Do Sales Quotas Belong in Dentistry?


The landscape of dentistry is changing and patients may not be aware that they are at risk.  Dentistry’s history in the US has been primarily a history of privately owned dental practices.  Your doctor owned the practice.  The fees you pay would go directly to running the business, paying the staff and anything left over would go to the doctor.  The doctor owned the office (and maybe the real estate) and made decisions free of outside influence.

Let’s fast forward to today.  A new thing has gained traction in dentistry:  the rise of the corporate practice.  Outside investors come in and hire doctors as employees.  The doctors are not the owners.  It may appear as a private practice but it is not.  The owners/investors could be several thousand miles away.  The office could even be traded publicly on a stock exchange.  Some offices like these are easy to spot.  They are a “chain”.  Other offices don’t wish to let on that they are run by some distant company.  They model their office to look like a typical private practice dentist.

How does this affect you?  Well, corporations have large expenses.  They have to pay middle managers, upper level managers, a large marketing department and pay for a large headquarters.  And none of the managers actually do any dentistry.  Only the dentist and the hygienist are producing the money necessary to support all this.  And what if the corporation is publicly traded on a stock exchange?  The goal of any stock is to produce a profit.  It’s not necessarily to offer the best oral health solutions to patients.  I’d love to say that the two can go together but I’ll let you decide.  Would you feel comfortable if your doctor had a sales quota or production goal pushed by middle and upper level managers that are in a constant pursuit to increase “the numbers?”  Do you see a conflict here?  To be fair, I’ve heard this tactic being used in both corporate and privately owned offices.  But it seems to be much more common in a corporate setting.  I know of several corporate CEOs that have their own Lear jets.  I don’t know of any private practice owners that do.

All businesses need to make a profit.  Nobody wants to work for free.  But healthcare is unique.  All doctors take the Hippocratic Oath which says we will do no harm to a patient.  This also means no unnecessary dentistry for the sake of money.   I for one do not want to see outside influences trying the bend the rules or put pressure on employee doctors to do things that are not right.  And you should also be concerned- it’s your money and your mouth.  If you think this doesn’t happen, you can learn more by watching the following PBS Frontline episode:

The good news is that the majority of dental offices are still privately owned and the owner is in the building and treating patients.  If you’re not sure what kind of office you’re in, ask.   If you have an issue, the owner doctor should be available to help you.  It’s his name on the door and it’s his reputation on the line.

For some patients, they could care less about any of this.  If the corporate office is advertising cheap dentistry, that’s all that matters to them.  They don’t see past the coupon (although in the long run, private practice can usually offer lower costs simply due to not having to pay all that corporate overhead).   For other patients, they see the value of doing business with people in their community where the doctor is the only one making the decisions in regards to their health.