Potential New Hire Asking Question On Dental Forum About Compensation Based On Production at Small Smiles Clinics

July 7 and July 8, 2010 conversation between members of a forum for new dentists.  Wonder if it was "internal and confidential" then too?  Oh, wait, that was long before I wrote anything about the bait and switch contract for Small Smiles dentists.

New Graduate asks:
Hi,
I will be interviewing for a position with Small Smiles. Here are the major pointers of the compensation and contract:
- Mon to Fri, 8 to 5
- 3 other dentists and 4 hygienists already working there.
- Production based compensation (22% of everything; xrays, hygiene exams, operative, exams, etc)
- Daily minimum $360 (but obviously this hardly happens, as I am told)
- $10k sign-on bonus.
- Average patient is billed $200 per visit, so I am told that I can see two patients at the same time, as well as hygiene exams too.
- 4 weeks paid holiday
- Did I mention this is a chain office?
Any pointers about this opportunity? Is this a good or bad deal for a new grad?

Fred:
Run for the hills

Wilma:
If it's truly a 'daily minimum,' get it in writing.  But. c'mon - a franchise just for low-income with an average per visit charge of $200, and making the offer they are making you?  If that doesn't sound fishy enough.....read this ( http://abcnews.go.com/2020/dental-chain-reaches-settlement-medical-fraud-performing-unnecessary/story?id=9615119 ) and then do as previously posted - run for the hills.

Ed:
I don't recommend franchise dental clinics for patients or people who are looking for work.  I looked at the link above and I thought it was "sensational".  Who really knows what shape the kids were in before getting in the chair.  Most of the mothers look like trailer trash and probably couldn't tell the difference between a cavity and a raisin their kid just ate that happened to get jammed into a hole in their kids "toof".   Sad that this is the only care available.  I suspect their are at least a few who work in these places that truly do care and are trying to do the best with a very bad situation and make a difference in the lives of these unfortunate kids.    
Catch a glimpse of the upper right quadrant of the kid early in this video that was not treated.  Mom says his teeth were perfect before he got in the chair.  Ignorant people see this stuff and think the dentists are evil.   Ed
http://www.youtube.com/watch?v=wdxeG6F41uc&feature=related

Gene:
Small Smile mainly takes Medicaid and Chips insurance patients. They only way to squeeze 200$ out of these low reimbursment insurances is by aggressively over-treatment planning every case ( Which of course they are notorious for) 
The worst part of working at Koolsmiles or SmallSmiles is that you will an office manager who will ensure that you meet these ridiculous production goals. If you do not produce you will called into the office and someone without a dental license will be telling you how to practice. "Dr. New Grad, Why don't start using the Papoose board. We have some Dentists producing 10,000$/ day." They don't give a crap that these kids are screaming in the back rooms and urinating on themselves out of sheer fear from the traumatic experiences they are subjected to.
The other worst part of working at the Smile Center/ Koolsmiles is that they set up the clinic so that the doctors will be fighting for production. You get a bonus if you produce X amount of dollars in operative. This will #1) lead to aggressive treatment planning #2) the doctors camp out in the operative rooms and fight over op patients.
Don't work for these guys or any smile-o-rama.
Barney:
Medicaid offices REQUIRE speed and efficiently to handle the volume of patients needed to offset the low compensation and profit margins.  Right out of school, some docs may not have the clinical skill needed.

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