Typical corporate offers for a new graduate?

[soxinabox90]

As I'm starting to approach the halfway mark through dental school I've started to get curious about what kind of offers a new graduate can expect if one chose to go the corporate route including salary, bonuses, benefits, etc. I'm also wondering if anything about the individual's experiences and skills can influence those offers. Essentially I am trying to avoid bad eggs and steer towards a rewarding (emotionally and financially) first few years in the real world of dentistry.

Does anyone have a breakdown of what each DSO might offer for a new graduate and what that offer might turn into 2-3 years down the road?

1. Heartland Dental - More than 750 practices
2. Aspen Dental – More than 600 practices
3. Pacific Dental Services – More than 500 practices
4. Smile Brands – 350 practices
5. American Dental Partners – 285 practices
6. Great Expressions Dental Centers – More than 280 practices
7. Dental Care Alliance – More than 260 practices
8. Affordable Dentures & Implants – More than 220 practices
9. Western Dental – More than 220 practices
10. InterDent – 200 practices

On the flip side, if someone was willing to live anywhere in the country, how would they go about finding a good fit for an associateship in a private practice?

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[ysrebob]

First year or two out is school of hard knocks no matter how you do it. More than maxing your pay, you need to find a job that won’t put you in an impossible situation while you get your feet under you w pt care. Some of the corps on your list above are well-known to be exploitative workplaces for the new dentist (impossibly tight schedules for a new dentist - 45min for molar RCT, ready go - or shady treatment planning). Some of them are very solid places to work.

Nobody is going to spell out who’s who in a public forum because that’s borderline libel and all these businesses have capable lawyers I’m sure.

You might try posting on DT when you get close to graduating/have some offers, and solicit pmail advice from working dentists who kind of know the score in their local area at least.

Nothing at all wrong with working in corporate, but not all corp workplaces are viable and salary is only a small part of that.

 

[yappy]

Nobody is going to spell out who’s who in a public forum because that’s borderline libel and all these businesses have capable lawyers I’m sure.

If true that is frightening and speaks volumes about those businesses.

This will not be a popular opinion, however; I would try landing somewhere that accepts the least amount of medicaid possible (unless you choose to work for a public clinic). The reason I suggest this is because medicaid pays very little which means their business model will be based on volume. Volume often means substandard care. Treatment plans tend to be limited as any elective treatment, or treatment that requires a copay, will be declined. Treatment plans for things that medicaid does cover tend to be aggressive. Therefore, working for a high volume practice with questionable ethics is probably the worst way to start your career. When interviewing, or approaching a practice / DSO, ask about their payer mix.

EDIT: 100-130k / year or 25-30% collection.

 

[AppalachianDentalBoy]

This will not be a popular opinion, .

Pre-dental here but why would this be an unpopular opinion?

I thought it was common knowledge that those clinics are run like mills and force high production quotas on the dentists leading to lower quality, faster work. The less the insurance pays the more patients you have to have in the chair to maintain the same revenue. Also it has been the experience in my boss's office that medicaid clients are less appreciative of the work and are less likely to take care of their mouths.

 

[yappy]

Pre-dental here but why would this be an unpopular opinion?

I thought it was common knowledge that those clinics are run like mills and force high production quotas on the dentists leading to lower quality, faster work. The less the insurance pays the more patients you have to have in the chair to maintain the same revenue. Also it has been the experience in my boss's office that medicaid clients are less appreciative of the work and are less likely to take care of their mouths.

It is unpopular to state that you do not want to accept medicaid or work in a medicaid practice. I certainly wouldn't advertise that or try to win over the general public with it. It's bad optics. Though, for the reasons you and I stated it is understandable because of the hard practice environment.
OP is interested in a rewarding practice environment so I suggest a job with a good payer mix that allows for comprehensive treatment at a reasonable pace.

 

[soxinabox90]

First year or two out is school of hard knocks no matter how you do it. More than maxing your pay, you need to find a job that won’t put you in an impossible situation while you get your feet under you w pt care. Some of the corps on your list above are well-known to be exploitative workplaces for the new dentist (impossibly tight schedules for a new dentist - 45min for molar RCT, ready go - or shady treatment planning). Some of them are very solid places to work.

Nobody is going to spell out who’s who in a public forum because that’s borderline libel and all these businesses have capable lawyers I’m sure.

You might try posting on DT when you get close to graduating/have some offers, and solicit pmail advice from working dentists who kind of know the score in their local area at least.

Nothing at all wrong with working in corporate, but not all corp workplaces are viable and salary is only a small part of that.

This is exactly the kind of work environment that I want to avoid. I'll try asking for opinions in a more private way.

I guess if anyone has any input on the topic that they don't feel comfortable posting here then I would appreciate a private message

 

[charlestweed]

You’ll learn more when you work in a busy office. Working with high patient volume forces you to teach yourself to do things faster and better…you learn to multitask, you learn to improve your chair time management skill, you focus more on patient treatments and talk less…and working with limited supplies forces you to learn how to improvise. If you are too picky about what type of patients you want to treat and what type of patients you don’t want to treat, then you won’t have as many patients as the dentists who are not picky. Your job options will be limited and you will be stuck with some low paying jobs at some slow pace private offices. The more cases you treat and the more complications you have to deal with, the more you’ll learn and the more competent dentist you will become. And being a competent dentist helps you find good paying jobs.

Treating high volume and doing everything fast don’t necessarily mean low quality treatments. Not all dentists are created equal. That’s why there are managing dentists and there are slower associate dentists who work at the same corp office. The reason some dentists earn the managing dentist title is they are able to do everything fast, have fewer redos and get fewer complaints from patients. The managing dentists usually work harder (because the higher the production, the higher they’ll get paid) and they never complain about things like: overbooking, medicaid patients, incompetent staff, lack of supplies, late and weekend hours etc….they just work, work, work. The slower associate dentists, on the other hand, don’t get to do a lot of complicated procedures because they can’t handle them, commit too many clinical errors (and the managing dentists have to help bailing them out), and take way too long to complete those procedures.

If I were a practice owner, who is looking for an associate, I would want to hire a dentist who is hard working, low maintenance, fast, not bossy to my staff, willing to work long hours and on weekends, willing to treat all kinds of patients (and not just the ones with good insurances), and able to work with instruments and supplies that are provided for him/her etc.

 

[Cold Front]

As I'm starting to approach the halfway mark through dental school I've started to get curious about what kind of offers a new graduate can expect if one chose to go the corporate route including salary, bonuses, benefits, etc. I'm also wondering if anything about the individual's experiences and skills can influence those offers. Essentially I am trying to avoid bad eggs and steer towards a rewarding (emotionally and financially) first few years in the real world of dentistry.

Does anyone have a breakdown of what each DSO might offer for a new graduate and what that offer might turn into 2-3 years down the road?

1. Heartland Dental - More than 750 practices
2. Aspen Dental – More than 600 practices
3. Pacific Dental Services – More than 500 practices
4. Smile Brands – 350 practices
5. American Dental Partners – 285 practices
6. Great Expressions Dental Centers – More than 280 practices
7. Dental Care Alliance – More than 260 practices
8. Affordable Dentures & Implants – More than 220 practices
9. Western Dental – More than 220 practices
10. InterDent – 200 practices

On the flip side, if someone was willing to live anywhere in the country, how would they go about finding a good fit for an associateship in a private practice?

Heartland has about 900 offices now, Aspen more than 700, etc. The last time I checked, Aspen opens a new office every 5 days and roughly hires 1 in 10 of all new grads each year (just Aspen alone). A good associate position in private practice is becoming hard to find as corporations are heavily marketing to new grads with higher starting salaries, better benefits, even student loan repayments than 95% of private practices offices would offer. Corporations are re-engineering every year how they can steer associates from private offices. It happened to me. I recently lost an associate to a corporate office. This particular associate has been getting daily calls, texts, emails and even social media messages from corporate recruiters, and it will only get worse in the future. There is now agencies of middle-men that help corporate dental offices look for a dentist. The best place to find a private office today is where there are no corporate dental offices. In other words, in rural areas, as suburbs and metro areas are already saturated with large group practices and corporations.

I think corporate dentistry today is where CVS Pharmacy was in the 1980’s, with about 1,000 stores. Today, CVS pharmacy is within 3 miles of 70% of the US population. It took CVS to buy other competition to expand and get to that level. Corporate dentistry knows that it will start to merge or buy each other eventually to expand faster and have a larger presence in the dental workforce and services. Just the other week, Western Dental bought 60+ other offices from another large group in Texas, which lead to about 25% instant growth in locations for Western Dental. In the long term, private practices will be losing and more new grads will be entering the workforce like pharmacy students. It’s a mathematical game; high student loans, more financially desperate new grads, more corporations that will entice new grads with debt relief options, and more Starbucks drive-thru style work schedule for those new grads to boost the corporations bottom line. It’s the reality that practicing dentists too busy to understand, and future grads are too naive to know.

 

[soxinabox90]

Heartland has about 900 offices now, Aspen more than 700, etc. The last time I checked, Aspen opens a new office every 5 days and roughly hires 1 in 10 of all new grads each year (just Aspen alone). A good associate position in private practice is becoming hard to find as corporations are heavily marketing to new grads with higher starting salaries, better benefits, even student loan repayments than 95% of private practices offices would offer. Corporations are re-engineering every year how they can steer associates from private offices. It happened to me. I recently lost an associate to a corporate office. This particular associate has been getting daily calls, texts, emails and even social media messages from corporate recruiters, and it will only get worse in the future. There is now agencies of middle-men that help corporate dental offices look for a dentist. The best place to find a private office today is where there are no corporate dental offices. In other words, in rural areas, as suburbs and metro areas are already saturated with large group practices and corporations.

I think corporate dentistry today is where CVS Pharmacy was in the 1980’s, with about 1,000 stores. Today, CVS pharmacy is within 3 miles of 70% of the US population. It took CVS to buy other competition to expand and get to that level. Corporate dentistry knows that it will start to merge or buy each other eventually to expand faster and have a larger presence in the dental workforce and services. Just the other week, Western Dental bought 60+ other offices from another large group in Texas, which lead to about 25% instant growth in locations for Western Dental. In the long term, private practices will be losing and more new grads will be entering the workforce like pharmacy students. It’s a mathematical game; high student loans, more financially desperate new grads, more corporations that will entice new grads with debt relief options, and more Starbucks drive-thru style work schedule for those new grads to boost the corporations bottom line. It’s the reality that practicing dentists too busy to understand, and future grads are too naive to know.

Well that's the most sobering thing I've read this week. One of the major reasons I got into dentistry was to own and work in my own practice. How many more years until you think purchasing a private practice won't be a viable/good option vs. working for a corporate?

 

[ysrebob]

A well-run small fee for serivice private practice can definitely compete against corps in the *current* environment; I don’t have any fear there. I can deliver a more personal level of service thus enjoy far greater patient loyalty, and my overhead is lower than theirs on every cost line except supplies/labs so I can compete head to head on price. In the short term, this ocean of private equity money pouring into our industry has even benefitted owners of traditional private practices in some ways, most obviously by inflating the value of their offices in a sale.

Coldfront is 100% right, though, that in the longer term the writing is on the wall for private practice. I don’t expect to be able to sell my office for any significant amount upon retirement, and recognize that I could be put out of business much sooner than that.

IMO small private offices will continue to be viable until either of two things happen:

1. Proliferation of EPO insurance plans. This could happen quickly and will badly damage small FFS offices like mine. Independent insurance-friendly offices could find themselves left out too. It is our future, I just don’t know how soon. There will still be a niche for FFS, but it will be a far smaller one and only the fittest will survive.

2. Proliferation of midlevel providers. Widespread availability of midlevels would make the economics of the small practice model completely untenable; corps will win this game. I suspect this too is our future, but it will happen slowly as it takes time for state regulations to change, degree programs to be created, and “dental therapists” to be trained.

Meanwhile, try to make hay while the sun shines.

 

[Cold Front]

Well that's the most sobering thing I've read this week. One of the major reasons I got into dentistry was to own and work in my own practice. How many more years until you think purchasing a private practice won't be a viable/good option vs. working for a corporate?

I was in your exact same shoes 10 years ago as a dental student, pondering what the real world dentistry potential would be like after I graduate. I really didn’t find anyone who really understood the long term outlook for private practice dentistry. Every practicing dentist I met was just too concerned in his/her bubble, and there were no publications that discussed the future realistic path of a career in dentistry - other than the few “there will be a shortage of dentists” or “technology will change almost everything in a dental office” or “the outlook is really good with a growing middle class”, and I researched a lot then, and almost all of those things didn’t happen since. What wasn’t discussed back then was the future of rising cost of dental education, the growth of corporations and their impact on the profession, the dental insurance game hurting private practices, the new direct to patient services (like Smiles Direct Club or Quip), the macroeconomics forces outside dentistry (society’s changing attitude towards oral health - and the role YouTube, Google and social media are becoming more of educational tools for the public) and so on. So a lot has changed in 10 years, and no one I met or a publication I read discussed the factors I mentioned above, to at least a level of the big issues they have become today. The world is evolving for better and worse, and dentistry too has evolved towards a Pac-Man like direction from a business point of view. Historically, all private practices use to exchange hands from retiring dentists to young dentists, and the process would repeat again in 2-4 decades. Today, most retiring dentists are being approached by corporate dentists to buy their practices with offers they can’t refuse (a Don Corleane offer so to speak), and leaves fewer options for younger grads who are looking to buy a private practice.

Is private practice still viable today? Yes. Will we see more consolidation and fewer private practices in the future? Absolutely. Can a new grad with a vision and pursue it with vigor become a successful private practice owner today? You bet. Will that be the case for majority of new grads? Don’t count on it.

 

[Cthuluhoop]

I would recommend doing what I was recommended to do on DentalTown and create a free account on glassdoor.com and do a search in areas you're interested in practicing post-graduation.
It was quite sobering to see the area I would like to practice (in Florida, but not South Florida), requiring at least 2 years of experience and the salary was between $120-$130k at the big name corporate offices.

 

[desertrat12]

Heartland has about 900 offices now, Aspen more than 700, etc. The last time I checked, Aspen opens a new office every 5 days and roughly hires 1 in 10 of all new grads each year (just Aspen alone). A good associate position in private practice is becoming hard to find as corporations are heavily marketing to new grads with higher starting salaries, better benefits, even student loan repayments than 95% of private practices offices would offer. Corporations are re-engineering every year how they can steer associates from private offices. It happened to me. I recently lost an associate to a corporate office. This particular associate has been getting daily calls, texts, emails and even social media messages from corporate recruiters, and it will only get worse in the future. There is now agencies of middle-men that help corporate dental offices look for a dentist. The best place to find a private office today is where there are no corporate dental offices. In other words, in rural areas, as suburbs and metro areas are already saturated with large group practices and corporations.

I think corporate dentistry today is where CVS Pharmacy was in the 1980’s, with about 1,000 stores. Today, CVS pharmacy is within 3 miles of 70% of the US population. It took CVS to buy other competition to expand and get to that level. Corporate dentistry knows that it will start to merge or buy each other eventually to expand faster and have a larger presence in the dental workforce and services. Just the other week, Western Dental bought 60+ other offices from another large group in Texas, which lead to about 25% instant growth in locations for Western Dental. In the long term, private practices will be losing and more new grads will be entering the workforce like pharmacy students. It’s a mathematical game; high student loans, more financially desperate new grads, more corporations that will entice new grads with debt relief options, and more Starbucks drive-thru style work schedule for those new grads to boost the corporations bottom line. It’s the reality that practicing dentists too busy to understand, and future grads are too naive to know.

Love reading this. Don’t necessarily love the reality, but love hearing how things really are. Seems like this kind of info is only found in forums (at least from my own research into the subject). Not sure why it isn’t more mainstream. When looked at objectively it become pretty obvious what is happening. It’s a strange experience beinbfg a student right now. D school faculty tells you one thing, your dentist down the street tells you another, and reality shows you something different.

 

[2TH MVR]

As a predent or dental student .... you haven't been around long enough to see the changes. When I started practicing (early 90's) there were only a few small Corp entities and I remember most of us dentists used to laugh at them. We figured they were doomed. We were wrong. The Corps have definitely impacted how dentistry is now delivered. They have grown so much in just the last 18 years. If you extrapolate their potential growth ... well .... lets just say that the private practice model is going to be a challenge. Especially in the saturated, urban areas.

But now a different issue is brewing. The Corps are competing with each other now. I see it in the Corp office I work at. Ortho new starts are down due to Corp offices everywhere. Like all big business ... the little Corps will be bought out by the larger Corps.

Like a poster said .... best place to open a practice is where Corps do not want to be.

 

[TanMan]

If true that is frightening and speaks volumes about those businesses.

This will not be a popular opinion, however; I would try landing somewhere that accepts the least amount of medicaid possible (unless you choose to work for a public clinic). The reason I suggest this is because medicaid pays very little which means their business model will be based on volume. Volume often means substandard care. Treatment plans tend to be limited as any elective treatment, or treatment that requires a copay, will be declined. Treatment plans for things that medicaid does cover tend to be aggressive. Therefore, working for a high volume practice with questionable ethics is probably the worst way to start your career. When interviewing, or approaching a practice / DSO, ask about their payer mix.

EDIT: 100-130k / year or 25-30% collection.

I would tend to disagree. Work for Medicaid mills, make lots of money, build your speed and go asap. See it as your practice to making money and speeding up to real world speeds.

It is unpopular to state that you do not want to accept medicaid or work in a medicaid practice. I certainly wouldn't advertise that or try to win over the general public with it. It's bad optics. Though, for the reasons you and I stated it is understandable because of the hard practice environment.
OP is interested in a rewarding practice environment so I suggest a job with a good payer mix that allows for comprehensive treatment at a reasonable pace.

You may be surprised... I find that advertising that you're not a Medicaid mill actually brings in lots of quality patients who don't want to be lumped in with Medicaid patients. I know it's quite elitist, but branding those Medicaid competitors as Medicaid mills tends to work towards your own brand differentiation.

 

[charlestweed]

Today, most retiring dentists are being approached by corporate dentists to buy their practices with offers they can’t refuse (a Don Corleane offer so to speak), and leaves fewer options for younger grads who are looking to buy a private practice.

I don’t really see this trend here in CA. Most older dentists still sell their practices to younger dentists and not to the corps. The corp I currently work for (Smile Brand) has added more offices either by building new offices from scratch or by purchasing offices from other smaller corp offices (ie Monarch Dental, Newport Dental etc). The acquisition of SmileCare by Coast Dental a few years ago was another example. All the corp offices, that I had worked at in the past and work at at the present time, have at least 2500-3000sf and 8-10 operatories. Corps need large offices so they can hire multiple GPs + specialists to work at the same time. And Most of private offices are too small (3-5 chairs, 1800-2000 sf) for what the corps need. Coldfront, I think the reason many corp offices have shown their interest in purchasing your office is your office is big enough (and is also located in a highly visible area) for what they need.

 

[Cold Front]

Coldfront, I think the reason many corp offices have shown their interest in purchasing your office is your office is big enough (and is also located in a highly visible area) for what they need.

Yes, you are right - I think so too.

 

[Cold Front]

Ortho new starts are down due to Corp offices everywhere.

That’s interesting... I wonder if this is due to cost of dental school + cost of residency + high cost of new office that is causing it, or because the corporations are simply a better deal financially for ortho new grads? Either way, it sounds like the choices are - you either drown in debt to make it into a solo ortho gig or you jump into the Corp boat to be saved and avoid a $1M+ debt.

 

[Cold Front]

Speaking of corps... Aspen Dental hired an orthodontist who is in the top 1% of Invisalign providers in North America as a VP, recently.

His main job will be to roll out more Invisalign products to all 700+ Aspen offices. Yep, he will train and coach Aspen dentists personally through workshops on how to treatment plan and recommend Invisalign to the 7 million+ patients Aspen sees every year, by summer 2019.

The corporate conveyor belt continues to grow.

https://www.chicagotribune.com/business/promotions/chi-ugc-article-aspen-dental-management-inc-hires-dr-david-2018-09-13-story,amp.html

 

[2TH MVR]

That’s interesting... I wonder if this is due to cost of dental school + cost of residency + high cost of new office that is causing it, or because the corporations are simply a better deal financially for ortho new grads? Either way, it sounds like the choices are - you either drown in debt to make it into a solo ortho gig or you jump into the Corp boat to be saved and avoid a $1M+ debt.

There is a smaller Corp group that opened within a few blocks of the Corp I work at. They are "giving" ortho tx away for around $2500-3000. Such a joke. They start alot of pts, but we both know at some point .... the low fee will work against you when the real numbers are anaylzed. The only strategy I see with their low ortho fees is. 1. they are positioning themselves for a buy out by a bigger Corp or 2. the offered ortho services maybe a break-even endeavor, but it helps the general side by bringing in new patients.

I have to commend the Corp I work for. They HAVE NOT LOWERED their ortho fees to compete. We are still above $3500 with most being above $4300 for braces. Seems like Corp internal interest paying financing is their strategy.

If I was starting out in ortho ..... off to the rural areas I would go. Stay away from urban saturated areas. Make your money in the urban areas and then go vacation in the nice areas.

 

[2TH MVR]

Speaking of corps... Aspen Dental hired an orthodontist who is in the top 1% of Invisalign providers in North America as a VP, recently.

His main job will be to roll out more Invisalign products to all 700+ Aspen offices. Yep, he will train and coach Aspen dentists personally through workshops on how to treatment plan and recommend Invisalign to the 7 million+ patients Aspen sees every year, by summer 2019.

The corporate conveyor belt continues to grow.

https://www.chicagotribune.com/business/promotions/chi-ugc-article-aspen-dental-management-inc-hires-dr-david-2018-09-13-story,amp.html

Yep. All the easy ortho stuff will be done by GPs which is fine. Lots of more complicated cases for the orthos. Well .... off to the golf course. Tee time in 1 hour.

 

[Cold Front]

Yep. All the easy ortho stuff will be done by GPs which is fine. Lots of more complicated cases for the orthos. Well .... off to the golf course. Tee time in 1 hour.

The easy ortho stuff was once a nice junk of orthodontists office production. Now there will be more difficult cases to do and longer treatment plans. Same thing that happened with Endo and the whole waveOne rotary system that allows GP’s to do more Endo and refer the very difficuot cases out.

Golfing Mondays? You are my hero!

 

[charlestweed]

There is a smaller Corp group that opened within a few blocks of the Corp I work at. They are "giving" ortho tx away for around $2500-3000. Such a joke. They start alot of pts, but we both know at some point .... the low fee will work against you when the real numbers are anaylzed. The only strategy I see with their low ortho fees is. 1. they are positioning themselves for a buy out by a bigger Corp or 2. the offered ortho services maybe a break-even endeavor, but it helps the general side by bringing in new patients.

I have to commend the Corp I work for. They HAVE NOT LOWERED their ortho fees to compete. We are still above $3500 with most being above $4300 for braces. Seems like Corp internal interest paying financing is their strategy.

If I was starting out in ortho ..... off to the rural areas I would go. Stay away from urban saturated areas. Make your money in the urban areas and then go vacation in the nice areas.

The corps still make lots of money with those low fees due to very low overhead:

1. Free rent. Ortho dept shares the same office space with the general, os, perio, endo. Therefore, the revenue generated by the general dentists and other specialists should be more than enough to cover all the fixed expenses such as rent, electricity, phone etc.

2. Flat daily pay rate. The associate orthodontist gets paid the same daily rate whether he/she treats 50 patients/day or 100 patients/day. The same thing for the assistants...they get paid 8 hours/day regardless of the number of patients they see a day. So why let them sit around? Why not make them work harder by starting more new cases?

3. Ortho supplies don't cost that much. The corps usually get very good discounts from vendors and from local labs because of the bulk purchases.

Starting new cases at low fee and earning something are many times better than sitting around doing nothing and generate zero income. And also, the more cases you start, the more patients who will know about you, and the more referrals you will get.

If I didn't start my career at the corps, I wouldn't have known some of these great business tips and tricks and applied them to my own practices. I share office spaces with my wife and other GPs to save in rent and utility bills. To save in staff salaries, I hire mostly P/T employees, who work at the same corp with me. When I don't work for the corp, these employees are also off and they come work for me.

 

[knewstance]

This thread is in part scary to think about the unknown and possibly negative future of our profession. At the same time, it is encouraging to work harder, become better, and be more creative to resisting the change or using the changes for further benefit as @charlestweed suggested

If I didn't start my career at the corps, I wouldn't have known some of these great business tips and tricks and applied them to my own practices. I share office spaces with my wife and other GPs to save in rent and utility bills. To save in staff salaries, I hire mostly P/T employees, who work at the same corp with me. When I don't work for the corp, these employees are also off and they come work for me.

This is a cool idea. I knew about the office space part, but I had never considered hiring your own staff to also work in your private office.

 

[Cold Front]

I had never considered hiring your own staff to also work in your private office.

Most corporate associate contracts that I have seen have a language that discusses not hiring the corporate office staff outside their offices, even after you leave the corporation all together for a certain period time, usually couple of year or so. It would be a conflict of interest issue, and I’m sure it was checked/addressed to not violate that condition before Charles took staff from his corporate gig to his private practice. However, corporations are well aware of the possibility of that happening.... whether it’s enforced or not is another issue.

 

[2TH MVR]

To bring this back to the original post. Predents/new dentists need to view Corp employment as a supplement to an eventual private practice. Just like @charlestweed . No way I would consider Corp a life time career. No way. I've stated it before. There is just no personal satisfaction working for a Corp. Not a lot of validation for working harder except for making more money. I'm convinced that the typical Corp patients cannot tell the difference between my work (perfected with over 26 years of private practice) or the work of a seasoned Corp dentist who is just "coasting" along, "pacing themselves". I've been in Corp for almost 2 yrs now.

The other side of this. Corp is perfect for us semi-retiring old guys and gals. I'm friends with a 72 yr old periodontist at the same Corp. This guy is FIT for a 72 yr old. He's a hoot to talk to. Tons of experience. He's kind of my mentor at the Corp. He's been at the same Corp for 8 years. He just recently sold his PT perio practice. He is the ONLY periodontist that works for this Corp. He travels to about 6-7 offices and works 3 days per week. He is the HIGHEST paid specialist at this Corp. On a slow week .... his take home is around 12K for two weeks. On a good week ... he makes over 20K (take home) every two weeks. 3 days a week. He doesn't even need the money lol.

For us dentists on the back nine of our careers ..... Corp is perfect. No stress. Just show up and git paid.

For predents/new dentists ..... follow in @charlestweed's path. Use Corp to your advantage. But get your own practice as soon as you can. Work both until your private practice is busy enough.

 

[charlestweed]

Most corporate associate contracts that I have seen have a language that discusses not hiring the corporate office staff outside their offices, even after you leave the corporation all together for a certain period time, usually couple of year or so. It would be a conflict of interest issue, and I’m sure it was checked/addressed to not violate that condition before Charles took staff from his corporate gig to his private practice. However, corporations are well aware of the possibility of that happening.... whether it’s enforced or not is another issue.

I too had to sign the paper which forbade me from hiring the corp’s employees. But most us, associate orthos at the corps, hired their employees anyway for a couple of reasons:

1. It’s not strictly enforced. It would probably cost the corp more money to hire lawyer and to file the lawsuit against me than just to hire another employee to replace the old one. I don't actually take their employees away....they simply work for me on the days that they don't work at the corp.

2. The corp offices wouldn’t want to let me go since I have helped produce a lot for them. It would be a huge hassle to find another replacement orthodontist, who is hard working, low maintenance, willing to work weekends, willing to start new case 10 minutes before closing etc. And plus, most patients want continuation of care and don’t like to switch orthodontist.

3. Some corp offices don’t mind if their ortho assistants get P/T jobs somewhere else because like me, some corps only want to hire P/T employees to save in overhead.

I like to open my offices on weekends because it’s easier for me to get these P/T assistants at the corp to come work for me, especially on Sundays. I have a large pool of ortho assistants who are eager to work for me. Many of them used to work with me at the same corp and when they left their jobs for another corp office, we exchanged numbers. With more helps, I can book 1.5-2x as many patients on the weekends…..80-120 patients/day instead of just 50-60 patients on weekdays.

 

[charlestweed]

This thread is in part scary to think about the unknown and possibly negative future of our profession. At the same time, it is encouraging to work harder, become better, and be more creative to resisting the change or using the changes for further benefit as @charlestweed suggested

I’ve never seen the expansion of corp offices a problem because this is not new to me. There were already a lot of corp offices here in SoCal when I graduated 16-17 years ago. There were already dental/ortho offices at every street corner 16-17 years ago. So I had to learn to adapt…working P/T for the corp and working P/T at my own offices. It may be a big shock for dentists who set up their offices in less competitive areas years ago and now they see several new corp offices and new private offices that are opened right next to theirs.

 

[Cold Front]

The corps still make lots of money with those low fees due to very low overhead:

1. Free rent. Ortho dept shares the same office space with the general, os, perio, endo. Therefore, the revenue generated by the general dentists and other specialists should be more than enough to cover all the fixed expenses such as rent, electricity, phone etc.

2. Flat daily pay rate. The associate orthodontist gets paid the same daily rate whether he/she treats 50 patients/day or 100 patients/day. The same thing for the assistants...they get paid 8 hours/day regardless of the number of patients they see a day. So why let them sit around? Why not make them work harder by starting more new cases?

3. Ortho supplies don't cost that much. The corps usually get very good discounts from vendors and from local labs because of the bulk purchases.

Starting new cases at low fee and earning something are many times better than sitting around doing nothing and generate zero income. And also, the more cases you start, the more patients who will know about you, and the more referrals you will get.

If I didn't start my career at the corps, I wouldn't have known some of these great business tips and tricks and applied them to my own practices. I share office spaces with my wife and other GPs to save in rent and utility bills. To save in staff salaries, I hire mostly P/T employees, who work at the same corp with me. When I don't work for the corp, these employees are also off and they come work for me.

I don’t know about ortho contracts, but a GP contract in a very competitive market will most likely be enforced. I interviewed couple of potential associates at my offices, who also happened to be employed at corporate offices within 2 miles radius. Their contracts forbade them from working for another office within the non-compete radius. I tried to talk to them out of it, but they were extremely hesitant that their corporate employer would enforce the clause, and they even shared stories on previous associates who ignored their non-compete agreements and had legal action against them.

 

[Firik]

80-120 patients/day instead of just 50-60 patients on weekdays.

Really?! How can you have 50 patients in 8 hours? Most GD I shadowed had about 10 patients and another 10 to do exams!

 

[charlestweed]

Really?! How can you have 50 patients in 8 hours? Most GD I shadowed had about 10 patients and another 10 to do exams!

Actually, 50+ patients in 4 hours.....myself and 2-3 chairside assistants working from 2pm-6pm. On the weekends with the help of 5-6 assistants, I can see nearly twice as many patients. So do all my full time employees sit around doing nothing from 9am -12pm? No. In order to see that many patients and to have a smooth clinic flow, my full time staff have to plan everything ahead such as pulling out charts a day before, calling patients to remind their appts, getting all the supplies fully stocked etc. I pay the part time chairside assistants the full 8 hours for working only 4 hours. That's the incentive for them to come to work part time for me.

The reason I book all my patients this way is I hate having a slow boring schedule in the morning when most of my patients (75% are teenagers) are at schools. I like to have a busy nonstop work schedule. Unfortunately, when I work for the corp, I have to work 8 hours. I have to bring a laptop and other handheld electronic devices to relieve the boredome during the slow morning hours. And that's why you see me posting a lot on this forum

 

[Firik]

Actually, 50+ patients in 4 hours.....myself and 2-3 chairside assistants working from 2pm-6pm. On the weekends with the help of 5-6 assistants, I can see nearly twice as many patients. So do all my full time employees sit around doing nothing from 9am -12pm? No. In order to see that many patients and to have a smooth clinic flow, my full time staff have to plan everything ahead such as pulling out charts a day before, calling patients to remind their appts, getting all the supplies fully stocked etc. I pay the part time chairside assistants the full 8 hours for working only 4 hours. That's the incentive for them to come to work part time for me.

The reason I book all my patients this way is I hate having a slow boring schedule in the morning when most of my patients (75% are teenagers) are at schools. I like to have a busy nonstop work schedule. Unfortunately, when I work for the corp, I have to work 8 hours. I have to bring a laptop and other handheld electronic devices to relieve the boredome during the slow morning hours. And that's why you see me posting a lot on this forum

Wow!
Let's do little math: 4 hours = 240 minutes and lets say it's 50 patients, which means 240/50= around 5 minutes per patient. I cannot believe this is possible, I guess I need to wait to see it. I can relate to this by working as a cashier and having 50+ customers in 4hours as a daily routine.

 

[charlestweed]

Wow!
Let's do little math: 4 hours = 240 minutes and lets say it's 50 patients, which means 240/50= around 5 minutes per patient. I cannot believe this is possible, I guess I need to wait to see it. I can relate to this by working as a cashier and having 50+ customers in 4hours as a daily routine.

That's right, the average doctor's time spent on each is under 5 minutes. You need to shadow at an orthodontic office. It actually takes my assistant 5-10 minutes to change an archwire and 20-30 minutes to put brackets on new patients or to repair loose brackets. I only need to spend 30 secs to a minute to greet the patient, examine the patient's mouth and write down the instructions for my assistants to perform. Since my office offers affordable fee, I don't need to spend a lot of time selling cases. I usually spend less than 5 minutes for each new patient consultation. So in order to have a smooth clinic flow, I need to have at least 6-7 chairs and experienced chairside assistants, who are familiar with my working style

 

[2TH MVR]

During my heyday.... I saw between 100-120 patients a day with 4 asst's.
At this point in my life .... 40-50 patients a day is PLENTY. I prefer a slower pace with more hands on treatment .

 

[charlestweed]

None. I feel like I am on vacation when I work for the corp….full autonomy (I am the only doc does all the diagnoses and tx plannings), good salary, guaranteed per diem pay, no need to go around begging the GPs for referrals etc. Below used to be on my list of cons but as I’ve gained more experience and become faster, they are no longer cons to me:

1. Overbooking. 80-100 patients a day with only 2-3 assistants.

2. High staff turnover. A lot of the staff quit because they were underpaid and corps would rather lose them than offering them a raise. Every time a new assistant comes in to replace the old one, I have re-train him/her how to take ortho records (xray, photos) and to learn the new clinical tricks.

3. Running out of supplies. There is a limited budget every month; therefore, the person, who is in charge of ordering supplies, cannot just order things that are running low. She has to order more important items (ie brackets, wires, bands etc) first.

4. Poor patient communication. Patients have to call some 800 numbers and they are put on hold for a long time. It's hard for patients to book an appointment. I always have to apologize. The good thing is when patients hear the apology directly from the doctor, all the anger go away almost instantly.

5. Fear of being let go....because I had a lot of debts: student loan, home loan, practice loan, car loans etc. I had to work hard and stay late to produce for them as much as possible. I had to fly to the corp headquarter in Dallas for some stupid meetings. Now I no longer have such fear because I have my own practices and I paid off all the debts (except for the home mortage).

 

[2TH MVR]

None. I feel like I am on vacation when I work for the corp….full autonomy (I am the only doc does all the diagnoses and tx plannings), good salary, guaranteed per diem pay, no need to go around begging the GPs for referrals etc. Below used to be on my list of cons but as I’ve gained more experience and become faster, they are no longer cons to me:

1. Overbooking. 80-100 patients a day with only 2-3 assistants.

2. High staff turnover. A lot of the staff quit because they were underpaid and corps would rather lose them than offering them a raise. Every time a new assistant comes in to replace the old one, I have re-train him/her how to take ortho records (xray, photos) and to learn the new clinical tricks.

3. Running out of supplies. There is a limited budget every month; therefore, the person, who is in charge of ordering supplies, cannot just order things that are running low. She has to order more important items (ie brackets, wires, bands etc) first.

4. Poor patient communication. Patients have to call some 800 numbers and they are put on hold for a long time. It's hard for patients to book an appointment. I always have to apologize. The good thing is when patients hear the apology directly from the doctor, all the anger go away almost instantly.

5. Fear of being let go....because I had a lot of debts: student loan, home loan, practice loan, car loans etc. I had to work hard and stay late to produce for them as much as possible. I had to fly to the corp headquarter in Dallas for some stupid meetings. Now I no longer have such fear because I have my own practices and I paid off all the debts (except for the home mortage).

I'll echo what Tweedy said. At my point in life .... there are more PROS than CONS for an orthodontist working for a CORP. Not sure I can say the same for a GP. The money is better than most realize. If you work hard and generate alot of ortho starts ... the bonuses really add up.
Not begging GPs for referrals is HUGE. At the start of my career in the early 90's .... an Ortho still kissed the GP's butts, but there was still a feeling of colleagues working together for the benefit of the patient. Now .... it's different. Seems like the GPs and the specialists are competing with each other. Regardless ... begging for referrals SUCKS. I'm done with that.

I don't have many CONS.
As for Tweedy's cons. Overbooking?. Occurs, but typically my schedule is around 50-60 patients a day. Perfect for myself and a staff of 3.
Staff turnover? I've had the same staff for the last 2 years. They are well trained .... by myself. Of course .... no staff is perfect. There is one member of my staff that I wish would move on. In private practice .... I simply could fire that person. Not in Corp. Multiple levels of regulations on when a staff member can be released. Has to be done legally.
Running out of supplies? Not us. If anything .... we waste more stuff than when I was in Private Practice. I'm not wasteful, but hey ... I'm not paying for the stuff.
Poor Pt communication front office, making appts. Not my concern. My concern is treating these patients on time and with quality.
Fear of being fired. It exists, but if you prove yourself to your employer .... which I have done .... I don't have this fear. You have to kiss your boss' a$$. Good thing my boss (female) has a nice Caboose so I don't mind . If anything I am moving up in the company. Two under-achieving orthodontists are being let go and I am taking their offices. These two orthodontists simply did not take their Corp jobs seriously. No different than having a Private Practice. If you do not work hard in your private practice or Corp .... you will fail.

 

[Cold Front]

I'll echo what Tweedy said. At my point in life .... there are more PROS than CONS for an orthodontist working for a CORP. Not sure I can say the same for a GP. The money is better than most realize. If you work hard and generate alot of ortho starts ... the bonuses really add up.
Not begging GPs for referrals is HUGE. At the start of my career in the early 90's .... an Ortho still kissed the GP's butts, but there was still a feeling of colleagues working together for the benefit of the patient. Now .... it's different. Seems like the GPs and the specialists are competing with each other. Regardless ... begging for referrals SUCKS. I'm done with that.

I don't have many CONS.
As for Tweedy's cons. Overbooking?. Occurs, but typically my schedule is around 50-60 patients a day. Perfect for myself and a staff of 3.
Staff turnover? I've had the same staff for the last 2 years. They are well trained .... by myself. Of course .... no staff is perfect. There is one member of my staff that I wish would move on. In private practice .... I simply could fire that person. Not in Corp. Multiple levels of regulations on when a staff member can be released. Has to be done legally.
Running out of supplies? Not us. If anything .... we waste more stuff than when I was in Private Practice. I'm not wasteful, but hey ... I'm not paying for the stuff.
Poor Pt communication front office, making appts. Not my concern. My concern is treating these patients on time and with quality.
Fear of being fired. It exists, but if you prove yourself to your employer .... which I have done .... I don't have this fear. You have to kiss your boss' a$$. Good thing my boss (female) has a nice Caboose so I don't mind . If anything I am moving up in the company. Two under-achieving orthodontists are being let go and I am taking their offices. These two orthodontists simply did not take their Corp jobs seriously. No different than having a Private Practice. If you do not work hard in your private practice or Corp .... you will fail.

You summarized another example of the dental workforce scale tilting towards corporations, and over time it turned out a good thing for orthodontists like yourself who works for a corporation. For corporations, that was their intended goal, to slowly change dentistry by taking over the dental service industry and keeping employees happy. Corporations understand the problems of a dentist or a specialist, so they focus on fixing those problems - in your case, “Kissing the GPs butts”. Corporations are constantly going after the unhappy dentists and specialists who are too overwhelmed with student loans, who struggle for referrals, who are too afraid from the business aspects of private practice, who are too afraid to manage staff, who lack self confidence for their career, and so on.

I remember, when I worked at a busy Aspen Dental office 8 years ago, the office manager (who had a “BS” degree in something and was trained in-house by Aspen to manage staff and doctors) kept a 1 page note of the personalities of the 3 dentists in her small office. This note was suppose to be kept hidden from the dentists working in the office. She was eventually replaced by corporate and the note was eventually passed on to a new office manager, who did a bad job in organizing her desk. I came across the note one day while dropping off paperwork to the new office manager’s desk. I don’t know who originally wrote the note, but it read (paraphrasing here..) - “Dr A: He can be pushed to treatment plan more patients, he won’t argue with you, give him the big cases”, and “Dr B: She talks a lot to patients, she struggles with production goals, and she is into herself and so on”. And “Dr C: This guy will probably not stay and has a chip on his shoulder, so try to make the most out of him before he leaves”. As a new grad, I realized that day that corporations have placed office managers as the higher people in the chain of command to have control over dentists and the way they function in a dental office, albeit a corporate dental office.

Dental corporations are not evil, they don’t break the law, they pay and compensate staff well, they provide what most dentists want (benefits and atmosphere for the most part). But, anyone who works for them should never think they have the best interest of “dentistry” in mind, let alone the “dentists” they employ. To them, everything is a number, one way or the other, you as a dentist is probably a W2 or a 1099 number who is part of pushing the big machine forward. Your corporate team (DA’s, hygienists and front desk) are all caught up in the same web of “you will be happy here”. I understand people have to put food on the table for their families and pay their bills, but to go to dental school and specialize through sweat and stress for over 10 years to just walk into a corporate dental office. That’s just wrong, to me.

 

[2TH MVR]

But, anyone who works for them should never think they have the best interest of “dentistry” in mind, let alone the “dentists”.
but to go to dental school and specialize through sweat and stress for over 10 years to just walk into a corporate dental office. That’s just wrong, to me.

I agree with most of your post. No way I go to school with the ultimate goal of working for a CORP. As you know ... I practiced privately for 25 years. Working for Corp is my way to reduce stress as I near retirement.

As for your other comment regarding what's good for dentistry. I'll have to respectively disagree. As we both know .... The dental environment is changing towards the Corp medical model. It's not just the big name Corp entities. You could also place blame on all those private GP and PEDO practices bringing specialists into their offices. They're EVERYWHERE. Basically operating like small Corps. How about when a GP or specialist sells their practice to a Corp? That just fuels the Corp machine.
Mom and pop small business are disappearing all over America.
Blame Amazon. Blame China lol. Blame the poor millennials. Blame the internet and mobile devices lol.
So no..... I don't blame the Corps solely for the demise of mom and pop private practices. Plenty of blame to go around.

 

[desertrat12]

So long as we’re throwing blame around, I’d just like to throw the ADA, or at least ASDA, into the mix as well. We get lunch seminars about ASDA retreats to fancy places at nice hotels, all provided and sponsored by Corps.

Fun hotels, easy job placement, “easy” money, yada yada yada...their message falls nicely to the ears of young dental students with high debt. No turning back from here. Only a small number of my class mates even discuss owning practices. The rest are all set on Corp.

 

[desertrat12]

Question for those who have worked Corp...in an imaginary scenario, let’s say a new grad has blistering speed and can personally produce a million bucks a year if given the patient flow. Have the Corps you’ve worked for had enough patients for someone like this?

I’m certainly not this imaginary person, just trying to figure out if Corps really do have the patient flow for a go getter to perform quite well.

 

[charlestweed]

So long as we’re throwing blame around, I’d just like to throw the ADA, or at least ASDA, into the mix as well. We get lunch seminars about ASDA retreats to fancy places at nice hotels, all provided and sponsored by Corps.

Fun hotels, easy job placement, “easy” money, yada yada yada...their message falls nicely to the ears of young dental students with high debt. No turning back from here. Only a small number of my class mates even discuss owning practices. The rest are all set on Corp.

It’s good to hear that the majority of your classmates have a more realistic plan. Coldfront and I both chose this safe path right after graduation. It would be a huge risk to take out an additional $100-500k to build or to buy a practice when a new grad only has the basic clinical skills that he/she learned in dental school and knows nothing about things like hiring staff, advertisement, choosing the right office location, building permit, ordering equipment and supplies etc. It’s easy to for one to say things like “I would never work for the evil corp”, “ I’ll plan to open my own office right after dental school,” “I won’t take any insurance and only accept cash,” “I won’t work on weekends,” “I will open a high end office and only treat high income patients” etc when he/she still in school and hasn’t yet faced the reality of fierce competition among dentists and the reality of paying back loans while having to support his/her family.

 

[Cold Front]

I agree with most of your post. No way I go to school with the ultimate goal of working for a CORP. As you know ... I practiced privately for 25 years. Working for Corp is my way to reduce stress as I near retirement.

As for your other comment regarding what's good for dentistry. I'll have to respectively disagree. As we both know .... The dental environment is changing towards the Corp medical model. It's not just the big name Corp entities. You could also place blame on all those private GP and PEDO practices bringing specialists into their offices. They're EVERYWHERE. Basically operating like small Corps. How about when a GP or specialist sells their practice to a Corp? That just fuels the Corp machine.
Mom and pop small business are disappearing all over America.
Blame Amazon. Blame China lol. Blame the poor millennials. Blame the internet and mobile devices lol.
So no..... I don't blame the Corps solely for the demise of mom and pop private practices. Plenty of blame to go around.

You practiced privately for 25 years, so you stayed out of the corporate circles for a very long time, and saved it as a pre-retirement phase gig. So you are by no means a ripe, fresh new grad, easy to mold dentist/specialist. You are working for corporate for professional “stress” reducing reasons, while majority are working for financial reasons. Different reasons all together.

Yes, corporations stemmed from large group practices with specialists, but when private equity backed money stepped in, that was the tipping point. Dentisty entered an uncharted territory as a result, similar to what happened when e-commerce opened up as a result of the internet, and the likes of Amazon, Google, Netflix and Co. became the big businesses that changed Main Street business.

Retiring dentists selling their offices to corporations is part of that big money finding it’s way to private practices. The buyer market for high producing offices and prime locations are now almost exclusively monitored by corporations, even approaching those offices and potential sellers before the practice hit the market. Most of those transactions end up keeping the selling dentists for couple of years, so the corporations can recoup some of its investment and find another dentist during the transition. It’s the “thread through the needle and tie the knot” approach for corporations, and the formula is perfected to acquire more practices. A dentist buying an office could take months, but a corporation buying an office could take weeks. Corporations also appraise practices at 1-2x of average production (depending on the deal), while a dentist buyer’s bank would appraise it at 0.5-1x. Corporate margins can be less than 10% per dental office as a result, but buyer dentist want 30% or more margins after they buy the practice for far less. Different purchase powers all together, which is what large pharmacy chains do these days - they bought out all small solo pharmacy shops and hired the seller pharmacists as employees as a condition of the “great deal” sale.

 

[charlestweed]

Question for those who have worked Corp...in an imaginary scenario, let’s say a new grad has blistering speed and can personally produce a million bucks a year if given the patient flow. Have the Corps you’ve worked for had enough patients for someone like this?

I’m certainly not this imaginary person, just trying to figure out if Corps really do have the patient flow for a go getter to perform quite well.

The reason corp have a lot more patients is they do things that most private practices are not willing to do: accepting medicaid and HMO plans, long offices hour 8am-8pm, weekend hours, in-house specialists etc. Since most private practices don’t accept Medicaid and decline to treat low income patients, where do you expect these patients to go get dental treatments done at? Either at a corp or at a nearby dental school.

Most new grads don’t have that blistering speed and therefore, they can only get a low paid associate position. They become faster when they are forced to treat high volume of patients. And some of them will get promoted to higher paid managing dentist position. Treating high volume of patients at a corp is not a bad thing. The more cases you treat, the more experience you’ll gain. It’s like to doing an extra year of residency, except you get paid a lot more.

 

[Cold Front]

Question for those who have worked Corp...in an imaginary scenario, let’s say a new grad has blistering speed and can personally produce a million bucks a year if given the patient flow. Have the Corps you’ve worked for had enough patients for someone like this?

I’m certainly not this imaginary person, just trying to figure out if Corps really do have the patient flow for a go getter to perform quite well.

Plenty of busy of corporate offices are out there for a speedy dentist. They will take you with an open arms and drool over you.

 

[2TH MVR]

I have to add that my observations are relative to the severe saturation in the Phoenix market. There is a dentist/Corp literally on EVERY street corner.

Go rural new dentists.

 

[charlestweed]

Plenty of busy of corporate offices are out there for a speedy dentist. They will take you with an open arms and drool over you.

For them to drool over you, you must first work for them for a few months to a year to prove to them that you have the speed, have fewer redos, have fewer complaints from patients and get along well with the staff. If they don't know anything about you because you are a new grad with zero work experience, you'll be offerred a low initial salary like other new grads.

And even when you have prior work experience, the corp still want to see your skills before they promise you a big paycheck. A lot of dentists tend to inflate their resume. Many of them have to seek employment at certain corp because the other corp offices let them go for being too slow.

The office managers also give preference to certain dentists working at the same corp. If you are better and faster than your colleague who works at the same corp office, the managers will assign more difficult and productive cases to you because you get the job done quicklly and they don't have to deal with complaints from patients.

 

[distressstudent]

I think corporate dentistry today is where CVS Pharmacy was in the 1980’s, with about 1,000 stores. Today, CVS pharmacy is within 3 miles of 70% of the US population. It took CVS to buy other competition to expand and get to that level. Corporate dentistry knows that it will start to merge or buy each other eventually to expand faster and have a larger presence in the dental workforce and services. Just the other week, Western Dental bought 60+ other offices from another large group in Texas, which lead to about 25% instant growth in locations for Western Dental. In the long term, private practices will be losing and more new grads will be entering the workforce like pharmacy students. It’s a mathematical game; high student loans, more financially desperate new grads, more corporations that will entice new grads with debt relief options, and more Starbucks drive-thru style work schedule for those new grads to boost the corporations bottom line. It’s the reality that practicing dentists too busy to understand, and future grads are too naive to know.

The attitude towards corporate has really changed for my cohort throughout dental school. As a matter of fact, even the school's attitude towards corp dentistry has changed.

When I first started, everyone wanted to avoid corporate like the plague. Everyone said, "that will never be me". Professor tells us, "hey watch out for corporate dentistry. don't fall into the trap"

Fast forward just a few years. After countless lunch and learns, vendor fairs, corporate sponsored gifts, etc. everyone's attitude towards corporate is more on the amiable side than hostile. Then people start looking at their student loans more closely, and started looking at the offers, private practice doesn't even come close to what corporates are offering. Maybe there are private practices with good deals, but they are certainly not actively reaching out to our students.

Then here is the real kicker. As time goes on, more part-time faculty are retiring from their private practice and more retired dentist are joining the faculty as part-timer. Well guess who is buying up all their practices at a much higher price and make sure their retirement goes smoothly? If you guessed corporate dentistry then you'll be right. Now the faculty is whistling a different tune, and of course their attitudes gets passed onto the students too.

And if you talk to graduated seniors, majority of them doesn't say it's too bad either. They work like dogs, but they get paid well. As long as their student loans balance motivates them, they don't have complaints. And private practices aren't always looking to hire, but corporate certainly is. A few decided to be pickier with their jobs, but ended being jobless for awhile and settled for corporate in the end too. And really, who is looking to offer a high salary to new grads who might not even be up to speed. Certainly, corporate offices are confident they will be able to squeeze what they can out of you.

 

[periopocket]

To bring this back to the original post. Predents/new dentists need to view Corp employment as a supplement to an eventual private practice. Just like @charlestweed .

He is the ONLY periodontist that works for this Corp. He travels to about 6-7 offices and works 3 days per week. He is the HIGHEST paid specialist at this Corp. On a slow week .... his take home is around 12K for two weeks. On a good week ... he makes over 20K (take home) every two weeks. 3 days a week. He doesn't even need the money.

For predents/new dentists ..... follow in @charlestweed's path. Use Corp to your advantage. But get your own practice as soon as you can. Work both until your private practice is busy enough.

Can you elaborate on his scope of practice: perio sx, mucogingival, GBR/GTR, Implants, Sinus lifts, Hybrids, exos/socket pres? Or is he doing it all, what’s his bread and butter? Thanks

 

[2TH MVR]

Can you elaborate on his scope of practice: perio sx, mucogingival, GBR/GTR, Implants, Sinus lifts, Hybrids, exos/socket pres? Or is he doing it all, what’s his bread and butter? Thanks

As far as I know .... He does everything. He is in demand due to his good work and experience. He's not happy that the Corp is experimenting with some CE trained GPs placing implants.

 

[charlestweed]

As far as I know .... He does everything. He is in demand due to his good work and experience. He's not happy that the Corp is experimenting with some CE trained GPs placing implants.

About 2 years ago, the corp I work for also made all the managing GPs attend the Invisalign CE class so they could learn to treat simple anterior crowded cases. They also made us attend the more advanced Invisalign CE classes for orthodontists at a fancy Flemming Steak House restaurant. They even bought the Itero scanner for the office I work at. The scanner is currently sitting in the corner collecting dust. The problem is they can't sell cases because required down payment is so high ($1500) and the overall cost is much more than traditional braces. With the traditional braces, it's much easier to ask the patients to pay $2-300 down payment and $99 monthly payments.