I am the owner of my dental practice. My office is not a franchise or corporate dental office.
In my experience, the worst dentistry I see is from those patients that went to “in-network” insurance mill practices and corporate dental offices.
When doctors participate in insurance lists and become “in-network” there are automatically gaining an constant influx of patients. However, the dental offices are forced to only charge what the insurance company says is allowable. These fees are often extremely low. In dentistry there is tremendous overhead costs with running the businesses. Therefore, in my opinion these “in-network” offices recommend treatment that is often not needed. These offices don’t care about the long term health of the patient because they know the patient is likely to leave the practice.
Corporate dentistry is franchise dental offices that are owned by CEOs and board members.
They hire dentist to be “puppet owners” because in most states it is illegal for corporations to own dental practices. The corporate dental offices are all about profit. They want a high return on investment. They want profits so badly they will do anything to reach it. Corporate dental offices will cut every corner possible to squeeze as much profit as possible. One example, is that most corporate offices also own a dental lab. The corporate doctors are forced to use this lab. Thus, doctors are not allowed to choose the best lab for their patients. If the corporation does not own a lab, doctors are required to use a company approved lab. This is typically the lab which is the lowest bidder and not always the one that offers the highest quality. Lastly, a lot of corporate dental offices outsource their dental labs to foreign dental labs. How would you like to have a crown or denture from a dental lab from Mexico, China or Pakistan? Would you trust the materials going into your mouth? Are these foreign labs regulated as tightly as they are in the United States?
It is all about profit for corporate dental franchises. They have constituencies outside of the dental office to please. There must fund corporate checking accounts, salaries and 401(k)s of corporate employees and executives outside of the dental office. These managed dental offices must generate a return on their investment that satisfies stockholders.
Corporate dental offices participate in all insurance plans and are “in-network” offices. They need a constant unlimited supply of patients because the turnover is so rapid in these types of dental office settings. Thus, there is a great urgency to extract as much money as possible from these patients because the corporate dental office is purely profit driven.
These corporate dental offices are governed by profit and loss spread sheet reports. Some corporations put doctors on production quotas which are strictly enforced. How would you like to be the last patient of the day. Your treating doctor is short of their daily quota so they recommend unwanted treatment? I see this all the time when new patients come to my office for second opinions. The treatment that is proposed at the corporate clinic is incredibly inflated and in my opinion just flat out wrong. Now there are different ways to provide dental care and dentist will not agree on treatment 100% of the time. However, when patients come from corporate dental offices with their treatment plans and there are 13 cavities listed and I only diagnosis cavities on 2 teeth something is fishy. Furthermore, in some corporate dental offices there are bonuses for increased up-selling. For example, if a doctor diagnosis a filling to fix a cavity and the treat plan coordinator can convince the patient to accept a crown there is monetary bonus awarded to the treatment plan coordinator.
Patients have the right to know who is the owner, who is really calling the shots regarding their dental care – the corporation of the dentist. The best basis for creating good dental health is a strong patient-doctor relationship where together. My office is very unique, since 1950 I am the third owner of the dental office. My office has generations of patients because of the quality care and trust that is synonymous with this office. I value honesty and quality over quotas and
Claims of over treatment take many different forms. What our office sees is that the majority of allegations are from in-network and corporate dental practices. Suggesting or providing treatment which is not necessary, often not justified, appears to be linked to in-network and corporate dental practices that desire to generate additional fees. Our Pasadena office sees this over treatment in two ways:
1) A patient comes to us for a second opinion because they went to as insurance mill type of practice and got a huge treatment quote. The patient was worried and expressed concern to a friend or family member. The trusted friend told the patient to come see our practice for and honest opinion.
2) Our office has a patient leave our practice due to the failure of their dental insurance. The patient quickly comes back when they see that the corporate in-network practice is over prescribing treatment.
Of course, the over prescribing of dental treatment and wrong treatment can happen in any office. There is substantial anecdotal evidence to suggest that in-network and corporate practices tend to recommend or provide more treatment when seeing a new patient for the first time, than they might do if they saw an existing patient, with exactly the same oral condition under their care for many years. The in-network and corporate offices have a steady stream of patients that MUST go to these offices. The patient does not get a choice as to what doctor is best for them. The insurance mill practices sign up for so many insurance plans they have a never-ending stream of patients. They operate on a system of get as many patients in for as much treatment in as short a time as possible. The new in-network patient appears as a new and fresh opportunity to extract as much money as possible.
In our Pasadena office, Drs. Nugent and West pride themselves in recommending treatment that is in the best interest of the patient despite the pressures of the current dental insurance system. They always present alternative treatment that might be available.