Episode Overview

Main Theme:
This episode features Dr. Hilary Abel, Doctor Development Advisor at SALT Dental Partners and President of the District of Columbia Dental Society. The discussion centers on current challenges and trends in dentistry, including Medicaid cuts, workforce issues, the evolving role of technology (especially AI), the future of Dental Service Organizations (DSOs), and the importance of engagement in organized dentistry.

Guest Introduction

• Dr. Hilary Abel introduces herself as a practicing general dentist, graduate of Tufts (2009), current President of the DC Dental Society, and Doctor Development Advisor at SALT Dental Partners.
• Key Quote:
  “What really ties it all together for me is being able to help strengthen the profession and also helping both patients and doctors thrive in that situation.” — Dr. Hilary Abel [00:42]

Key Issues in Dentistry (2025)

Medicaid Cuts and Fee Schedule Challenges

• Dr. Abel highlights Medicaid cuts as a significant concern, especially in D.C. where a large population relies on Medicaid and the federal match is high.
  • Any cuts deeply impact patient access to care, provider operations, and the city health infrastructure.
• She notes that dental coverage is particularly vulnerable to budget cuts.
• A major advocacy win:
  “We had previously gone for more than 15 years without a meaningful fee schedule update. ...We’re finally able to secure one this year. So our advocacy in that area has been incredibly important.” — Dr. Hilary Abel [01:47]

Workforce Turnover and Training Challenges

• Workforce turnover is a persistent problem: recruiting and retaining team members is increasingly difficult.
• Training and supporting dental assistants “to the top of their certifications” is seen as a crucial step.
• However, inconsistent state regulations for dental assistants and hygienists (notably across D.C., Maryland, and Virginia) cause inefficiencies and increased costs.
  • “These inconsistencies make things less efficient and more expensive. So I really believe that more alignment and investing in trainings and certification through that alignment would go a long way towards stabilizing those teams and ultimately improving patient care.” — Dr. Hilary Abel [02:52]

Excitement and Concerns in Dentistry

Excitements: Technology and DSO Evolution

• Dr. Abel is optimistic about technology, especially AI:
  • “We've seen radiologists use AI successfully, and I think in dentistry, it can just really help us with diagnosis and treatment planning...” [03:26]
  • Emphasizes that AI is not about replacing doctors, but enhancing clarity, confidence, and outcomes.
• Highlights positive shifts in how DSOs support practices:
  • Moving from “cost-cutting and rebranding” models to “preserving what's special about a doctor's practice while giving them the support that they need.”
  • “At Salt, for example, we've worked hard to build a culture that protects doctor's autonomy, but just adds efficiency where it's needed. And to me, that's the future of DSOs.” [03:52]

Concerns: Engagement in Organized Dentistry

• Dr. Abel expresses worry about declining engagement in dental societies, which advocate for the profession.
  • “If fewer dentists get involved, the collective voice really gets weaker, and that has real consequences for the profession.” [04:30]
• Clarifies that “fewer engagement” refers to fewer dentist memberships. [04:56]

The Evolving Role of Healthcare Leaders

• Leaders will need to enthusiastically embrace technology without losing the human touch:
  • “Patients still want really great experiences and team members want to feel supported.” [05:12]
• Simplification is critical as practices now juggle many tech platforms for operations.
  • Leaders need to “simplify that without losing what makes the patient experience and team so great.” [05:22]
• Advocates for robust collaboration between DSOs and organized dentistry:
  • “I believe it's really shortsighted for societies to ignore the role that DSOs play now, and it's just as shortsighted for DSOs to not encourage their doctors to be engaged locally.” [05:37]
  • The goal: advocacy, business support, and clinical excellence working together.

Notable Quotes & Memorable Moments

• “I'm really excited about the technology, especially AI. ...It’s not about replacing the doctor. It's really just another tool to help give us and our patients more clarity and confidence in their care.” — Dr. Hilary Abel [03:26]
• “At Salt, for example, we've worked hard to build a culture that protects doctor's autonomy, but just adds efficiency where it's needed. And to me, that's the future of DSOs.” — Dr. Hilary Abel [03:52]
• “If fewer dentists get involved, the collective voice really gets weaker, and that has real consequences for the profession.” — Dr. Hilary Abel [04:30]

Key Segment Timestamps

• 0:22 — Guest introduction and background (Dr. Hilary Abel)
• 1:11 — Major industry issues: Medicaid, fee schedules, workforce
• 3:18 — What excites and worries Dr. Abel (technology, DSO evolution, dental society engagement)
• 5:08 — What effective healthcare leaders will need in the next 2-3 years

Tone and Style

The conversation is straightforward, insightful, and solution-oriented, with Dr. Abel balancing technical expertise with emphasis on care, advocacy, and proactive leadership.