Ask Me Anything...

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
And I just wanted to apologize to all of you, I know it's been a while since I've been on. My wife and I just had a well-deserved (she did anyways :)) weekend in the mountains, we didn't take any cell phones or computers. Hope you're all doing well, keep up the fight!!!

Members don't see this ad.
 
  • Like
Reactions: 4 users
Just want to let you know that I really, really appreciate all of the input you are giving us.
 
  • Like
Reactions: 1 users
You said you were in the military before dental school. So did you ever consider HPSP? Or was there a reason you got out of the military and chose the student loan route?

I also second @predental21250 . Your advice is so valuable and appreciated. I'd love to shake your hand if I could. And to hear that you're balancing life with faith and family is refreshing, so thank you for that.
 
  • Like
Reactions: 2 users
Members don't see this ad :)
A few thoughts...

1) I think the future of dentistry is polarized right now. People that HAVE to live in highly desirable areas will struggle, especially those with high student loan debt load. For those willing to do some research to find unsaturated areas and take advantage of that, and not have their lives dictated by insurance companies...the future is bright. It's really as simple as that. I think lots of "baby boomers" are finally starting to retire, which is opening up a HUGE potential in our field. They were holding on for as long as possible after the market crashed in 2008 (or so) because they lost so much..they couldn't afford to retire. Again, it depends on the sacrifices you're willing to make.

2) Honestly, I know of only 2 other classmates of mine that have purchased practices. One is in Alaska, one is in North Carolina. We went to school in California (SoCal), with a lot of kids that HAVE to live there to be happy. They'll be forever stuck in insurance hell imo. They'll live happy lives for the most part, but will never be able to have the same (income) potential we do.I do realize, however, that income isn't that big of a deal. If being close to family makes you happiest, you should always do what makes YOU happiest.

3) That's a very good question. As implants become more and more popular, and root canals less popular due to high rate of retreats...I'd probably say Ortho. If you can specialize in implants, that could potentially pay off. I'd stay away from Endo tbh, unless you get the implant training with it. I honestly think that in the near future, implants will be favored by insurance companies over root canals. Just my opinion though, it's all a statistical game with insurance companies, and they've just now had enough time to really get a good feel for their ROI (possible) on implants vs. RCT.

Curious about a couple of these points! In comparisons to GP's, how you do think specialists who insist on living in SoCal or other populous cities thrive (i.e. Peds/OS)? I'm also really curious about why you say ortho will have the best future-- around my area there are a couple GP's who do their own ortho and only refer out when it's an extremely difficult case (if I remember correctly, I think they said class 3 malocclusions, but I'm probably just throwing incorrect buzzwords around; hopefully you get the idea). Based on what they said, I don't think they ever referred out very frequently either. In your opinion, what about ortho gives it such a bright future?
 
  • Like
Reactions: 1 user
Do you have a similar fee schedule to the previous owner? If not, how is yours different and how did you go about implementing the change (gradual or overnight)? I'm curious to hear more about your transition into ownership and if you have encountered any major obstacles.

Thanks for sharing with us.
 
  • Like
Reactions: 1 users
Is doing research important when you are in dental school? If yes, why is that important?
 
  • Like
Reactions: 1 user
I got into a dental school that is not in my state or at least the state that I don't want to practice after I graduate, and I'm wondering if it is easy to come back to my state after I graduate? I know I would get the same education/degree, but I'm concerned about the network I built up during the school and the name of the school may not be known by people in my state. Also, that state is in a different license system to my state, so I'm wondering if it'll be hard to get the license later. Any thoughts on this? Thanks a lot in advance!
 
  • Like
Reactions: 1 user
what are your thoughts on franchises like monarch and comfort dental. I work as an RDA at one for three doctors and they seem to like it but id imagine theyd make considerably less
 
  • Like
Reactions: 1 user
How many years in the future do you think dental reimbursements and insurance will go the path of medicine? What do you think dentistry will look like 10 years from now?
 
Do you have a similar fee schedule to the previous owner? If not, how is yours different and how did you go about implementing the change (gradual or overnight)? I'm curious to hear more about your transition into ownership and if you have encountered any major obstacles.

Thanks for sharing with us.

Sorry, it's been a crazy week. I actually haven't changed the fee schedule one bit. We contemplated doing so, but our patients watch our fees VERY closely for some reason. I'm thinking I will most likely raise the fees on the operative side first, since the fees that are more noticeable are the hygiene ones and exams. You'd be surprised how much people complain about a few dollars. At some point they will need to be raised, obviously, but right now I need to gain the patients' confidence and not look like a money-hungry prick for a year or so...so to answer your question directly, I will most likely wait a year..until I've met each patient (hopefully) twice. At that point, I'll probably raise slowly starting with operative (fillings, crowns, etc.). I have lots of things to improve upon, like hygiene treatment planning...they've, for the most part, always just charged out prophy codes for what technically should be being charged out as S/RP.

I haven't really encountered many obstacles, just a different philosophy of treatment. Another example would be that I ALWAYS plan for a buildup when doing a crown prep if there's an existing and I cannot see under it. Patients have been a little upset about this, because the former doc didn't charge those out. We use different burs, different composite, etc...but all in all, it's been a very smooth transition. We both trust one another and have done whatever we could to make life easier on the other. It's nice having such an honest, well-respected guy to transition with...but even though I trust him, we still track every penny. Hope this helps a little.
 
  • Like
Reactions: 1 user
Is doing research important when you are in dental school? If yes, why is that important?

Well, I'd never say doing research is not important. I guess some of us have more of an inquisitive mindset, while others are more interested in the business side of things vs. the science behind dentistry and the functionality of different materials and techniques. To me personally, I enjoyed doing research, and still try to do as much as possible...which, unfortunately, isn't much due to lack of time. I literally have about 15 minutes of free time to myself on the weekdays (leave for work @ 5:15am, get home around 7:00pm, personal training from 7:30-8:30, and I try to spend a few minutes with my wife and dogs before bed at 9:00pm) and on the weekends, the last thing I feel like doing is dental-related stuff.

I think research is very important, do as much as possible when in school because you most likely will not have much time when you're out to enjoy it.
 
  • Like
Reactions: 1 user
I got into a dental school that is not in my state or at least the state that I don't want to practice after I graduate, and I'm wondering if it is easy to come back to my state after I graduate? I know I would get the same education/degree, but I'm concerned about the network I built up during the school and the name of the school may not be known by people in my state. Also, that state is in a different license system to my state, so I'm wondering if it'll be hard to get the license later. Any thoughts on this? Thanks a lot in advance!

First of all, I grew up in Mississippi, went to dental school in California, and practice in South Carolina. I don't think the networking aspect will be as difficult as you think. As long as you get involved with the dentists around your area and actually go meet the specialists you refer to, you should be good. Get involved in your state's dental association, maybe in your district too if they break it up into districts like they do here.

So..I too was up against the licensing system when I graduated. I went to a California school that only offered WREB while I needed to take ADEX/CDCA. I had to pay ~$7k to get Lu Lau dental services to screen and select my patients because I literally didn't have time to do it, since I was in school and also I got married 4 days after my graduation...talk about a hectic month :bang:

I had to fly to Mississippi on a Wednesday after school, take ADEX endo/prosth day 1 on Thursday, then Class II, Class III, and SRP that Friday. My patients were flown into MS from California at 1:30am the day of my licensing exam. I had to wake up at 2:00am to meet them at my hotel, get all of their medical hxs, radiographs, charts, etc...and be at my licensing exam day 2 at 6:45am that morning. My alarm for 5:30am didn't go off, and just by the grace of God, I woke up...I'll never understand how I woke up, being as tired as I was. Passed everything, which was crazy. Found out on my honeymoon day 1 in Kauai!!!
 
  • Like
Reactions: 1 user
what are your thoughts on franchises like monarch and comfort dental. I work as an RDA at one for three doctors and they seem to like it but id imagine theyd make considerably less

To be honest with you, from a dentist's perspective...I cannot stand franchises. I just feel like they only focus on numbers and not doing great work. They make an atmosphere that forces associate dentists to choose between doing standard of care, quality, ethically-sound work vs. aggressive treatment planning that makes them money. If you don't do what they say, you are going. I feel terrible for those that are forced into those decisions, and it's why I chose to go the route I did. Do I do perfect work? Heck no...I'm still learning, and I learn a lot every day. But if I do something wrong, I fix it and care about my reputation with my patients. I don't run an insurance-driven assembly line where patients feel like a project.
 
  • Like
Reactions: 1 user
How many years in the future do you think dental reimbursements and insurance will go the path of medicine? What do you think dentistry will look like 10 years from now?

Great question, to some extent they already have. I feel bad for patients, insurances are covering less and less and patients are responsible for more and more (which is part of the reason I've tried to keep my fees so low, since I'm not in network with any insurances). Insurance companies are getting more aggressive, last week Delta Dental sent me a letter telling me they aren't accepting any new fee schedules for the foreseeable future to cut costs. Metlife is starting to force dentists to go online to get EOBs, vs. sending them in the mail so we can sort them all out. It's absolutely a full-time job keeping up with the insurance companies and making sure they do not hose you over. My front desk caught Delta Dental of Missouri trying to scheme us out of $700 the other day.

I sure hope dental insurance doesn't go the path of medicine, I can't imagine people that take care of their teeth and attend their normal routine periodic exams/prophys being punished by having to supplement those who use Mountain Dew as a mouthrinse just before bed and never go to the dentist...which is precisely the model of medical insurance. Anytime politicians and insurance company lobbyists get together, we're all screwed.
 
Last edited:
  • Like
Reactions: 3 users
I'm helping my father taking over an existing dental practice. Are there any advice or stuff that we should pay attention to when signing the contract? We didn't go through a dental broker and a lawyer. We are purchasing the practice through a contract drafted by the current owner's CPA.
 
  • Like
Reactions: 1 user
I'm helping my father taking over an existing dental practice. Are there any advice or stuff that we should pay attention to when signing the contract? We didn't go through a dental broker and a lawyer. We are purchasing the practice through a contract drafted by the current owner's CPA.

So if you are going to purchase a practice, you will need your own dental transition attorney as well as your own dental specific CPA representative, preferably one with experience in dental transitions. If you need some names, I'd be happy to recommend who I used in a PM. My attorney cost was around $9,500 for the purchase agreement/negotiating he did, he drew up the initial LOI (letter of intent), negotiated with the seller's attorney, and drafted the final purchase agreement. His attorney or CPA should not be drafting your purchase agreement, IMO. This is a perfect way for you to get completely hosed over. I'm not sure of the entire situation, but you absolutely need your own representation. Little things like patient credit balances accounts, equipment breakage issues, overhead issues that devalue the practice, insurance issues (you may be forced to go into networks that he wasn't---depending on where you live, Delta Dental PPO).

The patient credit balance was over $13,000. The seller wanted to "pay the credits as they came in." My attorney said absolutely not, you need to zero out your tab completely before the practice is sold. So on my first day as owner, the seller wrote me a check for over $13,000. That paid for the attorney cost itself, and I would've never even thought of that, nor would an attorney that didn't have experience in dental transitions---and guess what, if it wouldn't have been included in the contract, the seller would've laughed at me when I asked him to pay back his own credits to the patients.

One major thing I'd recommend (especially if you are purchasing an older practice with older equipment) is to get a one year warranty of some sort on the equipment. I've been there four months and the following things have gone down: Autoclave ($5,500), Pano sensor (~$4,000), Nitrous system leak ($800 to get fixed by Patterson), Ultrasonic ($2,000). Learn from my mistakes, get a 1 year warranty and also have someone come in and test the equipment/building for major issues (i.e. electrical issues causing equipment failure).

The good thing about having professionals (dental specific CPA and attorney) is that they 1) save you a TON of money and headache (on things like I listed above) and 2) know the industry and what the true valuation of the actual practice and what it is producing/region/potential, any negative insurance repercussions, etc.

Someone can fake to be your friend to get their practice sold, and trust me, they put on a BIG show for you and make you feel like they'd absolutely never get over on you. "I'm treating this as if you were my own son taking over my practice." They intentionally "Jerry rig" everything until you take over and then you're stuck with it. I guess I shouldn't be too upset about it, because I will get a lot of years of usage from my own equipment...but it's just irritating to barely have taken over a practice and have so much of a hit so soon. If you need any advice, let me know and I'll try to steer you guys as best possible.
 
  • Like
Reactions: 3 users
So if you are going to purchase a practice, you will need your own dental transition attorney as well as your own dental specific CPA representative, preferably one with experience in dental transitions. If you need some names, I'd be happy to recommend who I used in a PM. My attorney cost was around $9,500 for the purchase agreement/negotiating he did, he drew up the initial LOI (letter of intent), negotiated with the seller's attorney, and drafted the final purchase agreement. His attorney or CPA should not be drafting your purchase agreement, IMO. This is a perfect way for you to get completely hosed over. I'm not sure of the entire situation, but you absolutely need your own representation. Little things like patient credit balances accounts, equipment breakage issues, overhead issues that devalue the practice, insurance issues (you may be forced to go into networks that he wasn't---depending on where you live, Delta Dental PPO).

The patient credit balance was over $13,000. The seller wanted to "pay the credits as they came in." My attorney said absolutely not, you need to zero out your tab completely before the practice is sold. So on my first day as owner, the seller wrote me a check for over $13,000. That paid for the attorney cost itself, and I would've never even thought of that, nor would an attorney that didn't have experience in dental transitions---and guess what, if it wouldn't have been included in the contract, the seller would've laughed at me when I asked him to pay back his own credits to the patients.

One major thing I'd recommend (especially if you are purchasing an older practice with older equipment) is to get a one year warranty of some sort on the equipment. I've been there four months and the following things have gone down: Autoclave ($5,500), Pano sensor (~$4,000), Nitrous system leak ($800 to get fixed by Patterson), Ultrasonic ($2,000). Learn from my mistakes, get a 1 year warranty and also have someone come in and test the equipment/building for major issues (i.e. electrical issues causing equipment failure).

The good thing about having professionals (dental specific CPA and attorney) is that they 1) save you a TON of money and headache (on things like I listed above) and 2) know the industry and what the true valuation of the actual practice and what it is producing/region/potential, any negative insurance repercussions, etc.

Someone can fake to be your friend to get their practice sold, and trust me, they put on a BIG show for you and make you feel like they'd absolutely never get over on you. "I'm treating this as if you were my own son taking over my practice." They intentionally "Jerry rig" everything until you take over and then you're stuck with it. I guess I shouldn't be too upset about it, because I will get a lot of years of usage from my own equipment...but it's just irritating to barely have taken over a practice and have so much of a hit so soon. If you need any advice, let me know and I'll try to steer you guys as best possible.
Man. I wish you will be online four years from now
 
  • Like
Reactions: 4 users
First of all, I grew up in Mississippi, went to dental school in California, and practice in South Carolina. I don't think the networking aspect will be as difficult as you think. As long as you get involved with the dentists around your area and actually go meet the specialists you refer to, you should be good. Get involved in your state's dental association, maybe in your district too if they break it up into districts like they do here.

So..I too was up against the licensing system when I graduated. I went to a California school that only offered WREB while I needed to take ADEX/CDCA. I had to pay ~$7k to get Lu Lau dental services to screen and select my patients because I literally didn't have time to do it, since I was in school and also I got married 4 days after my graduation...talk about a hectic month :bang:

I had to fly to Mississippi on a Wednesday after school, take ADEX endo/prosth day 1 on Thursday, then Class II, Class III, and SRP that Friday. My patients were flown into MS from California at 1:30am the day of my licensing exam. I had to wake up at 2:00am to meet them at my hotel, get all of their medical hxs, radiographs, charts, etc...and be at my licensing exam day 2 at 6:45am that morning. My alarm for 5:30am didn't go off, and just by the grace of God, I woke up...I'll never understand how I woke up, being as tired as I was. Passed everything, which was crazy. Found out on my honeymoon day 1 in Kauai!!!
Thank you so much for your info!!
That's an adventurous experience! I'm so glad you made it!!! I had a similar experience as your alarm part during one of my interviews lol
 
  • Like
Reactions: 1 user
Top