Gentle Dental, Western Dental?

[La salle india]

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Members don't see this ad.

Do you think it´s worth working with these companies?

Are they good, bad, etc?

What´s the base pay for a DDS in these dental clinics ?

thank you

 

[browncrack]

Good pay. Great people. Free pizza.

 

[omaralt]

Good pay. Great people. Free pizza.

It's probably a good place to start out but it's definitely not a place u want to be at after a year or two. With them you have a guaranteed cash flow (for six months at least) and have an opportunity to get your speed up. However there's a lot of pressure to produce more and more. The real money and happiness is in owning your own place

 

[dentheartthrob]

my former boss first started with western dental, he says, that he's gotten really proficient with his speed and endo treatment , due to the sheer volume of patients he had to do to just to reach/surpass his monthly quota.

 

[mike3kgt]

Do you think it´s worth working with these companies?

Are they good, bad, etc?

What´s the base pay for a DDS in these dental clinics ?

thank you

After working in 4 different types of places, I can give you my preference:
1. Traditional private practice
2. Community health center
3. Indian health service
4. Corporate dentistry

Corporate dentistry was by far my worst experience, albeit good income. I made far more income at #4 than at #1, but my happiness did not improve as a result. I would caution against any new grad going to work for a large corporation or medicaid office. While the job market and student loan burden may dictate whether you MUST accept a position such as this, it is a slippery slope. After some time working in a place like this, you become accustomed to thinking 1. this is the way dentistry should be done, 2. all patients should be treated like a fee schedule, and 3. those bad habits follow you. Just look at some of mrlanterns posts... your experiences right out of dental school can permanently traumatize you and make you question why you chose dentistry. Finding a good mentor, however, and a nice practice, can further reinforce your desire to strive for excellence in dentistry.

I would hesitate to hire anybody who has worked at Western or any of these types of places in a full-time position. That being said, I don't think it's an irreversible effect upon skill or knowledge and there are some exceptions out there and there are some decent corporations and some truly scary ones (such as the ones you listed).

 

[La salle india]

Thank you all for sharing your points of view.

Is the dental work done efficiently?
Do they pay the over-production you make?

😕

 

[charlestweed]

There are good and bad things about working for big corporate offices like Western and Gentle Dental. Right now, you don’t really have a lot of choices if you live in Southern California. Many struggling private practices can only offer part time jobs for new grads. Therefore, many of these new grads have to work for Western Dental and other corporate offices…. lower daily rate but at least they have 5 days/week job….some companies offer health insurance and malpractice insurance.

The Bads:

-Treat a lot of patients (HMO, medicaid) in a day.
-No respect from the assistants and the manager….and you cannot do anything about it. You have to be nice to them so they assist you better and you can go home on time. I am very lucky to have good staff...I take them out to lunch at least 4-5 times a year.
-Work 8-9 hours straigtht. They give you 1hr lunch but a lot of time, you have work thru lunch due to busy schedules.
-Attend meaningless corporate meetings 2-3 times a year.
-Not so good dental instruments/equipments.

The Goods:

-Stable salary. Good additional source of income if you plan to work part time at a corporate office and part time at you own private practice (when your practice is not doing too well).
-Good documentations (inform consent, tx plan, perio charting, drug dosage etc.) because the charts get audited by the HMO insurance companies all the time.

- You’ll learn a lot:
- Become faster and are able to handle a busy schedule more effectively.
- Learn how to fix mess up cases that were started by the previous doctors. When you make a mistake, you can fix your own mistake.
- Learn some cool clinical tricks from previous doctors.
- When you have your own office, you learn not to treat your private practice patients the same way the corporate offices treat their patients.
-Learn how to compete against big corporate offices when you start your own practice.
- Learn how to keep the overhead low.
- Learn how to treat your employees.

 

[La salle india]

What procedures do you commonly do in those corporate offices?pretty much all fields of dentistry?

Do you have to sell or upgrade some treatments?

thanks for the info!

 

[charlestweed]

What procedures do you commonly do in those corporate offices?pretty much all fields of dentistry?

Do you have to sell or upgrade some treatments?

thanks for the info!

No, the company I work for doesn’t allow dentists place/restore implants. I have to refer them out to my wife’s perio office. The in-house OS don’t do orthognthic surgeries, biopsy, jaw resection (for cancer patients)….they do mostly wisdom teeth extraction. I, an in-house ortho, am only allowed to do non-surgical orthodontic treatments…no combined orthognathic surgery/orthodontic treatments.

 

[La salle india]

No, the company I work for doesn’t allow dentists place/restore implants. I have to refer them out to my wife’s perio office. The in-house OS don’t do orthognthic surgeries, biopsy, jaw resection (for cancer patients)….they do mostly wisdom teeth extraction. I, an in-house ortho, am only allowed to do non-surgical orthodontic treatments…no combined orthognathic surgery/orthodontic treatments.

Thank you for sharing your job experience!
Congrats for being a Ortho 🙂

 

[NileBDS]

my former boss first started with western dental, he says, that he's gotten really proficient with his speed and endo treatment , due to the sheer volume of patients he had to do to just to reach/surpass his monthly quota.

With all due respect to your boss, there are so many wrong things you just said here that I don't know where to even start.

 

[dentheartthrob]

With all due respect to your boss, there are so many wrong things you just said here that I don't know where to even start.

In terms of clinical skills, I think its more of an opinion of being subjective. He does things fast because he's used the pace of what he is doing, and perhaps there are times he would sarifice quality over quantity with his work, but it still does adhere to the standard of care (and sometimes at a minimum)...case in point, one time after finishing a molar endo he instructed me to take an xray of the finished work, while I was waiting for the radiograph to be developed he was prepping another tooth. By the time the xray was developed, and had return back to the room with xray, I was so surprise that that the patient was ready to have his temporary made. He prepped a tooth in about 5 minutes! In regards to what he was being paid, Im not to sure with the numbers, but from what I understand, he needed to reach a certain number when it comes to production each month in order for him to atleast get his base salary. Otherwise, the difference would be taken off from him. Correct me if I'm wrong?

 

[TKD]

After working in 4 different types of places, I can give you my preference:
1. Traditional private practice
2. Community health center
3. Indian health service
4. Corporate dentistry

Agree with this list.
Only caveat is perhaps consider reversing 2 and 1 if going rural is an option. Loan repayment is a huge plus for #2 (and #3), and eventually going into private practice in the area is much easier to get started.

Corporate dentistry avoid at all costs. Managers are not dentists. They don't know **** and treat everyone like ****.

 

[La salle india]

Agree with this list.
Only caveat is perhaps consider reversing 2 and 1 if going rural is an option. Loan repayment is a huge plus for #2 (and #3), and eventually going into private practice in the area is much easier to get started.

Corporate dentistry avoid at all costs. Managers are not dentists. They don't know **** and treat everyone like ****.

I thought corporate dentistry was not that bad.
What do the managers exactly do to treat everyone like ****

😕

 

[DrJeff]

I thought corporate dentistry was not that bad.
What do the managers exactly do to treat everyone like ****

😕

Bottomline for many a manager in a corporate office, is in their minds (and often the minds of their boss (which usually ISN'T you BTW) ) is they are the boss of the office and often have a bit of a powertrip ordering everyone around to meet the typically large monthly quota's/production goals that the corporate office sets.

It's this lack of autonomy that you the dentist often has in a "corporate" office that causes the issues, and hence often high turn over rates, of dentists in a "corporate" office.

 

[La salle india]

Bottomline for many a manager in a corporate office, is in their minds (and often the minds of their boss (which usually ISN'T you BTW) ) is they are the boss of the office and often have a bit of a powertrip ordering everyone around to meet the typically large monthly quota's/production goals that the corporate office sets.

It's this lack of autonomy that you the dentist often has in a "corporate" office that causes the issues, and hence often high turn over rates, of dentists in a "corporate" office.

Wow..amazing! didn´t know this
Thanks for sharing Dr Jeff

 

[La salle india]

Does anybody else know something about these companies?????😕😕😕😕😕😕

 

[mike3kgt]

Does anybody else know something about these companies?????😕😕😕😕😕😕

It seems that your intent on posting seems to vie for justification for working at either of these offices. For some, it may be the only option available. Thus the reason why these places stay in business while so many others fail.

 

[PG2010]

Does anybody else know something about these companies?????😕😕😕😕😕😕

Well, I agree with the fact that corporate office managers and staff have no respect for dentists. I graduated this year. I had offers from some decent private offices in the area, but all of them were offering me a percentage based salary, while I didn't know any thing about my work speed and my daily production. So I decided to join a company to have a stable income, atleast for first few months or an year. It's my 5th month in the company and I have decided to find another job. My manger has been very insulting at times and even the assistants. When you are right out of school, no matter how good you are they think that you don't know a **** about dentistry. I complained against manager, but nothing happened, infact it got worse. because the person above manager is a regional manager, and the person above that is zonal manager, and none of them is the doctor. I don't know who should I talk to, so I have decided to switch my job. My epxerience with my first job has been quite traumatizing.

 

[mike3kgt]

When you are right out of school, no matter how good you are they think that you don't know a **** about dentistry. I complained against manager, but nothing happened, infact it got worse.

Actually, this is quite true... you know almost nothing if even enough to barely practice clinical dentistry when you graduate compared to someone who has been in practice for even as short as 2 years.

This is, however, no excuse for a high school educated person who thinks they know how to be a dentist to tell a dentist how to do their job.

While they can help you stay busy and on time but most of the time they ask questions like, "Doc, whey does it take you an hour to do a root canal when Dr. X only take 15 minutes... does that mean you are not good?" or "Why don't you take out that tooth, it's pointing in your direction and it's just a little below the bone, come on doc, I **know** you can do it!".

Good choice, good luck on your future endeavors! Say no to corporate hell.

 

[BenDentalMatrix]

Gentle Dental really took off in California with their radio ads. If you can get a sense of how their marketing works, it can really help your own practice.

 

[charlestweed]

... Say no to corporate hell.

It’s easier said than done. Dental schools continue to pump out more new grads every year. The tuition continues to rise. I would rather get bossed around by HS educated managers and work with rude staff than staying unemployed or running an unsuccessful practice. I laugh every time I hear a dental student or a resident says that he/she would never work for a chain….and then I find out this same person works for a dental chain.

Every time a pre-dental/dental student asks me for an advice. I always tell that student to work hard in dental school and specialize if he/she wants to practice in a saturated market like SoCal.

 

[Stroszeck]

Charles, first of all corporate dentistry REALLY is killing dentistry as we know it. I mean its unbelievable since most dentists are no longer being bosses and are being bossed around at these corporate offices for treatment plans etc. to increase production. Also, I see SOOO many specialists right now who are hurting and not doing that well! I don't think that specializing is any longer some sort of golden ticket to save you. I have several very very capable smart friends with EXCELLENT bedside manner who are having trouble keeping days. I'm not sure what the answer is and perhaps its the economy, but LA, NYC in particular and also SF from what i have heard are VERY tough markets and for every single two-day part time job available to specialists (or GPs) they get TONS of applications and resumes! ANd now with new schools constantly opening up it might just be getting harder.

 

[ortho lurker]

Charles, first of all corporate dentistry REALLY is killing dentistry as we know it. I mean its unbelievable since most dentists are no longer being bosses and are being bossed around at these corporate offices for treatment plans etc. to increase production. Also, I see SOOO many specialists right now who are hurting and not doing that well! I don't think that specializing is any longer some sort of golden ticket to save you. I have several very very capable smart friends with EXCELLENT bedside manner who are having trouble keeping days. I'm not sure what the answer is and perhaps its the economy, but LA, NYC in particular and also SF from what i have heard are VERY tough markets and for every single two-day part time job available to specialists (or GPs) they get TONS of applications and resumes! ANd now with new schools constantly opening up it might just be getting harder.

The opportunities are available for specialists in big cities, but people just have to keep an open mind and travel. Gone are the days where a specialist could dream about opening the "nice office" in a very desirable community (Irvine/Orange County, CA for example) and expect to be open 4-5 days/week. There are 3 basic options: suffer and whine, leave the profession (dort-ort), or adapt. By adapting, I mean either opening satellite offices or traveling to chain/gp/multi-specialty centers. The problem nowadays is that dental school tuitions have soared so high that you can no longer just sit on your practice once you get out (you can claim financial hardship but the interests keeps adding). You hear the same type of complaints by new grads such as "I don't want to travel too far to work, I only want to be a FFS practice and don't want to accept dental insurances, I only want to treat a certain demography, I can only work with the newest equipment and technologies, I don't want to make $ for others, I didn't go through X number of years to do this" but when times are tough then you may only have a few options to make your specialist's income. At least you have the potential to make that kind of $$$ with good hours while others are stuck in dead-end careers with terrible schedules and no hope. I have met very few business owners who don't set quotas and are okay with low production (unless they were already loaded to begin with) so I don't think opening your practice solves the problem of pushing for profits. Every 2-3 days you see a new job listing on craigslist or local ad boards like the dental trader in so cal because there is higher turnover and gps are more willing to hire specialists in big cities due to the influx of new grads. As I mentioned before, traveling specialists do not exist in smaller towns because they are more fixed on their old ways and because the professional circles are tighter knit. Yes, the competition may be stiff landing a job but it's not like you haven't seen the same type of adversity before (ie. getting into a residency). As an associate, if things get slow then they could cut your hours and you get paid less and then you can go look for another job. As an owner, if things slow down then you still have fixed expenses to worry about like the rent, insurances, etc. (yes you can cut staff hours but only to a certain point until you are no longer convenient for your patients to return). Getting that DDS or DMD and speciality certificate does not entitle you to that income, there is such a thing as working for it such as driving to the next county if needed and you can even write-off miles. Things may not be ideal but I am just trying to keep things in perspective.

 

[Stroszeck]

Well, driving around from office to office is easier said than done, especially in those big cities. How long does it take to get from OC to LA on a typical day? 2-3 hours?

 

[ortho lurker]

Well, driving around from office to office is easier said than done, especially in those big cities. How long does it take to get from OC to LA on a typical day? 2-3 hours?

It can take 2-3 hours, but would you rather have that $ in your pocket or sit at home with $0 and complain? I think the strategy now is to have these jobs on the side as a hedge to your office. Once the economy gets better and your practice takes off, then you can ditch them. Some specialists fly from out of town & stay in hotel rooms on a routine basis because they have no chains/gp/multi-specialty offices in their area, talk about a commute!

 

[charlestweed]

Well, driving around from office to office is easier said than done, especially in those big cities. How long does it take to get from OC to LA on a typical day? 2-3 hours?

It’s hard to find good jobs in LA…it is saturated there. Most of the good jobs can be found in the Riverside and San Berndino areas…if you live in OC, it takes about 30-45 mins to get there.

An endodontist friend of mine commutes to an LA office via train and he has done this for 11 years. My wife used to drive 60 mile (each way) to a Smilecare office while she was pregnant with our 2nd child. Currently, I spend about 30-40 minutes in traffic to get to 6 different offices. I know an ortho who flies from Utah to Arizona to work for a Western Dental office in AZ. It’s bad if you have to spend 2+hours in traffic everyday….not bad if you only do this 2-3 times a month.

 

[charlestweed]

There are 3 basic options: suffer and whine, leave the profession (dort-ort), or adapt. By adapting, I mean either opening satellite offices or traveling to chain/gp/multi-specialty centers.....

Another great post, Ortholurker. “Adapt” is the key to success. You can’t stop the chain office from opening up more new offices. You can’t tell the ADA not to open more new dental schools. You can’t tell the schools not increase their class size (10 years ago, USC class size was 110…now, USC class size is about 130-140). You can’t tell the schools not to raise the tuitions. To survive all of these unfavorable trends, you have to learn to adapt:
- travel to different GP or chain offices.
- agree to work with poorly trained (and rude) staff at chain offices. deall with bossy managers.
-go door-to-to and beg the GPs to send the patients to your office
-setup your own low cost office.
- reduce the tx fees to attract more patients etc.

I wouldn't be able to have the lifestyle that I currently enjoy, if I didn't do all of things that I list above.

 

[drhobie7]

I have worked for a bunch of Denti-Cal/Medicaid offices doing oral surgery, and generally find it ok but just a little bit painful compared to a nice private practice. My worst experience was with one office that was set up to be a 'higher class' corporate chain practice. The first patient I saw was a 36 year-old guy with perfect dentition, including 4 erupted 3rd molars. 2-3mm pockets all around them. Spotless hygiene. No conceivable indication for extraction, but he was there for...3rd molar extractions! I told the guy I could see no reason to extract the teeth. He was stoked, and left. Then the office manager (who bore a striking resemblance to Jabba The Hut) came over to me and said, "Hey Doc, when my GPs refer patients to you they don't want your opinion, they want you to to take the tooth out." I was so pissed I nearly jabbed my elevator in his tympanic membrane. Instead I told him I would be happy to leave the office immediately and they could find another surgeon. He backed down, and I called the office owner and told him if I ever saw this guy at the practice again I would leave on the spot. To my surprise they transfered the office manager to another clinic. I'm sure that would not be the normal outcome if this happend in other practices. My point is it's nice to maintain your ethics because these practices will test your limits.

 

[BenDentalMatrix]

It’s hard to find good jobs in LA…it is saturated there. Most of the good jobs can be found in the Riverside and San Berndino areas…if you live in OC, it takes about 30-45 mins to get there.

An endodontist friend of mine commutes to an LA office via train and he has done this for 11 years. My wife used to drive 60 mile (each way) to a Smilecare office while she was pregnant with our 2nd child. Currently, I spend about 30-40 minutes in traffic to get to 6 different offices. I know an ortho who flies from Utah to Arizona to work for a Western Dental office in AZ. It’s bad if you have to spend 2+hours in traffic everyday….not bad if you only do this 2-3 times a month.

I would not recommend living in Riverside or San Bernardino, no matter how good the jobs are. It gets so hot, there is a low income population (never a good benefit for pay), and well, on the show "The OC," it was the area where Marissa's mom got made fun of for growing up in 🙂

 

[mike3kgt]

... "Hey Doc, when my GPs refer patients to you they don't want your opinion, they want you to to take the tooth out."

Tell you what, if I referred a patient with the referral saying "Please extract teeth 1,16,17,32" and the patient comes back with all four of them, I'd want a serious explanation from you and unless it's "I'd probably kill the patient" I'd be pretty unhappy. It's a prescription when written like that, not a consultation. You have to think of your referring dentist who may have put a lot of time and energy into a treatment plan and the decision to refer the patient.

Now if I wrote a referral that said, "Please evaluate 1,16,17,32 for extraction" and that were the case, it'd be different. Usually if one is kinda nuts-o crazy, they'll come back with a note "Extraction of 1,16,17 unremarkable, however, discussed possible sequelae of extraction of #32 and mutual agreement to watch this tooth decided".

It bothers me when young oral surgeons get so huffy over this stuff. The surgeons who I work with in practice that are well established won't usually turn away a good 3rd extraction case and will perform with great skill, without consequence, and often times return a satisfied patient.

 

[ortho lurker]

I would not recommend living in Riverside or San Bernardino, no matter how good the jobs are. It gets so hot, there is a low income population (never a good benefit for pay), and well, on the show "The OC," it was the area where Marissa's mom got made fun of for growing up in 🙂

You don't have to live in Riverside or San Bernardino, but you could drive there. Yes, a lot of doctors in So Cal want to live in Irvine, Newport Beach, etc. but that does not mean you have to be the 20th orthodontist to open an office in Irvine or Tustin and pay over $3/s.f. a month in lease and complain that there is too much competition there (go to www.braces.org and click on "Find an Orthodontist" and type in Irvine, CA) . You see these orthodontic leaseholds in O.C. on sale on a monthly basis in the dental sale journals.

 

[drhobie7]

Tell you what, if I referred a patient with the referral saying "Please extract teeth 1,16,17,32" and the patient comes back with all four of them, I'd want a serious explanation from you and unless it's "I'd probably kill the patient" I'd be pretty unhappy. It's a prescription when written like that, not a consultation. You have to think of your referring dentist who may have put a lot of time and energy into a treatment plan and the decision to refer the patient.

Now if I wrote a referral that said, "Please evaluate 1,16,17,32 for extraction" and that were the case, it'd be different. Usually if one is kinda nuts-o crazy, they'll come back with a note "Extraction of 1,16,17 unremarkable, however, discussed possible sequelae of extraction of #32 and mutual agreement to watch this tooth decided".

It bothers me when young oral surgeons get so huffy over this stuff. The surgeons who I work with in practice that are well established won't usually turn away a good 3rd extraction case and will perform with great skill, without consequence, and often times return a satisfied patient.

I don't think you understand. The point was that corporate dental offices may encourage the dentist working for them to overdiagnose or overtreat in order to increase production. That was what my anecdote was about. There was no outside referral. I was working for a company that lined up 1 day a month of extractions, and during this episode asked me to take out teeth that had no indication for extraction.

There are indications for the extraction of a wisdom tooth just like there are indications for doing a root canal. I sometimes encounter GPs who do not know the indications for extracting a wisdom tooth. For example, a 45 year old patient with an asymptomatic, FBI #17, is unlikely to be indicated for extraction. Performing a procedure that is not indicated is bad for the patient, and puts my license as well as the referral's in jeopardy. (If you're interested, AAOMS has a Third Molar White Paper that discusses the indications for extraction of wisdom teeth.)

I happen to feel a referral is not a prescription, and treating a fellow clinician in that manner is impolite and neglects their experience. I think a referral is a request for evaluation to render treatment. Whenever I have a question about the thought process behind a treatment plan or consultation I always talk with the GP before discussing treatment with the patient. And I did that in the case I was referring to. Upon discussion, the GP agreed there was no indication for extraction. It was the office manager who irritated me so much by asking me to throw out my clinical judgment and treat the patient like a bank account.

 

[omaralt]

I don't think you understand. The point was that corporate dental offices may encourage the dentist working for them to overdiagnose or overtreat in order to increase production. That was what my anecdote was about. There was no outside referral. I was working for a company that lined up 1 day a month of extractions, and during this episode asked me to take out teeth that had no indication for extraction.

There are indications for the extraction of a wisdom tooth just like there are indications for doing a root canal. I sometimes encounter GPs who do not know the indications for extracting a wisdom tooth. For example, a 45 year old patient with an asymptomatic, FBI #17, is unlikely to be indicated for extraction. Performing a procedure that is not indicated is bad for the patient, and puts my license as well as the referral's in jeopardy. (If you're interested, AAOMS has a Third Molar White Paper that discusses the indications for extraction of wisdom teeth.)

I happen to feel a referral is not a prescription, and treating a fellow clinician in that manner is impolite and neglects their experience. I think a referral is a request for evaluation to render treatment. Whenever I have a question about the thought process behind a treatment plan or consultation I always talk with the GP before discussing treatment with the patient. And I did that in the case I was referring to. Upon discussion, the GP agreed there was no indication for extraction. It was the office manager who irritated me so much by asking me to throw out my clinical judgment and treat the patient like a bank account.

i see what your saying however i still like to prophylicatically (spelling?) extract wisdom teeth in my younger patients (20's-30's). what i've noticed is that while they may be fully erupted with no "indications for ext" over time those teeth get neglected because the patient is not able to keep them clean. then when they're in their 40's and 50's they have severely carious third molars, with possible other medical issues. the extractions at that point become much more difficult and traumatic. thats why i routinely refer those patients for ext; and my O.S. has no problem extracting them. different philosophies i guess

 

[charlestweed]

I don't think you understand. The point was that corporate dental offices may encourage the dentist working for them to overdiagnose or overtreat in order to increase production. That was what my anecdote was about. There was no outside referral. I was working for a company that lined up 1 day a month of extractions, and during this episode asked me to take out teeth that had no indication for extraction.

And this is one of the advantages of working for a chain. You can get the patients and earn your well paid specialist salary (+ bonus) without having to go from door to door to beg the GPs. Trust me, when you have your own private practice, going door to door to meet the GPs is not fun.

There are indications for the extraction of a wisdom tooth just like there are indications for doing a root canal. I sometimes encounter GPs who do not know the indications for extracting a wisdom tooth. For example, a 45 year old patient with an asymptomatic, FBI #17, is unlikely to be indicated for extraction. Performing a procedure that is not indicated is bad for the patient, and puts my license as well as the referral's in jeopardy. (If you're interested, AAOMS has a Third Molar White Paper that discusses the indications for extraction of wisdom teeth.)

I happen to feel a referral is not a prescription, and treating a fellow clinician in that manner is impolite and neglects their experience. I think a referral is a request for evaluation to render treatment. Whenever I have a question about the thought process behind a treatment plan or consultation I always talk with the GP before discussing treatment with the patient. And I did that in the case I was referring to. Upon discussion, the GP agreed there was no indication for extraction. It was the office manager who irritated me so much by asking me to throw out my clinical judgment and treat the patient like a bank account.

I agree. Protecting your dental license should be the number one priority. Not all 3rd molars need extraction. Not all crooked teeth need ortho tx…especially when the kids still have a bunch of baby teeth. Not all teeth with deep pockets require perio surgery…in some cases, they need to be extracted.

At the chain offices, the office managers are just trying to do their job by pushing the doctors to produce.....and sometimes, they are rude to the doctor. I know it's not easy dealing with bossy managers. However, I would rather deal with them than staying unemployed and stretching the student loan repayment to 30 years. I feel that having a DDS (and MS😀) degree does not put me above the assistants and office managers. Having worked at dental chains for 10 years, I've learned that I can earn the respect from the assistants and office managers when I also treat them with respect. They become more helpful when I am busy with the patients. My current manager and I get along fine. I have no problem declining to treat the ortho cases that are sent to us from the general dentistry department.

 

[mike3kgt]

I don't think you understand. The point was that corporate dental offices may encourage the dentist working for them to overdiagnose or overtreat in order to increase production. That was what my anecdote was about. There was no outside referral. I was working for a company that lined up 1 day a month of extractions, and during this episode asked me to take out teeth that had no indication for extraction.

There are indications for the extraction of a wisdom tooth just like there are indications for doing a root canal. I sometimes encounter GPs who do not know the indications for extracting a wisdom tooth. For example, a 45 year old patient with an asymptomatic, FBI #17, is unlikely to be indicated for extraction. Performing a procedure that is not indicated is bad for the patient, and puts my license as well as the referral's in jeopardy. (If you're interested, AAOMS has a Third Molar White Paper that discusses the indications for extraction of wisdom teeth.)

I happen to feel a referral is not a prescription, and treating a fellow clinician in that manner is impolite and neglects their experience. I think a referral is a request for evaluation to render treatment. Whenever I have a question about the thought process behind a treatment plan or consultation I always talk with the GP before discussing treatment with the patient. And I did that in the case I was referring to. Upon discussion, the GP agreed there was no indication for extraction. It was the office manager who irritated me so much by asking me to throw out my clinical judgment and treat the patient like a bank account.

One of the best posts I've read in regards to this. I can truly feel what you have been through in corporate chains as I have been there.

I can say definitively that it is one thing to have another dentist say "take out this tooth" versus an "office manager" I cannot tell you how many times during my or my wife's experience did something like this come up and piss us off. Why even bother spending 4+ years in school beyond college when a high school grad feels they can treatment plan.

Oh wait, that's what our plans are in dentistry right now! I wonder why I'm so against it. 😛

BTW, I have had nothing but great experience with my local oral surgeons. Now that I am back in residency again, working with them here in school is often just awful at times. I love looking at them straight in the face and letting them know that they had better get it out of their systems because I guarantee that if they spoke to me that way in practice or spoke to my patients in that way, no referral anymore!!

I can buy my own damn honey baked ham at the freggin store thank you very much!

 

[omaralt]

I can buy my own damn honey baked ham at the freggin store thank you very much!

lol funny that you mention that; this is my first full year in practice and i've already received a ham, two bottles of wine, and a bunch of cookies/snacks.. ha and it's still two weeks from christmas! gotta love being a GP; we get catered to 🙂

 

[2TH MVR]

Well, I dredged this old thread up.

A couple of observations from working in both environments: Corporate and Private from an Orthodontist point of view.

1. I cannot imagine doing general dentistry in the corp arena. As has been mentioned .... lots of production quotas pressuring the GPs to do a lot of possibly questionable dentistry. Patients can't diagnose or see what your recommending. Although these same pressures to produce exist in the private sector also.
2. Orthodontic need is visible to the patients. "My teeth are crooked. I need braces" I think it is easier for the ortho specialists in the corp arena to ...... shall I say .... "Sleep easier at night with a clean conscience" when recommending orthodontic treatment to corp patients.
3. One big disadvantage to corp dentistry in my opinion is the staff. They are not compensated by YOU. I find it difficult to "manage" a staff whereby you do not sign their checks. My only ploy is to convince the staff that if we work as a team .... life will be easier and less stress full. So far ... limited success.

 

[allantois]

As I former patient at Gentle dental: they are the most fraudulent dental office I've been with. Treatment recommendations are questionable and prices are handled by the office manager who I question finished their GED. Also dentists compete for patients and and try to get you transferred to them.

Please go support your local owner-dentist 😉

 

[2TH MVR]

As I former patient at Gentle dental: they are the most fraudulent dental office I've been with. Treatment recommendations are questionable and prices are handled by the office manager who I question finished their GED. Also dentists compete for patients and and try to get you transferred to them.

Please go support your local owner-dentist 😉

I hear what you are saying, but unfortunately .... there are a lot of local

As I former patient at Gentle dental: they are the most fraudulent dental office I've been with. Treatment recommendations are questionable and prices are handled by the office manager who I question finished their GED. Also dentists compete for patients and and try to get you transferred to them.

Please go support your local owner-dentist 😉

In general ... I agree with you 100%. But .......... lets be honest and realize there are just as many privately owned practices, if not more that are overly aggressive with their treatment plans. i.e lets crown and veneer all the front teeth instead of recommending ortho tx. Lets crown and veneer all the front teeth due to excessive anterior wear "without" correcting the etiology which is the DEEP OVERBITE.