Nightguard

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Apr 1, 2009
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Dentist
I would like to know what it's like working in a Community Health Clinic. I'm an associate in private practice right now but have always been interested in community health dentistry. What types of procedures are usually performed (is there variety like private practice), what are the patients like (a lot of kids or mostly adults?), is the salary decent compared to private associate (I'm in So. Cal), work hours, satisfaction, general experiences. Any input would be appreciated!
 

mike3kgt

Hopefully scuba diving
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Dentist
I would like to know what it's like working in a Community Health Clinic. I'm an associate in private practice right now but have always been interested in community health dentistry. What types of procedures are usually performed (is there variety like private practice), what are the patients like (a lot of kids or mostly adults?), is the salary decent compared to private associate (I'm in So. Cal), work hours, satisfaction, general experiences. Any input would be appreciated!
Don't know if my experience is commensurate, but I had an outstanding experience in a CHC. :thumbup:

I worked in Florida 1.5 days a week at the CHC and 3.5 days a week at a traditional private practice. It was a great balance to the work week and would highly recommend CHC far and above any sort of Medicaid style practice or DHMO.

I performed mostly EXTs, direct restorations, and removable. Very few RCTs and no children (by personal choice). The CHC was based upon a national structure of 1/3's and a sliding scale fee structure. The % of what your income compared to poverty levels will determine what you pay. Some people pay $25 for an EXT while the next person $150. Total overhead (salaries, rent etc) was paid for by 1/3s... meaning 1/3 covered by federal grants, 1/3 state/local grants, 1/3 paid by patient. Whether it be 100% or 10% fee, it was generally the way it worked. We worked with local organizations, such as Ryan White, and local community organizations to help the poor and subsidize those less well-off.

Patients, for the most part, were very appreciative, but was challenging at times. I would do it again in a heartbeat... but it HIGHLY depends on the community that the CHC is in and whether they participate in Medicaid (which I HIGHLY recommend against participating/giving up your soul).

Good luck.
 

Saddleshoes

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Oct 28, 2007
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Dentist
My experience is a lot like Mike3kgt’s. However, I am on the downhill side of my career. I am retired from a state job/military/private practice/teaching dental career. I have been working in a CHC part time for 4+ years now. Here is how my place shapes up…

The Dental Clinic is part of a much larger CHC which includes 4 medical clinics. All the dental patients must see one of our MD’s first, so we know their medical status the moment they walk in. We also have many patients referred directly from the MD’s due to medical issues i.e. pregnancy, diabetes, pre-surg. work-ups, etc. As a result of the medical clinic connection we get a lot of medically compromised patients that are a bit of a challenge.

I see very few children in the clinic as another dentist takes most of them. (Fine with me!) I love surgery. This is good, as there are days I do 100% surgery. I do mostly operative, surgery, removable prosthetics, a little endo. and practically zero crown and bridge.

The payment mix is about 40% public aid, 40% sliding scale self pay, 15% grants (We have about 3 different community programs that cover dental treatment for some of our patients.) and 5% other. We accept no insurance.

I work in a newly built clinic with first class equipment. We have a computerize clinic which is close to being paperless. The staff I work with is excellent. However, the management of the HCH is by committee and not very good. They also understand nothing about dentistry. As a result some of the edicts coming down from the leadership are a joke.

The patients I take care of are good people. They are generally very appreciative of the care they receive. There are a few patients that are jerks but not many. We do have a no show problem.

Over all I like it!
 

Nightguard

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Apr 1, 2009
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Thanks for the input. I was wondering how most community clinics pay their dentists. I imagine that it would be mostly fixed salary but I could be wrong. Also, do you think the stress level is less than that of private practice? I do like the variety of private clinics though.
 

Daurang

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Dec 6, 2006
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I temped for three months at a CHC in Boston and loved it. As typical and expected of government jobs, you don't have to do much. Most days you get 3-5 patients because most would be no-show. Everyone gets pay no matter what so no need to doublebook nor take emergency patients. I'd probably go that route when I quit my practice within a few years.
 

DrReo

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Jun 29, 2007
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I temped for three months at a CHC in Boston and loved it. As typical and expected of government jobs, you don't have to do much. Most days you get 3-5 patients because most would be no-show. Everyone gets pay no matter what so no need to doublebook nor take emergency patients. I'd probably go that route when I quit my practice within a few years.
Is the pay legitimate? I'd really like to move to a Boston suburb when I finish up with school, but it's probably grossly saturated.
 

Daurang

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Is the pay legitimate? I'd really like to move to a Boston suburb when I finish up with school, but it's probably grossly saturated.

You won't make $300K+ but you'll live a decent upper middle class lifestyle with much less stress and lots of balogney vacation days off (Bunker Hill Day, Columbus Day, etc.). The government forgive a certain amount of your loans after a few years and wipe it out clean after 10 years of working for them. I'd say you get pay very generously for what little work you do in comparison to the private sector. Just to show you how laidback everyone is, I worked there and can't even get an appointment for myself despite probably 60% daily no show.
 

mike3kgt

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I temped for three months at a CHC in Boston and loved it. As typical and expected of government jobs, you don't have to do much. Most days you get 3-5 patients because most would be no-show. Everyone gets pay no matter what so no need to doublebook nor take emergency patients. I'd probably go that route when I quit my practice within a few years.
Sounds like a great gig! I used to see between 20-30 patients a day at the CHC. Far easier than Medicaid where I used to see 40+ a day.

Fixed salary, well over 6 figures. No salary tied with production. I felt obligated to work hard to say "thanks" for doing what they did and keeping me on staff. On average, I used to produce over 2k a day on a sliding scale fee structure.

Very nice option, but leads to easy burnout if you cannot handle this type of work. It's not easy, long hours and lots of extractions and complex class 2 amalgams/composites. Dentures and RPDs that go in only with a little bit of "suggestion" because the lab you use is cheap. Ah well, CHCs part time = OK, full time = tough.
 

Demeter

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I did. It sucked big time.