Oral Health Group
Feature

Entrepreneurism and Dentistry

November 1, 2011
by Bruce Glazer


The word ‘entrepreneur’ came into vogue in the 1980s and has now come to mean a person who organizes and operates a business or businesses, taking on greater than normal financial risks in order to do so. Entre­preneurism is an uncertain endeavor as the odds for success are not favourable. Thus, according to this definition, a dentist is not a true entrepreneur, as the chance of success is relatively high. However, the spirit of entrepreneurism surely does exist within dentistry. Most dentists desire to be successful and given the demand for dental services – they are! Dental practices do not bring new services to the public. But, they can be marketed in a unique and different way, perhaps in an entrepreneurial way. If an entrepreneur is successful, the company created can be sold, taken public, or retained personally. Either way, business success is measured in the millions. Most solo dental practices differ from this scenario. They usually grow steadily, but slowly and offer the owner a comfortable living.

In many ways, this slow and steady growth is the genesis of a practitioner who, after graduation, needs considerable time to develop the clinical skills necessary to practice above the accepted standard. Most stakeholders in dentistry agree that, to become really accomplished in dentistry, it requires considerable practice and the passage of time, much like a musician. I believe the aforementioned scenario, to be the proper developmental path in dentistry. The problem, however, occurs when dentists begin to acquire many active offices in an attempt to become entrepreneurial. These practices are demanding and are in need of a distinct business model, which usually is at odds with quality dentistry. These models go beyond savvy purchasing, good staffing, and increased services – they are about increased productivity.

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There is only so much that production can increase before compromise creeps in and quality nose dives. No longer are record keeping, informed consent, and proper diagnostics practiced as they are too time intensive and poorly compensated. Adverse outcomes become the norm and it does not take long for the dentist to be involved in a malpractice lawsuit or a collegial complaint. Most dentists whom I have taught or mentored possess adequate skills but the demands of overproduction can cause them to skip steps and become sloppy. When this occurs and a College complaint follows, the dentist must step back and realistically evaluate the reason the problem occurred in the first place.

From my experience working with CDPA as a dental advisor, the lack of record keeping, diagnostics, and dental work in general below the provincial standard are the symptoms of the underlying disease. The root cause is an unrealistic production schedule which, in most cases, makes dentistry and entrepreneurialism mutually exclusive.  OH


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