R. Kirk Huntsman
Was it just me, or did anyone else out there read Dr. Mike Maroon`s ridiculous, condescending diatribe (Viewpoint, August 1998 issue) against DMSOs? Did you wonder whether this was a serious attempt to expose the truth about DMSOs or a thinly veiled, self-promotional publicity stunt? Do I sense a lucrative new seminar series from Dr. Maroon playing on the concerns and fears of his fellow dentists? Once again, it seems we have a self-appointed savior of the dental profession condescending to prescribe for his poor misguided colleagues what they should think. Having filed bankruptcy himself, Dr. Maroon apparently feels especially qualified to opine on how others should conduct their business affairs.
If he was serious, then it is unfortunate that the article did not contain more truth. If he was not serious, then it is up to readers to look past all the huffing and puffing and decide for themselves what to make of the issues. For his patients` sake, one can only hope that Dr. Maroon pays more attention to getting his clinical act together than he does to getting his facts straight about DMSOs.
The errors he makes in describing a "typical scenario" are numerous. Can anyone follow Dr. Maroon`s math in his first scenario? He claims the cash consideration in a typical DMSO transaction is 20 to 40 percent of the "net worth" of the practice. In financial accounting, the term "net worth" has a specific meaning - assets minus liabilities. Since few practices actually book intangible assets, the "net worth" of many dental practices is actually negative. Nobody calculates the cash consideration in a practice sale as a percentage of "net worth," and no DMSO I am aware of attempts to hoodwink dentists out of their accounts receivable. We certainly do not. If we acquire accounts receivable in an acquisition, we pay for them in full, in addition to the practice sale price.
Dr. Maroon goes on to say that the selling doctor makes $12,250, plus stock options ($15,750). How? From his provider services? That`s utter nonsense. Our doctors` average compensation last year was in excess of $132,000 - well above the national average for general dentists. They worked four days a week, saw an average of 12 patients a day, and took three weeks vacation in addition to time off attending company-sponsored, continuing education programs.
The only thing made clear in his second scenario is that Dr. Maroon has a firm grip on the cable channel tuner. If only Dr. Maroon were as acquainted with the facts about DMSOs as he seems to be with Saturday Night Live, Back to the Future, and McHale`s Navy reruns! I can`t even bring myself to comment further on this part of his article, as it is devoid of any substantive argument.
To the charge that "DPMCs are in business to make money for the principals of the company and maybe - if they`re lucky - the stockholders," I say that`s gross hypocrisy. I`m sure Dr. Maroon gives all of his income from dentistry to charity. Would all dentists in private practice who are not in business to make money for themselves please raise their hand? I don`t see many hands going up. Of course, you`re in business to make money. But making money is not the moral equivalent of taking unfair advantage of someone. In fact, just the opposite is true. Businesses of any kind that pursue a course of narrow self-interest or greed will ultimately fail.
The truth is that under many DMSO programs, the company gets paid last - if there is anything left over. If not, the company takes it in the shorts. That`s one reason why the survival imperative for a DMSO is to "add value or perish." Some DMSOs have impressive track records in this regard, generating same-practice growth rates of 30 percent or more and dramatically improving cost efficiencies without compromising patient care, and without resorting to managed care.
Dr. Maroon goes to great lengths extolling the virtues of our American free enterprise system, and I couldn`t agree more. Yet, his enthusiasm for the values that make America great are superceded only by his passion for restraining the free market the moment he feels threatened by it. Apparently, Dr. Maroon wants it both ways. On the one hand, he wants us to know what a great country this is - how we are free to act for ourselves and make what we can with our lives. On the other hand, Dr. Maroon seeks to prescribe for all his fellow dentists just how they should realize the American dream. I always thought that was called socialism. Apparently, if you are somehow tired of the hassles and frustrations of running your own business and "sell your soul" to a DMSO you are, according to Dr. Maroon, not only an idiot, you are un-American!
Never once does Dr. Maroon call for a disclosure of the facts about what dentists who are working within DMSOs have to say about their experience. Yet, endorsements from within abound. I offer the following examples:
"I find, first and foremost, that I am experiencing a sense of freedom ... I no longer feel isolated or alone. I feel a greater sense of self-confidence. You and others have placed trust in me as a person and in my clinical abilities. It has been, and is now, extremely gratifying to see the backing you provide me with high ethical standards, broad knowledge, technical expertise, and compassion of those in leadership. To be invited into this endeavor and to participate with such highly-skilled individuals is both a humbling and exciting experience." -Gary W. Wilson, DDS
"After considerable soul searching and deliberation, I decided to join with another practice and become an [affiliated] office. That was 16 months ago, and the fun is back! Once again, I am excited to come to the office. I get to do what I like best, and that is to provide patient care. This can only lead to a greater benefit to the patient, and that`s what it`s all about. Thanks again." -Donald W. Zajac, DDS
"I have been a part of the [DMSO affiliated] team almost from its conception. I had serious concerns in the beginning. [However], I must admit that with each new achievement, my excitement about [being a DMSO affiliate] and what it is all about continues to grow. Every person that I have had the pleasure of meeting who is associated with [my DMSO] has proven to be an individual with uncompromising moral character and the highest of ethical standards. Thank you for this opportunity." -David E. Griffin, DDS
"After more than 13 years in the dental/medical field, I have never had the pleasure of experiencing an organization with such professional integrity, honesty, and sincere concern for each employee. From day one, I have been supported and encouraged by each and every member of this dynamic team. Thank you so much." -Darci Thurman, front desk staff
"[Our DMSO] has really helped our ability to work together as a team. The working environment here provides me with challenges and growth
potential, as well as job security. I definitely consider it an improvement ..." -Mandy Jenkins, RDH
So who`s right? Are DMSOs truly the "devil in disguise" as Dr. Maroon would have you believe? Or, are DMSOs the greatest thing to ever happen to dentistry? The truth is probably somewhere in between. One thing we can be sure of, some DMSO companies will be better than others. Check them out thoroughly before making a long-term commitment, and be sure the value system of the DMSO management team is congruent with your own. If you desire an affiliation with good people who strive for excellence and can add value to your practice, you can find it.
R. Kirk Huntsman is president and CEO of Dental One, Inc. based in Dallas. His company has affiliated offices in Dallas, Fort Worth, Houston, San Antonio, Denver, and Salt Lake City. For more information, he can be contacted at (972) 726-6393, ext. 108.