Group Practice after D-school

[maryanne213]

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Anyone have experience or info with what it is like working at a group practice such as Gentle Dentle? How much autonomy do you get? Is the pay ok? Enjoyable? Satisfying?

I did all of my shadowing with private practice dentists, but I'm thinking now that I may just want to work in a group practice and not have to deal with managing a practice. Wouldn't mind the paycut too much as long as I have enough to live comfortably. This would also allow me to relocate if i choose 👍

I came across an employment listing where gentle dentle was seeking an associate in the vancouver, wa and the base pay was 100-250K. Sounds too good to be true 🙄

 

[diagnodent]

I've worked in group practices and they suck. And I've seen dentistry from group practices like gentle dentle andit isn't high quality. The reason is due to a rushed schedule, accepting lots of "plans" and having too many patients for an unexperienced dentist, not buying great products, and using cheap labs.

I would look at working at a health clinic like the va, IHS clinics, community clinics b/c they don't rush you and will typically buy whatever you want.

 

[shammah98]

I've worked in group practices and they suck. And I've seen dentistry from group practices like gentle dentle andit isn't high quality. The reason is due to a rushed schedule, accepting lots of "plans" and having too many patients for an unexperienced dentist, not buying great products, and using cheap labs.

I would look at working at a health clinic like the va, IHS clinics, community clinics b/c they don't rush you and will typically buy whatever you want.

I keep hearing comments like this, and sometimes I wonder if sometimes it isnt just a stereotype that dentists have created due to some bad apples and their reduced reimbursement from such groups. after all, i've seen/heard of many private dentists who "practice on roller skates" and churn out less than desirable work. so it is possible that there are actually some large group practices that are pretty decent?
just curious...

 

[Dr.SpongeBobDDS]

I just saw a patient yesterday. She had a brand new max partial made at Affordable Dentures in 2005. She came to see me to get a "cleaning." The abutments for the partial were the canine and first bi on either side. One of the abutments had a failing endo, the rest were grossly decayed with 5-6 mm probing depths. The chances of her keeping that partial are pretty slim.

There is no way this amount of decay could have happened in the last year. I didn't tell the patient she got screwed because I don't believe in putting down another dentist if I don't know the whole situation. But it sure looked like she got screwed.

I know it is easy to say that patients get what they pay for, but patients don't know enough to know the difference between good and bad dentistry to make that decision. I just don't see how denture mill / amalgam mill practices like that are capable of offering consistently acceptable dentistry to their patients.

That isn't to say there aren't good franchise/group practices out there. If you want to be a lifetime associate there are plenty of opportunities, but I think you have to watch out for the super high volume practices.

 

[DrJeff]

In *certain* cases, the groups settings (i.e. Gentle Dental, Aspen Dental, etc) can be good. Think of them basically as a pyramid scheme. If you're a new associate going in there, your on the bottom level, you're seeing all the DMO patients, meaning high volume, lower fees, less autonomy (not over patient treatment choices, but over your working hours, material choices, etc). If your able to survive the often hectic pace and limited practice management autonomy, you can start climbing up the ladder, and getting some associates under you. As you start climbing the ladder, and if you choose to buy-in to one of these franchises(I like to think of them more like a McDonalds), then you'll end up picking and choosing patients and doing more high end crown and bridge work with greater autonomy over managerial descisions and materials.

The reason why the "franchises" have a bad reputation amongst the new practitioners is that as a newbie there, you'll work like a dog and often feel you have as much descision making choices as you did in dental school. Many, many new associates in these franchise will leave the franchise in less than a year due to burn-out, and decide to head towards another practice opportunity(often the traditonal private practice setting).

If you do persist through the 1st years at a Franchise and start the buy in process, it very often has a BIG financial winfall for you, and its this potental that will keep some young dentists going. Unfortunately though, many of these "franchises" do get the reputation of overtreating with lower quality work, often using marketing schemes such as "free x-rays" or "free cleaning/exam" to get many folks through the door.

If you choose to practice that way, thats fine, I just know that for me a situation like that wouldn't allow me to sleep well at night!

 

[Dr. Dai Phan]

I just saw a patient yesterday. She had a brand new max partial made at Affordable Dentures in 2005. She came to see me to get a "cleaning." The abutments for the partial were the canine and first bi on either side. One of the abutments had a failing endo, the rest were grossly decayed with 5-6 mm probing depths. The chances of her keeping that partial are pretty slim.

There is no way this amount of decay could have happened in the last year. I didn't tell the patient she got screwed because I don't believe in putting down another dentist if I don't know the whole situation. But it sure looked like she got screwed.

I know it is easy to say that patients get what they pay for, but patients don't know enough to know the difference between good and bad dentistry to make that decision. I just don't see how denture mill / amalgam mill practices like that are capable of offering consistently acceptable dentistry to their patients.

That isn't to say there aren't good franchise/group practices out there. If you want to be a lifetime associate there are plenty of opportunities, but I think you have to watch out for the super high volume practices.

Hi,

It is sad that many patients do not know the difference between bad and good dentisty. Cheap dentistry does not have to equal bad dentistry. As long as a "flipper" is well made on sound tooth structure for 75 bucks, I have no problem with that. I think that the patients who go to the "dental mills" are not dentally "smart" and these companies thrive on these un-informed patients. Too many , I mean too many times I have seen immediate dentures inserted without any kind of post operative adjustments that resulted in horrible epulis fissuratum. When I asked on a patient on why he did not call the dentist for adjustments, I was told the dentist said to him " don't worry, the dentures will settle in and you will have to get used to it"! and the patient bought it!!! I then advised patient that we need to surgically remove the excess tissues then new dentures made. Unfortunately, this patient has no trust in me since he kept asking me how long I have been in dentistry, how many dentures have I done, can he ask another dentist to come in and check my work and so forth... At the end, I told him to look for second opinion elsewhere and that's the end of it. The last time I heard from my assistant, he went back to that denture mill ! I am sure that these DDS in these "dental factories" are really smooth talkers... Sad indeed. DP

 

[hockeydentist]

Hi,

It is sad that many patients do not know the difference between bad and good dentisty. Cheap dentistry does not have to equal bad dentistry. As long as a "flipper" is well made on sound tooth structure for 75 bucks, I have no problem with that. I think that the patients who go to the "dental mills" are not dentally "smart" and these companies thrive on these un-informed patients. Too many , I mean too many times I have seen immediate dentures inserted without any kind of post operative adjustments that resulted in horrible epulis fissuratum. When I asked on a patient on why he did not call the dentist for adjustments, I was told the dentist said to him " don't worry, the dentures will settle in and you will have to get used to it"! and the patient bought it!!! I then advised patient that we need to surgically remove the excess tissues then new dentures made. Unfortunately, this patient has no trust in me since he kept asking me how long I have been in dentistry, how many dentures have I done, can he ask another dentist to come in and check my work and so forth... At the end, I told him to look for second opinion elsewhere and that's the end of it. The last time I heard from my assistant, he went back to that denture mill ! I am sure that these DDS in these "dental factories" are really smooth talkers... Sad indeed. DP

Are you saying your less likely to cut corners in private practice rather than a group practice? I would think ****ty dentistry could happen anywhere regardless of the sign out front..

 

[DrJeff]

Are you saying your less likely to cut corners in private practice rather than a group practice? I would think ****ty dentistry could happen anywhere regardless of the sign out front..

It's true that sh*&&^ dentistry can happen anywhere, but in situations where you're being pushed/driven to see more people and reduce your operating costs to turn out a product that is less expensive to the consumer, it is easier to happen in the "franchise practice" than traditional private practice. In general, if someone is seeing you simply based on what you charge, or because your the only dentist that takes their insurance plan ("franchise" practices will often be particpiating providers with basically any and every insurance plan, even the DMO's 😱 , and hence may be the only office that is "in network" for the price driven patient), they're not the most highly educated dental patient. Scenarios such as Dr. D. P.'s epulis patient can, and do happen 😱 simply because of patient ignornace.

Can this happen in private practice, sure, but if you as the practitioner with a greater administrative/ownership role that you often do in a private practice situation take even an ounce of pride in your work, scenarios like the afforementioned denture patient happen much less. In general in private practice, if your work is largely sub-par, word of mouth in the community spreads, and your selective patient base decreases simply because many of them choose to have a CHOICE about who they see, and will very often pay extra to be seen "out of network" if the dentist/patient trust is there.

 

[Dr. Dai Phan]

It's true that sh*&&^ dentistry can happen anywhere, but in situations where you're being pushed/driven to see more people and reduce your operating costs to turn out a product that is less expensive to the consumer, it is easier to happen in the "franchise practice" than traditional private practice. In general, if someone is seeing you simply based on what you charge, or because your the only dentist that takes their insurance plan ("franchise" practices will often be particpiating providers with basically any and every insurance plan, even the DMO's 😱 , and hence may be the only office that is "in network" for the price driven patient), they're not the most highly educated dental patient. Scenarios such as Dr. D. P.'s epulis patient can, and do happen 😱 simply because of patient ignornace.

Can this happen in private practice, sure, but if you as the practitioner with a greater administrative/ownership role that you often do in a private practice situation take even an ounce of pride in your work, scenarios like the afforementioned denture patient happen much less. In general in private practice, if your work is largely sub-par, word of mouth in the community spreads, and your selective patient base decreases simply because many of them choose to have a CHOICE about who they see, and will very often pay extra to be seen "out of network" if the dentist/patient trust is there.

What Dr.Jeff said is quite true. If you own your practice with your name prominenty display on the building, you certainly do not want anything bad said about you. Bad news will spread like wildfire and your reputation will be at risk not to mention loss of patient pool. Therefore you thrive to do the best work you can to built up your reputation. However, if you are in a dental mill working with 10 other dentists, it is not YOUR reputation is at stake but the company's name so you just don't care for shoddy workmanship. And that results in sh-tty dentistry. Every single dentist I know who left from these mills told me that PRODUCTION is a priority, everything else is rubbish. If you work in a dental mill and you bring the patient back 5 times post delivery of dentures for adjustments, you will be asked to leave faster than the eye can blink! One girl I used to date worked for one of these national chains and when I look on her memo board about monthly meeting, everything is about BILLING ... BILING and PRODUCTION GOAL. I have yet to see quality dental work from these dental mills. DP

 

[joel4sale]

Wow........Guess I will be here to provide the otherside of story then.

I started out working in the a sister office of Gentle Dental, hearing all the horrible story back int he school so I have my contract duration time as "At Will" which mean I can quit WHENEVER I want to. Every dentist I know work for this dental group had work for them for many years.

There are no dentist ever been fired due to production in this region. The only dentist I know got fired was because of poor chairside manner (ex-military guy, slapped the kid & told him to shut the **** up, got fired first month of work). I work with an old dentist who is also my mentor (20 yrs with the group). We both on salary so we never need to fight for procedures. In fact, he took many of my PITA just because I am tired of them, and I took many of his pt just because I want the practice. I get to dictate my own schedule...the manager and front desk make sure I have enough time for my procedure. I get to refer pt to specialist if necessary. Company give me 2 week of PTO, take care of my CE. Pay is not not notch but not bad. I get to use what ever I think is the best for the patient. I use resin for 90% of my patient and no one tells me overhead is too high. Each dentist would get at least 2 assistant. I get to try many different equipment within reasonable range (Just in past 12 month, I tried 3 different rotary handpiece, 3 different curing light, 4 different kind of Endo obturation material and plenty more). Ofcourse I got out of hand once a while and manager whine to me and that's about it. Two new grad who join the company few month ago love the job.

The major down side for my current job is actually patients and location. Because the nature of group practice, I got plenty of PITA and hilly-billy weirdos. I see meth teeth and druggies on daily basis. Extract/Endo anywhere from 20 to 80 teeth a week. Office is 250 miles away to the nearest major city and my wife is already sick and tired of creek and trees.


Many people see horrible dental work come from the mill. I had see many horrible work come from private office. Not all the group practice are bad just as not all the private practice are great.

 

[Sunnyy]

What are other options other than opening your own private practice or joining a group practice as a new dental grad? I'd like to reside in the city still but the market in the city is so saturated with dentists already, it'd be difficult to become established. I'm aware of the option of taking over a retiring dentist's practice, but opportunities in that area seem scarce as well.

 

[maryanne213]

thanks for all of the info!
i agree that bad dentistry can happen anywhere, but it does seem more likely to happen in a "franchise" based practice.

I guess my biggest concern is being forced to practice crappy dentistry(using cheap material, limited resources) in order to meet certain financial quotas...

Great to hear opinions from both sides 👍

 

[gryffindor]

What are other options other than opening your own private practice or joining a group practice as a new dental grad? I'd like to reside in the city still but the market in the city is so saturated with dentists already, it'd be difficult to become established. I'm aware of the option of taking over a retiring dentist's practice, but opportunities in that area seem scarce as well.

Find a job, any job, to pay the rent. Sign up with multiple temp agencies to temp hygiene & dentistry if you don't have enough work days. If you want to stay/establish a practice in the city, then network, network, network.

 

[mdub]

It is sad that many patients do not know the difference between bad and good dentisty.

That's the case with virtually all the professions. For instance, how does a person know how good their lawyer's $1,000 or $1,500 motion for summary judgment was?

That's one of the main arguments for license requirements and/or rating systems.

 

[rehabilitator]

That's the case with virtually all the professions. For instance, how does a person know how good their lawyer's $1,000 or $1,500 motion for summary judgment was?

That's one of the main arguments for license requirements and/or rating systems.

testing

 

[rehabilitator]

testing

testing again

 

[aphistis]

testing again

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