Corporate dentistry is divided into two main organizational structures. A DSO, or dental service organization, is dentist owned, while an MSO, or managed service organization, is an equity-backed corporation. Either way, though, for the dentist considering joining the world of corporate dentistry, both types of organizations look and feel similar. Here are the pros and cons of joining an MSO versus a private practice.
An MSO carries quite a few benefits for dentists who don’t see themselves as business types. Here are just a few pros:
100% of time spent on dentistry:MSOs handle all of the “business duties” associated with a dental practice. You won’t need to worry about hiring, training, and firing office staff. You won’t have to chase down late payments, make sure the light bill is paid, or order office furniture.
Set schedule:In most cases, dentists working for an MSO can set their hours and compensation. If you like to golf on Friday morning or take Monday afternoon off, other dentists will be covering those hours, so you don’t need to worry that patients will not be cared for.
Freedom:Dentists in private practice work hard to establish and retain patient lists. If they want to go on vacation, they have to make sure their patients are taken care of. If they want to move to a new city, they must find someone to buy the existing practice, and then start over in the new location. Dentists working for a national MSO can simply transfer, while those working for a local MSO can give notice and find a new MSO to join in their new city.
Of course, MSOs do have their drawbacks. Here a few cons:
Corporate profits:MSOs are 100% business oriented. You might be pushed to promote certain products or techniques, and your treatment plans will likely be analyzed, all with the goal of maximizing corporate profits.
Restrictions:If you want to do research or explore cutting-edge dental techniques, you will likely be disappointed. MSOs tend to focus on streamlined, well-proven theories and techniques, and do not give dentists a lot of room to deviate from their standards.
Financial considerations:With the risks of private practice come the rewards. While private practice dentists keep 100% of their profits, MSO dentists have an employment agreement that governs their compensation. If you’re a natural salesperson, you could be leaving money on the table by joining an MSO.
Private practice is the ultimate solution for dentists with an entrepreneurial spirit. Here are a few of the pros:
Control:Everything about your practice is under your control. From the theories and techniques you choose to the lighting design in the office, you need only follow ethics and best practices guidelines, and everything else is up to you. You can hire the staff members who best fit with your style, and train them to your standards.
Flexibility:Running a private dental practice is sometimes an exercise in trial and error. You can run promotions, throw a pizza party, or use other creative solutions to build and maintain your patient list. You can specialize in dental implants or focus solely on older patients. You can even find someone to manage your patients while you spend a month in the Caribbean.
Profit potential:While MSO dentists are limited to their agreed-upon compensation, the sky is the limit for private practice dentists. You might choose to discount your rates to make money on volume, or raise them to maximize per-patient spending. You can negotiate with insurance companies or accept only patients who pay in full. However you choose to do business, you get to keep 100% of your profits.
Private practices do have their downside, though. Here are a few cons:
Location restriction:Building a private practice is a long-term commitment. Should you decide to relocate, you will need to go through the process of selling your practice and transferring your patients, and then start from scratch in your new city. This can be time-consuming and expensive, so it is best to start your practice in a place you’re sure you want to be long-term.
Business requirements:A private dental practice is a small business. You must comply with federal, state, and local ordinances in everything from insurance requirements to zoning laws to building codes. You are responsible for hiring, training, and firing your entire staff. You must deal with late accounts, financing programs, and all of the monthly bills. You might decide to hire a business manager to handle these items day to day, but you are the one with ultimate responsibility for them.
Scheduling considerations:Patients like to visit the dentist when they have free time. Depending on your patient demographics, you might find it necessary to stay open late or provide Saturday hours to keep your patients happy. You might find it difficult to take a vacation, as it could mean shifting patients temporarily to another dentist or risking them deciding to find a new dentist.
Neither an MSO nor a private practice is a perfect solution for dentists. Both have major pros and cons. The best way to decide what to do is spend some time soul-searching to determine which factors are truly the most important to you.
And he knows that once you “get it right,” it’s not a great leap to replicate that success over and over again.
Today, in addition to his work as an actual dentist, Dr. Coughlin coaches, consults and speaks to dentists across the country on how to build the practice of their dreams – based on proven processes and procedures.
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