Castro, president of dentists: “Clinics have lost half of their income in 2020”

The sector foresees that between 20% and 30% of the centers will close due to not being able to bear the fiscal pressure.

Doctor Óscar Castro, president of the General Council of Dentists.

The dentists were considered as essential activity during the harshest months of the pandemic. However, they could only attend emergencies. A situation that has generated a “Serious economic loss” to the sector.

The president of the General Council of Dentists, Dr. Óscar Castro, explains in this interview with Invertia how the pandemic has affected dental clinics. A sector that has lost up to 50% of its income in 2020 due to the increase in the prices of protective equipment and the lack of patients.

Already in 2019, these centers showed a 30% decrease in their billing, to which the crisis generated by Covid-19 is now added. The result? Between 20% and 30% of dental clinics will end up closing, according to the forecasts of the General Council of Dentists.

How has Covid-19 affected the dental sector?

Each autonomous community has set the guidelines from which establishments should be kept open to the vaccination groups. During the toughest months of the pandemic, we were considered essential activity.

Now, with the measures taken by each region, people are afraid to leave home and postpone their dental appointments. This has caused a serious economic loss to the sector.

This industry is made up of more than 100,000 people with direct jobs, to which we must add indirect ones. The economic problems are different depending on each community and this occurs because there is no clear criterion or leadership work on the part of the Ministry of Health.

This situation can be extrapolated to vaccines against Covid-19. There are communities that have already vaccinated dentists and others have not even started. It must be understood that we are trained for contagious diseases, but also that transmission occurs through microdroplets that the patient can exhale. For this reason, we demand to be a priority group in vaccination and not depend on political criteria.

In addition, they have to give us the vaccine with maximum efficiency. Not only us, but also the entire population. AstraZeneca’s is close to 70% effective. It is necessary to vaccinate with the most effective ones to achieve the objective of having 70% of the population immunized in summer. However, I find it difficult to achieve this goal.

Between 20% and 30% of dental clinics will disappear due to not being able to bear the tax burden

How many clinics have closed in 2020? Are new closings expected for 2021?

The forecast for 2021 is that many freelancers will disappear, including dentists. Between 20% and 30% of dental clinics will disappear because they cannot bear the tax burden. There has been an emergency situation, but there has been no aid. The companies are subsisting on the ERTE, but when this figure disappears it will be a disaster. The same will happen in the dental sector.

The ERTEs have been an oxygen value. This has been the case of Dentix, a company that was on the verge of bankruptcy. However, the pandemic and the figure of the ERTEs have not allowed to focus the problem that this chain of dental clinics has had. From the Council we value that this has to be controlled so that health prevails and not the economic aspect of the matter. It is the duty of the State to watch over the citizens.

How much have the expenses of the clinics increased with the purchase of personal protective equipment (PPE)?

The price of the products that we already used before the pandemic has increased by 50%. We have witnessed a stage characterized by speculation, counterfeiting, a decrease in the quality of the products and we have bought the PPE from the highest bidder.

There is also the circumstance that we continue with a VAT of 21% on FFP2 masks, when the Government tells us that they are the most effective. While in other countries they have reduced or reduced VAT, in Spain we continue to charge 21% for these masks.

Now you have to disinfect more thoroughly before seeing a new patient and use protective equipment that was not necessary before the pandemic. Has this resulted in an increase in dentist fees?

The problem is that there are no patients in the consultations. There has been a decrease in the number of people who come to the clinics, while they continue to have the same taxes and expenses.

In addition, the strictest cleaning protocols are added to prevent patients from colliding in the waiting room. The average disinfection between patient and patient is 15 minutes. That is, you have to space out appointments and that means seeing fewer people, to which is added the increased cost of protective equipment.

Despite this, there are no times to increase rates. I do not know of any dentist who has increased their prices because it would be counterproductive to the practice itself. They are assuming the extra expenses without these having an impact on the patients.

I do not know of any dentist who has increased their prices because it would be counterproductive to the practice itself

The sector foresees a decline in revenue in 2020, by how much?

Objective it with the circumstances of the closure of clinics is difficult, but we foresee losses of 50% in income, that is, half. Already in 2019 an economic crisis was already sensed because there had been a 30% decrease in billing. 2020 has been chaotic and that affects dental clinics, some even disappearing.

How many dentists were infected with Covid during the pandemic?

We do not have clear statistics, but we have registered three deaths due to declared disease. The problem is following the contagion line. It is much easier to catch it in the supermarket queue than at the dentist. Within the healthcare group, dentists have been the ones with the least casualties in terms of mortality and morbidity.

Dentists are one of the priority groups in vaccination. How do they value it?

We dentists are in group 3a and we will get the Moderna and Pfizer vaccines. Other groups will be given AstraZeneca. I think you should use the antigens that have shown the greatest efficacy, but it is better to use a 70% than not at all.

What is your opinion that the Ministry of Health does not have the private health sector to accelerate the vaccination campaign?

Health is one. Then you can put the surname of the private. What is sought with health care is to cure the patient and he does not consider where he is cared for. Entering into a comparison between what is public and what is private has a political rather than a social connotation. Making separations is called sectarianism. It is necessary to speak of a single healing.

If dentists, in an extraordinary way, have to vaccinate, we will do it without asking. We are sanitary and we are here to heal. In the United Kingdom, for example, they asked for volunteers and have made an army of 30,000 people who have been given adequate training to inoculate antigens.

We are at a crucial moment. You have to vaccinate and with everyone who can.

Health is one. Then you can put the surname of the private. What is sought with a healing is to cure the patient

A few weeks ago, the dental clinics in Madrid began to carry out rapid diagnostic tests for Covid. How are they working?

Right now there are a series of clinics, through volunteer dentists, doing rapid diagnostic tests for Covid-19. In areas where there is a higher prevalence of coronavirus, these tests are being done in pharmacies and dental clinics, thus helping to screen to limit the disease. Dentists have to be there, as do pharmacists, nurses and veterinarians.

How do you rate this initiative? Would you ask that it be implanted throughout Spain?

Of course yes. All that is to detect possible asymptomatic cases is to go in the right direction to limit the disease. Everything we do is little to get out of this situation as soon as possible. In short, you have to do a test.

The Ministry of Health is working on expanding the portfolio of oral health services. How should this enlargement be?

The enlargement must be rational. What cannot be is that we had absolutely nothing in the portfolio of services. The interlocutors when developing oral health protocols are the dentists. We would have to start with the most vulnerable groups in society.

We need a cohesion system of the National Health System and not leave it in the hands of the autonomous communities to avoid inequalities. Right now, the health of the mouth of the Spanish depends on the postal code, it depends on where they are born.

Budgetary items must be earmarked for oral health. It would be necessary to prioritize doing a rational study and on that get to work. The General Council of Dentists has had contacts with health and we are open to everything they need.