Rural America – a Dental Crisis!


A crisis is developing in rural America! A dramatic demographic shift is occurring in dentistry as baby boomers begin to retire. By the year 2007, more dentists will retire from dentistry than will graduate from dental school. Up to 50 percent of the new graduates will be female dentists, and they are expected to work 30 percent fewer hours than their male counterparts. As many as 10 percent of the graduates will be foreign students who may return to their homelands to practice. This demographic shift is being felt the most in rural America, where dentists are retiring without replacements. In Florida, my home state, there are 18 entire counties that have five or fewer dentists … and three that have none! In the past two years, 14 counties have had a net loss in dentists, while urban or large population centers have experienced an increase in dentist numbers. In discussing this issue with my colleagues at American Dental Sales, the same problem of finding dentists for rural America seems to exist throughout the country. Each month, I present a seminar in different parts of the country where I discuss transition options and retirement-planning with dentists. In each seminar over the last year, the issue of finding dentists to relocate in rural areas has come up.

Here’s an example of what I am seeing. Dr. C. is a middle-aged dentist in a very attractive community in Ohio. He had returned home after dental school to set up his office. At that time, three other dentists were practicing in this community. In the past five years, two of the three have retired and most of the patients have migrated to Dr. C.’s practice. The remaining dentist in the community is 65, and he plans to retire next year.

Dr. C. is booked out six months. He can’t handle anymore patients, and he can’t attract an associate to assist him. Because he is an integral part of the community, he has the dilemma of not wanting to turn patients away. He was pleading with me for some solution to the problem, but I could not help him. For some reason, rural America does not seem to be as desirable to buyers as urban or suburban America. In reality, rural areas have a lot of very attractive options:

  • Little, if any, competition
  • Cost of living is usually less
  • Employee costs are usually less
  • Rent and utilities are usually less
  • Patient loyalty is strong
  • High collection percentages and little A/R problems
  • Lifestyle can be very rewarding

These are a few of the advantages of living away from “The Big City.”

Recently, I became aware of a dentist who settled in St. George, Utah, a very fast-growing retirement area. He was competing with dozens of other dentists for the same patients and just couldn’t get his practice to the level he wanted because of the competition. He heard about an opportunity in rural Kansas, where he had grown up. He relocated and, within months, was busier and making more money than he had dreamed possible.

Some dentists have suggested to me that rural America won’t accept the same type of dentistry that they want to practice. In talking to dentists throughout the country, I have found this not to be the case at all. In fact, it appears that trust in the “country doctor” is so great that if he or she says a procedure needs to be done, the patient feels it must be so, so “let’s do it.”

As a result of recent events, a lot of people are taking a hard look around and trying to decide what is truly important, how they want to live, and where and how they want to raise a family. In other words, what really matters in life?

So, if you’re looking for an opportunity to relocate or you are just starting out, I would suggest that you seriously consider establishing a practice in rural America. Country living can provide you with the opportunity to have a very successful practice and to enjoy a superior quality of life.

Hy Smith, MBA, is president of Practice Transitions, Inc., a practice management and brokerage company serving Florida. He is a member of the Institute of Business Appraisers and past president of American Dental Sales. He currently is serving as director of transition strategies for the Pride Institute. He can be reached by phone at (800) 262-4119 or by email at hysmith@aol.com. See the classified ads for names and phone numbers of ADS members.


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