Workforce Shortages, Part 2: Leaders Plan Solutions
by GUY DEYTON, DDS T
here is an old saying: “The best way to predict the future is to create it!” This article moves from explaining the problem of severe
oral healthcare workforce shortages (which I covered last issue) to discussing possible solutions.
This spring, the Office of Dental Health (ODH) was asked by Governor Parson to report on the state of the oral healthcare workforce and recommend solutions. To that end, ODH sent out and analyzed a workforce survey and co-facilitated an ad hoc commit- tee of dental leaders to understand and rec- ommend solutions for workforce shortages.
In my previous article (refer to QR code next page), I discussed why many oral healthcare facilities in Missouri, including all practice models (private, corporate and clinics) have had great difficulty filling staff openings. In this article, we will briefly review the reasons for oral healthcare workforce shortages. We’ll also review the major takeaways from the Oral Healthcare Workforce Surveys distributed and report on initial outcomes of a Workforce Ad Hoc Committee. Lastly, we will outline possible actions to begin ad- dressing oral healthcare workforce shortages so facilities can be adequately staffed and patients have reasonable access to care.
WHY CAN’T YOU FIND STAFF?
As a review, these are some reasons there are too few oral healthcare providers in Missouri and facilities are often understaffed:
Preceding the COVID-19 pandemic there was a significant shortage of dentists in Missouri. Missouri had 327 fewer dentists in 2020 caring for Missourians than we had in 1990. See my last article for full explanation.
The average workload per dentist increased by 35 percent from 1990 to 2020. This workload increase was due to the decrease
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in dentists and a state population increase of more than 1 million people.
A significant number of people left the Oral Healthcare Workforce due to the COVID-19 pandemic. The follow- ing are ODH estimates of the impact of COVID-19 on Missouri’s oral healthcare workforce between January 2020 and March 2022:
• Approximately 1-3 percent of Mis- souri dentists exited the workforce.
• Approximately 8 percent of dental hygienists left the oral healthcare workforce.
• Between 5-10 percent of dental assistants left the oral healthcare workforce.
• Approximately 3 percent of admin- istrative staff left the oral healthcare workforce.
The workforce shortage cuts across all roles in Missouri oral healthcare facilities:
• Dentists: 57 percent of surveyed facilities were unable to fill openings for dentists.
• Hygienists: 44 percent of surveyed facilities were unable to fill openings for RDH.
• Dental Assistants: 45 percent of surveyed facilities took longer than three months or were unable to fill openings for dental assistants. Many hired untrained applicants and trained OTJ. • EFDAs: 60 percent of surveyed facilities were unable to fill openings for EFDAs.
ODH estimates the oral healthcare workforce lost approximately 1,000 oral healthcare workers statewide due to the COVID-19 pandemic. The most acute short- ages are hygienists and EFDAs. Anecdotal evidence indicates that rural areas were more severely impacted.
This distribution map of providers illustrates large areas of Missouri are classified as Dental Healthcare Professional Shortage Areas. All areas NOT colored blue are designated as such. Providing care to the state, considering this data, is just one of the statement of problems identified by the Workforce Ad Hoc Committee. (2,100 population-per-dentist based on
https://pubmed.ncbi.nlm.nih. gov/28765446. Population data 2020 MICA Dentist https://
pr.mo.gov/listings-den.asp.)
AD HOC COMMITTEE OUTCOMES
To understand and plan solutions for the workforce shortage, a Workforce Ad Hoc Committee of oral healthcare leaders con- vened in May and early June. Each of the three major associations (MDA, Missouri Dental Hygienists’ Association (MDHA) and Missouri Primary Care Association (MPCA)) nominated three representatives. I along with Brian Barnett, Missouri Dental Board executive director, facilitated the four meet- ings. The following is a synopsis of discussion items and possible solution paths to pursue:
Statement of Problems
• Many oral healthcare facilities in Missouri are operating at reduced ca- pacity due to workforce shortages. − There are large populations in Missouri currently not receiving care.
− There are 65,000+ Missouri nursing home residents. ODH estimates only 6 percent are receiving care.
− 250,000+ children are categorized as high-risk for decay because they come for a socio-economic strata that seeks
SEE RELATED
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