Dental practices led record health care job losses in April but are bouncing back

The health care sector lost a record 1.4 million jobs in April led by more than half a million job cuts at dentist offices according to the Labor Department, as the coronavirus pandemic kept most non-emergency health care services on hold nationally.

The staggering jobs losses mark a 53% decline in dental practice employment over two months.  All but 3% of dental offices nationally were shut down except for emergency appointments last month, according to the American Dental Association, and nearly 9 out of 10 had laid off staff. 

Most of the jobs could come back online over the next few weeks. The first week of May saw nearly half of dental practices bringing workers back, according to the ADA.

“This week 28 states have reopened… in those states we’re finding 48% of dentists have fully hired back their staff, which is a considerable jump from two weeks ago,” said Marko Vujicic, the ADA’s chief economist.

Dr. Paul Giotopoulos and his partners in New Rochelle, New York furloughed a dozen employees last month. They’ll be bringing them back next week, with the moratorium on routine dental care scheduled to be lifted on May 15^th in the state.

It will be anything but business as usual.

“We’re going to be doing a lot of different things–taking some of the seats out of the waiting room… we’ve put up barriers for the receptionists at the front desk,” as well as doing pre-screening of patients for Covid symptoms, Giotopoulos said. 

For many practices, one of the biggest challenges to fully ramping up service is finding enough personal protection equipment for their staff. The other is trying to control the spread of patient aerosols that occur during dental procedures.

“Aerosols are created when we use our drills or ultrasonic tools.  If you’re ever had your cleaning done with your hygienist – that creates an aerosol and the aerosol spreads all over the office,” in the air said Giotopoulos.

Dental practices that have resumed service this month are seeing about a quarter of their usual patient volumes, to maintain safe practices.  At the same time, they are facing higher costs because of new safety protocols to protect themselves and their patients. 

“Protocols like spacing patients out –and even some states are requiring exam rooms to be left vacant, so the aerosols can settle– all these things are going to reduce productivity and increase variable costs for dental offices,” said Vujicic. “That’s not a constraint to reopening, but it’s definitely going to affect profitability and depends on… who bears the cost of that increased PPE expense.”

The ADA has asked Congress to provide tax credits to dental practices in the next round of coronavirus funding, to help cover the increased costs of PPE.

Following the 2008 financial crisis, while other service sectors shed jobs in droves, health care hiring steadily rose.  But the sharp spike in unemployment poses a headwind for providers trying resume their practices.

Millions of Americans who have lost their jobs may qualify for health insurance coverage through the Affordable Care Act exchanges or the Medicaid safety net program, which could provide a hedge for doctors and hospitals.  But dental coverage is generally separate from insurance for medical care.

“We’re going to be facing a two-fold problem… the disease itself and then now you’ve got people that can’t pay. They don’t have a job,” said Giotopoulos. “I don’t think we really understand the scope of that just yet, and that’s something we’re going to have to work our way through.”