If you can't buy a burger in some towns, what makes us think we can get dental care there?

April 15, 2016
Sonic Drive-In is the burger king (no relation to Burger King) in my region.

Sonic Drive-In is the burger king (no relation to Burger King) in my region. The headquarters for Sonic is about 100 miles from where I work every day. As you drive through the countryside, passing through the smaller towns, you'll see a Sonic where McDonalds, Burger King, In-and-Out, etc., have likely determined, "Our corporation will not yield the minimum revenue from selling hamburgers in that town." But there's not a Sonic in every town. In Oklahoma, there's not a Sonic in eight of the state's 77 counties. There are some residents who do not have easy access to the Sonic Burger. They are underserved.

I'm not suggesting a connection between dental support organizations (DSOs) and fast-food franchises. But I was eating a homemade sandwich while reading a press release about a DSO raising $15 million to help fund growth among its dental, uh, franchises in the area. As an advocate for dental hygienists, I admit I'm a little indecisive about DSOs. Some hygienists speak in very glowing terms about being able to practice dental care in a corporate environment. Others very disgustedly compare DSOs to what used to be called "prophy mills."

The CEO of the company raising the $15 million said the capital commitments would "partner with dentists that are enthusiastic about changing the delivery of care." The company prides itself on being "responsive to the unique needs of each practice while offering significant long-term benefits for our dental partners." I'll knock on wood here and hope that the dental hygienists employed by the company enjoy some of the "significant long-term benefits." It's the enthusiasm of dental professionals "changing the delivery of care" that caught my eye while eating bologna instead of a Sonic Burger.

At some point, DSOs will be challenged about access to care issues too, right? Dental associations bow to the will of its members first, and then the will of the people second. Dental hygienists who have volunteered for service with their dental hygiene associations can fill your ear with horror stories about dealing with the associations for dentists. But dental associations do frequently modify their stance on issues based on what consumer, state governments, etc., desire. Corporations are different, though. They answer to a board of directors and stockholders. As long as there is no violation of law and no threat to public safety, they can do as they please.

What's it going to take to get a DSO franchise in all 77 Oklahoma counties, including those counties without a Sonic Drive-In? Right now, the advocates for care of underserved populations are making great strides in persuading dental associations to consider alternatives in the delivery of care. The will of the people doesn't tolerate young kids being killed or crippled by dental disease.

It will be interesting to see what happens when a DSO says, "Our corporation will not yield the minimum revenue necessary for providing dental care in that town."

Mark Hartley

[email protected]