I used to read the SDN forums regularly before and during dental school, though I never created an account. I haven't been on the site for a while but a friend of mine that is still in dental school told me about this thread. After reading all the posts, I felt a need to share my thoughts. So, I created an account...
I graduated from dental school in 2011, and upon graduation I worked with a solo practitioner for just under a year. While in private practice, I used care credit as an option for patients to get the treatment they needed/wanted. The dentist I worked with had no marketing strategy, and a bad location, and had very little concern for patient convenience (no late hours, no weekends, over $250 for new patient exam and X-rays). After a frustrating several months (mostly due to a low new patient count), I decided to look elsewhere for work. I looked into several opportunities, and decided on working for Aspen. I had some concerns with a corporate setting, especially with not wanting the "factory" feel. Also, I didn't want anyone breathing down my neck to do any unnecessary treatment. I was told that it would not be the case.
I have worked for Aspen for about a year now, and I can say that I am happy with the decision that I made. There has never been any questioning of my treatment plans. I have never been asked to do anything that I was uncomfortable with. I am the only dentist in the office, with a staff of 7. It feels a lot like a small private practice. The office manager is laid back, and there is no high pressure sales going on. Due to the advertising and location, I see about 6 new patients per day. The free exam and X-rays make it nice for the patients. I regularly see patients that haven't been to the dentist in 10+ years, and it was the free exam that got them in. They often accept treatment because it was less than they expected. Many patients are glad to have Carecredit to allow monthly payments. So I see the free exams and Care credit as very ethical. Sure, a pushy office manager can take advantage of people, but that is not a problem limited to corporate dentistry.
I have found the pay structure to be fair. The more dentistry you do, the more you make. That sounds pretty American to me, and definitely normal for traditional small practices. The staff is paid pretty average compared to the other dental offices in my area.
I have complete autonomy with clinical decisions. I order what materials I want to use. I choose amalgam or composites. I choose what types of crowns. I can refer endo, or do endo. I choose procedure times. If I want a little longer for that tricky bridge prep or DO on #2, I tell whoever schedules it to give me more time.
I have a great relationship with my patients. I have time to shoot the breeze with them. I get thank you cards in the mail. I cry with my patients over a diagnosis of terminal cancer. I have a great relationship with the staff. There is very little drama. We are busy but not overstressed.
Now for the bad.... With free exams comes drug seekers. Not a lot, but some. But clearly explaining that we are not a drug dispensary helps. I get patients that want me to fix today a problem that took them years to develop. Maybe the heavy advertising brings in a higher percentage of people with a low dental IQ. Sometimes there is some politicking due the fact that it's a big company, and there is a structured "hierarchy". I also get "trouble patients" dumped on me by other Aspen offices. It's frustrating and can lead to inter-office conflict. I can't set my fees, which isn't a big deal to me. Before taking time off, I have to make sure there is a "float" dentist available, which can be frustrating if something comes up with short notice (weddings, etc.)
In short, I feel good about Aspen as a company. It has developed a streamlined system to provide dental care. Yes, it is owned by investors, but I am at peace with that. Dentistry is a profitable business, and I have no problem with it as long as the clinical decisions are made by licensed dentists. The company is far from perfect. I don't know if I will work with them forever, but I am happy with where I am for now.
I hope this helps contribute to the discussion. By no means am I asking anyone to drink the Aspen kool-aid, but they have been fair with me, and I have seen no dishonest business practices. I see more shady stuff going on in some of the private practices around me.
