Making the Case for the Independent Dental Practitioner

David Charnowitz


“Be kind to your dentist. Even dentists have fillings.” ~ Unknown 

Filling a cavity and filling a sales quota. With corporate dentistry on the rise, patients are increasingly encountering two types of “fillings” in the dental office.

It can be argued that corporate dentistry poses a threat to the survival of independent practitioners. Increasingly, “corporate dentistry” means multi-location, multi-doctor dental practices that are affiliated with dental service organizations (DSOs).

Yet it is not all “doom and gloom” for dentists who choose to follow their dream to own their own small business. This article will discuss the comparative advantages and disadvantages of independent dentists versus corporate dentistry and offer survival tips for dentists who choose to go it alone.

Factors Causing the Rise of Corporate Dentistry

In today’s economy, increased market efficiency—hyper-efficiency, in fact—is becoming a key survival factor. Yet independent dentists, by the very nature of this cottage industry, are not set up to be very large or very efficient. The “back office” functions of a dental practice pose the biggest hurdles for private practitioners who are struggling to stay competitive with corporations.

At the same time, other factors are contributing to the rise of corporate dentistry:

  • For dental school graduates, student debt can be an insurmountable barrier to entry when it comes to starting one’s own practice. 
  • For older dentists, a move to the corporate side of the industry can be a smart exit strategy. These professionals are looking to create more flexibility and ease into retirement.
  • Demographics are another factor contributing to the rise of corporate dentistry. More than 50% of new dental school grads are women, who tend to prefer more flexibility and are less inclined to start their own practices or work full-time.

Back-End Challenges of Running an Independent Practice 

Patient acquisition and retention. Human resources and staffing. Insurance. Supply chain efficiency. Budgeting and cost management.

All these factors need to be managed in the dental office environment. Unfortunately, the independent dentist cannot afford to have a dedicated staff person for each of these jobs. A corporate dental practice, on the other hand, will have skilled personnel in each of these functional areas. 

The practitioner who chooses to become an employee of a corporate dental practice will no longer have to shoulder the burden of running the business side of dentistry. For some dental professionals, this can be the make-or-break decision factor.

Marketing is often the tipping point. Take the independent dentist who is not as busy as he or she could be. This dentist may conclude that, instead of reinvesting earnings to grow the practice, he or she could make just as much on the corporate side without the marketing headaches.

Quality of Patient Care Remains the #1 Differentiator 

When it comes to the quality of patient care, independent practitioners offer several advantages over corporate dental practices. 

The independent practitioner is in control of his or her own clinical decisions. He or she is the sole patient care provider and is attentive to what is in the patient’s best interest. Nobody else is dictating the level of care.

In addition, building relationships with patients can lead to a sense of professional fulfillment. In your own practice, you can have a greater impact on people’s lives. 

Conversely, one of the big advantages for corporate dental practices is that they can leverage specialists to keep all facets of dentistry under one roof. This creates a seamless clinical environment for the patient.

On the flip side, there are also clinical disadvantages on the corporate side. The dentist in a corporate environment may lose autonomy and control in clinical decisions. In addition, he or she may be under pressure to hit patient quotas and upsell clinical services. This makes it more difficult to put the patient’s best interests first.

What Is the Role of the Independent Practitioner Moving Forward?

When we look at the future marketplace, the dentists who take pride in their work will thrive because their differentiator is providing the best patient care. We expect some independent practitioners will go to a fee-for-service model to establish themselves in a higher-end market niche.

Meanwhile, we are seeing the rise of independent dentists opening more locations. They are expanding into multiple offices to gain scale, bringing in additional associates but maintaining the small office environment. This allows them to generate more revenue while maintaining a high level of patient care quality.

One Independent Practitioner’s Viewpoint

Joanne Block Rief, DDS, owner of Crossroads Dental Arts in Owings Mills, Md, is the immediate past president of the Baltimore County Dental Association. She offers the following advice on what it takes to be a successful independent dental practitioner:

  • “It’s important to reinvest continually in marketing your practice, instead of relying on patients to come back on their own.”
  • “You must be available 24/7, maintaining those personal relationships. In an emergency, patients need to know they are not going to get the kind of generic service they would get from a corporate practice.”
  • “You have to work on your practice, not just in your practice. It comes down to how hard you are willing to work at building your practice by differentiating yourself


Nobody can say for sure where the dental industry growth numbers will settle. But it is an undeniable fact that corporate dentistry is on the rise. Ultimately, if you want to succeed as an independent practitioner, you must focus on providing excellent care, creating a warm environment, and building strong patient relationships. Did we mention that, in return for doing all of this, you get to keep all your earnings? 

In the long run, patients will drive the success or failure of independent dental practices. If patients seek out those practices where they can find that warm and personalized ambiance as opposed to a colder corporate environment, independent dentists will stay busy and become more profitable.

Finally, we are seeing an emergence of practice management services, such as billing and insurance coding/compliance, that can help independents achieve a higher level of efficiency. Practice management will get easier, we have no doubt. What remains in question is the number of independent dentists, both established and new, who will have the commitment and fortitude to succeed as small business enterprises.

Mr. Charnowitz is CEO of DC Dental, the Baltimore-based independent dental supplier dedicated to helping doctors “Practice Savvy.” Since its founding in 2002, DC Dental has differentiated itself as a solutions-based supplier offering a commitment to value, large selection, faster delivery, and high-quality customer service. DC Dental serves dentists throughout the country with a focus on the Mid-Atlantic region. For more information, call (877) 653-7500 or email

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