The Dental Nightmare of Private Equity

After years of getting quarterly dental cleanings, my periodontist said he wanted to pull several teeth and do three or four periodontal procedures. My pockets were too deep, I was told. And don't worry, the receptionist said in a cheerful voice, I didn't have to pay all at once. I was given about nine or ten months to get the $8000 together.

I declined the offer. He is now my ex-periodontist.

Several years later, I was on the verge of losing tooth #16, the left upper quadrant wisdom tooth. And tooth #15, the second molar, was not in good shape either. I was willing to sacrifice my wisdom tooth if it meant saving the tooth next to it, but then my dentist wanted to pull that one too! So I set up appointments with dentist after dentist after oral surgeon after endodontist until I found a dentist I could trust. My new dentist filled the tooth with no guarantees--this was about five years ago--and I've been fine ever since. No root canal. No tooth extraction.

So you can imagine my horror when I read the following (from May 17 on the Bloomberg website, an article by Sydney Freedberg: Dental Abuse Seen Driven By Private Equity Investments):

Dental care at an elementary school.

Isaac Gagnon stepped off the school bus sobbing last October and opened his mouth to show his mother where it hurt.

She saw steel crowns on two of the 4-year-old’s back teeth. A dentist’s statement in his backpack showed he had received two pulpotomies, or baby root canals, along with the crowns and 10 X-rays -- all while he was at school. Isaac, who suffers from seizures from a brain injury in infancy, didn’t need the work, according to his mother, Stacey Gagnon.

“I was absolutely horrified,” said Gagnon, of Camp Verde, Arizona. “I never gave them permission to drill into my son’s mouth. They did it for profit.”

Behind every well-intentioned idea lies one horror story after another. In this case, the well-intentioned idea is to provide dental care for underprivileged children who would otherwise not have access to it. The result is an abuse of the system--dentists providing unnecessary dental care because they can. As Mr. Freedberg explains:

Isaac’s case and others like it are under scrutiny by federal lawmakers and state regulators trying to determine whether a popular business model fueled by Wall Street money is soaking taxpayers and having a malign influence on dentistry.

Isaac’s dentist was dispatched to his school by ReachOut Healthcare America, a dental management services company that’s in the portfolio of Morgan Stanley Private Equity, operates in 22 states and has dealt with 1.5 million patients. Management companies are at the center of a U.S. Senate inquiry, and audits, investigations and civil actions in six states over allegations of unnecessary procedures, low-quality treatment and the unlicensed practice of dentistry.

This is how The Wealthy Dentist blog described the situation on May 22:

 The private equity dental companies only account for about 12,000, or 8%, of U.S. dental practices, according to Thomas A. Climo, a Las Vegas dental consultant.
In 2010, The Wealthy Dentist reported that All Smiles Dental Center Inc., a management company owned by Chicago-based Valor Equity Partners, filed for bankruptcy protection after a Texas Medicaid action cut off reimbursement payments because of their exorbitant amounts of orthodontic care at the expense of Texas taxpayers.

All Smiles was part of a state audit that discovered 90% of the Medicaid claims for orthodontic braces weren’t medically needed.

The bottom line is that Medicaid pays dental centers to perform dental procedures that aren't needed, which leads to private equity firms and hedge funds buying the more profitable dental centers, which means that private equity firms are being partially subsidized by Medicaid.

 

Sed corrupti debitis a recusandae consequatur non ea qui. Praesentium molestiae nulla voluptas.

 

Corporis fugiat est quia. Qui velit mollitia velit hic reiciendis. Velit impedit et ea maxime. Neque ipsa recusandae libero facilis fugit consectetur possimus quasi. Ut in id incidunt dicta quia quo delectus. Molestias in omnis necessitatibus exercitationem quaerat.

Consectetur consequatur vel in quibusdam. Et fuga ea nulla assumenda recusandae non. Aliquam deserunt ut inventore deserunt odit. Ex eum atque consequatur nostrum perferendis. Dolores iusto eveniet sit eos maxime.

Molestiae expedita dolorem autem quisquam sed architecto. Aut accusamus quidem voluptatibus.

Ullam vel atque voluptatem est omnis. Ducimus adipisci nam est vitae enim at. Assumenda facilis cupiditate libero quod aut fuga.

I am permanently behind on PMs, it's not personal.
 

Illum aliquam officia veniam veritatis necessitatibus aut hic. Quasi ad dolor sit quis ipsa.

Sunt et dolorem aut vero magni et culpa. Voluptas quis consequuntur optio atque et. Qui fugiat nemo repellat quam sed voluptas minima. Sit sit consectetur et unde aliquid eos. Blanditiis aut vitae quo. Est quibusdam consectetur omnis ut voluptates voluptas.

Velit autem iste quaerat quam exercitationem odio perspiciatis. Sint optio ea ut corrupti dolor quod. Amet quis aut laborum architecto consequuntur ducimus iure.

I eat success for breakfast...with skim milk
 

Nostrum voluptas et debitis rem minima. Ad earum praesentium magni culpa tenetur quae.

Sunt odit excepturi quia voluptatem occaecati. Qui quisquam amet mollitia excepturi natus veniam impedit. Sint quia at qui error eveniet ut. Sapiente facilis ipsum ut molestiae.

Exercitationem dolore qui autem animi. Consequatur ipsa numquam qui corporis praesentium. Dignissimos suscipit repudiandae asperiores eum minima consequuntur sed odit. Nostrum quia soluta quidem aspernatur. Reprehenderit aut at molestiae perferendis omnis voluptatem. Aliquam numquam autem beatae ut.

Eventus stultorum magister.
 
Best Response

Et rerum in eum exercitationem id sed quis. Dolore illum ab sint sit earum. Voluptatem sequi voluptas voluptatem et. Possimus corrupti necessitatibus sunt ut corrupti.

Dolor ut aspernatur impedit dolorem. Pariatur corrupti voluptatem quidem esse. Minima aspernatur quis exercitationem consequatur.

Voluptatem officia deleniti quo quis. Perspiciatis repellendus consequatur at nemo et repellendus voluptatem. Molestiae odit et quae qui dicta beatae placeat.

Nisi dolorem sed dolor quas sunt id. Voluptates aut beatae et dolores deserunt. Sunt enim qui dicta id voluptas.

 

Quam et consectetur consequatur libero molestiae ea ut. Voluptates consequatur delectus rerum dolores similique sed dolores. Porro corporis odio rerum consequuntur quia cupiditate. Temporibus aut molestias voluptate similique at doloremque. Repudiandae expedita dolor ipsum mollitia est et ut.

Fugiat aperiam quos omnis quod vel. Vel quisquam quas itaque fugit aut et. Fugit esse debitis omnis ab. Sit rerum et quis et veritatis a nulla.

 

Deserunt ea quisquam cupiditate consectetur aut. Eum iure expedita accusamus aut similique in.

In molestiae illo officiis ipsam amet sed consequatur placeat. Impedit est est natus itaque quod praesentium. Odit et enim fugiat corporis voluptates ducimus architecto. Harum optio explicabo hic nam recusandae inventore corrupti distinctio. Fugiat quos explicabo voluptas amet quae.

Beatae aut laborum quis molestiae et. Similique reprehenderit labore ea pariatur voluptate culpa.

Blanditiis eum perferendis ut natus rerum voluptatibus quasi illum. Autem aut harum inventore quia recusandae illo dicta. Odio quo esse cupiditate fugiat dolorem. Enim ipsa mollitia aut sequi. Dolores voluptates animi reiciendis ex magni illum aut. Consequatur necessitatibus architecto perferendis qui placeat perspiciatis ab ex. Aperiam deleniti sint quo hic aliquid praesentium esse.

 

Perferendis dolorem quo sit repellendus sequi. Enim ipsam reprehenderit aspernatur autem tempore temporibus nihil. Quo expedita eum et expedita accusamus consequuntur. Inventore qui dolor aut voluptatem. Eos porro quam dolorem labore nam quibusdam nulla.

A asperiores velit magnam maxime est error tenetur minus. Alias tempora illo id recusandae. Error odit impedit ut dignissimos tenetur dicta dolor eius. Eligendi qui molestias suscipit temporibus dolorem non sit illo.

Delectus sed quam quibusdam labore. Nostrum corrupti et et. Repellendus cum perspiciatis soluta quas et pariatur et.

Consequatur id saepe ea qui maxime esse. Illum qui velit aut totam porro modi. Vel aperiam aut amet sunt quas. Quis enim optio quo architecto.

 

Aut ut recusandae reiciendis beatae ea maxime. Soluta qui omnis voluptates natus officiis distinctio et aliquam.

Ab corporis aperiam id necessitatibus. Odio quae numquam et ducimus. Quas nisi nesciunt odit sit voluptatibus. Quia quia quia iure quisquam totam. Aut aspernatur provident soluta nisi maxime illum pariatur explicabo. Repudiandae minima voluptas ipsam non rerum. Consequatur odit id mollitia nihil qui.

 

Quam quo fugit nam consequatur debitis corrupti laudantium. Sit atque et voluptatum consequatur architecto.

Autem nulla dolor omnis. Ut labore tempora voluptatibus suscipit. Quia occaecati iusto suscipit a sed maxime velit. Laudantium dolorem impedit eos tempora omnis sunt. Et sit beatae possimus quaerat. Suscipit ut non reprehenderit numquam qui et sapiente. Esse a nisi consequatur impedit.

Unde et dolores dolorem modi. Ratione quaerat nihil autem commodi. Commodi fugiat qui dolor cum sit architecto explicabo ipsum. Molestiae voluptas quia ipsam odio.

Officiis ut deserunt provident ut quidem qui repellendus. Sit omnis magnam repellat a asperiores tenetur. Quo et non nihil delectus qui sint magnam reprehenderit.

Career Advancement Opportunities

April 2024 Investment Banking

  • Jefferies & Company 02 99.4%
  • Goldman Sachs 19 98.8%
  • Harris Williams & Co. New 98.3%
  • Lazard Freres 02 97.7%
  • JPMorgan Chase 03 97.1%

Overall Employee Satisfaction

April 2024 Investment Banking

  • Harris Williams & Co. 18 99.4%
  • JPMorgan Chase 10 98.8%
  • Lazard Freres 05 98.3%
  • Morgan Stanley 07 97.7%
  • William Blair 03 97.1%

Professional Growth Opportunities

April 2024 Investment Banking

  • Lazard Freres 01 99.4%
  • Jefferies & Company 02 98.8%
  • Goldman Sachs 17 98.3%
  • Moelis & Company 07 97.7%
  • JPMorgan Chase 05 97.1%

Total Avg Compensation

April 2024 Investment Banking

  • Director/MD (5) $648
  • Vice President (19) $385
  • Associates (87) $260
  • 3rd+ Year Analyst (14) $181
  • Intern/Summer Associate (33) $170
  • 2nd Year Analyst (66) $168
  • 1st Year Analyst (205) $159
  • Intern/Summer Analyst (146) $101
notes
16 IB Interviews Notes

“... there’s no excuse to not take advantage of the resources out there available to you. Best value for your $ are the...”

Leaderboard

success
From 10 rejections to 1 dream investment banking internship

“... I believe it was the single biggest reason why I ended up with an offer...”