21 responses

  1. John Stivers DMD
    June 2, 2018

    I couldn’t agree more Mike. That’s why the following, of all my google reviews, is my favorite: “The office is a perfect example of why I prefer individually owned dental offices vs large corporate owned ones…”

    Though I preach your message all the time, I didn’t coax this particular patient at all. She just got it!!!

    Reply

  2. Jim Van Eaton DDS
    June 2, 2018

    I’ve recently been approached by several large corporate groups to buy my practice, but the only people I’ll sell to are my associates.

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  3. Sherm House DDS
    June 2, 2018

    Excellent Mike! Having worked, and even “owned,” a number of corporate practices (and determining that I wasn’t ever going to bend to their way of doing, “business,”) I’m thankfully in private practice exclusively now.

    With student loans out of control, for many young dentists, corporate practice is their only option. So they become indentured servants to these assholes with AA degrees that think they know dentistry better than doctors. It’s criminal…and many of those docs have the social skills of a yam, so they’ll cow to the corpos, and do their bidding for money. It’s bullshit.

    I wish that there was more guys like us, who’ve seen the, “Dark Side,” of the Evil Empire, to keep providers away from corporate practices. However, the ones in my area do a pretty good job of pushing patients to me, and as you did in this case; it isn’t hard to see why they suck so badly.

    We just had a big, national chain office close here, about 8 miles from my office. Fuck them! One down, 4 more to go. They’re crooks, all of them.

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    • Squiddoc
      September 2, 2018

      You’re my personal hero. I could have said it better myself.

      Reply

  4. Brian K. Van Netta, DDS
    June 2, 2018

    Hi Mike. You, me,Dr. Stivers, and many others will agree all day long on this topic. I’m afraid we are preaching to the choir. The root cause of the problem is bigger than all of us. And it begins at the student level. I’ll visit student blogs to get a feel for what’s happening today at that level and it looks quite bleak. It really is disheartening to hear from many, at the student or recent grad level, that are already soured and discouraged with the profession. Not all of these individuals are just malcontents.

    Corporatization would not exist if there wasn’t a need – just like the sex industry, illegal drugs, or any of a multitude of “services” that flourish today. We may not like it, but it fills a need. All of us are culpable, directly or indirectly, whether we like it or not. Idealistic students rack up massive debt to become doctors, only to be thrown out into a system that is not really working well in the private sector. Dentists in our age bracket are working longer into our careers and many are not hiring associates. What are these poor grads supposed to do? There’s your “need”. Dental schools let representatives from corporate come in and court impending grads.

    They are organized, and have a crap ton of money behind them to sustain this effort. What are we doing? Nothing. Just bitching on a blog. Our profession is so disorganized and fractured, that we are too busy fighting with each other to give a damn about recent grads. Organized dentistry is impotent politically, never strapping on some balls because some attorney shouts “anti-trust”.

    The end result? A flood of new grads, year after year, mired in debt, with scarce private sector job opportunities. Enter corporate, which produces your hi-lighted patient with a fucked up treatment plan. We’ve all seen it way too many times and it’s sickening. But if we can’t collectively figure out a way to organize and inject a healthy dose of ethics back into our once noble profession, then dental professionals and patients will continue to suffer the consequences.

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  5. Gerald Benjamin
    June 3, 2018

    I completely agree with Brian when he says that, “All of us are culpable…” Most of us who are old were so poorly treated in dental school that we vowed never to put a foot in the door of the school once we graduated and we can all understand our vow. Unfortunately, that gave schools permission to mistreat following generations of students and none of us stood up…Sad. What that also did was to permit the schools to teach the same information to students for the last 45 years; teaching the Krebs Cycle was useless 45 years ago and it is STILL useless. More importantly, the schools have failed to adequately teach diagnosis, treatment planning, occlusion, function, esthetics and implant restoration all which would be more important than the Krebs Cycle. When I went into practice 40+ years ago insurance paid up to 92% of my fee; today it pays 20 % and that is why I have been insurance independent for 25 years. Why is this important? Because the parents of kids who want to go to dental school remember when older dentists did extremely well financially and they are willing to pay any price for tuition so that their children will be successful which is why dental schools are able to charge so much. Something has to change but it will not change unless successful older dentists are willing to step up to make it change. The leadership of the ADA has traditionally been between 60-70 yrs old while todays average dentist is ~42 years old. This too must change. We need professional leadership and the ADA is not it. These are just some thoughts for discussion; there is no right or wrong.

    Reply

    • The Dental Warrior
      June 4, 2018

      Most of us who are old were so poorly treated in dental school that we vowed never to put a foot in the door of the school once we graduated and we can all understand our vow. Unfortunately, that gave schools permission to mistreat following generations of students and none of us stood up…Sad.

      Bullshit. I reject the notion of collective guilt or “it takes a village” crap. That you believe stepping foot back through the doors of the dental schools would change them is naive. It’s the same canard about “getting involved” in the dental association to change it. Been there. Done that. Got the plaque with the little gavel on it. It doesn’t work! I got involved, and it changed NOTHING, despite my efforts. The traditions and polices of such institutions (dental associations and dental schools, alike) are FAR too entrenched to be changed by simply “getting involved.” The BEST way to change them is to REJECT them. To NOT get involved and LEAVE those organizations to languish by diminishing membership and MONEY.

      Joining them is tacit approval of what they have been doing and continue to do. One person…. two people… twenty people joining with the intent of changing them will do nothing. The poor treatment is the VERY BASIS of their existence. We aren’t going to change it by joining them. They will either change or DIE when we REFUSE to join them.

      The ONLY thing dental schools want from alumni is their MONEY… not their opinions.

      Your suggestions are pollyannish at best, or naive (which I don’t think you are). But, given your experience I would have expected you’d have figured it out. I did.

      No. The BEST thing I can do is post articles like this one: Dental School Still Sucks 25 Years Later. It’s my third most popular article, with over 44,000 views, and the bane of dental schools. I’ve been told the article has been printed and circulated at dental schools to the chagrin of the faculty.

      I did something similar many years ago, before I had a blog. I wrote a letter to the editor of the ADA News. It was in response to a report about the lack of faculty and former students not coming back to the schools. The report concluded that it was because the schools didn’t pay as much as private practice. My letter argued that it was the way we were treated in school. I was very specific and even called out my school by name. It got published in its entirety. And, it caused a firestorm! 🙂

      The best thing I can do is use my platform to EXPOSE them for what they are. Fuck them! Really. I mean it. It is NOT us. It is the sick traditions of the schools. My military experience was better than dental school, and I was in a war zone. I’ve had many bad dreams about dental school. Never about my time in the Navy. Why would I EVER go back to the school. I’d sooner rejoin the military, and I’m not kidding.

      Reply

      • Susan
        June 20, 2018

        Reject the system if you prefer, but don’t forget that without dental school (as flawed as it was) you would not be where you are today: practicing dentistry.

        Reply

      • The Dental Warrior
        June 20, 2018

        Ummm…. the point being (about dental school)???

        I disagree that it is “the system.” Corporate dentistry is A “system,” but it’s not THE “system. It doesn’t affect me one way or the other, except for some benefit by driving some high-value patients to my practice. 😀

        My missive was observational. The free market (as long as it remains free) will determine the long-term outcome.

        Reply

      • Susan Vadnais
        June 22, 2018

        Yes. My comment was referring to your sentiments in regard to dental school. Sorry I conflated the two topics.

        In regard to corporate dentistry, I agree it is not ideal and yes, the free market and other larger influences will determine the outcome. Honestly, I don’t think the ADA nor the people working in the profession have as much control over the direction of the profession as we would hope to think, especially as mentioned, it’s fractured nature.

        As pointed out, the free market presented an opportunity (a need) for corporate dentistry. Increasing tuition, increasing overhead costs, fewer associate opportunities has made it increasingly difficult for new graduates to obtain viable positions withini PP. The economic recession of 2008 affected retirement investments as well as care acceptance placing economic pressures on long time dentists to continue working past intended retirement.

        If these guys and gals can hang on long enough and not sell out to corporations, maybe there will some hope for turnover into PP for the younger generation.

        The problem with this scenario (as it pertains to PP versus corporate) jimho is that the consumer often can’t good dentistry versus poor dentistry unless it is very, very obvious.

        Of course the free market in this case involves many consumers (not just the end user, I.e the patient).

        Reply

  6. Robert Toth
    July 28, 2018

    I disagree.

    Young docs work in corporate because no one in private practice will hire them. It’s not glamorous. It’s not like they want to do it.

    Patients choose corporate because private practices don’t take their insurance. Everyone knows it’s not the best dentists in town. It is a symbiotic relationship.

    The quality of work is pretty bad. This is more likely the result of lack of experience. Everyone sucks right out of school.

    I’ve worked for corporate and private. I was pressured more at the private practice. Either way, how many dentists do you know are going to roll-over and misdiagnose because they are told to? Would you?

    And yes, dentists leave corporate after a year or two. This is before the fees are low and patients are mostly lower class and a pain in the ass.

    It’s a stepping stone.

    If you don’t like the system, you either need to hire new associates yourself, or take HMOs.

    Would you rather have the government step in with socialized dentistry or should we force private practice owners to hire new associates? What’s your solution?

    Reply

    • The Dental Warrior
      July 28, 2018

      I’m not suggesting a “solution” be enforced by anyone, and certainly not the government. I say let the EDUCATED FREE MARKET take care of it. My suggestion, if any, is that we all (private care dentists) win the battle, one patient at a time. Eventually, the public will figure it out. In the mean time, I’ll also use my writing skills to spread the truth.

      Your condescending suggestion of taking HMOs or hiring an unneeded associate is both vacuous and specious. Why would I do either of those, both being detrimental to my practice?? To make a point? To “solve” a societal problem? Yeah… no. I’m not going to sacrifice myself on that altar.

      But, to answer your question about dentists who would “roll over”…. Ummm, yeah. PLENTY. I’ve seen it. Would I? No. Did I (when I worked in a chain)? No. But, I also lasted only 10 months.

      Reply

  7. Squiddoc
    August 28, 2018

    After nearly 7 years in the military as a dentist I worked in a corporate chain briefly, and it was not a good experience. There was so much that was below the standard of care that I was amazed the clinic was still open. Bringing up shortcomings in materials, staff, and organization were not welcomed. Patients openly complained about not seeing the same doctors and even front desk personnel. I wouldn’t work in a corporate chain again nor would I advise anyone else to do so either without realizing first you won’t be able to practice at your best in my humble opinion.

    Reply

    • The Dental Warrior
      August 28, 2018

      “Squiddoc” = Navy? Me, too. When and where were you stationed? I also went straight from the Navy to a corporate clinic. HUGE “culture shock” in terms of “standard of care.”

      Thanks for your comment!

      Reply

  8. Roger Holten
    September 20, 2018

    I have a hard time finding a good dentist for me because I do not react to the numbing medicine like most patients. It often takes much more and I metabolize it rapidly. I have only been to two dentists in my area, Albuquerque nm, that have been able to work with me. With both it was a training experience for the dentist as it does not seem to be a common issue, unfortunately for me the dentist who was covered under my insurance no longer practices, and the dentist who took over the practice was extremely aggressive about treatments that she would not offer alternate options or identify risks for the treatment or non treatment. So again I find myself without a dentist and unwilling to find another due to the difficulty of finding one who will listen and work with me on numbing before working on my teeth.
    I have been to several dentists who give up numbing me and just start working on my teeth and those are experiences I do not wish to re-live.
    When you find a good dentist keep them and I will not go to places where there is multiple dentists seeing any individual patient.

    Reply

    • The Dental Warrior
      October 5, 2018

      Hi Roger,

      Sorry to hear about your challenges finding the right dentist. Don’t give up! There are lots of great dentists out there. Though, if you are limiting your choices to those on a restrictive dental plan, it’s going to be very hard. Consider finding a private care dentist who will treat you rather than your plan. Yes, you’ll have to pay out of pocket. When you find one willing to listen to you about your difficulty getting numb, you might refer him or her to my article: https://thedentalwarrior.com/2014/05/21/slam-dunk-anesthesia-for-lower-molars/

      Good luck and best wishes!

      Reply

  9. Eric
    September 2, 2019

    Hello Dr. Mike!
    Loved reading this article and I would love to hear more about how you set up your practice. I am a new owner after finishing 4 years in the Army and currently bought a practice that participates with all PPOs and want to move away from it. Would love to hear about your experience with it and see if possible to try when a practice is still not busy with schedule (in fact, still filling schedule day by day)

    Reply

    • The Dental Warrior
      September 3, 2019

      I started off from Day-1 with no plans. So, I don’t have any experience dropping out of them. But, from what I hear, you don’t want to do it willy-nilly.

      While open spots in the schedule scare most dentists, I see them as opportunities to fill with “good” patients. They don’t always fill, of course. But, being booked out for months with no open spots can lead to MISSED opportunities.

      Reply

  10. Lou Sachs, DDS
    June 24, 2020

    We have a lot of “big box” dental practices in our area–both corporate and private offices styled after the corporate models. The dental insurance companies are complicit in this too. When Dr. Bramson left the ADA, as executive director and went to insurance, I noticed that the insurance company went downhill and fast. I said he went to the dark side, much like Darth Vader, hence my new nickname for him, Darth Vader. Since he left, it has improved a little bit. I dropped out of that plan, but I had some serious ethical issues with them and I could not ethically work with them any more. I have seen a lot of corporate dentistry and it sucks. Young dentists right out of school being force fed to do high level procedures, that should be referred out to specialists, create lots of failed treatment. They want to keep as much treatment in house as possible, to increase profits and I guess, to keep other dentists from seeing their below the standard of care treatment. That’s my soapbox for today!

    Reply

    • The Dental Warrior
      June 24, 2020

      Thanks for you comments, Lou!

      Seems there’s quite a bit of “inbreeding” between the ADA and inscos. You might enjoy another article I wrote: Why Can’t the ADA More Like the NRA? 🙂

      Reply

  11. bjj_bob
    April 2, 2023

    I agree with your comment.

    Reply

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