Background: The authors examined the relationship between education debt and career choice, particularly dentists' decisions to specialize, participate in public health insurance programs, and join dental management service organizations (DMSOs).
Methods: The authors used data from the American Dental Association 2015 office database, which contains dentist demographic information and identifies dentists who participate in public health insurance programs for pediatric dental care services. The authors merged this database with the 2002-2015 American Dental Association Survey of Dental Graduates, which contains information about education debt, to assess the relationship between education debt and career choices. The authors used probit and multinomial logit models to determine the relationships among education debt, demographic characteristics, and dentist career choices.
Results: For each $10,000 increase in education debt, dentists were 0.9% more likely to join a DMSO (relative risk ratio, 1.009; 95% confidence interval, 1.0021 to 1.0164) and 0.6% less likely to join a non-DMSO group practice (relative risk ratio, 0.994; 95% confidence interval, 0.9897 to 0.9987) over a solo practice. Education debt did not have a statistically significant association with the decision to participate in public health insurance programs, but it did have a statistically significant association with the decision to specialize.
Conclusions: Education debt had a modest association with some career choices among dentists. Demographic characteristics, such as race and sex, had a greater association.
Practical implications: Dental education debt has increased substantially in recent years. Debt had only a modest association with some career choices. Policy makers could consider this when considering education debt relief.
Keywords: Education debt; Medicaid participation; career choice; dental management service organizations.
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