Private practice dentists face several challenges in today's industry, including increased competition from DSOs, stagnant reimbursement rates and rising operating costs.
These challenges could be harder to overcome for young, newly graduated dentists who are entering the industry with large amounts of student debt.
Here, five dentists discuss whether private practice is still feasible for young dentists in 2023.
Editor's note: Responses were lightly edited for clarity and length.
Eugene Bass, DMD. Bass Dental (New City, N.Y.): Opportunities are still available for the right young dentists in private practice. Those candidates who would be best able to parlay a successful purchase of a private practice into a growing business would have certain attributes. A well-rounded general practice residency experience where their skill set would multiply and their speed would increase. They will also have a business vision to employ specialists within their practice in order to provide a wider range of services and refer less work outside of their practice. Finally, a commitment to community involvement and an outgoing personality would go a long way toward cultivating long-term growth.
Paul Chaiken, DDS. North Dental Professionals (Skokie, Ill.): Yes, private practice is still feasible for young dentists. Larger PPO practices may be able to provide enough patients. Private fee-for-service or "out of network" practices may be less possible.
Daniel Lingenfelter, DDS. Fitch Mountain Dental (Healdsburg, Calif.): Private practice is no longer feasible for young dentists in 2023. The debt placed on the dentists graduating is way too large to allow them to compete with a DSO in practice purchases. Can they afford the technology they need to stay competitive even if they are able to purchase a practice? Likely not. Dentistry is not far behind medicine, but is this really an issue? Many of my colleagues don't want to own a practice, and they just want to show up and do dentistry. The modern private practice dentist needs a bit of luck, a ton of business savvy and the ability to work fast and hard while producing high quality dentistry. Maybe some young dentists can check these boxes, but if I were in their shoes I'm not sure I would take on all that risk and stress. I think my generation will be the last generation of private practice owners other than a few small boutique exemptions.
Eric Mintalar, DDS. Mintalar Family Dental (Minneapolis): I am a solo practitioner. I started my private practice from scratch in 1990 with no patients and one employee. Today, I have 2,100 active patients and employ six team members. The first two years in practice I was eating ramen noodles out of a package for dinner, a very rare vacation but only for five days. A new graduate starting a private practice in 2023 faces an even harder, formidable and daunting financial challenge. If the young dentist would purchase an existing dental office, he/she would be in debt $1 million dollars and more if he/she has student loans from dental school. To compound the challenges the young dentist would face are the increasing salaries for the dental team and staffing a dental team. In addition to that are the cost of dental supplies, dental laboratories, OSHA requirements, etc., and most frustrating is the lack of adequate compensation increases from the various dental insurers. The feasibility of a young dentist in today's private practice would depend on his personal capital and amount of debt coming into a practice, but it would be very challenging. The emergence of DSOs have become an attractive option for young dentists, and I believe the DSOs and private equity groups are here to stay and will exponentially grow as the market pivots to a managed group practice. There is legitimacy to more leveraging power with groups toward insurances, supplies, labs, staffing and salaries.
Vasilios Pournaras, DMD. Pournaras Cosmetics (Myrtle Beach, S.C.): Private practice is feasible in 2023, but it is different than in 2000 when I graduated. Today, young graduating dentists are joining DSOs because of all the money they are throwing at them, but for those that want private practice, the days of building your own office are dwindling as building costs have skyrocketed and so has dental equipment and supplies. Young dentists are better off joining a private group practice, rather than trying to start their own. That way all expenses and operating costs are shared. So yes, private practice is feasible in 2023, but mostly in a group setting.