Do you know where Cherokee Place is in New York City? Don’t cheat by going to Google Maps. Fifty years ago NYC cab drivers would sit around their favorite eatery, The Belmore Cafeteria on Park Avenue, and quiz each other on the little known streets in the Big Apple.
Cherokee Place is an alley between 77th and 78th streets between York Avenue and the East River. The Belmore, by the way is long gone; it was a cab driver’s hangout made famous by Martin Scorsese in the movie Taxi Driver. I know because I drove a cab while going to dental school.
My point is that cab drivers back then had to have a certain knowledge about the city’s geography. That and a license to operate the cab, known as a medallion, were the only barriers to enter the field. In London, cabdrivers have to take a test called “Appearances” to “Acquire the Knowledge” of over 25,000 places in that city. That’s a barrier tho entry.
Today things have changed.
First there were 2 way radios, then gypsy cabs and those black cars would roam the streets, unlicensed, picking up passengers. Today there is Uber and Google maps. The barriers to enter the taxicab industry have all but broken down. The prices for medallions are falling by the day. All industries get disrupted…books, music and even healthcare.
In the cab industry guilds were formed to protect the independent drivers. Taylor Swift recently spoke up about protecting artists. In dentistry I wonder who or what protects the fee for service dentists who are seeing similar disruptions in dentistry. And the forces are quite formidable.
Adam Smith one of the original framers of capitalism warned of “pirates” entering a marketplace for their own self-interests. We have seen the age of dental insurance and now we beginning to see the age of the dental service organizations. Corporate dentistry is moving quickly to become the predominant force in dentistry…as providers and educators.
Prominent practices owned by some of dentistry’s finest educators are being swallowed up by dental service organizations. The smaller practices are being bought at discount prices and young dentists who have spent a fortune to become independent practitioners will soon have no choice but to work in corporate dentistry.
Who is protecting them?
Who is the voice of fee for service dentists?
Not the ADA. Not dental schools. Not the state licensing boards.
Really, they paid a heavy price to enter dentistry…in time and money. Okay, I know that dentists will still be able to make a respectable income, but what about the ability to learn and grow through autonomy…doing the kind of dentistry they enjoy rather than selling out to corporate forces.
Really, what’s at stake isn’t money as much as it’s well- being, autonomy and independence—the real reasons for becoming a dentist.
Unlike driving a cab, dentistry is a complex job. Today’s complete dentist must know more than “acquiring the knowledge.” He must be able to “apply the knowledge.” The application goes way beyond technical dentistry. Today’s complete dentist must be expert in leadership, business and communication in addition to diagnosis, planning and treatment. The dental service organizations will compete with economies of scale that the fee-for service dentist cannot match.
Cab drivers could not see Uber coming. Dentists must learn how to become “Complete Dentists.” The answer lies in the dental education system…training dentists to learn just how complex their job really is and applying that knowledge.