Heartland Dental Care: An Easier Smile - Health Executive - RedCoat Publishing - Inside Healthcare

As it relates to healthcare in North America, the dental industry is about as fragmented as it gets. Somewhere around 85% of dentists are part of independent practices. But Dr. Rick Workman, CEO and founder of Heartland Dental Care, sees signs indicating change is on the horizon.

Dr. Rick Workman, founder and CEO

“There are all of a sudden a number of positions across the country where dentists can have a nice career path opportunity and not have to borrow money to buy a practice,” said Workman, whose career spans nearly 30 years.

One sharp shift has been in demographics. When Workman graduated from dental school in 1980, only 15% of graduates were female. Today, it is essentially 50-50. Also, virtually all dentists used to end up owning their own practices, as there weren’t many high earnings opportunities outside of owning a practice. Now, many factors are conspiring to set the stage for the same type of consolidation in dentistry that is currently affecting other segments of healthcare.

“Most pharmacies used to be independently owned, but now they aren’t. CV surgeons and radiologists now work for hospitals or healthcare organizations, so it is almost rare that physicians work alone now,” said Workman. “It is a rapidly increasing change, and, over the next 15 to 20 years, maybe half the dental graduates will never own their own practice.”

The largest factor influencing all of this is money. Today, the average dental school graduate comes out of school with $180,000 of debt. When Workman got his start, the whole cost of his dental schooling was less than $5,000, and it cost a mere $33,000 to start a practice compared to a minimum of $350,000 to start a full-service practice complete with digital radiography. It isn’t exactly a closely guarded secret that the lending market isn’t as strong as it used to be, and marketing a new dental office to attract patients is extremely difficult.

The newest generation of dentists now sees that a solid career path to financial well-being may not involve borrowing money to set up a practice. Workman said while past generations have been the primary bread winners in a household, many now realize that, as a dentist, they can get a job anywhere in the country and can move to accommodate their spouse’s career path. He also indicated most new graduates are more comfortable in a collaborative working environment as opposed to working alone.

Pioneering spirit
Heartland Dental is one of the leading companies in a new generation of dental practice management companies. It is a part of a new industry group called the Dental Group Practice Association, a nonprofit industry group with 12 founding members. Combined, the group expects to do more than $2 billion worth of business this year, and all of the companies are growing at about 20% per year, currently totaling about 3,000 dentists.

To keep Heartland’s growth moving forward, the company has three full-time development employees. The company’s growth strategy is evenly split between organic growth and acquisition. Workman said Heartland is currently opening eight new practices and acquiring 25 to 30 annually. The development team seeks out locations for new builds and sends out large mailings to existing practices to gauge interest in a partnership. The company has 225 practices in 12 states right now, but they are each locally branded.

As a practice management company, Heartland doesn’t control or influence the dental care per se. The dentist is employed by a professional corporation, which has complete control over diagnosis and treatment. But that isn’t quite the whole story.

Part of its development practices involves Heartland representatives regularly visiting top dental schools and industry conventions to recruit prospective doctors. The company also provides continuing education to dentists, whether they are fresh out of school or aging veterans. Each Heartland dentist receives 150 hours of continuing education lessons regardless of years in the field. The company also has an employee stock ownership plan to provide additional financial incentive to dentists.

Another plus for Heartland is its use of state-of-the-art technology. The company selected Kodak’s RVG 6100 Digital Radiography Systems, Kodak’s 8000 Digital Panoramic Systems, and Logicon Caries Detector for earlier identification of tooth decay, as well as the ViziLite Plus tool for oral cancer screenings. These investments provide all its dentists the latest advances in dental imaging technology. This will help Heartland’s dentists provide total oral care, for both teeth and tissue, and allow for patients affected by tooth decay or oral cancer to receive an earlier diagnosis.

The challenge now for Heartland is to retain its willingness to adapt in an ever-changing environment. The company experienced 35% compounded annual growth during the last decade, and there is no indication that growth is about to slow in any way. The goal is to provide patients across the country with a reasonable sense of what to expect whenever they enter a dental office—that care will include a full suite of state-of-the-art service. For many independent dentists, this type of complete care can be difficult to guarantee. Workman believes the advantages his company gives its affiliates can bring better care to the people through less headaches for the dentist.

“A typical dentist has to run a business; manage employees; negotiate with suppliers, landlords, and insurance companies; and figure out what is new in the industry in terms of clinical care. It’s really a formidable task,” said Workman. “We take care of all of that, which allows them to focus on being a dentist and be the best dental care provider they can.”

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