Everything You Need To Know About ASPEN DENTAL

[Bobby Fischer]

...The internet is full of ASPEN complaints. ASPEN has an entire department dedicated to damage-control from patients and staff who want to warn the rest of society...

High possibility ASPEN paid staff part of said department is doing PR damage control on this thread (shuckin wizzies and HappyAspenDoc). Oh wait: they are paid staff and have admitted it. And they call themselves dentists...what a joke on themselves and the profession (if they aren't lawyers or PR people posing as dentists)

Its like a Taco Bell employee on the taco assembly line calling themselves a 'Chef'

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[periopocket]

But coldfront didn't you work at aspen for 6 months before starting your practices...the pay is very decent and gives some of us future grads a hope of starting out nice! Also, I have lots of questions for you! You seem extremely successful and it looks like we may be of the same alumni in the future!

 

[Cold Front]

But coldfront didn't you work at aspen for 6 months before starting your practices...the pay is very decent and gives some of us future grads a hope of starting out nice! Also, I have lots of questions for you! You seem extremely successful and it looks like we may be of the same alumni in the future!

I had no plans to work for ASPEN after I graduated, I was focused on getting finances for my office at the time. As soon as I knew my office would take 6 months to build, I wanted to work as an associate at a busy office. Local ASPEN office seemed a good place to keep myself busy at the rime, and I would say they needed me bad at their $300k a month office, which to me was not a problem until I got to know the office manager more, and how much she hated being pressured to get things done from corporate through the regional manager. Regional manager was actually the person who hired me, not the senior dentist.

As a new graduate, you would think the pay is decent, but ASPEN will talk into you even more money once they see you have a potential with the company and you follow orders. I didn't buy it, because without my dental license, ASPEN can't operate the office they illegally run without an "actual" dentist-ownership (mandated by my state laws). This is another reason why they are getting sued, they are opening shops at states where the business is required to be owned by a dentist, fully or partially, and ASPEN doesn't. Even though they sometimes place an ASPEN dentist name on the door, an investor at corporate level, who doesn't actually work at the office.

Don't do it for the money. They need you more than you need them.

 

[periopocket]

I see the money and extra clinical experience do seem attractive....heck I checked my local listings and they have 3 associate positions starting at 166k...I'm sure this is probably incorrect! But dang!

 

[Bobby Fischer]

I see the money and extra clinical experience do seem attractive....heck I checked my local listings and they have 3 associate positions starting at 166k...I'm sure this is probably incorrect! But dang!

****** are a dime a dozen in every profession. don't you be one.

 

[periopocket]

Bob some of us will have no choice...I wish you would understand this...You're hunger may not begin until u graduate dental school but mine has already began...

 

[Bobby Fischer]

Bob some of us will have no choice...I wish you would understand this...You're hunger may not begin until u graduate dental school but mine has already began...

if the option is to either starve to death or ***** myself: starvation here I come!

I've been making no income 3 years predent with a wife and a gaggle of kids at home. 4 more years in d school to go.

Ramen noodles and a beater of a car.

the older I get the more I realize that money, like talk, is cheap. Once you get on the talk/ money treadmill where it stops for you to get off nobody knows.

The soul is the only thing of any lasting value. Don't sell yours no matter how little value you might be tempted to think it has.

And why take ye thought for raiment? Consider the lilies of the field, how they grow; they toil not, neither do they spin:

- King James Bible

 

[yappy]

I think it's important to note that this is a real concern. It's not realistic to allow loans to grow and grow while not being able to work in dentistry.

Periopocket, have you looked into national health programs that pay 30k/yr towards loans (tax free) and pay good salaries if you work in an undeserved area? Perhaps you can begin networking in the areas where you want to practice for viable associate positions that are non-corp. ? I don't have many good solutions for you because I'm not there yet; however, if the average dental school indebtedness was <100k I bet you we would not even be having this conversation. It's too bad debt has become a hindrance to career development and lead to the growth of corp offices.

Bob some of us will have no choice...I wish you would understand this...You're hunger may not begin until u graduate dental school but mine has already began...

 

[goffdent]

Like I said in many previous posts, the dentist is never at fault, but the management creates many unethical situations for patients, like the 11 who are suing ASPEN under the current lawsuit.

The manager is a big part of the treatment planning equation. He or she is trained how to sell and make patient accept items on the treatment plan at their highest value. Not only that, but treatment will also be charged in ADVANCE before the patient gets their treatment is performed by the dentist. So extractions can be pre-billed as surgical or soft tissue when they were not, same goes for the hygiene department and their SRP's and tons of other items insurances don't cover. All prepaid through CareCredit.

Managers are hawks for reversing any payments or differences, even if doctors did not perform the items on the treatment plan, as it could cost them their performance evaluation and their job eventually. So the ICD-9 billing code are totally under the Managers control, and many patients are not well informed to understand the billing process, and the dentists never deal with that aspect of the office.

In that case.. that's ridiculous!

 

[yappy]

I agree. I feel like if patients knew this no one would choose to go to these offices. There are some offices in my town that are private that do sliding fee prices based on income that have ethical business practices and good-older-doctors that just want to give back. For patients with ins I cannot imagine they would knowingly go to a dental office where over treatment was encouraged for PE returns. It's a complete conflict of interest.

In that case.. that's ridiculous!

 

[Cold Front]

I agree. I feel like if patients knew this no one would choose to go to these offices. There are some offices in my town that are private that do sliding fee prices based on income that have ethical business practices and good-older-doctors that just want to give back. For patients with ins I cannot imagine they would knowingly go to a dental office where over treatment was encouraged for PE returns. It's a complete conflict of interest.

Exactly.

In economics, there is a theory called "Information Asymmetry". It deals with the study of decisions in transactions where one party has more or better information than the other.

The underinformed party (patients) will always be in a position to trust and accept the "dentist", and assume the manager is on the dentist's side, when in reality, the Manager is on "executive" side. Executives hired the manager, the doctor did not. So the line is always drawn, but the patient doesn't know this. If patient did know this, we would not be discussing this topic.

 

[periopocket]

Yappy - ill definitely take a look at those programs once I graduate. Thanks so much for informing me.

Bobby - loco

Cold front - you are my hero!

 

[HappyAspenDoc]

The best way to fight ASPEN is if the ADA speaks up for dentists against corporate dentistry, and Better Business Bureau (BBB) listens to the complaints from ASPEN patients who are being over-billed and getting dental services they don't need, which directly contributes to the patient's decisions of never seeing a dentist again. State level dental associations should be more aware of the ASPEN schemes and work with dental schools to help new graduates avoid ASPEN style dentistry, where new grads are trained the ASPEN way through corporate trainings. More emphasis of ethics in the work place in school curriculums.

The internet is full of ASPEN complaints. ASPEN has an entire department dedicated to damage-control from patients and staff who want to warn the rest of society.

Remember, ASPEN dentists are recruited by non-dentists, trained by non-dentists, and directly managed in the office by non-dentists on how they should treatment plan (classic example is the ASPEN perio program, which is not taught in dental school as a standard of dentistry, i.e. Arestin in all 6 pockets of a tooth on multiple teeth in all perio patients, thanks to their supplier recommendations - Zila, who sells all perio products to Aspen as a pre-packaged hygient products as a bundle).

The lawsuit is broad, but it can be expose all the other companies who are profiting from this GREED scheme.

All of the training of Aspen dentists is completed by dentists, including treatment planning. Office Managers do not in any way manage any clinical decisions, clinical decisions are completly handled by the dentist. Each patient is individually and thoroughly examined by a dentist, most patients state that our exams are the most through that they have ever had. Most patients also have a complete periodontal charting completed by the hygienist, and most patients tell us that they have never had an examination like that. Aspen does have a Patient Satisfaction department that handles both patient praises and patient complaints. Aspen has experienced a steady increase in patient satisfaction rating over the past 12-18 months. In fact, the top 20%of Aspen offices currently have an average rating of 4.87 out of 5.0.

For the record, I am an actual dentist like all of you!

 

[yappy]

This cannot be true. I was TX planned for ortho and cleaning/exam by a office manager not a dentist. They told the dentist what I needed. I wanted a dentist to use clinical information to discuss what type of cleaning / exam / X-rays and ortho I needed. NOT a manager selling me dental services off a menu. It was complete BS. I didn't get to talk to a clinical person until well after my care plan had already been established - not one clinical person looked at my teeth or smile to say if any of those things were even appropriate.

It would be like walking into a doctors office and telling them what type of exam, images, or blood work I wanted - how the hell should I know? how about I tell my chief complaint to the doctor and they use their extensive education and training to decide. That is what is wrong with Aspen and these other corp offices.

It's great that your office received such a high customer rating - next thing you're going to try to tell me is that Press Ganey scores are a good indication of a providers skill or quality of care...

All of the training of Aspen dentists is completed by dentists, including treatment planning. Office Managers do not in any way manage any clinical decisions, clinical decisions are completly handled by the dentist. Each patient is individually and thoroughly examined by a dentist, most patients state that our exams are the most through that they have ever had. Most patients also have a complete periodontal charting completed by the hygienist, and most patients tell us that they have never had an examination like that. Aspen does have a Patient Satisfaction department that handles both patient praises and patient complaints. Aspen has experienced a steady increase in patient satisfaction rating over the past 12-18 months. In fact, the top 20%of Aspen offices currently have an average rating of 4.87 out of 5.0.
For the record, I am an actual dentist like all of you!

 

[periopocket]

FYI: ASPEN has an affiliation with Marquette and Boston University and hands out 2 3rd year students from each class generous scholarships! Does anybody know how one can receive these?!?

 

[Cold Front]

All of the training of Aspen dentists is completed by dentists, including treatment planning. Office Managers do not in any way manage any clinical decisions, clinical decisions are completly handled by the dentist. Each patient is individually and thoroughly examined by a dentist, most patients state that our exams are the most through that they have ever had. Most patients also have a complete periodontal charting completed by the hygienist, and most patients tell us that they have never had an examination like that. Aspen does have a Patient Satisfaction department that handles both patient praises and patient complaints. Aspen has experienced a steady increase in patient satisfaction rating over the past 12-18 months. In fact, the top 20%of Aspen offices currently have an average rating of 4.87 out of 5.0.

For the record, I am an actual dentist like all of you!

Relax, no one said you (the dentist) did something wrong The lawsuit is against the company (the private equities), which I'm sure you probably don't know all of them, because that was not something that was covered in your New York training.

Recognize any of these names?

ASPEN DENTAL MANAGEMENT, INC., ADMI CORPORATION, ADMI HOLDINGS L.P., ROBERT A. FONTANA, LEONARD GREEN & PARTNERS, L.P., GREEN EQUITY INVESTORS V, L.P., GREEN EQUITY INVESTORS SIDE V, L.P., and LGP SMILE COINVEST LLC,

Maybe you should ask about why so many Private Equities named above have so much interest in the office you work in, your diploma and your treatment plan outcomes.

 

[suarez 7]

As Cold Front mentioned, dental chains like Aspen and KoolSmiles need us more than we need them. So I feel that if there is more pressure on dental chains, then many will start to go out of business and close up shop.

But as a side, does any dentist private practitioner really believe they are "competing" with these corporate chains next door? As far as I know, they are traditionally medicaid chop-shops which most dentists do not take. Aspen does take private insurance, but in general why would an insured American family choose Aspen over a private-owned dental office? I think most Americans will imagine that there is a difference in quality of dental treatment between the two. For patients who pay with cash, it's also unlikely that they would go to Aspen because there is no financial motive to choose them over a private clinician (other than maybe the $49 exam + X-rays). Are most of Aspen's patient base Medicaid insured, or is there another population that I am not aware of?

 

[goffdent]

As Cold Front mentioned, dental chains like Aspen and KoolSmiles need us more than we need them. So I feel that if there is more pressure on dental chains, then many will start to go out of business and close up shop.

But as a side, does any dentist private practitioner really believe they are "competing" with these corporate chains next door? As far as I know, they are traditionally medicaid chop-shops which most dentists do not take. Aspen does take private insurance, but in general why would an insured American family choose Aspen over a private-owned dental office? I think most Americans will imagine that there is a difference in quality of dental treatment between the two. For patients who pay with cash, it's also unlikely that they would go to Aspen because there is no financial motive to choose them over a private clinician (other than maybe the $49 exam + X-rays). Are most of Aspen's patient base Medicaid insured, or is there another population that I am not aware of?

I don't think that many americans would necessarily think there is a difference in quality between the two. AND there isn't necessarily a difference.. The thing is they might think it's better quality due to the pretty waiting room and modern operatories... A clean and modern building can go a long way to influencing a patient's perception. And if your dental IQ is low.. you wouldn't think anything different at all.

 

[shuckin wizzies]

Its like a Taco Bell employee on the taco assembly line calling themselves a 'Chef'[/QUOTE]

I take offense to this statement. I graduated from dental school and passed a regional board. I take pride in the work that I do. Taco Bell isn't the only corporation. Ruth's Chris makes a pretty good steak, and it's a large company. If I'm not happy with the contact on a crown, I redo the crown. I go after that root that snapped off of a RCT'd #14. There is no less quality in the work that I do than any of my peers.

The problems that dentistry faces will not be solved by cynicism or by repeated old phrases. If you want to talk about the pros and cons of DSO's, or the ethics of 3rd party financing, let's talk. Maybe we can use this thread as an actual forum for the benefit of dentistry. However, if you are looking to tear down a company, or accuse people who disagree with you as being fake people or computer generated, the problems won't get solved.

Corporate dentistry has gained popularity in response to a void in the market. As stated by someone earlier, many new grads are looking for a good environment to get up to speed, and make decent money while doing so. Many older dentists are tired of running a business. This is why corporate dentistry is gaining popularity. In my opinion, small private offices are going to be the majority for a long time to come. As retiring dentists realize that they can't just dump off fillings to a new grad (because school doesn't cost the same as it did 30 years ago), but they actually need to have a system in place for bringing in an associate and selling the practice, small offices will become more attractive for us young guys.

The average dentist will be sued at least once in their career (at least that's what I was taught). And when your turn comes, the patient's lawyer will paint the picture that you are the scum of the earth and only wanted their money. They will say stuff about you personally that you will hope that nobody else hears. With about 400 dentists seeing millions of patients, that's a lot of opportunity for mud slinging. Looking through the lawsuit, a lot of the "shady" stuff going on are things that are taught frequently at the ADA annual convention. The concept of rocks, sand, water (leaving space for high production) has been taught by practice management "guru's" for decades. Setting production goals is a staple of many, if not most, dental practices. The goals are reviewed during morning huddles.

If you know anything about the majority of dentists, we are head-strong people who take pride in our work. The few Aspen dentists that I have met (maybe 10 or so), are not "yes men". I can assure you that if the clinical decisions were taken from the dentists, the company would not last. I repeat that I have never had anybody, dentist or non-dentist, dictate treatment to me. I have been in control since day 1.

I'm not much for arguing, maybe that's why I never posted before (and yes I've been reading SDN and dentaltown for 7 years). It just offends me to be judged by people who have never seen they way I treat patients, or the work that I do. I'm happy to continue to be a part of this thread (if another viewpoint is appreciated), but let's not do ourselves a disservice by oversimplifying the issue or being disrespectful.

 

[goffdent]

Its like a Taco Bell employee on the taco assembly line calling themselves a 'Chef'

I take offense to this statement.

I would take offense to that as well. It's not like someone who decides to work at a dental chain took some weeknight technical college course in dentistry for 9 months... It's the same school qualifications as a 15 year dentist in private practice, only difference might be the length of time practicing.

I think what predents feel is that chains get a bad rap.. and the thought of going into one is a last ditch effort to get any paying job as opposed to not having one at all. (like a highschooler getting a job at Taco-Bell or McDonalds). If a chain was run only by dental therapists.. I could see you saying that.. but full-fledged graduated and licensed dentists. come on?! Where's tha brotha-hood?

 

[Cold Front]

Its like a Taco Bell employee on the taco assembly line calling themselves a 'Chef'
I'm not much for arguing, maybe that's why I never posted before (and yes I've been reading SDN and dentaltown for 7 years). It just offends me to be judged by people who have never seen they way I treat patients, or the work that I do. I'm happy to continue to be a part of this thread (if another viewpoint is appreciated), but let's not do ourselves a disservice by oversimplifying the issue or being disrespectful.

No one is judging you. If you are ASPEN "dentist as you claim, I'm sure you are upholding the standard of dentistry to good levels, otherwise your license would have been revoked if you did sub-standard work, even on ASPEN patients, even ASPEN would not let that slide if this was about your clinical skills.

However, the topic here is about "corporate greed", and you or anyone else in ASPEN will never see things from ASPEN "patient" perspective, because you are so focused on doing great job on what you do, and ASPEN is asking you to leave the rest of the non-clinical stuff to them.

Bob Fontana, founder of ASPEN always tells the media "Aspen Dental frees dentists to focus solely on patients, because the company handles back-office duties such as marketing, accounting and billing".

Source: $2,540 for 2 fillings? Poor hit by high costs at dental chain.

Again, this is not "dentist" issue, but "company" running dentistry to maximize profits. You can keep switching the debate back to your moot point on how well you do dentistry, but we have been discussing the "lawsuit".

 

[charlestweed]

Its like a Taco Bell employee on the taco assembly line calling themselves a 'Chef'

..

 

[charlestweed]

Its like a Taco Bell employee on the taco assembly line calling themselves a 'Chef'

I take offense to this statement. I graduated from dental school and passed a regional board. I take pride in the work that I do. Taco Bell isn't the only corporation. Ruth's Chris makes a pretty good steak, and it's a large company. If I'm not happy with the contact on a crown, I redo the crown. I go after that root that snapped off of a RCT'd #14. There is no less quality in the work that I do than any of my peers.

The problems that dentistry faces will not be solved by cynicism or by repeated old phrases. If you want to talk about the pros and cons of DSO's, or the ethics of 3rd party financing, let's talk. Maybe we can use this thread as an actual forum for the benefit of dentistry. However, if you are looking to tear down a company, or accuse people who disagree with you as being fake people or computer generated, the problems won't get solved.

Corporate dentistry has gained popularity in response to a void in the market. As stated by someone earlier, many new grads are looking for a good environment to get up to speed, and make decent money while doing so. Many older dentists are tired of running a business. This is why corporate dentistry is gaining popularity. In my opinion, small private offices are going to be the majority for a long time to come. As retiring dentists realize that they can't just dump off fillings to a new grad (because school doesn't cost the same as it did 30 years ago), but they actually need to have a system in place for bringing in an associate and selling the practice, small offices will become more attractive for us young guys.

The average dentist will be sued at least once in their career (at least that's what I was taught). And when your turn comes, the patient's lawyer will paint the picture that you are the scum of the earth and only wanted their money. They will say stuff about you personally that you will hope that nobody else hears. With about 400 dentists seeing millions of patients, that's a lot of opportunity for mud slinging. Looking through the lawsuit, a lot of the "shady" stuff going on are things that are taught frequently at the ADA annual convention. The concept of rocks, sand, water (leaving space for high production) has been taught by practice management "guru's" for decades. Setting production goals is a staple of many, if not most, dental practices. The goals are reviewed during morning huddles.

If you know anything about the majority of dentists, we are head-strong people who take pride in our work. The few Aspen dentists that I have met (maybe 10 or so), are not "yes men". I can assure you that if the clinical decisions were taken from the dentists, the company would not last. I repeat that I have never had anybody, dentist or non-dentist, dictate treatment to me. I have been in control since day 1.

I'm not much for arguing, maybe that's why I never posted before (and yes I've been reading SDN and dentaltown for 7 years). It just offends me to be judged by people who have never seen they way I treat patients, or the work that I do. I'm happy to continue to be a part of this thread (if another viewpoint is appreciated), but let's not do ourselves a disservice by oversimplifying the issue or being disrespectful.[/QUOTE]

Shukin Wizzie, I've also received a lot of criticism from the ortho colleagues when I said I work for the dental chain or when I said I charge a fee that is much lower than theirs or when I said that I don't use digital xray. They automatically assume that my work must be horrible. The last time I check, I graduated from the accredited dental school and ortho program just like them. What make them think that they provide better treatments for their patients than what I do for my patients? How can they have such bad assumption against me when they haven't seen my work? I never criticize them for being greedy when they charge high fee. This is a free market country and therefore, you can charge any fee you want.

Don't worry about what many here think about you. Just keep on doing what you think is best for your patients and for your family.

 

[Cold Front]

Shukin Wizzie, I've also received a lot of criticism from the ortho colleagues when I said I work for the dental chain or when I said I charge a fee that is much lower than theirs or when I said that I don't use digital xray. They automatically assume that my work must be horrible. The last time I check, I graduated from the accredited dental school and ortho program just like them. What make them think that they provide better treatments for their patients than what I do for my patients? How can they have such bad assumption against me when they haven't seen my work? I never criticize them for being greedy when they charge high fee. This is a free market country and therefore, you can charge any fee you want.

Don't worry about what many here think about you. Just keep on doing what you think is best for your patients and for your family.

Charles, you do not work at ASPEN, and no one challenged the corporate you work for and their business model. Even if you did, the quality of you work has nothing to do with the corporate level issues.

"Free market country and charging fees you want" is not the same as "recommending and performing treatments on patients who don't need them". ASPEN doctors follow a perio program specific to their hygiene departments. which forces their patients to buy extra products and over-treatment of their perio needs. This is done every day, so this is nothing to do with your free market theory. ASPEN can run a legitimate dental offices if they change these practices, and even I would be a patient if they have the best interest of the profession in mind, and not their executives.

 

[UCSFx2017]

Its like a Taco Bell employee on the taco assembly line calling themselves a 'Chef'

I take offense to this statement. I graduated from dental school and passed a regional board. I take pride in the work that I do. Taco Bell isn't the only corporation. Ruth's Chris makes a pretty good steak, and it's a large company. If I'm not happy with the contact on a crown, I redo the crown. I go after that root that snapped off of a RCT'd #14. There is no less quality in the work that I do than any of my peers.

The problems that dentistry faces will not be solved by cynicism or by repeated old phrases. If you want to talk about the pros and cons of DSO's, or the ethics of 3rd party financing, let's talk. Maybe we can use this thread as an actual forum for the benefit of dentistry. However, if you are looking to tear down a company, or accuse people who disagree with you as being fake people or computer generated, the problems won't get solved.

Corporate dentistry has gained popularity in response to a void in the market. As stated by someone earlier, many new grads are looking for a good environment to get up to speed, and make decent money while doing so. Many older dentists are tired of running a business. This is why corporate dentistry is gaining popularity. In my opinion, small private offices are going to be the majority for a long time to come. As retiring dentists realize that they can't just dump off fillings to a new grad (because school doesn't cost the same as it did 30 years ago), but they actually need to have a system in place for bringing in an associate and selling the practice, small offices will become more attractive for us young guys.

The average dentist will be sued at least once in their career (at least that's what I was taught). And when your turn comes, the patient's lawyer will paint the picture that you are the scum of the earth and only wanted their money. They will say stuff about you personally that you will hope that nobody else hears. With about 400 dentists seeing millions of patients, that's a lot of opportunity for mud slinging. Looking through the lawsuit, a lot of the "shady" stuff going on are things that are taught frequently at the ADA annual convention. The concept of rocks, sand, water (leaving space for high production) has been taught by practice management "guru's" for decades. Setting production goals is a staple of many, if not most, dental practices. The goals are reviewed during morning huddles.

If you know anything about the majority of dentists, we are head-strong people who take pride in our work. The few Aspen dentists that I have met (maybe 10 or so), are not "yes men". I can assure you that if the clinical decisions were taken from the dentists, the company would not last. I repeat that I have never had anybody, dentist or non-dentist, dictate treatment to me. I have been in control since day 1.

I'm not much for arguing, maybe that's why I never posted before (and yes I've been reading SDN and dentaltown for 7 years). It just offends me to be judged by people who have never seen they way I treat patients, or the work that I do. I'm happy to continue to be a part of this thread (if another viewpoint is appreciated), but let's not do ourselves a disservice by oversimplifying the issue or being disrespectful.

Look, no one singled out your competency as a dentist. All the criticisms were directed at the organization where you chose to work at. Why have you continually ignored the giant elephant in the room which is the unscrupulous practices of Aspen Dental? If you were a self-respecting health professional, entrusted with the responsibility of caring for your patients, you too would have acknowledged, agreed, and maybe joined in on what surely deserves stark criticisms. It makes no sense to me why you would ignore and inadvertently justify the actions of a corporation that has taken advantage of those who are most vulnerable of being taken advantaged of (low-income medicaid/medicare patients). Not once have you addressed the serious issues at hand.

http://www.publicintegrity.org/2012/10/19/11580/aspen-dental-faces-class-action-suit

 

[shuckin wizzies]

Look, no one singled out your competency as a dentist. All the criticisms were directed at the organization where you chose to work at. Why have you continually ignored the giant elephant in the room which is the unscrupulous practices of Aspen Dental? If you were a self-respecting health professional, entrusted with the responsibility of caring for your patients, you too would have acknowledged, agreed, and maybe joined in on what surely deserves stark criticisms. It makes no sense to me why you would ignore and inadvertently justify the actions of a corporation that has taken advantage of those who are most vulnerable of being taken advantaged of (low-income medicaid/medicare patients). Not once have you addressed the serious issues at hand.

http://www.publicintegrity.org/2012/10/19/11580/aspen-dental-faces-class-action-suit

Thanks for the clarification, Cold Front and UCSF. I am not intentionally detracting the topic away from the original intent of the thread or meaning to ignore any elephants. I did feel it necessary to clear up some confusion on the clinical side of things.

I am not sure how Aspen is taking advantage of the low income. There are some offices in my area (not Aspen) that accept medicaid. I am not one of them. Our prices are competitive with the offices around me. Nobody is signed up for a payment plan without first understanding and approving it.

I think we can agree that the most important person is the patient, and their perspective. The patients that come to me seem to be happy with it. I clearly explain the treatment plan, my office manager clearly explains cost and payment options. The far majority of the patients are glad to have free exams. Some patients come to me with years of neglect, and have reached the tipping point and want to get fixed. And they understand and are happy to pay for it.

What exactly is the elephant? Is it the way the profits get split? Is it the setting of production goals? Is it the care credit?

I am assuming (dangerous thing to do) that it has to do with the way the profits are split. In a typical solo practice business, the owner/dentist pays all the overhead (staff wages, supplies, etc) and keeps the profit. If he hires an associate, the associate is an employee or independent contractor and gets paid according to the contract. The remaining profits go to the owner/dentist. In a corporate structure, some of the profit goes to the corporation. From a patients perspective, it is the same. They pay for services, and receive the services. The advantage of a corporate setting is that overhead is lowered due to a centralization of many non-clinical business tasks (payroll, advertising, etc.) and a streamlined system for some clinical stuff (new patient scheduling, office set-up, ordering supplies, etc.) If a private practice owner had to pay for these things, he might advertise with an agency, use a practice management company to decorate the office and train an office manager, and use a payroll company. The private practice owner is trying to maximize profits as well. I understand that some of my hard earned money is going into the system. But it is a system that works, and a system that is good for patients.

If I am still missing the elephant, please let me know. I repeat, nobody has ever told me how to do my job. There are resources available, but where the rubber meets the road (the sacred trust between patient and doctor) I have been the sole decision maker.

I can understand that working for a chain isn't for everyone. Working in a large group (10+ dentists, the patient sees a different dentist every time) isn't my cup of tea. Only doing fillings while the owner dentist poaches the C+B definitely isn't for me. But I think painting a picture of it being the downfall of dentistry and that it cheapens the profession is not accurate. I think that by not having evening or weekend hours makes us come off as arrogant. I think that by not offering some type of payment plans is condescending. I am not trying to be the posterboy for corporate dentistry or Aspen specifically. I am not trying to recruit for them or talk anyone into it. But I am concerned about some of the misinformation that is out there.

Sorry to be so long winded, but I think there is a big issue nationally, which is a saturation of dentists in some areas and a shortage of dentists in rural areas. It is an access to care issue. That is what is going to create the Dental Therapist nightmare.

I feel that by stating that "everything you need to know about aspen dental" is simply a link to a lawsuit (written by skilled lawyers) doesn't do justice to the topic.

Thanks again for clarifying that the attacks aren't personal. And thanks for your perspective and feedback.

 

[Cold Front]

Thanks for the clarification, Cold Front and UCSF. I am not intentionally detracting the topic away from the original intent of the thread or meaning to ignore any elephants. I did feel it necessary to clear up some confusion on the clinical side of things.

Again, no need to clear up any "clinical side of things". This is not a deposition, anything you say will not be on any court records, except a google search on the word "ASPEN".

The point of this discussion is...

The Judiciary committee who is investigating ASPEN knows the company opens a new office nearly every week, and the company meticulously tracks revenue targets for each office in the interest of large investment groups who know nothing about dentistry, but dictate how the "business" should be run. Yet Fontana said the business model doesn't apply to dentists, but his private equities.

There is a video on ASPEN website that gives a glimpse of the revenue targets for an office in Springfield, Mass. A multicolored spreadsheet titled "My Practice Metrics" showing that "dentistry" billings in a recent month were 243 percent above "budget." The image shows there are also revenue targets for cleanings and dentures set by corporate.

The scrutiny dentists are under at Aspen Dental is clear in a report that Fontana called the "game tape." It's a monthly performance measure sent to office managers. CPI and FRONTLINE obtained one of these confidential reports for an office in Owensboro, Ky. It shows that in February, the office had billed $270,000 so far this year, $35,000 above its target.

The document shows that Aspen Dental also scrutinizes the billings of its dentists. The lead dentist in Owensboro was billing an average of $5,206 a day, earning him praise from the regional director, who wrote "Showing great trends for this month." But the tape also compared the dentist to top producing dentists, and in that regard, he fell nearly $1,000 short each day.

Heather Haynes, who managed an Aspen Dental office in Joliet, Illinois, said that office managers who didn't hit their targets consistently were likely to be fired. She said that's in fact what happened to her. Haynes said dentists and hygienists, the office's revenue makers, faced the same pressures.

There is a team on the Judiciary Committee working with Senator Grasley's office dedicated to this investigation, and I'm sure they would like to hear your clinical side of things. If you care so much about ASPEN, contact them and fight this lawsuit on behalf of ASPEN.

 

[doc toothache]

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.

We have to assume that this is a case of misspeaking since it is the patient who ultimately makes/should make the decision on what type of material he/she would want to have.
___________________
Whether or not the 100 years old CPOM dogma is still relevant in the 21st century remains to be seen, but considering the number of states where corporate dentistry/medicine has fairly deep roots it is likely to be an uphill battle.

 

[charlestweed]

We have to assume that this is a case of misspeaking since it is the patient who ultimately makes/should make the decision on what type of material he/she would want to have.

A gp friend of mine told me that there are certain cases that he thinks Ag filling material works better than the composite. And if the patients reject the Ag filling material, he would not treat them.

I have a few ortho cases that I tell my patients that they can only be treated with metal brackets. If these patients say they only want clear ceramic brackets or Invisalign, then I would ask the patient to get treatment at another office that does what they want. I guess it is different for ortho since most ortho appliances are temporary and they will be removed in 2-3 years.

 

[doc toothache]

A gp friend of mine told me that there are certain cases that he thinks Ag filling material works better than the composite. And if the patients reject the Ag filling material, he would not treat them.

I have a few ortho cases that I tell my patients that they can only be treated with metal brackets. If these patients say they only want clear ceramic brackets or Invisalign, then I would ask the patient to get treatment at another office that does what they want. I guess it is different for ortho since most ortho appliances are temporary and they will be removed in 2-3 years.

Nothing wrong there. The pt is free to seek satisfaction elsewhere, assuming here is no contraindication to the alternative tx plan.

 

[Cold Front]

A gp friend of mine told me that there are certain cases that he thinks Ag filling material works better than the composite. And if the patients reject the Ag filling material, he would not treat them.

The opposite would be true too, if doctor recommends a treatment and patient refuses even if it's a poor decision on the patient's part.

I use to see patients with broken root tips during my d-school externships at a local community clinic, and they would refuse the root tips to be extracted. Patient autonomy always comes first, you can educate patients, but you don't go after their wallets like certain corporate offices.

ASPEN is doing what Olive-Garden did to Italian food. You can't cheat patients and tell them to go for PREMIUM dentures, and then provide a COLD CURED product - patients are falling for the oldest tricks in the book.

ADA should set-up a panel of dentists to examine these practices, just like there are peer panels who evaluate standards of dentistry if a GP performed a procedure which required a specialist and failed at it.

 

[bsmcga0]

The advantage of a corporate setting is that overhead is lowered due to a centralization of many non-clinical business tasks (payroll, advertising, etc.) and a streamlined system for some clinical stuff (new patient scheduling, office set-up, ordering supplies, etc.) If a private practice owner had to pay for these things, he might advertise with an agency, use a practice management company to decorate the office and train an office manager, and use a payroll company. The private practice owner is trying to maximize profits as well. I understand that some of my hard earned money is going into the system. But it is a system that works, and a system that is good for patients.

I think this is on of the disadvantages. I have worked at Monarch and opened my own office. Monarch had a person that scheduled the ortho assistants for the 4 orthodontists. She was considered management and that is all she did. That is a waste of money.

Monarch also paid their assistants very little, and there was constant turnover - very difficult to work with. They were very ghetto, talking about drinking and their baby daddy in front of patients. They won't buy quality equipment, which means all the distal end cutters would knock off the 1st molar tube at 4:30.

The biggest problem I saw, because the dentist didn't plan to be there long term, they don't care about long term relationships. This resulted in all 3rds coming out, all large amalgams are replaced with crowns (monarch actually makes their docs sign a document stating this). Everybody was recommended for SRP.

I was once scheduled 10 bondings in one day. I reminded the office manager I only wanted four per day. She said "but it is good production". The next week there were no bondings. What is the difference if we put them all on one day, or space them out so I have adequate time to work.

They kept a doctor that was sued several times and everybody talked about his poor work, because he was a top producer.

 

[charlestweed]

Monarch also paid their assistants very little, and there was constant turnover - very difficult to work with. They were very ghetto, talking about drinking and their baby daddy in front of patients. They won't buy quality equipment, which means all the distal end cutters would knock off the 1st molar tube at 4:30.

Line up the new wire to the old wire. Then cut the new wire to the same exact length with the old wire with a straight cutter (or with a bird beak plier by bending the wire back and forth)…and problem is solved. It takes about 10 seconds for you do this while your assistant do the retie on the opposing arch. How about banding the 6s instead of using bondable molar tubes?

Instead of making the assistants taking their gloves off, I tell them to stay with the patients and I go get the distal end cutters, the power chain, the new wires etc for them. When the assistants respect you they will do anything that you ask. Team work is the key to overcome busy schedule and to avoid making the patient wait too long.

Just this afternoon, I started a case that I tx plan for 18 months. The private orthodontist down the street treatment planed this same case for 30 months with a bite plate. No wonder why the people continue to choose to get tx at the chain where I work at despite the poor customer service and lack of supplies.

 

[gryffindor]

Line up the new wire to the old wire. Then cut the new wire to the same exact length with the old wire with a straight cutter (or with a bird beak plier by bending the wire back and forth)&#8230;and problem is solved. It takes about 10 seconds for you do this while your assistant do the retie on the opposing arch. How about banding the 6s instead of using bondable molar tubes?

Instead of making the assistants taking their gloves off, I tell them to stay with the patients and I go get the distal end cutters, the power chain, the new wires etc for them. When the assistants respect you they will do anything that you ask. Team work is the key to overcome busy schedule and to avoid making the patient wait too long.

All of this requires assistants who have even a remote clue about what ortho is. Your solution to bmscag0 not using the distal end cutter requires taking the wire out. That means you have to have an assistant who knows how to do that or even knows what a wire and bracket are. Sure, bmscag0 can sit down and take the wire out himself. But then he also has to find the new wire and something to cut it because I bet his assistants don't know what either of those things are or where to find them. Now he's running 4 chairs behind. If they do know, they may not feel like getting them because they get paid whether the patient leaves having made progress on their treatment plan or angry.

Teamwork?
I'm sure the assistants bmscag0 worked with at Monarch had zero interest in being a team player.

A friend took over at a corporate dental office where none of the cases had tubes or bands on the 6s or 7s. Why? Because the previous orthodontists got paid for a bonding as long as brackets went on from 5--5. Crap like this is why private offices stay in business.

 

[charlestweed]

All of this requires assistants who have even a remote clue about what ortho is. Your solution to bmscag0 not using the distal end cutter requires taking the wire out. That means you have to have an assistant who knows how to do that or even knows what a wire and bracket are. Sure, bmscag0 can sit down and take the wire out himself. But then he also has to find the new wire and something to cut it because I bet his assistants don't know what either of those things are or where to find them. Now he's running 4 chairs behind. If they do know, they may not feel like getting them because they get paid whether the patient leaves having made progress on their treatment plan or angry.

These assistants are in fact very good. Unlike the private ortho assistants, who only stay at one assigned chair, these chain’s assistants are very good at moving from chair to chair. When you work with them long enough, they know your working style. For example, when the assistant sees the words “upper closing loop AW” written on the next visit column of the chart, he/she automatically takes out a 16x22ss wire, a bird beak plier, and marks the wire for me. When there are loose brackets on the bicuspids, he/she automatically put separators on so we can put bands on these teeth next visit. In fact, all of my part time ortho assistants at my private practices come from the dental chain. Monarch Dental is now owned by the same company that I currently work for.

Teamwork?
I'm sure the assistants bmscag0 worked with at Monarch had zero interest in being a team player.

One thing that motivates these assistants display teamwork is they and I want to go home on time. They’d rather go home on time than going home late and getting paid OT. They are not some heartless people. They have kids and they love their kids just as much as you and I love our own kids. They want the patients to be treated the same way that they want their own kids to be treated.

A friend took over at a corporate dental office where none of the cases had tubes or bands on the 6s or 7s. Why? Because the previous orthodontists got paid for a bonding as long as brackets went on from 5--5. Crap like this is why private offices stay in business.

That was the poor clinical decision that was made by the previous orthodontists. Just like some GPs who choose to do endo without using the rubber dam. It’s has nothing to do with the corporate office where your friend works at. If the chain owner doesn't want to provide your friend the molar bands, your friend can just quit his job.

 

[gryffindor]

These assistants are in fact very good. Unlike the private ortho assistants, who only stay at one assigned chair, these chain's assistants are very good at moving from chair to chair. When you work with them long enough, they know your working style. For example, when the assistant sees the words "upper closing loop AW" written on the next visit column of the chart, he/she automatically takes out a 16x22ss wire, a bird beak plier, and marks the wire for me. When there are loose brackets on the bicuspids, he/she automatically put separators on so we can put bands on these teeth next visit. In fact, all of my part time ortho assistants at my private practices come from the dental chain. Monarch Dental is now owned by the same company that I currently work for

I'm sorry charles, but I think you've said before that the assistants you work with have been with you for several years. That means they have training and experience to know your expectations, treatment style, and know what "upper closing loop AW" means, what a 16x22 SS wire and bird beak plier are, what separators are, etc.

When's the last time you worked with an assistant who had no clue? I worked with one last month who between the time I went to the next room to write a chart and came back to her room, had dismissed the new records patient, peeled out all the alginate from the trays of the new patient's start impressions that I had taken (because she didn't know how), threw them out and cleaned the trays. Why? Because she had been hired off the street 4 days prior with no dental knowledge and didn't know a real tooth from a denture tooth. Of course, I didn't learn this little fact until it was too late. It never occurred to me that I had to tell her to "save these trays with the molds that I just took." The next time I work with a new assistant, which could be next month because turnover is so high at this office, I will be sure to say that.

I think these are the types of assistants people are complaining about.

And the previous orthodontists who didn't bond or band 6s or 7s? It's not because they didn't have bands. It's because they got paid for the bonding according to the rules the corporate chain wrote themselves: bond from 5--5 = full bonding. The only ones suffering in that case are the patients who don't know any better.

 

[bsmcga0]

Line up the new wire to the old wire. Then cut the new wire to the same exact length with the old wire with a straight cutter (or with a bird beak plier by bending the wire back and forth)&#8230;and problem is solved. It takes about 10 seconds for you do this while your assistant do the retie on the opposing arch. How about banding the 6s instead of using bondable molar tubes?

Instead of making the assistants taking their gloves off, I tell them to stay with the patients and I go get the distal end cutters, the power chain, the new wires etc for them. When the assistants respect you they will do anything that you ask. Team work is the key to overcome busy schedule and to avoid making the patient wait too long.

Thanks, I do know how to repo a bracket. Using a bird beak to cut a wire will place a large nick in the wire, so then the assistant would have to polish the wire. Monarch could replace the 30 year old sterilizer (which me and the other doctor in the office thought was the problem) but that would hurt the bottom line

I believe I remember you stating you use a 16X22 in a 022 slot, so I am not surprised you don't have the same problem. You must be placing lots of torque bends while you grab powerchain for your staff (which is the job description for my assistants, not myself).

I personally saw so much fraud and poor clinical work at Monarch, I am glad I was there for 12 months.

 

[charlestweed]

Thanks, I do know how to repo a bracket. Using a bird beak to cut a wire will place a large nick in the wire, so then the assistant would have to polish the wire. Monarch could replace the 30 year old sterilizer (which me and the other doctor in the office thought was the problem) but that would hurt the bottom line.

I use the very same bird beak to smash down the ledge that it created. Dull distal end cutter also creates the same ledges, which make it hard for your staff to pull the wire out of the molar tubes. So why not take care of this problem before you insert the wire?

I believe I remember you stating you use a 16X22 in a 022 slot, so I am not surprised you don't have the same problem. You must be placing lots of torque bends while you grab powerchain for your staff (which is the job description for my assistants, not myself).

This is why we are different from the general dentists who do ortho. We can bend wires. We can put torque on the wires. And we finish the cases nicer.

....you grab powerchain for your staff (which is the job description for my assistants, not myself).

That's the difference between you and me. I'd rather work hard and work as an extra assistant and get paid more than working for private ortho practice, that pays me less. The reason the chains pay the doctors more is they are able to keep the overhead low (ie buying fewer instruments). I deal with the lack of instruments by improvising. One of my assistants nicknamed me "Macgyver"&#8230;and I am very proud of that nickname.

Oh, when my assistant is too busy taking the ortho records for the start, I even help her do the sterilization....so we can have the instruments available for the next patients. That's not my job description but I don't want my patients to wait either.

I personally saw so much fraud and poor clinical work at Monarch, I am glad I was there for 12 months.

You can easily change from poor to good clinical work. You have the full power to do that. Ortho is an art. It's all about diagnosis and tx planning.

 

[bsmcga0]

That’s the difference between you and me. I’d rather work hard and work as an extra assistant and get paid more than working for private ortho practice, that pays me less. The reason the chains pay the doctors more is they are able to keep the overhead low (ie buying fewer instruments). I deal with the lack of instruments by improvising. One of my assistants nicknamed me “Macgyver”…and I am very proud of that nickname.

that is the difference, my assistants hand instruments to me while I work on the patient. I don't hand them instruments so that they can do all the work

 

[charlestweed]

that is the difference, my assistants hand instruments to me while I work on the patient. I don't hand them instruments so that they can do all the work

Yup, that’s the difference. Now you can see why the chain office is more suitable for the orthodontists like myself. Now you can see how I am able to keep the overhead very low without compromising the quality of care.

 

[slayer]

I agree with bsmcgao....I work for one of these chains, and the last thing they care about is the patient. Matter-of-fact, they often overbook beyond any semblance of sanity and will easily endorse and encourage very unethical behavior.
They also tend to hire crooks and folks with criminal backgrounds for whom lying and cheating is a way of life. It’s a numbers game and the patient is always the loser. The brackets that some of these chains use are so bad, that they literally disintegrate and shatter during Tx or removal. I think these charlatans with neither any dental knowledge or training need to be excoriated from dentistry/orthodontics. All they are doing is perpetrating fraud.
I also agree with the orthodontist doing the therapy and not being "the instrument transporter". I have seen hundreds of these cases with assistants doing all the Tx and it is an incredible disaster. With these places, it is always about production and patients are just like cattle and currency. They will not provide staff/materials or adequate time for eg;1 ortho assistant and 70 patients on the schedule.

 

[Cold Front]

As of today, ASPEN has over 130 dentist positions available on their site throughout the country. Ofcourse of some of these spots are dentists who are about to leave the company (or what we use to call at ASPEN, dentist who are about to be fired for not meeting goal).

http://www.aspendentaljobs.com/sear...ter=1&radius=50&location=&keywords=&zip_code=

ASPEN will open 100 more offices in 2 years, that's 100 more positions that needs to be filled. ASPEN HR agents get commission for signing grads right out of school. ASPEN HR provide frees lunch and learns at local dental schools and talk 4th year students into joining the company and promise them salaries and offers that are difficult to refuse - specially for those with very high debt.

This also means - the recruitment of more office managers with no single dental related experience on their resume who will overlook young dental grads and make them treatment plan the ASPEN way to keep the executives happy.

[YOUTUBE]CnaVoTfkqa8[/YOUTUBE]

 

[katagrah]

All of the training of Aspen dentists is completed by dentists, including treatment planning. Office Managers do not in any way manage any clinical decisions, clinical decisions are completly handled by the dentist. Each patient is individually and thoroughly examined by a dentist, most patients state that our exams are the most through that they have ever had. Most patients also have a complete periodontal charting completed by the hygienist, and most patients tell us that they have never had an examination like that. Aspen does have a Patient Satisfaction department that handles both patient praises and patient complaints. Aspen has experienced a steady increase in patient satisfaction rating over the past 12-18 months. In fact, the top 20%of Aspen offices currently have an average rating of 4.87 out of 5.0.

For the record, I am an actual dentist like all of you!

I think these are just students, not dentists. It sounds like the one who is really driving this blog just started (graduates 2017, has not finished D1 yet).

I started with ASPEN when I graduated in 2008. I wanted to work as an associate and save up money until I could finance my private practice. I decided to stay with ASPEN because the company is an incredible organization to work with. The people who work with me are there to support me and my practice goals. Our goal is to get patients the care they need. No one tells us what we should treatment plan. I would be up in arms if someone did. My ethical standards are rooted from God and my family. I have been fortunate enough to partner with ASPEN on two locations. I would be happy for any of you to come in and see how I run my practice. No patient is forced into treatment. In fact, most of my patients who come to my practice are patients who had bad experiences in a private setting. I hear at least once a day "The dentist did not listen to me" "The dentist I had was mean" or "The dentist did not care I was not numb". When you guys get in to your respective practices you will understand about patient expectations and how they process information.

I did not "*****" my self. Some of this language is a little ridiculous by the way. It definately shows the level maturity. I am pretty sure these comments are going to go on def ears. However I am going to say this again. ASPEN is not the big bad wolf. We are an organization who provides dental care to patients who need it. That is all.

 

[djeffreyt]

No one is judging you.

After reading all these posts today, I'd say there is at least one person responding consistently to this thread that is judging them, and judging them pretty harshly through generalization about who they are, their ethical limitation, and the work they do...
Cold Front, doesn't seem to be judging, but others seem pretty much set on their judgements.

 

[Halcion]

I think this is on of the disadvantages. I have worked at Monarch and opened my own office. Monarch had a person that scheduled the ortho assistants for the 4 orthodontists. She was considered management and that is all she did. That is a waste of money.

Monarch also paid their assistants very little, and there was constant turnover - very difficult to work with. They were very ghetto, talking about drinking and their baby daddy in front of patients. They won't buy quality equipment, which means all the distal end cutters would knock off the 1st molar tube at 4:30.

The biggest problem I saw, because the dentist didn't plan to be there long term, they don't care about long term relationships. This resulted in all 3rds coming out, all large amalgams are replaced with crowns (monarch actually makes their docs sign a document stating this). Everybody was recommended for SRP.

I was once scheduled 10 bondings in one day. I reminded the office manager I only wanted four per day. She said "but it is good production". The next week there were no bondings. What is the difference if we put them all on one day, or space them out so I have adequate time to work.

They kept a doctor that was sued several times and everybody talked about his poor work, because he was a top producer.

I work for Monarch and I have never signed any paperwork regarding this. I'll admit, there are times where some of the office managers I have worked with would question me and try to upsell work to the patients, but I have always been in complete control of diagnosis, treatment planning, and rendering care. You have to stick to your guns. It's more work for me, but I make sure the treatment plan was printed appropriately and presented to the patient the way I did, and if not, the office manager or treatment coordinator is on the phone with the patient ASAP telling them about the changes. I have my insurance coordinator print out a list of the patients I saw and the work that was charged out to make sure there is no fraudulent activity. After doing that for 3-4 months, they get the point not to play games with me. And I am in charge. The way I look at it, if Monarch didn't like it, they would fire me. But the truth is, as already mentioned, they need me more than I need them.

 

[Cold Front]

I think these are just students, not dentists. It sounds like the one who is really driving this blog just started (graduates 2017, has not finished D1 yet).

I started with ASPEN when I graduated in 2008. I wanted to work as an associate and save up money until I could finance my private practice. I decided to stay with ASPEN because the company is an incredible organization to work with. The people who work with me are there to support me and my practice goals. Our goal is to get patients the care they need. No one tells us what we should treatment plan. I would be up in arms if someone did. My ethical standards are rooted from God and my family. I have been fortunate enough to partner with ASPEN on two locations. I would be happy for any of you to come in and see how I run my practice. No patient is forced into treatment. In fact, most of my patients who come to my practice are patients who had bad experiences in a private setting. I hear at least once a day "The dentist did not listen to me" "The dentist I had was mean" or "The dentist did not care I was not numb". When you guys get in to your respective practices you will understand about patient expectations and how they process information.

I did not "*****" my self. Some of this language is a little ridiculous by the way. It definately shows the level maturity. I am pretty sure these comments are going to go on def ears. However I am going to say this again. ASPEN is not the big bad wolf. We are an organization who provides dental care to patients who need it. That is all.

I started this thread because of "awareness" of what corporate dentistry is doing to the general public. The information I provided were all based on the lawsuit, ASPEN press releases and my person experience. I'm not a D1, I'm a practicing dentist who owns dental offices.

The use of words, "we are an organization" is so obvious you are speaking for the company, and not for yourself. Specially with 1 post to your name on these forums.

 

[suarez 7]

The use of words, "we are an organization" is so obvious you are speaking for the company, and not for yourself. Specially with 1 post to your name on these forums.

 

[bsmcga0]

I work for Monarch and I have never signed any paperwork regarding this. I'll admit, there are times where some of the office managers I have worked with would question me and try to upsell work to the patients, but I have always been in complete control of diagnosis, treatment planning, and rendering care. You have to stick to your guns. It's more work for me, but I make sure the treatment plan was printed appropriately and presented to the patient the way I did, and if not, the office manager or treatment coordinator is on the phone with the patient ASAP telling them about the changes. I have my insurance coordinator print out a list of the patients I saw and the work that was charged out to make sure there is no fraudulent activity. After doing that for 3-4 months, they get the point not to play games with me. And I am in charge. The way I look at it, if Monarch didn't like it, they would fire me. But the truth is, as already mentioned, they need me more than I need them.

how long have you worked there and how closely did you read your contract. It was in my contract - and while it made me sick to sign it, I am ortho so it didn't affect me. I wish I would have saved it, I would post the contract

 

[charlestweed]

I agree with bsmcgao....I work for one of these chains, and the last thing they care about is the patient. Matter-of-fact, they often overbook beyond any semblance of sanity and will easily endorse and encourage very unethical behavior.
They also tend to hire crooks and folks with criminal backgrounds for whom lying and cheating is a way of life. It's a numbers game and the patient is always the loser. The brackets that some of these chains use are so bad, that they literally disintegrate and shatter during Tx or removal. I think these charlatans with neither any dental knowledge or training need to be excoriated from dentistry/orthodontics. All they are doing is perpetrating fraud.
I also agree with the orthodontist doing the therapy and not being "the instrument transporter". I have seen hundreds of these cases with assistants doing all the Tx and it is an incredible disaster. With these places, it is always about production and patients are just like cattle and currency. They will not provide staff/materials or adequate time for eg;1 ortho assistant and 70 patients on the schedule.

I guess the bad experiences that you and Bsmcag0 had must have something to do with the Texas medicaid system, which accepts every single ortho case. At the chain where I work at, less than 5% of the patients are medidcaid patients.

The brackets that shatter must be the clear ones because the metal brackets don't do that. Again, you, the orthodontist, has the full power to decide. If you think the case cannot be treated properly with clear brackets but the patient demands clear brackets, then you can deny treating him/her. If the case is a simple one (eg 12 month ortho retreat), then I am totally fine with the clear brackets.

 

[Bobby Fischer]

I work for Monarch and I have never signed any paperwork regarding this. I'll admit, there are times where some of the office managers I have worked with would question me and try to upsell work to the patients, but I have always been in complete control of diagnosis, treatment planning, and rendering care. You have to stick to your guns. It's more work for me, but I make sure the treatment plan was printed appropriately and presented to the patient the way I did, and if not, the office manager or treatment coordinator is on the phone with the patient ASAP telling them about the changes. I have my insurance coordinator print out a list of the patients I saw and the work that was charged out to make sure there is no fraudulent activity. After doing that for 3-4 months, they get the point not to play games with me. And I am in charge. The way I look at it, if Monarch didn't like it, they would fire me. But the truth is, as already mentioned, they need me more than I need them.

That, in and of itself, is evidence that there is a very real threat of shady stuff going on. Even in your mind and even if you won't admit it to yourself.