Affordable Care? Not For This Doctor.


by Dr. Bill Simpson

It was a first for me.

After thirty years of practice as the only dentist in a small town in rural Mississippi, I fired an employee. I’ve had employees retire, employees move on to other jobs, and have had some employees who, by mutual agreement, decide that a dental office wasn’t a good fit for them, but I’ve never had to fire one. I didn’t want to terminate someone that I needed and valued but I really didn’t feel that I had another option.

I hated the experience.

First, a little background. Furniture manufacturing was once the linchpin of the economy in this area. The majority of those jobs are now in China. Then the recession hit. In 2011, the unemployment rate here was 13.5%. In the next county it was 20.1%. Unemployment has decreased slightly but most are still waiting on the recovery. Folks around here don’t talk about income equality; they talk about income, period.

My practice serves lower and middle income patients. I don’t have a high-end, high-fee practice like some dentists in more affluent areas. That is by choice. I grew up in a small town, I love the people in a small town, the sense of familiarity and community. I guess I’ll die in a small town but it is not an easy way of life. Years ago, my cousin, a Harvard-educated architect, spent the summer here in order to design and build my dental office. As the building neared completion he turned to me and said, “People say that if you can make it in New York City, you can make it anywhere. They’re wrong.” He pointed to the ground. “If you can make it HERE, you can make it anywhere.” So true.

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