Salaries and Job Satisfaction of Health Center Dental Providers: 2013 Trends. Kenneth A Bolin, DDS, MPH

Transcription

1 Salaries and Job Satisfaction of Health Center Dental Providers: 2013 Trends Kenneth A Bolin, DDS, MPH

2 NNOHA Webinar Series Archived presentations from the NNOHA webinar series are available online at To download today s slides now visit, Disclaimer: This speaker has been engaged for educational purposes only and does necessarily reflect the opinions of NNOHA, its agents or employees, or the organization as a whole. NNOHA does not endorse any specific claim(s) relative to the effectiveness of products or techniques suggested by the speaker and does not accept any liability for actions taken based on the content of this webinar or for any and all consequences resulting from the use of the information. NNOHA does not warrant that this webinar will be presented uninterrupted or error-free, nor that the website or server which make this webinar available are free from viruses or other dangerous conditions. NNOHA does not accept any liability for damage which may ensue as a result of such potentially harmful elements. The viewer and/or any entity using this information assumes all risk associated with its use.

3 Learning Objectives Understand the characteristics of current practitioners in Health Center dental clinics Learn about job satisfaction indicators of dental providers and ranges of salaries currently being offered Identify the factors which contribute to career change decisions among dental providers in Health Center practices

4 Origins of Study NNOHA obtained funds for survey from HRSA Cooperative Agreement NNOHA wanted to do an update of previous survey conducted in 2009 Prior instrument needed additional questions regarding demographics, and comparisons to prior surveys were of interest

5 Survey Design Health Center master list obtained by NNOHA for all Executive Directors Survey questions derived from survey designed by former Health Center Dental Director Input from NNOHA Workforce Workgroup and staff

6 Survey Methods Survey was administered electronically. Link mailed to all Health Center Executive Directors Introductory message included message from NNOHA Project Director 4-5 weeks later a USPS postcard reminder was mailed to all Health Centers in U.S. with links for providers and Executive Directors respective surveys

7 Response 650 Dentists/Dental Hygienists 246 Executive Directors 246/1120 (22%) Response rate for providers unknown due to unknown denominator Response slightly lower than paper survey of 2009, but denominator much higher

8 Data Entry and Analysis Data analyzed using SPSS 21.0 Frequency Analysis performed for each variable Association tests performed on key variables Chi-square cross tabulation; p values T-test for independent samples Logistic Regression to obtain Odds Ratios with 95% CI to determine validity

9 Demographics Year of graduation Range Mean = 17.2 years All 10 HRSA Regions represented Mean years since graduation from school Dentist= 15.8 RDH= 14.2 Median years since graduation Dentist= 13.0 RDH= 10.0

10 Demographics Dental Director 224/ % Staff Dentist 233/ % Dental Hygienist 144/ % Unclassified/missing 49/ % Gender Dentist 55.2% Female RDH 95.8% Female

11 Activity Prior to Health Center Employment Dentist Frequency Percent Private practice owner/partner/associate Private practice employed dentist Dental student Local, state, public health agency/other community dental center Grad dental program/specialty program Commissioned Officer PHS/Military Retired Total Dental Hygienist Private practice associate or employee Dental Hygiene student Local, state, public health agency/other community dental center Graduate program Total

12 Scholarships and Loans Received NHSC Scholarship Dentist 8.5% RDH 2.2% NHSC Loan Repayment Dentist 37.0% RDH 15.9% State Loan Repayment Dentist 11.8% RDH 9.4% Loan repayment completed Dentist 31.8% RDH 72.3%

13 Reasons for choosing CHC Felt a mission to the dentally underserved population Wished to offer oral health care within an interdisciplinary environment Wished to practice dentistry in a community based setting Did not want to invest capital in a private practice

14 Reasons for choosing CHC Attracted by work schedule/leave policies of Community Health Center Loan repayment was offered or promised to you in Community Health Care dentistry Sold private practice, or retired from government service Dissatisfied with associate/employee dentist arrangements currently available

15 Highest Response Rate Responses from dentists Felt a mission to the underserved 42.2% Loan repayment available in HC 19.9% Wished to practice dentistry in HC 10.3% Responses from dental hygienists Felt a mission to the underserved 43.1% Wished to practice DH in HC 22.2% Attracted by work schedule/leave 16.0%

16 Perception of Autonomy Dentist Number Percent Full Autonomy Limited Autonomy Dental Hygienist Full Autonomy Limited Autonomy

17 Perception of Limited Autonomy Top three reasons reported for dentists Level of patient compliance with treatment Limitations on types of services due to $$ Scope of treatment offered at HC practice Top three reasons for RDH Level of patient compliance with treatment State s Medicaid policies/requirements Amount of access to specialists

18 Availability of Specialists Type of Specialist N % Oral Surgeon Pediatric Dentist Periodontist Prosthodontist Orthodontist Other (incl. Endodontists) No Specialists Available

19 Perception of Admin Time Mean time reported 9.7 hrs Enough time allowed 40.0% Some but not enough time 47.1% No time allowed 12.9%

20 Are Benefits Adequate? % Answering Yes Dentist RDH Leave Time (PTO) 74.8% 66.7% Medical Insurance 71.8% 72.6% Retirement Plan 91.3% 94.2% Employer Match 66.7% 78.8% Production Incentive 34.2% 19.1%

21 Vacation/PTO Dental Director Median # days = 27 Staff Dentist Median # days = 23.5 Dental Hygienist Median # days = 20

22 CE Allowance Dentist 5.0 Days (Median) RDH 4.0 Days (Median) Dental Director $1849 (Mean) Staff Dentist $1789 (Mean) Dental Hygienist $1048 (Mean)

23 Length of Time in HC Dentistry Dentist Number of Valid 436 Number of Missing 21 Mean 8.19 Median 5.00 Mode 3 Percentiles Hygienist Number of Valid 133 Number of Missing 11 Mean 6.28 Median 4.00 Mode 1 Percentiles

24 Years in Health Center (Dentist)

25 Years in Health Center (RDH)

26 Total Years of Practice Provider Length of time Frequency Percent Dentist Less than one year to <5 years to <10 years years Missing Total Hygienist Less than one year to <5 years to <10 years years 51.4 Missing Total

27 Years of Total Experience Dentist RDH 3.5% 2.8% 56.5% 18.8% 19.7% % 23.6%

28 Perception of Facility Provider Frequency Percent Dentist Very good Good Adequate Needs improvement Poor Missing Total Hygienist Very good Good Adequate Needs improvement Poor Missing Total

29 Perception of Equipment & Supplies Provider Frequency Percent Dentist Very good Good Adequate Needs improvement Poor Missing Total Hygienist Very good Good Adequate Needs improvement Missing Total

30 Perceptions of Support Answering Adequate %Dentist %RDH Number of DAs Quality of DAs Clerical support Admin support Number of Dentists Number of RDHs Number of EFDAs Assistant to Dentist ratio Interaction with Medical

31 Dentist Salaries Reported $95K $95K-$110K $110K-$125K $125K-$140K >$140K 5 0 Dental Director Staff Dentist

32 RDH Salaries Reported Dental Hygienist Salary Distribution $40K $40K-$50K $50K-$60K $60K-$70K >$70K

33 Dentist 2009 vs 2013 Distribution of Dentist Salary by Survey Year

34 RDH 2009 vs 2013 Distribution of Dental Hygiene Salary by Survey Year $40K $40K-$50K $50K-$60K $60K-$70K >$70K

35 Non-Salaried Personnel Dentists Mean hourly fee $66.84 Median hourly fee $62.00 Dental Hygienists Mean hourly fee $32.44 Median hourly fee $34.00

36 Memberships Dentists #1 ADA 61.3% #2 NNOHA 40.0% #3 AGD 19.5% #4 None 14.2% Employer reimbursement YES= 60.5%

37 Memberships Dental Hygienists #1 ADHA 46.5% #2 None 30.0% #3 NNOHA 25.0% Employer reimbursement YES= 49.2%

38 Encounters Required? All providers were asked if encounter quotas were mentioned by administration of Health Center: Yes= 64.5% Average # reported Mean # 2,667 Median # 2,600 Mode # 2,500

39 Intend to Remain in CHC Dentists 83.6% 362/433 Dental Hygienists 93.9% 123/131 Of those intending Dentist RDH to leave Leaving in 2-5 yrs 37.5% 33.3% Within one year 29.2% 22.2% ASAP 33.3% 44.4%

40 Executive Director Survey FTEs Unfilled positions Salary information Benefits information Recruitment methods

41 Vacancies Dentist Frequency Percent Valid Percent Less than 6 months months >12-24months >24 months No Vacancies Missing Total

42 Recruitment Methods For Dentists Working with NHSC 11.4% Networking PCAs 9.3% Newspapers 9.3% Dental Schools 8.1% NNOHA Website 2.8%

43 Hygiene Vacancies Frequency Percent Valid Percent <6 months months >12-24 months >24 months No Vacancies Missing Total

44 Salaries: Dentists and Dental Hygienists by Level of Experience Dentist Mean Dentist Median RDH Mean RDH Median Entry to 1 yr >1 yr-5 yr >5 yr-10 yr >10 yr Fringe % $108,927 $111,514 $122,304 $125, $110,000 $112,500 $131,000 $135, $52,093 $48,287 $55,870 $60, $48,200 $49,000 $54,000 $62,

45 Use of Contract Labor Contract Dentist (Used in 17.6% of HCs) Lowest Mean/Median $75.19/$70.00 Highest Mean/Median $81.21/$75.00 Contract RDH (Used in 5.5% of HCs) Lowest and Highest Mean $35.20/$40.17

46 STATISTICAL ANALYSIS OF ASSOCIATIONS

47 Intent to leave and Salary HRSA region Population NHSC scholarship Federal loan repayment On-call duty perception Number of dental assistants Experience/Quality of dental assistants Number of dentists employed Number of dental hygienists employed Etc.

48 Significant Associations Years of Health Center practice Years of total experience Level of autonomy in practice Pre-existing value of loan repayment Administrative support/clerical support Quality of facility/condition of equipment and supplies Number & quality of dental assistants Number of EFDAs employed Interaction with medical colleagues in Health Center practice

49 Significant Associations Experience Overall 10 or more Reference group >5 but <10 OR=2.71 p=.001 >1 but <5 OR=2.56 p=.003 <1 year OR=3.57 p=.022 Using logistic regression model

50 Associations Years of CHC Experience Intend to Remain 8.04 yrs Intend to Leave 5.33 yrs t-test <.001

51 Associations with Intent to Leave Health Center Practice Autonomy OR 3.30 p<.001 Loan repayment OR 2.06 p=.032 No. Assistants OR 1.76 p=.024 Quality Assistants OR 2.67 p<.001 Number of EFDAs OR 2.20 p=.008 Admin Support OR 1.97 p=.006

52 Associations with Intent to Leave Health Center Practice Clerical support OR 1.74 p=.021 Rating of facility OR 2.00 p=.006 Rating of equip OR 2.29 p=.001 and supplies Interaction with OR 2.86 p<.001 Medical Colleagues

53 Summary and Discussion Trends appear to be similar in 2013 with a few important changes Wages and benefits are improving Workforce in HC seems more stable Non-response bias Unknown numbers of providers in HC dental components

54 Contact Us! Ken Bolin, DDS, MPH Associate Professor and Graduate Program Director Department of Public Health Sciences Baylor College of Dentistry NNOHA

55 Join NNOHA Today! NNOHA is a network of safety-net oral health providers committed to improving the health of the underserved. Join us today ($50 per individual / $350 per organization) for benefits including: Publications Technical Assistance Job Bank Newsletter Discount to National Primary Oral Health Conference Register for the 2014 National Primary Oral Health Conference August 17-20, 2014, Disney s Coronado Springs Resort, Lake Buena Vista, FL

56 QUESTIONS?