Say you’re a young Dentist, just starting out. You finished your residency; now's the time to get a "real job". You need something that is going to allow you to make a living, perhaps start a family, and have some fun. You need an income that will allow you to pay back your student loans. You have a decision to make. Should you join a private practice, start working for a dental management company or start your own practice? Should you try to combine all three? Some dentists are natural entrepreneurs with keen business minds. Some dentists are drawn more to the science and practice of dentistry, eager to focus solely on doing the work they love. As different as they may be, both types often dream of owning their own practice. From a dentist’s standpoint, there are four types of practices to consider.
1. Traditional Private Practice: No insurance accepted; patients pay fees set by the dentist. The fees are set by the dentist and are usually competitive for the area. The owner/practitioner may sometimes have another Dentist working with them. These associate Dentists may work for a daily fee or for a percentage of production or collection. Some of these traditional private practices may offer courtesy billing. This means they may work with your insurance, collecting part of the fee from the insurance company. Crucially, the patient is responsible for the difference between what the insurance pays and the total bill. This is similiar to using the out of network benefits of a PPO plan. Dentists who own practices like this do all their own promotion.
2. PPO Practice: The owner/practitioner decides to participate with some or many insurance companies and become an “in-network Dentist.” To the Dentist, the biggest advantage of joining a PPO is that your practice shows up on the insurance website – an important source of new patients. The huge disadvantage is that you work for fees that the insurance company sets. Depending on the plan, these fees range from very low to almost reasonable. Bottom line is, most patients come to you because you "take their insurance". More on this later.
3. Insurance Practice: The owner/practitioner decides to participate with all or most insurance plans: HMO’s , PPO’s, DMO’s and Medicaid. Many of these pay very little. The advantage to this practice is that your chair(s) may be full. This is also the disadvantage: your chairs may become overfull, and you will need an ever growing number of patients just to keep your doors open and the lights on with no time to properly service "private" patients. You may end up practicing "fast" dentistry. Every dentist insists that they provide quality care, but the reality is that no one can do a quality cleaning in 10 minutes. Yet in some insurance practices, 10 minutes may be all you can afford.
4. Hybrid Practice: Some owner/practitioners try some combination of all three types.
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