Sunday, May 04, 2008

Warning To Dental Grads Being Wooed By Corporate Dental Companies

Be careful about how you interpret the word "guaranteed” income when being wooed by a corporate dental management company such as FORBA, Heartland or Western Dental. Read this next paragraph very carefully.

A lot of these
corporate associateship contracts are set up so that you are guaranteed a certain salary based upon a specific (and sometimes unattainable) level of production. If you don't hit that level of production, you are still "paid" that salary, but you then owe the corporation the difference between the salary and what you actually produced.

So, in many cases it may seem that you will be guaranteed big dollars right out of graduation, but often that is based upon unrealistic levels of production. They spin it as "guaranteed" because you will in fact be making that money, but you will ultimately have to pay part of it back.
Go ask a few optometrists or pharmacists how much they like the corporatization of their respective professions, and you'll hear all the reasons why every effort should be made to preserve dentistry's professional autonomy.
Then you get hooked up with a Corporate Dental Company that gets nailed for mistreatment, over treatment and over billing insurances or using a blanket DEA number for prescriptions and your once stellar reputation is tarnished forever.

All those long months, days and years spent preparing yourself for a wonderful noble career is gone down the drain in less than 6 months. Not even mentioning the enormous education debt you’ve accumulated and now you won’t be able to get a job that would earn enough wages to make your loan payments let alone live, have a family or anything else. All those dreams of a fruitful life that got you through all those years of study are gone in a flash.

Lets say you don't like the procedures they teach you at their "training camps". What are you to do, you have signed a "non compete" clause in your contract. Then what are you going to do. Talk about stuck between a rock and a hard place!

There's no altruism involved in these corporations' business decisions. Corporate mills are notorious for encouraging over treatment in order to meet production goals. If you're seriously trying to come up with a minimally acceptable treatment plan for a Medicaid patient, you're looking at sealants vs. restoring every pit & fissure in the mouth, complex direct restorations instead of pressed ceramic crowns, periodontal debridement, flippers instead of implant-supported bridges, etc.

Heartland and Western shareholders are just like the ADHP proponents in that respect--they're out for their own best interests, not the public's, but they also know saying "it's for the greater good!" is a nearly impenetrable moral shield for them to hide behind.

The moral in both cases is that dentistry needs to start being proactive about figuring out solutions to the access to care problem, instead of letting other groups seize the initiative and then trying to fend them off while backpedaling.

Some companies like Kool Smiles ask employees to sign a 'restrictive covenant for 1 or more years in a radius of 5-10 miles. This mean you might be SOL if you want to work in that area.

A portion of Small Smiles /  FORBA contract says:
...for a period of 2 years following termination, you can't provide dental services for Medicaid patients within 10 mile aerial radius of the Practice Location, or Employer's practice location on the date of termination if Employer has moved its location, or the location of any of the Employer's related practices.

Add this to the $500 a day penalty for not giving them a 90 day notice and you are just screwed!  What if you had relocated!  What now?

2 Must Read Comments:

Anonymous said...

There are bad actors and good actors in every profession. There are many solo dentists that run there own "mal" practice, but there is no one watching them. Group dental practice has the potential to police themselves and have superior quality control. Plus dentists who set up or purchase a practice have much more pressure to produce (to meet salaries, rent, and monthly debt)than do salaried or commissioned dentists.

Anonymous said...

I agree with most of this. I have seen most of this happen to some really good dentists, and it is hard to come back from. But at the same time being that I have actually worked for the companies you have listed I must defend them a little saying that no one is perfect and they are reevaluating a lot of their policies and making changes though some people may not be happy with it all, well you can't make everyone happy!