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Letters: Stress and practice models

August 18, 2014 On behalf of countless numbers of struggling, stressed-out, overworked owners of private practices, I would like to thank Dr. Rick Workman ("Practice Options," July 14 ADA News) for his letter of support and empathy for Dr. Susan Cushing (My View, "Dental Careers and Stress," June 16 ADA News).  

I, like Dr. Cushing, feel similar stress as many of my colleagues do on a daily basis. Contrary to what Dr. Workman believes, many of us do not think the corporate dental model improves patient care. And despite the fact that some dentists may benefit from it, the primary beneficiary of the corporate model is the corporation itself.

As I read Dr. Workman's letter, it sounded more like a cost-free advertisement for Heartland Dental disguised as a letter of concern. He states that when starting his career, "I struggled with this reality firsthand when I was practicing, and that is why I created Heartland Dental." Ironically, his solution to his own practice ownership stress was to own more dental practices and do less dentistry — pure corporate genius.

I challenge the notion that most dentists prefer to be employees of large corporations. I believe, all other factors being equal, the vast majority of professionals would prefer to be owners of their own practices and be their own bosses. Dentists are driven away from practice ownership because of an excessively competitive, overcrowded marketplace with too many dentists competing for the same health care dollar. It is the same financial environment that allows insurance plans with inadequate reimbursements to prosper. It could foster a rushed doctor-patient relationship and possible patient overtreatment that insults and degrades our profession.

I am afraid that our profession's lack of resolve is playing right into the hands of government and third-party payers who, for motives of their own, are unwittingly destroying patient care in the name of improving it.

Anthony R. Silvestri Jr., D.M.D.
Boston