.4
40 30 20 10 0
1990
1991
1992
1993
1994
1995
YEAR Unincorporated
Incorporated
Figure 4. Employment status of solo specialists, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
gross billings was approximately 2.5 percent. Practice expenses. We calculated the solo general practitioners’ total practice expenses by subtracting their average net income from their average gross
billings. Their average nominal total practice expenses increased 34.6 percent, from $159,860 in 1990 to $215,150 in 1995, or an average of 5.1 percent annually. Solo general practitioners’ average real
JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
1157
TRENDS
AVERAGE NUMBER OF PATIENT VISITS PER WEEK
120
100
98.9
94.4
94.7
95.6
1990
1991
1992
94.1
91.8
80
60
40
20
0
1993
1994
1995
CHARACTERISTICS OF SOLO SPECIALISTS
YEAR
Figure 5. Average number of patient visits per week, excluding dental hygienist visits, for solo specialists, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
GROSS BILLINGS AND NET INCOME ($)
600,000 479,150
500,000 416,730 400,000
370,330
363,560
383,620
382,360
300,000
200,000 135,390
135,860
149,610
144,320
168,130
175,810
100,000
0 1990
1991
1992
1993
1994
1995
YEAR Nominal Gross Billings
Nominal Net Income
Figure 6. Average nominal total primary practice gross billings and net income, for solo specialists, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
(base = 1995) total practice expenses increased 15.4 percent, from $186,401 in 1990 to $215,150 in 1995, or an average of 2.4 percent annually. Net income. Net income is a dentist’s personal income after practice expenses are paid and before personal income taxes are paid. In 1995, the average 1158
Mountain ($133,310) and Pacific ($116,000). During the period of 1990 through 1995, solo general practitioners’ average nominal total net income increased 37.2 percent, approximately an average of 5.4 percent annually. Solo general practitioners’ average real (base = 1995) total net income increased 17.7 percent during this period, from $98,320 in 1990 to $115,690 in 1995, or an average of 2.8 percent annually.
nominal total net income from solo general practitioners’ primary practice was $115,690 (Figure 3). In 1995, solo general practitioners’ average nominal total net income was exceeded in the following U.S. census regions: New England ($129,030), South Atlantic ($116,730), West South Central ($128,760),
In 1995, 64.3 percent of specialists in private practice were solo practitioners. Solo specialists who responded to the “Survey of Dental Practice” were, on average, 48 years old in 1995. Male solo specialists who responded to the survey were an average of 48.6 years old. The average age of female solo specialists who responded to the survey is not available, because of a low response rate. Employment status. As shown in Figure 4, solo specialists were almost as likely to be in an unincorporated as in an incorporated practice during the period of 1990 through 1995. Employees. During this sixyear period, the percentage of solo specialists who employed five or more full- or part-time staff members increased from 44.8 percent to 53.1 percent. The percentage of these dentists who did not employ dental hygienists increased from 69.9 percent in 1990 to 72.1 percent in 1995. Fifty percent or more of solo specialists consistently reported employing one secretary or receptionist during the period of 1990 through 1995, ranging from a low of 50.0 percent in 1995 to a high of 59.2
JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
TRENDS
percent in 1991. The percentage of solo specialists employing one chairside assistant decreased from 57.3 percent in 1990 to 50.0 percent in 1995. Office time. Solo specialists spent an average of 47.5 weeks per year in their primary practices in 1995. Of the average 37.1 hours per week they spent in their primary practices, 32.5 hours (87.6 percent) were spent treating patients. Only 16.5 percent of solo specialists worked part-time (less than 32 hours per week) in 1995. The average number of hours worked per week has remained stable during the six-year period. In 1990, solo specialists spent an average of 37.7 hours per week in the office and 32.7 hours per week treating patients. Patient visits. The average number of patient visits per week, excluding dental hygienist visits, for solo specialists also remained stable during the period of 1990 through 1995 (Figure 5). In 1990, the average number of patient visits per year, excluding dental hygienist visits, was 94.4 among solo specialists, while the average number of patient visits per week, excluding dental hygienist visits, was 98.9 in 1995. The average number of patient visits per year, excluding dental hygienist visits, was 4,729.4 among solo specialists in 1995. Solo specialists treated an average of 2.7 patients per hour, excluding dental hygienist visits in 1995, and a typical patient visited a solo specialist an average of 6.9 times per year during this period. The majority of responding specialists were orthodontists. Gross billings. Solo special-
ists’ average nominal total gross billings grew from $363,560 in 1990 to $479,150 in 1995 (Figure 6)—an increase of 31.8 percent. During this six-year period, the average annual increase in nominal total gross billings was approximately 4.7 percent. Solo specialists’ average real (base = 1995) total gross billings increased 13.0 percent, from $423,922 in 1990 to $479,150 in 1995, or an average of 2.1 percent annually. Practice expenses. We calculated the solo specialists’ total practice expenses by subtracting their average net income from their average gross billings. Solo specialists’ average nominal total practice expenses increased 32.9 percent, from $228,170 in 1990 to $303,340 in 1995, or 4.9 percent annually. Solo specialists’ average real (base = 1995) total practice expenses increased 14.0 percent during the period of 1990 through 1995, from $266,053 to $303,340, or an average of 2.2 percent annually. Net income. In 1995, the average nominal total net income from solo specialists’ primary private practices was $175,810 in 1995 (Figure 6). During the period of 1990 through 1995, solo specialists’ average nominal total net income increased 29.9 percent, approximately 4.5 percent per year. Solo specialists’ average real (base = 1995) total net income increased 11.4 percent during this period, or an average of 1.8 percent annually. SUMMARY
The solo practice has been the predominant type of dental practice among private practitioners since the late 1970s.
This brief look at the solo practice has shown that during the period of 1990 Dr. Brown is associthrough 1995 ate executive direcprivate practor, American Dental Association, Health tice characterPolicy Resources istics—such as Center, 211 E. employment Chicago Ave., Chicago, Ill. 60611. status, number Address reprint reof employees, quests to Dr. Brown. time spent in the office and number of patient visits per week—have varied little for both solo general practitioners and specialists. The growth in dentists’ incomes is an important indicator of the economic health of dental practice. Both solo general practitioners’ and specialists’ average total gross billings and average total net income increased during the period of 1990 through 1995. The percentage increase in gross billings was 35.5 percent for solo general practitioners and 31.8 percent for solo specialists. The percentage increase in net income also was higher for solo general practitioners (37.2 percent) than it was for solo specialists (29.2 percent). Solo general practitioners’ average total practice expenses increased 34.6 percent during the period of 1990 through 1995, and solo specialists’ average total practice expenses increased 32.9 percent. ■ Ms. Lazar is manager, Health Policy Programs, American Dental Association, Health Policy Resources Center, Chicago. 1. American Dental Association, Survey Center. Distribution of dentists in the United States by region and state: 1995. Chicago: American Dental Association; 1997.
JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
1159
SOLO GENERAL PRACTITIONERS AND SPECIALISTS L. JACKSON BROWN, D.D.S., PH.D.; VICKIE LAZAR, M.A., M.S.
A
B
S
T
R
A
C
T
A solo practitioner is the sole owner of and the only dentist in a dental practice and also is the most common type of dental practitioner in the United States. The authors provide a brief look at solo general practitioners’ and specialists’ characteristics, including employment status, number of employees, time spent in the office, number of patient visits per week, gross billings, net income and practice expenses.
The ADA’s Survey Center conducts an annual, random survey of
about 5 percent of U.S. dentists in private practice. The results are published annually in a series of documents titled “Survey of Dental Practice,” which is a comprehensive source of information for practice characteristics. Results from the “Survey of Dental Practice” for the years 1990 through 1995 show that more than 90 percent of private practitioners own their practices, which are either sole proprietorships or partnerships. About 70 percent of private practitioners are solo practitioners. Although the number of private practitioners in the United States rose 27.1 percent between 1982 and 1995, from 116,208 to 141,396,1 the percentage of solo practices has remained fairly constant, near 70 percent. Solo dentists do not typically practice alone in their offices. In 1995, they employed an average 4.7 full- or part-time nondentist staff members. The average age of solo dentists is 48 years, which is 2.5 years older than dentists who practice in nonsolo practices. Solo dentists spent an average of 37.3 hours per week in their dental offices in 1995 and an average of 33.5 of those hours treating patients. Nonsolo dentists spend an average of 36.5 hours per week in their dental offices and an average of 32.9 of those hours treating patients. Solo dentists reported an average of 62.0 patient visits per week in 1995, not counting visits to the dental hygienist, while nonsolo dentists reported an average of 60.8 patient visits per week. The following brief overview of solo general practitioners and specialists was written using data gathered from the “Survey of Dental Practice” for the years 1990 through 1995; 1995 is the most recent year for which data are available. CHARACTERISTICS OF SOLO GENERAL PRACTITIONERS
In 1995, 70.5 percent of general practitioners in private practice were solo dentists. Solo general practitioners who responded to the 1995 “Survey of Dental Practice” were an average of 48 years old. Male solo general practitioners who responded to the survey were an average of 48.5 years old, while female solo general practitioners were an average of 40.6 years old. JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
1155
TRENDS
80 72.3
71.5
70.7
72.0
71.2
67.0
PERCENTAGE
70 60 50 40
33.0 27.7
30
29.3
28.8
28.5
28.0
20 10 0
1990
1991
1992
1993
1994
1995
YEAR Unincorporated
Incorporated
AVERAGE NUMBER OF PATIENT VISITS PER WEEK
Figure 1. Employment status of solo general practitioners, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
80 70 60
55.8
56.2
55.1
55.8
54.7
55.3
1990
1991
1992
1993
1994
1995
50 40 30 20 10 0
YEAR
Figure 2. Average number of patient visits per week, excluding dental hygienist visits, for solo general practitioners, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
Employment status. As shown in Figure 1, most solo general practitioners were in unincorporated practices during the period of 1990 through 1995. The percentage of solo general practitioners in unincorporated practices dropped 1156
from a steady 70.7 to 72.3 percent in the period of 1990 through 1994 to 67.0 percent in 1995. The percentage of solo general practitioners in incorporated practices rose from a steady 27.7 to 29.3 percent in the period of 1990 through 1994
to 33.0 percent in 1995. Employees. The percentage of solo general practitioners who did not employ any staff members dropped from 3.9 percent in 1990 to 2.7 percent in 1995. The percentage of solo general practitioners who did not employ any chairside assistants during this period dropped from 13.8 percent in 1990 to 7.5 percent in 1995. One-third or more of solo general practitioners consistently reported not employing any dental hygienists during the period of 1990 through 1995. In 1995, nearly 10 percent of solo general practitioners did not employ any secretaries or receptionists, compared with 17.8 percent who did not do so in 1990. Office time. Solo general practitioners spent an average of 48.1 weeks per year in their primary practices in 1995. Of the average 37.4 hours per week they spent in their primary practices, 33.7 hours (90.1 percent) were spent treating patients. Only 13.1 percent of solo general practitioners worked part-time (less than 32 hours per week) in 1995. The average number of hours worked per week remained consistent during the six-year period of 1990 through 1995. In 1990, solo general practitioners spent an average of 37.6 hours per week in the office and 33.9 hours per week treating patients. Patient visits. The average number of patient visits per week, excluding dental hygienist visits, for solo general practitioners also remained stable during the period of 1990 through 1995 (Figure 2). In 1995, the average number of patient visits per week, excluding dental hygienist visits, was 55.3 among solo general practition-
JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
TRENDS
GROSS BILLINGS AND NET INCOME ($)
400,000 350,000
330,840
300,000 250,000
306,190
295,580 270,760
255,690
244,180
200,000 150,000 100,000
102,810
91,940
87,980
84,320
115,690
111,000
50,000 0
1990
1991
1992
1993
1994
1995
YEAR Nominal Gross Billings
Nominal Net Income
Figure 3. Average nominal total primary practice gross billings and net income, for solo general practitioners, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
80 70
PERCENTAGE
ers, while the average number of patient visits per week, excluding dental hygienist visits, was 55.8 in 1990. The average number of patient visits per year, excluding dental hygienist visits, was 2,672.8 among solo general practitioners in 1995. Solo general practitioners treated an average of 1.5 patients per hour, excluding dental hygienist visits in 1995, and a typical patient visited a solo general practitioner an average of 3.2 times per year during this period. Gross billings. Gross billings are the total amount of fees charged by the entire primary practice for dental care provided during a year. Solo general practitioners’ average nominal total gross billings grew from $244,180 in 1990 to $330,840 in 1995 (Figure 3)—an increase of 35.5 percent. In 1995, solo general practitioners’ average nominal total gross billings were exceeded in the following U.S. census regions: New England ($331,420), South Atlantic ($348,830), West South Central ($346,480), Mountain ($407,100) and Pacific ($374,010). During the period of 1990 through 1995, the average annual increase in nominal total gross billings was approximately 5.2 percent. After adjusting for inflation using 1995 U.S. dollars as a base, the increase of solo general practitioners’ real total gross billings during this period was more modest than the increase of their nominal total gross billings. Solo general practitioners’ average real (base = 1995) total gross billings increased 16.2 percent, from $284,721 in 1990 to $330,840 in 1995. During this six-year period, solo general practitioners’ average annual increase in real (base = 1995) total
60 53.7
52.2 50
47.8
51.9
51.6 48.4
46.3
48.1
50.9 49.1
50.6
49.4
40 30 20 10 0
1990
1991
1992
1993
1994
1995
YEAR Unincorporated
Incorporated
Figure 4. Employment status of solo specialists, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
gross billings was approximately 2.5 percent. Practice expenses. We calculated the solo general practitioners’ total practice expenses by subtracting their average net income from their average gross
billings. Their average nominal total practice expenses increased 34.6 percent, from $159,860 in 1990 to $215,150 in 1995, or an average of 5.1 percent annually. Solo general practitioners’ average real
JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
1157
TRENDS
AVERAGE NUMBER OF PATIENT VISITS PER WEEK
120
100
98.9
94.4
94.7
95.6
1990
1991
1992
94.1
91.8
80
60
40
20
0
1993
1994
1995
CHARACTERISTICS OF SOLO SPECIALISTS
YEAR
Figure 5. Average number of patient visits per week, excluding dental hygienist visits, for solo specialists, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
GROSS BILLINGS AND NET INCOME ($)
600,000 479,150
500,000 416,730 400,000
370,330
363,560
383,620
382,360
300,000
200,000 135,390
135,860
149,610
144,320
168,130
175,810
100,000
0 1990
1991
1992
1993
1994
1995
YEAR Nominal Gross Billings
Nominal Net Income
Figure 6. Average nominal total primary practice gross billings and net income, for solo specialists, 1990 through 1995. Source: “Survey of Dental Practice” series, American Dental Association, Survey Center.
(base = 1995) total practice expenses increased 15.4 percent, from $186,401 in 1990 to $215,150 in 1995, or an average of 2.4 percent annually. Net income. Net income is a dentist’s personal income after practice expenses are paid and before personal income taxes are paid. In 1995, the average 1158
Mountain ($133,310) and Pacific ($116,000). During the period of 1990 through 1995, solo general practitioners’ average nominal total net income increased 37.2 percent, approximately an average of 5.4 percent annually. Solo general practitioners’ average real (base = 1995) total net income increased 17.7 percent during this period, from $98,320 in 1990 to $115,690 in 1995, or an average of 2.8 percent annually.
nominal total net income from solo general practitioners’ primary practice was $115,690 (Figure 3). In 1995, solo general practitioners’ average nominal total net income was exceeded in the following U.S. census regions: New England ($129,030), South Atlantic ($116,730), West South Central ($128,760),
In 1995, 64.3 percent of specialists in private practice were solo practitioners. Solo specialists who responded to the “Survey of Dental Practice” were, on average, 48 years old in 1995. Male solo specialists who responded to the survey were an average of 48.6 years old. The average age of female solo specialists who responded to the survey is not available, because of a low response rate. Employment status. As shown in Figure 4, solo specialists were almost as likely to be in an unincorporated as in an incorporated practice during the period of 1990 through 1995. Employees. During this sixyear period, the percentage of solo specialists who employed five or more full- or part-time staff members increased from 44.8 percent to 53.1 percent. The percentage of these dentists who did not employ dental hygienists increased from 69.9 percent in 1990 to 72.1 percent in 1995. Fifty percent or more of solo specialists consistently reported employing one secretary or receptionist during the period of 1990 through 1995, ranging from a low of 50.0 percent in 1995 to a high of 59.2
JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
TRENDS
percent in 1991. The percentage of solo specialists employing one chairside assistant decreased from 57.3 percent in 1990 to 50.0 percent in 1995. Office time. Solo specialists spent an average of 47.5 weeks per year in their primary practices in 1995. Of the average 37.1 hours per week they spent in their primary practices, 32.5 hours (87.6 percent) were spent treating patients. Only 16.5 percent of solo specialists worked part-time (less than 32 hours per week) in 1995. The average number of hours worked per week has remained stable during the six-year period. In 1990, solo specialists spent an average of 37.7 hours per week in the office and 32.7 hours per week treating patients. Patient visits. The average number of patient visits per week, excluding dental hygienist visits, for solo specialists also remained stable during the period of 1990 through 1995 (Figure 5). In 1990, the average number of patient visits per year, excluding dental hygienist visits, was 94.4 among solo specialists, while the average number of patient visits per week, excluding dental hygienist visits, was 98.9 in 1995. The average number of patient visits per year, excluding dental hygienist visits, was 4,729.4 among solo specialists in 1995. Solo specialists treated an average of 2.7 patients per hour, excluding dental hygienist visits in 1995, and a typical patient visited a solo specialist an average of 6.9 times per year during this period. The majority of responding specialists were orthodontists. Gross billings. Solo special-
ists’ average nominal total gross billings grew from $363,560 in 1990 to $479,150 in 1995 (Figure 6)—an increase of 31.8 percent. During this six-year period, the average annual increase in nominal total gross billings was approximately 4.7 percent. Solo specialists’ average real (base = 1995) total gross billings increased 13.0 percent, from $423,922 in 1990 to $479,150 in 1995, or an average of 2.1 percent annually. Practice expenses. We calculated the solo specialists’ total practice expenses by subtracting their average net income from their average gross billings. Solo specialists’ average nominal total practice expenses increased 32.9 percent, from $228,170 in 1990 to $303,340 in 1995, or 4.9 percent annually. Solo specialists’ average real (base = 1995) total practice expenses increased 14.0 percent during the period of 1990 through 1995, from $266,053 to $303,340, or an average of 2.2 percent annually. Net income. In 1995, the average nominal total net income from solo specialists’ primary private practices was $175,810 in 1995 (Figure 6). During the period of 1990 through 1995, solo specialists’ average nominal total net income increased 29.9 percent, approximately 4.5 percent per year. Solo specialists’ average real (base = 1995) total net income increased 11.4 percent during this period, or an average of 1.8 percent annually. SUMMARY
The solo practice has been the predominant type of dental practice among private practitioners since the late 1970s.
This brief look at the solo practice has shown that during the period of 1990 Dr. Brown is associthrough 1995 ate executive direcprivate practor, American Dental Association, Health tice characterPolicy Resources istics—such as Center, 211 E. employment Chicago Ave., Chicago, Ill. 60611. status, number Address reprint reof employees, quests to Dr. Brown. time spent in the office and number of patient visits per week—have varied little for both solo general practitioners and specialists. The growth in dentists’ incomes is an important indicator of the economic health of dental practice. Both solo general practitioners’ and specialists’ average total gross billings and average total net income increased during the period of 1990 through 1995. The percentage increase in gross billings was 35.5 percent for solo general practitioners and 31.8 percent for solo specialists. The percentage increase in net income also was higher for solo general practitioners (37.2 percent) than it was for solo specialists (29.2 percent). Solo general practitioners’ average total practice expenses increased 34.6 percent during the period of 1990 through 1995, and solo specialists’ average total practice expenses increased 32.9 percent. ■ Ms. Lazar is manager, Health Policy Programs, American Dental Association, Health Policy Resources Center, Chicago. 1. American Dental Association, Survey Center. Distribution of dentists in the United States by region and state: 1995. Chicago: American Dental Association; 1997.
JADA, Vol. 129, August 1998 Copyright ©1998-2001 American Dental Association. All rights reserved.
1159