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“Any disease related to the mouth has an impact elsewhere in the body,” ~ Denis F. Kinane, BDS, Ph.D., University of Pennsylvania in Philadelphia.

There are more options than ever when it comes to selecting the right dental care provider for you and your family. As a conscientious patient, parent or caregiver, it’s best to have an established relationship with the right dental provider. It’s also to do this far before being confronted with a dental emergency.  

Few relationships in life carry the highest bonds of trust; where honesty, integrity, and partnership are paramount. A healthcare office should be a respected and safe space where life‐changing moments are shared, and choices shape our future. Outside of matrimony, it is the relationship between patients and their healthcare providers that should be so sacred. With medical studies proving connections between oral health and the health of the brain, heart, lungs, bones, joints, blood and even pregnancy, it behooves us to choose our dental care providers wisely.

This point may seem inarguable. However, the all‐important doctor‐patient relationship has deteriorated across healthcare over the last several years.  Many believe this deterioration is thanks to trends in legislation, insurance and the healthcare industry at large. They believe these trends put corporations, not patients or healthcare providers, in charge of the future of a patient’s healthcare.  

Private practice in healthcare is declining around the world, and corporate control is taking its place.  

Currently, in American healthcare, the percentage of physicians and dentists who privately own their practices is dropping. According to the 2016 American Medical Association (AMA) Physician Benchmark Survey, “2016 became the first year when less than half (47.1 percent) of patient care physicians had an ownership stake in their practice.” This represents a 14 percent drop in 15 years. While the decrease is less dramatic for dentists, the American Dental Association (ADA) has also reported a steady decline in the percentage of existing private practices in dental medicine over the last decade.  

Conversely, corporate‐managed healthcare is increasing at a higher rate than private practice is decreasing. So, while less than 1% per year may seem small, it becomes a factor of multiplication in effect when you combine that rate with the rate of growth of corporate healthcare.

We see this trend affecting general medicine and dental medicine alike as dental management organizations (DMOs), dental service organizations (DSOs), and large dental group practices are becoming more prevalent.

The rapid infiltration of corporate‐managed care into the dental market raises many concerns for doctors and patients alike. In the quest for optimal health, it is essential to understand what changes corporate‐run practices bring to the world of oral healthcare.   

What does corporate managed healthcare offer to dental healthcare?

Corporate dental management companies consolidate and manage dental practices. Merging management seems well suited for increasing profits and handling an increasing amount of patients with possible short‐term savings through group buying power. Also, in the corporate setting, dentists can avoid the headaches of hiring support staff and handling paperwork by letting the business oversight part of the group take care of it. Therefore, it separates the dentist from the management side of dental healthcare.

Under the corporate organization model, dentists can focus on simply taking care of dental work, while leaving the concerns of pricing, hiring qualified staff and keeping up with current paperwork requirements to someone else.

However, to receive these benefits, dentists give up ownership of their practices and become contracted employees instead.  

What about the doctor‐patient relationship?

In some cases, cost savings measures introduced by DMOs are acceptable. However, in others, the “savings” can create additional, unforeseen costs as corners are cut. Less qualified and lower paid staff are hired, cutting edge equipment and techniques are nixed, and high‐grade or biocompatible materials with low‐profit margins become budgeted out of the dental care offered to patients.  

Within corporate dental organizations, interactions with patients are typically controlled and managed by policies devised by administrators who may, or may not, have a healthcare related degree. As the corporate system handles patients like an assembly line, seeking greater efficiency and profit margins, dentists may find that they lose some freedom to customize treatments and care for their individual patients’ needs. They may even be penalized for challenging policies. Now seen as employees instead of doctors, dentists can be required to fulfill certain obligations, log a certain number of hours, and fulfill quotas for number and type of procedures performed.

The result is often a lack of personal care, potentially avoidable or unnecessary treatments, and negative outcomes that can detrimentally affect patients’ health.  

Developing a long‐term trusted relationship with a dental doctor is much more difficult in the “streamlined” corporate environment. Practices may limit clinical time and place greater focus on corporate policies over doing what’s best for patients. There’s no guarantee that a patient will even be able to see the same dentist visit to visit.  Turnover is high, and the firm can replace dentists in an instant.

Patients frequently feel that corporate dental offices are less compassionate about individual patient concerns and are more focused on their bottom line.  

Records show that, along with the growth of corporate‐managed dentistry and healthcare in general, standard‐of‐care complaints to the state have also steadily increased over the past several years.

Many patients report the use of high‐pressure sales tactics for expensive, or even unnecessary dental procedures, while “dental employees” are given quotas and pressured to spend less time with patients. Not to mention that higher quality and longer‐lasting dental treatment solutions are frequently unavailable to offer, even if patients ask for them or if dentists feel that these options would be better for their patients. Such practices impose ethical dilemmas for the dentists and the staff of these corporate institutions.  

It’s no wonder many patients lose trust in their relationship with dental professionals altogether.

The heart of a healthy dentist‐patient relationship lies within a deeply personal environment that depends on conversation and working together.  

Long‐term oral and holistic health is possible with a positive, trusted partnership. Two of the greatest benefits of private practice are that dentists and their patients have much more freedom in how they interact and that dentists have greater leverage in their ability to educate and advocate for their patients’ optimal health.  

Patients deserve to have confidence and trust in their provider. That only comes from a relationship built on compassion, respect, and commitment. Private practice dentistry can offer a warmer, more authentic relationship with your dentist and their staff, and can be done in a welcoming environment. A private practice dentist will know your oral history as a person, not just as numbers and reports. This gives them a significant advantage in helping you with your long‐term oral care and enhancing your health goals.

Communication, education and specialized, custom care can be tailored around your needs, while the dentist is better able to integrate cutting edge and biocompatible tools, materials and techniques.  

Patients’ lives and long‐term health can benefit from the inherent freedom private dental practice offers.

This comes in the form of spending quality time with, building trusted relationships and customizing the best clinical solutions for their patients.  

While corporate dental offices work for some, we feel that it is important to provide our patients with a customized and personal experience. One that addresses their concerns, is tailored to their needs and comes with the best knowledge and treatment options we can offer.   

And only private dental practice can guarantee that.  

~ By Matthew F Carpenter, DDS
Dr. Carpenter received his Doctorate of Dental Surgery from the University of Texas, San Antonio in 1999 and currently owns a practice in Round Rock, TX (Transcend Dental Health). His current memberships and Accreditations include:

  • IAOMT (International Academy of Oral Medicine & Toxicology) – Member and Accredited, 12/2010 – Current
  • IABDM (International Academy of Biological Dentistry & Medicine) – Member and Accredited, 10/2011 – Current
  • Parenteral Conscious Sedation Accredited
  • Oxygen/Ozone Therapy in Dental Medicine Accredited – AAOT
  • Board Certified Doctor of Integrative Medicine, BCDIM – 7/2017 – Current




For more about Dr. Matthew Carpenter, visit his website, Transcend Dental Health and stay tuned for more member articles. Interested in getting your own articles published? Contact us for more information!


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