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Embrace Progress: How Staffing Helps Mitigate the Threat of Corporate Dentistry by Daniel Grob, DDS, MS, Editorial Director

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As I travel around the country speaking with colleagues, inevitably someone in every group asks the question, "What do you think about corporate dentistry?" The topic seems to be on everyone's mind.

Depending on the situation, I might reply, "Aren't most of us corporations?"

This somewhat snarky response usually gets a "You know what I mean" reply. It seems like there has always been some form of disruptive technology or financial mechanism threatening to alter the way the service industry of dentistry is practiced.

In the 1960s, it was dental insurance. Next, assignment of benefits threatened to take away the independence of the profession. PPOs, capitation and closed panels were countered by direct reimbursement.

Now, corporate dentistry has borrowed from the best (or worst) of all of the above and created the next disruptive force to challenge the profession.

Let's define corporate dentistry
For the purpose of this column, we'll use the term "corporate dentistry" to mean a business or organization that manages multiple dental or orthodontic practices under a common name, with employees managed from a central facility and payments made and recorded at that same facility.

Then we can answer the question of what makes corporate dentistry such a popular topic for discussion, and what makes it a supposed threat. The report, "Critical Trends Affecting the Future of Dentistry," commissioned in 2013 by the American Dental Association, provides some insight into what is on the horizon for us as practitioners. Some of the report's points follow.
  • Ninety two percent of dentists remain in private practice.
  • There is, no doubt, a growing trend toward multisite, smaller networks, with cost and system evaluations being the key for reimbursement.
  • A decrease in traditional dental insurance with an increase in government-sponsored and self- payment options is the future.
Yikes! You say. Doesn't look good!

Starts with staff
What can we do to compete? Most practice consultants and advisers agree that it starts with staffing.

We can ignore the threat or paradigm shift or perhaps join a professional employer organization (PEO) that takes care of all of the details of building, running or growing a practice, with the caveat of perhaps an easy exit upon reaching retirement age.

Most of the benefits of these entities involve staffing and training. It would not take much to get most dentists to agree that staffing is one of the most difficult elements of not only starting a dental practice, but growing and maintaining it, as well.

In Dr. Howard Farran's book, "Uncomplicate Business," the first of three sections is devoted to people, before any mention of time and money.

People means staff! Long gone are the days when clinicians practiced by themselves in an operatory with a cherished key employee at the front desk—often his or her spouse—with a capable dental assistant at his or her side.

Gradually, the employee with the most years got the next job or promotion and pretty soon the practice was staffed with overpaid, undertrained, underutilized and unproductive staff.

In the field of orthodontics, employees have always been essential to delivering cost-effective and standardized care. In our practice, and I am sure in most of your practices, patients are scheduled by the number of employees available and matched to facility and not to the doctor.

Other considerations
Before you can begin to hire employees, you need to understand yourself. This includes your personality, values and purpose in life. It is after understanding your own style and personality traits that you can begin to hire effectively to complement your own skills and gain the assistance of others.

I can certainly attest to the importance of this priority. I will gladly tell anyone who will listen that building a team of capable, trusted and loyal employees has been the biggest challenge to my new practice venture. My compliments and accolades to my prior team and those who followed me to help me build my next practice.

Luring the right employee starts with distinct steps in getting the call out for help. The traditional "want ad" for a dental receptionist or assistant is almost guaranteed to reach the same tired and recycled employees who, most of the time, have not had the benefit of a true leader guiding a coherent team.

Spending time on the call for employees needs to start with a creative, clever and passionate solicitation for help. This call will hopefully stress the uniqueness of the practice and team by appealing to a personality, rather than skill. Of the hundreds of patient opinion surveys that have been returned to our practice during the past years, almost none have mentioned me (the doctor), but most have complimented the staff and their positive attitude, caring nature and competency. During his coaching and consulting visits, well-known practice consultant Dr. Dustin Burleson, business owner and orthodontic visionary, starts a practice makeover with staffing.

Stressing that job descriptions are the first building blocks to building or growing a successful "stand above the rest" practice, Burleson has some specific guidelines for recruiting key employees. He depends on:
  • a well-placed ad with nontraditional job descriptions and specific instructions, encouraging only well-qualified and motivated people to reply
  • a shared mission statement, including a vision for the practice
  • a specific 90-day assessment period
  • regular measurements
  • staff meetings
In her manual, "Managing the Orthodontic Practice," Charlene White emphasizes marketing to staff through meetings, incentives and specific job descriptions. She emphasizes that the staff is just as important as other external sources when marketing the practice. Her 10 steps to effective staff management are:
  • Eliminate attitude problems from the team
  • Don't hire if you can't fire
  • Be the boss
  • Don't discuss if profits are down
  • Don't wage-freeze across the board
  • Do give unexpected perks
  • Be consistent
  • Listen
  • Give feedback
  • Don't expect staff to be like you.
With all these suggestions for building the ideal team, where does one turn? I have used many resources, but I feel that turning to professional consultants and agencies offers the new practitioner—as well as seasoned doctors—the time to properly train and introduce a new staff member to the practice. The details of reference checking, legal requirements and ever-changing HR rules and regulations can be handled by those charged with those responsibilities.

Many experts agree that doing things that do not increase the top or bottom line are best left to professionals such as accountants, lawyers and now, HR and staffing companies. The reasonable fees paid are more than offset by the peace of mind that comes from knowing that the fine details of modern HR management are being handled in the most efficient and legal manner.

So Daniel Grob says
In the end, your staff will mirror or complement your personality and core values. After working with dozens of staff members, I find that the best employees for me, and the individuals that surround me, were those who were raised with similar values and aspired to the same level of excellence as myself. If you surround yourself with great staff members, you'll be less vulnerable to the pressures of corporate dentistry, real or dramatized. A great team is priceless and will increase your bottom line.

Orthotown Magazine
September 2025
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