Corporate vs private specialist jobs

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Deep Impact

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I’m in an OMFS partnership but always wonder why some of my friends who signed on at their respective corporate gigs stay and don’t want to seek a partnership type opportunities...they laugh at my salary, saying I’m making 1/3 of what they make. Plus, most work 3-4 days...no need to beg for patients since everything gets referred internally...this had me really thinking this week, looking at my pay stub for the first time in a while, where 1/3 of my pay is going toward partnership shares. I get a touch more than an associate but I also have 5 more years of payments to go. Not to mention student loans. My buddies at various corporate gigs make close to $750k a year easily, granted that they work like dogs...is this where specialties are headed also? I’m seriously thinking about exploring the corporate side in 2020. I’m not saying all partnerships are like mine but we are no where close in terms of revenue or patient load like most of the corporate offices where my friends work.


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I’m seriously thinking about exploring the corporate side in 2020.
If you have some extra days (days when your partner works and when you are off) every month, why stay home doing nothing? Why not use some of these free days to work for the corp office to see how you like it? You never know how good the corp job is if you never try. Don’t just assume that all jobs at the corp offices are bad. If you don’t like it after a few month of working at the corp, you can quit anytime. Unlike ortho, you don’t have to give them a 90-day notice when you quit.

There's no reason why you can't do both: P/T job at corp office and P/T work at your own office. I know a lot of OS's who are doing this. My wife's GP boss hires an in-house OS, who also has a private office that he partners with another OS.
 
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750k as an associate. More than double what I'd get as an ortho
That’s their reward for spending 3-4 more years of schooling than you + 60-80 hours that they have to work per week during their OS residencies. The harder you work earlier in your life, the greater the reward later……AKA delayed gratification.
 
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A bunch of OMS on these boards have said traveling from office to office in different cities for corporate is pretty unethical because there is no continued care for the patient.

So even if you're making less money, atleast your standard of care is higher. You also have a better lifestyle, since you don't have to drive 100 miles to the next office. Grass is always greener...
 
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That’s their reward for spending 3-4 more years of schooling than you + 60-80 hours that they have to work per week during their OS residencies. The harder you work earlier in your life, the greater the reward later……AKA delayed gratification.
3-4 more years? The majority of ortho programs are 3 years and some omfs programs are 4 years. Paid residency for omfs vs huge debt for ortho probably offsets the 60-80hr weeks from the get go
 
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3-4 more years? The majority of ortho programs are 3 years and some omfs programs are 4 years. Paid residency for omfs vs huge debt for ortho probably offsets the 60-80hr weeks from the get go
I am under the impression that most of the OS programs are 6 years....and 6 years minuses 2 (or 3) years of ortho = 3-4 years. I have seen a few OS residents and practicing OS's, who switched to ortho but I haven't yet seen one ortho who switches to OS.

And according to the OP, for his OS friends to make $750k, they have to work like dogs. We, orthos, don't work like dogs. If you are willing to work like a dog (ie charging low fees, treating high volume patients per day etc), I am sure you can make $750k as well.....and much less liability.
 
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Yeah, no doubt about it. Most of my friends at Corp offices have a patient in all the available chairs. They mow through 11-14 cases a day with a nurse anesthetist with consults tacked on. My partners are all older than me, saved a lot of money over the years and they don’t feel the need to work that hard, nor do they want to anymore. We have basically see about third of what my Corp buddies see, using single chair for surgeries and do our own anesthesia. They think corporate dentistry is unethical and they complete disparage the thought of doing that.


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If you have some extra days (days when your partner works and when you are off) every month, why stay home doing nothing? Why not use some of these free days to work for the corp office to see how you like it? You never know how good the corp job is if you never try. Don’t just assume that all jobs at the corp offices are bad. If you don’t like it after a few month of working at the corp, you can quit anytime. Unlike ortho, you don’t have to give them a 90-day notice when you quit.

There's no reason why you can't do both: P/T job at corp office and P/T work at your own office. I know a lot of OS's who are doing this. My wife's GP boss hires an in-house OS, who also has a private office that he partners with another OS.

My partners will laugh at me but then again, I’m giving them a nice boost every paycheck with my buyin. While I still live in a small house and driving a “normal” car, they are coming to work in their 911s and going to their beach homes. Talking to my buddies at Corp clinics makes me want to do this bad, sounds like a no brainer if I can find a gig part time. I have plenty of days off where I sit at home doing nothing anyhow. Lol.


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A bunch of OMS on these boards have said traveling from office to office in different cities for corporate is pretty unethical because there is no continued care for the patient.

So even if you're making less money, atleast your standard of care is higher. You also have a better lifestyle, since you don't have to drive 100 miles to the next office. Grass is always greener...
Continued care is not really an issue when it comes to extractions. They’re not performing LeForts all over the place.
 
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Another thing to consider is that even the traditional OMFS practice is changing and becoming more "corporate." Have a look at many of the larger group practices in large cities. They have been sold to USOSM. Unfortunately, it appears that with more pressure on traditional private practices to create income inhouse, more OS are going to private practices or working for DSOs. Even people with their own practices now look to supplement income by working at DSOs.
 
Funny. Salary wasn't something I looked at when I chose Ortho over the other specialties.
People say things like this, but then they also tell young orthos they screwed themselves with debt by going to expensive schools. I think it would be stupid to choose a specialty without knowing what you will be paid after. You must have studied ortho during a time where things were easier in the profession and you didnt have to worry about salary or debt
 
I’ve seen people dropping out of residency programs when money is ahead of passion for the chosen specialty or just being miserable doing what they do. You can only put up with so much crap if you don’t love what you do. I couldn’t imagine anyone would go through OMS residency just for money but then again...

I’ve been an associate and now a partner for a few years. It’s fine. Im not starving or desperate but like I said, my friends at their corporate practices make me question my choice a little bit. I’m being reminded by my partners that my partnership share although expensive will be a great investment and will give me a nice return in 20 years or so.

Another interesting thing is that our referral base is getting old and I’d say there aren’t many GP practice owners under 40 in my area. Most are in 50s or 60s whereas local chain/Corp practices seem to have many new grads. If young docs stay in corporate practices and old guys get bought out by corporate guys which is the trend, maybe it’ll be inevitable that the practice model as we know might slowly change.


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Young doctors don’t stay in corporate gigs long. The turnover is extremely high and will continue to be that way.
 
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I’m not sure why your buy in is structured this way, over so long. Specialist offices are built on goodwill and it’s not really transferable to general dentists. GP offices have more goodwill to transfer because of the hygiene department.

When I was in a corporate office our OS schedule was packed. 1 day per week and then he’d rotate to other corporate offices. I think he was working 4 days most weeks, but I may not be remembering correctly.

10k In adjusted production would be about the minimum, paid 50%. Brought his own staff.
Endo did well too. 8-12 cases per day + consults. 2 days per month.
We had trouble filling the perio schedule consistently though.

Very busy office. 3 FT GPs 5 days per week each, seeing about 20-24 patients per day each.
 
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Big corporates have the benefit of pulling from multiple offices too. So if we couldn’t fill the schedule, they would call partner offices and then contact patients who were waiting.

I wouldn’t specialize to practice this way though. But..it’s lucrative.
 
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I’m not sure why your buy in is structured this way, over so long.

Well, the partnership terms were negotiated somewhat but the length was set to keep my salary at a reasonable rate while paying off a hefty sum over time. I might be in a pretty crappy partnership deal that’s much more favorable to the existing partners but i think I was just elated to be in a position to buyin. And at the time, I thought it was reasonable. I had a few friends who basically embarked on different paths. We talk/text a lot and those who started off at corporate practices stayed to my surprise and plan to do so. I know these guys well and we all sort of waged a bet to see who’s gonna have the first beach home etc. well, I can tell you we are all doing well. I bust their balls about unethical practices etc but they have their reasons which to me is sounding more and more convincing...especially $$ wise. we’ll see what happens I guess.




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I am a partner and make PLENTY of money. Youngish. Debt is under control and likely debt free before 35. Medium town, 1million people. Corporates have very good penetration and are SERVING THE NEEDS OF THE CONSUMER very well. I support one of the 3 largest DSOs in the country that has a very large presence in our city/state. They are growing. The patients are majority happy. Don't let people tell you all the corporates are bad. The target population is used to target, walmart, chipotle level customer service. So when you go in there and treat them awesome, you win everytime.

The DSO income is staggering. At least 2-3 times take home per hour. It's like old school oral surgery when all you do is sedations, 3rds, full mouth exts, implants and an occasional single tooth local. The GPs take care of basic stuff. I feel very welcome every day I show up and not dealing with a bunch of entitled assistants. When you've spent 10+ years surrounded by people who treat you bad, it's REALLY nice to be treated well. It's not perfect but very nice. I am also very nice. I work very hard. Specialists tend not to last more than a few years. As their private office grows and is good enough, the money isn't worth it, more about time off and other goals in life. I have no end date in mind. That being said, 2-4 days a month with the DSO can keep you a basic lifestyle if no debt.

There is nothing unethical about it if you are close and available for the practices and patients. You decide how to treat the patients. OS is so straight forward. There is no inlay vs crown vs direct restoration argument. There is prophy vs srp arguement. There is no arrestin. It's "tooth out? ok. looks like you're healthy enough for sedation, sound good? ok. etc. " One reason why I love OS. It's very straight forward. Patient charts transfer easily to the other offices and patients oddly enough don't care if they have to drive somewhere else to say hello. Can you do unethical things in a corporate office? Absolutely and the business people will turn their back for awhile. My patient experience is as close as possible to my private office. The one difference is same day consults and procedure and routine followup is by the GP. They are licensed dentists too. All my patients have my cell phone. Once a month I drive to an office just to say hello to a patient. Once a quarter a patient comes directly to my private office at no charge for subperiosteal abscess, bone spicule, etc.

At the end of the day, you don't get to control the GP offices that bring in their own specialists, the huge stealth DSO groups that together represent millions of OS production, the USOSM trajectory, the demands of the consumer, and the likely pathway of our young general dentist colleagues. Participate in the dental economy however you want, we always do very well. Our GP colleagues face some very challenging reimbursement and cost issues. There will be negative people who look down upon you. I look down on the old oral surgeons who think it's ok to charge a young OS $1mil for a PART OF A practice and then treat them like slaves for 5 years plus.
 
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That’s their reward for spending 3-4 more years of schooling than you + 60-80 hours that they have to work per week during their OS residencies. The harder you work earlier in your life, the greater the reward later……AKA delayed gratification.

More like 80-100 hours / week. It's a brutal road
 
Appreciate all the great feedback and thoughts, especially to OSOSOS. It’s nice to hear those feedbacks. Last week, I actually applied to a DSO outside of my restrictive area and have a phone interview next week. Haha. I should keep my options open especially since I still think my partnership deal isn’t the greatest and I don’t anticipate any significant change to my income or situation for a while until I pay off my share of the partnership. I never felt things were fair since signing the agreement a few years ago. Senior partners still seem to make major decisions and I often find out after the fact. Nothing earthshaking but it’s these little things that don’t sit well with me.

I’m not getting any younger either and lately, this investment doesn’t seem wise to me. My lawyer advised me to wait 18 months to plot any exit from my partnership due to severely damaging language in the partnership agreement if I were to leave within that time. Another lesson learned, partners can include language to screw you in case you want to bail on your agreement. My lawyer who charges $300 an hour has dissected my contract and if I were to walk now, he says there is a decent chance that the shares could be devalued and I would possibly walk away with nothing even though I’m about half way paid off. Not all marriages work out I guess. We shall see. Hope this also can be a learning moment for anyone potentially thinking about partnerships. Believe me I read all the articles on partnerships from Niamtu and AAOMS editorials etc. and did my best to avoid pitfalls...


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Appreciate all the great feedback and thoughts, especially to OSOSOS. It’s nice to hear those feedbacks. Last week, I actually applied to a DSO outside of my restrictive area and have a phone interview next week. Haha. I should keep my options open especially since I still think my partnership deal isn’t the greatest and I don’t anticipate any significant change to my income or situation for a while until I pay off my share of the partnership. I never felt things were fair since signing the agreement a few years ago. Senior partners still seem to make major decisions and I often find out after the fact. Nothing earthshaking but it’s these little things that don’t sit well with me.

I’m not getting any younger either and lately, this investment doesn’t seem wise to me. My lawyer advised me to wait 18 months to plot any exit from my partnership due to severely damaging language in the partnership agreement if I were to leave within that time. Another lesson learned, partners can include language to screw you in case you want to bail on your agreement. My lawyer who charges $300 an hour has dissected my contract and if I were to walk now, he says there is a decent chance that the shares could be devalued and I would possibly walk away with nothing even though I’m about half way paid off. Not all marriages work out I guess. We shall see. Hope this also can be a learning moment for anyone potentially thinking about partnerships. Believe me I read all the articles on partnerships from Niamtu and AAOMS editorials etc. and did my best to avoid pitfalls...


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Although the partnership deal isn't the greatest, you still make money from it. I think you should keep it. Once you pay off the partnership share, your net take home income will be higher. Hopefully, with your good associate income at the corp, you can pay off this partnership share a lot sooner. It's always better to make money from multiple sources: your partnership, your associate job at the corp, and your other investments. The road that leads to financial independence becomes much shorter.

My friend, who is a perio, signed a partnership contract with an older perio. I remember he told me he wasn't happy with the deal either. On one day, my friend got into a very bad automobile accident that prevented him from working for almost 5 months. This partnership saved him because he still got paid while he recovered from his injury at home. His partner eventually retired. He now owns 100% of the practice and gets to do whatever he wants. During my last visit to his house, I saw a Porsche Panamera and a Mercedes GLS in his garage. His wife is a general dentist but she is a stay home mom.

No matter how busy you are, never leave the patients unattended. There was one death at the corp office I work for. The patient was a healthy 26 yo who needed 3rd molar extractions under IV sedation. Her family filed a lawsuit. I knew because the mananging dentist, who referred the patient to this OS, told me that he also got sued. This happened 8-9 years ago. The OS, who got sued, is still working for the corp. And I still refer patients to him.
 
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I am under the impression that most of the OS programs are 6 years....and 6 years minuses 2 (or 3) years of ortho = 3-4 years.
OS has a 4 yr (more popular) and 6 yr (with a medical degree) residencies. While ortho is mostly 3 yrs. So the actual net difference is just 1 yr between the two for the most grads.

OS training is insanely brutal (7 days a week) for 4 years, while ortho is weekdays 9-5 for 3 years.

I would choose ortho, and set up few shops and still be on a par (or make more) with OS income.



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I saw a Porsche Panamera and a Mercedes GLS in his garage.
Off topic ...... but
Are these cars financed, leased or owned outright? I try to educate my daughters that what a person drives can be misleading and not necessarily a measure of that person's financial health.

As for the OS partnership. I agree with you. OP has already invested X amount into this partnership. Another option for OP is to find another OS to buy him out of the partnership. That might be a cleaner exit than trying to put a dollar amount on his partial partnership and having his partner (s) buy him out. Best to be amicable. Lawsuits only benefit the lawyers.
 
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Off topic ...... but
Are these cars financed, leased or owned outright? I try to educate my daughters that what a person drives can be misleading and not necessarily a measure of that person's financial health.
I've always convinced him to lease but my friend doesn't believe in leasing. He no longer lives in that house, which he paid $1.6M back in 2001. I haven't seen his new house yet but I heard that it has a tennis court.
 
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OS has a 4 yr (more popular) and 6 yr (with a medical degree) residencies. While ortho is mostly 3 yrs. So the actual net difference is just 1 yr between the two for the most grads.

OS training is insanely brutal (7 days a week) for 4 years, while ortho is weekdays 9-5 for 3 years.

I would choose ortho, and set up few shops and still be on a par (or make more) with OS income.



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You are right. I did some google searches and found out that half of the OS programs are 4-year and half are 6-year.

If an ortho is willing to put in the same amount of work hours as an OS, he/she should earn similar income. The problem is most orthodontists are not willing to do this ....they say no to corp jobs....they say no to working on weekends....they say no to traveling to multiple offices....and then some of them came on here saying they wish they should have specialized in OS.
 
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The problem is most orthodontists are not willing to do this ....they say no to corp jobs....they say no to working on weekends....they say no to traveling to multiple offices....and then some of them came on here saying they wish they should have specialized in OS.
The old adage of “early to bed, early to rise” applies to anyone who is regretting their career choices. The decision of choosing dentistry and a specialty has never been more critical. Students don’t have the luxury to plan as they move along the career anymore. The decision these days should be - choose your endgame before dental school, and not half way through DS, or after practicing few years, or even after specializing half heartedly. It will cost anyone a fortune (and time) to backtrack on any decision that was not calculated thoroughly.

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As for the OS partnership. I agree with you. OP has already invested X amount into this partnership. Another option for OP is to find another OS to buy him out of the partnership. That might be a cleaner exit than trying to put a dollar amount on his partial partnership and having his partner (s) buy him out. Best to be amicable. Lawsuits only benefit the lawyers.

I will likely finish my buyin while I explore some corporate side gig. Thing is that while I’m paying off the partnership for a few more years, my partners will likely want to slow down even more. It blows my mind that we only use one or two rooms out of four we have. They don’t want to take many emergencies from GPs (almost none), whereas I do most of the time, thinking that’s how you build up a practice. I’ve increased referrals, just to see them drop off because my senior partners said no to them when I wasn’t around. I don’t see this getting better as they get older. Plus, I feel like the retiring partners will be asking a premium for their own buyout, for their lifetime of work. Frankly, I stopped going around practices on my own since other guys never do it. You guys get the picture?

So, I either need to accept the status quo, supplement income with corporate side gig or cut my loses now and look for another avenue all together. Sure, grass isn’t always greener on the other side but I just hate to stay stagnant and accept it either. I wish I could turn back time and had reassessed instead of being overly eager to be a partner at any cost...That’s what prompted the whole corporate job quest as an option to escape or eventually just start my own practice perhaps.

All this going on in my head while my friends working at various Corporate offices telling me how simple their life is...


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It’s just practically impossible to know too far ahead if you’re going to enjoy day it and day out the responsibilities of the job. Hence why most go into dental school shooting for ortho or OS and then decide not to. People change and circumstances change too.
It use to be “not everyone can specialize”, but I have seen that pendulum now swinging more to “most people can specialize with connections” or if “they are willing to pay $$$$$$$”. I personally can attest to the latter through people/friends I know. Private schools and many residency programs have slowly changed the landscape of dental schools and specialty programs over the years, with their financially driven and back door requirements.


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I will likely finish my buyin while I explore some corporate side gig. Thing is that while I’m paying off the partnership for a few more years, my partners will likely want to slow down even more. It blows my mind that we only use one or two rooms out of four we have. They don’t want to take many emergencies from GPs (almost none), whereas I do most of the time, thinking that’s how you build up a practice. I’ve increased referrals, just to see them drop off because my senior partners said no to them when I wasn’t around. I don’t see this getting better as they get older. Plus, I feel like the retiring partners will be asking a premium for their own buyout, for their lifetime of work. Frankly, I stopped going around practices on my own since other guys never do it. You guys get the picture?

So, I either need to accept the status quo, supplement income with corporate side gig or cut my loses now and look for another avenue all together. Sure, grass isn’t always greener on the other side but I just hate to stay stagnant and accept it either. I wish I could turn back time and had reassessed instead of being overly eager to be a partner at any cost...That’s what prompted the whole corporate job quest as an option to escape or eventually just start my own practice perhaps.

All this going on in my head while my friends working at various Corporate offices telling me how simple their life is...


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Yes. What you describe is an all too familiar experience....it's disheartening, isn't it?? This is being repeated all over the country.
 
“choose your endgame before dental school, and not half way through DS”

Preaching to the choir my man, I’ve said many times for pre-dents to start preparing before they go to dental school. Better early than late. The response is always “just chill, wait till you’re in dental school, don’t worry about it right now”

Its a dangerous game when you’re dealing with half a million dollars...



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I will likely finish my buyin while I explore some corporate side gig. Thing is that while I’m paying off the partnership for a few more years, my partners will likely want to slow down even more. It blows my mind that we only use one or two rooms out of four we have. They don’t want to take many emergencies from GPs (almost none), whereas I do most of the time, thinking that’s how you build up a practice. I’ve increased referrals, just to see them drop off because my senior partners said no to them when I wasn’t around. I don’t see this getting better as they get older. Plus, I feel like the retiring partners will be asking a premium for their own buyout, for their lifetime of work. Frankly, I stopped going around practices on my own since other guys never do it. You guys get the picture?

So, I either need to accept the status quo, supplement income with corporate side gig or cut my loses now and look for another avenue all together. Sure, grass isn’t always greener on the other side but I just hate to stay stagnant and accept it either. I wish I could turn back time and had reassessed instead of being overly eager to be a partner at any cost...That’s what prompted the whole corporate job quest as an option to escape or eventually just start my own practice perhaps.

All this going on in my head while my friends working at various Corporate offices telling me how simple their life is...


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It's hard to get along with a partner, who has a different vision than yours. You want to expand the referral base and to keep the referring GPs happy. Your partner, on the other hand, wants to slow down and work less. When the older partner no longer has any debt to pay back, he tends to care less about production and more about doing enjoyable things outside of work. And when the boss is not motivated to work hard, the staff become lazy and unmotivated as well. The receptionist just books the patients according to what the boss wants. I don't have any experience being a partner. But I remember when I took over an existing practice that I bought from a 60 yo orthodontist, I noticed the existing staff were so unmotivated, slow and lazy. I had to fire all of them (except for the manager, whom I later demoted to a receptionist position).

I will probably become unmotivated like your older partner in a few more years.....when I pay off all my home mortgage and save enough for my kids' college education. I am 48 now. I no longer go door to door to meet referring GPs. I no longer write treatment reports to my referring GPs. Many of my dentist and specialist friends, who are around my age, are slowing down also.
 
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“choose your endgame before dental school, and not half way through DS”

Preaching to the choir my man, I’ve said many times for pre-dents to start preparing before they go to dental school. Better early than late. The response is always “just chill, wait till you’re in dental school, don’t worry about it right now”

Its a dangerous game when you’re dealing with half a million dollars...



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I am a strong proponnent of working hard and do everything right early. If you make wrong decisions when you are still young, you should have enough time and energy work hard to correct your mistakes..... and you can still retire early or ontime. This means that no messing around in college and try to finish it in 4 or less years. When you start dental school, work hard on day 1 even if you don't know if you want to specialize or not. With good grades that you've earned during your D1, D2 and D3 years, you'll have more options to pick the specialty you want to pursue and you will also have higher chance of getting into a cheap specialty program. If you later realize that it's not the right specialty for you and want to switch, you should still have time do so because you did everything right early. You can afford to borrow more loans (because you attend a cheap specialty program) to switch to another specialty.
 
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I will likely finish my buyin while I explore some corporate side gig. Thing is that while I’m paying off the partnership for a few more years, my partners will likely want to slow down even more. It blows my mind that we only use one or two rooms out of four we have. They don’t want to take many emergencies from GPs (almost none), whereas I do most of the time, thinking that’s how you build up a practice. I’ve increased referrals, just to see them drop off because my senior partners said no to them when I wasn’t around. I don’t see this getting better as they get older. Plus, I feel like the retiring partners will be asking a premium for their own buyout, for their lifetime of work. Frankly, I stopped going around practices on my own since other guys never do it. You guys get the picture?

So, I either need to accept the status quo, supplement income with corporate side gig or cut my loses now and look for another avenue all together. Sure, grass isn’t always greener on the other side but I just hate to stay stagnant and accept it either. I wish I could turn back time and had reassessed instead of being overly eager to be a partner at any cost...That’s what prompted the whole corporate job quest as an option to escape or eventually just start my own practice perhaps.

All this going on in my head while my friends working at various Corporate offices telling me how simple their life is...


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I am curious, but what kind of income are the partners at your practice making? Are they making similar to the 750k corporate income your friends are marking? If so, partnership might not be a bad deal, since you would end up making the same while treating fewer patients.
 
I am curious, but what kind of income are the partners at your practice making? Are they making similar to the 750k corporate income your friends are marking? If so, partnership might not be a bad deal, since you would end up making the same while treating fewer patients.

I wish my partners made that kind of money, then this discussion wouldn’t be taking place. They make about $400k with some profit share which we didn’t have much last year. Thats not including the money I pay them every month for the partnership shares...I make about 75% of what they make for another 5 years. I was told we would split any profit at the end of the year but last few years have been pretty pathetic.

My corporate buddy takes home 40% of all his collections, where he averages around 5-6k a day, working 3-4 days a week. He says his average production is about 12k with 10-12 cases of mostly 3rd molars with anesthesia done by a CRNA. Crazy thing is...the corporate bean counters know what makes them money and doesn’t want him to waste time on single tooth cases. GPs at his place pick up those cases.

We do our own anesthesia and see 2-3 anesthesia cases a day, working all 5 days although we have a pretty laid back schedule.

I suppose that I have more of a security blanket with my job but one can also argue that my corporate buddy with decent disability insurance and life insurance should be ok too.


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I wish my partners made that kind of money, then this discussion wouldn’t be taking place. They make about $400k with some profit share which we didn’t have much last year. Thats not including the money I pay them every month for the partnership shares...I make about 75% of what they make for another 5 years. I was told we would split any profit at the end of the year but last few years have been pretty pathetic.

My corporate buddy takes home 40% of all his collections, where he averages around 5-6k a day, working 3-4 days a week. He says his average production is about 12k with 10-12 cases of mostly 3rd molars with anesthesia done by a CRNA. Crazy thing is...the corporate bean counters know what makes them money and doesn’t want him to waste time on single tooth cases. GPs at his place pick up those cases.

We do our own anesthesia and see 2-3 anesthesia cases a day, working all 5 days although we have a pretty laid back schedule.

I suppose that I have more of a security blanket with my job but one can also argue that my corporate buddy with decent disability insurance and life insurance should be ok too.


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There has to be a catch right? Otherwise wouldn't every OMS be jumping on this opportunity?
Are they independent contractors or employed by the corporation?
 
ToothJockey. My friends dad this this for a year after residency. It is really not sustainable..... Pulling teeth at that capacity all day everyday for 5 days a week. It would be good for a year or so after graduation to pay back debt and then find something more sustainable (what my friends dad did).
 
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ToothJockey. My friends dad this this for a year after residency. It is really not sustainable..... Pulling teeth at that capacity all day everyday for 5 days a week. It would be good for a year or so after graduation to pay back debt and then find something more sustainable (what my friends dad did).

Ah, gotcha, it seems like that corp lifestyle can lead to burnout. Traveling so much, doing so many procedures. Plus paid 40% of collections, in private practice you can control your overhead and make 50-60% of collections. Possibly more money for doing less work.
 
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Ah, gotcha, it seems like that corp lifestyle can lead to burnout. Traveling so much, doing so many procedures. Plus paid 40% of collections, in private practice you can control your overhead and make 50-60% of collections. Possibly more money for doing less work.

He makes more because he has 3 offices and only travels to two that are an hour apart. However, he does less clinical work.
 
He makes more because he has 3 offices and only travels to two that are an hour apart. However, he does less clinical work.
Seems like a great gig. I hope OP sticks with his partnership along with his future corp job. Who knows, when his older partners retire he can rejuvenate the practice and have a much better lifestyle than as a corp associate.
 
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I am a partner and make PLENTY of money. Youngish. Debt is under control and likely debt free before 35. Medium town, 1million people. Corporates have very good penetration and are SERVING THE NEEDS OF THE CONSUMER very well. I support one of the 3 largest DSOs in the country that has a very large presence in our city/state. They are growing. The patients are majority happy. Don't let people tell you all the corporates are bad. The target population is used to target, walmart, chipotle level customer service. So when you go in there and treat them awesome, you win everytime.

The DSO income is staggering. At least 2-3 times take home per hour. It's like old school oral surgery when all you do is sedations, 3rds, full mouth exts, implants and an occasional single tooth local. The GPs take care of basic stuff. I feel very welcome every day I show up and not dealing with a bunch of entitled assistants. When you've spent 10+ years surrounded by people who treat you bad, it's REALLY nice to be treated well. It's not perfect but very nice. I am also very nice. I work very hard. Specialists tend not to last more than a few years. As their private office grows and is good enough, the money isn't worth it, more about time off and other goals in life. I have no end date in mind. That being said, 2-4 days a month with the DSO can keep you a basic lifestyle if no debt.

There is nothing unethical about it if you are close and available for the practices and patients. You decide how to treat the patients. OS is so straight forward. There is no inlay vs crown vs direct restoration argument. There is prophy vs srp arguement. There is no arrestin. It's "tooth out? ok. looks like you're healthy enough for sedation, sound good? ok. etc. " One reason why I love OS. It's very straight forward. Patient charts transfer easily to the other offices and patients oddly enough don't care if they have to drive somewhere else to say hello. Can you do unethical things in a corporate office? Absolutely and the business people will turn their back for awhile. My patient experience is as close as possible to my private office. The one difference is same day consults and procedure and routine followup is by the GP. They are licensed dentists too. All my patients have my cell phone. Once a month I drive to an office just to say hello to a patient. Once a quarter a patient comes directly to my private office at no charge for subperiosteal abscess, bone spicule, etc.

At the end of the day, you don't get to control the GP offices that bring in their own specialists, the huge stealth DSO groups that together represent millions of OS production, the USOSM trajectory, the demands of the consumer, and the likely pathway of our young general dentist colleagues. Participate in the dental economy however you want, we always do very well. Our GP colleagues face some very challenging reimbursement and cost issues. There will be negative people who look down upon you. I look down on the old oral surgeons who think it's ok to charge a young OS $1mil for a PART OF A practice and then treat them like slaves for 5 years plus.
This sounds like Aspen Dental.


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I interviewed recently to work a few days days a month at a DSO outside my restriction. Swallowed my pride and got official permission from my partners too. They seem to understand that my partnership payments suck. No ****. Haha.

I think I’ll stick with the partnership for now. My partners are pretty laid back and maybe the side gig will allow me to be like them and relax. It does provide a lot in terms of benefits, disability, profit share 401k etc. My 401k did great last year. Maybe the part time work will help me pay off the shares early. Or pay off my mortgage like Dave Ramsey says. Lol.

Oh and perhaps less texting with my rich buddies who drive Porsches and live in million dollar mansions. My wife says comparing with my friends will only gets me in trouble and just be happy with the things I can control. Keep you posted in 2020.


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less texting with my rich buddies who drive Porsches and live in million dollar mansions.


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Birds of the same feather. Porsche is a great car btw.

Home values are going up insanely - better than 401k returns. Housing market for 2020 is going to continue to be on fire - millennials are finally going to start buying homes in large numbers. It’s forecasted that 50% of 2020 mortgages will be made to millennials. Rentals will also be strong, and inventory will remain tight and there will be bidding wars for urban markets. Rates will continue to remain low in 2020, about 3.5% +/-.



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There is nothing wrong with working for a cooperate office. You can make more money early and pay off your debt faster. My old attendings were completely disappointed when I told them I am joining cooperate but who cares? I think its a great opportunity. I agree that it is not a long term solution but nothing is guaranteed in life.
 
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There is nothing wrong with working for a cooperate office. You can make more money early and pay off your debt faster. My old attendings were completely disappointed when I told them I am joining cooperate but who cares? I think its a great opportunity. I agree that it is not a long term solution but nothing is guaranteed in life.



I think the last 4 minutes of this video does a good job explaining why your attendings likely feel that way (the rest of it is totally unrelated to this thread)
 
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I wish my partners made that kind of money, then this discussion wouldn’t be taking place. They make about $400k with some profit share which we didn’t have much last year. Thats not including the money I pay them every month for the partnership shares...I make about 75% of what they make for another 5 years. I was told we would split any profit at the end of the year but last few years have been pretty pathetic.

My corporate buddy takes home 40% of all his collections, where he averages around 5-6k a day, working 3-4 days a week. He says his average production is about 12k with 10-12 cases of mostly 3rd molars with anesthesia done by a CRNA. Crazy thing is...the corporate bean counters know what makes them money and doesn’t want him to waste time on single tooth cases. GPs at his place pick up those cases.

We do our own anesthesia and see 2-3 anesthesia cases a day, working all 5 days although we have a pretty laid back schedule.

I suppose that I have more of a security blanket with my job but one can also argue that my corporate buddy with decent disability insurance and life insurance should be ok too.


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You’re getting screwed over. You should be making minimum significantly more. You need to consider what it will cost you if you don’t leave.
 
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You’re getting screwed over. You should be making minimum significantly more. You need to consider what it will cost you if you don’t leave.

Some thoughts.

1. For years .... the accepted route out of school was to enter a partnership or associateship leading to eventual ownership. That was my entry into ortho ownership. Associate for 6 months ..... partnership for 18 months ..... owner. Of course .... all of this was in writing from day one of the partnership (buyout in 18 months). Lots of positives. Mentorship. Real life learning. Salary. Probably most important was that the new dentist/specialist was buying in a situation where the older docs have done all the work to establish a successful practice. Pretty sure most young grads (specialists) have no idea how hard it is to finance/build a practice and then establish referrals. It is very difficult being the young guy trying to break into established referral patterns. It's give and take. As the OP stated .... the older docs are not as aggressive as they once were. That's why YOU ARE there. A young specialist can establish new referrals with the younger dentists. Also .... the older docs have a built-in situation for when they want to retire. Right or wrong. :)

or 2. Quote. "You're getting screwed over." End quote. :eek:

Then 3. This is a good example of the reality of Corp dentistry. Corp dentistry offering higher levels of $$$$ than established speciality practice with multiple partners. The reality of Corp dentistry taking over. :(
 
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