The Future of Dentistry

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I don't have a lot knowledge specific to the business of dentistry; however, I thought it was telling that he was suggested that a traditional corporate structure was necessary for these "future" larger practice to be successful along with executive talent.

One thing that always drew me to dentistry was to be an "eagle" as he put it. I don't want a corporate structure hanging around my neck; it's too many mouths to feed. Hopefully he's incorrect in predicting the future as it would take away alot of autonomy that dentists enjoy today.

I also noted that built into this discussion was a lot of hard selling for the services of couching and accepting their vision of the future which; coincidentally, also falls in line with his predictions of the future.

EDIT: Finished the VID - I thought one key part was when he was discussing how the future of dentistry wont ever be like the past. Solo practices struggling now will continue to struggle and a new larger group practice is the solution. However, I think that a case could be that this is due to a rough economy - revenue is down because people have less discretionary spending - and not because solo practice is an obsolete model that must change.
 
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Want to watch something awkward? Watch the same speaker @ 6:10 and on. Gets into a little bit with a dentist in the crowd lol.
[YOUTUBE]http://www.youtube.com/watch?v=FkzcWks8Hnw&feature=endscreen&NR=1[/YOUTUBE]
 
persenmi said:
http://www.youtube.com/watch?v=Jul4os_7yA4

Thoughts?
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Let me tell you this, as a new graduate- IT IS COMING. This guy is ON THE BALL, he is right about just about everything. Corporate dentistry is coming and it is going to take over dentistry. I'm not saying it won't be good, but large managed group practices and corporate are going to take over everything.

Let me tell you why:
1. Females in dental school. Females are just as capable as doing everything a male can, but females, in general, don't want to own their own practice as much as males. They would prefer to raise a family and "work for someone else". They have every right to do this, but they will provide a large supply of workers for corporate offices and group practices.

2. Corporate structures can market 10 times more, get 10 times as many patients and garner a much larger market share.

3. They can vertically integrate- meaning they can make their own supplies, machines, equipment, temp companies, etc...Individuals or even group practices CANNOT compete on the same price scheme.

4. They have WAY WAY WAY more capital available than individuals, or even groups, can get access to. More money means more room for error, more room for marketing, more room for making the better offices, equipment, etc..Dentistry is one of the last bastions that hasn't been taken over by corporate- they know this and see this opportunity and are RIGHT NOW actively coming to take it over.

5. They can negotiate FAR better than an individual with insurance companies. the insurance companies can get BETTER FEE reimbursement than you, all along they are getting supplies for cheaper then you. How can you compete when they get more patients and make more money off of patients than you can?

You say, "he's just playing chicken little and he's scared of going into private practice".
You can say what you want, but step back and really look at the situation and then come back
 
Interesting: Do you believe there is a corporate structure to medicine? Given the choice between being a partner at a group practice vs a corporate pawn; it seems that a dentist driven group would be preferable if solo practice is becoming impossible. So, why have physicians not succumb to a corporate take over when the pressures are greater than they are in dentistry?
 
OMG the sky is falling! LOL paranoia and mass hysteria.. take a chill pill.
 
davaidavai1 said:
OMG the sky is falling! LOL paranoia and mass hysteria.. take a chill pill.
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I don't think he's so very far off the mark. The cost of dental school is very high now. If you can't open your own practice because you took out 350K-400K worth of debt, you very well may be pushed into corporate dentistry. Eventually this field will go the way of medicine, and when it does, don't expect to make more than, say, an optometrist.

That's not bad, but I feel like too many pre-dents have this silly impression that they are going to get rich by placing fillings. You had better actually want to work in other people's mouths.
 
It's all going to Corporate Dentistry or large group practices. I tried to get some people in my area think about doing a group practice long term and they resist that too. They just want to keep the status quo. Not sure if the large group practices will be multi-specialty or single specialist like medicine but the days of a solo practioner in the larger metro areas is almost gone.
 
DMDWANNABEE said:
I don't think he's so very far off the mark. The cost of dental school is very high now. If you can't open your own practice because you took out 350K-400K worth of debt, you very well may be pushed into corporate dentistry. Eventually this field will go the way of medicine, and when it does, don't expect to make more than, say, an optometrist.

That's not bad, but I feel like too many pre-dents have this silly impression that they are going to get rich by placing fillings. You had better actually want to work in other people's mouths.
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If you take out 400K worth of loans and assume you'll be running a practice after dental school, then I think you should wake up an smell the coffee. Majority of dental students only take out 200K in loans. A lot of people don't like to talk about the intimate details of their finances but they'll have financial help from their families. 200K worth of loans is nothing when you're earning 100K or more per year. You'll pay it off and still have enough to build a future life. I also don't think the scenario is as bleak as people make it out to be because at the end of the day its a business. There are obstacles but as a business owner your limitations are largely dependent on you. There are plenty of towns around America that offer the ability of a solo dentist to shine. Now would most dentists want to live there? Probably not. but then again the opportunities are there.

At the end of the day, negativity and pessimism turns into a vicious cycle. I'm sure there were plenty of times in our lives when someone told us we couldn't do something. And we proved them dead wrong, that's how I feel whenever I read these types of threads. Is corporate dentistry a threat? Perhaps. Will it definitely and without a doubt kill your dream of running a successful solo practice? Definitely not!
 
@Davai

The old-timer raises some good points though. It is difficult to trust him completely because he is selling a couching service. His whole presentation could be viewed as him creating a "need" for his services weather the risks he's talking about are real or not. I hope that PP solo will endure in the future; but, I guess you never know. Working for a "boss" sucks.
 
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6a00d83451960269e20148c7b9c944970c-800wi
 
yappy said:
@Davai

The old-timer raises some good points though. It is difficult to trust him completely because he is selling a couching service. His whole presentation could be viewed as him creating a "need" for his services weather the risks he's talking about are real or not. I hope that PP solo will endure in the future; but, I guess you never know. Working for a "boss" sucks.
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You were also saying how you see no sense in a large practice office and reading your post threads makes me feel like you don't even know if you want to be a dentist. So I apologize if I don't take you seriously 🙂
 
There are a lot of theories out there on this topic.

When I was graduating in 2010, a research professor from Harvard gave a lecture at our school on this issue. He told my class that in 2012, dentist population would contract, and the next 15 years, the total workforce of dentists would go down about 5%. Over the same period, this country will increase 15% in population. This supply issue will lead to higher income for dentists, and possible radical changes in the dental profession to compensate this problem; opening of more schools, mid-level practitioners, etc. We have already seen some of these proposed changes in our weekly dental publications, which are all being ignored by the average dentist. This is a bigger threat than large group based practices taking over the profession.

There is no mention of corporate threat in most publications that discuss the future of dentistry. Corporate dentistry today has 10-15% market share in the dentist workforce. This number may grow, but it will take a very long time (20-30 years minimum) to dwarf solo practitioners, with economic situations favoring corportations. Think about it, corporation growth depends on their own dentist workforce. Over 90% of dentists working for corporate dental office have the ability to leave their job any time and start a practice. Regardless of debt, this phenomenon alone is a huge bubble that can burst anytime, and luckily, the odds are currently with corporations to take advantage of the current economic problems that's scaring a lot of dentists from going solo. When and If the economy comes back strong, there is no financial benefit to work for anyone, let alone a corporation.

Again, the biggest challenge will be coming from the expansion of the dental workforce, by adding mid-level practitioners/therapists. When it does happen, it will shift power away from dentists, and more towards corporations.
 
lol. looks like he got banned. Most likely for saying inflammatory things.

davaidavai1 said:
You were also saying how you see no sense in a large practice office and reading your post threads makes me feel like you don't even know if you want to be a dentist. So I apologize if I don't take you seriously 🙂
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Thank you, Cold Front. It's interesting to hear different perspectives. In the presentation I thought that the speaker made an interesting observation about payers. He mentioned that since the 1980's the payer for dentistry has been shifting towards government and insurance and away from out of pocket. He mentioned that one of the implications of this is tougher negotiations from insurances to dentists which has resulted in some stagnating reimbursement and in some cases a decrease. The problem for solo practices, according to him, is that because lab fees, costs to retain good employees, etc. have increased they need to rethink their practice structure or delivery model. This was his rational for having a larger group practice all under one roof. He believed that it could optimize your practice and get a sort of 'economies of scale' going to drop your operating costs.

If we accept what the speaker is saying it seems that like medicine, dentistry is needing to reshape itself in order to stay ahead of the 8 ball (read: insurance). Perhaps mid-levels will also be apart of that equation as you pointed out.

EDIT: I thought this was an interesting read on a group practice that has outsourced their "business" work to a DMO and embraced the group practice concept. Looks like a pretty impressive operation:

http://www.dentaleconomics.com/arti...atures/the-dental-practice-of-the-future.html
 
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jay47 said:
Let me tell you this, as a new graduate- IT IS COMING. This guy is ON THE BALL, he is right about just about everything. Corporate dentistry is coming and it is going to take over dentistry. I'm not saying it won't be good, but large managed group practices and corporate are going to take over everything.
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No one is going to "take over" anything, Jay47. Please, overcome your Limiting Beliefs and re-draw your map of the world to a less fear-based one before you graduate. You owe it to yourself and to your colleagues.

Part of why is that we dentists hold all the cards. When a massive wave of Boomers retires, those who have been holding out since 2008 when the economuy tanked, the number of dentists in the U.S. will likely be inadequate to meet demand. Plus, patients who have not sought care will, unfortunately for them, have built up problems that will have to be addressed at the point they become physically or esthetically painful. On top of all that, dental insurance is dying back as many companies choose to cut that particular cost. We have, like many dentists, created our own in-house insurance plan which is wildly popular.

The result: if we treat people right and listen to our patients, we're all going to be busy.

I don't want to repeat my entire post over on Corporate versus Private Practice thread. It's 06-02-2012, 02:21 PM #16. But here is the main idea why corporate dentistry will remain a small part of the profession in America-

Yes, there is a "race to the bottom" on cost and corporations win there. See http://en.wikipedia.org/wiki/Bertrand_competition

The problem with racing to the bottom on cost is that someone else can always beat you. It's a race that you will lose, period. So- Don't enter it!

The fact is there is no better time to be a dentist. We have great tech and more than that, people have been beaten down by corporate treatment to the point where they (I should say "we") don't want to take it anymore. We've been treated, in our roles as consumer and as employee, as interchangeable, temporary and disposable on such a massive scale that we are rebelling.

Rebelling not with pitchforks and torches but with our precious Attention.

Well, many patients are going to ignore corporate dentistry. Because it only satisfies the one criterium- cost. It does not, cannot provide true human Connection, the Certainty and trust that a superb dental practice builds over time, or things like patiently executed treatment plans for hard-pressed families and detailed discussions of preventive strategies. They cannot make time or space for these things. That's the definition of a race to the bottom.

Dentists and students, friends and I have done it and it works- race to the top. If you race to the bottom, like corporate does, you're vulnerable because all you are is a commodity. If you race to the top, you're invulnerable.

Plus, you have to start looking at success differently. If you're a commodity, then success is defined simply as More, capital "M." That kind of success always wants to sell More. advertise More, cut costs More, treat employees and patients as interchangeable cogs More, as it tries to feed its insatiable appetite for More.

But here's a chilling thought- what if you make yourself into a commodity, and then you can't get More?

A character from a book I'm writing about all this looks at it differently. Here's a quote:

"Success isn't a number in a ledger. For me, the true definition of success is this: If you don't show up, people miss you. They miss you badly." -AStJS-G
 
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yappy said:
The problem for solo practices, according to him, is that because lab fees, costs to retain good employees, etc. have increased they need to rethink their practice structure or delivery model. This was his rational for having a larger group practice all under one roof.
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Many solo doctors like myself, are adapting to these high cost fees. If doctors are in the right niche and have the right business model, they can hire a lab tech and do their denture in-house. We also have accounts from some local doctors who need their dentures done locally, and at a competitive rate too. I started to do this few months ago, and I see it as another business within my dental office. So this is one example on controlling your variable cost.

This video of Gordon Christensen talks about good dental labs in China. I personally don't send my cases to China, but I know doctors who do, and they love the quality of work some of these labs do. The fees are about 50% cheaper than the labs here it at home. So this is another area where I disagree with Dr. Cooper on "Future of Dentistry". Corporations are doing everything in house, and send all their cases in China, doesn't mean solo practitioners can't afford to as well.

[YOUTUBE]http://www.youtube.com/watch?v=wGwCFPsGEHk[/YOUTUBE]

The fixed cost of paying office staff is far important than any other cost in my opinion. If you look at the grocery food industry, Costco has the highest paid employees, and as a result have the highest retention than any other store in the country. Corporate dentistry is doing the opposite, which leads to high turn over rates of doctors, managers, assistants, etc. If you meet most corporate dental employees, they will flat out tell you their jobs is not at the best dental setting they would love to work in and always feel burned out and under-paid. In solo practices, I'm a proponent that staff should be better compensated based on what they put into the company, not just a standard hourly salary and but also realistic incentives in place.
 
Cold Front said:
There are a lot of theories out there on this topic.

When I was graduating in 2010, a research professor from Harvard gave a lecture at our school on this issue. He told my class that in 2012, dentist population would contract, and the next 15 years, the total workforce of dentists would go down about 5%. Over the same period, this country will increase 15% in population. This supply issue will lead to higher income for dentists, and possible radical changes in the dental profession to compensate this problem; opening of more schools, mid-level practitioners, etc. We have already seen some of these proposed changes in our weekly dental publications, which are all being ignored by the average dentist. This is a bigger threat than large group based practices taking over the profession.

There is no mention of corporate threat in most publications that discuss the future of dentistry. Corporate dentistry today has 10-15% market share in the dentist workforce. This number may grow, but it will take a very long time (20-30 years minimum) to dwarf solo practitioners, with economic situations favoring corportations. Think about it, corporation growth depends on their own dentist workforce. Over 90% of dentists working for corporate dental office have the ability to leave their job any time and start a practice. Regardless of debt, this phenomenon alone is a huge bubble that can burst anytime, and luckily, the odds are currently with corporations to take advantage of the current economic problems that's scaring a lot of dentists from going solo. When and If the economy comes back strong, there is no financial benefit to work for anyone, let alone a corporation.

Again, the biggest challenge will be coming from the expansion of the dental workforce, by adding mid-level practitioners/therapists. When it does happen, it will shift power away from dentists, and more towards corporations.
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👍 Excellent post Cold Front! I hate the paranoia sky is falling type of people on this site who think they have a clue but really dont know what their talking about cough... yappy... cough... The point is that changes will occur as they always do, but it's not like solo dentistry will go away. And in many parts of the country it will thrive and remain as the go to source of dentistry.
 
I believe in paying employees 20% more than the going rate for the area and giving benefits. They don't look for other places to go and they work 100% harder because they know that others want their job. So 20% investment, 100% return.

I'm not sure how to get the group practice to work. There are too many egos. The staff hates the constant change from OS one day to General to Ortho. Every doctor hates the layout of the office because they can never get comfortable. They all want certain specific things that make them practice better. Does the staff stay at each location? Do they rotate with the doctor?
 
Firm said:
I'm not sure how to get the group practice to work. There are too many egos. The staff hates the constant change from OS one day to General to Ortho. Every doctor hates the layout of the office because they can never get comfortable. They all want certain specific things that make them practice better. Does the staff stay at each location? Do they rotate with the doctor?
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Why not have the kind of partnership where each practitioner has their own office and staff? If it's a GP/GP relationship it seems it would be ideal to have the office far enough apart not to poach on their immediate surrounding population, but with enough proximity to operate under, and collectively promote, their dental brand.
 
Ferneezy said:
Why not have the kind of partnership where each practitioner has their own office and staff? If it's a GP/GP relationship it seems it would be ideal to have the office far enough apart not to poach on their immediate surrounding population, but with enough proximity to operate under, and collectively promote, their dental brand.
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That's kind of my plan. I just have to find the right people and they have to accept. Everyone that I have approached does not want to admit that the days of the solo practitioner are ending. Even though year after year it gets harder and they make less money, I keep getting "I like what I'm doing. I'm just going to wait it out until the economy improves". Kind of like a frog slowly boiling in water. I'll keep asking though.
 
Firm said:
That's kind of my plan. I just have to find the right people and they have to accept. Everyone that I have approached does not want to admit that the days of the solo practitioner are ending. Even though year after year it gets harder and they make less money, I keep getting "I like what I'm doing. I'm just going to wait it out until the economy improves". Kind of like a frog slowly boiling in water. I'll keep asking though.
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Do you have anything to support this? ADA says the opposite on their GP income surveys year after year.

The problem usually lies with doctors not being knowledgeable about business aspects of dentistry, and not the idea of being "solo" itself.

For example; corporations add new offices all the time, and each new office usually has an independent and unique set of goals based on the market that it targets. This same office could have been a "solo" office, and could have done well too under the same business model.
 
Cold Front said:
Do you have anything to support this? ADA says the opposite on their GP income surveys year after year.

The problem usually lies with doctors not being knowledgeable about business aspects of dentistry, and not the idea of being "solo" itself.

For example; corporations add new offices all the time, and each new office usually has an independent and unique set of goals based on the market that it targets. This same office could have been a "solo" office, and could have done well too under the same business model.
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Most of those projections have a final year of 2009. Most of the GP's that I know say that they are down from 5 years ago. I live in a large city. Solo practitioners are doing fine in rural areas. In the larger metro areas more chain corporations and dentists move into the area than proportional amount of people. It becomes harder to fill your schedule every year.
 
I may be way off base as I'm not in the know like you guys are; but, I cannot help but suggest that maybe the economy does have a lot to do with difficulties that dentists are facing as solo practitioners rather than the business model itself.

a slide in the past few years would be reasonable considering higher unemployment and people having less income. Consumers don't have a lot of confidence in any sector of the economy except possibly cell phone plans & internet/cable tv bundles - people would rather be evicted than give those up.
 
We started with Permission Marketing well before 2008. When the economy tanked then, we never really got slow. Talking to one person at a time, with permission and respect, builds out like a megaphone. Referrals abound. Traditional advertising funnels were the processs that stopped working, even more than they already had. People who relied on them in niche, "cosmetic" practices suffered most. (I don't like the term "cosmetic dentist." Everything we do, all the time, should be as cosmetic as possible given the current technology and the financial restrictions that the patient may have. Why wouldn't everything always be maximally cosmetic?)

http://en.wikipedia.org/wiki/Permission_marketing

What prevents growth, I've found, is what I call the Four Horsemen of the Dental Practice Apocalypse. (Anyone read Malcolm Gladwell's Blink?) They are:

-Patients who move away.

-Patients who die. Preferably not in the chair. (Little gallows humor there but most of us in practice really miss these people. The ones we know a long time get to be like family.)

-Patients who leave for administrative reasons. "My insurance changed and I 'can't' see you anymore." "Your hygienist scrapes my gums too hard." "I don't like you payment policies." (These should all be screamed in the voice Jerry Lewis used when he yelled "Laaaaady!")

http://http://www.youtube.com/watch?v=nROMRVUhXuY

-Patients who get so healthy that they hardly need us. This is the good one! No perio, ortho in retention, no caries or endo. This is the GOAL.

If a dental practice can bring in more patients than it loses through these mechanisms, and exams are comprehensive and diagnoses are thorough, it will be doing fine.

Many of our patients become quite healthy, which again is the goal. We ASK about esthetics. If they are happy, we don't push them into anything, even though they may not be ideal by our standards.

I want to float the idea of WHY it's not imperative to push veneers and such things on people. There are only three kinds of dental patients in the entire world, if we look at them from one aspect.
-There are patients who are in active orthodontics.
-There are patients who are wearing their retainers.
-There are patients who are crowding more and more by the month. Their teeth march towards the front and slide past each other, and the buccal segments move lingually/palatally in most people.

Thus, I suggest that dentists learn Invisalign to a high level and don't overuse it, but employ it to unwind the crowding that all your patients are experiencing all the time. And then retain them, comfortably. In fact, make the whole orthodontic conversation start and end with retainers. Refer every case that's too complex to your orthodontist colleagues. Once you realize the magnitude of this problem, you and your orthodontists will all be extremely busy.

And yes, not nearly all patients will do this at first. Many never will at all. But those ugly, crowded lower anteriors that make perio maintenance difficult and fracture the maxillary incisors in random places along the incisal edge are going to bother most people eventually. Educate and be patient.

And by the way, I'm astonished by the number of lecturers who veneer or otherwise restore the maxillary incisors and leave a crowded mess below, to wreak havoc with the porcelain in the fullness of time.

And then, as if all that wasn't enough to keep you busy, there's always the effects of deferred maintenance. Your patients who didn't come in for a long time will suddenly realize one day that dental problems do not ever improve with time.

Regrettably, they always worsen. They only worsen.

Get ready to be very busy as they all come back. Just make sure to be there for them, and if they can't afford everything at once, don't act like a damn corporation. Have a little heart, cut them a break here and there or figure out a creative financial solution and they will never want to go anywhere else but to you.
 
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OMGGGGGGGG its the end LoL get a grip people
 
I watched 5 min in. I came back here to argue against Dr. Coooper's points, but you guys already did it. 😀
One thing that is not talked about here is that private practices usually do not adapt to new changes. At least in my opinions.

No real visible sign outside. same old brochure from many years go. no changes in an reception area (not even moving furniture around) same old boring frames and pictures on the wall. No message while being on hold, no reminder for appointment thru text messages, etc.
Each one doesn't cost more than $500.

I will be like go up to a random person in the grocery store or something. hey i will give you a free exam and $50 to come into my office. give me some feedback on the office and staff. like a secret shopper

people just blame for economy (which is a major reason) but at the same time, practices need to adapt to new technology, system and ever changing market.

I wanna point out Sears, bestbuy and Sony for examples. 6-10 years ago, the companies with brightest future.
And look at Amazon, Whole Food Market, Chipolte, Wendy's, Pepsi-Co etc. They all grew tremendously.

I think that a dentist should have a mindset of a CEO of a Fortune 500 company. Of course you have to provide excellent care, care for patients, be honest, have good staff. But isn't that most dentists try to do anyway?
 
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TheClutch said:
I watched 5 min in. I came back here to argue against Dr. Coooper's points, but you guys already did it. 😀
One thing that is not talked about here is that private practices usually do not adapt to new changes. At least in my opinions.

No real visible sign outside. same old brochure from many years go. no changes in an reception area (not even moving furniture around) same old boring frames and pictures on the wall. No message while being on hold, no reminder for appointment thru text messages, etc.
Each one doesn't cost more than $500.

I will be like go up to a random person in the grocery store or something. hey i will give you a free exam and $50 to come into my office. give me some feedback on the office and staff. like a secret shopper

people just blame for economy (which is a major reason) but at the same time, practices need to adapt to new technology, system and ever changing market.

I wanna point out Sears, bestbuy and Sony for examples. 6-10 years ago, the companies with brightest future.
And look at Amazon, Whole Food Market, Chipolte, Wendy's, Pepsi-Co etc. They all grew tremendously.

I think that a dentist should have a mindset of a CEO of a Fortune 500 company. Of course you have to provide excellent care, care for patients, be honest, have good staff. But isn't that most dentists try to do anyway?
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I have always considered the "secret shopper" idea as well. I like the idea of having feedback... a lot. Hell, I have even considered telling my staff that there will be x number of secret shoppers in the next few months even if there are none so that they stay on there job lol. 😀
 
Bereno said:
I have always considered the "secret shopper" idea as well. I like the idea of having feedback... a lot. Hell, I have even considered telling my staff that there will be x number of secret shoppers in the next few months even if there are none so that they stay on there job lol. 😀
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lol sneaky sneaky señor.


Although telling your staff that you will have people randomly check up on them might leave some hard feelings behind.
 
hellopeople said:
lol sneaky sneaky señor.


Although telling your staff that you will have people randomly check up on them might leave some hard feelings behind.
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Haha, yeah, that is why I am considering it, not flat out doing it. 😀
 
You do realize that "Wellness Hour" is an advertisement, right?

He will say whatever he thinks will drum up customers.
 
Snazzy bill, but what does it really mean

How can you prove dental chains with dentists in them aren't taking care of the patients best interest.

I am sorry, but the bill won't block dental chains. Infact, I doubt it will even affect them.

I mean corporate optos and hospitals have share holders as well. They seem to have no trouble getting around these kinds of laws. These laws are also silly, and we should let the market self regulate. I think corporate is coming, but I believe "coldfront" is a member we should all look at. He worked in a chain, he saw how it ran, and he went opened his own practice and improved on the product. This is what countless pharmacies, optometry clinics, and other small business owners do all the time. We are not immune simply because we are "dental". The market changes, and we change with it.
 
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Well, yeah, theleatherwalle, the best way to counter a negative ideavirus is to spread a better, more compelling one, not to legislate or litigate. Those strategies don't sustain as well as a better ideavirus does.

I mostly just wanted a chance to quote Bakan and riff on his stuff, it's amazing. We humans created corporations, and most of us have no idea how they work. It's scary, when you open them up and look inside.

What will affect corporate dentistry is this, from Seth Godin's Linchpin. I've quoted more of it in this forum before. Look out for his new book, The Icarus Deception, later in the year. It should be very interesting.

Here's an excerpt from Linchpin-


We can't profitably get more average.

We can't get more homogenized, more obedient, or cheaper. We can't get faster, either.

We've gone against our true nature and corporatized, anonymized, and dehumanized as many of our systems as we possibly can. Even health care is a system now, not a human interaction. We could probably go even further, actually, but I'm betting it won't be a fun or profitable journey.

If all mortgages are the same, of course they can be chopped up and remixed and resold. But that means all bankers and all homes are the same, and so are all homeowners. Which means the cheap ones or the profitable ones are all that matter.

If all online products at all online stores are the same, then of course I'll use a price-shopping Website to find the cheapest product.

If all employees are nothing but a résumé, and résumés can be scanned, then why are we surprised that our computers end up finding us anonymous average people to fill our anonymous average jobs?

If every restaurant on the highway will give me precisely the same cheery service from the same robotic staff, at the same prices, then why does it matter where I stop?

Do we need to be flatter and smaller?

It's our desire to be treated like individuals that will end this cycle. Our passion for contribution and possibility, the passion we've drowned out in school and in the corporate world—that's the only way out.

Every successful organization is built around people. Humans who do art. People who interact with other people. Men and women who don't merely shuffle money, but interact, give gifts, and connect.

All these interactions are art. Art isn't only a painting; it's anything that changes someone for the better, any nonanonymous interaction that leads to a human (not simply a commercial) conclusion.
 
What are you explaining is good but can you provide more detailed information which will be more offended to us.
 
stevepearls said:
What are you explaining is good but can you provide more detailed information which will be more offended to us.
Click to expand...

Sure... Not sure what you mean by 'more offended to us' tho...

Are you guys up for a long detailed post on specific tacitcs? It's no trouble, I can copy and paste from what I've already written about Permission Marketing in dentistry. Let me know.

Also do you want it here or as a separate discussion.
 
you know i kind of want the opinion of a few dentists here.

Would you suggest going solo in private practice or opening up a group practice with other colleagues from your dental school who you feel comfortable with.

I figure a large practice of three to four dentists would be much more competitive against a large chain.
 
anyone telling you about future of dentistry is full of crap! there is no way to predict. Dentistry is changing but there is no way in hell to say with certainty what will happen!
 
PaulS said:
anyone telling you about future of dentistry is full of crap! there is no way to predict. Dentistry is changing but there is no way in hell to say with certainty what will happen!
Click to expand...
Nothing in life is certain.

The known knowns:

1. Student loans will continue to increase.
2. Insurance reimbursements will be behind inflation.
3. Starting salary for new dentists will mostly be stagnant for the first 2-4 years out school as an associate, if not longer.
4. The cost of opening a practice will continue to rise, as a space in real estate market continues to become more expensive (for good locations), with less incentives from landlords.
5. Corporate dentistry reach and share in the dental workforce will continue to grow, and not be a welcoming news for the profession as a whole.

The known unknowns:

1. Midlevel providers could become more widespread, as access becomes more of an issue in rural areas.
2. Obamacare could be the lion share of patients looking for dental services in the future, which would create more demand for lower socioeconomic type of dentistry.
3. Technology in dentistry is evolving, could have big impact on helping dentists with better diagnostics, marketing and even do more specialty services (like waveOne did in endo).
4. There are talks of creating 1 national regional license (combining NERB, WREB, even for Florida).
5. Dental suppliers and services are becoming more centralized and web based, which will make the future of local reps bleaker. No more meeting other humans trying to sell you a dental product in offices.

The Unknown Unkowns:

1. Dental income will plateau and/or decline relative to student debt, leading to less applicants for dental school (like law schools).
2. Pediatric dentistry in the long term might slow down in many communities who will have fewer children. The demand for geriatric dentistry might be the new pedo for many communities.
3. As income inequality continues to grow across the country, we will see new trend of dental services catered to the wealthy, future of dentistry may become more zipcode based than today.
4. The ADA may be challenged by certain forces in the future to be less regulated. We could see the profession become like pharmacy.
5. Dentist may work longer hours, 50+ Hours, to make ends meet if they won't make enough to save and retire (millennials?).

All these points, some or all, will be discussed among dentist/ over the course of their careers.
 
Cold Front said:
Nothing in life is certain.

The known knowns:

1. Student loans will continue to increase.
2. Insurance reimbursements will be behind inflation.
3. Starting salary for new dentists will mostly be stagnant for the first 2-4 years out school as an associate, if not longer.
4. The cost of opening a practice will continue to rise, as a space in real estate market continues to become more expensive (for good locations), with less incentives from landlords.
5. Corporate dentistry reach and share in the dental workforce will continue to grow, and not be a welcoming news for the profession as a whole.

The known unknowns:

1. Midlevel providers could become more widespread, as access becomes more of an issue in rural areas.
2. Obamacare could be the lion share of patients looking for dental services in the future, which would create more demand for lower socioeconomic type of dentistry.
3. Technology in dentistry is evolving, could have big impact on helping dentists with better diagnostics, marketing and even do more specialty services (like waveOne did in endo).
4. There are talks of creating 1 national regional license (combining NERB, WREB, even for Florida).
5. Dental suppliers and services are becoming more centralized and web based, which will make the future of local reps bleaker. No more meeting other humans trying to sell you a dental product in offices.

The Unknown Unkowns:

1. Dental income will plateau and/or decline relative to student debt, leading to less applicants for dental school (like law schools).
2. Pediatric dentistry in the long term might slow down in many communities who will have fewer children. The demand for geriatric dentistry might be the new pedo for many communities.
3. As income inequality continues to grow across the country, we will see new trend of dental services catered to the wealthy, future of dentistry may become more zipcode based than today.
4. The ADA may be challenged by certain forces in the future to be less regulated. We could see the profession become like pharmacy.
5. Dentist may work longer hours, 50+ Hours, to make ends meet if they won't make enough to save and retire (millennials?).

All these points, some or all, will be discussed among dentist/ over the course of their careers.
Click to expand...

In regards to insurance reimbursements, do you think this will be more of an issue for GP's or specialist, or will it affect both equally?


Sent from my iPhone using SDN mobile
 
wengerout said:
In regards to insurance reimbursements, do you think this will be more of an issue for GP's or specialist, or will it affect both equally?


Sent from my iPhone using SDN mobile
Click to expand...
I think both. Insurances have bottom lines, and they will push everyone to squeeze profits for their shareholders.
 
people said the same thing 20 years ago haha dentistry is always been changing and let me tell you one thing! being a doctor in a first world country is a very good financial decision and you will never ever starve in your life. you might not get rich but will never struggle to pay bills!
 
I can offer some real world experiences. I'm an Orthodontist and I have been in practice for the last 26 years. I graduated with less than $50,000 in student loans. Bought my 1st practice ($375,000) right after I graduated. Things were SO GOOD that I started and built 2 more practices from SCRATCH. One was a building that I bought and with furnishings, equipment, build out, etc etc .... the cost was around 1 million dollars. Life was good. Vacation Florida beach home. Fancy cars. My revenue was RISING every year. I seriously thought the sky was the limit. Every year would be better than the last year. Can't wait to see the new 911 Turbo. (had 3 of these btw).

Then something happened. 2008. Recession. The life I was used to ..... changed. Numerous new patients weren't walking through my doors anymore. I felt like I was competing with every general dentist that offered Invisalign. New patient starts were declining and have been declining for the past 8-10 years. I currently make 1/3 to 1/2 of what I used to make. Still a very good living.

Currently I've decided that the headaches of private practice just isn't worth it. Currently I work 3 days at a Corp Dent and Ortho company and 3 days at my 2 offices. That's right. 6 days a week at age 55. I didn't need the money, but something new and different. The 2 private offices are presently up for sale. BTW: the corporate office sees more new patients in a day than I see in a week at my private practices.

Future of Dentistry? Being optimistic ....dentistry as a whole will IMPROVE as the economy moves out of it's slow recovery.
One thing is for sure. Prior to 2008 ..... dentistry (Ortho) was sublime. I truly miss those years.
 
This is such a depressing thread. I almost wish I hadn't come across it.
 
Kurk said:
This is such a depressing thread. I almost wish I hadn't come across it.
Click to expand...

2TH MVR is still doing as well financially as he used to do. He just happened to change the way he practiced. Still ok.
 
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