What's so bad about corporate dentistry?

[zammyd]

So I'm fairly new to these forums and am a pre-dental student. From what I've read so far, when people mention going into corporate dentistry it is often not in a positive light. So why the negative stigma? To me corporate dentistry seems to have a similar paradigm to hospital management (i.e. hospital is the corporation/employer and you treat the patients and make your pay) which seems like a decent deal to me.

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[FOX_ONE]

going to dental school next year here.

from what i've seen, corporate dentistry pays bread and can be good for starting out.

im looking at $450,000 in debt from dental school and a $120k to $150k salary will be amazing help. (hopefully it is around 120K to 150K because i havent seen any decently acceptable statistics).

 

[Volfram]

So I'm fairly new to these forums and am a pre-dental student. From what I've read so far, when people mention going into corporate dentistry it is often not in a positive light. So why the negative stigma? To me corporate dentistry seems to have a similar paradigm to hospital management (i.e. hospital is the corporation/employer and you treat the patients and make your pay) which seems like a decent deal to me.

Corporate practices can work in theory. Problems arise for many dentists though when they find that their materials, labs, and access to patient scheduling and assistant hiring is restricted. The biggest problem though is when the pressure to produce starts impacting the ethics of practice - particularly overtreating, pressure to do advanced procedures, and substandard work due to rushing. None of these issues are isolated to corporate practices- I've heard similar stories for associates at some private practices. No matter which direction you go, it's important to find a hiring dentist with high standards of care and willingness to mentor. No small task- I graduated a few years ago and have yet to find the perfect practice. I guess I just have to start my own!

 

[RxStudentatUB]

So I'm fairly new to these forums and am a pre-dental student. From what I've read so far, when people mention going into corporate dentistry it is often not in a positive light. So why the negative stigma? To me corporate dentistry seems to have a similar paradigm to hospital management (i.e. hospital is the corporation/employer and you treat the patients and make your pay) which seems like a decent deal to me.

Corporate = bottom line. While they provide you equipment and leave you not worrying about overhead cost, management will push their dentists to increase profits and sometimes through unethical areas. For example, doing unnecessary fillings and procedures. So it is mostly an ethical issue with corporate, for the most part it is all about making big bucks than customer care and safety. While nothing is 100% guaranteed, your life will be so much easier managing your own business as a dentist or working for another private practice owner who won't push you to do things that make you uncomfortable when using your professional judgment. So it is best to build a network during dental school while juggling classes so you are not limited to egging on corporate dentistry to take over smaller practices like already happening in med.

 

[TourdeTeeth]

I asked this exact question to some practicing dentists last week and they had varied opinions on it. They said that while corporate dentists saw more patients than a private practice dentist, they couldn't really have a relationship with the dentist. The relationships are one of the things that makes being a dentist special. Though they admitted that corporate dentistry will probably improve and be more enticing in the future.

 

[Anglevator inventor]

So I'm fairly new to these forums and am a pre-dental student. From what I've read so far, when people mention going into corporate dentistry it is often not in a positive light. So why the negative stigma? To me corporate dentistry seems to have a similar paradigm to hospital management (i.e. hospital is the corporation/employer and you treat the patients and make your pay) which seems like a decent deal to me.

All good answers, I've worked in both, private and corporate. No comparison, it's ALWAYS better to be your own boss. But with so much debt coming out of school, most are forced into corp dentistry. It's ALL ABOUT THE MONEY with them, don't let them fool you. You want to be in control of your materials, your labs, your assistants. Dentistry is not like medicine, that personal relationship goes a long way and impacts your results tremendously. It all has plus and minuses but overall, corp dentistry is a minus, for patients and dentists but it is here to stay, just like herpes.

 

[yappy]

In my opinion corporate dentistry is bad for patients and dentists. I think that the majority of them have maligned interests that cheapen the profession, harm patients, and breed distrust between dentists and patients.

If you work for a corp practice because of debt, or perceived less headache because someone else deals with the business side, you're selling your future for pennies on the dollar. If you understand capitalism you should know it is infinitely better to own capital rather than work for it.

Did you go into dentistry to treat patients based on scientific literature and address their healthcare needs; or, to "sell" treatment plans based on a corporate strategy where success looks like cramming as much dentistry in their mouths until they say no?

 

[FOX_ONE]

In my opinion corporate dentistry is bad for patients and dentists. I think that the majority of them have maligned interests that cheapen the profession, harm patients, and breed distrust between dentists and patients.

If you work for a corp practice because of debt, or perceived less headache because someone else deals with the business side, you're selling your future for pennies on the dollar. If you understand capitalism you should know it is infinitely better to own capital rather than work for it.

Did you go into dentistry to treat patients based on scientific literature and address their healthcare needs; or, to "sell" treatment plans based on a corporate strategy where success looks like cramming as much dentistry in their mouths until they say no?

id do corporate to become free from debt. then make my own moves from there.

$450k debt can be a ball and chain

 

[RxStudentatUB]

It is a tough choice. If I were to choose, I would probably network during dental school and link up with a reliable associate after graduation. By signing up with corporate, we are giving them extra ammunition and leverage to steamroll the smaller independent practices. Don't get me wrong, it looks like they do pay well, $130-$160K as a starting GP dentist. Long run we have to play this smart.

 

[Coloradoboulder]

The problem is corporate jobs is very appealing because of the high pay. I have heard many times there are very very few good associate position for graduates. Some of my recent graduates from dental school said they searched for a long time and found only crappy associate positions while corporate jobs offered them a much nicer salary. I am not defending corporate dentistry by any means. I'm just saying it doesn't look good for graduates especially with large debt looming over their shoulders. It seems to me in theory...due to non-appealing associate positions, people flock to corporate.

 

[Confused321]

Corporate practices can work in theory. Problems arise for many dentists though when they find that their materials, labs, and access to patient scheduling and assistant hiring is restricted. The biggest problem though is when the pressure to produce starts impacting the ethics of practice - particularly overtreating, pressure to do advanced procedures, and substandard work due to rushing. None of these issues are isolated to corporate practices- I've heard similar stories for associates at some private practices. No matter which direction you go, it's important to find a hiring dentist with high standards of care and willingness to mentor. No small task- I graduated a few years ago and have yet to find the perfect practice. I guess I just have to start my own!

I have been going to a corporate dentistry my entire life and I never felt like they were doing more procedures than necessary
or that they were stressing me to have more advanced work done on me.

where is all of this coming from?
is the "overtreating" something that all corporate dentists have to follow in their job description or just some kind of general trend that people have noticed?

 

[Hedgy]

Corporate dentistry power advertises and uses insurance for volume production. They streamline everything to maximize profits. They get big discounts on supplies/equipment. I see a lot of overtreatment, but I also see that with many of my solo practitioner colleagues. ie. MOD=crown, 10 yr-old crown=replace crown, 4mm pockets=Scale and root plane every time, etc. If you get a $4000 treatment plan....time to get a second opinion (that's the average tx plan for a new patient at the highest producing Aspen Dental office BTW).

The debt of dental students needs to be addressed. You know its bad when the MDs are saying, "wow, you have a lot of debt!".

 

[Scumbag_Steve]

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[Incis0r]

So I'm fairly new to these forums and am a pre-dental student. From what I've read so far, when people mention going into corporate dentistry it is often not in a positive light. So why the negative stigma? To me corporate dentistry seems to have a similar paradigm to hospital management (i.e. hospital is the corporation/employer and you treat the patients and make your pay) which seems like a decent deal to me.

I know a dentist who works in corporate. In this case, there is 0 pressure to push aggressive treatment plans and no dubious business practices. Yes, the practice schedules the dentist to work out of 2-3 ops at a time (numb one, go do the filling on the other, do hygiene check on the third quickly), and the dentist is paid based on collections, but there is no crossing of ethical lines in this case. Anecdotal case, sure, but if I can find a corporate office within 25 miles of me which isn't pushing aggressive treatment plans, I'm CERTAIN that there have to be more good ones like this out there.

 

[tc434]

I worked for a corporation for about a year after graduation so I'll give you my personal horror stories.
I was told when I was hired that my indirect to direct restoration ratio needed to be 2:1. We were told to tell patients that a composite filling is considered temporary and the permanent solution is an inlay/onlay. People that did not meet those requirements were let go.
The owner (my mentor) would take a class II resin and pulp the tooth. He would do endo with no isolation and no irrigation. When the tooth would flare up about 8 months later, he would removed the tooth and place an implant. This was common practice for him. He has since lost his license in this state but is practicing happily in another state with the same company. The company loves him as he owns multiple offices and his daily production is about $7k.
When we would refer to an endodontist outside the practice our referrals would get intercepted by the tx coordinator and those patients would get shifted to the owner doctor's schedule and he would do the endo. He called himself an endodontist although he couldn't be further from one.
I also watched him pull teeth he had done endo on and guttapercha would be hanging out the side of the tooth.
My biggest problem was with hygiene. They find 5 mm pockets on anybody. 24 year old female with perfect smile and has never had a cavity needs S/RP's. When they get S/RP's they are ALWAYS upsold on irrigation and laser therapy. It turns out to be over $1000k for a cleaning. Obviously the patient does not have to accept the treatment but the treatment coordinators are very good at what they do.
Myself and another associate had a meeting with the owner dentist about accurate perio diagnosing because it was our license they were working under and he told us to let the hygienists do their job as they do it everyday and are better at probing than we are.
This guy had a lower incisor with plus class III mobility and severe bone loss that I was going to remove for about $170. The treatment coordinator moved the pt to a different day when the periodontist was going to be there and they removed the tooth, did some grafting, a membrane and probably some snake oil for about $1100. Very good treatment if he wanted an implant but he didn't. The treatment coordinator essentially told him the bacteria was going to go to his heart and kill him if he didn't prepare the site for an implant in addition to removing the tooth.
I am certain there are corporations that are somewhat ethical, but decisions are being made about what your production is supposed to be by people wearing suits in a boardroom.
Patients are not stupid. You can fool them once but there is a reason corporations care very little about recall. It is all about high volume, maximizing insurance, the patient's credit limit and heavy marketing. Very few patients return. The problem is they then go to private practice and have very little trust in their new dentist.
Mass marketing and $39 specials have taught patients that dentistry is a commodity market as opposed to healthcare.
Thanks for letting me vent

 

[zammyd]

I worked for a corporation for about a year after graduation so I'll give you my personal horror stories.
I was told when I was hired that my indirect to direct restoration ratio needed to be 2:1. We were told to tell patients that a composite filling is considered temporary and the permanent solution is an inlay/onlay. People that did not meet those requirements were let go.
The owner (my mentor) would take a class II resin and pulp the tooth. He would do endo with no isolation and no irrigation. When the tooth would flare up about 8 months later, he would removed the tooth and place an implant. This was common practice for him. He has since lost his license in this state but is practicing happily in another state with the same company. The company loves him as he owns multiple offices and his daily production is about $7k.
When we would refer to an endodontist outside the practice our referrals would get intercepted by the tx coordinator and those patients would get shifted to the owner doctor's schedule and he would do the endo. He called himself an endodontist although he couldn't be further from one.
I also watched him pull teeth he had done endo on and guttapercha would be hanging out the side of the tooth.
My biggest problem was with hygiene. They find 5 mm pockets on anybody. 24 year old female with perfect smile and has never had a cavity needs S/RP's. When they get S/RP's they are ALWAYS upsold on irrigation and laser therapy. It turns out to be over $1000k for a cleaning. Obviously the patient does not have to accept the treatment but the treatment coordinators are very good at what they do.
Myself and another associate had a meeting with the owner dentist about accurate perio diagnosing because it was our license they were working under and he told us to let the hygienists do their job as they do it everyday and are better at probing than we are.
This guy had a lower incisor with plus class III mobility and severe bone loss that I was going to remove for about $170. The treatment coordinator moved the pt to a different day when the periodontist was going to be there and they removed the tooth, did some grafting, a membrane and probably some snake oil for about $1100. Very good treatment if he wanted an implant but he didn't. The treatment coordinator essentially told him the bacteria was going to go to his heart and kill him if he didn't prepare the site for an implant in addition to removing the tooth.
I am certain there are corporations that are somewhat ethical, but decisions are being made about what your production is supposed to be by people wearing suits in a boardroom.
Patients are not stupid. You can fool them once but there is a reason corporations care very little about recall. It is all about high volume, maximizing insurance, the patient's credit limit and heavy marketing. Very few patients return. The problem is they then go to private practice and have very little trust in their new dentist.
Mass marketing and $39 specials have taught patients that dentistry is a commodity market as opposed to healthcare.
Thanks for letting me vent

Holy **** that is despicable. Dental fraud needs to be investigated and punished more severely. These 'dentists' are the ones ruining the reputation of the profession in the eye of the public.

 

[CanaDMD]

They are run by MBAs, not doctors. MBAs did not have to 'promise to be ethical', nor are they bound to it.

 

[arlmay]

This is sickening. Corporate dentistry is one of the worst things that has ever happened to the profession

I worked for a corporation for about a year after graduation so I'll give you my personal horror stories.
I was told when I was hired that my indirect to direct restoration ratio needed to be 2:1. We were told to tell patients that a composite filling is considered temporary and the permanent solution is an inlay/onlay. People that did not meet those requirements were let go.
The owner (my mentor) would take a class II resin and pulp the tooth. He would do endo with no isolation and no irrigation. When the tooth would flare up about 8 months later, he would removed the tooth and place an implant. This was common practice for him. He has since lost his license in this state but is practicing happily in another state with the same company. The company loves him as he owns multiple offices and his daily production is about $7k.
When we would refer to an endodontist outside the practice our referrals would get intercepted by the tx coordinator and those patients would get shifted to the owner doctor's schedule and he would do the endo. He called himself an endodontist although he couldn't be further from one.
I also watched him pull teeth he had done endo on and guttapercha would be hanging out the side of the tooth.
My biggest problem was with hygiene. They find 5 mm pockets on anybody. 24 year old female with perfect smile and has never had a cavity needs S/RP's. When they get S/RP's they are ALWAYS upsold on irrigation and laser therapy. It turns out to be over $1000k for a cleaning. Obviously the patient does not have to accept the treatment but the treatment coordinators are very good at what they do.
Myself and another associate had a meeting with the owner dentist about accurate perio diagnosing because it was our license they were working under and he told us to let the hygienists do their job as they do it everyday and are better at probing than we are.
This guy had a lower incisor with plus class III mobility and severe bone loss that I was going to remove for about $170. The treatment coordinator moved the pt to a different day when the periodontist was going to be there and they removed the tooth, did some grafting, a membrane and probably some snake oil for about $1100. Very good treatment if he wanted an implant but he didn't. The treatment coordinator essentially told him the bacteria was going to go to his heart and kill him if he didn't prepare the site for an implant in addition to removing the tooth.
I am certain there are corporations that are somewhat ethical, but decisions are being made about what your production is supposed to be by people wearing suits in a boardroom.
Patients are not stupid. You can fool them once but there is a reason corporations care very little about recall. It is all about high volume, maximizing insurance, the patient's credit limit and heavy marketing. Very few patients return. The problem is they then go to private practice and have very little trust in their new dentist.
Mass marketing and $39 specials have taught patients that dentistry is a commodity market as opposed to healthcare.
Thanks for letting me vent

 

[helpmepleasedentists]

does corporate give dentists a higher average salary than private practice?
i want to be in private practice one day but I am worried about loan repayment so if corporate will help with this it would be great

 

[nealofgrafton]

I work corporate. It depends on the practice you work at. Right now I get paid a salary, very little pressure to produce or perform procedures I am not confident in doing. My main gripe is I think we use to much arrestin, that's it. it really depends on which corporation you work for. Additionally a lot of private practices are looking for someone with 3+ years experience, where else you going to get experience.

 

[CanaDMD]

does corporate give dentists a higher average salary than private practice?
i want to be in private practice one day but I am worried about loan repayment so if corporate will help with this it would be great

no

 

[Scumbag_Steve]

.

 

[Hedgy]

Just look at all the speakers out there promoting increase in production. How do you do that? Upsell everything. When I started, hygiene production was supposed to be about 20-25%. Now they talk 33%. How's that? S&RP + Arrestin for all. I think the prior unethical corporate guy was an exception, but the treatment coordinator thing is very common. It's like the closer at the car dealership for financing. But people are lemmings, they don't know any better until they check around, but that takes effort and these guys are banking on that.


There is one corporate office in my small city, soon to be two. They have 18/100 dentists in the area. They power advertise to the tune of $120k/mo. The local dental society has gone from 50-60 attending in 2006 to 15 or so at best at our current meetings. They hate these guys so much that they won't even be in the same room with them. I don't care for the owners much either. It's poisoned the atmosphere and camaraderie.

 

[arlmay]

Definately agree when you say they just upsell all these bs treatments to patients. I saw an email not to long ago from one of heartlands regional managers to all her office managers and dentists congratulating X hygienist for a new record production selling 28 application sites of arrestin to some poor old soul who didn't know any better for $3100. Look at the studies the manufacturer did when they brought the product out and it's something like a .3mm improvement in pocket depths on average, what a joke. These corporate office's business practices are beyond shady, in my opinion downright criminal. I wouldn't sit in a room with them either. I'll probably go into default before I go work for corporate, or sell my soul to the devil before doing so.

 

[Hedgy]

Not sure which devil is worse corporate or insurance. Start looking into a small group, you may need that to survive.

 

[tc434]

Not sure which devil is worse corporate or insurance.

Insurance companies have been increasing the rate of reimbursement to corporations and decreasing the rate of reimbursement to private practitioners. Delta Dental had huge profits the last couple of years by doing nothing other than cutting reimbursement rates. Because there is nothing saying they can't. They have also been investing heavily in corporate dentistry stocks. It makes too much sense.

 

[480640]

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[Hedgy]

Insurance companies have been increasing the rate of reimbursement to corporations and decreasing the rate of reimbursement to private practitioners. Delta Dental had huge profits the last couple of years by doing nothing other than cutting reimbursement rates. Because there is nothing saying they can't. They have also been investing heavily in corporate dentistry stocks. It makes too much sense.

The ex-CEO of Delta is now President of the ADA. I'm FFS...and all I hear is bitching from the guys that are preferred providers because they bundle codes, change codes, and don't increase reimbursement. But they don't have the guts to drop the ins cos. The reason they increase rates for corporations is the negotiating power of volume of patients. Corporations seem to take care of each other.

I cringe whenever I get the reimbursement schedule for these companies, particularly Delta and BCBS. Hmmm, take a 30-40% hit from existing patients, then see if you can make that up and then some from the new ones you may get. I'll pass. I'm better off taking Medicaid than BCBS of Montana.

 

[Incis0r]

The ex-CEO of Delta is now President of the ADA. I'm FFS...and all I hear is bitching from the guys that are preferred providers because they bundle codes, change codes, and don't increase reimbursement. But they don't have the guts to drop the ins cos. The reason they increase rates for corporations is the negotiating power of volume of patients. Corporations seem to take care of each other.

I cringe whenever I get the reimbursement schedule for these companies, particularly Delta and BCBS. Hmmm, take a 30-40% hit from existing patients, then see if you can make that up and then some from the new ones you may get. I'll pass. I'm better off taking Medicaid than BCBS of Montana.

Do you think the FFS model will survive into the future?

 

[Hedgy]

Personally, I think FFS will survive, but I think you will see more group practices that can compete with corporate hours and lower operating costs. The era of the solo practitioner, particularly with cost of dental school, is getting more challenging. The majority of practices are still solo, but that is gradually decreasing.

 

[CanaDMD]

Personally, I think FFS will survive, but I think you will see more group practices that can compete with corporate hours and lower operating costs. The era of the solo practitioner, particularly with cost of dental school, is getting more challenging. The majority of practices are still solo, but that is gradually decreasing.

How long do you give dentistry before it becomes like pharmacy, where opening your own gig isn't really viable and franchising/corporate is the only thing available, especially for new grads/people without established practices?

 

[Hedgy]

It depends on how and where you practice and if you want to be a solo practitioner, group, or corporate. Most want to practice in cities and suburbs. We are a small city and are about 10 dentists over what we should have for the population. Hence, more competition and a need to either advertise, accept insurance, or find ways to make your practice visible and viable. If you want the solo practice, I would look into smaller communities. You may have to be a preferred provider or take Medicaid, but overhead is less. It can be hard to staff if you are in an isolated area. Another route is the dental entrepreneur in which you buy several small practices to get deals on supplies and then staff them with new dentists who can buy in as partners after a few years. I see quite a few guys doing that now.

 

[CanaDMD]

It depends on how and where you practice and if you want to be a solo practitioner, group, or corporate. Most want to practice in cities and suburbs. We are a small city and are about 10 dentists over what we should have for the population. Hence, more competition and a need to either advertise, accept insurance, or find ways to make your practice visible and viable. If you want the solo practice, I would look into smaller communities. You may have to be a preferred provider or take Medicaid, but overhead is less. It can be hard to staff if you are in an isolated area. Another route is the dental entrepreneur in which you buy several small practices to get deals on supplies and then staff them with new dentists who can buy in as partners after a few years. I see quite a few guys doing that now.

There will come a point where dental entrepreneurs will only be the corporates (ie supply companies will only give deals to the bigger fish). Well see what happens then

 

[Hedgy]

A new dentist can't even get financed to purchase a practice nowadays. I think now the banks require 2 years of practice before they will finance. I see a few of retiree dentists financing the incoming docs.

 

[CanaDMD]

A new dentist can't even get financed to purchase a practice nowadays. I think now the banks require 2 years of practice before they will finance. I see a few of retiree dentists financing the incoming docs.

It depends on many factors, I know people who got financed out of school just this past year

 

[Firm]

Not sure which devil is worse corporate or insurance. Start looking into a small group, you may need that to survive.

They are working together to create more dental schools.

 

[Firm]

How long do you give dentistry before it becomes like pharmacy, where opening your own gig isn't really viable and franchising/corporate is the only thing available, especially for new grads/people without established practices?

There are so many rotating hacks in corporate offices or the good dentists get burned out and leave that the private practice won't go away because you can build decades of relationships.

 

[DrT2202]

I work corporate. It depends on the practice you work at. Right now I get paid a salary, very little pressure to produce or perform procedures I am not confident in doing. My main gripe is I think we use to much arrestin, that's it. it really depends on which corporation you work for. Additionally a lot of private practices are looking for someone with 3+ years experience, where else you going to get experience.

I think we're both working in the same corporation and I have to agree. i don't feel pressured to do anything I'm not comfortable doing or that is not ethical. I have complete and full autonomy on what materials and instruments I can use even if it's not from a preferred vendor. same thing with labs. i work in a state of the art practice and I am the leader of the practice clinically and bear weight administratively as well. Nothing bad about corporate dentistry on my side. Oh, and lots of paid for (well, the practice pays for it, but still not me personally) CE at a high level.

 

[IAlongbuccal]

I'm graduating in a few months, I have 2 offers from Corporate that pays $650 daily or 30% production with a 15k sign on bonus. That's more than most private practice ($500/day) here in California, if you can even find a full time job here. I think more than 50% of my classmates r going corporate 1st year out, we don't have a choice guys.

 

[jda02624]

I'm graduating in a few months, I have 2 offers from Corporate that pays $650 daily or 30% production with a 15k sign on bonus. That's more than most private practice ($500/day) here in California, if you can even find a full time job here. I think more than 50% of my classmates r going corporate 1st year out, we don't have a choice guys.

For a bonus like this, do you have to agree to stay for a certain amount of time (i.e. 2 or 3 years or you must pay it back)?

I'm not a fan of corporate either, but it is providing an option for new graduates that does not seem to be there in the private sector. Take what you can but have an end goal in mind if you don't want to stay corporate long-term.

 

[DoctaFauci]

I'm graduating in a few months, I have 2 offers from Corporate that pays $650 daily or 30% production with a 15k sign on bonus. That's more than most private practice ($500/day) here in California, if you can even find a full time job here. I think more than 50% of my classmates r going corporate 1st year out, we don't have a choice guys.

You do have an option. CA is significantly underserved, yet the six dental schools keep funneling dentists into highly saturated markets: Bay Area, SD, LA. Your classmates could all move to NorCal and make a killing in a group practice or make a solid salary/benefits at an FQHC with loan forgiveness options.

ADEA, the AGD and the ADA have all published studies of the corporate model in recent years. The speculation is that the bubble will pop as the abundance of corporate chains ultimately consolidate into about four chains, at which point the profit and return on the capital acquired will have diminishing returns. The best model right now is opening a group practice; highest return on investment and greatest satisfaction to the clinician while maintaining autonomy.

Just b/c 50% of your class is pursuing the corporate model doesn't mean it's the only, or best, option.

 

[CanaDMD]

You do have an option. CA is significantly underserved, yet the six dental schools keep funneling dentists into highly saturated markets: Bay Area, SD, LA. Your classmates could all move to NorCal and make a killing in a group practice or make a solid salary/benefits at an FQHC with loan forgiveness options.

ADEA, the AGD and the ADA have all published studies of the corporate model in recent years. The speculation is that the bubble will pop as the abundance of corporate chains ultimately consolidate into about four chains, at which point the profit and return on the capital acquired will have diminishing returns. The best model right now is opening a group practice; highest return on investment and greatest satisfaction to the clinician while maintaining autonomy.

Just b/c 50% of your class is pursuing the corporate model doesn't mean it's the only, or best, option.

it's the only/best option for those who don't want or can't leave LA, which by the sound of it would be safe to assume for this poster

 

[IAlongbuccal]

You do have an option. CA is significantly underserved, yet the six dental schools keep funneling dentists into highly saturated markets: Bay Area, SD, LA. Your classmates could all move to NorCal and make a killing in a group practice or make a solid salary/benefits at an FQHC with loan forgiveness options.

ADEA, the AGD and the ADA have all published studies of the corporate model in recent years. The speculation is that the bubble will pop as the abundance of corporate chains ultimately consolidate into about four chains, at which point the profit and return on the capital acquired will have diminishing returns. The best model right now is opening a group practice; highest return on investment and greatest satisfaction to the clinician while maintaining autonomy.

Just b/c 50% of your class is pursuing the corporate model doesn't mean it's the only, or best, option.

Community clinic jobs are hard to find, please point me in some directions if you can. Most private practice requires 2 years of experience. Same can be said about the group practice model, it might work in a few years, but at the rate we're producing, we gonna make nothing after overheads. I been focusing on SoCal suburbs like Ventura, Riverside. I'll be sending out resumes to practices in Central Valley and Sacramento area after WREB next week.

 

[IAlongbuccal]

For a bonus like this, do you have to agree to stay for a certain amount of time (i.e. 2 or 3 years or you must pay it back)?

I'm not a fan of corporate either, but it is providing an option for new graduates that does not seem to be there in the private sector. Take what you can but have an end goal in mind if you don't want to stay corporate long-term.

year to year contracts

 

[Hedgy]

One other thing that power advertising does is drives the "surplus" patients to these offices. Other dentists feel they need to advertise to do the same. Essentially, IMO, we are paying advertising to get patients into our offices for a discount in treatment (insurance) and in the end it does not benefit anyone.

I do feel for dental students with the huge expense of schooling. Corporate offers a way in to dentistry that allows less stress financially. $1M in debt between school and a practice and you haven't seen your first patient is hard for me to fathom.

 

[DoctaFauci]

Community clinic jobs are hard to find, please point me in some directions if you can. Most private practice requires 2 years of experience. Same can be said about the group practice model, it might work in a few years, but at the rate we're producing, we gonna make nothing after overheads. I been focusing on SoCal suburbs like Ventura, Riverside. I'll be sending out resumes to practices in Central Valley and Sacramento area after WREB next week.

They're hard to find in a saturated market in CA, yes. It's much more difficult to establish an FQHC than it is to hang a shingle and open a for-profit practice. But since you said Sacramento, there's an overabundance. This is one resource: https://nhscjobs.hrsa.gov/external/search/index.seam

Also check with your state gov. office of primary care division as many jobs are not listed through the NHSC.

 

[Marmalade]

They are working together to create more dental schools.

Insurance companies and corporate dental offices are working together to create more D schools?

Could you elaborate on that?

I can see how their effects are contributing to the situation, but "Working together"?

PD

 

[msoendo]

So I'm fairly new to these forums and am a pre-dental student. From what I've read so far, when people mention going into corporate dentistry it is often not in a positive light. So why the negative stigma? To me corporate dentistry seems to have a similar paradigm to hospital management (i.e. hospital is the corporation/employer and you treat the patients and make your pay) which seems like a decent deal to me.

You do have an option. CA is significantly underserved, yet the six dental schools keep funneling dentists into highly saturated markets: Bay Area, SD, LA. Your classmates could all move to NorCal and make a killing in a group practice or make a solid salary/benefits at an FQHC with loan forgiveness options.

ADEA, the AGD and the ADA have all published studies of the corporate model in recent years. The speculation is that the bubble will pop as the abundance of corporate chains ultimately consolidate into about four chains, at which point the profit and return on the capital acquired will have diminishing returns. The best model right now is opening a group practice; highest return on investment and greatest satisfaction to the clinician while maintaining autonomy.

Just b/c 50% of your class is pursuing the corporate model doesn't mean it's the only, or best, option.

For a bonus like this, do you have to agree to stay for a certain amount of time (i.e. 2 or 3 years or you must pay it back)?

I'm not a fan of corporate either, but it is providing an option for new graduates that does not seem to be there in the private sector. Take what you can but have an end goal in mind if you don't want to stay corporate long-term.

So I'm fairly new to these forums and am a pre-dental student. From what I've read so far, when people mention going into corporate dentistry it is often not in a positive light. So why the negative stigma? To me corporate dentistry seems to have a similar paradigm to hospital management (i.e. hospital is the corporation/employer and you treat the patients and make your pay) which seems like a decent deal to me.

Lots of things are different when it comes to dental offices owned by a corporation versus medical offices or hospitals. Pretty sure hospitals don't try and up sell you to a kidney transplant when you go in for treatment of kidney stones. Too much liability in medicine. Dentistry is fortunate in that we generally do not have issues that involve irreversible damage or horrible long term pain and suffering. The pain and suffering/humiliation will be on the dentist once taken to the board; we are seeing a tremendous increase in board complaints against new graduates from these corporate owned offices. Please read employee reviews of the actual corporations on glassdoor.com or other sites. If you don't sell, lie, and produce they will find someone that will. If you want experience do a GPR, become a specialist, or find a practice and buy it or into it. Don't forget to thank the business of opening dental schools for generating a huge number of new dentists that are under a tremendous load of debt. Undergrad/UCLA dental/OHSU specialty all cost me a combined whopping $80,000 and I attended my last program in 1999. Why in the world do they charge you guys the tuition they do other than they can!!! Always remember you have a choice what to do and how to do it. Money isn't worth it!!

 

[bjj_bob]

I worked for a corporation for about a year after graduation so I'll give you my personal horror stories.
I was told when I was hired that my indirect to direct restoration ratio needed to be 2:1. We were told to tell patients that a composite filling is considered temporary and the permanent solution is an inlay/onlay. People that did not meet those requirements were let go.
The owner (my mentor) would take a class II resin and pulp the tooth. He would do endo with no isolation and no irrigation. When the tooth would flare up about 8 months later, he would removed the tooth and place an implant. This was common practice for him. He has since lost his license in this state but is practicing happily in another state with the same company. The company loves him as he owns multiple offices and his daily production is about $7k.
When we would refer to an endodontist outside the practice our referrals would get intercepted by the tx coordinator and those patients would get shifted to the owner doctor's schedule and he would do the endo. He called himself an endodontist although he couldn't be further from one.
I also watched him pull teeth he had done endo on and guttapercha would be hanging out the side of the tooth.
My biggest problem was with hygiene. They find 5 mm pockets on anybody. 24 year old female with perfect smile and has never had a cavity needs S/RP's. When they get S/RP's they are ALWAYS upsold on irrigation and laser therapy. It turns out to be over $1000k for a cleaning. Obviously the patient does not have to accept the treatment but the treatment coordinators are very good at what they do.
Myself and another associate had a meeting with the owner dentist about accurate perio diagnosing because it was our license they were working under and he told us to let the hygienists do their job as they do it everyday and are better at probing than we are.
This guy had a lower incisor with plus class III mobility and severe bone loss that I was going to remove for about $170. The treatment coordinator moved the pt to a different day when the periodontist was going to be there and they removed the tooth, did some grafting, a membrane and probably some snake oil for about $1100. Very good treatment if he wanted an implant but he didn't. The treatment coordinator essentially told him the bacteria was going to go to his heart and kill him if he didn't prepare the site for an implant in addition to removing the tooth.
I am certain there are corporations that are somewhat ethical, but decisions are being made about what your production is supposed to be by people wearing suits in a boardroom.
Patients are not stupid. You can fool them once but there is a reason corporations care very little about recall. It is all about high volume, maximizing insurance, the patient's credit limit and heavy marketing. Very few patients return. The problem is they then go to private practice and have very little trust in their new dentist.
Mass marketing and $39 specials have taught patients that dentistry is a commodity market as opposed to healthcare.
Thanks for letting me vent

You’re talking about “the greatest dental company in America?”

I worked for a corporation for about a year after graduation so I'll give you my personal horror stories.
I was told when I was hired that my indirect to direct restoration ratio needed to be 2:1. We were told to tell patients that a composite filling is considered temporary and the permanent solution is an inlay/onlay. People that did not meet those requirements were let go.
The owner (my mentor) would take a class II resin and pulp the tooth. He would do endo with no isolation and no irrigation. When the tooth would flare up about 8 months later, he would removed the tooth and place an implant. This was common practice for him. He has since lost his license in this state but is practicing happily in another state with the same company. The company loves him as he owns multiple offices and his daily production is about $7k.
When we would refer to an endodontist outside the practice our referrals would get intercepted by the tx coordinator and those patients would get shifted to the owner doctor's schedule and he would do the endo. He called himself an endodontist although he couldn't be further from one.
I also watched him pull teeth he had done endo on and guttapercha would be hanging out the side of the tooth.
My biggest problem was with hygiene. They find 5 mm pockets on anybody. 24 year old female with perfect smile and has never had a cavity needs S/RP's. When they get S/RP's they are ALWAYS upsold on irrigation and laser therapy. It turns out to be over $1000k for a cleaning. Obviously the patient does not have to accept the treatment but the treatment coordinators are very good at what they do.
Myself and another associate had a meeting with the owner dentist about accurate perio diagnosing because it was our license they were working under and he told us to let the hygienists do their job as they do it everyday and are better at probing than we are.
This guy had a lower incisor with plus class III mobility and severe bone loss that I was going to remove for about $170. The treatment coordinator moved the pt to a different day when the periodontist was going to be there and they removed the tooth, did some grafting, a membrane and probably some snake oil for about $1100. Very good treatment if he wanted an implant but he didn't. The treatment coordinator essentially told him the bacteria was going to go to his heart and kill him if he didn't prepare the site for an implant in addition to removing the tooth.
I am certain there are corporations that are somewhat ethical, but decisions are being made about what your production is supposed to be by people wearing suits in a boardroom.
Patients are not stupid. You can fool them once but there is a reason corporations care very little about recall. It is all about high volume, maximizing insurance, the patient's credit limit and heavy marketing. Very few patients return. The problem is they then go to private practice and have very little trust in their new dentist.
Mass marketing and $39 specials have taught patients that dentistry is a commodity market as opposed to healthcare.
Thanks for letting me vent

you were talking about “the greatest dental company in America”? LMAO

these corporate leeches are are a cancer to the dental profession. They talk about being noble, and serving the community, but their business practices are predatory.

stay away from corporate. if you have to work for these leeches, then work only for a short period of time (couple of months) and move on. Also, be stubborn when the treatment coordinator or manager make you do something that you’re not comfortable with. Always stand your ground and learn to say “No”.