The difference between private practice and corporate

I’ve worked at both corporate and private offices as an associate. I’ve learned a lot of things in the last few years and have also had to unlearn a few aspects. Here are some thoughts on the 3 key differences between private and corporate.

Patient flow

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Most corporate offices take a lot of insurance plans. This is not possible for a number of small offices because they are unable to breakeven with the reimbursements off of some of these plans. Corporate offices are able to offset those costs due to their number.

This usually translates to an increased new patient flow, and on a good day, lots of opportunity to diagnose, plan and treat for comprehensive dentistry, in corporate. Several of these patients, after getting their initial treatment done, however, never return for hygiene in 6 months. I’d like to think there are various reasons for this- however, primarily, it is the quality of the insurance plans or frequent changes in those plans. Although those appointments may be made for them by the front office, hygiene schedules in corporate offices typically have several holes in them.

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This means most doctors who work at such offices need to focus their efforts on new patients. The pandemic was a particularly hard time for several doctors to be at such offices. Their dependency on new patient flow was challenged and there were often less than 5 patients to be seen in a day.

This scenario plays very differently in private offices. Most private offices have their strong suit in the hygiene pool. This is one of the reasons why private offices sell at a higher price when they go on the market. The larger their recall base, the higher the purchase price. In the pandemic, new patient inflow trickled down to 2-3 per month.  In my office, we had a strong hygiene pool and nearly zero cancellations. We also almost never had a no show. As a result, the loss in new patient flow did not completely disable our margins.

Team dynamics

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The one or two times that we were short staffed in my private office, everyone pitched in to make the schedule work. Everyone worked extra hard to cover for the person who missed work. In due part to the leadership of my owner doc, every single team member understood what value they bring to the table. They also understood the financial implications of having to re-schedule patients. Re scheduling would mean, few of them would have to go home without a pay-check for the day.

In my corporate office whenever this happened, we would either re-schedule patients or get a temporary dental assistant for the day. These assistants could come with any amount of experience in dentistry and so working with them could prove to be a challenge. Hiring from one of several ‘temp agencies’ also requires the office to pay an upfront fee, which is often difficult to justify in a private office that has thin margins.

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In the 2 corporate offices that I worked at, not once did I hear people complain about not being paid on time. Now that I’m in private practice, I hear all kinds of stories from friends in other smaller offices. Not getting paid the production on time, having to wait several months to get exact pay, is sadly, very common.

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Why? Perhaps because the owner doctor is also managing the business operations of the whole practice. If they don’t delegate certain activities, like payroll, and end up doing everything themselves, things are bound to be missed. This in turn, creates tension with the staff and harms their long-term vision of retaining excellent people. Effective delegation and management is key in any office.

Can you think of more differences? At this time, I cannot. Comment below with your thoughts!

3 more weeks to the new year! Happy holidays!

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