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Say you’re a young dentist, just starting out. You’ve just finished your residency, and now it is 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. Most of all, 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;start your own private 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 this work they love so much. 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 is accepted; patients pay fees set by the dentist. The fees are set by the dentist but are usually very competitive for the area. The owner/practitioner willsometimes have another dentist working for them. These hired dentists may work for a daily fee or for a percentage on production or collection. Some of these traditional private practices may offer courtesy billing. This means they may work with your insurance, collecting what they can collect. Crucially, you are responsible for the difference between what the insurance pays and the practice bills. (This is the same as using the out of network benefits for a PPO plan). Dentists who own practices like this will have to do all the promotion themselves.
2. PPO Practice: The owner-dentist decides to participate with some (or all) 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 all the insurance websites – one of the most important sources of new patients. The huge disadvantage is that you work for the fees that the insurance companies will pay you. Depending on the plan, thiscan range from almost nothing to a reasonable amount for various procedures. Bottom line, most patients come to you because you ‘take their insurance’. We will get more in to this later.
3. Insurance Practice: The owner-dentist decides that they will participate with all or most insurance plans: HMO’s , PPO’s, DMO’s and Medicaid. Some of thesepay virtually nothing to the dentist. The huge advantage to this practice is that your chair(s) will always be full. This is also the disadvantage: your chairs will be overfull, and you will need an ever growing number of patients just to keep your doors open and the lights on. To make that happen, you’ll end up practicing ‘fast’ dentistry. Every dentist insists that they provide quality care, but the reality is you can’t do an adequate cleaning in 10 minutes. Yet in some insurance practices, 10 minutes may be all you can afford.
4. Hybrid Practice: Some owner-dentists try some combination of the other three types.