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Author: mcbdds Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 734617  
Subject: Re: Medical Residents and Work Hours Date: 2/22/2013 2:30 PM
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If someone told me I had to start over again, there is not enough money in the world to make me choose to be a physician. JLC

About 25 years ago, deep into private practice, I crunched some numbers and thought Oh my God! the Dental business model is unsustainable. I did it again and again and came up with the same conclusions. Figuring that I'm a dope and better at dentistry than math and business I must be wrong. According to my calculations the crossover on the graph was about 5-8 years away. Decided to get schooled up on the actual icky business part of my practice. Went to school, management, operations, marketing etc.
Studied my fanny off, actually went to work for the "Dark Side", the evil corporate insurance companies. I became a consultant for three companies, and a defense expert witness for another liability carrier. I also did quite a bit of peer review and settlement negotiations.

Long story short, I got schooled up on both sides of the fence. Went back after five years, ran the numbers and came to the conclusion that The Dental Business Model is unsustainable.

The crux of the problem is that the reimbursement for services is determined by a third party whose interest is hostile to the provider. Payment is not based upon cost of service. Think about it. What other business in the USA will render a service, and have an agency, whose sole fiduciary goal is to pay you as little as possible, actually set your fee structure independent of overhead? Dentistry does that.
We complained. The insurance companies told us to get efficient, increase production, control overhead in other areas better. We did that. We worked longer hours to stay In the same place.

Doc, If I had to start over again, I would not do it. When asked I tell students the reality of their intended profession. Dentistry is the most expensive education to purchase, and the financials don't work out.

The last 5 years of my practice about killed me.


mcb
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