Rise of Corporate Dentistry

[cali1]

Hey all,

I wanted to ask some of the future dentists about corporate dentistry and its impact on the dental profession. By Corporate Dentistry, I mean companies like Heartland and SmileCare, out in the West Coast, that own many practices and hire dentists to work as associates. SmileCare has 70 or so practices in Cali alone, and I think Heartland is much bigger. Their ad says they add 25 to 30 practices a year. Do you think this is a growing pattern, or no? Personally, I think if this became very popular, it would be a huge blow to dentistry. One of the best benefits of this field is being your own boss, and running your own practice. And corporate dentistry would take away from that.
Ideally, I would like these corporate dental practices to provide work for those dentists that don't want to deal with the hassle of a practice. But I don't want them to become so large that small practices would not be able to compete with them. They definetly have a competitive edge in that they charge lower prices than a normal practice. What do you guys think about this?

---

Members don't see this ad.

 

[DrJeff]

In all honesty if you don't like the concept, don't participate in one of them. My experience with patients who've been treated by one of the dental factories is that the patient's aren't very satisfied. They're at first drawn in by the prices (I.E. the 1/4 to 1/2 pages adds touting discount dentures or free exam/x-rays with a cleaning, etc), but after a few visits they'll often leave and head back to a "private" office. The most common reason that the 10 or so patients I have that left the "factory" is to paraphrase, "I didn't like that I kept seeing a different dentist each time whose name I couldn't even come close to pronouncing"

Even if these companies get bigger and bigger and start becoming dental HMO factories, there will still always way more offices that when push comes to shove, would leave the insurance company affliation(and bring ALOT of patients with them) rather then particpiate with that type of plan.

Remember, if you don't participate with those types of programs, what has happened to medicine won't happen to dentistry

 

[blankguy]

Here is Boston, we have GentleDental which advertises very heavily. My experience with them is that a lot of the dentists working for them are not very experienced.

 

[cali1]

Yeah, you're both right. I have noticed that most of those dentists are new and typically inexperienced. They're usually right out of dental school. Most work for a year or two and then leave for private practice. I guess that right there limits how big these companies can be, since most of their doctors leave after such a short time. It would be hard to bring in many more doctors.
I guess I worried prematurely about a corporate dentistry taking over private practice and all. Dentists have high regards for themselves, and that is important because they won't take S*** easily. They won't settle for bad hours, little pay, not being their own boss,if they don't have to, and that prevents corporations from really taking over. In most cases of Corporations prospering, (Starbucks, FastFood, Supermarkets, etc) the workers are numerous and easily replaced, so if they don't take the BS or demand better, they can find other workers very easily. Not so with dentists. That'll prevent us from being pushed around.

"Support Organized Dentistry "

 

[trypmo]

I once went to a "factory" to get a cleaning and x-rays, and they guy who cleaned my teeth looked about 19 yrs old and was scared like a deer in headlights. Scrape, scrape, shudder, scrape. (I didn't take great care of my teeth back then.) Then the dentist came along and he exuded a horrible put-on pompousness and also a deep resentment (probably at having to work there, but it came out as a sneering look he gave to patients). It was a thoroughly unpleasant experience, and I've never gone back to one of those. I can't even imagine how terrible it would be to have to actually work there!

 

[Zurich5]

I?m pretty familiar with one of the places you listed, and they?re strictly there for production?they make a lot of money in the process too. Most of the docs that work for the place are straight out of school, aren?t too familiar with other options following graduation, or do not feel comfortable running a practice. Regardless of their reason, they work very hard while they are under contract with this company, and are usually forced to move far away when they break off on their own due to restrictive covenants. Their waiting rooms are stock full of public aid patients, and I can assure you that they do not try to sell much cosmetic work. This isn?t a horrible route if you want to get your speed up following graduation, but I couldn?t imagine having five or six guys looking over my shoulder every day preaching about production standards?all while I?m consistently yanking out pita patient?s teeth. This is definitely not the long term solution for dentistry, even though a few are in the process of setting up stock option plans for their ?employees.? Keep in mind that the men running these businesses are businessmen, first and foremost, they see the bottom line, not your personal well being. Factories are definitely the appropriate name for these giants.

 

[aphistis]

Originally posted by Zurich5
I?m pretty familiar with one of the places you listed, and they?re strictly there for production?they make a lot of money in the process too. Most of the docs that work for the place are straight out of school, aren?t too familiar with other options following graduation, or do not feel comfortable running a practice. Regardless of their reason, they work very hard while they are under contract with this company, and are usually forced to move far away when they break off on their own due to restrictive covenants. Their waiting rooms are stock full of public aid patients, and I can assure you that they do not try to sell much cosmetic work. This isn?t a horrible route if you want to get your speed up following graduation, but I couldn?t imagine having five or six guys looking over my shoulder every day preaching about production standards?all while I?m consistently yanking out pita patient?s teeth. This is definitely not the long term solution for dentistry, even though a few are in the process of setting up stock option plans for their ?employees.? Keep in mind that the men running these businesses are businessmen, first and foremost, they see the bottom line, not your personal well being. Factories are definitely the appropriate name for these giants.

So you're saying you really like these places, eh Ryan?

 

[blankguy]

Originally posted by trypmo
I once went to a "factory" to get a cleaning and x-rays, and they guy who cleaned my teeth looked about 19 yrs old and was scared like a deer in headlights. Scrape, scrape, shudder, scrape. (I didn't take great care of my teeth back then.) Then the dentist came along and he exuded a horrible put-on pompousness and also a deep resentment (probably at having to work there, but it came out as a sneering look he gave to patients). It was a thoroughly unpleasant experience, and I've never gone back to one of those. I can't even imagine how terrible it would be to have to actually work there!

It may be terrible for a patient but I suspect that it is a good place to get a new dentist out of dental school get some experience. I know a BU dental grad that works at one of the Gentle Dental locations.

 

[Zurich5]

Originally posted by aphistis
So you're saying you really like these places, eh Ryan?

I?m pretty impartial to what they do. Heartland actually has their headquarters in my hometown (pop. 15,000)? so you can imagine what their influence on the community is like. It?s not a bad deal for dentists fresh out of school (get your speed up, see tons of patients) but in the long run they take a HUGE chunk of your change?plus they have specialists now, so as a general dentists, you?re pretty much just a machine for bread and butter dentistry?they?ll give you endless ce courses, but you have to work your way up the food chain. They also take something like sixty percent of your production?damn, I?d rather be in the board room.. That's for sure.

think I?ll try and figure out how to run a payroll and handle running a business on my own, rather than making half as much with some huge conglomerate. Heartland is making it?s way into Indiana too? not sure what the Indy area is like. Their CEO/Owner, whatever you wan to call him, posts quite a bit on dentaltown, pretty good stuff for a farm boy

 

[CarliDee]

I currently work as a dental assistant for a corporate dental office & it has been quite a learning experience. The Doc I work for runs an insane schedule (he's burnt out after practicing for 5 years) & he has difficulties dealing with public aid patients.

I will definitely join a private practice/buy a practice/start my own practice after I graduate dental school.

 

[larryt]

Originally posted by cali1
In most cases of Corporations prospering, (Starbucks, FastFood, Supermarkets, etc) the workers are numerous and easily replaced, so if they don't take the BS or demand better, they can find other workers very easily. Not so with dentists.

Do you have any stat to back your statement ? My friend and I are about to purchase a dental office here in town. Our deal and paperworks will finalize this coming month. We put an ad out for dentist and got several calls (lots of dentists and 4th dental students with and without experience). So far we have interviewed 7 experience dentists in the last 2 weeks. We may choose 1 lady whom we interviewed last nite with 7 yrs experience and has a stable life. Will see how thing going.

In California, there is an army of dentists looking for jobs there, especially in Orange county and San Jose area. Few of my friends have to move to other states such as Texas and Lousiana for jobs. I went to San jose last summer.. man... dental office was in every freaking block. Many shopping strips had more than one offices in there.

 

[KAJALKIRAN]

corporate dentistry, though provides a tremendous amount of ground for a graduate just of school, might be detrimental to "quality care" on the long run...i say this cuz untill now there were only 2 channels where the patient could go...one is where the care might be "not so good" but really cheap--i.e students at dental schools, and the second one is "good care" by experienced dentists.....
corporate dentistry has succeded in luring all new graduates (to their benefits ofcourse!) and has literally got in to become the intermediate form of care available to the patient...yeah not all dentists in corp. dentistry are mediocre, in fact some could be really excellent as well, so the gamble of the patient might pay off...so the bottom line is that corporate dentistry will continue to thrive as US is a capitalistic form of economy, but cannot emerge as the dominant one in the market, and the budding dentist needs to only acknowledge the fact that it is just another ground for him to gain experience.....

 

[cali1]

To larryt's respone about backing my statement with stats? Well, I guess I can't really do that, but it really seems to make rational sense. It's like supply and demand. When there are a lot of workers, and not as many jobs, you can pay the workers less and get away with more, because if the workers quit, there are many other workers who will step in. I don't know how I would back this with statistics.
I noticed your buying a practice. Are you not a dental hygienst, and you're going to be going to dental school?
And in your case, you aren't a corporate, so I'm sure you will get a lot of calls from people. But try to treat those dentists poorly, and see what happens. I doubt they will stay that long.

 

[3rdMolarRoller]

There is a Smilecare in FL that I went to for years and had great service. There is only one dentist in the office and he has been there since 1989. He said he sticks with it bec he makes a good salary, a little above $140k, and doesn't have to worry about the business aspect of the practice. They do all of the advertising, billing, payroll...etc.

So I guess it depends on the size of these offices in these chains.

 

[DrJeff]

Originally posted by larryt
Do you have any stat to back your statement ? My friend and I are about to purchase a dental office here in town. Our deal and paperworks will finalize this coming month.

I'd hope that your friend is a dentist, either that or your state has laws that are way different than mine. In my state, a dental practice(not a hygiene practice) can be owned ONLY by a licensed dentist.

There is currently a situation in the town where I practice in which this has become an issue recently. The only pediatric dentist in town passed away suddenly and unexpectedly after a brief illness (he practically went from his office to the ICU of our local hospital). His kids in trying to settle his estate, including his son who was an expanded function assistant tried to keep the practice open and running once they located another pediatric dentist to come into the office. The state department of health closed them down because they(the kids) didn't have a license to practice dentistry.

If neither of you posses a license LarryT, I'd really suggest that you have the attorney that I'd presume is handling the purchase to check the laws for you. I'd hate to see you buy into an office and then quickly have to turn around and sell it (likely at a loss) due to a legal situation like that.

 

[UBTom]

Yep... The dental practice law in Texas also prohibits non-dentists from owning a dental practice, except widows, widowers and next-of-kin of a recently deceased dentist, and they must sell within 6 months.

Not sure how Texas handles partnerships with non-dentists, but I have a feeling Larry will be hearing from the Texas State Board of Dental Examiners..

 

[UBTom]

Originally posted by KAJALKIRAN
one is where the care might be "not so good" but really cheap--i.e students at dental schools,

Are you kiddin'? We dental students are the ones who are exhorted to do as close to "ideal dentistry" as possible. It's only after we graduate do we start picking up "short cuts" like not using rubber dams anymore.

Yeah, there are dental students who are better suited to being butchers than dentists, but those are pretty rare... At least at my school. In the almost four years that I've been here, there has only been one incident in which a dental student was disciplined for committing a critical error in patient care (cutting an amalgam prep on the wrong tooth).

Dental schools ARE good places to go to for dental care-- The major drawback being the amount of time the patient has to put into it, not the quality of the work (for the most part).

 

[Jone]

I'd love to work for one of those corp shops...

From what I hear they give you all the CE you want.

Milk them for the CE a few years, then get out and open up a real practice...

Their business model will guarantee high turnover, but it's their fault, so why not take advantage of them, since they are bending over and asking for it.

 

[larryt]

Originally posted by UBTom
Yep... The dental practice law in Texas also prohibits non-dentists from owning a dental practice, except widows, widowers and next-of-kin of a recently deceased dentist, and they must sell within 6 months.

Not sure how Texas handles partnerships with non-dentists, but I have a feeling Larry will be hearing from the Texas State Board of Dental Examiners..

We talked about this last time. You were right. In texas, only license dentist can open the dental office. My friend is a dentist. We already worked out with our lawer about the legal processes.