Retail Dentistry

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Do you think dentistry will ever head towards retail environments to the likes of optometrists, pharmacists, etc.?

 

[DrJeff]

Do you think dentistry will ever head towards retail environments to the likes of optometrists, pharmacists, etc.?

That's so far beyond even trying to compare apples and oranges that I can't even begin to fathom an answer that doesn't sound condescending.

 

[HawkeyeDDS]

I think you'd have a difficult time trying to buy produce in the same area that someone is getting their third molars extracted. Just doesn't seem right. Can you imagine going to walmart and hearing the handpiece going or some patient yelling as you inject anesthesia? It'll only happen if we screw ourselves like some other professions have.

"blue light special on crowns"

 

[1992Corolla]

I really hope it doesn't.

Anyone who wants to cheapen the profession (do I sound arrogant? - I am not meaning to) in this way...

Walking around walmart buying socks for 2.43 while waiting for the page 'The Dr. is ready to see you mr. johnson' doesn't sound like I payed 300,000 to go to school and learn a very technical profession...

 

[KifsterDDS]

Do you think dentistry will ever head towards retail environments to the likes of optometrists, pharmacists, etc.?

I've been a dentist since 2004.

By nature of the work that we perform--which almost exclusively consists of "surgical" procedures, I don't think it will ever go the route of optometry and pharmacy, where products are sold. Besides, pharmacists, for all intents and purposes, aren't even health care providers. Their job is to oversee the dispensing of medications. Despite their efforts to increase patient contact, they have none.

I will say this, however: there are certainly dentists out there whose attitude toward their work is more suited to a retail environment. There is certainly a disturbingly high number of practices found in strip-malls rather than medical parks. Dentists who advertise smiles (which is pretty-much every dentist out there) should be working in hair salons rather than treating patients in a health care setting. One could argue that plastic surgeons and dermatologists advertise cosmetics as well, but lets be honest here: cosmetic dentistry is hardly medically-oriented work. I speak from experience. I did my share of cosmetic cases.

The manner in which dentists advertise themselves to the public as smile-fixers rather than doctors who provide oral health care is one of the main reasons I decided to leave the profession (I'm in med school now).

 

[rkamsterdam]

http://www.searsdental.com/

Right next to the sales rack.

 

[biocmp]

...or not...

I'm hoping people quit giving themselves to the MBAs in the world.

 

[Cold Front]

It is heading more towards that direction. Aspen Dental offices are located in retail environments. This is a direct effort to maximize access to care for patients. We place our offices in locations where the "non-compliant" patient will feel more comfortable, and we have processes in place to enable those people to afford the quality care they need.

As far as the dentists themselves, we pride ourselves on the ability to provide our dentists with offices that include the most up to date technologies, and the support to focus on patient care. Each dental office is also staffed with a Denture Lab Tech that is able to work with dentists and their patients on site.

Visit our website found in my signature, and see just how much growth Aspen is experiencing. It shows the rate of success Aspen is having, which in turn reveals the continued approval from patients and dentists alike.

It's nice to know that, but today's market share of dental offices are:

- 67% solo offices,
- 10% partnership,
- 13% group practices
- 3% dental schools,
- 4% government (VA hospitals, community centers, military, etc).
- 3% dental chains and other type of clinics

Bottom line, people like ASPEN dental, or SEARS dental, will be no where near dominating the dental services market for the coming decades.

Most dentists would agree, that dental chains are dental mills. You work to meet the quota first. It might be a good place to start for some, but won't attract many dentists for that reason alone.

 

[HawkeyeDDS]

It is heading more towards that direction. Aspen Dental offices are located in retail environments. This is a direct effort to maximize access to care for patients. We place our offices in locations where the "non-compliant" patient will feel more comfortable, and we have processes in place to enable those people to afford the quality care they need.

As far as the dentists themselves, we pride ourselves on the ability to provide our dentists with offices that include the most up to date technologies, and the support to focus on patient care. Each dental office is also staffed with a Denture Lab Tech that is able to work with dentists and their patients on site.

Visit our website found in my signature, and see just how much growth Aspen is experiencing. It shows the rate of success Aspen is having, which in turn reveals the continued approval from patients and dentists alike.

It's the same patients that run to Mexico for their dental work, just to save a buck. You can have all those patients, they probably won't pay thier bills anyway. And most likely the first ones to sue.

No Corporation will ever have the best intrest of the Dr. or patients at heart. It's the $. Granted there are dentists that are pieces of crap and don't care at all either. These dental mills will only work if we allow ourselves to be run by them. Search for the older threads on this same topic and see just how much SearsDental cares about the providers. Quotas on crowns, extractions, how many patients they "have" to see etc.

Where does it stop?? Walmart? no thanks.

 

[diagnodent]

Actually, corporate run dental clinics are going to increase in the near future. The reason is because the offices will be run on efficiency. Most dentist's do not understand basic business principles and cannot properly run an office so they have inflated overhead. The well run corporate offices will be more efficent and decrease overhead to earn money for the shareholders. With the prices of dental school increasing every year the new grads aren't going to want to take on more loans to buy a practice (its already happening).

I do not like most corporate run offices, but I see it as an inevitable future in dentistry. We are one of the last cottage industries and I hate to say it but the days of the solo office are coming to an end.

 

[alanan84]

Actually, corporate run dental clinics are going to increase in the near future. The reason is because the offices will be run on efficiency. Most dentist's do not understand basic business principles and cannot properly run an office so they have inflated overhead. The well run corporate offices will be more efficent and decrease overhead to earn money for the shareholders. With the prices of dental school increasing every year the new grads aren't going to want to take on more loans to buy a practice (its already happening).

I do not like most corporate run offices, but I see it as an inevitable future in dentistry. We are one of the last cottage industries and I hate to say it but the days of the solo office are coming to an end.

For those of you in dental school or practicing, would you say this is true? One of the many things that attracts me to dentistry is that someday I could have my own practice and run my own business. Is it true that those days are coming to an end in dentistry? It wouldn't change my goal of being a dentist but I do seem to see more and more monarch dentals and the like being put up...

 

[Cold Front]

Actually, corporate run dental clinics are going to increase in the near future. The reason is because the offices will be run on efficiency. Most dentist's do not understand basic business principles and cannot properly run an office so they have inflated overhead. The well run corporate offices will be more efficent and decrease overhead to earn money for the shareholders. With the prices of dental school increasing every year the new grads aren't going to want to take on more loans to buy a practice (its already happening).

I do not like most corporate run offices, but I see it as an inevitable future in dentistry. We are one of the last cottage industries and I hate to say it but the days of the solo office are coming to an end.

We can debate all day about this, but reality will matter the most .... there will always be limited # of supply (dentists) that will never catch-up with the demand over the next 30 years or so.

The biggest graduating dental classes were between 1975 to 1985, about 5,300 graduate students on average (as oppose to the current 4,200 new grads). Those guys have started to retire, and their effect of the supply side have already started to show in many communities all over the country. This means, for every 4,200 new grads today, there are 5,200 retiring dentists (from class of 1978). Assuming this holds true, there will a net loss of 1,000 dentists every year until it levels off (maybe by the year 2020 - at the earliest).

Meanwhile, the demand will grow even bigger during that time (because supply dropped). The U.S. population is growing faster than the dental profession. Even if 10 more schools open during that time, it will not have much effect on the equation.

The moral of the story... dental chains can set-up as many offices as they want around the country, but who will work in these offices if the supply of dentists is in red? These corporations will not be able to expand for this reason alone (maybe after this period is over, which will not be anytime soon).

Dentistry as a market is run by dentists, not by corporations.

 

[Rube]

Also we should figure something else in terms of numbers, half of the dental schools now are female. Some of these women will be part time dentists or may even take off a couple of years, so the shortage is even greater than the numbers suggest.

The biggest threat are future mid level providers like the "advanced dental practicioner." It takes 2 years to pump them out and corporations could pay them $25/hr and have 10 of them being "supervised" by 1 dentist. Fortunately they are 5-10 years away but they are already being tried out. Watch what the state legislatures do. Join the ADA.

 

[diagnodent]

This isn't a simple supply and demand equation. It's much more complicated than that. In the short time I have been a dentist I have seen more corporate run dental offices. They are able to offer lower prices and more hours open than solo offices generally. Most industries eventually evolve and become more efficient...its just the typical business cycle. Dentistry is starting to evolve and I'm not saying it's going to happen quickly, but it is happening. If you wonder who is going to work at the offices, it's going to be the new practicioner with 300K+ in debt, the foreign grad, the ADHP, etc. I don't like it as much as the next solo practicioner but us solo's need to be smarter to compete.

 

[pietrodds]

It is heading more towards that direction. Aspen Dental offices are located in retail environments. This is a direct effort to maximize access to care for patients. We place our offices in locations where the "non-compliant" patient will feel more comfortable, and we have processes in place to enable those people to afford the quality care they need.

As far as the dentists themselves, we pride ourselves on the ability to provide our dentists with offices that include the most up to date technologies, and the support to focus on patient care. Each dental office is also staffed with a Denture Lab Tech that is able to work with dentists and their patients on site.

Visit our website found in my signature, and see just how much growth Aspen is experiencing. It shows the rate of success Aspen is having, which in turn reveals the continued approval from patients and dentists alike.

Good lord, now we have Aspen creeping around the dental student websites trying to sink it's teeth into young, naive soon-to-be dentists. Aspen runs a good business but business in dentistry is only half the equation... it's still health care and if you just treated the practice of dentistry like a business 24/7 you'll come to hate dentistry and your patients will hate you. The corporates haven't figured out how to take care of people and they probably never will... nor do they care to.

By the way, I didn't think you could promote your business on this site???

 

[Cold Front]

Also we should figure something else in terms of numbers, half of the dental schools now are female. Some of these women will be part time dentists or may even take off a couple of years, so the shortage is even greater than the numbers suggest.

I think there is (and will be) rapid increase in female participation in dentistry. The estimates now are about 1/5 dentists are women, but dental enrollment trends show 1/2 are females. The will be a big segment of female dentists in the dental workforce in the future, which means the male dentists workforce is expected to decline over the next few decades (keep in mind, majority of retiring dentists are men). In addition, female dentists work fewer hours than male dentists because of family obligations and such, which will reduce the overall hours of services provided by the profession. But is this a good news for dental chains?

This isn't a simple supply and demand equation. It's much more complicated than that. In the short time I have been a dentist I have seen more corporate run dental offices. They are able to offer lower prices and more hours open than solo offices generally. Most industries eventually evolve and become more efficient...its just the typical business cycle. Dentistry is starting to evolve and I'm not saying it's going to happen quickly, but it is happening. If you wonder who is going to work at the offices, it's going to be the new practicioner with 300K+ in debt, the foreign grad, the ADHP, etc. I don't like it as much as the next solo practicioner but us solo's need to be smarter to compete.

The count of federally designated dental health professional shortage (lack of supply) areas (HPSAs)—over 2,000 in 2002—has increased significantly in recent years. However, this change may not be indicative of the true growing need (demand) for dental providers in certain (mostly rural) communities across the country, because 1) many communities without a dentist have not applied for HPSA designation; 2) some areas that have started processes have been blocked by neighboring dentists; and 3) the way communities are designated might not reflect actual need. Everything is about supply-and-demand, as long you have a patient who needs dental service, and a dentist who can provide it.

As far as new graduates working for dental chains, regardless of their debt, it will not be a long term commitment. Go to dentaltown.com, you will see how bad the turn-over rates for those corporations are. No one wanted to become a dentist because they wanted to work for Aspen Dental or the likes.

Dental chains go after high volumes for one reason, because they won't struggle to provide low-cost services. Their management nerds with MBA's will not care so much about quality dentistry, they see the whole thing as Pepsi vs. Coca-Cola.

 

[OceanDMD]

I've been a dentist since 2004.

By nature of the work that we perform--which almost exclusively consists of "surgical" procedures, I don't think it will ever go the route of optometry and pharmacy, where products are sold. Besides, pharmacists, for all intents and purposes, aren't even health care providers. Their job is to oversee the dispensing of medications. Despite their efforts to increase patient contact, they have none.

I will say this, however: there are certainly dentists out there whose attitude toward their work is more suited to a retail environment. There is certainly a disturbingly high number of practices found in strip-malls rather than medical parks. Dentists who advertise smiles (which is pretty-much every dentist out there) should be working in hair salons rather than treating patients in a health care setting. One could argue that plastic surgeons and dermatologists advertise cosmetics as well, but lets be honest here: cosmetic dentistry is hardly medically-oriented work. I speak from experience. I did my share of cosmetic cases.

The manner in which dentists advertise themselves to the public as smile-fixers rather than doctors who provide oral health care is one of the main reasons I decided to leave the profession (I'm in med school now).

So you think (let me rephrase that) thought, its better to be a tooth doctor than a smile enhancer? Now you are out of the field. Look, Im not saying there isnt advertising out there that is "cheapening", but treating the "smile" is a common approach to selling cosmetic dentistry. I am happy providing "oral health care", but want dentisty can be much more satisfying to the patient and as a result to the dentist. Maybe if you had embraced this somewhat (since you have done a fair share of cosmetic dentistry) rather than critique it you might still be in the field. Good luck in med school, and pray for the right candidate in November who won't socialize medicine. Id keep your dental license current.

 

[diagnodent]

Cold Front you can believe what you believe and I don't really care because you won't change your mind (I'm sure the pharmacist's use to think the same thing too).

I've worked at the corporate run chains and it sucks. But dentistry is just beginning to change and in 15-20 years those same chains won't be around (a few still will), but new corporate run dental clinics that are more economically viable will take their place(ie. comfort dental). In the 10 years I've been a dentist, I've seen dentistry change a lot and it is still changing. Solo offices will still exist, but I think we will see more partnerships, group practices and corporate chains.

 

[setdoc7]

I have been a dentist for 25 years, and I have seen the corporate chain dental emporiums come and go. They are not a financially good investment, because running a dental practice is very expensive. The profit at the bottom line is not enough for the amount of work, salaries, equipment, and management a practice takes. On the other hand, I would not be so quick to bash the MBA's. We can learn a lot from them about running a business, as that is the one major flaw with dental school. We come out as health care providers, but with little or no financial training. Don't be misled, dentistry is a business.

 

[eson]

Actually, corporate-run offices would be less efficient if it weren't for the fact that they push production so much.

They have more overhead. Remember, corporate offices must employ both a manager and a dentist, while dentist-owned offices only need one.

 

[diagnodent]

Eson, in a typical solo practice the office is owned by a dentist who also employs an office manager which increases overhead (b/c generally the office doesn't need a manager).

In a typical corporate office they employee a manager who oversees the office; however, they generally have multiple dentists, more days open and longer hours. This allows them to have more production and less overhead. Remember the fixed overhead remains constant and is not dependent on if the office is open or not. This is how the coporate offices decrease overhead---they are utilizing the facility better.

Everyone here needs to go to dentaltown and watch the virtues of profitable dentistry by howard farran free on the website. It teaches you about basic business principles of a dental offices.

 

[eson]

I've only been to a dozen dental offices, but the ones I've experienced only have secretaries.

Utilizing the facility better is not exclusive to a corporate scheme. Most retail dentist offices have no foot advantage over solo practices (ie: Wal-Mart) and aren't any more efficient than solo practices by nature. Many solo practices employ more than one dentist as well.

What large corporations do have though is the ability to illegally under pay taxes and get away with it as well as receive discounts on bulk supplies.

 

[diagnodent]

Eson, please go watch Howard Farran's Online CE. It will give you a hole new perspective on the dental business.

You said that solo offices employ more than one dentist....by definition they are no longer a solo practice then....they are a group practice or partnership. Also, corporations do not illegally under pay taxes...that just doesn't happen because it's illegal. Corporate chains do receive discounts on supplies but supplies only account for 5-7% of overhead so if you save 1-2% on overhead that is not much. The larger offices save money by having more hours and are open more days which is not exclusive to large corporations, but a solo practicioner generally isn't going to work 7am-7pm Monday thru Saturday. If you look at comfort dental's model of lean and mean you will learn that they are more efficient than most dental offices. Most of the dental offices that I see are horribly managed due to a lack of business knowledge and leadership by the dentist. Many solo offices hemmorage money through poor control of overhead and a lack of a business plan. (I evaluate all of my friend's P&L's they get when looking to buy an office)

This is the reason everyone who wants their own office needs to watch Howard Farran's CE. Learn about general business principles and apply them to a dental office and you will be more successful.

 

[charlestweed]

Actually, corporate-run offices would be less efficient if it weren't for the fact that they push production so much.

They have more overhead. Remember, corporate offices must employ both a manager and a dentist, while dentist-owned offices only need one.

I agree. Solo practices usually have significantly lower overhead. Most successful private GP practices only have 2-3 employees and these employees do everything: billing, treatment plan presentation, placing orders, billing, assisting, mopping floor etc. My wife (a periodontist) and I share 2 full time employees. I also have 4 part time RDA’s who only work at my office 8 days a month. Our overhead is less than 40%.

I’ve worked for several chain offices as an associate orthodontist since 2001. I’ve seen so many of my GP friends (including my younger sister) who worked with me at these chain offices quit their job and set up their own private practices. They all do very well. They see fewer patients per day, work fewer days per week, and make more $$$ (because of lower overhead)

 

[DrJeff]

Many "private" practices when compared to "corporate" practices also WON'T participate in nearly as many insurance plans(both higher reimbursing PPO/traditional fee for service plans AND lower reimbursing HMO style plans). As a result of this, many "private" practices won't see the same volume of patients as the "corporate" office, but have a comparable per patient/per hour yield.

Either scheme can make you a very comfortable living. Personally for me I prefer to reach my daily target production goal by seeing 8 to 12 patients a day at a higher reimbursement/fee level than reaching that same target daily production by seeing say 14 to 18 patients a day at a lower reimbursement/fee.

The other thing that I like about my partnership, is the profit generated in my office entirely stays and is distributed in my office, a portion of the profit that I work to earn in my office doesn't get kicked up to "corporate headquarters"

 

[Oculomotor]

1) Medical Physicians (MD/DO's) in Walmart and other discount megastores

http://www.quickhealth.com/ this first one is interesting

http://www.ama-assn.org/amednews/2008/02/25/bil10225.htm

2) Dentists (DDS/DMD's) in Sears

http://searsdental.com/

3) Optometrists (OD's) in Walmart, Sears

http://www.searsoptical.com/

http://walmartstores.com/HealthWellness/8021.aspx


The thing is, 70% of optometrists are in private practice, roughly 10% are in commercial practices. Primary care medicine and optometry are limited to basically non-surgical practice (for OD's glasses, contacts, medications, etc... for primary care medicine--medications more or less). Dentistry is much more immune to this because you guys have a "surgical" profession and it would be more costly to implement Dental centers in these settings (although Sears has done it now.) Dentists are one group of primary care providers (Optometry , General Dentistry, Family Medicine, General Podiatry) that have little to worry about in become too commercial (i.e Walmart, Costco, etc....).

I for one as a future primary eye doctor (optometrist) will never work in an environment like a commercial superstore----I would rather go into another career than do that. Some graduating students take the easy money ($115,000...or whatever) coming right out of school but fail to realize that professional respect is priceless.

Dentistry in my mind is on a wonderful island and a model of just how much a health profession that does not "go to medical school" can do. 👍 I admire you guys......

 

[Aceofspades]

We can debate all day about this, but reality will matter the most .... there will always be limited # of supply (dentists) that will never catch-up with the demand over the next 30 years or so.

The biggest graduating dental classes were between 1975 to 1985, about 5,300 graduate students on average (as oppose to the current 4,200 new grads). Those guys have started to retire, and their effect of the supply side have already started to show in many communities all over the country. This means, for every 4,200 new grads today, there are 5,200 retiring dentists (from class of 1978). Assuming this holds true, there will a net loss of 1,000 dentists every year until it levels off (maybe by the year 2020 - at the earliest).

Meanwhile, the demand will grow even bigger during that time (because supply dropped). The U.S. population is growing faster than the dental profession. Even if 10 more schools open during that time, it will not have much effect on the equation.

The moral of the story... dental chains can set-up as many offices as they want around the country, but who will work in these offices if the supply of dentists is in red? These corporations will not be able to expand for this reason alone (maybe after this period is over, which will not be anytime soon).

Dentistry as a market is run by dentists, not by corporations.

The ADA will approve a large number of new schools opening up, as well as accreditation of foreign schools. In addition, the emancipation of mid-levels such as dental hygienists to do dental procedures will be on the rise. Dentists may not operate in malls, but who's to say dental therapists won't?

With the stock market the way it is today, I think many old dentists will put their retirement on hold. Once your 401k and other retirement investments lose over 40% you tend to push retirement back a little. And while some may say that this economic situation we are in will be short-lived, many, including me, disagree.

There are many things that were once run by practitioners only to be taken over by corporations. Never underestimate corporate power in America. Where else can a bunch of failed businesses get a $700 million bailout? A corporation fails, the CEO gets a huge financial package and they get bailed out. A private dentist fails and he goes bankrupt and loses everything.

I won't even get started on a national health-care plan. It that involves dentistry, all bets are off.

 

[youngmc27]

I don't know about you guys but I was surprised to see that there is Searsdental what a waste of a lot fo hard work I went to school so I didn't have to work for Walmart or Sears.

 

[Daurang]

Aspen Dental is offering FREE exam and xrays...

http://www.aspendent.com/coupons.html

Are they desperate or prudent? Do they really expect to extract any money out of people who comes in for the freebies? Maybe I should visit them sometime to see how corporate dentistry works.

 

[KOM]

Aspen Dental is offering FREE exam and xrays...

http://www.aspendent.com/coupons.html

Are they desperate or prudent? Do they really expect to extract any money out of people who comes in for the freebies? Maybe I should visit them sometime to see how corporate dentistry works.

Sounds sketchy. Free for all patients at all locations?

 

[desert rat]

I know of several people that have sold their practices to Heartland Dental and work for them.

 

[mmb20]

Who knows what will happen in the future, especially with Obama and Democrats mandate to lessen the cost of health care.

 

[OceanDMD]

Who knows what will happen in the future, especially with Obama and Democrats mandate to lessen the cost of health care.

Watch out what you say about Obama around here.........

 

[Lopyswine]

Who knows what will happen in the future, especially with Obama and Democrats mandate to lessen the cost of health care.

you bumped a 4 month old thread to take a jab at our president?