Graduated in 1995 from the USC School of Dentistry. Can't believe 20 years passed so quickly. Survived a widow-maker heart attack 3 years ago and realize that has nothing to do with this thread but feel that I have been through alot as a dentist. I work in Los Angeles, CA and really only know this area. You may find that your state or city may be different. Medi-cal sucks and has been lowering fees in forever. They recently gave us back a 10% reduction and much clawing and gnashing of teeth. Even Western Dental, the largest medi-cal provider has told California to take their medi-cal and shove it.
First off, let me give you the three most important things you need to know when you get out of school and that will help you to retain your job at whatever office you plan to work at. These three things are never spoken of in school, which is understandable since the schools are very insular. I recall being at USC for 4 years and hardly seeing Tommy Trojan or walking around the main quad. My life was spent with my body, mind, and soul inside of the labs or the treatment areas. In any event, the three things are the following: PRODUCTION, PRODUCTION, PRODUCTION. Yes, you read that correctly. If you can't produce you won't have a job. Now what sort of production do you mean, Dr. Dandogdds? Well, the minimum per day production should be about 2,000 a day with anything above that being expected all the time. You will find that one of the first questions you will be asked by any dental office owner or manager will be "How fast can you do a molar endo?" (The correct answer should be "about an hour") Of course that question implies that it will be a "GOOD" molar endo that will allow the office to be paid by the insurance company. Insurance companies almost always require a post-op xray to be paid (at least medi-cal does) and if you plan to crown this tooth then the endo must be good to be able to place the crown. So, if you screw up the endo you will screw up the offices ability to be paid for the endo AND the crown. Yikes.
Now you may opt to open your own practice which is a great idea but the economy is horrible and the insurance companies hate to pay us what we deserve to be paid for any given procedure. I'm more of a Medi-cal doctor in California and can tell you that silver fillings are paid exactly the same fee as composite fillings. So the extra time for a composite filling is not recognized by the State. So if you want to open your practice you will be a slave to the insurance companies since so few people can pay cash for procedures. In Los Angeles the whole city is saturated with dentists. Almost every corner has a dental office. You will be in competition with every other dental office and with the advent of Yelp and Google you will be graded by the patients and any negative review will turn customers from your business. Any great reviews will bring more patients but you will find that the patients you have tend to be, what's the word, "special" when it comes to their expectations.
HMO's suck. At least when I was in an HMO office. Not sure what has changed but from I've heard it's not much. You will given the "bible" by the office manager. The "bible" is the fee schedule for the particular patient you will be seeing. You will look at it BEFORE you even set eyes on the patient. An easy thing to remember is the following: A patient with a great insurance for the patient, is a bad insurance for the dentist. A patient with a horrible insurance for the patient, is a fantastic insurance for a dentist. Now what does that mean? If the patient has a great insurance (for him/her) and you see the bible and notice that EVERY procedure is a $0.00 deductible then you will be paid that. So that means that miraculously the patient will have no cavities. Thank you Mr. Jones, great exam, see you in 2 years! If the patient has a 0 dollar deductible for crowns and not fillings then somehow the patient will be better off with fillings even though the huge hole in the molar would be better restored with a crown! If the patient has a 0 dollar deductible for fillings and not crowns then that little filling you need, Mr. Jones, would really be better off getting an onlay since the damage is just enough to need it. Get the point? Now, this is not what I did, I quickly got in trouble for not reading the bible and being a "real" dentist so I quit after 1 month. Almost forgot: Now if the patient really needs a filling and you can convince him to get a crown then the patient has then "asked" for crown which is an "upgrade" which means he/she will pay CASH prices for that crown! Sounds complicated? It really isn't. Just follow the money and you will be just fine in an HMO dental office.
My dental partner and myself have many times commented on how we never were warned by the dental school the way it REALLY is in the real world. You think you will see 1 patient and that you have 3 hours to complete the procedure and then go to lunch and come back and see another patient for another 3 hours. Nope. You will slave away doing 5 minute fillings and seeing 5 or 6 patients an hour (or more). You think I am making this up and that's ok. I hope when you get into the world out there you can reply to this thread and then comment on whether I'm right or wrong. Sure, there are some very successful dental offices but they are few and far between. Most of us "regular" dentists will struggle to make payments for rent both in the home and in the office. It is not an easy job and there is no retirement package unless you do it yourself. Most offices will pay you as a "private" contractor even though you don't make your own hours and you don't hire your own staff which means you pay your payroll taxes, the city taxes, the state taxes, and the federal taxes. You won't have any job-given health insurance or any holiday bonuses and certainly not any paid sick days. Start saving when you first get your job and get some sort of retirement package so you don't have to do dentistry at age 80. MANY MANY dentists will work until their fingers fall off or they are in the casket.
Cheers.
ps. I'm not a bitter dentist and only wish someone had warned me so I would at the very least know what to "possibly" expect. YMMV
First off, let me give you the three most important things you need to know when you get out of school and that will help you to retain your job at whatever office you plan to work at. These three things are never spoken of in school, which is understandable since the schools are very insular. I recall being at USC for 4 years and hardly seeing Tommy Trojan or walking around the main quad. My life was spent with my body, mind, and soul inside of the labs or the treatment areas. In any event, the three things are the following: PRODUCTION, PRODUCTION, PRODUCTION. Yes, you read that correctly. If you can't produce you won't have a job. Now what sort of production do you mean, Dr. Dandogdds? Well, the minimum per day production should be about 2,000 a day with anything above that being expected all the time. You will find that one of the first questions you will be asked by any dental office owner or manager will be "How fast can you do a molar endo?" (The correct answer should be "about an hour") Of course that question implies that it will be a "GOOD" molar endo that will allow the office to be paid by the insurance company. Insurance companies almost always require a post-op xray to be paid (at least medi-cal does) and if you plan to crown this tooth then the endo must be good to be able to place the crown. So, if you screw up the endo you will screw up the offices ability to be paid for the endo AND the crown. Yikes.
Now you may opt to open your own practice which is a great idea but the economy is horrible and the insurance companies hate to pay us what we deserve to be paid for any given procedure. I'm more of a Medi-cal doctor in California and can tell you that silver fillings are paid exactly the same fee as composite fillings. So the extra time for a composite filling is not recognized by the State. So if you want to open your practice you will be a slave to the insurance companies since so few people can pay cash for procedures. In Los Angeles the whole city is saturated with dentists. Almost every corner has a dental office. You will be in competition with every other dental office and with the advent of Yelp and Google you will be graded by the patients and any negative review will turn customers from your business. Any great reviews will bring more patients but you will find that the patients you have tend to be, what's the word, "special" when it comes to their expectations.
HMO's suck. At least when I was in an HMO office. Not sure what has changed but from I've heard it's not much. You will given the "bible" by the office manager. The "bible" is the fee schedule for the particular patient you will be seeing. You will look at it BEFORE you even set eyes on the patient. An easy thing to remember is the following: A patient with a great insurance for the patient, is a bad insurance for the dentist. A patient with a horrible insurance for the patient, is a fantastic insurance for a dentist. Now what does that mean? If the patient has a great insurance (for him/her) and you see the bible and notice that EVERY procedure is a $0.00 deductible then you will be paid that. So that means that miraculously the patient will have no cavities. Thank you Mr. Jones, great exam, see you in 2 years! If the patient has a 0 dollar deductible for crowns and not fillings then somehow the patient will be better off with fillings even though the huge hole in the molar would be better restored with a crown! If the patient has a 0 dollar deductible for fillings and not crowns then that little filling you need, Mr. Jones, would really be better off getting an onlay since the damage is just enough to need it. Get the point? Now, this is not what I did, I quickly got in trouble for not reading the bible and being a "real" dentist so I quit after 1 month. Almost forgot: Now if the patient really needs a filling and you can convince him to get a crown then the patient has then "asked" for crown which is an "upgrade" which means he/she will pay CASH prices for that crown! Sounds complicated? It really isn't. Just follow the money and you will be just fine in an HMO dental office.
My dental partner and myself have many times commented on how we never were warned by the dental school the way it REALLY is in the real world. You think you will see 1 patient and that you have 3 hours to complete the procedure and then go to lunch and come back and see another patient for another 3 hours. Nope. You will slave away doing 5 minute fillings and seeing 5 or 6 patients an hour (or more). You think I am making this up and that's ok. I hope when you get into the world out there you can reply to this thread and then comment on whether I'm right or wrong. Sure, there are some very successful dental offices but they are few and far between. Most of us "regular" dentists will struggle to make payments for rent both in the home and in the office. It is not an easy job and there is no retirement package unless you do it yourself. Most offices will pay you as a "private" contractor even though you don't make your own hours and you don't hire your own staff which means you pay your payroll taxes, the city taxes, the state taxes, and the federal taxes. You won't have any job-given health insurance or any holiday bonuses and certainly not any paid sick days. Start saving when you first get your job and get some sort of retirement package so you don't have to do dentistry at age 80. MANY MANY dentists will work until their fingers fall off or they are in the casket.
Cheers.
ps. I'm not a bitter dentist and only wish someone had warned me so I would at the very least know what to "possibly" expect. YMMV
