AMA - Practice startups and early retirement

[TanMan]

After PMing for awhile with another member regarding startups, I decided to answer any questions you may have regarding starting your own office and retiring early (yes, they are connected). I started my office a over 3 years ago and have been practicing for 5years. I love dentistry, but it takes it toll on you and life's too short to work for the rest of your life. If given the decision to do a startup or buy an office again, I'd choose a startup everytime unless the office was supercheap, but superprofitable.

---

Members don't see this ad.

 

[786783]

Did you do demographic analysis yourself or did you pay a company?

 

[Chipotlegonewild]

Did you start up right after school? Did you go for a high growth area or good pt/Dr ratio?

 

[TanMan]

Did you do demographic analysis yourself or did you pay a company?

Did the demographic analysis myself. However, one of the things to consider is that in my area, there's a sharp distinction of middle/uppermiddle class and lower class/medicaid. On the surface, it would appear that that it was an undesirable demographic, but upon further analysis, there wasn't enough FFS/PPO offices in my area to serve the middle/uppermiddle class (note that I do not want to treat upper class/high income since they tend to be higher maintenance and tighter on their pocketbooks)

 

[TanMan]

Did you start up right after school? Did you go for a high growth area or good pt/Dr ratio?

I wish I had the funds to do it from the get-go, but I worked for 2 medicaid mills for a little over a year and paid for the startup with cash. I went to a high growth area with lots of medicaid, but some PPO/FFS. I decided to corner the market on PPO/FFS instead, since ironically, it was that population that was underserved. Pt/Dr ratio is good for non-medicaid in my area,, but the medicaid mills popped up everywhere in my region. Let them fight it out, haha. In retrospect, pt/dr ratios are not as important as having a solid marketing plan.

 

[786783]

Amount of school loans? Loan payment strategy?
How many decades until retirement? Retirement planning strategies?
Planning on expanding, or doing more start-ups?

There's so much to ask...

 

[TanMan]

Amount of school loans? Loan payment strategy?
How many decades until retirement? Retirement planning strategies?
Planning on expanding, or doing more start-ups?

There's so much to ask...

220k. Loan payment strategy: pay as little as possible until your office is making a good amount. (My stupid mistake was to accelerate payment in the first few months and ended up getting delayed in getting an office started)

Retirement in 3 years hopefully, depending on whether my investments payoff. Still relatively young, so if it all comes crashing down, I can work a few extra years. In terms of strategy, you need to determine how much money you're going to need per month for the rest of your life. From there, determine how aggressive you need to invest. I have very risky businesses right now that I've invested in. If it pays off, I can retire in 2-3 years. I would like to make enough money to the point where I can walk away from my office without worrying about selling it.

No more additional offices for a few reasons:
- Each incremental office can cannibalize my current patient pool. As long as my hands don't fall off, I'll keep working and seeing as many as I can.
- Each incremental office doesn't mean double income. Increases income by about 15-20% each additional office, and doesn't seem worth it to jeopardize the brand I've developed, cleaning up any messes that associates might do, nor having to hire administrative staff to manage more offices, etc... for 20% more income. I got better things to do with my time and money than create jobs.

I've expanded once already, and I'm at my capacity. I might be at the upper limit of what dentistry can provide financially.

 

[CanaDMD]

After PMing for awhile with another member regarding startups, I decided to answer any questions you may have regarding starting your own office and retiring early (yes, they are connected). I started my office a over 3 years ago and have been practicing for 5years. I love dentistry, but it takes it toll on you and life's too short to work for the rest of your life. If given the decision to do a startup or buy an office again, I'd choose a startup everytime unless the office was supercheap, but superprofitable.

Give us more details about your story? How you were in DS, evolution from DS1-4-post grad, etc?

 

[TanMan]

Dental School: When I first started, I knew I wanted to make lots of money and succeed; only chose dentistry at first because of the money. However, as DS1/DS2 progressed, I got lucky in that I actually enjoyed what I got myself into. DS3, I finished my requirements early so I didn't have to worry about the requirement aspects of school - I got to focus on what mattered most, succeeding in clinical practice. I knew that the full-time professors had no clue about the real world, so I made sure to work with part-timers that were no-nonsense, pragmatic, and real world dentists. I made sure to focus on training myself on molar endo; I was able to by finding a loophole that let me do a lot of endos, but give my classmates the credit for the endo. The ones specializing didn't care, and I wanted the experience. DS4 - those that specialized, I bought all their dental equipment that I needed for my office, the rest I ebayed for profit for my future office.

After graduation, I didn't have enough money to start my office from the get-go; had to work for chains to save up enough money, took their respective bonus, saved enough for an office after a bit over a year, then opened up. Worked part-time initially at my own office, and full-time at the other office. When the office realized that I had my own office, they fired me. Having little money left, I spent the rest of my reserves on heavy advertising, and from there, it just took off. At this point, the gamble could either backfire or result in success. Thank goodness it succeeded. 3 yrs later, here we are, on track for retirement in 3 yrs (unless investments go south, I get bored, etc...)

 

[CanaDMD]

Dental School: When I first started, I knew I wanted to make lots of money and succeed; only chose dentistry at first because of the money. However, as DS1/DS2 progressed, I got lucky in that I actually enjoyed what I got myself into. DS3, I finished my requirements early so I didn't have to worry about the requirement aspects of school - I got to focus on what mattered most, succeeding in clinical practice. I knew that the full-time professors had no clue about the real world, so I made sure to work with part-timers that were no-nonsense, pragmatic, and real world dentists. I made sure to focus on training myself on molar endo; I was able to by finding a loophole that let me do a lot of endos, but give my classmates the credit for the endo. The ones specializing didn't care, and I wanted the experience. DS4 - those that specialized, I bought all their dental equipment that I needed for my office, the rest I ebayed for profit for my future office.

After graduation, I didn't have enough money to start my office from the get-go; had to work for chains to save up enough money, took their respective bonus, saved enough for an office after a bit over a year, then opened up. Worked part-time initially at my own office, and full-time at the other office. When the office realized that I had my own office, they fired me. Having little money left, I spent the rest of my reserves on heavy advertising, and from there, it just took off. At this point, the gamble could either backfire or result in success. Thank goodness it succeeded. 3 yrs later, here we are, on track for retirement in 3 yrs (unless investments go south, I get bored, etc...)

So you're telling me you were able to finish your requirements to GRADUATE by end of D3? May I somehow know how you were able to accomplish such a thing?

 

[CanaDMD]

Dental School: When I first started, I knew I wanted to make lots of money and succeed; only chose dentistry at first because of the money. However, as DS1/DS2 progressed, I got lucky in that I actually enjoyed what I got myself into. DS3, I finished my requirements early so I didn't have to worry about the requirement aspects of school - I got to focus on what mattered most, succeeding in clinical practice. I knew that the full-time professors had no clue about the real world, so I made sure to work with part-timers that were no-nonsense, pragmatic, and real world dentists. I made sure to focus on training myself on molar endo; I was able to by finding a loophole that let me do a lot of endos, but give my classmates the credit for the endo. The ones specializing didn't care, and I wanted the experience. DS4 - those that specialized, I bought all their dental equipment that I needed for my office, the rest I ebayed for profit for my future office.

After graduation, I didn't have enough money to start my office from the get-go; had to work for chains to save up enough money, took their respective bonus, saved enough for an office after a bit over a year, then opened up. Worked part-time initially at my own office, and full-time at the other office. When the office realized that I had my own office, they fired me. Having little money left, I spent the rest of my reserves on heavy advertising, and from there, it just took off. At this point, the gamble could either backfire or result in success. Thank goodness it succeeded. 3 yrs later, here we are, on track for retirement in 3 yrs (unless investments go south, I get bored, etc...)

Also, out of curiosity, what is your "magic number" you're trying to hit to retire? Is it your standard 4m? If so, thats a lot of money to have made within 8 years out of dental school 😳

 

[TanMan]

perio - easy to get (not even a worry)
restorative - offsite rotations got me 1/6th of my requirements in a single day...
removable - purchased my own stones, impression materials, equipment, etc... and did the lab work in front of the patient so I was able to finish multiple steps in one visit. 10 appt dentures became 3-4.
endo - u know the story (see above)
oral surgery - took most ghetto offsite rotation, got more difficult cases and more numerous cases (no requirements here, but good training)
Common theme? Be proactive, understand the system to work the system; be more efficient. You really dont need to be a lab tech in the end, but it teaches you to work under pressure and not just follow the cookie cutter mold.
On getting patients:
If I needed a patient, I would trade to get a patient/procedure, If my team needed a patient, I would get it for them by trading. Help others and don't be greedy. I didn't go above and beyond to rob others of their dental school experience, but I did look out for myself and others. There were some jerks that would go double or triple the restorative requirements but that ultimately comes at the expense of others lacking procedures.

Magic number? 5 minimum/ 10 ideal in liquid assets. I'm happy with 50k/month for the rest of my life.

 

[Grinz]

How many active patients do you have currently and what is the production and collection for your office?

 

[Hoopin4dayz]

Have you considered specializing in dental school? Why not go into Ortho or OS?

 

[TanMan]

How many active patients do you have currently and what is the production and collection for your office?

Active Patients: 7254
2016 Production: 2.86
2016 Collection: 2.73

 

[periopocket]

1. Where did you go to Dental school?
2. Are you practicing in an underserved area?
3. Do you refer any specialty work?
4. Do you attribute your success to having enhanced clinical skill?
5. Would you ever recommend someone to specialize only to enhance their clinical skills to open a general practice after?

Thank you and congrats!


Sent from my iPhone using SDN mobile

 

[TanMan]

1. Where did you go to Dental school?
2. Are you practicing in an underserved area?
3. Do you refer any specialty work?
4. Do you attribute your success to having enhanced clinical skill?
5. Would you ever recommend someone to specialize only to enhance their clinical skills to open a general practice after?

Thank you and congrats!


Sent from my iPhone using SDN mobile

1. I probably should not mention it since I believe those loopholes still exist and could ruin it for them (I know that they patched some up when I left) - PM for the dschool (Let's just say school in socal)
2. No, poor area overall but not underserved.
3. Yes, I don't do a lot of thirds, implants, apico's, PITA patients, pediatrics, starting with dentures, TMJ, cosmetic/veneers
4. Some, not completely. I think its moreso business and luck
5. NO! Waste of time. If you try to do anything beyond your specialty, you'll sink your referral base. Also, the biggest regret I have about dental school is how long it took. 4 years, assume I live to be 50, that's 8% of my life I can't get back. That's why I want to retire early because I dont want to enjoy life starting 50. Just seems like a miserable existence.

 

[deleted696582]

How much free time do you have after the demands of seeing patients and the business side of your practice? Does the business side of things blend into family time if you have family?

Do you take many vacations? It seems like you appreciate a balance of work and free time, and I'm interested in hearing from this perspective.

 

[TanMan]

How much free time do you have after the demands of seeing patients and the business side of your practice? Does the business side of things blend into family time if you have family?

Do you take many vacations? It seems like you appreciate a balance of work and free time, and I'm interested in hearing from this perspective.

I don't have free time on days when I work. No kids, no wife, no restrictions. Nothing to do here anyway.

1 company vacation per year with staff, usually 5 days. Last year went to Hawaii, this year they want to go to cancun.

Right now, I have no balance since my goal is to finish early so that everyday can be a vacation for the rest of my life. Condensing 30 years of practice in a few years. I think small vacations make me lazy. Now... I do have to take some days off such as easter sunday, xmas and new years since my staff wants those days off. Im off most Mondays and Tuesdays so its good a lot of those 3 day weekends fall into that category

 

[periopocket]

1. I probably should not mention it since I believe those loopholes still exist and could ruin it for them (I know that they patched some up when I left) - PM for the dschool (Let's just say school in socal)
2. No, poor area overall but not underserved.
3. Yes, I don't do a lot of thirds, implants, apico's, PITA patients, pediatrics, starting with dentures, TMJ, cosmetic/veneers
4. Some, not completely. I think its moreso business and luck
5. NO! Waste of time. If you try to do anything beyond your specialty, you'll sink your referral base. Also, the biggest regret I have about dental school is how long it took. 4 years, assume I live to be 50, that's 8% of my life I can't get back. That's why I want to retire early because I dont want to enjoy life starting 50. Just seems like a miserable existence.

Thanks for your feedback!

5. What I meant was practice as a general practitioner after receiving a specialty certificate - not relying on referrals and practicing general.

The additional training would make me proficient in implants, grafting, 3rds and IV sedation.

I currently suck at molar endo - took me 6 - 7 hours first time. I'm not very good at denture work. Would you say these are vital to general practitioners success. Or can bread and butter lead to productions and success that you have presented?

Thanks!


Sent from my iPhone using SDN mobile

 

[TanMan]

Thanks for your feedback!

5. What I meant was practice as a general practitioner after receiving a specialty certificate - not relying on referrals and practicing general.

The additional training would make me proficient in implants, grafting, 3rds and IV sedation.

I currently suck at molar endo - took me 6 - 7 hours first time. I'm not very good at denture work. Would you say these are vital to general practitioners success. Or can bread and butter lead to productions and success that you have presented?

Thanks!


Sent from my iPhone using SDN mobile

I'll give you a resounding hell NO on that... pardon my language.
On paper, sounds great to do all that: implants, grafting, 3rds and IV. I'll knock each one off the to-do list for the following reasons.
Implants - Takes too long, unrealistic expectations; easy to place, difficult to manage complications. Can make lots of money in theory, but not worth the headache of placement. MUCH easier to restore, less problems, instant money.
Grafting - Similar to implants. What happens if it doesn't take hold? Post-op complications, redoing it, it's your time that's getting wasted.
3rd's - Only do easy ones. Less liability, less headache; better patient experiences with you personally if you dont make them swell up or affect their opening
IV Sedation - This attracts the most annoying patients. Phobic, never satisfied but superanxious patients. Makes your procedure easy, but you're most likely married to the patient for awhile especially if you're doing full mouth reconstruction. They can pay 20-40k and expect lifetime warranty... forget that. Your car doesn't last that long, neither will your teeth unless you take care of them

Molar endo is probably the most important procedure to learn. It's the gateway to crown, buildup, and crown lengthening (as needed). Dentures are irrelevant and a money drain in the office. That's why I'm almost rid of them. You really don't want to attract old people in your office since most of their work has either been done, they need dentures, and/or want to talk on forever. First step is don't take medicare or adult medicaid/children's medicaid.

 

[periopocket]

I'll give you a resounding hell NO on that... pardon my language.
On paper, sounds great to do all that: implants, grafting, 3rds and IV. I'll knock each one off the to-do list for the following reasons.
Implants - Takes too long, unrealistic expectations; easy to place, difficult to manage complications. Can make lots of money in theory, but not worth the headache of placement. MUCH easier to restore, less problems, instant money.
Grafting - Similar to implants. What happens if it doesn't take hold? Post-op complications, redoing it, it's your time that's getting wasted.
3rd's - Only do easy ones. Less liability, less headache; better patient experiences with you personally if you dont make them swell up or affect their opening
IV Sedation - This attracts the most annoying patients. Phobic, never satisfied but superanxious patients. Makes your procedure easy, but you're most likely married to the patient for awhile especially if you're doing full mouth reconstruction. They can pay 20-40k and expect lifetime warranty... forget that. Your car doesn't last that long, neither will your teeth unless you take care of them

Molar endo is probably the most important procedure to learn. It's the gateway to crown, buildup, and crown lengthening (as needed). Dentures are irrelevant and a money drain in the office. That's why I'm almost rid of them. You really don't want to attract old people in your office since most of their work has either been done, they need dentures, and/or want to talk on forever. First step is don't take medicare or adult medicaid/children's medicaid.

I see, thanks, this makes a lot of sense. Molar endo ->post + core build up -> crown prep -> provisionalize -> crown lengthen -> cement crown = $$$$$$$$$$$

Learn molar endo, refer the other shiz




Sent from my iPhone using SDN mobile

 

[cacajuate]

What are the risky business that you invested in that will allow you to retire while having only been a dentist for ~8ish years? Flying in cocaine?


I was super excited about this post until I started reading and now I don't believe you.

 

[TanMan]

I see, thanks, this makes a lot of sense. Molar endo ->post + core build up -> crown prep -> provisionalize -> crown lengthen -> cement crown = $$$$$$$$$$$

Learn molar endo, refer the other shiz



Sent from my iPhone using SDN mobile

Yep, don't forget extractions, crowns, bridges, fillings (I hate using the word restoration in front of patients)

What are the risky business that you invested in that will allow you to retire while having only been a dentist for ~8ish years? Flying in cocaine?


I was super excited about this post until I started reading and now I don't believe you.

I would if I could, but the social consequences to my freedom are too high and I wouldn't risk everything I worked for. For something that stupid. I could've done that without dental school. You don't have to believe me though, I state what works, and what to focus on to be profitable. Your statement makes it seem like its impossible to work less and retire early as a dentist and it's attitudes like that, that drive away future colleagues for fear of slavery to debt. We're not minimum wage laborers here and we have so much more income potential than even our MD counterparts.

Now, what businesses can you do? Hard money lending, invoice factoring, petroleum transport, etc.... if you have the capital, you can do whatever you want. That's the point of working hard in dentistry, raise capital.

 

[deleted696582]

Im off most Mondays and Tuesdays

Do you work three days a week, or do you work weekends or really long days Wed-Fri?

I have no balance since my goal is to finish early so that everyday can be a vacation for the rest of my life

Does that ever get tiring? Do you ever worry that you might not be able to vacation later in life due to unforeseen circumstances (injury, disease, etc.)?

You really don't want to attract old people in your office since most of their work has either been done, they need dentures, and/or want to talk on forever. First step is don't take medicare or adult medicaid/children's medicaid.

Do you refer these patients out to specialists or medicaid clinics? Do you ever feel bad prioritizing profit over medicare/medicaid/elderly patient procedures?

 

[CanaDMD]

perio - easy to get (not even a worry)
restorative - offsite rotations got me 1/6th of my requirements in a single day...
removable - purchased my own stones, impression materials, equipment, etc... and did the lab work in front of the patient so I was able to finish multiple steps in one visit. 10 appt dentures became 3-4.
endo - u know the story (see above)
oral surgery - took most ghetto offsite rotation, got more difficult cases and more numerous cases (no requirements here, but good training)
Common theme? Be proactive, understand the system to work the system; be more efficient. You really dont need to be a lab tech in the end, but it teaches you to work under pressure and not just follow the cookie cutter mold.
On getting patients:
If I needed a patient, I would trade to get a patient/procedure, If my team needed a patient, I would get it for them by trading. Help others and don't be greedy. I didn't go above and beyond to rob others of their dental school experience, but I did look out for myself and others. There were some jerks that would go double or triple the restorative requirements but that ultimately comes at the expense of others lacking procedures.

Magic number? 5 minimum/ 10 ideal in liquid assets. I'm happy with 50k/month for the rest of my life.

Impressive. In particular, removable. Could you PM me a list of things you bought to be able to do this? I'd love to do it myself.

How far are you from your 5 min?

If your office is collecting 2.7ish, what's overhead like?

Also, what do you recommend investing in?

 

[TanMan]

Do you work three days a week, or do you work weekends or really long days Wed-Fri?

Does that ever get tiring? Do you ever worry that you might not be able to vacation later in life due to unforeseen circumstances (injury, disease, etc.)?

Do you refer these patients out to specialists or medicaid clinics? Do you ever feel bad prioritizing profit over medicare/medicaid/elderly patient procedures?

I work Wed-Sun. It gets very tiring, but I'm sure a few years wont kill me. If it does, at least I have great disability insurance.

We don't take medicaid/medicare at all, we don't even see them since the barrier to entry is the phone. So we can recommend someone to them over the phone unless they are willing to go as private pay. If they still go in, then we may have to refer them if they dont want to pay my fees. I don't feel bad because there's others that will see them.

 

[CanaDMD]

Yep, don't forget extractions, crowns, bridges, fillings (I hate using the word restoration in front of patients)



I would if I could, but the social consequences to my freedom are too high and I wouldn't risk everything I worked for. For something that stupid. I could've done that without dental school. You don't have to believe me though, I state what works, and what to focus on to be profitable. Your statement makes it seem like its impossible to work less and retire early as a dentist and it's attitudes like that, that drive away future colleagues for fear of slavery to debt. We're not minimum wage laborers here and we have so much more income potential than even our MD counterparts.

Now, what businesses can you do? Hard money lending, invoice factoring, petroleum transport, etc.... if you have the capital, you can do whatever you want. That's the point of working hard in dentistry, raise capital.

I looked into invoice factoring, super cool. But my question is, how do you get into that?

 

[deleted696582]

I work Wed-Sun. It gets very tiring, but I'm sure a few years wont kill me. If it does, at least I have great disability insurance.

We don't take medicaid/medicare at all, we don't even see them since the barrier to entry is the phone. So we can recommend someone to them over the phone unless they are willing to go as private pay. If they still go in, then we may have to refer them if they dont want to pay my fees. I don't feel bad because there's others that will see them.

That does sound tiring, but I'm sure it's great money. Thanks for the answers.

 

[TanMan]

Impressive. In particular, removable. Could you PM me a list of things you bought to be able to do this? I'd love to do it myself.

How far are you from your 5 min?

If your office is collecting 2.7ish, what's overhead like?

Also, what do you recommend investing in?

Removable (some things I can remember off the top of my head: snap stone (superfast for custom tray fab), fujistone (better quality stone, very little bubbles w/o vacuum mixing), stone vibrator, lightcure base plate material, lightcuring unit (I made my own with a halogen light and ducting material, heating plate for wax rims, typhoon bur for very fast cast reductions, electric lab handpiece
dental school appt 1: take pre-impression, pour it up in snapstone, let it set, make the custom tray, take impression w/ custom tray, pour final cast with fujirock, make baseplates w/ waxrim, try-in, adjust prn, then send pt home, mount your casts, set teeth
appt 2, try-in denture, adjust prn, festoon, process.
appt 3, try-in final, then all your required checks

Still a bit to go, overhead about 55%. Investing: see above posts, those are some that i'm vested in. Traditional stocks and other investment vehicles won't accelerate your wealth production. Side businesses have a lot of risk, but a lot in return to. There's a few that I cannot discuss due to partnership/NDA.

 

[CanaDMD]

Removable (some things I can remember off the top of my head: snap stone (superfast for custom tray fab), fujistone (better quality stone, very little bubbles w/o vacuum mixing), stone vibrator, lightcure base plate material, lightcuring unit (I made my own with a halogen light and ducting material, heating plate for wax rims, typhoon bur for very fast cast reductions, electric lab handpiece
dental school appt 1: take pre-impression, pour it up in snapstone, let it set, make the custom tray, take impression w/ custom tray, pour final cast with fujirock, make baseplates w/ waxrim, try-in, adjust prn, then send pt home, mount your casts, set teeth
appt 2, try-in denture, adjust prn, festoon, process.
appt 3, try-in final, then all your required checks

Still a bit to go, overhead about 55%. Investing: see above posts, those are some that i'm vested in. Traditional stocks and other investment vehicles won't accelerate your wealth production. Side businesses have a lot of risk, but a lot in return to. There's a few that I cannot discuss due to partnership/NDA.

My questions gets back into, how do you join such side businesses? They usually seem to be sealed tight

also thank u so much for that removables guideline list!

 

[Gold_Toof]

So much easier to make money when you have capital, but you still have to be very smart. That's another aspect I like about dentistry...the ability to have free time (some) and capital to invest in other things/businesses.

 

[TanMan]

My questions gets back into, how do you join such side businesses? They usually seem to be sealed tight

also thank u so much for that removables guideline list!

Some are pretty easy(such as hard money lending), there are some crowdsourcing investment firms that will accept you as an accredited investor (200k/yr min income or 5m assets) w/ 5-50k minimum investments. Some are harder to come by, either starting from scratch and having to network slowly, identifying distressed business operations and offering a bailout with operational control or limited partnerships and a significantly large share of the company, or just by meeting people and identifying random opportunities.

 

[cheesyfries]

Awesome advice, TanMan. I have a couple questions:

1. Your production to collection ratio is great, how do you collect from your patients? Do you estimate insurance coverage and collect a patient portion or collect 100% upfront? Also do you offer payment plans or cash/check discounts?
2. Do you have staff that works primarily on administrative and insurance/collection tasks?

 

[super frank]

It makes me laugh to see people ask you what you're investing in. If only life was that easy, lol.

 

[TanMan]

Awesome advice, TanMan. I have a couple questions:

1. Your production to collection ratio is great, how do you collect from your patients? Do you estimate insurance coverage and collect a patient portion or collect 100% upfront? Also do you offer payment plans or cash/check discounts?
2. Do you have staff that works primarily on administrative and insurance/collection tasks?

1. Depends on the insurance. For insurances that honor what we contract with, we will collect estimated portion; for not so good insurances or require pre-auths, we wait on procedure or collect upfront if patient needs the procedure done immediately. If the insurance is really bad, we terminate our contract with them. Payment plans are offered, 50% down minimum, 3 monthly payments. No check discounts, cash discounts if requested and large enough.
2. Yes, I have 3 billers and 2 front staff.

 

[ncide]

Active Patients: 7254
2016 Production: 2.86
2016 Collection: 2.73

Damn, that's insanely impressive.

 

[LogOff]

Ar you producing that much on your own or including associates? What's a typical schedule look like because that's impressively high.

 

[TanMan]

No associates, 3 hygienists. 7 columns of hygiene, 6 ops (but utilize about 3-4 ops per hour on avg, rest is just spillover for hyg or walkin emergencies)

 

[ncide]

No associates, 3 hygienists. 7 columns of hygiene, 6 ops (but utilize about 3-4 ops per hour on avg, rest is just spillover for hyg or walkin emergencies)

Any EFDAs or restorative hygienists?

 

[TanMan]

Any EFDAs or restorative hygienists?

No

 

[CanaDMD]

Any EFDAs or restorative hygienists?

just one superhero

 

[Grinz]

How many hygiene appointments are you doing per day? Is your office open and doing hygiene on your days off (i.e. monday and tuesday)?

 

[TanMan]

How many hygiene appointments are you doing per day? Is your office open and doing hygiene on your days off (i.e. monday and tuesday)?

Only my billing staff is there on mondays and tuesdays to do all preauths, billing, verify insurance, and answer phones. Up to 60 hygiene in a day, but they don't always show up.

 

[NewRider44]

How do you you see 60 hygiene patients in one day with 3 hygienists?

 

[CanaDMD]

How do you you see 60 hygiene patients in one day with 3 hygienists?

that is a great question

 

[TanMan]

It's chaos... 60 is max, only a few days of the year do we reach the max. We use FIFO principle, first in, first out, on high demand days, patients are expected to wait... i.e week b/w xmas and new years, summer vacation, spring break. Not everyone accepts the recommended periodontal treatment (even prophies if they have a copay because they'll say their previous dentist waived their copays). Kids are fast, perio maintenance is quick, SRP's sometimes have to be broken down into two appts.... adapt to the situation to accommodate everyone.

 

[Grinz]

It's chaos... 60 is max, only a few days of the year do we reach the max. We use FIFO principle, first in, first out, on high demand days, patients are expected to wait... i.e week b/w xmas and new years, summer vacation, spring break. Not everyone accepts the recommended periodontal treatment (even prophies if they have a copay because they'll say their previous dentist waived their copays). Kids are fast, perio maintenance is quick, SRP's sometimes have to be broken down into two appts.... adapt to the situation to accommodate everyone.

I honestly can't tell if you are trolling. You are have a 55% overhead on a 2.7 mil practice, working 3 days per week, with ~7000 active patients?! you're bringing home 1mil+ pretax dollars??

And you are doing 60 hygiene patients per day only a few days per year? Doing the math, you have to do about 92 patients per day for hygiene if you wanted to fit every single one of your patients in every 6 months. Not to mention you have to get about $324 on average from each patient just to hit your 2.7mill number. How are you doing that if you aren't even getting your hygiene patients into the office twice per fiscal year?? Unless your reimbursements are out of this world, which would be able to clarify a lot if you told us, then there's no way.

 

[periopocket]

I honestly can't tell if you are trolling. You are have a 55% overhead on a 2.7 mil practice, working 3 days per week, with ~7000 active patients?! you're bringing home 1mil+ pretax dollars??

And you are doing 60 hygiene patients per day only a few days per year? Doing the math, you have to do about 92 patients per day for hygiene if you wanted to fit every single one of your patients in every 6 months. Not to mention you have to get about $324 on average from each patient just to hit your 2.7mill number. How are you doing that if you aren't even getting your hygiene patients into the office twice per fiscal year?? Unless your reimbursements are out of this world, which would be able to clarify a lot if you told us, then there's no way.

Why can't some peeps handle hearing a success story!? Learn something from the guy!


Sent from my iPhone using SDN mobile

 

[TanMan]

I honestly can't tell if you are trolling. You are have a 55% overhead on a 2.7 mil practice, working 3 days per week, with ~7000 active patients?! you're bringing home 1mil+ pretax dollars??

And you are doing 60 hygiene patients per day only a few days per year? Doing the math, you have to do about 92 patients per day for hygiene if you wanted to fit every single one of your patients in every 6 months. Not to mention you have to get about $324 on average from each patient just to hit your 2.7mill number. How are you doing that if you aren't even getting your hygiene patients into the office twice per fiscal year?? Unless your reimbursements are out of this world, which would be able to clarify a lot if you told us, then there's no way.

I work 5 days a week (35 hours)... Wed-Sunday (I don't know where people get the assumption that if I don't work Monday or Tuesday, I must be working only Wed-Fri). 60 hygiene patients is the max capacity, We dont hit max capacity every day, that would be crazy. Combined, I see an average of 45-60 patients a day in hygiene and ops; most we've ever seen is 76 I think in a day for hyg/ops. I can book all 60 hygiene, not all of them will show up. Your assumption is that all those active patients all come at their 6 month intervals; if only my patients were all that compliant, I could close my office to new patients. My active patient figure comes from my patient management system (Lighthouse).

It's not really that hard to reach the figures that we have up there if you throw ops in there. Example: Insurances pay 1200-1600 for RCT,b/u/crown, private is around 2400; that one patient alone has a value of 1200-2400. Extractions are 305 private, 110-171 for insurance. (These are single tooth figures) When you have 3-4 columns of these, they add up quickly. Not just that, walk-ins, same day conversions, etc...

Again, you don't have to believe me. I'm not going to bust out my 1040's, the financial data comes from my PMS/quickbooks. I'm here to let you guys know that solo practice isn't dead, hysteria around corporate dentistry is unfounded, and there is hope for the solo practitioner. I don't care so much as guarding this as trade secret, since I will hopefully be retired by then.

Hygiene plays a role in my office, but the majority of production comes from ops.