Why Are There So Many Dentists’ Offices on Somerville’s College Avenue?
Walking on College Avenue, from the Davis Square T stop to the main campus of Tufts University, one cannot help but notice that nearly half of the businesses from Davis to Powderhouse Square are dental practices. Is Somerville just a smile-conscious city, or is there something more to it?
“It used to be called Doctor’s Row,” says Carol, the administrative lead at the offices of Anthony Parella. “I knew a lady who was about 100 years old. Her husband was a doctor, and his practice was in their house, on the first floor. It went on like that for decades.” Parella, who specializes in cosmetic dentistry and periodontics, has a small private practice on the main floor of what was once a single-family home. The second and third floors of the building have since been converted into apartments.
“It’s very rare to see a practice just disintegrate,” Carol explains. “When someone retires, a new doctor usually comes in and takes up the practice.”
As with other types of businesses, the city maintains specific zoning and licensing requirements for privately-owned healthcare practices — while not impossible, dental office staff say that licenses aren’t easy to come by. Rather than filing for new permissions when starting a new practice, many of the dentists in the area have established their practices using pre-existing infrastructure that has made it easier for them to move in, change the window dressing, and get to work.
But is it really practical to have so many dentists in such a concentrated area? Like a fabric district or jeweler’s row, dentists in Somerville look a bit like a real-life illustration of the economic theorem developed by Harold Hoteling which suggests that when located next to one another, stores offering similar goods, pricing and services can generally expect to evenly split their surrounding clientele.
“It’s all about what the patient’s looking for,” said Deanna, who works as a receptionist at Somerville Dental Associates. “Most want the exam, the x-rays, and the cleaning. Some people just want a cleaning, like a one-time deal. But not all practices will do that for you.” Deanna pointed out that larger corporate practices in the area often can’t guarantee that a patient will see the same dentist at each visit.
She also spoke to the question of referrals, explaining that some practices offer specialist services, while others do not. “We regularly refer patients to our neighbors, when we can’t give them the services they need.” If your dentist can’t provide you with periodontic treatment, she can easily refer you to a colleague down the street.
This seemed due in part to the unique services each practice offers, and to the distinct patient populations they tended to serve.
Private practices like those of Lorna Lally and Anthony Parella reported that families and Tufts students made up the majority of their clientele, and that nearly all of their patients either had dental insurance through an employer or parent, or that they paid for services out-of-pocket. Both practices offer both general and pediatric services.
Dental Associates of Davis Square, a corporate practice with orthodontics, periodontics, cosmetic and general dentistry all under one roof, sees patients from throughout the surrounding area. Although they have fewer student patients than other nearby practices, office manager Kayann explained that their model attracts families with growing children, particularly given the offering of orthodontic services. Most clients had some kind of dental insurance, ranging from private plans to MassHealth.
When asked about competition with other businesses in the area, Kayann described their marketing strategy, which targets both older and younger audiences through both print and online advertising, and television commercials mainly on Spanish and Portuguese channels. Patients could request a Spanish or Portuguese-speaking doctor if they wished to do so.
Every staff person I spoke with emphasized the value of being located next to a major public transit stop. Deanna pointed out that most people don’t visit the dentist more than two or three times a year. “So they’re willing to travel for it. And the T makes it easy.”
None of the staff at the five practices that I visited seemed concerned about competition with other nearby offices. “It’s a diverse enough area with a high population density, ” said Deanna. So we all manage to do all right.”