Working for the man?


"Working for the man" means working for a corporation or or otherwise large company lacking in independent spirit. Less specifically, it can mean working for some type of authority which was at one time ostensibly oppressive to said worker."

First it was the death of owner operated pharmacies. How could they compete with big, modern chains pharmacies such as CVS, Duanne Reade and Walgreens? Then the medical profession went under the knife. Now most of my doctors are working either for hospitals or are participating in a corporate named group medical practice. When I go to see them for visits it is very clear that their practices are not owner operated and they are employees. To make matter worse their boss is usually monitoring their activities through the computer that they so raptly stare into. Clearly they have less time to actually pay attention to their patients and are instead most intent at making sure they have entered all the appropriate information into their computers. One of my physicians confided with me that now "He is working for the man" and not solely responsible for what is going on in his office.  He no longer can take phone call,s but instead I have to communicate via email with him.

Dentistry is probably next. The push for paperless dental offices and the increasingly digitization of dentistry are insuring that more and more our backs will be turned towards our patients. True we still have to perform procedures in order to have something to enter into our computers, but the emphasis has changed.

More and more recent graduates are showing interest in joining practices in a non equity position. They are reticent to take the plunge and spend the money needed to buy or start a practice. It is not entirely surprising since more and more potential patients  have managed care insurance plans. In our profession, most of my colleagues report that these patients are notoriously fickle and tend to go to a plan dentist and will switch when ever their employer switches their insurer ( this seems to happen frequently).

How will our profession respond.... probably by establishing larger group practices in order to negotiate better rates with insurance companies, who seem to be somewhat responsive when confronted with a larger group that threatens to leave a plan en mass. The writing is on the wall and I am not entirely pleased with the message. Solo dental practices are on their way out and practices with corny corporate names and super modern offices are on the rise. These practices will do the volume of dentistry needed to invest in high tech improvements as they come along and be truly the next steep in "managed" dentistry My fear is that these offices may have more in common with fast food franchises than with the traditional type of dental offices that I have known.

Given the current trends in the insurance industry , I believe the writing is on the wall. I don't blame my younger colleagues for joining group practices since there is less initial risk and they can concentrate at delivering 21rst century dentistry. Since I have 5 more years on my lease and already have a  viable dental practice I can afford to postpone any decision on joining a group. That being said,  even I sometimes envy those in group practice who can share the expense of purchasing new technologies and share the decision making involved with managing an office.




from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/10/working-for-man.html - http://lspindelnycdds.blogspot.com/

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