End of the Solo Practitioner

end of the solo dentist

As healthcare and medical models evolve, changes occur in the dental industry as well. At the moment, what we’re seeing in both dentistry and healthcare at large is fewer solo practitioners and more group practices.

A Dinosaur

Solo practitioners are fewer and farther between than they were even just a few years ago. Those operating on an old-school model are even rarer.

One such practitioner is Dr. Douglas Gerard, who in a 2013 article in the CT Mirror described his practice as a dinosaur.

Norman Rockwell prints hang on the walls of Dr. Douglas Gerard’s office, and the New Hartford primary care physician says his practice would fit into that era.

Gerard is the only medical provider in the office, so he’s the one who takes patients’ vital signs and medical histories.

His files are all on paper, and he’s not planning to replace them with an electronic system because he thinks it will distract from the face-to-face encounters with patients. “It’s a dinosaur, he said of his practice. Nobody’s going to do this when I leave.”

– Arielle Levine Becker, CT Mirror

Writing on the Wall

Many physicians feel powerless to change the conditions that limit their professional effectiveness—namely, the administrative burden of running a solo practice.

In a dialogue on the future of medical practices sponsored by Sermo, the online physician community, one practitioner said private practices are “doomed.”

I see few that are successful. The practices in my community that still exist are getting subsidies from the hospital (loan repayment guarantees, recruiting assistance), are supported by the feds (FQHC), or are engaged in what one participant so aptly describes as ‘corrupt practices.’

There are a couple of ethical, honest practices that are still trying to serve the public. But every time I see the docs in those practices they have bigger bags under their eyes and they look more and more tired and depressed. No young physician wants to take any business responsibility or ownership position in a private practice anymore.

– Sermo

From Solo to Group Practices

Historically, small independent practices have dominated the dental and medical landscape.

But increasingly, dentists and physicians are giving up their independence to join larger groups or hospital systems.

By doing so, these dentists and physicians get help with back-office functions such as billing and insurance negotiations, while staying in their old offices and seeing their same patients.

And like Gerard, many people in the healthcare system think the days of independent, solo or small medical practices are numbered.

Over 18 months, the Northeast Medical Group, a physician group affiliated with Yale-New Haven Health, added over 100 physicians to their system.

If I had to predict ten years into the future, I think it will be very rare to find a practice that has no affiliation with a larger entity.

It’s a change brought on by demographics, technology and changes in the way healthcare is delivered and paid for, and part of a broader move toward consolidation in healthcare that includes mergers and affiliations among hospitals.

– Dr. Robert Nordgren, CEO of Northeast Medical Group

Allocation of Resources

We, as a society, must address the hard issues of allocating resources for healthcare. It comes down to basic mathematics: we can’t sustain the current system.

There simply aren’t enough financial resources, physicians, nurses, technologies or drugs to give every person everything they need in healthcare.

We need to find models that help reduce the costs associated with dental care and healthcare so that we can provide every person with the care they need.

Finding New Models

If the current system isn’t working—which it isn’t—we need to find new models that will work.

At the moment, solo practices are dying out. It’s looking like group practices are the future of dental care and healthcare.


By Quinn Dufurrena, DDS