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Professional Courtesy: Perks or Power? by Dr. Thomas Giacobbi

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Categories: Practice Management, HR and Accounting;
Professional Courtesy: Perks or Power?

by Thomas Giacobbi, DDS, FAGD, editorial director

Author’s note: The word "power" in the headline serves as some nice alliteration but it also refers to a host of owner obligations and for many, power is the benefit of autonomy.

When I graduated from dental school in 1995, my primary career goal was the same as most of my classmates: to own my dental practice and enjoy the autonomy of being my own boss. Today, most dental school graduates are evaluating opportunities with “big dental”—a term I’m using as shorthand for DSOs, corporate dental, large group practice or whatever phrase you like to represent a dental practice with more than one owner and location.

Last month, we celebrated the 20th anniversary of opening our practice from scratch. Occasions like these make us a bit nostalgic, and now more than ever I think the notion of having a private practice with only one or two providers sounds a bit nostalgic. I can still remember the fear and worry that accompanied my excitement to finally have a practice home to call my own. We started with no patients and while we were in a growing community, success was not guaranteed.

Many new graduates, though, don’t have enough experience to open a practice from scratch or buy an existing practice. This is just one of many reasons why big dental is an attractive option for most new dentists. These large organizations offer many perks that might include multiple practice locations to choose from, CE opportunities, working with peers and mentors, and none of the hassles of ownership.

The one thing missing from that long list of perks is autonomy. This is the superpower of a small business owner—the ability to choose the who, when and how of your work.

I recently played golf with a dentist who will turn 69 this year. He is in terrific health and loves his practice. I asked him if he had considered bringing in an associate to begin buying him out. He told me that he wasn’t ready for that, because he’s been the boss for so long that he isn’t ready to give it up. While some transition experts may disagree with this approach, I share it to illustrate just how important autonomy can be as an ingredient for a long and happy career. It also illustrates the dilemma that some retiring dentists will face if they sell their practice to big dental when they approach retirement. These deals often require the selling dentist to stay at the practice for a few years to maintain patient relationships and provide continuity. Sometimes this is a more difficult requirement than you might think.

The other team members in the practice often see the value in a mom-and-pop style private practice when it comes to the business model. Over the years, I have interviewed many team members who were seeking an independent practice because of numerous issues faced in their previous big dental setting. The most common issues reported are turnover of other team members, poor treatment from managers and getting moved around to other locations to accommodate staffing shortages.

In the world of private practice, we also have our share of issues with our dental families, but I think the majority of situations see more stability and career satisfaction over time.

The world has certainly become more complicated since I opened my doors 20 years ago, but I think the profession will continue to have a place for dentists who want to practice in a single location and be their own bosses. People often look to the profession of medicine for what our future might hold as dentists, and the trend of physicians leaving large groups to become concierge providers is very revealing.

I would love to hear your thoughts on this topic. If you work for big dental, tell me what you love most and if you think that will be the place you work your entire career. If you have a private practice, are you happy and would you do it the same all over again? Please share in the comments under this article, or reach me via email at tom@dentaltown.com.


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