The devil you say!

Oct. 1, 1998
I have just read Dr. Mike Maroon`s editorial piece bashing the dental practice management companies (DPMCs) as the "devil in disguise." I am appalled by his arrogance and limited vision. It is perhaps Dr. Maroon`s experience with a practice bankruptcy that leads him to wax so patriotic about the joys of self-employment in America, but for the life of me I can`t see what the appeal is.

I have just read Dr. Mike Maroon`s editorial piece bashing the dental practice management companies (DPMCs) as the "devil in disguise." I am appalled by his arrogance and limited vision. It is perhaps Dr. Maroon`s experience with a practice bankruptcy that leads him to wax so patriotic about the joys of self-employment in America, but for the life of me I can`t see what the appeal is.

Dentistry is fun, and each passing year has brought greater enjoyment to me in my 16 years of clinical practice. But business is a pain. If running a business is your idea of fun, then more power to you. Why insist that we all share your joy ... or is it that misery loves company? For many dentists, the reality is that being in business for themselves is a major stress, with little to show for the effort.

Sure, there are risks in working with or investing in a management company, yet to lay out these arrangements as being devil-inspired seems naive and dogmatic. As to whether affiliated dentists still will be subjected to the economic realities of the business of dentistry, the answer is "of course." A new financial arrangement between dentist and investor/manager cannot change the economic realities of the world. If your practice does not produce enough to afford expensive equipment or staff now, this may not change with new ownership alone.

It has been estimated that less than 10 percent of the American population has the personality and desire to own and operate a business. Of those who try, many will fail. Why is it assumed that virtually all dentists want this challenge? Are we to assume that all associates, partners, and group-practice members are underpaid and unhappy? Are we to assume that sound business principles are adverse to a high quality of life or high quality of dental practice? Are we to assume, that in a professionally managed practice, the dentist is less well off than he/she is under self-management? Isn`t it possible that better business makes better (not worse) dentistry? Haven`t we always known that good dentistry is good business?

Does Dr. Maroon think that all professional airline pilots should yearn to own their own plane, sell their own tickets, fuel up their own tanks, serve drinks to passengers, and clean up? No way! Most pilots are more than content to concentrate on what they do, do it well, and be well-compensated. Why is dentistry any different? Why does Dr. Maroon assume that businesslike management is bad management? Why does he assume that all dentists can, or even want to excel in business?

Dr. Maroon does raise some important issues. I challenge the emerging practice-management industry to show us, in concrete and verifiable terms, how all parties can gain from this new type of relationship. The profession doesn`t need another "get rich quick" scheme. However, soundly operated partnerships between professional and business experts could benefit us all. As dentists, our concern with management companies ought to focus on their ability to manage a dental practice effectively for mutual benefit, not on name-calling and predictions of doom.

Other than the salary we earn as professionals, can most dentists really see a profitable return on equity from the ownership of their own practice? Perhaps selling their "business" to a competent manager would be a good idea for many.

I am engaged full time in the practice of dentistry in Santa Barbara, Calif. I neither endorse nor have any financial interest in any publicly traded practice-management company. But I like the concept, and I think it may be worth a try.

Neil Millikin, DDS

Santa Barbara, CA

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