Is Cooperate dentistry providing dentists with a new kind of "Sofie's choice"?
Apparently, some young dentists are in so much debt that they see little chance in starting their own practices. Often they are forced to work in jobs, 5 days a week seeing 18 poorly "insurance plan" patients a day, many of whom have coverage that doesn't pay a lot for their procedures. They may desire a better situation, but can't see their way out of their present work environment.
One issue that confronts them is they have zero experience with the "business of dentistry". How to bill insurance companies, hire employees, create a budget for their office. They may be competent clinicians, but are just not prepared to have the responsibilities of running their own practices.
This is not an entirely new phenomenon. Years ago I had a wonderful colleague, who rented space from me. She was a really nice person and treated her patients well and was loved by them. Unfortunately, she never really had the heart to bill them appropriately and ended up not really running a "viable " practice. Luckily for her, her husband was a financially successful physician.
One day when we were sitting together and discussing her practice, she confessed to me that she had really preferred the job she used to have, since she could just show up and work and not be involved with billing her patients and that she would still be primarily working there except for the fact that after 11 years of employment , her employer had sold his dental practice and she was let go.
This anecdote really shows the problem with being an employee dentist rather than an owner operator. All employees can be terminated if the employer needs to let go of them for a valid (non discriminatory) reason. An employee dentist has no real job security, even when they are loyal employees.
I am writing this post, because although their have always been employee dentists, the percentage of the profession practicing in corporate settings seems to be increasing. It used to be employee dentists eventually ended up in a dental practice where they had an equity position, but it is not clear that this is the direction that dentistry is headed today.
Yesterday I had a meeting with a dentist and made her an offer I didn't think she could refuse. She had many years experience in the field but has worked exclusively in other dentists practices. The arrangement involved little financial risk to her and would allow her to comfortably make the transition to owning her own practice. That being the case, she still saw lots of potential roadblocks. "There are so many other dentists in this neighborhood, where will I find patients?"
"What happens if a patient needs to be seen for an emergency if I am not available?" "Will my days here make it difficult to find another employee dentist position, since they may want me five days a week?" These are valid concerns, but If I was her, sooner or later, I would feel the need to figure out a solution to allow me to develop my own dental practice. Yes, I would have to make a sacrifice but I went into dentistry partly so I could eventually be my own boss.
It was apparent to me, that both dentists had become habituated to being employees and may not have a strong desire to "be on their own". It is sad to say, but more and more when I speak with young dentists,many are reticent about taking the steps needed to have their own dental practices. Basically their choices boil down to a few options. They either have to buy an existing practice, become partners in the practice that employs them or open their own dental practice.
This issue seems to be a real trend in healthcare in general, since physicians as well as dentists are finding traditional private practice settings too challenging and are choosing to work as "wage slaves" for hospitals or corporate settings rather than choosing the responsibilities involved with owning their own practices. I am not sure this trend is ultimately a better model for our healthcare delivery system, but this train has left the station and those going it alone may just bewaiting on the platform or worse, standing on the tracks.
from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2017/12/is-cooperate-dentistry-providing.html - http://lspindelnycdds.blogspot.com/
One issue that confronts them is they have zero experience with the "business of dentistry". How to bill insurance companies, hire employees, create a budget for their office. They may be competent clinicians, but are just not prepared to have the responsibilities of running their own practices.
This is not an entirely new phenomenon. Years ago I had a wonderful colleague, who rented space from me. She was a really nice person and treated her patients well and was loved by them. Unfortunately, she never really had the heart to bill them appropriately and ended up not really running a "viable " practice. Luckily for her, her husband was a financially successful physician.
One day when we were sitting together and discussing her practice, she confessed to me that she had really preferred the job she used to have, since she could just show up and work and not be involved with billing her patients and that she would still be primarily working there except for the fact that after 11 years of employment , her employer had sold his dental practice and she was let go.
This anecdote really shows the problem with being an employee dentist rather than an owner operator. All employees can be terminated if the employer needs to let go of them for a valid (non discriminatory) reason. An employee dentist has no real job security, even when they are loyal employees.
I am writing this post, because although their have always been employee dentists, the percentage of the profession practicing in corporate settings seems to be increasing. It used to be employee dentists eventually ended up in a dental practice where they had an equity position, but it is not clear that this is the direction that dentistry is headed today.
Yesterday I had a meeting with a dentist and made her an offer I didn't think she could refuse. She had many years experience in the field but has worked exclusively in other dentists practices. The arrangement involved little financial risk to her and would allow her to comfortably make the transition to owning her own practice. That being the case, she still saw lots of potential roadblocks. "There are so many other dentists in this neighborhood, where will I find patients?"
"What happens if a patient needs to be seen for an emergency if I am not available?" "Will my days here make it difficult to find another employee dentist position, since they may want me five days a week?" These are valid concerns, but If I was her, sooner or later, I would feel the need to figure out a solution to allow me to develop my own dental practice. Yes, I would have to make a sacrifice but I went into dentistry partly so I could eventually be my own boss.
It was apparent to me, that both dentists had become habituated to being employees and may not have a strong desire to "be on their own". It is sad to say, but more and more when I speak with young dentists,many are reticent about taking the steps needed to have their own dental practices. Basically their choices boil down to a few options. They either have to buy an existing practice, become partners in the practice that employs them or open their own dental practice.
This issue seems to be a real trend in healthcare in general, since physicians as well as dentists are finding traditional private practice settings too challenging and are choosing to work as "wage slaves" for hospitals or corporate settings rather than choosing the responsibilities involved with owning their own practices. I am not sure this trend is ultimately a better model for our healthcare delivery system, but this train has left the station and those going it alone may just bewaiting on the platform or worse, standing on the tracks.
from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2017/12/is-cooperate-dentistry-providing.html - http://lspindelnycdds.blogspot.com/
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