Kinds of Practice

BAYABORDA, BULAUN, CAAB, CABILOS

Kinds of practice
Private practice, Military dental service, public
health, dental education, and research
 Dental Specialties
Specialties to date that merit official recognition of the ADA:
Endodontics
Oral and Maxillofacial surgery
Prosthodontics
Orthodontics
Public Health Dentistry
Periodontics
Oral Pathology
Pediatrics
Cosmetic/Esthetic Dentistry
Implant Dentistry
Prosthodontics
Dental Public Health
concerned with preventing and controlling
dental diseases and promoting dental
health through organized community
efforts
Endodontics
is concerned with the etiology, diagnosis,
preventing, and treatment of diseases and
injuries of the pulp associated periradicular
tissue.

-endodontist
Oral Pathology
is concerned with the nature of diseases
affecting the oral structures and adjacent
regions

-oral pathologist
Oral and maxillofacial surgery

is concerned with the diagnosis and surgical treatment of diseases, injuries,

and defects of the oral and maxillofacial regions

oral surgeon
Orthodontics
is concerned with the supervision, guidance,
and correction of all forms of
maloclussion of the growing or mature
dentofacial structures

orthodontist
Pediatric Dentistry
is concerned with the preventive and
therapeutic oral healthcare of children from
birth through adolescence

it also includes patients beyond

adolescence who because of mental,
physical, or emotional problems require
specialized help in receiving dental care

pediatric dentist
Periodontics
is concerned with the diagnosis and
treatment of disease of the supporting and
surrounding issues of the teeth

periodontist
Prosthodontics
is concerned with the restoration and
maintenance of oral functions by the
restorations of natural teeth or the
replacement of missing teeth and
contiguous oral and maxillofacial tissues
with artificial substitutes called prosthesis.

prosthodontist
Factors why a general practitioner opt for a specialty:
1. exciting experience with a case
2. economic opportunities
3. obvious case of the specialty
4. lack of desire to fulfill the scope of responsibility incumbent
on general practice
Factors that should merit objective consideration:
1. Does one's true talent best fit for the opted specialty?
2. Is there a demand for more specialists?
3. Is employment available?
4. Will a specialist be needed in the area of domicile that one
chooses?
 Basic kinds or genres of practice
1. Individual
2. Expense-sharing solo (separate) relationships
3. Partnerships
4. Group practice
5. employer-employee relationships
6. independent contractor relationships
7. multi-located practice
8. part-time practice
Solo Practice
Advantages:
1. one-man policy decision
2. sole control of personnel
3. maximum privacy of one's own
conduct in matters relevant to
practice
4. limited exposure to personality
conflicts
5. feeling of being "in full control"
6. one man responsibility
7. possible tax advantages
income potential greater after one
becomes established
8. broad spectrum of independence and
self-reliance
10. Lesser problems
11. favorable quiet ambiance
12. no conflict of assignment of parties
13. no implied partnership
14. freedom to work much or little
 Solo Practice
Disadvantages:
1. All - overhead responsibility
2. Initial expense possibly bigger
3. lower or smaller initial income
4. wanting in professional/ business or
administrative experience
5. referral system indispensable in case
of emergencies
6. no other dentist available to oversee
personnel during one's absence
7. limited opportunity for consultation
and spontaneous sharing of ideas,
approaches
8. No opportunity to borrow or share
personnel, equipment and supplies
9. need for at least one staff member
always present to answer phone calls
or for an answering device or service
 Expense-Sharing Solo (Separate) Relationships
two or more dentist bind themselves into cost-sharing agreement
retained complete autonomy in matters of having and maintaining separate
practices

Dentist may join together and share numerous things among them:
1. reception room or foyer and receptionist
2. business office and manager
3. hygiene room equipment, hygienist
4. patient education material
Expense-Sharing Solo (Separate) Relationships
Dentist may join together and share numerous things among them:
5. plaque control room
6. staff lounge
7. laboratory and equipment; its laboratory technicians
8. data processing equipment
9. many miscellaneous items that may not require simultaneous or
concomitant use
Expense-Sharing Solo (Separate) Relationships
Such implied relationship must consider the following:

1. implied partnership
2. necessity of legal contact to define responsibility in the event of
death or movement of a participant
3. compatibility
Group Practice
practice of 3 or more dentists joined together in a cost-sharing
arrangement to provide improved service at decreased cost
Structure:
A cluster of separate private practices
Partnership
Corporation and
Property of a single owner
Group Practice
also used to designate insurance prepayment -related organizations
of dentists under contract
Group may be owned and operated by the union of parent
organizations or they may operate independently as contractors
"capitution programme"
agreement to provide care for a premium received for each
patient covered
Advantages

Peeling of expertise Duality control

Freedom to be absent Special area of practice
Personnel utilization efficiency Retirement benefits
Quantity purchase Post-mortem benefits
Sharing knowledge to estate
Disadvantages

Possible personality conflicts or disparities

Complexity of increased personnel structure
Group control of invested capital
Efforts directed and devoted to the group instead of to self
Necessity of acceptance of direction from group leadership
Unavoidable dependency upon the others
Disadvantages

Possible inequality of production

Stifling (oppressive) or hampering of talents in some cases
Tendency to become stale, with maturity and experience
Difficult to some instances to withdraw invested capital
when one elects to withdraw from the group
Know Your Would-be Associates
Preparatory to binding oneself into a relationship with
another dentist
GUIDELINES
Interview prominent dentists in the area which, while possible
difficulty may provide an indication
A key figure in the evaluation of a prospective associate may be an
accountant (CPA)
A lawyer friend may also be helpful from numerous standpoints
Know Your Would-be Associates

The “must: information indispensable, include…

Personal moral character

Credit standing; and

Quality of service rendered

Employer-employee
Relationships
practice of recent successful dental board examinees who seek
employed positions as a buffer or period of re-adjustment
to acquire experience and evaluate private practice opportunities
Advantages

Period of adjustment following dental board examinations;

Opportunity to gain experience
Less ‘ticklish’ management responsibilities
Opportune period for evaluating practice opportunities
Advantages

Identify with personable or reputable employer

Non-necessity for outlay of money
Immediate recompense (salary)
Straight salary
Base salary plus commission
Percentage of gross production
Percentage of net collections
Disadvantages

Must compliance with policies/procedures set by

someone else;
Possibilities of communication-gap with employer;
May have to accept assigned patients with certain
procedures always performed by employer or another in
the organization
Identical to group prcative, the possibility of personality
clashes
Other considerations
Expected working hours/days
Holidays - working or non-working
Benefits of vacation and duration
Length of agreement
The how’s of relationship termination
Restrictions, if any
Period of your pay
Percentage of gross production
Other considerations
Assignment of auxiliaries, who pays them or their salaries as
deducted from gross production.
Collection fees (forced) as deducted from the gross.
Other expenses satisfied or paid by the employer.
Who determines fees and how.
Responsibility of making patient payment arrangements.
Responsibility of accounts collectable
Responsibility of equipment, maintenance, purchase of supplies,
instruments, etc.
Insurance coverage, if any.
Other considerations
The employee's ''patient of record''

Records owner

Incorporation of a restrictive covenant

Night and weekend emergencies

Independent Contractor
Relationships
He's one not subject to control by others.
Equipped with his own business license in areas requiring such.
He supplies his own business license in areas requiring such
He supplies his own equipment, pays overhead expense, etc.
A written contract merits recommendation when contracting on an associate
basis. It is possible that an independent contractor may be deemed an employer

For one to be construed as an independent contractor, the following

factors may merit consideration:

1. records and patients treated by the associate belong to the

associate.
2. the associate may establish his own working ours, leaves, etc.
 Multi-located Practice
In need of more clientele
A dentist may apportion his time to serve other locations, said to be
a difficult method of establishing a practice
it can be expensive unless and until an overhead or rental
agreement can be negotiated with another dentist in at least one
office it not both.
 Part-time Practice
Dentist in health departments, or having other employment may
have an opportune time to engage in part time practice.

factors that should be considered re: such arrangement

1. how will emergencies be cared for in the renters' absence?
2. Is (are) the assistant(s) included?
3. Ditto on all supplies and equipment.
4. Who shoulders responsibility for sending statements (of accounts)
collections, ordering supplies etc.
Professional Corporations
Utilized principally for tax and retirement fund benefits
only in extreme unusual case will the novice practitioner avail on
incorporation.

Service Militaire
Military considerations would make it indispensable that some
successful Board of Dentistry new certificate of registration
holders may be obligated to make use their acquired
professional skills for a period of service in a dental corps.
ADVANTAGES
The dentist-militaire is the recipient of instant or immediate income from
various sources of provision

at the end of 30-year service, military dentist leaves the service with
approximately 75% of this base pay as lifetime or retirement benefit

establish private practice or to enter some phase of productive dental activity,

earns additional income while being buoyed up.

allowed to attend government-paid post graduate courses

the physical and emotional strains are less on dental officers

Per actual ocular observations in the military dental dispensaries, working

conditions are excellent.
 Service Militaire
Disadvantages
1. Less recognition and lack of authority till officer has gained stature and command
to a point that he is more of an overseer than overseen

2. Advancement may be either at a turtle’s pace or rapid depending on the war-or-

peace status of the country, politics, too and verily play a prime role

3. If the dental officer is passed over for promotion a couple of times due to lack of
requisite ability incumbent on him or possibly, a crowding in rank and grade, he may
be released from the service by attrition (the act of weakening to the point of
exhaustion via constant harassment, use or abuse, pressure, etc.)
 Service Militaire
Disadvantages
4. Assignment rotation in numerous place during the dental officer’s tenure that
dictates changes and adaptations for his family and children’s education

5. Attractive to the new graduate non obstante, the monthly base pay and
allowances are not comparable, in the ultimate and to the income that accrue in
terms of private practice and

6. A pampered dentist while in service militaire (retinue of aids auxiliaries while in

the course of his clinical sit-down performances) the military dentist may have a
hard time when he gets to solo practice in terms of adjustments
 Public Health Dentistry
Employed at the municipal level, the public health is able to put up or
establish a fairly permanent social life and family life, with logical
expectations this status will be uninterrupted as long as:

1. The department functions on a relatively stable budget and

2. is stripped of political color or whims
 Public Health Dentistry
Advantages and Disadvantages
Almost the same as those in the military except:
recompense and working conditions (facilities, equipment,etc.)
 Dental Education
The genre of quality of education in our dental schools may be
attributed to factors as:

administrative skills and capabilities

clinical and laboratory facilities
teaching aids
mentor, principally
 Dental Education
Successful teaching or mentorship requires inherent (at times latent)
abilities and of course, dedication to a cause. Some of our good mentors
rate as among the better in private practice, with others on the opposite
end.

To date, admission prevails that we are still in dire or desperate need of

quality instructors. Frustrations of some of our private practitioners
stem from a deep-seated desire to teach rather than to practice.
 Dental Education
Graduate study
1. The investment essential to put up a dental office can be postponed
2. Study trends they have mastered and capitalized on will afford mental
reception and continued retention of knowledge
3. The eventual genre of practice will have been decided upon earlier
4. The educational "must" for subsequent certification by the various
specialty boards will have been satisfied and
5. The right/ privilege to practice in the opted field in dentistry from the
first day of practice will have been earned
 Dental Education
Disadvantages
1. Necessity of instant and uninterrupted financial back up
2. Delay in realizing other objectives
3. Uncovering at times that the precise choice of limited practice has
not been made or undertaken
HERITAGE
PRACTICE
 Heritage Practice
Practice in dentistry brought by heritage indicate perpetuity in such practice. Local
dentists, as well as their counterparts from all the corners of the globe
encourage their children and other relations to join the ranks of future dental
practitioners with obvious advantages:

1. Practice is retained in a family or clan of practitioners with the patient

load inherited by the beginner member and
2. Ultimately, the latter takes over the entire practice
 Heritage Practice
Disadvantages:
1. The "rookie" dentist must accept all patient transferees in most cases
2. Certainly and, expectedly, there will be conflicting ideas as to:
a. clinical practice
b. administrative functions
c. office facilities and equipment
 Heritage Practice
Solution offered:
Cooperation from all the members concerned and open mindedness of
each with the objective of:
1. Keeping inviolate the wishes and talents of each and
2. Safeguarding happiness in the practice
 Heritage Practice
Robert K. Stinaff

"Heritage in Practice is a remarkable tribute to the feeling of

satisfaction that the predecessor gains in the profession,
but it calls for responsibility and understanding in order that,
that such feeling is ensured for the successor"
Portfolio
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Strengths
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SWOT
Weaknesses
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Opportunities Threats
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88 % 77 % 66 %
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