Rural dentistry — benefits of leaving “big city life”

Practicing dentistry in a rural setting is my chosen way to practice in today’s dental landscape. I didn’t come to this conclusion without a lot of headache and heartache, but for me, the choice was undeniable. I have been practicing in a rural setting for almost 4 years, and I will never go back to “big- city” dentistry.

First, let’s define the term “rural.” Definitions can vary depending on who you’re talking to. Fort Collins, population 150,000, was once the “smallest” place we had ever lived. By no means is Fort Collins a rural community. They have a Costco! That’s criterion number one. (If you have a Costco, you are not rural!) Most people will define rural based on population size. My current town has a population of approximately 25,000 people. Others will define rural based on geography — how isolated you are from a major city. We are 2 hours from the closest major airport and city. A third criteria would be based on the socioeconomics of the people in the area. Aspen, Colorado has a population of just under 7,000 people, and it’s almost a 4 hour drive to the closest major city, Denver. According to the U.S. Census Bureau, the median household income for Aspen from 2017-2021 was $89,625. Many would not consider Aspen as a rural community.

Some stark contrasts are apparent when I compare practicing rurally and practicing in an urban/suburban setting. The following are the five main benefits to practicing in a rural community.

  1. The level of competition

I have practiced in heavily populated areas where there are literally five dentists on every block. There simply aren’t enough patients to go around. If you practice in an area where competition is either low or nonexistent, your ability to produce is greatly increased. This sounds so simple, yet so many dentists turn a blind eye to this fact. Personally, I previously have naively disregarded the competition level in other places I’ve practiced. I was told in dental school that you can simply decide where you want to live, practice there, and you’ll be just fine. That is absolutely not true. Competition matters. It matters if you don’t have enough people to work on. It matters if you have to drastically reduce your fees or be encumbered by every insurance plan under the sun because you have to compete with every other dentist within a mile radius of your office.

When patients have multiple options, more times than not, they are going to choose based on price. That’s a no-win for everyone involved. There are rural communities throughout the country that are in desperate need of providers. These are the situations that foster success not only professionally, but financially as well.

  1. Lower cost of living

The largest expense of any adult/family is housing. Whether you’re renting or buying, housing is less expensive in rural areas. When I moved from Colorado to Kentucky, my house payment was cut in half while only sacrificing a few hundred square feet from my Colorado home to my Kentucky home. Gas is cheaper. Groceries are cheaper. Utilities are cheaper. Also, (and this is purely anecdotal), when one has less “shopping” options in town, you are more likely to spend less money. When all the factors are considered, you can decrease your home’s “overhead” by thousands of dollars per month by living in a rural community. The amount of stress that can be alleviated from knowing that your monthly take-home pay doesn’t have to be an astronomical number each month makes practicing dentistry a little more enjoyable. Instead of fretting over the implant patient that didn’t show up, you’re happy to have a little extra time to surf the web. That one broken appointment won’t make or break your month.

  1. Work/life balance

Dentistry is hard work. Dealing with the general public is difficult. Dealing with staffng issues is difficult. Even if you’re an associate with no ownership responsibilities, you still have to deal with patients and staff. We all need to find ways to get out of the office and de-stress. Working in a rural community gives you that opportunity. The vast majority of rural practices still operate Monday through Thursday from 8 a.m. to 5 p.m. I work on Fridays, and I’m the outlier. Evenings and weekends seldom need to be covered. Working 4 to 5 days per week provides opportunities to get out of the office and pursue passions that reinvigorate us. It provides down time to simply relax and recharge for another day/week. It provides time to spend with family at ball games, swim meets, or orchestra concerts. It provides time to work on that side hustle that you’re passionate about. Again, dentistry is hard on us physically and mentally. We all need breaks. Practicing rurally gives us those breaks.

  1. Opportunity to get involved in the community where you practice

This might sound like a nightmare to some of you. My biggest fear when I decided to practice in a small town was running into patients in public — that awkward exchange of me knowing who they are but them not knowing who I am is so uncomfortable to me. That being said, getting involved in the community where you practice is so very rewarding. In a big city, dentists are a dime a dozen, but in a small community, you stand out. You’re a healthcare provider. Your donation to a school sports team actually makes a difference. The board seat that you can hold for whatever local organization you are passionate about can enact real change that helps your community. A couple of decades ago, the elected mayor in our town also was a local dentist! I have enjoyed being able to contribute to the sports teams that my kids have played on over the past few years. I have also enjoyed getting involved in community events like homecoming parades, 5k races, and community outreach that help improve our community and those who live here.

  1. Career fulfillment

Not only do you have the opportunity to do more dentistry, but you have the ability to choose the type of dentistry you want to do. You can narrow your scope of practice and focus solely on placing implants, treating children, or treating sleep apnea. More importantly, you can also eliminate procedures that might cause you more stress than you want to deal with. Personally, I have never been proficient at molar endo. In the past I’ve done it, mostly because I “needed” the production, but it was never very profitable to me because I wasn’t very fast at it. Plus, I always felt guilty if one I did failed. When I transitioned to a rural practice, I decided I would refer out all my molar endo to the specialist. It has made my life so much easier. I love seeing a crown on my schedule where the endo was done by someone else. Not only can you narrow your focus, but you can extend your career in a rural environment. Less wear and tear from working long hours can extend your career by years, if not close to a decade.

Rural dentistry has been ignored for far too long. The benefits of practicing in a rural area far outweigh the drawbacks, in my opinion. You can practice the way you want with little/ no competition in an environment that is cheaper to live in. Sounds like a win-win to me.

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