To practice dentistry in the United States, a dentist needs a valid license. But does one need a dental license to own and operate a dental practice? In some places, the answer is a resounding “yes.” In others, it's “no.” In Florida, it is a notable YES.

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The policy behind these laws was to prevent unlicensed people from interfering with a licensed dentist's professional judgment. States such as Florida, California, and Texas believe that it's vital for a dentist to have sole control over all health care decisions such as:

• The number of patients the dentist sees;
• How many hours a day the dentist is required to work;
• Hiring and firing of dental associates, technicians, and assistants;
• Setting the parameters for insurance contracts;
• Coding and billing procedures;
• Selecting dental equipment and supplies;
• Content of advertising for the practice.

In Florida, a licensed dentist may enter into an agreement with a non-dentist to receive “Practice Management Services.” The term “Practice Management Services” is defined to include consultation or other activities or services offered by someone other than a Florida-licensed dentist regarding one or more of the following types of products or services:

(a) The suitability of dental office space, furnishings and equipment;

(b) Staff necessary to operate a dental practice;

(c) Regulatory compliance expertise and services;

(d) Methods to increase productivity of a dental practice;

(e) Inventory and supplies required to operate a dental practice;

(f) Information systems designed to produce financial and operational data on the dental practice;

(g) Marketing plans or advertising to increase the productivity of a dental practice;

(h) Site selection, relocation, design, or physical layout of a dental practice, or

(i) Financial services such as accounting and bookkeeping, monitoring and payment of accounts receivable, payment of leases and subleases, payroll or benefits administration, billing and collection for patient services, payment of federal or state income tax, personal property or intangible taxes, administration of interest expense or indebtedness incurred to finance the operation of the dental practice or malpractice insurance expenses.

See Florida Statute Chapter 466, and Florida Administrative Code 64B5.

 As it stands now, changes in the laws of some states have limited, and in some cases completely eliminated, the application of this doctrine to medical and dental practices. According to an article on bizlawdds.com, “these changes often came at the request of physicians and dentists who wanted to obtain the tax and liability benefits of corporate status for their practices.”

At one time, most states prohibited corporations from owning dental or medical practices. This stemmed from the theory that only a person could be licensed to practice medicine or dentistry and, therefore, only a person with the proper license could own a medical or dental practice. This belief is known as the “corporate practice of medicine doctrine” or the “corporate practice of dentistry doctrine.” And as time changed, so did the belief in this doctrine.

Eventually, all fifty states passed laws that would create a service, professional or professional service corporation, designed specifically, and exclusively, for dental and other professional service practices. These corporations generally limit the ownership of the corporation to people holding the same professional license, or a license in a related field, such as health care.

In states that uphold the service, professional or professional service corporation, dentists cannot delegate any of these health-related decisions to an unlicensed person, including a management service company. Additionally, dentists can't consult with an unlicensed person or corporation when making these types of decisions.

But this does not mean that an unlicensed person can't work in, or with, the dental practice. A license isn't needed to provide administrative assistance or to sell goods or services to the practice.

For example, a non-licensed person can lease office space and certain dental equipment to the practice. A license isn't required to provide back-office administrative services including accounts payable and billing services, help with traditional marketing or to provide staffing of non-licensed personnel. However, non-licensed employees must receive compensation directly related to the goods and services they provide, not from the net profits of the practice.

By employing a management service company to fulfill the duties legally appropriate for someone without a license, dentists are able to focus on patient care. Contracts link the management service company with the dental corporation, providing the terms of service and compensation.

But what about the states that do not have this rule of separation in place? In these cases, a non-dentist who owns a dental practice must still hire licensed dentists to perform all of the dental work. Otherwise, the only limitation on the ownership of dental practices is a statute that prohibits a contract of employment that requires a dentist to act in a manner that violates professional standards.

If you have any questions about how to set up your dental office agreements so they steer clear of these pitfalls, call Cell/Text at 954-634-2370, or email at [email protected].