The missing link in today's curriculum

For graduating dentists, making the best career choice can be a daunting task. In this article, soon-to-be graduate Erin Fraundorf analyzes her options. She considers her student debt, the attraction of DSOs, and her practice management training in dental school.

May 19th, 2016
Content Dam De En Articles Print Volume 106 Issue 5 Macroeconomics The Missing Link In Today S Curriculum Leftcolumn Article Thumbnailimage File

For graduating dentists, making the best career choice can be a daunting task. In this article, soon-to-be graduate Erin Fraundorf analyzes her options. She considers her student debt, the attraction of DSOs, and her practice management training in dental school.

I'm graduating.

After four long years of grueling lab work and sleepless nights studying, it is time for me to step into the professional world. I will be a dentist, yet I feel like my career path is not clear.

While my education has provided me with confidence in my clinical abilities and specialty choice, I am unsure what comes after school. The vast number of opportunities and diverse practice types present a challenge in selecting the best option. I still have a few years to explore while I am in an orthodontics residency program, but not all my classmates are so lucky. Many of them will be entering the real world and practicing in a few short months. They are faced with a tough decision now.

The dental landscape has changed drastically in recent years. From private practice and small groups to affiliating with a dental support organization (DSO), it is difficult for my peers and me to determine which path will be financially sound, yet still offer the autonomy and work-life balance we all desire.

Historically, dentists looked at independent private practice as the Holy Grail, but for students graduating today, it may not be financially feasible. I already have hundreds of thousands of dollars in student debt, so why take on more? With competition in metropolitan areas fierce, hanging your own shingle is a risky proposition. If I don't start my own practice, how long will it take to find a suitable associate position? Moreover, how long will it be before I can start paying off my enormous student debt, particularly in an era of declining income for dentists?

Although the most obvious and quantifiable, debt is not the only issue that affects how soon-to-be graduates like me approach the future. There is a certain balance I hope to maintain in my life. This work-life balance that is characteristic of dentistry is a reason many of us pursued this career.

Although I am fortunate that my school, unlike many, provides practice management classes, it does not provide a full and just representation of all viable business and practice models in dentistry. Often, DSOs are left out of this conversation. Other times they are briefly touched on, but in a negative light. They are compared to Walmart and Costco, in that they are warehouses that don't always treat patients or employees with respect.

With most professors having graduated many years ago and having little to no student debt, they do not understand our perspective. While masters of clinical dentistry, it is clear that they are not fans of the emergence of DSOs. Recognizing that everyone is entitled to his or her opinion, bias should not be integrated into lectures. All options, whether the lecturer agrees with them or not, should be presented so that students can develop their own beliefs.

As a very active member and leader of the American Student Dental Association, I have had the opportunity to attend numerous conferences, which have shown me other practice options in dentistry. This includes the corporate models, such as Aspen Dental, Heartland Dental, and ImmediaDent. When I was a third-year student, I was invited to the Aspen Dental Management Inc. Women's Leadership Experience, an event aimed at addressing glass ceilings and office leadership challenges from a woman's perspective.

Through this event and other conferences, I learned more about what a DSO can offer, from a support network of hundreds of dentists to tangible business support. More importantly, educating myself debugged the stereotypes against so-called "corporate dentistry," revealing to me that DSOs represent an avenue in dentistry that values flexibility, clinical autonomy, and patient care within a unique culture and community.

The multitude of students who are not able to spend their free time at events outside of class are left in the dark by today's curricula. All students deserve an unbiased and unfettered look at the options available to them, including DSOs. Ideally, this information should come from the classes for which we already pay. If not, this bias in academia will continue to leave current and future dental students without the proper information to make an informed decision postgraduation.

Regardless of whether a student plans on opening a private practice, affiliating with a DSO, or pursuing a career in academia, he or she deserves to be informed about the options. Every student deserves to find the career practice model that fits.


Erin Fraundorf is a fourth-year dental student at the University of Louisville School of Dentistry. She is the American Student Dental Association District 7 immediate-past trustee and Louisville Chapter president. Erin is originally from Milwaukee, Wisconsin, and completed her undergraduate studies at the University of Wisconsin-La Crosse with majors in biology, biochemistry, and Spanish, with a minor in art. Following graduation, Erin will be attending Saint Louis University to pursue a career in orthodontics.

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