SOS- A desperate D4 trying to learn how to get a job!!

[LolaLu]

Hi everyone!
Dramatic title but I'm a little embarrassed on how lost I am on the process of FINDING A JOB. First two years was all studying.Third year, and my final year is all patients [and hell, still studying]. But I have NO IDEA on when to find a job, how to find one, and what even to ask/look for? I don't know the business aspect of dentistry AT ALL and don't want to get sucked into corporate because it's easy.

I've looked at all old threads and I know of dentpost, dentaltown, indeed, ADA, Schein/Patterson reps for associateships and of course corporate. But I guess my question is,


Do I straight up call dentists in the area I'm interested and just say, "Hey, I saw you were interested in hiring a new dentist and I'm graduating this May. Is the offer still available"?

What questions should I ask to make sure the practice I'm looking into is succesful?

Do I then shadow them or interview with them for a week or what?

My next question is, lets say that all goes well. How does the contract get to me? Do they just email it once they think I'm a good fit?
And an important question is: what things did you guys wish you had asked for when editing a contract? {I.E. you want percentage of production not collection...etc}.

My last question is this. I always told myself, hey just work for corporate for a year or two to build up speed and learn how to run a dental business and then go do an associateship/own? Is this a silly idea? Why or why not?


Ok, I'm done with 1001 questions. I know someone is laughing at this right now remembering when they were in my position and hopefully writes a beautifully detailed description/gist of what to do/ where to go. And I hope this helps other fourth year students like me. Thanks in advance.

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[2TH MVR]

No one is laughing. We've all been there. Priority is to make sure the location is where you want to practice. I'm sure you've read all the threads regarding urban, saturated areas vs. rural areas. I would re-read them. Location will be the most important factor in your future success.
Next. Don't be stressed about finding that perfect situation immediately. Give yourself 6 months in the location that you want to practice in. It is difficult to do long distance research on a PERFECT job right out of school. Much easier if you are physically there in the chosen area.
Once you locate a position. If it is a Corp position .... their reps will get a hold of you. I know when I was looking for a Corp job ... I went to their websites and essentially applied for the job. As a specialist .... I had to sign a 2 yr contract. I'm not sure how long a GP contract would be. Hopefully only 6-12 months. If you're looking for an associate position with a dentist ..... I would call and set up a time to see the practice and meet the dr. and staff. Spend the day with them. See the area. Again .... you should only commit for 6 months.
Regardless of the situation .... you need TIME to make sure this situation is acceptable to you and the owner/Corp.
As for questions to ask the practice to see if it is successful. I have no answer. You are new. You have no idea what to look for. Again .... the reason for a 6 month commitment only. During this 6 months .... start networking. Check out some other opportunities. I petty well knew I wanted to be an owner. I contacted all the OLD orthodontists and met them for lunch.
As for the contract. I'm sure others will chime in. Just make sure the noncompete covenent is reasonable. In urban areas .... that noncompete shouldn't be more than 5-10 miles. In a rural area ... that number will be larger.
As for working for a Corp. You will build speed. As for learning business stuff ... well .... you'll learn a little, but not as much as if you were in a private practice.
Owning your own practice should always be the priority. Again ... choose your location very carefully. I am of the opinion that especially with the high DS debts .... I'm not a fan of purchasing these mega expensive practices. I would be looking for that inexpensive, plenty of upside, little practice to buy. Preferably from a retiring dentist. Perfect scenario: work Corp PT. Associate with a retiring dentist for 6 months (no commitment) and then buy the GP practice for a pre-determined amount after the initial 6 months if the practice is "growable" and the owner is SET on retiring. If the owner GP is not willing to commit to retiring, or transitioning the practice in a pre-set date .... then walk. This is a dead end.

The take home message. Don't look for the PERFECT opportunity. Picking the right location is more important. Get there. Find a temp job (6 mos) either associateship or Corp .... then start your REAL research.

Good luck.

 

[LolaLu]

@2TH MVR WHY are you so wonderful!! Really appreciate you taking the time to write all that.

Hoping for more answers from other members!

 

[charlestweed]

It sure is a lot easier to find a job at a corp than at a private office. Working for a busy corp is much harder than at a slower private office but I think you’ll learn a lot more because:

1. It’s not easy to lower your ego and have to listen to the manager who only has a HS diploma. You also have to be “nice” to the assistants so they will be more helpful to you. Corp office is already very stressful environment to work at; being bossy to your staff and arguing with them will increase the stress level even more. You need to realize that you, alone, cannot get things done….teamwork is very important. When you can deal with people you work with you will have less problem when you start your own office and hire your own staff.

2. High patient volume at the corp forces you to learn to multi-task and manage the chair time better….ie numb the pt in chair 1, cement a crown on chair 2, do an exam on chair 3 and let the manager discuss tx fee with the pt, move back to chair 1 and start drilling. With more cases you treat at the corp, you gain more experience and do things faster and more accurately. You don't learn much if you work at a place that gives you 1 hour for 1 filling. Private office may not give you enough patients and to lower the overhead, the owner dentist may cut your days. Many private offices only have enough patients to hire P/T associate.

3. High patient volume also means more headache and more complaints from patients that you’ll have to deal with. But that’s how you learn. When you start your own office, you should have no problem dealing with the patients’ complaints and you know what to do to avoid getting these complaints. The good thing is most patients at the corp are very nice. They are mostly low income patients and they trust their dentists. They get tx at the corp because the private offices don’t accept their insurances or charge too much.

4. You learn how the corps keep their overhead low. You learn how they manage their staff and all the labor laws (+other laws like OSHA/infection control) that they have to follow.

5. Most private office owners make you sign a not-to-compete agreement that prohibits you from setting up your own offices within certain mile radius. Many corp offices don’t make you sign such agreement and if they do, it’s only like 1-2 mile radius. My friend’s ortho office is only 2 miles away from the corp office he currently works for.

An ideal job with good pay, good boss, good patients etc doesn't exist. The jobs that pay you well usually expect you to work hard to produce for them and they are harder to find because the associate dentists at these places don’t quit their good paying jobs. The ones that give you everything: slow easy schedule, good expensive instruments and supplies, good obedient staff etc usually pay you less because of their high overhead.

I highly recommend working for a busy corp office because you’ll learn a lot more from treating much higher patient volume than in a private practice. Most successful practice owners I know had worked for the corps before they started their own offices. ColdFront and Rainee are among them.

 

[lemoncurry]

there's also Indian Health and FQHCs that might be a decent middle ground of keeping fairly busy but not insanely so. For FQHCs, I would just google ones near where you want to live and check their websites for openings.

 

[charlestweed]

there's also Indian Health and FQHCs that might be a decent middle ground of keeping fairly busy but not insanely so. For FQHCs, I would just google ones near where you want to live and check their websites for openings.

Do you get to do cometic procedures like veneers, crowns, bridges, and implants at these types of government run health clinics? How high is the no-show rate? Isn't it hard to learn the business side of dentistry when everything is paid for by the government...... and the staff who can't be fired?

I think these places are great for dentists who don't want the headache of owning a practice.

 

[lemoncurry]

At my FQHC office, yes, we do crowns, bridges and the occasional veneer. Does medicaid cover those procedures? Not unless you're pregnant or a kid. We also accept private insurance as well. As far as the business side, you do learn some of it wherever you are but it's not as important at a public health facility. The biggest thing, IMO, should be about getting better at doing actual dentistry. My experience was that I didn't have to focus on business things and I could focus on dentistry, and I feel it has worked in my favor. Of course I still have much to learn about private practice as I make the transition into that arena but that's only because I chose to go that route.

 

[LolaLu]

@charlestweed @lemoncurry Wow thank you guys for the input, REALLY appreciate it!

 

[lemoncurry]

@charlestweed @lemoncurry Wow thank you guys for the input, REALLY appreciate it!

Other places you can look include at Indeed.com, state dental society job listings, facebook groups for dentists (there are a bunch and they have helpful information) and even your school should have listings. Good luck!

 

[predent2151]

No one is laughing. We've all been there. Priority is to make sure the location is where you want to practice. I'm sure you've read all the threads regarding urban, saturated areas vs. rural areas. I would re-read them. Location will be the most important factor in your future success.
Next. Don't be stressed about finding that perfect situation immediately. Give yourself 6 months in the location that you want to practice in. It is difficult to do long distance research on a PERFECT job right out of school. Much easier if you are physically there in the chosen area.
Once you locate a position. If it is a Corp position .... their reps will get a hold of you. I know when I was looking for a Corp job ... I went to their websites and essentially applied for the job. As a specialist .... I had to sign a 2 yr contract. I'm not sure how long a GP contract would be. Hopefully only 6-12 months. If you're looking for an associate position with a dentist ..... I would call and set up a time to see the practice and meet the dr. and staff. Spend the day with them. See the area. Again .... you should only commit for 6 months.
Regardless of the situation .... you need TIME to make sure this situation is acceptable to you and the owner/Corp.
As for questions to ask the practice to see if it is successful. I have no answer. You are new. You have no idea what to look for. Again .... the reason for a 6 month commitment only. During this 6 months .... start networking. Check out some other opportunities. I petty well knew I wanted to be an owner. I contacted all the OLD orthodontists and met them for lunch.
As for the contract. I'm sure others will chime in. Just make sure the noncompete covenent is reasonable. In urban areas .... that noncompete shouldn't be more than 5-10 miles. In a rural area ... that number will be larger.
As for working for a Corp. You will build speed. As for learning business stuff ... well .... you'll learn a little, but not as much as if you were in a private practice.
Owning your own practice should always be the priority. Again ... choose your location very carefully. I am of the opinion that especially with the high DS debts .... I'm not a fan of purchasing these mega expensive practices. I would be looking for that inexpensive, plenty of upside, little practice to buy. Preferably from a retiring dentist. Perfect scenario: work Corp PT. Associate with a retiring dentist for 6 months (no commitment) and then buy the GP practice for a pre-determined amount after the initial 6 months if the practice is "growable" and the owner is SET on retiring. If the owner GP is not willing to commit to retiring, or transitioning the practice in a pre-set date .... then walk. This is a dead end.

The take home message. Don't look for the PERFECT opportunity. Picking the right location is more important. Get there. Find a temp job (6 mos) either associateship or Corp .... then start your REAL research.

Good luck.

Why not purchase a high cash flowing practice? Especially if you can produce. I would rather be 500k in debt with an office collecting 1 million on 60% OH cash flowing 400k then 500k in debt with an office collecting 400k with upside potential on 60% OH cash flowing 160k which you may or may not be able to grow.

 

[P7898]

Why not purchase a high cash flowing practice? Especially if you can produce. I would rather be 500k in debt with an office collecting 1 million on 60% OH cash flowing 400k then 500k in debt with an office collecting 400k with upside potential on 60% OH cash flowing 160k which you may or may not be able to grow.

Great point; in addition they need a substantial cash flow to make payments on their school loans which have the higher interest rates first. The practice loans have lower interest rates.

 

[2TH MVR]

Why not purchase a high cash flowing practice? Especially if you can produce. I would rather be 500k in debt with an office collecting 1 million on 60% OH cash flowing 400k then 500k in debt with an office collecting 400k with upside potential on 60% OH cash flowing 160k which you may or may not be able to grow.

OP is a D4 just looking to get their feet wet in the dentist world. Also .... what makes you think that a new dentist right out of school will have the speed, experience, and business knowledge to maintain the production levels on a mature, high production practice? This is not the same as getting a job with a high salary. You're buying a business that has been built by the original selling dentist. That dentist is responsible for the success of that practice. There is no guarantee that a new grad will be able to match the success of a seasoned dentist.
Also .... 500K is on the middle side of practice sales. I'm talking about practices costing around a million plus. That's high end.

 

[P7898]

OP is a D4 just looking to get their feet wet in the dentist world. Also .... what makes you think that a new dentist right out of school will have the speed, experience, and business knowledge to maintain the production levels on a mature, high production practice? This is not the same as getting a job with a high salary. You're buying a business that has been built by the original selling dentist. That dentist is responsible for the success of that practice. There is no guarantee that a new grad will be able to match the success of a seasoned dentist.
Also .... 500K is on the middle side of practice sales. I'm talking about practices costing around a million plus. That's high end.

Great point. You could try and find an office where 30% of collections is hygiene. If OP did a solid AEGD and worked for a year this would be more realistic or really just worked for a year in a high producing office granted the practice he or she would buy was bread and butter.

 

[predent2151]

OP is a D4 just looking to get their feet wet in the dentist world. Also .... what makes you think that a new dentist right out of school will have the speed, experience, and business knowledge to maintain the production levels on a mature, high production practice? This is not the same as getting a job with a high salary. You're buying a business that has been built by the original selling dentist. That dentist is responsible for the success of that practice. There is no guarantee that a new grad will be able to match the success of a seasoned dentist.
Also .... 500K is on the middle side of practice sales. I'm talking about practices costing around a million plus. That's high end.

OP is a D4 just looking to get their feet wet in the dentist world. Also .... what makes you think that a new dentist right out of school will have the speed, experience, and business knowledge to maintain the production levels on a mature, high production practice? This is not the same as getting a job with a high salary. You're buying a business that has been built by the original selling dentist. That dentist is responsible for the success of that practice. There is no guarantee that a new grad will be able to match the success of a seasoned dentist.
Also .... 500K is on the middle side of practice sales. I'm talking about practices costing around a million plus. That's high end.

I said if OP can produce. Why purchase a practice if you aren't ready to handle it. Why not do an AEGD, work a few years, be able to produce. A 500K practice is not a great practice. The overhead will be large due to fixed costs. IMO it is way more risk purchasing a low cash flowing practice with the idea that since it is small possibly I can handle it then working or doing an AEGD and gaining the experience to be able to establish systems that will allow you to produce more. Learning how to run a dental practice, gaining clinical speed. If they can't do that perhaps they should delay ownership till they are comfortable practicing real world dentistry. There are plenty of new grads that have the capability to produce btw. Not all of them of course. But just saying, purchasing a low cash flowing practice with the expectation to grow it over time is greater risk then buying into a systemize machine given that you are sufficient clinically. At around 900k collections you can assume that is probably what you are getting yourself into if the practice is mostly bread and butter. Plus a 500k collections practice is producing like 2K a day. If it has a healthy hygiene percentage the dentist is producing like 1500. That's really something that all new grads should be able to handle. Would you not agree?

 

[P7898]

He makes a great point. Especially now when new graduates are coming out with a lot of student debt at 6.6-10% interest rates depending if they used grad plus loans or not. Business loans are floating from 3.8-5% so it would be like shooting yourself in the foot financially to grow and existing practice especially if it is not producing enough to pay down loans and live comfortably. I can see someone with no loans buying a $500k practice who wants to own but doesn't have those financial burdens....

 

[P7898]

2k/day is doable depending on the insurance reimbursement fees. Class 2 fills are $50 in CA if it’s Medicaid. That’s 40 fills a day just to make 2k in production.

Those poor souls...oh yeah...stay out of Cali...forgot to mention that.

 

[predent2151]

Why does everyone flock to Cali lol? It’s hard to be successful in a highly competitive saturated market accepting Medicaid. Perhaps I’m skewed given I’m from the rural southeast.

 

[charlestweed]

My sister set up her 1200sf 4 op office from scratch in 2004 in Orange County, CA for $120k (construction + equipment). With the money that she had saved from her associate job of 3 years and from living with our parents, she didn't need to borrow anything from the bank. Her student loan debt for attending UCSF was only $80k. She accepted everything (medicaid, PPO) except HMO. The office was plumbed for 4 chairs but most of the time, she only used 2 chairs to treat 8-10 patients a day.....she did all the cleanings herself....no hygienist. A year later, I joined her practice to do ortho there. About 5-6 years later, she sold this office (a leasehold sale) for $65k and moved all her patients to a new office building, which she purchased for $1.2 million. The passive income she earns from the in-house ortho and perio is almost enough to pay for her staff (1 front, 1 back) salaries and supplies. Whatever she produces are hers to take home because she has no rent, no debt to pay. Doing a $50 filling on a medicaid patient at an office that has almost 0% overhead like hers is better than doing a $150 filling at an office that has 70-80% overhead. When things go bad (economic recessions, housing bubble, natural disasters etc), the low overhead offices (with low rent, low staff salaries) suffer less than the high end offices that have high overhead.

 

[P7898]

My sister set up her 1200sf 4 op office from scratch in 2004 in Orange County, CA for $120k (construction + equipment). With the money that she had saved from her associate job of 3 years and from living with our parents, she didn't need to borrow anything from the bank. Her student loan debt for attending UCSF was only $80k. She accepted everything (medicaid, PPO) except HMO. The office was plumbed for 4 chairs but most of the time, she only used 2 chairs to treat 8-10 patients a day.....she did all the cleanings herself....no hygienist. A year later, I joined her practice to do ortho there. About 5-6 years later, she sold this office (a leasehold sale) for $65k and moved all her patients to a new office building, which she purchased for $1.2 million. The passive income she earns from the in-house ortho and perio is almost enough to pay for her staff (1 front, 1 back) salaries and supplies. Whatever she produces are hers to take home because she has no rent, no debt to pay. Doing a $50 filling on a medicaid patient at an office that has almost 0% overhead like hers is better than doing a $150 filling at an office that has 70-80% overhead. When things go bad (economic recessions, housing bubble, natural disasters etc), the low overhead offices (with low rent, low staff salaries) suffer less than the high end offices that have high overhead.

I agree keeping fixed costs is good and all and to make sure everything is low as you can go. However we are talking about graduates coming out with $400k of debt. Something completely different...these guys need $50k+ just to pay interest once it is compounding so they need something with higher stakes and higher flow. Congrats to your sister by the way. That is a great way of creating passive income; very creative.

 

[charlestweed]

I agree keeping fixed costs is good and all and to make sure everything is low as you can go. However we are talking about graduates coming out with $400k of debt. Something completely different...these guys need $50k+ just to pay interest once it is compounding so they need something with higher stakes and higher flow. Congrats to your sister by the way. That is a great way of creating passive income; very creative.

The sad thing is even with so much higher student loan debt than what we, older dentists, owed, many recent grads don't see this as a problem and still want to take out addtional $500-600k loan to either set up their new their offices or to buy existing practices. Good production high end practices are usually not listed for sell, unless the owners of these practices have a serious illness that forces them to retire early. Dentists usually sell their practices because they are not doing well financially. These are usually older doctors, who can no longer produce at the same level as when they were younger. These practices tend to have high overhead (because the selling doctors keep raising their staff salaries and giving them more benefits) and are overstaffed (because the selling doctors don't want to cut their loyal employees' hours even when the office is losing new paients to the younger doc down the street).

There are plenty of abandonned dental offices in CA that are listed for sale for as low as $25k. Why not purchase one of these offices?...and save hundreds of thousands of dollars in construction cost?. These older offices may not have things that the new grads want but it's a good startup office, especially for new grads with a lot of debts. At the beginning, when there are not a lot of patients, they can work P/T at their own office and P/T for the corp office so they can have possitive cashflow to pay back their student loans. The advantage of working in CA is there are plenty of P/T corp jobs available. That's what my sister did in 2004. She worked 4 days/week for the corp and 3 days/week (Saturdays and Sundays) at her own office.

 

[charlestweed]

How does she have no rent?

Because she owns the building. It's a standalone office building with a very large parking lot. Because it is zoned for both residential and commercial purposes, my sister is planning to use 1/2 of the parking lot space to build 2 attached homes and rent them out.