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Death of the Solo Practitioner: Corporate Dentistry and Proprietary Shit

Death of the Solo Practitioner: Corporate Dentistry and Proprietary Shit
Stella Forrester

It was an otherwise routine Thursday morning in the life of a CEREC doctors mentor, sitting in the expansive lecture hall of the Scottsdale Center for Dentistry, fumbling with my lanyard string and fighting with my brain to stay actively engaged during the third straight hour of lecturing. But then something happened. The final speaker for that morning presented a topic that piqued my interest and demanded all my conscious faculties.

Spear was unleashing a new service, one that paralleled a business proposal I had been furtively working on for the last year. Something that I knew would revolutionize the future of dentistry. And I sat, enrapt, wondering if everyone else realized that they were witnessing the end of the current era of dentistry.


The Marketplace is Evolving

Like it or not, there have been subtle encroachments happening around us, and sometime—seemingly in our sleep—very big players made sweeping alterations to the humble practice of solo clinic dentistry. Alternations that will impact us all: those of us in the prime of our career who will invariably need to compete, those looking to retire from the profession now faced with either selling to a stable corporation versus an associate who may or may not be viable, and the upcoming dental workforce who is averaging 400,000 in debt.


For many of us who were chasing the dream, it is time to start considering how we will respond.


But first, I’d like you all to revisit that dental dream. The blissful one so many of us were all sold on, the one that transfixed us and sent us starry eyed into that first year of dental school. I believe it went something like this:

(Please, place your head in the clouds and imagine gentle harp music dancing in pirouettes around you.)


You would create something astounding: A pristine empire, a well-oiled machine. And inside your OSHA regulatory compliance meeting walls, you and your fearless team would master all the clinical skills and provide state-of-the-art standard of care, all while your empire thrived.

And you were going to lead them.


But someday, someone faultless would join you. They would soak up your wisdom and adopt your perfect ways, and then, side by side, like-mind by like-mind, you would kick dentistry’s ass, simultaneously fortifying an epic domain.

During your years of unspoiled bliss, you would amass a large chunk of money in an account in Zurich—enough to leave your empire behind while your youth and vitality still draped lusciously around you. And you would say “it is time.” And melt ethereally away. And then those who came after would long reap the benefits of your labor.

(Please now shatter a vase on the ground.)



The solo practitioner offering dentistry to the highest standard of care—the one large facilities like Spear, LVI, Pankey, etc. are educating people to achieve—is rapidly becoming unobtainable.  I am a woman who loves to engage my colleagues, and this is a resonate theme at every CE event I attend: the huge spikes in overhead that accompany such a goal, and the practical application of many of the concepts deemed “standard,” are often difficult to implement for a team already operating one way. Single manned enterprises are struggling to keep up, and inch for inch losing ground while corporations descend.

Corporate dental Walmart’s are popping up all over the place, and brand recognition is an undeniably strong consumer force. SEO has become somewhat of a buzz word, with high players scrambling to pay for their spot top on some list, yet, the value one can place on “the top spot on a list” has no ceiling – and we can’t all be number one. Dollar for dollar, when it comes down to it, a corporate firm will win.

Read also: Corporate Dentistry and it’s Impact on Quality Care

Last month I was at a class and the speaker said, in full sincerity “who here senses we will all be working for corporations in a very short period of time?” I quickly raised my hand. I honestly fear it!

And let’s be real – who became a dentist because they want to work for a corporation? I polled as many friends as I could when I started writing this article and these were some of the responses given to me:

  • “I will never work for a corporation.”
  • “I’d rather do my own hygiene than be a slave.”
  • “Yeh, I like to avoid brain washing enterprises.”

Read also: Corporate Dentistry: What it Means to Me


And the similar responses went on. General takeaway: the majority of dentists are programmed to be solo empire builders, it’s in our DNA. But now, the type of empires we can feasibly build are becoming less diverse. It seems small bread and butter practices with no bells and whistles and high end fee for service boutiques can still manage fine, but what about the multitudes of dentists somewhere in the middle? What does this mean for them?


Honest Truth:

The prototypical “Patterson” dental practice with state of the art equipment, CAD/CAM, Cone Beam, Implants, digital x-rays and treatment planning software, dental photography, highly trained staff, latest equipment and materials … is forking out operating expenses anywhere from 800,000-1,000,000 annually. And that’s my weak ballpark. Obviously this is a gross oversimplification.

Still, to come out ahead, the clinic has to be set up for flawless production. It takes a heavily invested in, highly tuned operation to crank out the kinds of numbers required even to sustain the cost. A profit can eventually be reached; it can be done. But, working ones’ self to death is also a thing.

There has got to be a better way. And there is, kind-of.


Consulting. Consulting firms love to come in and help you maximize your business. They’ll get your staff tracking all the hard data and help you take the helm of your boat. However, they still don’t tackle the hardest of things, which is “How do we take all these amazing new skills we’ve just paid to acquire—the high production cases that can both change our patients lives and catapult us into the bracket of producing—and revamp our facilities to deliver it?”

Therein lies my solution to this problem.

We need a player out there who is looking out for the backbone of dentistry: the independent solo enterprise. Who can help doctors maintain their autonomy, while benefiting from being banded together under a larger franchise? A business which would grant participating clinics purchasing power, so proprietary costs no longer are prohibitive, and SEO optimization that can be shared amongst the larger group.

We need a player that will take the time to invest in functional and individualized team training, such that systems and procedural implementation of those things that we see but seem impossible to reach, can become our practice realities. Billing and finance can be delegated, the major headaches of a highly successful dental clinic can be managed by the larger entity, and the greater community can foster continuing education and general support for the participating doctors and their team.

And the dentist can rediscover their passion for the practice; rediscover their love for the art of dentistry. Work isn’t work when it feels just like play, and if something could logistically provide that support, the age of the solo practitioner could reach a new wave. Because then the solo practice doctor could honestly do it better, and the corporations will feel the competition rise.

Spear practice solutions is just getting underway, only time will tell if it is all they are hyping it up to be. But keep your eyes peeled, because this will be a game changer, and I’m sure it’ll be just a matter of time before other services start popping up. I don’t know about you, but I’m equal parts excited and terrified for what this means for the future of dentistry.

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