What do dentists do and earn? An exploratory analysis of French dentists with a focus on primary care teams

Access to dental care in France faces two main barriers: high out-of-pocket costs and a widely uneven distribution of dentists. Multiprofessional primary care groups (MPCGs) are currently in development to improve primary care efficiency and enhance the attractiveness of medically underserved areas. We aim to address the research question: What factors influence the income and activity of self-employed dentists, and how do multiprofessional primary care groups (MPCGs) and local socio-economic conditions shape these outcomes? We use data merging an administrative health insurance database and information from tax declarations of professionals in 2017, which we combined with contextual socio-economic information on the areas where dentists practice. There were 20,961 self-employed dentists, including 201 working in MPCGs, in 2017. We study various aspects of dentists' practices, including net income, turnover, activity volumes, and case mix among professionals. We analyze their associated factors by conducting standard OLS regression methods. Male, middle-aged, and self-employed dentists with children provided more services and saw more patients than others. In line with market behaviour expectations, the dental bill increases with the local median income, while the volume of procedures decreases in parallel, echoing labour-leisure trade-offs. The activity and annual income of dentists decreased in areas with high densities of dental practitioners. Despite the limited number of dentists in MPCGs, our results advocate for a deeper investigation of the topic, as MPCG dentists provided more dental care than others in terms of volume, with a higher share of young patients and lower extra fees per service.