Dr. Christian Piers is a recent graduate of the University of Colorado School of Dental Medicine. He is currently serving as immediate past president of the American Student Dental Association (ASDA) and editorial board member for JADA. He will be attending a residency in orthodontics at UNC-Chapel Hill beginning in August
In this episode we discuss:
– Student Debt
– Specialty Licensure
– New dentists: DSO or Private Practice?
What motivated you to want to be the president of the Student Dental Association?
Yeah it really started so innocently when I ran into an editor for ASDA at a national meeting and she explained to me what being an editor entailed and it just sounded so fascinating to me. As someone who did a master of Fine Arts and creative writing and also loves the scientific piece of dentistry, I have always kind of searched for a way to reconcile those two passions and so I signed up for it and had an incredible time writing articles, working with other student authors, and it really was just kind of all about the journalism, but I slowly found myself becoming more passionate about the things that I was writing about and I moved on to being editor-in-chief during my second year and I realized that especially with the licensure process I was kind of caught in an interesting situation where if I wanted to go back to Hawaii I needed to take some specific exam that was not offered at my dental school and I needed to bring patients to another state so you know cover their airfare, make sure nobody missed their flights, everybody’s fed, and in hopes that they’ll be accepted to be a part of this examination process and then one shot in this foreign environment for everything to go well and the patients to wake up on time etcetera. So I saw this looming on the horizon for me and knew that there would be nothing that I could do to change that experience for me but that I could maybe play a part in helping students be able to avoid that fate and also really move the system toward something it was a little more patient centered and then I had a lot of ethical issues with the way that patience kind of turned into commodities in those transactions, so it was kind of a choice between telling other students that I’ve wanted this work done which seemed to me somewhat unfair or trying to trying to work on it myself. So really through no direct choosing of my own I kind of found myself into this pipeline that ended with me running for ASDA president in Boston in 2015.
What is your opinion on the idea that specialists need to take a a general dentistry exam to pass the license for a state? Fo example, you could be an orthodontist for 20 years and if you want to move to hawaii now from North Carolina, you have to take a licensure exam that has nothing to do with orthodontics.
As a future orthodontist, I know that if I want to change states there will be a time where I will be demonstrating my proficiency and my concern there is that that’s a hurdle that specialist need to go through and it might be a radiologist truly not touched a hand piece in 15-20 years, and theres some risk inherent for the patient. One of the former editors of JADA, Lawrence Meskin said, “is it right or ethical to use human subjects for the purpose of discovering incompetence.” There’s this real live breathing person that you’re putting in in front of that radiologist whose wielding a hand piece they have been handled for a while and their purpose in that transaction is to weed out the incompetent ones and if they serve their function and locate and incompetent practitioner that’s their permanent cost and irreparable damage so I think you I think you hit the nail on the head. The unfortunate issue with talking about specialty licensure is that nobody’s really interested in having the conversation until the larger licensure question is addressed and I think it makes actually a lot more logical sense to tackle that specialty piece first I think everyone can understand that there’s really no rationale there but in a certain order of operations of change, it seems that because a smaller proportion of the profession is affected it’s just going to take a little bit longer to be addressed.
So I contacted you based on the article that you were involved in, concerning student debt. I wanted to talk to you about this because you are the past president of the ASDA, you understand whats going on in students minds. Can you elaborate on this a little more?
As far as hot topic issues go for dental students it’s a it’s huge, it’s dominant on our horizon everyday. You know for me coming from Hawaii where I only lived for 4 years, I didn’t qualify for the interstate exchange that they had set up with western state dental schools. You have to live in Hawaii for five years to be considered for that so I was stateless, I was out of state everywhere so dental school was going to be pretty expensive for me wherever I went and the University of Colorado I think it started out being in the low 60 thousands for me my first year and I ended up paying my fourth year on 67000. So around the average for what students are paying for their dental education these days, right around a quarter million dollars. The numbers are large enough to be to be abstract I mean it is difficult to fit one’s mind around that number being a level of debt that is associated with you as a person. We certainly are facing a situation where dentists across the country are talking about busyness and whether or not the levels are what they used to be, but whether or not they’re reaching places that are satisfactory to dentist who have been practicing for decades. You know most dentists aren’t super happy about where those levels are today and their established, so when you have students coming into the market, you either have the opportunity to take on a pretty high risk scenario in starting your own practice from scratch or buying a practice and kind of going through the attrition of losing some of your patients and figuring out all the business aspects in those first few years and how to figure out that in a few years after dental school without the benefit of years of experience to navigate that financially, dental students really are you know they’re going to struggle to take the reins immediately and be able to generate the kind of income that pays back that debt. Another option is to go into a DSO and there’s a pretty wide variety of earnings you can have depending on which DSO you go into but but they’re they’re finite. It’s a little bit more like a salary and it just kind of makes that debt level and a number of years it’s going to take to bring it down it makes it a little bit more difficult to take on any other scenario but I would say that inflation really doesn’t totally take care of the picture of the increase in cost and dental education.
You mentioned that you have the options of starting your own practice/buying into an established practice or going into a DSO. As a recent graduate, how do you see these two options and what do you think is the better choice for new graduates such as yourself?
First, a DSO has somebody who is a paid professional and who knows how to relate with the with the market that they are looking to recruit from and they’re really good at what they do because that’s that’s the one thing that they do. So when there is someone somebody up in front who knows how to relate to people and how to talk about the risks and fears that are inherent in being a millennial dental student, you get a lot of people listening but I think that you also are very right in comparing the McDonald’s eating experience to the mom-and-pop dinner eating experience because and I have no data to back this up, but I wonder if private practice might become something more of a boutique experience, something that say you know the foodies are the ones who don’t really want to go to McDonald’s and are going for the experience of the meal as opposed to for a base set of nutrients they want higher quality, they want some pleasure out of an experience that really requires only some basic necessities. They’re looking for more than just the nutrients, so I think private practice maybe maybe it’s niche is a catering to those foodies of dental care, the people who want the boutique experience where they’re treated as an individual and not as somebody who’s coming through the door and has really valid needs that need to be met and and meets them in as timely and effective away as possible which is maybe what some and certainly not all DSO’s are striving to do. There are market niches for both I’m just interested in what patients will mainly be looking for as this generation of dental students goes into practice because the economy seems to be getting better albeit slowly and that there may just be a little bit less of market drive for the cheapest service.
How can we get in contact with you?
Email: Christian.piers@gmail.com