Growth Trends in Dental Service Organizations.

There are a number of factors fueling the growth of large group practices managed by corporations across the U.S., including California. These evolving trends are shaping the dental profession and practice models in a variety of ways.

We Have Your Back.

Healthcare delivery in the United States, including dental services, has changed rapidly in the last few years, and will continue to change in the years to come. Oral and Maxillofacial Surgery Partners (OMSP) was initially formed to specialize in the unique issues of running the business aspects of an oral surgery practice. Over the past 17 years we have grown to the point of including 25 practices, in most specialty fields, primarily solo practitioners and small partnerships. The need for this service is a direct function of the increasing requirements for and complexity of the business aspects of small businesses and the need to ensure quality standards in health care.

Dental Support Organizations.

The Association of Dental Support Organizations is a recently formed association of 33 companies representing a range of management and support services for dental practices. These organizations do not engage in the practice of dentistry, although in some cases they operate as holding companies for practices that do, thus separating the legal responsibility of providing treatment from the management and flow of funds. This report summarizes some of the recent trends in oral health care and dentists' practice patterns that are prompting the increased prevalence of this model. The general functioning of the DSO model is described, including some common variations, and the core values of ADSO are featured.

Decision dilemmas and opportunities for the new graduate dentist.

Career options for new graduate dentists are changing because of economic and management challenges in traditional practice, the growing trend toward group practice models, enormous educational debt load and lifestyle expectations of the millennial dentist. While new dentists learn to survive and adapt to an evolving profession with many pitfalls, they also have the opportunity to shape the future of our profession.

Practice transitions--past, present, and future.

Until the 1960s, the value of a practice upon the retirement of the dentist was considered to be nil. In the next several decades, the value of a practice as a going business concern was recognized and formulas based on productivity were used to establish the sales price of "walkaway" practice transitions. Increasingly creative means, such as pre-sale, deferred pre-sale, shareholder process, incremental practice sale, and practice mergers have been created to make practice transitions more flexible, thereby maximizing the financial value of transitions. Dentists at the beginning of their careers will have an increasing range of opportunities in the future, with various combinations of financial security, freedom from manage- ment concerns, control over the practice, and accumulation of equity. Those in the 45- to 55-year age range should be planning in detail for their transition. Those older than 55 should begin exercising their plans since the future will involve much longer transitions.

The evolution of dental group practices.

Dentists and the dental profession are changing. One significant change in the deliver of dental care is the evolution of group practices to include networks of dental practices with central management by various service organizations that are owned or financed by private equity firms. This article discusses their evolution and potential advantages and disadvantages for dentists who join them. The article concludes with a prediction about the future heterogeneity of the dental care system.

Power, ethics, and corporate dentistry.

The North Carolina Dental Association recently sought to place clear statutory limits on the influence of corporate, nondental interests over dentists practices' decision-making. This report describes the two-year legislative battle with well-funded and politically connected parties that ultimately resulted in laws that protect patients' rights to be treated by a dentist free of outside commercial interests.

Reflections on dental management service organizations.

There are a multitude of practice options for the young dentist today. First, many practicing clinicians remain in solo practice or small group settings; flexibility, autonomy, and the ability to control one's environment are important factors in deciding to practice privately. The modern dentist, in order to succeed, will have to learn the business side of dentistry quickly and apply it more strategically in this new economic environment. A second choice is working in a large clinic or clinic environment, which is an option for those interested in a group setting with related benefits but no ownership option. The third alternative is working for a DMSO that operates facilities and offers their staff commensurate salaries and benefits, professional pride, and the potential for ownership that will be a stable component of caregiving in the future. Lastly, joining the military as a dental practitioner is worth noting; 10 percent of the men and women of the TUSDM 2010 graduating class opted for this clinical setting.