May 26, 2012
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hi everyone, my first thread. I am in my 3rd year in dental school and looking suggestions on which route should I take. Should I go for private pratice or corporate dentistry? Any advice would be appreicated and help me in my decision. Please give me your reasons which route you would have taken if you were in my place and why.

Thanks again, :)
 

Blizzard1mage

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Apr 4, 2012
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If you were starting your own practice, or even purchasing a fixer-upper practice, you may still need to work elsewhere (at least for the first year or two) while building it up. But the hope is that it will give you the lifestyle you may desire, both in terms of financial profitability and independence in your work/life decisions.
 

djeffreyt

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If you can, find a dentist who needs an associate in private practice that does the kind of work you would be proud to do and the kind of procedures you would want to do yourself now or in the future. Make sure the fit is good between you personally and try to work there.

You can work in several places and even work part time with a corporate group.

Your first few years out help to set the foundation of your practice philosopy, so find someplace that fits right with you and you'll do fine.
 
Sep 14, 2010
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We're ALL going to work for corporate dental chains. If you try to buy a private practice it'll go bust because the corporations are going to have ALL THE PATIENTS in just a few years. The old guys are all being advised to get their numbers up and sell their practice for max value before the new health care reform kicks in. I don't know what we younger dentists should do but I know that buying a private practice is probably not in our best interest because the days of solo private practice are OVER. The corporate monster devoured the medical commnity and its hungry for the dental community. Why? BECAUSE DENTISTRY IS LUCRATIVE THAT'S WHY!!! They see a market with HUGE profit potential and they want to make it their own...and they will make it their own. The corporate model is such that they can offer low cost dental care to the consumer (who hasn't the slightest idea of what good dental care is or looks like) that a private practice can't compete with. Sure, there will be a few private dentist with a loyal following that are able to eek out an existance but that will be the exception not the rule.
 

billythekid

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We're ALL going to work for corporate dental chains. If you try to buy a private practice it'll go bust because the corporations are going to have ALL THE PATIENTS in just a few years. The old guys are all being advised to get their numbers up and sell their practice for max value before the new health care reform kicks in. I don't know what we younger dentists should do but I know that buying a private practice is probably not in our best interest because the days of solo private practice are OVER. The corporate monster devoured the medical commnity and its hungry for the dental community. Why? BECAUSE DENTISTRY IS LUCRATIVE THAT'S WHY!!! They see a market with HUGE profit potential and they want to make it their own...and they will make it their own. The corporate model is such that they can offer low cost dental care to the consumer (who hasn't the slightest idea of what good dental care is or looks like) that a private practice can't compete with. Sure, there will be a few private dentist with a loyal following that are able to eek out an existance but that will be the exception not the rule.
well that's a depressing attitude.

even my patients at the dental school recognize that corporate dentistry is of lesser quality. patients have the sense to know when they are on an assembly line and are only seen by a dentist for 7 seconds at a time.

private practice dentistry has been stagnant for the past couple of years because of the economy; this is also the reason why corporate dentistry has exploded. private practice will bounce back in a big way.
 

charlestweed

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...even my patients at the dental school recognize that corporate dentistry is of lesser quality. patients have the sense to know when they are on an assembly line and are only seen by a dentist for 7 seconds at a time....
The patients know they get lesser quality care at the dental chains but they still go there because dental chains offer things that many private dental practices don't offer such as low fees, medicaid, HMO, late office hours etc. If you, a private practice owner, offer the same low fees that the dental chains offer and provide things that the chains fail to provide (such as good communication, shorter wait time, more doctor time for each patient, better quality care etc), you will be fine. Dentistry will never be like pharmacy and optometry, which are completely taken over by companies like Walmart and Costco.
 

DrDDSman

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Jul 19, 2007
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The patients know they get lesser quality care at the dental chains but they still go there because dental chains offer things that many private dental practices don't offer such as low fees, medicaid, HMO, late office hours etc. If you, a private practice owner, offer the same low fees that the dental chains offer and provide things that the chains fail to provide (such as good communication, shorter wait time, more doctor time for each patient, better quality care etc), you will be fine. Dentistry will never be like pharmacy and optometry, which are completely taken over by companies like Walmart and Costco.

A little off topic, but it bothers me to thing about...do you think that in 5-10 years that this can be a possibility? Some markets are flooded with dentists and big companies like Walmart and Target are trying many things to expand their horizons...and share price. Why not be able to get a RCT and pick up some antibiotics and NSAIDs without having to leave the building? Oh and you can also pick up some groceries and etc while you wait for them to fill.

This is a scary thought for me.
 

djeffreyt

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A little off topic, but it bothers me to thing about...do you think that in 5-10 years that this can be a possibility? Some markets are flooded with dentists and big companies like Walmart and Target are trying many things to expand their horizons...and share price. Why not be able to get a RCT and pick up some antibiotics and NSAIDs without having to leave the building? Oh and you can also pick up some groceries and etc while you wait for them to fill.

This is a scary thought for me.
I'm sure once they work out the logistics, Walmart dental offices will open, but they still need to be owned by a dentist, so that loophole will take a little while to figure out.

You could just sell your antibiotics and narcotics at your office if you wanted to serve your patients in that way easier. You just have to keep records of it and dispose of wasted stock appropriately.

And you might get lower quality work at a chain, but you might not. It's all dependent on the dentist. Experience doesn't always count either. I've seen some amazing root canals done by 1st year out graduates and horrible ones done by private practice endodontists. Some of the best crowns I've seen in my area were done by a prosthodontist who works for a local chain practice. It all depends on the dentist, and I know you all know that. Some of the best clinical students at your schools may end up working at chain practices, while some of the ones you wouldn't even let do a cleaning on you might end up working at their Uncle's private practice putting fillings in that fail a year later because of poor bonding techniques. You never know what you might get.
 
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txaggie03

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Aug 2, 2010
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Dentistry, like optometry, will always have a subset of patients who understand quality care.

Provide quality care, and the patients will be there.

Not every dental school graduate has the qualities to make it outside the corporate arena. Corporate chains have realized this and are picking up those graduates without any confidence to try to make it on their own. I dont fault them for it; it is brilliant, really.

To the original post: where is your confidence level? What have you done in school to make your confidence level as high as possible?
 

charlestweed

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A little off topic, but it bothers me to thing about...do you think that in 5-10 years that this can be a possibility? Some markets are flooded with dentists and big companies like Walmart and Target are trying many things to expand their horizons...and share price. Why not be able to get a RCT and pick up some antibiotics and NSAIDs without having to leave the building? Oh and you can also pick up some groceries and etc while you wait for them to fill.

This is a scary thought for me.
If you were a patient, would you want your RCT to be performed by the chain dentist who also has to see 10 other patients at the same time (overbooking is very common in corporate dental settings) or by a private practice dentist who only has you as his patient?

You can buy the same quality Acuvue contact lenses for less at Costco's optometry department. You can buy the same quality Amoxicillin tablets for less at Walmart 's pharmacy department. You cannot get the same quality dental care at the dental chain due to overbooking, lack of communication, rude office manager, lazy staff, long wait time etc.
 

Shnurek

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Dentistry will never be like pharmacy and optometry, which are completely taken over by companies like Walmart and Costco.
Pharmacy is taken over by commercial companies almost completely. Optometry is only 25% taken over and the bottom of the barrel optometrists that just want money go into commercial. They just do refractions for glasses and contacts 90% of the time. The other 75% are better off as they get onto medical insurance panels and do a lot more medical eye care. This is why we are pushing our scope of practice so greatly in the last 20 years or so and our education has improved exponentially. We even started to break the surgery frontier as we do not want to end up like pharmacy. I picked optometry because I like where it is going, although dentistry would have been a fine career choice as well.
 

txaggie03

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Aug 2, 2010
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Pharmacy is taken over by commercial companies almost completely. Optometry is only 25% taken over and the bottom of the barrel optometrists that just want money go into commercial. They just do refractions for glasses and contacts 90% of the time. The other 75% are better off as they get onto medical insurance panels and do a lot more medical eye care. This is why we are pushing our scope of practice so greatly in the last 20 years or so and our education has improved exponentially. We even started to break the surgery frontier as we do not want to end up like pharmacy. I picked optometry because I like where it is going, although dentistry would have been a fine career choice as well.
what is the rational for pushing the surgery frontier when optometrists can't prescribe antibiotics lasting more than 10 days?

I am not saying they shouldnt push all boundaries, but priorities seem oddly placed.

(this is not meant as a poke, but rather a legitimate question).
 

jeffity

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Oct 23, 2009
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Do corporate chains have to be owned by a dentist? I've never looked into it, but those I know who have worked corporate gigs made it seem like a big part of the issues (for them personally) was that there was more of a businessman at the top than a healthcare provider. I mean, no one is going to work for free and not all corporate gigs are like this, obviously. But his production was struggling because he refused to give what he deemed dishonest and excessive treatment plans like co-workers. He was being pressured.
 
May 31, 2012
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well that's a depressing attitude.

even my patients at the dental school recognize that corporate dentistry is of lesser quality. patients have the sense to know when they are on an assembly line and are only seen by a dentist for 7 seconds at a time.

private practice dentistry has been stagnant for the past couple of years because of the economy; this is also the reason why corporate dentistry has exploded. private practice will bounce back in a big way.
I certainly hope this is the case.. but there was an article in May 2012 JADA that says while the economy has hurt dentists, it isn't the only reason dentistry has been pretty stagnant. Even before the recession people were utilizing dental care less than in the past, and the authors conclude that when the economy improves, it won't likely mean a new boom for dentists. Especially when we take into account health care reform.

That being said, I don't think we have anything to worry about.. :confused:
 

DentinBond

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Sep 26, 2010
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We're ALL going to work for corporate dental chains. If you try to buy a private practice it'll go bust because the corporations are going to have ALL THE PATIENTS in just a few years. The old guys are all being advised to get their numbers up and sell their practice for max value before the new health care reform kicks in. I don't know what we younger dentists should do but I know that buying a private practice is probably not in our best interest because the days of solo private practice are OVER. The corporate monster devoured the medical commnity and its hungry for the dental community. Why? BECAUSE DENTISTRY IS LUCRATIVE THAT'S WHY!!! They see a market with HUGE profit potential and they want to make it their own...and they will make it their own. The corporate model is such that they can offer low cost dental care to the consumer (who hasn't the slightest idea of what good dental care is or looks like) that a private practice can't compete with. Sure, there will be a few private dentist with a loyal following that are able to eek out an existance but that will be the exception not the rule.
Persenmi, you are severely misinterpreting what you see, to your own detriment. The middle has indeed gone out of the Bell Curve and you are looking only at the end where lowest cost wins. There is good news to go with the bad, though- there's another end of the curve based on Connection and Certainty.

Yes, there is a "race to the bottom" on cost and corporations win there. See http://en.wikipedia.org/wiki/Bertrand_competition

The problem with racing to the bottom on cost is that someone else can always beat you. It's a race that you will lose, period. So- Don't enter it!

The fact is there is no better time to be a dentist. We have great tech and more than that, people have been beaten down by corporate treatment to the point where they (I should say "we") don't want to take it anymore. We've been treated, in our roles as consumer and as employee, as interchangeable, temporary and disposable on such a massive scale that we are rebelling.

Rebelling not with pitchforks and torches but with our precious Attention.

Because along came the Internet and allowed us to connect, to organize, to share information. And to find out almost anything about anything. The online review is one of the most significant changes in human history; we don't see it as such too easily because we're living through the change. But it gives us awesome power, as do many other aspects of what the Internet has built. As Seth Godin recently said when I saw him in Tribeca, "The Internet is the first medium in history where everyone who has a receiver has a transmitter."

I know there are practical limits. But do a gedankenexperiment and imagine that we collectively withdraw our Attention completely from any entity. WalMart, 60 Minutes, you name it. If enough of us ignore it, it dies. The people who run these things are in a state of fear. You want a great example, look at the music industry. Until very recently they had all the power. Then along came the well-armed consumer and we destroyed them. Every label is a shadow of its former self, and the artists themselves don't really need them at all anymore.

Well, many patients are going to ignore corporate dentistry. Because it only satisfies the one criterium- cost. It does not, cannot provide true human Connection, the Certainty and trust that a superb dental practice builds over time, or things like patiently executed treatment plans for hard-pressed families and detailed discussions of preventive strategies. They cannot make time or space for these things. That's the definition of a race to the bottom.

Seth said something awhile back that's so powerful it has become my main guidance in practice. After detailing how sick and tired people are of being treated as interchangeable, temporary and disposable, he asserts that our best strategy is:

(1) Delight people.
(By providing remarkable experiences, far beyond what they expect.)

(2) Solve their (interesting) problems.
I put (interesting) in parentheses to emphasize that the more interesting their problem is to them, the easier it is to sell them a solution. For instance, picture two patients, both with large radiolucent lesions at the apices of #30, and you diagnose them both as endodontic lesions. One patient is in severe pain. The other has no symptoms. Same diagnosis, but one person is very interested in their problem, the other will need some convincing.

This is where your communication skills come in. You are going to develop your communication skills, right? (I mean all of you here.) Because that's something else that a corporation that has raced to the bottom cannot afford to do.

Advice: Read Seth Godin's book Linchpin. Read it yesterday. And if I may be allowed to reference myself, have a look at the blog that I started to let my own book live online a little as I write it. It deals with these isues in fictional form. Learning through a story, the best way. Feel free to nose around a bit, but these posts are most relevant:

http://rickwilsondmd.typepad.com/the_man_who_wore_mismatch/2012/03/please-dont-ever-give-in-and-race-to-the-bottom.html

http://rickwilsondmd.typepad.com/the_man_who_wore_mismatch/2012/03/it-matters-how-a-company-views-its-products-and-services.html

Thank you for listening.
 
Last edited:

KAIN DDS

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May 1, 2012
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We're ALL going to work for corporate dental chains. If you try to buy a private practice it'll go bust because the corporations are going to have ALL THE PATIENTS in just a few years. The old guys are all being advised to get their numbers up and sell their practice for max value before the new health care reform kicks in. I don't know what we younger dentists should do but I know that buying a private practice is probably not in our best interest because the days of solo private practice are OVER. The corporate monster devoured the medical commnity and its hungry for the dental community. Why? BECAUSE DENTISTRY IS LUCRATIVE THAT'S WHY!!! They see a market with HUGE profit potential and they want to make it their own...and they will make it their own. The corporate model is such that they can offer low cost dental care to the consumer (who hasn't the slightest idea of what good dental care is or looks like) that a private practice can't compete with. Sure, there will be a few private dentist with a loyal following that are able to eek out an existance but that will be the exception not the rule.
They usually give cheap insurance which makes it competitive but people know where to get good work, and it's not a chain. We win bc of values, family atmosphere and skill
 

NileBDS

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Persenmi, you are severely misinterpreting what you see, to your own detriment. The middle has indeed gone out of the Bell Curve and you are looking only at the end where lowest cost wins. There is good news to go with the bad, though- there's another end of the curve based on Connection and Certainty.

Yes, there is a "race to the bottom" on cost and corporations win there. See http://en.wikipedia.org/wiki/Bertrand_competition

The problem with racing to the bottom on cost is that someone else can always beat you. It's a race that you will lose, period. So- Don't enter it!

The fact is there is no better time to be a dentist. We have great tech and more than that, people have been beaten down by corporate treatment to the point where they (I should say "we") don't want to take it anymore. We've been treated, in our roles as consumer and as employee, as interchangeable, temporary and disposable on such a massive scale that we are rebelling.

Rebelling not with pitchforks and torches but with our precious Attention.

Because along came the Internet and allowed us to connect, to organize, to share information. And to find out almost anything about anything. The online review is one of the most significant changes in human history; we don't see it as such too easily because we're living through the change. But it gives us awesome power, as do many other aspects of what the Internet has built. As Seth Godin recently said when I saw him in Tribeca, "The Internet is the first medium in history where everyone who has a receiver has a transmitter."

I know there are practical limits. But do a gedankenexperiment and imagine that we collectively withdraw our Attention completely from any entity. WalMart, 60 Minutes, you name it. If enough of us ignore it, it dies. The people who run these things are in a state of fear. You want a great example, look at the music industry. Until very recently they had all the power. Then along came the well-armed consumer and we destroyed them. Every label is a shadow of its former self, and the artists themselves don't really need them at all anymore.

Well, many patients are going to ignore corporate dentistry. Because it only satisfies the one criterium- cost. It does not, cannot provide true human Connection, the Certainty and trust that a superb dental practice builds over time, or things like patiently executed treatment plans for hard-pressed families and detailed discussions of preventive strategies. They cannot make time or space for these things. That's the definition of a race to the bottom.

Seth said something awhile back that's so powerful it has become my main guidance in practice. After detailing how sick and tired people are of being treated as interchangeable, temporary and disposable, he asserts that our best strategy is:

(1) Delight people.
(By providing remarkable experiences, far beyond what they expect.)

(2) Solve their (interesting) problems.
I put (interesting) in parentheses to emphasize that the more interesting their problem is to them, the easier it is to sell them a solution. For instance, picture two patients, both with large radiolucent lesions at the apices of #30, and you diagnose them both as endodontic lesions. One patient is in severe pain. The other has no symptoms. Same diagnosis, but one person is very interested in their problem, the other will need some convincing.

This is where your communication skills come in. You are going to develop your communication skills, right? (I mean all of you here.) Because that's something else that a corporation that has raced to the bottom cannot afford to do.

Advice: Read Seth Godin's book Linchpin. Read it yesterday. And if I may be allowed to reference myself, have a look at the blog that I started to let my own book live online a little as I write it. It deals with these isues in fictional form. Learning through a story, the best way. Feel free to nose around a bit, but these posts are most relevant:

http://rickwilsondmd.typepad.com/the_man_who_wore_mismatch/2012/03/please-dont-ever-give-in-and-race-to-the-bottom.html

http://rickwilsondmd.typepad.com/the_man_who_wore_mismatch/2012/03/it-matters-how-a-company-views-its-products-and-services.html

Thank you for listening.

What a great post! Thank you.
 

Mr. Thirsty

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May 28, 2011
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If you were a patient, would you want your RCT to be performed by the chain dentist who also has to see 10 other patients at the same time (overbooking is very common in corporate dental settings) or by a private practice dentist who only has you as his patient?

You can buy the same quality Acuvue contact lenses for less at Costco's optometry department. You can buy the same quality Amoxicillin tablets for less at Walmart 's pharmacy department. You cannot get the same quality dental care at the dental chain due to overbooking, lack of communication, rude office manager, lazy staff, long wait time etc.
:thumbup:

What's with all this fear about corporate dentistry? Im not a dentist yet, but can they really force this?...they can make it harder for private practice. But I feel like corporate dentistry will never pay enough to make it worth it unless your in 300k+ of debt. Nobody wants ****ty dental care and that's all corporate companies will turn it into. It seems like they focus 90% of their energy on marketing and looking for desperate dentists. (No offense)

Sent from my DROIDX using SDN Mobile
 

KAIN DDS

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May 1, 2012
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:thumbup:

What's with all this fear about corporate dentistry? Im not a dentist yet, but can they really force this?...they can make it harder for private practice. But I feel like corporate dentistry will never pay enough to make it worth it unless your in 300k+ of debt. Nobody wants ****ty dental care and that's all corporate companies will turn it into. It seems like they focus 90% of their energy on marketing and looking for desperate dentists. (No offense)

Sent from my DROIDX using SDN Mobile
True
 

Aceofspades

10+ Year Member
Dec 26, 2007
443
10
Status
Dental Student
A big problem is that once Obamacare goes into full effect, the cost of medical care will be largely shielded from the American public. Once the compare and contrast the costs of their medical care with that of their dental care they will demand reforms. Americans never like to see the full cost of goods/services so they will demand dental insurance even more. This is why insurance works so well, even though dental insurance is not "insurance" at all. This is why Americas buy 2-year cell phone contract "deals" and wind up paying more over time. This is why Americans have insist on having social security taken out of their paychecks and invested by the Government in treasury bills, when they could take that same exact money and invest in the same exact treasury bills with more control and a greater yield.
 

djeffreyt

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So many things...

One poster asked if practices have to be owned by a dentist. Yes, in the USA, they do. That however does not mean that a corporation cannot also run the practice. For example, a dentist, who works for the corporation, open the practice under his or her name, but all the management of the practice is done by the corporation that the dentist is a part of.


As for the crappy work out of corporate dental offices, I still think some of you are pretty tunnel visioned. Yeah, sure, I've seen plenty of crap from corporate/pseudo-corporate practices. That's a lot of what you see as a dentist, other people's crap that goes wrong. You also see other dentist's awesome stuff, but more often, patients ask us to focus on the crap someone else did to them. The patients who didn't move or have a dentist retire on them, probably stayed if the work was good enough not to hurt, and you won't see them in your office.

I don't think you are off base in saying corporations who run dental practices will more often than not try to push the bottom line over the quality of care, but if you honestly think that at least a decent number of private practice and small group practice dentists in the world don't also try to do that then you just haven't been paying that much attention.

I've seen corporate dental offices that use some of the best materials and equipment and bring in CE experts to train them in the correct usage while at the same time seeing cottage practices that cut corners on equipment and materials because of the costs of running the solo practice. I've seen some great work from private practices, and also from corporate offices. I've met private practice dentists who say: all proximal decay must be restored with an inlay or onlay, and not gold, Cerec. I don't give the option of a resin filling. So are these dentists considering the patient quality of care or their pocketbook? I was once shocked when I referred a patient to a private periodontist to team up on his perio care of ScRP and perio maintenance. I got a letter back saying the periodontist recommended 4 quadrants of bone grafting. Skeptical, I sent the radiographs and chart information to 3 other periodontists (an old instructor, a friend in another state, and another periodontist that I had trusted but moved out of the city). All three said the grafts had almost no chance of success and any bone increase would be minimal.

The point is there is shady practice and poor quality in all arenas of dentistry, the corporate arena has it's bad dentists and emphasis on profit, but there is plenty of that in private practice too. There's plenty of people who will hate the corporate model of multiple patients each hour and would prefer the private dentist who sees 1-2 patients an hour, but there are enough patients who like the cost benefits and will keep going to the corporate offices. But honestly, I don't think that many private practices work under the 1 patient per hour model anymore. It's more like: 1 small procedure, 1 large procedure and 1-2 hygiene recalls per hour. The field is and always will slowly change and evolve, just got to find your niche
 
Sep 14, 2010
211
1
Status
Dental Student
Persenmi, you are severely misinterpreting what you see, to your own detriment. The middle has indeed gone out of the Bell Curve and you are looking only at the end where lowest cost wins. There is good news to go with the bad, though- there's another end of the curve based on Connection and Certainty.

Yes, there is a "race to the bottom" on cost and corporations win there. See http://en.wikipedia.org/wiki/Bertrand_competition

The problem with racing to the bottom on cost is that someone else can always beat you. It's a race that you will lose, period. So- Don't enter it!

The fact is there is no better time to be a dentist. We have great tech and more than that, people have been beaten down by corporate treatment to the point where they (I should say "we") don't want to take it anymore. We've been treated, in our roles as consumer and as employee, as interchangeable, temporary and disposable on such a massive scale that we are rebelling.

Rebelling not with pitchforks and torches but with our precious Attention.

Because along came the Internet and allowed us to connect, to organize, to share information. And to find out almost anything about anything. The online review is one of the most significant changes in human history; we don't see it as such too easily because we're living through the change. But it gives us awesome power, as do many other aspects of what the Internet has built. As Seth Godin recently said when I saw him in Tribeca, "The Internet is the first medium in history where everyone who has a receiver has a transmitter."

I know there are practical limits. But do a gedankenexperiment and imagine that we collectively withdraw our Attention completely from any entity. WalMart, 60 Minutes, you name it. If enough of us ignore it, it dies. The people who run these things are in a state of fear. You want a great example, look at the music industry. Until very recently they had all the power. Then along came the well-armed consumer and we destroyed them. Every label is a shadow of its former self, and the artists themselves don't really need them at all anymore.

Well, many patients are going to ignore corporate dentistry. Because it only satisfies the one criterium- cost. It does not, cannot provide true human Connection, the Certainty and trust that a superb dental practice builds over time, or things like patiently executed treatment plans for hard-pressed families and detailed discussions of preventive strategies. They cannot make time or space for these things. That's the definition of a race to the bottom.

Seth said something awhile back that's so powerful it has become my main guidance in practice. After detailing how sick and tired people are of being treated as interchangeable, temporary and disposable, he asserts that our best strategy is:

(1) Delight people.
(By providing remarkable experiences, far beyond what they expect.)

(2) Solve their (interesting) problems.
I put (interesting) in parentheses to emphasize that the more interesting their problem is to them, the easier it is to sell them a solution. For instance, picture two patients, both with large radiolucent lesions at the apices of #30, and you diagnose them both as endodontic lesions. One patient is in severe pain. The other has no symptoms. Same diagnosis, but one person is very interested in their problem, the other will need some convincing.

This is where your communication skills come in. You are going to develop your communication skills, right? (I mean all of you here.) Because that's something else that a corporation that has raced to the bottom cannot afford to do.

Advice: Read Seth Godin's book Linchpin. Read it yesterday. And if I may be allowed to reference myself, have a look at the blog that I started to let my own book live online a little as I write it. It deals with these isues in fictional form. Learning through a story, the best way. Feel free to nose around a bit, but these posts are most relevant:

http://rickwilsondmd.typepad.com/the_man_who_wore_mismatch/2012/03/please-dont-ever-give-in-and-race-to-the-bottom.html

http://rickwilsondmd.typepad.com/the_man_who_wore_mismatch/2012/03/it-matters-how-a-company-views-its-products-and-services.html

Thank you for listening.
Dentinbond,

I enjoyed reading your post and I agree with most of it, however, I feel that there are a few factors that you haven't concidered. First, you are 100% correct about the power of the internet...and that's the problem. THE POWERFUL CORPORATIONS (of all kinds) KNOW THIS TOO! That is why they are pumping millions if not billions into lobbying congress to end the internet as we know it using outmoded copyright law. Remember the SOPA bill that came along just a few months ago (the wikipedia blackout deal)? Had that bill passed, the internet would be totally regulated and controlled by wealthy corporations either directly or indirectly to protect their business whatever it may be. If you think that was the end of it, your're wrong. They are cutting backroom deals with politicians as we speak to put a new dress on the same bill and ram it through and they won't stop until they succeed. That is how they operate. That means, we have to fight them forever and I don't see that happening. It pains me greatly to say it, but the internet will not be allowed to be as free as it is for much longer for the exact reason you mentioned in your post. It gives us too much power and they want to put that jeanie back in the bottle. But I agree otherwise, so long as the internet is free and unregulated, the private dental model will rule in the end.

Second, the middle class in the US is vanishing at an alarming rate and has been for a long time now. As this vast class gets poorer, as all trends suggest they will, cost will become more and more important until it becomes the major deciding factor with respect to health care and many will turn to corporate dentistry albeit against their will. In my opinion, this is the most vexing problem facing dentists today because the solutions (and there are many viable solutions from many brilliant people) are very unlikely to ever occur because the wealth that was transferred from the middle class is in the coffers of major corporations that turn around and use it to lobby congress to preserve their wealth (e.g. internet regulation legislation, tax loop holes, etc. etc.)! In other words, once they get it, and they already have it now, they aint givin' it back!

However, there is one thing that we can aggree on, we have to fight back if we want to preserve the private practice dental model. I will be with you on the front lines and forums like this one are a great example of how powerful the internet is. Let's use it while we still can!
 

corymartin2012

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Jul 17, 2011
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I think the best idea concerning private vs. corporate is a meeting a compromise. This would be along the ideas of group practicing.

You could have smaller corporations (not national or global but rather regional local and state wide) that combine together to pool the capital, management systems and various other tools needed to succeed. This pool of resources can assist and create a more efficient dentist practice.

The hard part is regulating the actions of this corporation so that it doesn't become large the larger corporate chains.But if you could pull this off you are looking at creating a great model that preserves several of the private practice values and goals while adding the great benefits of effective management, capital and other resources of a corporation setting.
 

djeffreyt

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I think the best idea concerning private vs. corporate is a meeting a compromise. This would be along the ideas of group practicing.

You could have smaller corporations (not national or global but rather regional local and state wide) that combine together to pool the capital, management systems and various other tools needed to succeed. This pool of resources can assist and create a more efficient dentist practice.

The hard part is regulating the actions of this corporation so that it doesn't become large the larger corporate chains.But if you could pull this off you are looking at creating a great model that preserves several of the private practice values and goals while adding the great benefits of effective management, capital and other resources of a corporation setting.
haha, this is what's been happening for years.
 

corymartin2012

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Jul 17, 2011
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haha, this is what's been happening for years.

Perfect lol! In my neck of the words its all solo practioners and they swear up and down by it.
 

Firm

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Perfect lol! In my neck of the words its all solo practioners and they swear up and down by it.
Solo is the way to go if you can afford it. Group practices are great if you get along with your partners. The best way to do group partnership is to have an office for each dentist with their own staff.
 

DentinBond

DentinBond
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Sep 26, 2010
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Dentinbond,

I enjoyed reading your post and I agree with most of it, however, I feel that there are a few factors that you haven't concidered. First, you are 100% correct about the power of the internet...and that's the problem. THE POWERFUL CORPORATIONS (of all kinds) KNOW THIS TOO! That is why they are pumping millions if not billions into lobbying congress to end the internet as we know it using outmoded copyright law. Remember the SOPA bill that came along just a few months ago (the wikipedia blackout deal)? Had that bill passed, the internet would be totally regulated and controlled by wealthy corporations either directly or indirectly to protect their business whatever it may be. If you think that was the end of it, your're wrong. They are cutting backroom deals with politicians as we speak to put a new dress on the same bill and ram it through and they won't stop until they succeed. That is how they operate. That means, we have to fight them forever and I don't see that happening. It pains me greatly to say it, but the internet will not be allowed to be as free as it is for much longer for the exact reason you mentioned in your post. It gives us too much power and they want to put that jeanie back in the bottle. But I agree otherwise, so long as the internet is free and unregulated, the private dental model will rule in the end.

Second, the middle class in the US is vanishing at an alarming rate and has been for a long time now. As this vast class gets poorer, as all trends suggest they will, cost will become more and more important until it becomes the major deciding factor with respect to health care and many will turn to corporate dentistry albeit against their will. In my opinion, this is the most vexing problem facing dentists today because the solutions (and there are many viable solutions from many brilliant people) are very unlikely to ever occur because the wealth that was transferred from the middle class is in the coffers of major corporations that turn around and use it to lobby congress to preserve their wealth (e.g. internet regulation legislation, tax loop holes, etc. etc.)! In other words, once they get it, and they already have it now, they aint givin' it back!

However, there is one thing that we can aggree on, we have to fight back if we want to preserve the private practice dental model. I will be with you on the front lines and forums like this one are a great example of how powerful the internet is. Let's use it while we still can!
So happy to see you in fighting spirit, Persenmi! That's more like it.

Yes, the Internet is complex. Many believe it's too big and decentralized to kill. Also, again, it's the first communications medium in human history where everyone who has a reciever has a transmitter. What we're seeing is definitely a severe reaction on the part of Gatekeepers, those who maintain power and information. The question is, will they succeed in putting the genie back in the bottle? They certainly want to, but I don't believe they can. Try reading Chris Anderson's Free: The Future of a Radical Price and The Long Tail. Once you hear him explain how this stuff works, you gain an amazing perspective on it all.

Yeah, the middle class. There are only two bumper stickers I've ever seen that I even considered putting on my car:
"Meter maids eat their young."
and
"Well, at least the war on the middle class is going well."

Here again I have to agree with Seth Godin about what's going on; I'll post an excerpt from Linchpin at the end here. And yes I'm struggling with what corporations mean for us all too. A great resource is Joel Bakan's The Corporation. At the end he does suggest some positive measures that could be taken to rein in these pathologic constructions that we've created. I don't pretend to have any answers here except to do your best in spite of corporations and governments. And whatever hits the middle class is taking, the standard of living is still way higher than it ever was.

Here's my full reading list on all these issues:

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2010/05/a-bakers-dozen-of-books-that-will-change-your-world.html

And here's the excerpt from Linchpin. Apologies for the length, but if it changes one person's direction in life it's worth it. Never stop fighting!

I grew up in a world where people did what they were told, followed instructions, found a job, made a living, and that was that. Now we live in a world where all the joy and profit have been squeezed out of following the rules. Outsourcing and automation and the new marketing punish anyone who is merely good, merely obedient, and merely reliable. It doesn't matter if you're a wedding photographer or an insurance broker; there's no longer a clear path to satisfaction in working for the man. The factory—that system where organized labor meets patient capital, productivity-improving devices, and leverage—has fallen apart. Ohio and Michiganhave lost their "real" factories, just as the factories of the service industries have crumbled as well. Worse still, the type of low-risk,high-stability jobs that three-quarters of us crave have turned into dead-end traps of dissatisfaction and unfair risk. The essence of the problem: The working middle class is suffering. Wages are stagnant; job security is, for many people, a fading memory; and stress is skyrocketing. Nowhere to run, and apparently, nowhere to hide. The cause of the suffering is the desire oforganizations to turn employees into replaceable cogs in a vast machine. The easier people are to replace, the less they need to be paid. And so far, workers have been complicit in this commoditization. This is your opportunity.The indispensable employee brings humanity and connection and art to her organization. She is the key player, the one who's difficult to live without, the person you can build something around. You reject whining about the economy and force yourself to acknowledge that the factory job is dead. Instead, you recognize the opportunity of becoming indispensable, highly sought after, and unique. If a Purple Cow is a product that's worth talking about, the indispensable employee—I call her a linchpin—is a person who's worth finding and keeping.

And this passage is so inspiring:

We can't profitably get more average.

We can't get more homogenized, more obedient, or cheaper. We can't get faster, either.

We've gone against our true nature and corporatized, anonymized, and dehumanized as many of our systems as we possibly can. Even health care is a system now, not a human interaction. We could probably go even further, actually, but I'm betting it won't be a fun or profitable journey.

If all mortgages are thes ame, of course they can be chopped up and remixed and resold. But that means all bankers and all homes are the same, and so are all homeowners. Which means the cheap ones or the profitable ones are all that matter.

If all online products at all online stores are the same, then of course I'll use a price-shopping Website to find the cheapest product.

If all employees are nothing but a résumé, and résumés can be scanned, then why are we surprised that our computers end up finding us anonymous average people to fill our anonymous average jobs?

If every restaurant on the highway will give me precisely the same cheery service from the same robotic staff, at the same prices, then why does it matter where I stop?

Do we need to be flatter and smaller?

It's our desire to be treated like individuals that will end this cycle. Our passion for contribution and possibility, the passion we've drowned out in school and in the corporate world—that's the only way out.

Every successfulo rganization is built around people. Humans who do art. People who interact with other people. Men and women who don't merely shuffle money, but interact,give gifts, and connect.

All these interactions are art. Art isn't only a painting; it's anything that changes someone for the better, any nonanonymous interaction that leads to a human (not simply a commercial) conclusion.



 
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txaggie03

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do your best in spite of corporations and governments. And whatever hits the middle class is taking, the standard of living is still way higher than it ever was.
:thumbup: