Dentistry is constantly changing. Over the past 10–12 years of writing for Dental Economics, I have talked a lot about changes in practice environment; the new normal; preserving the independent dental practice; reducing overhead; understanding the factors facing practice, inflation, and staff; and the incorporation and utilization of technology into practice. As I look at dentistry today, many of the things that I have previously written about are still relevant. While economic forces are ongoing, the thing that I am observing now is the shift in how we view community in dentistry.
Dentistry has always been a very fragmented industry. When I entered the profession, most practices were solo. The March 6, 2024, issue of Becker’s Dental + DSO Review reported that only 36% of dentists are working in solo practice.1 We are seeing a shift to multidoctor practices, small groups, and are even seeing 13% of dentists now affiliated with DSOs.
In our society, we tend not to be solitary beings or loners. We value family, community, and belonging. Since the beginning of time, people have come together in groups, tribes, neighborhoods, and collectives. We belong to teams, religious groups, social and professional organizations, societies, fraternities, sororities, supper clubs, and other organizations that promote community and togetherness.
Sometimes we join groups for security, some for camaraderie, some to engage in discussion and share ideas, and some to pool our numbers in an organization that has more power and influence than individuals on their own.
Organized groups in dentistry
Dentistry is no different than the rest of society in this respect. In my 22 years of practice, the most basic level of dental community has been local and state dental societies. Most cities, counties, districts, and states have organized societies. These groups hold regular meetings that include time to meet and interact with colleagues as well as providing continuing education opportunities. These societies allow us to connect with our peers and develop a sense of community in our profession.
The progression continued with the development of group purchasing organizations (GPOs), buying groups, and DSOs. These more formalized organizations can develop and create community. Some of these groups develop message boards and communities for users to share experiences. Others promote actions that may benefit the overall organization and its goals. It is up to the practitioner to determine if the benefits these groups provide contribute to their desire for community or simply address financial aspects of dentistry. Some of the buying groups are no-cost organizations, but others charge members a fee to participate. DSOs create community with organized meetings on local and national levels. They also require doctors to sell some or all of their practices to the parent organization.
While dentists get great foundational training in dental school, we all know that most new graduates know just enough to be dangerous. That is why the development of continuing education groups has been so prominent. Two great examples of this are Spear Education and CDOCS. Led by Dr. Frank Spear, Spear Education has probably been the most impactful CE experience I have encountered. Similarly, CDOCS, founded by Dr. Sameer Puri, is the premier educational opportunity for doctors to develop their CEREC skills.
While providing great education, both groups have helped advance community in dentistry through online forums and message boards for members with the help of highly trained moderators. These forums allow doctors with similar interests to come together, ask questions, and get feedback on clinical and educational issues they all share. These organizations have developed great communities, but they also have a barrier to entry—cost. Doctors need to subscribe to be a participant. While this restricts entry for some docs, it has also helped create a more engaged community for its members.
Dentists communicate differently now
This leads us to where we are today. While many of the things we’ve discussed still flourish, dentistry continues to have an ever-changing population of roughly 200,000 clinicians. Over the years, this population has changed how it communicates and how it gets its information. This also leads to changes in how we develop our communities.
News media or social media has changed how we interact with one another. As groups like Meta (Facebook) and Instagram impact our daily lives, they also affect our professional lives and communities. Facebook groups are in every aspect of life, and dentistry is no different. Facebook is an extremely popular medium, and Facebook groups share in this popularity. An estimated 1.8 billion Facebook users are members of Facebook groups.
We currently see some of the larger dental Facebook groups having 50,000–60,000 members. Facebook groups present easy access and low barriers to entry. They are typically private groups and are free to join. The private aspect allows some very limited control of entry into the group. Beyond that, it is up to the administrators/moderators to develop rules for and prevent abuse of the group.
Building community within dentistry
When we have 60,000 people joining a group, have we created a community or just a mass of people? To dig a little deeper into this, I reached out to longtime industry friends Dr. Sameer Puri and Dr. Tarun Agarwal, as well as a new colleague, Dr. Dhaval Patel. Ironically, I met Dr. Patel through his Facebook group Keep CERECing, which is now named Keep CADCAMing. In my opinion, Dr. Sameer Puri is the best at developing community in our profession.
Dr. Patel mentioned that he started Keep CADCAMing to have a group to discuss CEREC cases and get feedback on his cases without paying a fee. He said that he used Facebook due to the ease of access. The group allows almost real-time ability to ask questions and receive answers. When I asked Dr. Patel how he viewed community in dentistry and Facebook as part of that, he responded that you cannot have community if you don’t bring philosophy together. If the group is too broad and tries to be all things for all practitioners, then you can’t develop a like-minded group. If you do not have a like-minded group, then you cannot have community.
If all dentists join the same groups, is that community? I think the answer is no. Facebook groups are great at providing access to information and real-time feedback. They offer a sense of belonging. I belong to five Facebook groups: Keep CADCAMing, Real World Dentistry, Dental Investment Group, Molis Coaching Doctor Community, and Simplify Dentistry. Most of these have a narrower focus. Keep CADCAMing addresses the connecting factor and philosophy of community with its community of all CEREC users. Molis Coaching is specific to subscribers of Molis Coaching’s Invisalign training group. Simplify Dentistry focuses on aspects of clinical practice along with day-to-day operational questions.
Is an approach like that too broad for the development of community, or is it common enough philosophically to bring like-minded thinkers together?
My partner, Dr. Richard Offutt, and I have discussed community at length. Dr. Puri, Dr. Agarwal, and I have discussed it as well. We all agree that doctors need to find community in some way. This is how we have the support to further our careers. Community is what joins us and binds us. In our quest to develop community, Dr. Offutt and I, along with Dr. Murtuza Shah-Khan, have developed Simplify Dentistry with the goal of dentists helping dentists. The group seeks to simplify the profession by exploring restorative, Invisalign, and implant dentistry along with operational topics to improve the daily grind of dentistry. By using various media from our podcasts in our Facebook group, we aim to bring together like-minded clinicians to help build an engaged dental community. Is this the best way to achieve community? Time will tell.
Talking to community leaders
In my research for this piece, I interviewed these industry leaders. Before each call, I had certain questions and expected certain answers. Invariably, all three of these doctors said three different things that led in three different directions. Dr. Sameer Puri is not just a great educator; he may be the best at marketing dentistry and is especially proficient at building community. With his work at CDOCS, Dr. Puri has been particularly instrumental in developing communities.
Recently, he began a new role as chief clinical officer of Imagen Dental Partners. In talking to him, he makes it very clear that Imagen is not a DSO; instead, it’s a group that has doctors join as true partners. What was interesting to me was that he said his entire career has been built around creating community and that this will not change at Imagen. The goal is to “create a massive community with an engaged group” of like-minded doctors who want to learn and grow while also developing greater financial success than they can on their own. This community has a high barrier to entry, but his hope is that it will grow at a slower rate than social media groups, yet be a substantial and engaged community with low turnover. Dr. Puri is an active user of social media channels, but social media is just one of his tools and not necessarily his platform.
Dr. Tarun Agarwal is another friend, colleague, and industry leader. Tarun (T-bone) has been in education and building networks for as long as I have known him. His take is much like Dr. Puri’s. Dental community is what joins us and binds us together. Dr. Agarwal said that in the pre-smartphone era, community came in the form of dental societies and study clubs, but these have fallen off because they no longer “harnessed a sense of unique belonging.”
When the conversation shifted to Facebook groups and other social media platforms, Dr. Agarwal surprised me by saying that he has personally not participated in social media in more than three years. He pointed out that while there is a lot of good to it, there is a certain lack of control and even civility that can lead to arguments instead of genuine discussion. My personal experience with another dental Facebook group confirmed this as I ended up leaving the group due to the amount of political rhetoric that was entering the discussions. Dr. Agarwal’s view of community is that he will be less social media-based moving forward. While social is great for attracting large numbers of people, his view is that true community comes from smaller groups where there is deeper engagement.
We need community in dentistry
So, as you can see, the only consensus about community in dentistry is that we all believe we need it to help us grow and develop as practitioners. Community provides commonality, but there is no clear direction on how best to achieve it.
We examined a few different options to look at the progression of community. Dr. Patel and others have developed large groups of members by using social media, particularly Facebook groups, as these have a low barrier of entry and ease of access. Dr. Agarwal prefers a smaller, more engaged population of like-minded doctors without necessarily being reliant on social media. While Dr. Puri prefers the more engaged population, he also believes that we can create a massive community of engaged practitioners while using social media as a tool. Both believe that there is certain value in having a higher barrier to entry to create greater engagement.
Dr. Offutt, Dr. Murtuza Shah-Khan, and I fall somewhere in between. We believe that the future of community lies in using a three-pronged approach of podcast, Facebook, and website. One concern that was expressed is the need to be able to control the platform that the community is built on. While social media may be an inexpensive way to build a community, invariably someone else controls the platform. This leads to difficulty in controlling the experience, housing resources, and potentially how the community develops.
We must work to develop community
Community cannot just develop on its own. We must work to identify commonality of thought and attract similar practitioners. Community can grow organically, but it may only become viable if we take steps to advance it.
Which route is the best one? I don’t know. What I do appreciate about dentistry is that it is large and diverse enough that more than one of these modalities can succeed and have a positive effect on the profession.
Editor's note: The article appeared in the January 2025 print edition of Dental Economics. Dentists in North America are eligible for a complimentary print subscription. Sign up here.
Reference
- 50 things to know about the dental industry in 2024. Becker’s Dental + DSO Review. March 6, 2024. https://www.beckersdental.com/dentists/43149-50-things-to-know-about-the-dental-industry-in-2024.html
