I asked for it and you delivered. I sent out a request on my Facebook page and Twitter account to gather your worst experiences working for other dentists. Friends, what you sent me was amazing, shocking, funny, sad, and weird.
Last year I wrote a post about how to decide if you should look for another associate position. Few jobs are perfect and it can be difficult weighing the pros and cons of a particular opportunity.
However, some offices are just plain terrible. Here’s three of the worst stories you sent me and my observations. All names and places have been removed to protect anonymity.
(1) The Medicaid Mill
“I showed up to work at a Medicaid mill to ‘try it out for the day’ at the owner’s request. When I arrived, I was instructed to show him the treatment plan before starting any work. I did so on the first patient and he instructed me to do 10 fillings in 4 quadrants. I finished the fillings against my better judgement and allowed the patient to leave. When he saw the patient walk by his office, he ushered her back into an operatory and instructed me to start a root canal on her ‘because she was already numb.’ The poor girl could no longer keep her mouth open so I again told her she could leave. The second patient that I saw was a 6 year old girl with beautiful teeth. I did an exam, cleaning and sealants and let her go. A minute later I was called into the office and was berated for doing sealants. He told me I should have done 2 surface fillings on all those teeth. At this point I had realized that this was not the place for me and walked out of the office. Places like this are not only terrible for patients but for the profession of dentistry as well.”
It is unfortunate that offices accepting certain insurance plans feel the need to over-diagnose and over-treat in order to turn a profit. It’s true, reimbursements for some plans are very low. But there are practices out there that accept those plans and find ways to make it work.
If anyone tells you to perform treatment that you don’t agree with… run! The “I was just following orders” excuse doesn’t work in a courtroom. The dentist who shared this story made the right decision to get out of that practice as soon as it became clear that the owner demanded unethical behavior.
(2) Preying on Young Dentists
“I worked as an associate at (name withheld) part-time. This place is run by incompetent office managers & the cheapest staff available with terrible skills just to save a buck. The owner has a cocaine habit & has some questionable dentistry skills. The basic formula is to scare every patient into getting a deep cleaning by the staff periodontist & crowns on every tooth. The office staff would bully patients into treatment. It was a money hungry operation from the top down. I realized it from the first day & did fillings where appropriate & to the standard of care as well as crown & bridge procedures. I was fast & could see many patients in a day so they ignored my complaints. When I gave them the requested 2 months notice that I would be leaving, they scheduled only crown seats & then I was done (a week later). The owner preys on new graduates to run his dental mill operation with promises of high income & any supplies they would like to use but the reality was re-used burs & only new ones when the dentists would confront the supplies manager. It was ridiculous. I wish the place would get shut down for the sake of the patients but it is one of the only offices that will take their crappy HMO dental insurance. So sad. So glad I am out of that place.”
Wow, where to begin? If we suspect a dentist has a drug habit, there are resources out there to help them. Contact your local dental society and you’ll find that many have a Committee on Chemical Dependency that will be discreet and effective.
Again we see aggressive diagnosis and treatment planning as a theme. An interesting point raised by this dentist is that offices like this rely on young dentists to fill their ranks. So true! Unfortunately, recent graduates don’t always know what they’re getting into when they join a practice. When we finally discover the truth, hopefully we make the right decision and leave. But there is always a fresh group of dentists behind us that take the job.
(3) 20 Minute Endo?
“First day as an associate for a guy claiming to be ‘one of the top cosmetic dentists in America,’ started off with a morning prayer as follows- ‘Dear Blessed heart of Jesus as you know we are falling shy of our Root Canal quota for the month. If we can trust in your kindness, love and grace to please see that patients will seek us out for their endodontic care.’ This was warning sign number one! Warning sign number two started when the owner took me into his office after the morning meeting/RCT prayer rally- with gospel music playing in the background and a 2 ft x 2ft picture of himself and (name of famous politician withheld) in the corner. He then proceeded to ask me how long it took me to do a molar root canal. Confidently I replied ‘an hour to an hour and fifteen.’ He quietly shook his head and said, ‘I will show you how to do molar endo efficiently in 25-30 minutes.’ I then witnessed him do a molar RCT in 20 minutes. The sequence went as follows:
Step 1: Access-no rubber dam of course (5 min)
Step 2: Instrument with #10 k file and take WL with Apex locator (5 minutes)
Step 3: Use the thinnest rotary file known to man and just shove it in
the canals as far as it will go one time per canal using a special
‘lubricant’ in an empty prescription bottle with no label (5 minutes)
Step 4: Use absolutely no irrigation (0 Min)
Step 5: Use the thinnest commercially available gutta percha and
utilize the patients ample supply of saliva, puss and blood as
endodontic sealer. (5 min)
Step 6: Leave the room to treat patients in his 6 other treatment
chairs (0 minutes)
Step 7: Having no qualms about doing an abhorrent root canals (Priceless)
Needless to say that first day was the last day of my associateship with that dentist.”
I would be very interested to see how this dentist explains to patients why none of his root canal treatment works. Proficiency with endodontics is admirable; speed is not.
So there you have it: three of the worst associate stories I’ve heard. To end on a happy note, I’d like to congratulate the three submitters on their courage for walking away from those jobs when it became clear that they were in unethical situations.
If this post is sparking some unpleasant memories and you’d like to share them, email me at curiousdentist*gmail.com (replace the * with an @). I will post more terrible associate stories in the future…