There are all sorts of people with a variety of self-serving agendas who will steer young dentists away from private practice ownership. Some in organized dentistry want to sell advertising to the dental service organization (DSO) industry, which recruits young dentists. The DSO industry (commonly called corporate dentistry) needs fresh doctors to staff its revolving door of doctor employment turnover. These junior colleagues are given all sorts of verbal promises, which are often gross misrepresentations of clinical and economic reality.
Doctor, as a true owner of a dental practice, you and not some unlicensed manager, who often has little more than a high school education, control the clinical operations and regimens. You and your patients don't have to tolerate highly questionable infection-control protocols. Since auxiliaries are employed by you directly, any actions not in the best interests of patients and the dental practice can be dealt with in a rapid and definitive manner of personnel change.
Michael W. Davis, DDS.You personally select the dental laboratories, which serve the best interests of your patients, and not the bottom line of some corporate executive. You have complete control over dental supplies and equipment to best serve your patients. You control the clinic's bank account, as you personally deem appropriate. You don't need to meet monthly production quotas to pad the quarterly reports of a private equity investor and beneficial clinic owner. You design your patient schedule as best serves your patient base, versus some nitwit earning a dollar over minimum wage from some remote call center boiler room.
It gets better. Your practice becomes like a special flower garden. Yes, it requires initial effort to weed out less desirables. However, with time and effort, you enjoy the rewards of caring for patients who become loving friends. You become more than a doctor -- you also become a trusted confidant, educator, and advisor. Each morning, you'll be excited to go to work and make a significant, positive difference in the lives of your neighbors.
The positives don't stop there. As a small-business owner, the growth of your practice is the growth of a viable economic asset. No one tells you who you may, or may not, sell your asset to in the future, as found in DSO "ownership" contracts. You enjoy control over doctor associates, potential future partners, and the eventual transition of your practice.
Yes, there is a learning curve. Mistakes can be costly, but they are part of the learning process. You'll require systems for payroll, employee management, regulatory requirements, scheduling, and monthly overhead budgeting. As complex as this may seem at first, it's nowhere near as costly as the $12,000 to $20,000 a DSO pulls out of a dental clinic monthly. There are great professional people who are there to be of service -- and at nowhere near the cost of a DSO.
Yes, there are risks. Dishonest dentists and dishonest practice brokers are all too willing to "cook the books" of an existing dental practice for sale. Fortunately, slime in the dental industry can largely be side-stepped with certain due diligence work. Take the effort to learn the good from the bad and the down-right ugly. Please know, wonderful dental consultants exist who want your continued business throughout your entire career. These are not always the big names featured in dental industry magazines and ads.
If you have the confidence and the right demographic, a cold start-up practice also is possible. Yes, it may require more time initially, and revenues may be more slim, but you may gain your eventually goal in a more timely manner. You'll definitely want the services of a dental marketing and demographics expert.
It's only fair and ethical that I give you a full disclosure. I absolutely want you to be successful. It's painful for me to attend continuing education or a dental meeting and see my junior colleagues with that defeated beaten-down look in their eyes. They're half my age and look older than me. Many exist as little more than itinerate indentured servants with DSOs, hating every day of their chosen professional career.
I contribute to organized dentistry efforts and too frequently only see the same old fossils like myself. Old geezers in organized dentistry, me included, need younger colleagues to inject energy and new thinking. We require your specific insights on dental therapist issues, access to care, government intrusion into healthcare, corporate investors' intrusion into healthcare, and the insurance industry's intrusion into healthcare. You are needed more than ever and perhaps far more than you realize. I can't afford to see a fantastic resource like my junior colleagues sitting on the sidelines and not assuming an active role because they have little stake in dentistry, other than a "job."
I need more dentists, especially younger doctors, to have "skin in the game." I implore you to seriously consider private practice ownership.
Michael W. Davis, DDS, maintains a private general dental practice in Santa Fe, NM. He serves as chairperson for the Santa Fe District Dental Society Peer Review. He is also active in expert witness legal services.
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