Associate vs. Public Health Dentistry

[RockerDDS]

I am trying to decide between going into public health or as an associate after dental school. Both have their pros and cons.

Public Health: Salary that doesn't change if patients no show plus this option lets me do loan repayment. However, it is mainly extractions and pedo with very limited endo and crown/bridge.

Associate: More exposure to things I like (crowns, endo) but more stress. Need to be able to work fast and fill schedule.

I have been offered a job at a public health clinic. It is 4 hours away. I wonder if I should take this or find something closer as an associate but be paid less without loan repayment?

What are your thoughts? Or experience with either one? Thanks!

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[reapply2007]

I wouldn't drive four hours to work. So, looking at moving for the public health clinic, the pedo is likely good experience plus speed can be worked up in that setting. The associate position, if you lack the confidence for the job you run the risk of a poor recommendation from your boss and risk future employment elsewhere. I more conservative decision as I see it from your description is the public health clinic.

 

[omaralt]

the problem with the public health option is that you will begin to get into bad habits and forget how to do crowns, etc. in the public sector you dont care about the business side of stuff, so you become lazy and complacent (not everybody, but mostly). you usually see 8 patients a day, dont care if somebody no shows (your not trying to fill in that gap in your schedule). if you plan on doing this long term, and never going to private practice thats fine. but if you do this for a few years, its going to be very difficult to go to private practice. you will go from seeing 8-10 patients to ~20 patients (including hygiene exams). the biggest money makers in dentistry are crowns, bridges, implants, removable (yes, dentures and partials are profitable 🙂); stuff you havent done in years, so will need to take a lot of CE to catch up.

in general, i recommend you go to private practice (definitely move closer though). and later on in life when your ready to start winding down, go to the public sector. this is all IMHO. good luck

 

[mike3kgt]

the problem with the public health option is that you will begin to get into bad habits and forget how to do crowns, etc. in the public sector you dont care about the business side of stuff, so you become lazy and complacent (not everybody, but mostly). you usually see 8 patients a day, dont care if somebody no shows (your not trying to fill in that gap in your schedule). if you plan on doing this long term, and never going to private practice thats fine. but if you do this for a few years, its going to be very difficult to go to private practice. you will go from seeing 8-10 patients to ~20 patients (including hygiene exams). the biggest money makers in dentistry are crowns, bridges, implants, removable (yes, dentures and partials are profitable 🙂); stuff you havent done in years, so will need to take a lot of CE to catch up.

in general, i recommend you go to private practice (definitely move closer though). and later on in life when your ready to start winding down, go to the public sector. this is all IMHO. good luck

There are plenty of "bad habits" that can be picked up in associate positions as well. SRP on everyone? Surgical exo's on every tooth?

I'd say do both. Why don't you ask them if they could do 2 days a week in the community health center and 2 -3 days a week in associate position? The 4 hour drive would be much more bearable. I doubt, however, that you will be able to handle a 4 hour commute each way for very long.

I found a great experience working at a high end private practice and a CHC at the same time. What a huge difference in procedures, but they were a nice match.

 

[redrocksdentist]

In public health you're going to see some things that you just don't see in private. I'm talking orofacial infections and lots of surgery like cutting out 3rds and managing that post op infection that keeps you up at night wondering why your patient isn't responding to Pen VK and or Clinda. Plus you'll get good treating kids (and knowing when refer). This is awesome dentistry because well...its what you trained for... drawing on your pharm knowledge, surgery and medicine training and doing stuff that has an impact in peoples lives. However, as rewarding as it is...

As others here have rightly said, you may be missing endo and crowns so you need to take the best of public health (surgery, pedo) and make an effort to stay current on pros. If you go public health, do removable and try to work out a deal with your employer where you can do the occasional crown for the right patient to maintain your skills. So that if you want to go into PP in a few years you remember how to cut a crown prep and take a good impression.

As far as bad habits, yeah as a salaried dentist its easy to wish patients won't show in public health but in private its easy to want to dx a crown for a regular MO. What's worse? Who knows and really who cares! Both are bad habits that you don't want.

Don't let either temptation get the best of you and you'll be happy when you go home at night.

 

[newyorkblork]

I have been offered a job at a public health clinic. It is 4 hours away. I wonder if I should take this or find something closer as an associate but be paid less without loan repayment?

4 hours away?

Save yourself an 8 hour commute and get a second job with your associateship...

 

[RockerDDS]

I wouldn't actually drive 4 hours to work and back. I would make the move but it will be very difficult on me on the weekends. The job sounds good but is it worth it if I am not sure if I will not be happy only seeing my family maybe twice a month? I don't have any other offers though.

 

[Offhegoes9]

RockerDDS,

I have worked full time in public health for the last three years and I enjoy my job very much. I always enjoyed pedo and oral surgery when I was in school and that makes up about 99% of what I do now. Crown and bridge was sort of fun in school, but I don't really miss it that much. I don't miss removable at all.

We typically see 12-20 patients a day. Some days are slow and others are very busy. Public health notoriously has a high no show rate, so we double book and over book some appointments thru the day. We take same day emergency appointments also. I am the director of the clinic, and I actually care very much if we have no shows or last minutes cancellations. It affects our bottom line and I don't like having holes in our schedule. We have monthly encounter and producion goals, which are fairly reasonable to achieve if you work hard. If the clinic is an FQHC, like ours, then HRSA will require the providers to maintain an annual encounter goal, which is typically around 2500-2800 encounters a year.

I can't speak for private practice, because I have never worked a day in a private practice setting. But, I enjoy my job very much and I have no regrets. I enjoy pedo and don't mind doing several extraction a day, so this type of work fits me very well. Also, I don't have to "sell dentistry" to patients, most of the services we provide are basic and straightforward. I can go home every night and feel like I provided a good and honest service for my patients. Plus, as redrockdentist pointed out you will learn to rely heavily on your knowledge of medicine and pharm. A lot of the patients you will see may be medically compromised or have behavioral or medical conditions which require your attention. You will not only be a dentist to these patients, but also a primary health care provider.

Hope that helps, good luck with you job search!

 

[McSexyDDS]

RockerDDS,

I have worked full time in public health for the last three years and I enjoy my job very much. I always enjoyed pedo and oral surgery when I was in school and that makes up about 99% of what I do now. Crown and bridge was sort of fun in school, but I don't really miss it that much. I don't miss removable at all.

We typically see 12-20 patients a day. Some days are slow and others are very busy. Public health notoriously has a high no show rate, so we double book and over book some appointments thru the day. We take same day emergency appointments also. I am the director of the clinic, and I actually care very much if we have no shows or last minutes cancellations. It affects our bottom line and I don't like having holes in our schedule. We have monthly encounter and producion goals, which are fairly reasonable to achieve if you work hard. If the clinic is an FQHC, like ours, then HRSA will require the providers to maintain an annual encounter goal, which is typically around 2500-2800 encounters a year.

I can't speak for private practice, because I have never worked a day in a private practice setting. But, I enjoy my job very much and I have no regrets. I enjoy pedo and don't mind doing several extraction a day, so this type of work fits me very well. Also, I don't have to "sell dentistry" to patients, most of the services we provide are basic and straightforward. I can go home every night and feel like I provided a good and honest service for my patients. Plus, as redrockdentist pointed out you will learn to rely heavily on your knowledge of medicine and pharm. A lot of the patients you will see may be medically compromised or have behavioral or medical conditions which require your attention. You will not only be a dentist to these patients, but also a primary health care provider.

Hope that helps, good luck with you job search!

thank you for writing that...there was a poster who said something like 8 patients a day, HA! i was a hygienist in public health for 6 years, our dentists worked their butts off!!!