shrine to the prophet of americana

The Truth About Dentistry

The Truth About Dentistry

This is interesting enough as regards dentistry, and you should read it for that.

But what I want to focus on is the bit where one dentist just straight-out buys another’s practice and inherits his patients, and point out that while you don’t hear about that stuff much that’s the normal way these things go, product of the residual student-journeyman-master guild structure of “professions” like medicine, dentistry, and law.

Likewise, a lawyer “making partner” is an equity event - with the approval of existing partners they start earning a share of firm profit because they have been invited to buy in to the firm to the tune of six or seven figures. (Retiring partners, in turn, are paid out.)

Investment banks and Hollywood agencies used to be structured similarly but have switched to more liquid capital backing which partially explains their more aggressive stances - they’re more vulnerable to capital withdrawal in fallow periods but in periods of strength they can outbid more constrained competitors through higher “burst” capitalraising

You don’t really hear about this as a barrier to professionals with extensive education debt to begin with though, and that’s because banks will basically automatically approve loans for this end at low rates, sure they’ll pay off.

This in turn though creates some of the pressure among professionals to “protect their own” – maintaining professional scarcity through firm gatekeeping, state bar associations and medical boards running extensive addiction-recovery programs (lawyers have an amazing rate of alcoholism) and forgiving professional ethics boards to deal with misconduct that in other settings would be treated as crime through the justice system. These systematically reduce the chance of a professional failing to earn out their investment, because any given professional’s path to ownership and riches depends on lenders considering any given professional a sure thing.