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The changing structure of the dental workforce: what do young dentists want today?

Blog Author Tom King

Blog Date 24/07/2018

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Millennials, those born somewhere between 1980 and 2000, have been the subject of seemingly endless column inches in recent years. 

The coverage, much of it derisory, has accused millennials of killing off everything from breakfast cereals to holiday postcards and spending so much on avocados they’ll never be able to afford to get onto the property ladder!

Yet, more serious generational analysis has identified shifts in attitudes and behaviours, particularly in how those aged 18 to 38 approach their working lives. 

 
But what does this have to do with dentists starting out in their careers today?
 

What do younger dentists want?

In general, the argument goes that millennials are more focused on achieving a good work-life balance, are motivated by career progression and personal development more than financial reward, and are unlikely to work for the same employer throughout their whole career. 

Millennials are said to seek employers offering flexibility, opportunities for continued learning and that will allow them to get ahead. 

But how much of this change is about a generational shift in attitudes, rather than about changes in the economy and the world of work? And what does it all mean for dentistry?

In the future, nearly 40% of millennials expect to work mostly regular hours with some flexible working and around 33% expect to work mainly flexible hours, while only 25% are expecting to work mainly regular office hours.

Shifts in the dental working environment

The idea of a job-for-life from leaving school to retirement is now a thing of the past and for around the last three decades the economy and labour market have increasingly shifted towards an emphasis on flexibility, de-regulation and competition. 

Millennials are also a generation increasingly burdened with enormous debts before they’ve even had chance to send out a CV. 

We’ve estimated that dental students in the first year of their degree now could graduate with more than £76,000 of debt. This creates clear imperatives to get on and get ahead as quickly as possible. 

Younger dentists today will never have known anything other than the UDA treadmill and the stresses this can cause for those working in general practice. 

Many are turning to more flexible, ‘portfolio careers’, to reduce their exposure to this high-pressure environment. Our research has found associates in all age groups are looking to reduce the number of hours they work in dentistry, including 30% of those aged 25-34 years old. 

This workforce shift may explain the recruitment problems observed across many areas of the country, with practices needing to contract more associates to complete the same number of hours. 

There is also anecdotal evidence that some practice owners do not feel that part-time working is a good fit for their practice and it may be that there is a mismatch between older practice owners’ expectations of their associates, and the younger dentists’ desire for flexible part-time hours and a work-life balance.  

In its report last year, the pay review body for dentists remarked that the decline in practice ownership among GDPs ‘could be connected to the desire for work-life balance, flexibility and fewer responsibilities’.(see page 109).
 

The urgent need for dental contract reform

While it may be that changing career aspirations partially explain the trend away from practice-ownership, it is more likely that structural factors within the dental market, not least the growing trend of dental corporates coming into the market, play a significant role. 

The growing gap between the value of dental practices and associates’ incomes, which have fallen by more than 30% over the last decade, means that practice-ownership is financially out of reach for an increasing number.

It is also worth noting that dental students remain interested in becoming practice-owners during their careers; with 72% of dental undergraduate students at the University of Bristol aspiring to become a partner after gaining experience as an associate and 7% hoping to find an opportunity for partnership immediately after graduation. 

It is perhaps to be expected that 71% of dental students intend to specialise, as one of a limited number routes to develop professionally. 

There are clearly potential challenges for the dental workforce if the observations about millennials do play out over coming years, but the underlying challenges for dentistry – a failed contract in England and Wales and overbearing and costly regulation – cut across generations. 

The truth is that the recruitment and retention problems faced by NHS general practice are less about generational attitudes towards work, and we've argued it's more a symptom of a system in urgent need of reform. 

Tom King, Policy Adviser
BDA 

This is an adaptation of a longer article originally published in BDJ in Practice Volume 31 Issue 4,  ‘The rise of the Millennial’ 

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