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corporate dentistry flaws

The 5 Primary Flaws of Corporate Dentistry

The 5 Primary Flaws of Corporate Dentistry

There are more choices than ever when it comes to finding the right dental care provide for yourself and your loved ones. As a diligent patient, spouse or parent, you would rather not wait until faced with a dental emergency before choosing the right dental provider.

One of the primary considerations that today’s dental patients face is whether to choose a corporate dental organization or a private dental practice.

What Is Corporate Dentistry?

You are probably able to pick up the meaning of corporate dentistry from the term itself, but we thought it might be helpful for you to have a more formal definition. Dentistry IQ shared Dr. Kevin Cain’s definition that corporate dentistry “has come to be colloquially understood within the profession as referring to multilocation, multidoctor dental practices,” as opposed to individual or small group practices.

Often owned by a dental partnership, there may be several—or even several thousand—locations for that single dental corporation across the state or the country. The main office for the dental partnership likely runs the billing department, scheduling and other administrative duties a small practice would ordinarily handle on its own.

How Did Corporate Dentistry Develop and Become Such a Competitive Force in the Dental Industry?

The origin of corporate dentistry can be traced back to Texas in around 1995 when the state allowed for the implementation of managed care programs, or HMOs, according to Dentist the Menace. Insurance companies were quick to catch on to a plan that focused on efficiency and savings for their interests, so they were instrumental in creating and selling these dental programs to employers.

The set-up was just as attractive to many dentists, dental students and recent dental graduate students. There are many reasons dentists might have chosen the corporate dentistry route, including:

  • Educational debt accrued and the need to begin working as quickly as possible to make payments
  • Local employment outlook at private practices not favorable for hiring or associate opportunities
  • Highly competitive market that would have delayed or impeded profits when starting one’s own practice
  • New dental schools in the area mean young dentists face even more competition for jobs and associate opportunities among peers at the same skill and experience level
  • The economy is in turmoil
  • Concern over gender and race in the marketplace hindering employment opportunities

The varying reasons dentists might find corporate dentistry appealing, along with the abundance of new and emerging corporate dental programs, created an industry that is still going strong. In the mid-1990s, more than 90% of dentists were owners of their own individual or small group practice. Jump ahead to 2015, and the number now stands at less than 85% as an increasing number of dentists—like ones with the reasons listed above—have migrated over to work in a dental management organization (DMO), dental service organization (DSO) or another type of dental practice, including some type of public health setting.

This phenomenon of corporate dental chains sweeping across the United States is not unique. Dr. Mark Costes at the Dental Success Institute explains that the reverberations of this growing trend can be felt as far away as the New Zealand and Australian markets.

The 5 Primary Flaws of Corporate Dentistry You Should Know

Corporate dentistry may seem like it solves a lot of problems for a lot of people. It does. However, we don’t think that you are necessarily part of the group of people that these programs are intended to truly help. Corporate dental firms were developed, implemented and encouraged to save money at the top. We understand the idea of creating pathways to savings. Individual and small dental practice groups also try to save money, as long as those efforts do not result in hindering commitment to and treatment of valued patients.

Our concerns with corporate dentistry are many and varied, but we feel that you should know a little more about the downside of corporate practices before making your decision about your dental provider.

We compiled a list of what we see as the five most glaring flaws in corporate dentistry to share with you.

1. Dentists Are Seen as “Employees” of the Dental Corporation

Dentists work and study hard to earn their dental degree. According to Reference, each dental candidate is required to take four years of pre-dental education to earn a bachelor’s degree before attending a dental school. Once dental graduates have completed their four years and earned their degree, they must pass the written and clinical Dental Boards. They now become licensed in their practicing state or region before they officially become dentists and are referred to as “doctor” by their colleagues, staff and patients.

That is a lot of hard work to go through to become a cog in the wheel of a massive dental conglomerate. We know that our own Dr. Briglia shudders at the thought.

Additionally, according to federal law, dental clinics are required to be owned, operated and controlled by practicing dentists whose dental education was based on strong ethical values about what it means to be a dental professional and always doing what is best for patient. Large corporations with teams of accountants wielding strict budgets, and pushing quotas for dentists to reach daily, may not be looking out for the patient’s best interests. The corporate dental entity may have shareholders looking to maximize profits at the patient’s expense. Their perspective on providing treatment, may lie directly at odds with what has ethically been the norm in private practice for decades.

2. Dentists Often Must Fulfill Patient and Productivity Quotas

Instead of vested partners and committed practitioners, dentists working for corporate dental organizations (again, keep in mind that these dentists are often seen as employees) must fulfill certain obligations, in terms of hours logged, procedures performed, hours fulfilled. Production is often monitored, and dentists are required to send daily stats to corporate offices, detailing the minutiae of their work day. These dentists have little-to-no input in their work in a corporate dental setting, which also means there is little-to-no room for them to recommend or provide creative solutions to complex dental problems for patients that they would be able to do in their own practice. Essentially, they are working to pad their dental corporation’s bottom line, which means they are focusing more on money than on vital patient care. Employee dentists in corporate dental offices many times work on commission, and with huge dental school debts racked up, may recommend more treatment than is actually needed, or warranted.

3. Dentists in Corporate Dentistry Often Lack Substantial Experience

Dentists in these corporate dental chains are often hired right out of dental school, bringing with them no real-world experience. These young dentists mean well, but they lack the insights and experience that comes with day-to-day work with new patients, as well as those they have gotten to know for years. While a fledgling dentist in an individual private practice will have a learning curve, he or she can still consult with trusted and valued colleagues. Dentists at private practices simply have more freedom, ability and confidence to tend to their patients’ needs in an effective, meaningful and caring way.

4. Dentists Are Often Replaced on a Whim in Corporate Dental Firms

In these large-scale and impersonal corporate dental firms, dentists are often let go and replaced in an instant. The quality of their work, as well as their work ethic, is not as important as profit with these organizations. If corporate dentistry professionals do not meet their productivity quotas or schedule advanced—and perhaps even unnecessary—procedures, the chances are strong they will not last with the company, leaving patients with no continuity of care or choice. Since most patients have some degree of apprehension about dental visits anyway, this situation does not encourage the sense of comfort and often the lasting bonds between dental patients and their corporate dentists is lacking. Many corporate dental patients have been surprised that when they return for their work another dentist is there to see them.

5. Corporate Dental Firms May Encourage or Force Third-Party Credit Cards onto Patients

It is no secret that quality dental care is an investment and often a stretch for patients who lack adequate dental insurance. Many corporate dental firms encourage patients to take on a third-party credit card that results in elevated debt for procedures with a high price tag. Frontline shared a story about CareCredit, which is a subsidiary of GE Capital Retail Bank, owing a refund of up to $34.1 million to more than 1 million dental patients, for having enrolled them in credit cards that the patients believed were interest-free. It turns out that these cards accrued extremely high interest rates.

Is a Small Private Dental Practice the Best Choice for You?

At Briglia Dental Group, we understand the allure of corporate dentistry. These organizations often offer low fee special introductory offers, discounts and promotions, including things like free tests, cleanings and exams. We want you to know what happens after those offers run out.

While corporate dental offices work for some dental patients, we feel that it is so important to offer our patients a personal experience. We focus on the benefits for you, which include quality care, individual treatment and creative solutions, and the expert dental professional of your choice each visit, no “over-treatment” and no forced credit cards.

Please feel free to contact us at 610-692-4440 or fill out an online request form if you would like more information about the benefits of small practice dental care over corporate dentistry or anything else at all.

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