Tara N. Hardin, DDS, and her dental practice, Tara N. Hardin, DDS, Inc. have brought a legal action against Heartland Dental, LLC (Heartland) for alleged usurping and exploitation of her intellectual property. The plaintiff alleges Heartland employed her image on their website and marketing materials without permission. Marketing was apparently aimed at attracting dentists to sell their practices to Heartland or affiliate with Heartland, by misrepresentation of a connection of Hardin with Heartland. The case was filed in US District Court, for the Southern District of Ohio, Eastern Division (case 1:22-cv-00542-TSB-Doc #1, filed 9-21-2022).
Heartland is the largest dental support organization (DSO) in the United States, and in the portfolio of publicly traded global investment firm, KK & R & Co., Inc. (NYSE- “KKR”). The DSO is affiliated with over 2,400 dentists, in more than 1,600 clinics, in 38 states. Heartland expands their chain of dental practices both with de novo start-ups and affiliations (purchase agreements) with existing small business dental practices and smaller DSOs.
The company states on their website in Core Values – “Honor – Honesty, integrity, and transparency help us maintain a healthy work environment. We strive to do the right things for the right reasons.”
Heartland is very motivated toward expanding their market share footprint within the dental industry.
“Our company’s growth is off to a very strong start, and we’re doing what we set out to do at the beginning of the year,” said Pat Bauer, President and CEO of Heartland. “Since the start of the year, we’ve closed 23 affiliations, with a strong pipeline that we expect will help generate new affiliations and yield strong growth in the second half of the year. With this strategic growth, Heartland Dental will have expanded geographical reach and operational resources to deliver unparalleled value and support to doctors and their teams across the nation.”
In the summer of 2022, Heartland launched their Doctor Difference brand campaign.
“The power of the Doctor Difference is that it is told through the experiences of current supported doctors, underscoring the authenticity and credibility that is the foundation of our brand,” said Stacy DeWalt, Chief Marketing Officer at Heartland Dental.
In a current Heartland dentist employment recruitment listing for Cincinnati, Ohio, it tenders, “Access to an expansive network of mentors with 1:1 mentorship support and networking opportunities available at your fingertips.”
Heartland, unlike many in the DSO industry, has made a worthy effort availing quality continuing education and access to mentors, for its supported dentists. Heartland has acquired a select number of high-production, high-profile dental practices under their brand.
As their current crop of eminent dentists at these specific elite practices retire, Heartland will require a subset of well-qualified junior professionals to assume these more challenging clinical roles. Internal mentoring and advanced continuing education are essentials.
DSOs all brand their dental clinics differently to the public. Some present a strong brand face, both with internal and external marketing to the national populace. Similar, or the exact same branding logos and images appear on all advertising, stationary, exterior building signage, etc.
Other DSOs like Heartland utilize stealth branding. The public generally has no idea the dental clinic which they receive services may be managed by Heartland. Company marketing of their brand is often more directed at the dental community, versus a target demographic of potential patient/customers.
Certain DSOs operate a limited percentage of their chain, as uniquely positioned clinics, with a specialized range of clinical services. It is essential they recruit a distinctive cadre of doctors to staff their subset of highly profitable and technically challenging clinics.
In plaintiffs’ exhibits presented to the court, Heartland demonstrated a pattern of using photographic images of their more renowned affiliated dentists, as well as allegedly images of Hardin. Such trademark images would likely have minor impact on the general population, which would not likely identify eminent dentists.
By contrast, the bulk of the dental profession would definitely recognize several illustrious doctors affiliated with Heartland. Such recognition might impact a doctor’s decision-making related to potential affiliation with Heartland, as well as allegedly Hardin and her reputation.
DSO DOCTOR RETENTION AND RECRUITMENT
Doctor retention and recruitment are issues throughout the DSO industry. Zippia reports for their updated info of September 9, 2022, with a specific profile “The Average Number of Years That Associate Dentists Stay in a Job.” Over 60% stay less than two-years. Of that number, 26% are employed less than one-year. 35% are retained from one to two-years.
Practice management expert, Dr. Chris Salierno, offers similar figures, with average DSO employee dentists lasting 18-months. He lists the primary reasons of associate doctors finding the exit door as practice profile of services, location, company culture, work/life balance and burnout, and desire for ownership.
Each company has a unique culture, and different cultures may exist within the same company at different locations. Moreover, a DSO’s direction and values may change with a merger or acquisition of the DSO, or with an alteration in senior management. All of this impacts a DSO’s focus on clinical care, their range of services, the pace of the practice, and quantity and quality of support staffing.
POTENTIAL LEGAL DAMAGES
Valuation of the business asset of Tara N. Hardin, DDS, Inc. might face resulting damage for a potential practice sale or merger. An ability to attract future associate dentists to the practice might suffer. Offers to obtain lecturing honorariums and manufacturers’ endorsements might be negatively impacted for Hardin.
Potential opportunities for outside employment at an educational institution, or from a dental products supplier, could also be threatened. Any negative media press or internal doctor disputes related to Heartland might adversely and unfairly impact Hardin.
Her strong stance in support of the doctor/patient relationship, free from tacit involvement of a corporate third-party, could therefore be viewed incorrectly within the dental profession, as hypocritical. The doctor’s reputation and good-will within the dental community might suffer. At the very least, this might damage her referral base from other practitioners.
Hardin practices in the suburban Cincinnati community of Mason, Ohio. She is well known nationally in the dental community for achieving Fellowship in the American Academy of Cosmetic Dentistry, Fellowship at the Las Vegas Institute, a dentist presenter on ABC TV’s “Extreme Makeover,” as well as a lecturer at various dental meetings.
“Heartland capitalized on my image and my brand,’’ Dr. Hardin said. “This is a family business – my father started this practice (now retired, Dr. Gary Hardin)–and I’ve worked my entire life to build on his work and establish myself locally and nationally. It’s appalling that they stole my brand to embellish theirs.’’
“We need more practices that focus on the doctor-patient relationship versus what corporate CEOs think is best,’’ Hardin said. “When you own the business, and it’s your name on the building and on the practice, you take pride in doing right by your patients.’’
Attorney Robert Allen of Glaser Weil Fink Howard Avchen & Shapiro LLP, who is representing Hardin in this litigation, along with attorney Karen Gaunt of Dinsmore & Shohl LLP stated, “We are filing this lawsuit to bring attention to Heartland’s appalling conduct in exploiting Dr. Hardin’s image and brand to give dentists the idea that she supported its business practices, when in fact she believes in strengthening sole proprietor and small practice dentistry – not turning it into a commoditized product.’’
Heartland was contacted for comment on this filed lawsuit and has not responded as of time of publication.
Hardin has committed to use proceeds from this case to fund scholarships for dentists seeking to maintain a sole proprietor practice model and continue their education.
“I want to help dentists stay independent of corporate dentistry, and develop the skills and tools needed to successfully build their own practices,’’ Hardin said.
ABOUT THE AUTHOR
Dr. Michael W. Davis practices general dentistry in Santa Fe, NM. He also provides attorney clients with legal expert witness work and consultation. Davis also currently chairs the Santa Fe District Dental Society Peer Review Committee. He can be reached at MWDavisDDS@Comcast.net.