My First Wal-Mart Dental Patient

As a consumer, I received Wal-Mart’s ads for incredibly low fees- $25 for a cleaning for example.

As a dentist, I received their frantic ads for dentists to work in these clinics.

I thought, “I have practiced for 35 years and know the business side inside and out. How can they make this business model work, honestly?” For instance, even dental hygienists are demanding at least $45 an hour now. How many patients could they treat in an hour?

Well I got my answer today. A patient who had been examined at Wal-Mart came to my office, claiming she had too much trouble getting an appointment at Wal-Mart to actually get treated. So she came to me. I got to look at her Wal-Mart treatment plan.

The patient had little calculus or gum disease, yet was planned for 4 quadrants of deep scaling and root planing instead of a regular cleaning. Since they could not make money on the regular cleaning she needed, they “upcoded” it to fees equalling $300. $75 per quadrant of deep scaling is cheap, but not if you aren’t really doing the work.

The patient needed a root canal on a front tooth. All young dentists are trained to do these. Yet she was referred out to a specialist for it. Why? Well, anything the dentist cannot make a profit on with Wal-Mart fees, he or she just refers out to specialists. Specialists charge much higher fees, not Wal-Mart’s paltry fees.

So in short perhaps this patient saved money on the Wal-Mart x-ray and exam. To be fair, the technician took a well-aimed x-ray series. But she would have paid more for everything else if she had followed Wal-Mart’s advice.

By the way, Wal-Mart’s high-profile dental director quit, and colleagues told me Wal-Mart has already abandoned the Dental Center idea in the Midwest. Why they think the same model will work down South is anyone’s guess. They think there are more stupid people down here?

My dentist is great and I have been going to him since he bought the practice from his father-in-law. He runs his own business and has a great office person and hygienists. He and I are the same age and I dread the day he retires and sells this private practice he built.

I had no idea WM does dental, or maybe ‘tries’ to do dental. I know their eye care program is respected but it’s contracted out, I dated an eye doctor that worked at various Walmarts.

Your biggest worry is that he sells out to some schmuck Wall Street Private Equity or Hedge Fund. Despite it being illegal in most states, they are the ones offering the most money for their practices.

Then the practice is quickly turned into a high-volume dental mill that rips off patients.

Shortly I will start scouring military bases seeking experienced dentists who may want to buy my practice. I will close the practice before selling it to Wall Street Scum.

Young dentists have such high student loan debt that it is impossible for them to buy decent practices when they graduate.

Henrius, are you talking about when a dentist practice becomes a national chain or where they pretend to be local but are anything but

Have you considered Partnering with a Young Dentist with the possibility of him taking over the Practice and Revenue sharing with you till paid for.

I assume the fallout of Patients with a change of Dentists is around 30%. probably less so if there is still a familiar face.

I told you how my dentist of 30 years retired and sold the Practice and it totally changed. I was one of the defections.

So Regular Dentists now do Root Canals rather than send you elsewhere… I like that.

So Dental Hygienists make 90K a year… How much Education is needed for that.

Take Care!!

Both happen. But the cheap road to corporate expansion is to buy practices with existing patient loads. Sometimes they “brand” them like Coast or Sage or Aspen.

But more and more, the shysters are learning the public is leery of these corporate names. So they leave some independent generic name, like “Forest Park Dental.” And they like to employ the former owner dentist, although these guys don’t last long.

The biggest chain doing this racket is Heartland. It was founded, sadly, by a dentist who made a ton of money selling his outfit to a corporation then being retained as a consultant.

Hard to know which practices are dentist-owned anymore. Staff is not always honest enough to give you a straight answer. Remember that to make the deal look legal, scumbag “front-man dentists” aide corporations by registering as the true owner.

Rule is that if the practice is super-pushy about selling treatment, and the selling is done by a person other than the dentist, and financing is pushed, a corporation is the owner of the practice.

GP dentists have always done root canals. Not all of them want to do molars, however.

One can be a dental hygienist with 2.5 years college. However, not many can do it 40 hours a week. Many hygienists on commission make over $100K.

Best case scenario for patient attrition is 10%.

My game is to find a left-handed dentist who speaks Spanish with my skill set to partner then buy the practice then let me work 1 day a week. Those criteria are very difficult.

When corporations own the practice everything changes. They accept most crappy insurance plans, even DMOs, then hold a gun to the poor dentist-employees’ heads. It is either bill the revenues or be fired. That is why so many youngsters go down on fraud. The dentist always takes the fall when his name is on he claims. Corporations can replace an employee dentist in a heartbeat if he loses his license doing scams for the corp.

Walmart tried a similar thing with veterinary clinics in the front of the stores. It failed quickly.

Of course, the obvious question should be… drum roll please!

How come teeth, eyes, and eyeteeth aren’t normally included in most healthcare insurance policies, both government-sponsored/supported and/or basic private plans. What powerful lobby is responsible for keeping this anachronism in place. Are eyes and teeth an outside-the-body issue?

British national healthcare includes dentistry. The fees are so low that almost few dentists participate except imported dentists who cannot speak decent English. We attended a dental convention in Birmingham, England. NHS dentist is simply horrible.

New Zealand public dentistry for children is nearly the same. Utilize non-dentists to fill teeth, but are not permitted to administer anesthesia. Heard an earful when our staff attended a convention there. Kids are traumatized and fillings fail because preps are not cut deep enough.

Government dental fees are always pathetic so government provided dentistry isn’t worth a rat’s ass.

Obvious answer…common fucking sense.

If I have 20/20 vision, why do I need eye insurance?

And here is a quick Econ 101 lesson, keeping the Insurance Cartel out of those industries has kept them from having the same level of inflation as other healthcare.

If that’s your “vision” of common sense, I think I’m starting to get a handle on the “common sense” of the balance of your other replies. I’m headed for the phone right now the fire insurance on our house as it doesn’t show any signs of being on fire. What’s the point?

I live in the KC area.
Do I need hurricane insurance?

Insuring for things that are a certainty is impossible. Imagine insuring yourself for a new set of tires. You know your tires will eventually wear out. The sum of any tire premiums would cost more than the cost of new tires and balancing.

You never know what may take you down medically. But vision and dental needs are different. Glasses and fillings are not catastrophic expenses like liver transplants, although they can be expensive. But the average dental maximum is probably $1500 annually these days, which does not buy much.

I live in the KC area.
Do I need hurricane insurance?
No, because there is really no such thing as “hurricane insurance” for starters. The insurance you get on your property covers all types of damages, some specific to your particular situation, others – not so much. The folks who live in California and Florida probably would not choose to cover tornado damage in your area either.
Insurance 101 _" Sharing , or pooling, of risk is the central concept of the business of … the basic function of property/ casualty insurance is the transfer of *risk".

But there is “fire insurance”?

There is dental and vision insurance available for purchase in the marketplace, just not as part of one’s health insurance. Most I have looked at aren’t really worth it. Although, some Medicare Advantage plans include dental and vision insurance for no or a small cost.

There is a reason it is not or small cost- most all of it I have encountered is garbage. Medicare Advantage plans are highly profitable to insurers. They want to add things to these plans to make them look better. So they offer dental and vision coverage as a bonus. Patients get all excited.

One of these “great plans” offered dental coverage of 100% of almost everything. The mouse print that nobody read said 100% of prevailing Medicaid fees. These are atrocious in most states, and nobody but the lowest bottom feeders in the profession will treat patients at these fees.

I haven’t encountered a decent Medicare Advantage dental coverage yet.

That’s what I’ve seen with my two kids too. Despite seeing 40 patients a day, my kids were somehow on six medications