'In good financial times, dentistry can boom': Dr. Michael Davis talks reimbursement, PE & more

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Michael Davis, DDS, is the founder of Smiles of Santa Fe (N.M.). As a dental leader, Dr. Davis is a consultant for patients, attorneys, legislators, policymakers and media personnel on various dental industry issues.

Like many dentists, Dr. Davis has witnessed changes in the industry, including the rise of dental service organizations and declining reimbursement rates.

Below, Dr. Davis discusses how private equity has changed the dental industry as well as how the economy affects his practice.

Editor's note: Responses are lightly edited for clarity and length.

Question: Is reimbursement getting tougher or easier for dentists?
Dr. Michael Davis: It gets more and more challenging as the insurance industry plays more games. Lots of unethical tricks are played. Recare hygiene visits must be six months plus one day or they burn you. They continually claim they never received X-rays or documentation, which is dishonest. They frequently deny pre-authorizations when there exists very clear evidence for necessary treatment.

Q: How has the introduction of private equity changed dentistry?
MD: Private equity ownership of healthcare facilities has certainly diminished the general level of healthcare. The claims of "quality care at reasonable prices” are hollow lip-service. In fairness, PE firms that beneficially own dental clinics are primarily obligated to generate maximal return for their shareholders or investors. Doctors are legally and ethically obligated to place interests of their patients to the fore because of the intrinsic inequity of the doctor/patient contract. The conflict of interest is fully evident. Employee doctors can either compromise their professional ethics or are shown the door.

Q: How do you get patients into your doors? And how do you keep them coming back?
MD: I’m not under the production pressures of the doctors working for DSOs. I personally control my staff, equipment, referrals to selected specialists, supplies, dental lab selection, etc. I don’t run a “cattle call”. Thus, my practice is largely self-selecting. Those who aren’t a “fit” usually leave of their own volition. I see numbers of former frustrated patients from the corporate chains. Their extensive external marketing efforts actually help me long-term. Someone needs to correct the messes created.

Q: Who/what is your biggest competitor?
MD: The strength of the local and general economy is my stiffest competitor. If the financials are tight for the public, my practice suffers. And yes, I offer third party financing. A large segment of the public has minimal to no savings. Many are not credit worthy. In good fiscal times, dentistry can boom. In down times, dentistry suffers. Naturally, it doesn’t help that the dental education industrial complex continues to pump out excessive numbers of doctors to survive in a glutted labor market.

More articles on dental:
How dentists, DSOs are attracting patients and keeping them as loyal costumers
SmileDirectClub preps for $1B IPO, CNBC reports
Renowned dentist Dr. Peter Dawson dies

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