Cold Front

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Meet the McDentist
Big in Europe, franchise dentistry has hit U.S. shores. Is this the future?
By BERNARD STAMLER

Sunday, Jul. 2, 2006

Americans buy everything from burgers to coffee to karate lessons at franchises. They're convenient, predictable and often cheap. So why not try franchising a service most of us avoid like a trip to the dentist? Actually, it is a trip to the dentist. Meet Vital Dent, purveyors of franchise dentistry.

Standing convention on its head--usually U.S. firms are the ones franchising their businesses in Europe--Vital Dent, based in Las Rozas de Madrid, Spain, launched its first U.S. location in New York City in December 2004. (Privately held Vital Dent operates some 250 offices in Spain, Portugal and Italy, most of them franchises.) Since then, the company has opened nine more dental offices there, all with an identical high-gloss, minimalist look, and seven more are under construction in Florida and Massachusetts. In the U.S., Vital Dent plans to draw traffic by offering new patients free cleaning, X rays and dental exams. Then it hopes they will return for higher-margin procedures such as dental implants and orthodontics. The stores have longer hours than traditional dentists' offices and are open even on weekends. They also offer patients financing and payment plans.

Vital Dent's founder, Ernesto Colman Mena, believes he will get people in the door by emphasizing convenience, reasonable prices and new technology, including the latest in dental implants. "That's what works in Spain," Colman says through a translator. In 2005 Vital Dent was second in Spain only to Burger King in attracting franchise investment, according to Franchisa, an industry consulting firm. And he hopes a similar strategy will appeal to Americans looking for an alternative to the old-fashioned neighborhood dentist. "The United States market offers a great opportunity," says Colman.

There is plenty of room for a new concept in U.S. dental care: 67% of dental practices in the U.S. are still run as traditional solo practices, according to Roger Levin, an industry management consultant in Owings Mills, Md. But Vital Dent will have to overcome more than just convention to find its way in the U.S. The new implant procedures Colman touts are not exclusive to the company. Vital Dent's prices, although below those of high-end dentists, are not much lower than the typical rates in most major cities (and like many traditional dentists, Vital Dent doesn't participate directly in insurance plans). According to a 2005 year-end survey published in the journal Dental Economics, the median price of a surface filling was $112; Vital Dent charges about $100.

The idea of dental franchises is not entirely new to the U.S. Several chains opened in the 1980s only to founder later, Levin says. They failed because of patient loyalty to the traditional private-office model--and Vital Dent faces its own obstacles. For example, any franchisee who is not a licensed dentist must contract with dentists or dental groups to provide services, a huge cost on top of the franchise fees paid to Vital Dent, which alone can run to $600,000. That's a lot to ask in an industry in which a new practice can easily be established for far less than $500,000, according to Tyson Steele, a dental marketing consultant in Eugene, Ore. "It's a tough business model," Steele says.

So far, all the U.S. franchisees are Europeans who also own franchises back home, but Colman hopes to expand his U.S. franchise base to 40 offices by the end of 2006. He's betting that Americans' endless appetite for convenience will have them lining up for dentistry that's quick and easy. Painless? He's working on it.

Source: TIME MAGAZINE
 

aphistis

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Cold Front said:
Meet the McDentist
Big in Europe, franchise dentistry has hit U.S. shores. Is this the future?
By BERNARD STAMLER

Sunday, Jul. 2, 2006

Americans buy everything from burgers to coffee to karate lessons at franchises. They're convenient, predictable and often cheap. So why not try franchising a service most of us avoid like a trip to the dentist? Actually, it is a trip to the dentist. Meet Vital Dent, purveyors of franchise dentistry.

Standing convention on its head--usually U.S. firms are the ones franchising their businesses in Europe--Vital Dent, based in Las Rozas de Madrid, Spain, launched its first U.S. location in New York City in December 2004. (Privately held Vital Dent operates some 250 offices in Spain, Portugal and Italy, most of them franchises.) Since then, the company has opened nine more dental offices there, all with an identical high-gloss, minimalist look, and seven more are under construction in Florida and Massachusetts. In the U.S., Vital Dent plans to draw traffic by offering new patients free cleaning, X rays and dental exams. Then it hopes they will return for higher-margin procedures such as dental implants and orthodontics. The stores have longer hours than traditional dentists' offices and are open even on weekends. They also offer patients financing and payment plans.

Vital Dent's founder, Ernesto Colman Mena, believes he will get people in the door by emphasizing convenience, reasonable prices and new technology, including the latest in dental implants. "That's what works in Spain," Colman says through a translator. In 2005 Vital Dent was second in Spain only to Burger King in attracting franchise investment, according to Franchisa, an industry consulting firm. And he hopes a similar strategy will appeal to Americans looking for an alternative to the old-fashioned neighborhood dentist. "The United States market offers a great opportunity," says Colman.

There is plenty of room for a new concept in U.S. dental care: 67% of dental practices in the U.S. are still run as traditional solo practices, according to Roger Levin, an industry management consultant in Owings Mills, Md. But Vital Dent will have to overcome more than just convention to find its way in the U.S. The new implant procedures Colman touts are not exclusive to the company. Vital Dent's prices, although below those of high-end dentists, are not much lower than the typical rates in most major cities (and like many traditional dentists, Vital Dent doesn't participate directly in insurance plans). According to a 2005 year-end survey published in the journal Dental Economics, the median price of a surface filling was $112; Vital Dent charges about $100.

The idea of dental franchises is not entirely new to the U.S. Several chains opened in the 1980s only to founder later, Levin says. They failed because of patient loyalty to the traditional private-office model--and Vital Dent faces its own obstacles. For example, any franchisee who is not a licensed dentist must contract with dentists or dental groups to provide services, a huge cost on top of the franchise fees paid to Vital Dent, which alone can run to $600,000. That's a lot to ask in an industry in which a new practice can easily be established for far less than $500,000, according to Tyson Steele, a dental marketing consultant in Eugene, Ore. "It's a tough business model," Steele says.

So far, all the U.S. franchisees are Europeans who also own franchises back home, but Colman hopes to expand his U.S. franchise base to 40 offices by the end of 2006. He's betting that Americans' endless appetite for convenience will have them lining up for dentistry that's quick and easy. Painless? He's working on it.

Source: TIME MAGAZINE
His gimmick for getting patients in the door is fine (and pretty old)...but how exactly does he plan on getting *dentists*? ;)
 

gryffindor

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aphistis said:
His gimmick for getting patients in the door is fine (and pretty old)...but how exactly does he plan on getting *dentists*? ;)
Unfortunately, these offices are springing up all over Manhattan where there is a very large number of inexperienced dentists looking for jobs. So it might not be as hard as you think.
 
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rchuloholla

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damn this is gonna make the average income of a dentist to significant decrease. this is not good for us future dentists... but then again..I kno for sure i would never go to a "walmart" dentist to save money.... I like the "personalized" care i get from my dentist where he remmebers my name and my teeth even if i come a year later...

One of the main requirements for a sucessful dentist is to have that good contact with their patients..and chain dental offices will lack that... who knows who's gonna be ur dentist the next time you go.

even at NJDS for the clinicals... patients return to the same student so they can develop the "dentist-patient" bond..

:D
 

aphistis

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griffin04 said:
Unfortunately, these offices are springing up all over Manhattan where there is a very large number of inexperienced dentists looking for jobs. So it might not be as hard as you think.
Fair enough. I wonder, if it successfully takes hold in the first place, whether it'll be restricted to locally/regonally saturated markets.

I don't want to sound unsympathetic to new grads, but if they're absolutely determined that they want to live in an area that's saturated with docs, they're going to have to put up with poorer job prospects and I don't feel too bad for suggesting they need to live with the priorities they've set for themselves. (I imagine you disagree with this, having spent some time working in NYC, but I'm curious to hear the details of what you think.)

Like I mentioned in another thread, you can live in an out-of-the-way area with plenty of patients to earn a good living treating, or you can live in a trendy urban area where you're competing for patients with 3 other dentists on your block alone, but a sexy location where you're not having to fight tooth & nail for your livelihood is a pretty rare bird.
 

gryffindor

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aphistis said:
Fair enough. I wonder, if it successfully takes hold in the first place, whether it'll be restricted to locally/regonally saturated markets.

I don't want to sound unsympathetic to new grads, but if they're absolutely determined that they want to live in an area that's saturated with docs, they're going to have to put up with poorer job prospects and I don't feel too bad for suggesting they need to live with the priorities they've set for themselves. (I imagine you disagree with this, having spent some time working in NYC, but I'm curious to hear the details of what you think.)

Like I mentioned in another thread, you can live in an out-of-the-way area with plenty of patients to earn a good living treating, or you can live in a trendy urban area where you're competing for patients with 3 other dentists on your block alone, but a sexy location where you're not having to fight tooth & nail for your livelihood is a pretty rare bird.
It all depends on what you call "poorer" job prospects. There are plenty of jobs that will pay your bills. You may be doing 2 handed dentistry, but if you don't like it, quit as soon as you find one where you do 4 handed dentistry.

After finishing my GPR, I really just wanted a job with a paycheck, preferably one where I didn't have to commute an hour each day. Although I was willing to commute for the right job. Being in a saturated market, I wasn't expecting get paid any higher than the "going rate" as a new dentist and I was pretty sure I wouldn't get any benefits. VitalDent in my old neighborhood opened in spring 2006. If they had opened up a year earlier, I would have walked right in there and asked if they were hiring, knowing full well that I would be bailing a year later if I got into a residency.
 

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I wonder how did walmart and the optometrist that work in them affect those that have solo practices, I know that they aren't owned by walmart but they do sign contracts with walmart on their fees for service, so has this lowered their average incomes, also how did this affect the pharmacists that work for say vons, rite aid, or other large companies
 

rchuloholla

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good point HmmWhat...

wow i can't imagine goin to a "walmart dentist" lol

but yea.. for optometry.. i think tht's y the avg salary is lower.. cuz of "chain eyedoctors" and same w/ pharmacist.. cuz of "chain pharmacy's"

but i noticed the private pharmacists still make a higher amout..and so do the private optometrists.... so I realized we dont' gotta worry bout this.. and plus w/ the babby boomers.. demand is goin to be higher
 

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Yeah, but how many private optometrists and pharmacists are there out there? Very few these days. There are some of the older established guys still out there practicing privately, but the new guys pretty much have no choice but to work for a chain.
 

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griffin04 said:
It all depends on what you call "poorer" job prospects. There are plenty of jobs that will pay your bills. You may be doing 2 handed dentistry, but if you don't like it, quit as soon as you find one where you do 4 handed dentistry.

After finishing my GPR, I really just wanted a job with a paycheck, preferably one where I didn't have to commute an hour each day. Although I was willing to commute for the right job. Being in a saturated market, I wasn't expecting get paid any higher than the "going rate" as a new dentist and I was pretty sure I wouldn't get any benefits. VitalDent in my old neighborhood opened in spring 2006. If they had opened up a year earlier, I would have walked right in there and asked if they were hiring, knowing full well that I would be bailing a year later if I got into a residency.
the previous generation of dentists graduated and immediately associated with intent to buy in, or else started from scratch. however the tide has shifted. this does represent the thoughts of a sizable percentage of new grads. it's a temporary fix, a paycheck (don't take this the wrong way, i know you wanted something for a year before specializing). they are what keep much of chain dentistry alive. they are also one of the many problems with chain dentistry, extremely high turnover. no patient/provider trust or meaningful relationship. generally these positions are more stressful, you are pushed to work faster, perhaps leading you to take shortcuts. remember these chain companies take decreased rates so it's about volume. i would never recommend family/friend to go to one of these places for treatment. man when i speak to dentists who practice in non-"saturated" areas they seem much happier with their quality of work and are earning more. to get a good job in a saturated areas (there definitely IS such a thing), you must commit for at least 3 yrs; the owner is smart and gives a **** about their patients. these "good practices" value their work and don't accept every tom dick and harry bs insurance plan. i personally am 100% against the philosophy of mcdentistry and wouldn't even think about being associated with them. they are a detriment to the profession.
 
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rchuloholla said:
so I realized we dont' gotta worry bout this.. and plus w/ the babby boomers.. demand is goin to be higher
I hear this so much, it's like forecasting the weather a week ahead. :D

This is how I look at it. Like all other elements of society, the dental sector is influenced by the overall performance of the economy. The supply and demand for dental care determine the amount and types of dental services provided, as well as the geographic distribution of dentists, the average income levels of dental professionals, the financial strength of dental practices and the number of applicants to and graduates from dental schools. So, you can't exactly bet on baby boomers alone, without taking these other factors into account.

Going back to the topic, McDentists :D - I think such idea will gain strength over time. Why? It's simple. Look at Walgreens, CVS, Walmarts, and the likes (who all happen to employ at least 80% of Pharmacists, and many optometrists). I think dentistry (not anytime soon) will also head that direction, simply because the public will need a more responsive, competent and "flexible" dental workforce. I know this sounds silly, but rapidly changing environment and emerging science and technology base continually place new demands on the existing and developing workforce - what actually makes Dentistry the exception? afterall, it's the public who keep healthcare professionals in business.

Ofcourse, I am just speaking 100 years from now... :D
 

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Ask yourself if you want to make dentistry a commodity. If you do you will cater to a different type of 'consumer' and practice a very different type of dentistry. Gas, blueberries, and socks are commodities. People generally purchase these for the lowest prices without concern for where they are shopping. There is not much loyalty to a brand or store. Dentistry is an experience. This means most people are concerned with how they are treated when they purchase dentistry. There is generally more loyalty to a dental office than say a mini-market. The vast majority of people will not want to purchase dentistry in a commodity business model. However, there will undoubtedly be some who can't afford anything else. This in no way threatens dentists working with people who value their dental experience. It does increase competition for Western Dental and other such chains.
 

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drhobie7 said:
Ask yourself if you want to make dentistry a commodity. If you do you will cater to a different type of 'consumer' and practice a very different type of dentistry. Gas, blueberries, and socks are commodities. People generally purchase these for the lowest prices without concern for where they are shopping. There is not much loyalty to a brand or store. Dentistry is an experience. This means most people are concerned with how they are treated when they purchase dentistry. There is generally more loyalty to a dental office than say a mini-market. The vast majority of people will not want to purchase dentistry in a commodity business model. However, there will undoubtedly be some who can't afford anything else. This in no way threatens dentists working with people who value their dental experience. It does increase competition for Western Dental and other such chains.
So when you have a prescription, do you go to the local corner private owned pharmacy, or do you go to the chain like CVS, Walgreens, and so forth. I think this is a concern. However, I do agree that people may not view dentistry as a commodity and would want to go to a private practice. Nevertheless, people value saving money and if these "McDentists" charge a few hundred less, a private dentist may have to be competitive with price and drive his or her cost down.
 
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S Files said:
the previous generation of dentists graduated and immediately associated with intent to buy in, or else started from scratch. however the tide has shifted. this does represent the thoughts of a sizable percentage of new grads. it's a temporary fix, a paycheck (don't take this the wrong way, i know you wanted something for a year before specializing). they are what keep much of chain dentistry alive. they are also one of the many problems with chain dentistry, extremely high turnover. no patient/provider trust or meaningful relationship. generally these positions are more stressful, you are pushed to work faster, perhaps leading you to take shortcuts. remember these chain companies take decreased rates so it's about volume. i would never recommend family/friend to go to one of these places for treatment. man when i speak to dentists who practice in non-"saturated" areas they seem much happier with their quality of work and are earning more. to get a good job in a saturated areas (there definitely IS such a thing), you must commit for at least 3 yrs; the owner is smart and gives a **** about their patients. these "good practices" value their work and don't accept every tom dick and harry bs insurance plan. i personally am 100% against the philosophy of mcdentistry and wouldn't even think about being associated with them. they are a detriment to the profession.
Chains aren't the only place where this occurs. There are plenty of private practices in NYC where you will get the same experience. High turnover, shortcuts abound, etc. Only difference is you will be walking into a fancy Manhattan building instead of the "Vital Dent" store front. I saw plenty of ghettodontics done in fancy buildings around town. Unfortunately, patients won't always know the difference - "a filling is a filling" mentality. It's just the nature of the job market there. There is no dentist/associate trust either - I couldn't trust telling any bosses that I was going for ortho because I would likely not get the job or be unemployed quickly. Like you said, there are some good jobs, but you have to "pay your dues" to find them. I did hygiene for a year in one office before I was offered a chance to do quality operative/fixed dentistry. My friends went through similar experiences as well.
 

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Dr. Dai Phan said:
I really hope McDentist won't take place in American as it really cheapens the profession. Do you think the medical profession would go low enough to have McDerm too? DP
In the long run, the economic/social/political forces win out. I'd say choose a path, pig out on CE courses, and be ready to adapt. In the out years I see business savy dentists running regional organizations made up of local tooth mills where a lot of grinders will choose to work for good wages and benefits (especially in the urban/suburban areas). The cottage industry models should remain viable in the more rural areas.
 

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drhobie7 said:
Ask yourself if you want to make dentistry a commodity. If you do you will cater to a different type of 'consumer' and practice a very different type of dentistry. Gas, blueberries, and socks are commodities. People generally purchase these for the lowest prices without concern for where they are shopping. There is not much loyalty to a brand or store. Dentistry is an experience. This means most people are concerned with how they are treated when they purchase dentistry. There is generally more loyalty to a dental office than say a mini-market. The vast majority of people will not want to purchase dentistry in a commodity business model. However, there will undoubtedly be some who can't afford anything else. This in no way threatens dentists working with people who value their dental experience. It does increase competition for Western Dental and other such chains.

I feel confident in saying that the general public already DOES think of dentistry as a commodity. They can get their teeth fixed anywhere, right? They don't understand the differences in practice philosophies that we do. A very large majority of patients are going to find the dental practice that has the best combination of proximity and insurance coverage; in other words, a commodity.
 

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UNCdentalguy said:
I feel confident in saying that the general public already DOES think of dentistry as a commodity. They can get their teeth fixed anywhere, right? They don't understand the differences in practice philosophies that we do. A very large majority of patients are going to find the dental practice that has the best combination of proximity and insurance coverage; in other words, a commodity.
How do you explain patients who are loyal to one dentist even if his fees are higher or he doesn't take their insurance? This is not unusual. I believe most people do not simply want a filling. They want a positive experience. If you want to stand out among the sea of general dentists you must understand you are offering an experience. Otherwise you will just be offering a commodity: PFMs for $750, cleanings for $75...It's the difference between offering 'dental care' and 'procedures'. You can excell doing either, but most people aren't fit to do both.
 

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griffin04 said:
Chains aren't the only place where this occurs. There are plenty of private practices in NYC where you will get the same experience. High turnover, shortcuts abound, etc. Only difference is you will be walking into a fancy Manhattan building instead of the "Vital Dent" store front. I saw plenty of ghettodontics done in fancy buildings around town. Unfortunately, patients won't always know the difference - "a filling is a filling" mentality. It's just the nature of the job market there. There is no dentist/associate trust either - I couldn't trust telling any bosses that I was going for ortho because I would likely not get the job or be unemployed quickly. Like you said, there are some good jobs, but you have to "pay your dues" to find them. I did hygiene for a year in one office before I was offered a chance to do quality operative/fixed dentistry. My friends went through similar experiences as well.
ok so my point is if new grads don't support chains, it'll be better for the profession as a whole, and better for new grads. i personally couldn't rationalize working at Vital Dent by saying there are plenty private practices that are the same way. i'm sorry about your bad experiences. i'm glad my colleagues who went to nyc had better experiences to tell me upon their recent graduation - mind you they're from nyc area and went to work for their old dentist, 1 bought in, 1 gave 3 yr commit, etc. from your post, it seems like you and your friends who went through similar experiences end up viewing dentistry as a commodity as well - at least for the short term. so there we have it. insurance always viewed dentistry as a commodity, some proportion of the population does and will, and now more dentists seem to be feeling the same way.
 

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What this boils down to is what we think the public want from a dentist, and obviously this will vary for different groups. For the low SES, they can care less for who their dentist is as long as their teeth don't hurt.
For the average SES and above, people want whatever in their mouth to last forever.

If I'm getting a doctor, I want that doctor to be damn good, and is not going to mess me up. Can this analogy be drawn to dentist? I don't know, maybe, maybe not. Maybe it depends on different case scenario. Perhaps, I will go to vitadent to get the annual check-up, root scaling stuff. But then for actual procedures, I probably go to a local boutique dentist.

The other issue is whether if newly grad dentist want to sell the profession to Vita Dents. I don't know. Seems, like people will do whatever for money, but then maybe the dental profession are different.

Now that leads to me wondering what the ADA would say about the Vital Dents. They always have something to say.

Dr.hobie, you are like the only upper-classmen from UCLA that's on SDN. Sheesh, where's everybody else?
 

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Here in Texas, we've had Castle Dental (also in Calif, Flor, and Tenn) and Monarch Dental for years and it has seemed to have little impact on private dentists. In my circle of friends it is generally understood that "doc in the box" facilities are of poorer quality and not worth the money in the end. In the office where I work, we get new pts everyday who come, not because their last dentist was a bad dentist, but because their last dentist was a jerk, or they weren't very friendly, or they didn't listen to their needs. Most people don't want to go to the dentist anyway, so I figure, if they're actually going to get work done, they want a comfortable, pleasant experience, not a cheap one. Low socio-economic pts have a totally different mindset, I agree, but I'm talking most people with insurance that want to be treated properly. Plus, I think as long as pain is involved, dentistry will never be considered a commodity :)
 

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jk5177 said:
Anyone else worried by the fact that they're able to give away so much stuff for "free," or does it simply mean the other things in dentistry are really profitable? I did go to a doctor's office once that was giving away free physicals, but it didn't last very long.
 
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