D4's and Dentists

[whodat4life]

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Hi,

I know this has been hit on before, but the economy has changed A LOT in the past six months or so. I am going to be starting dental school at Loma Linda in the fall and I was wondering, from your experiences, what's the best route to go straight out of school? I mean, working in academics, working as an associate under a private practice dentist, working at a company like Aspen, Gentle, Western, etc..

When I get out of school, I will owe about 350k. Is it smart to get a practice straight out of school? I talked to a dentist the other day and he highly recommended against it and said the business aspect of running his practice is what he struggles most with. How about going into a partnership with a couple other dentists graduating from school? Also, another option would be going into public health for a while until I get some school debt paid down...

Thanks so much in advance for any help. I just need some advice from someone who's had firsthand experience with this in the recent months. The dentist I spoke with had been practicing for a while so he's probably a little better off than most (the ones who just graduated or will be graduating).

 

[HupHolland]

Hi,

I know this has been hit on before, but the economy has changed A LOT in the past six months or so. I am going to be starting dental school at Loma Linda in the fall and I was wondering, from your experiences, what's the best route to go straight out of school? I mean, working in academics, working as an associate under a private practice dentist, working at a company like Aspen, Gentle, Western, etc..

When I get out of school, I will owe about 350k. Is it smart to get a practice straight out of school? I talked to a dentist the other day and he highly recommended against it and said the business aspect of running his practice is what he struggles most with. How about going into a partnership with a couple other dentists graduating from school? Also, another option would be going into public health for a while until I get some school debt paid down...

Thanks so much in advance for any help. I just need some advice from someone who's had firsthand experience with this in the recent months. The dentist I spoke with had been practicing for a while so he's probably a little better off than most (the ones who just graduated or will be graduating).

As a general dentist you really have 2 options post-graduation: work or do a residency (AEGD or GPR).

If you're confident and have a family, most would recommend going directly to work. If you want to build up some speed/confidence and want to do some more advanced dentistry under the umbrella of an academic institution or hospital, then do a residency.

We just finished our practice management course, and this is what I gathered from the speakers (if you're going straight into practice)..

-DON'T take out a huge loan and start up a practice right out of school. Not only do we know nothing about running a business, but we're in debt up to our eyeballs. Plus, banks aren't as willing to shell out a bunch of money to a dentist with no real experience.

-DO work as an associate, the more practices the better. Chances are you will not buy into your first associateship. Treat your associateship as a learning experience.. get fast + confident and the production (and higher pay!) will follow. Working at multiple practices will let you see what works and what doesn't, that way when/if you decide to open up your own place you are armed with the knowledge of how to manage a practice efficiently.

-Partnerships: there are very few "true" partnerships--by this i mean 50%-50% split. Just because there are 2 docs names on the door does not mean it's a partnership. Also, most ads for an associate dentist "leading to potential partnership" are really just associateships that will never become partnerships, just sayin.

So basically.. get out, work at as many practices as possible to learn the ropes, make money, pay off your loans and once to decide where you want to live you can start/join a practice in that community!

Hup

 

[whodat4life]

As a general dentist you really have 2 options post-graduation: work or do a residency (AEGD or GPR).

If you're confident and have a family, most would recommend going directly to work. If you want to build up some speed/confidence and want to do some more advanced dentistry under the umbrella of an academic institution or hospital, then do a residency.

We just finished our practice management course, and this is what I gathered from the speakers (if you're going straight into practice)..

-DON'T take out a huge loan and start up a practice right out of school. Not only do we know nothing about running a business, but we're in debt up to our eyeballs. Plus, banks aren't as willing to shell out a bunch of money to a dentist with no real experience.

-DO work as an associate, the more practices the better. Chances are you will not buy into your first associateship. Treat your associateship as a learning experience.. get fast + confident and the production (and higher pay!) will follow. Working at multiple practices will let you see what works and what doesn't, that way when/if you decide to open up your own place you are armed with the knowledge of how to manage a practice efficiently.

-Partnerships: there are very few "true" partnerships--by this i mean 50%-50% split. Just because there are 2 docs names on the door does not mean it's a partnership. Also, most ads for an associate dentist "leading to potential partnership" are really just associateships that will never become partnerships, just sayin.

So basically.. get out, work at as many practices as possible to learn the ropes, make money, pay off your loans and once to decide where you want to live you can start/join a practice in that community!

Hup

Awesome, thanks so much for sharing this. I sort of figured that would be the best way to get through it. I mean, if you think about it...if it takes you 5 years to pay off your debt, you will be ~35 and will be just ready to start doing really well. I always looked at student debt as a horrible thing, but it doesn't get to me as bad when I think about it from your perspective. I think we would all want someone working in our mouths that has lots of experience and aren't in a hurry to just get us out the door and get our money. We will still have around 30 years to enjoy our work until we retire.

What do you think the best companies are to work for? Places like Aspen, Gentle, Western, etc...did they happen to mention which ones were the best?

I had a cleaning the other day and I asked the dentist these questions...but I figured it may be slightly inaccurate because he's been in his own practice for a long time (10+ years). Anyways, he said not to worry about it (easier said than done) because you will end up making it all back tenfold. But, he also said that, from what he could tell, the market has changed. It used to be that you could get straight out of school and open up shop. Now, it's almost a stupid move to make, too risky. Some people do it and do great at it, but there are more that do not.

Thanks so much for your input Hup! I really appreciate your advice!

 

[doc3232]

Awesome, thanks so much for sharing this. I sort of figured that would be the best way to get through it. I mean, if you think about it...if it takes you 5 years to pay off your debt, you will be ~35 and will be just ready to start doing really well. I always looked at student debt as a horrible thing, but it doesn't get to me as bad when I think about it from your perspective. I think we would all want someone working in our mouths that has lots of experience and aren't in a hurry to just get us out the door and get our money. We will still have around 30 years to enjoy our work until we retire.

What do you think the best companies are to work for? Places like Aspen, Gentle, Western, etc...did they happen to mention which ones were the best?

I had a cleaning the other day and I asked the dentist these questions...but I figured it may be slightly inaccurate because he's been in his own practice for a long time (10+ years). Anyways, he said not to worry about it (easier said than done) because you will end up making it all back tenfold. But, he also said that, from what he could tell, the market has changed. It used to be that you could get straight out of school and open up shop. Now, it's almost a stupid move to make, too risky. Some people do it and do great at it, but there are more that do not.

Thanks so much for your input Hup! I really appreciate your advice!

Paying 350k back in 5 years?
The first year you will pay about 25k for the interest of your loan...
If you make 120k (wont even be 90k after taxes), you have only paid off 35k of your loan...

 

[HupHolland]

Paying 350k back in 5 years?
The first year you will pay about 25k for the interest of your loan...
If you make 120k (wont even be 90k after taxes), you have only paid off 35k of your loan...

Agreed. $350k over 5 years is not realistic. Realistic is 20 years. Don't worry about the debt now.. just be happy that you're about to enter a profession where you will have plenty of autonomy and the ability to become independently weathly, not necessarily filthy rich.

As for the best "company" to work for? My opinion: these chains are the bottom of the barrel. Sure, they're not all bad, but they're the closest thing to dentistry coming to walmart! However, if you graduate and have no job and need to make loan payments, then do what ya gotta do. I know people who have worked for the chains, loupe reps that sell to them and supply companies that distribute to them. Each and every one of these people have told me that they would never have their families treated by Western/Aspen/Etc. Enough said..

Hup

 

[whodat4life]

Agreed. $350k over 5 years is not realistic. Realistic is 20 years. Don't worry about the debt now.. just be happy that you're about to enter a profession where you will have plenty of autonomy and the ability to become independently weathly, not necessarily filthy rich.

As for the best "company" to work for? My opinion: these chains are the bottom of the barrel. Sure, they're not all bad, but they're the closest thing to dentistry coming to walmart! However, if you graduate and have no job and need to make loan payments, then do what ya gotta do. I know people who have worked for the chains, loupe reps that sell to them and supply companies that distribute to them. Each and every one of these people have told me that they would never have their families treated by Western/Aspen/Etc. Enough said..

Hup

I see...if I'm going to do the twenty years, do you think it would be best to do the IBR plan (I think it's for 25 total) and whatever isn't paid off will be forgiven?

I've heard the same about these chains...I'm just terrified that when I get out I will not be able to find work and will be sitting there with 350k in student loan debt. As soon as the NHSC scholarship program (full paid tuition + fees + monthly living stipend) opens up, I'm going to apply to it. I spent a lot of time trying to make my application stand out.

What do you guys think about the public health route? From what I can tell, they will pay like 30k the first two years and 40k the next two (for the "Loan Forgiveness" plan, not the "Scholarship.") It says that if you serve six or more years, they pay off the full amount. I know it's probably not going to be as fun as running your own private practice, but if you can pay down most of your debt in those years, that would be awesome.

The reason I said five years (which is still sort of unrealistic I guess) is because I will be able to allot about 75% of my yearly earnings towards my student loans. My wife makes decent money, so we will basically be living the same (maybe a little better) than we do now. I'm used to living like this (as a student) so it doesn't bother me all that much.

Basically, I was thinking that if the public health route would pay the 30k per year...that would cover the interest while I fight the principal.

I know I don't need to be putting all of my eggs in one basket, but I think this is a pretty decent plan. I'm sure there will be a lot of things I can't see yet that will cause bumps in my path and that's why I'm hear to listen and learn from what you all say. Hopefully, the economy will be a little better by the time I get out and I will not have to work for a dental chain. Thanks again guys for your advice!!!

 

[doc3232]

I see...if I'm going to do the twenty years, do you think it would be best to do the IBR plan (I think it's for 25 total) and whatever isn't paid off will be forgiven?

I've heard the same about these chains...I'm just terrified that when I get out I will not be able to find work and will be sitting there with 350k in student loan debt. As soon as the NHSC scholarship program (full paid tuition + fees + monthly living stipend) opens up, I'm going to apply to it. I spent a lot of time trying to make my application stand out.

What do you guys think about the public health route? From what I can tell, they will pay like 30k the first two years and 40k the next two (for the "Loan Forgiveness" plan, not the "Scholarship.") It says that if you serve six or more years, they pay off the full amount. I know it's probably not going to be as fun as running your own private practice, but if you can pay down most of your debt in those years, that would be awesome.

The reason I said five years (which is still sort of unrealistic I guess) is because I will be able to allot about 75% of my yearly earnings towards my student loans. My wife makes decent money, so we will basically be living the same (maybe a little better) than we do now. I'm used to living like this (as a student) so it doesn't bother me all that much.

Basically, I was thinking that if the public health route would pay the 30k per year...that would cover the interest while I fight the principal.

I know I don't need to be putting all of my eggs in one basket, but I think this is a pretty decent plan. I'm sure there will be a lot of things I can't see yet that will cause bumps in my path and that's why I'm hear to listen and learn from what you all say. Hopefully, the economy will be a little better by the time I get out and I will not have to work for a dental chain. Thanks again guys for your advice!!!

Don't think about these things right now...you really have no idea what will actually happen in the future.

 

[whodat4life]

Don't think about these things right now...you really have no idea what will actually happen in the future.

Very true...it looks as if it will only get worse. I hate to have such a negative outlook on things, but as taxes continue to raise, people continue to lose their jobs, and gas prices skyrocket...our economy is on the brink. It's sad to see our country in the state it's in right now. Thanks for your response though!!!

 

[armorshell]

Very true...it looks as if it will only get worse. I hate to have such a negative outlook on things, but as taxes continue to raise, people continue to lose their jobs, and gas prices skyrocket...our economy is on the brink. It's sad to see our country in the state it's in right now. Thanks for your response though!!!

At least when we get the Weimar republic style hyper-inflation you can just go down to the student loan office and pay off your entire debt with a wheelbarrow full of $100 bills.

 

[John Durian]

At least when we get the Weimar republic style hyper-inflation you can just go down to the student loan office and pay off your entire debt with a wheelbarrow full of $100 bills.

lmao 👍

 

[7 Iron]

I see...if I'm going to do the twenty years, do you think it would be best to do the IBR plan (I think it's for 25 total) and whatever isn't paid off will be forgiven?

I've heard the same about these chains...I'm just terrified that when I get out I will not be able to find work and will be sitting there with 350k in student loan debt. As soon as the NHSC scholarship program (full paid tuition + fees + monthly living stipend) opens up, I'm going to apply to it. I spent a lot of time trying to make my application stand out.

What do you guys think about the public health route? From what I can tell, they will pay like 30k the first two years and 40k the next two (for the "Loan Forgiveness" plan, not the "Scholarship.") It says that if you serve six or more years, they pay off the full amount. I know it's probably not going to be as fun as running your own private practice, but if you can pay down most of your debt in those years, that would be awesome.

The reason I said five years (which is still sort of unrealistic I guess) is because I will be able to allot about 75% of my yearly earnings towards my student loans. My wife makes decent money, so we will basically be living the same (maybe a little better) than we do now. I'm used to living like this (as a student) so it doesn't bother me all that much.

Basically, I was thinking that if the public health route would pay the 30k per year...that would cover the interest while I fight the principal.

I know I don't need to be putting all of my eggs in one basket, but I think this is a pretty decent plan. I'm sure there will be a lot of things I can't see yet that will cause bumps in my path and that's why I'm hear to listen and learn from what you all say. Hopefully, the economy will be a little better by the time I get out and I will not have to work for a dental chain. Thanks again guys for your advice!!!

Sure, you say YOU don't mind living like a student, but what about her? Marriage always throws a wrench into things...

 

[whodat4life]

At least when we get the Weimar republic style hyper-inflation you can just go down to the student loan office and pay off your entire debt with a wheelbarrow full of $100 bills.

LOL 👍👍

 

[NotPennysBoat]

At least when we get the Weimar republic style hyper-inflation you can just go down to the student loan office and pay off your entire debt with a wheelbarrow full of $100 bills.

HAHAH!

 

[dragonteeth]

My co-resident went to LLU and loved it - hope you like it as much as he did.

Chances are the economy will change somewhat between now and your graduation, so you may not be considering the same things in 4 years that you are now. Work hard enough to get the grades that you would need to do a residency should you decide your junior or senior year you'd like to specialize. At the same time become proficient and efficient enough in the basics that you could do well as an associate (and no, grades and proficiency do not _always_ go hand in hand - know some great book dentists whom I would never let near my mouth). That way both doors will stay open to you.

There are a number of loan payback/forgiveness programs out there should the economy still be bad and you decide not to specialize. Both National Health Service Corps and Indian Health Service have loan repayment programs (about 24k/year), as does the military, some academic positions (through NIH grants) and many state public health programs. As it stands right now, if you work for the feds (in or out of uniform) for 10 years and make regular payments, the balance of your federal loans will be forgiven at the end of that 10 years. When you're staring down the barrel of a 30 year loan repayment schedule the size of most mortgages, that can suddenly become very appealing.

 

[whodat4life]

My co-resident went to LLU and loved it - hope you like it as much as he did.

Chances are the economy will change somewhat between now and your graduation, so you may not be considering the same things in 4 years that you are now. Work hard enough to get the grades that you would need to do a residency should you decide your junior or senior year you'd like to specialize. At the same time become proficient and efficient enough in the basics that you could do well as an associate (and no, grades and proficiency do not _always_ go hand in hand - know some great book dentists whom I would never let near my mouth). That way both doors will stay open to you.

There are a number of loan payback/forgiveness programs out there should the economy still be bad and you decide not to specialize. Both National Health Service Corps and Indian Health Service have loan repayment programs (about 24k/year), as does the military, some academic positions (through NIH grants) and many state public health programs. As it stands right now, if you work for the feds (in or out of uniform) for 10 years and make regular payments, the balance of your federal loans will be forgiven at the end of that 10 years. When you're staring down the barrel of a 30 year loan repayment schedule the size of most mortgages, that can suddenly become very appealing.

That's actually exactly what I was thinking about doing. I'm going to apply to the NHSC Scholarship program when the app opens up, btw, anyone know when it will open? I called about a month ago and a guy told me in April, but it has yet to open up. Should I not get accepted to it, I'm going to definitely do the NHSC Loan Forgiveness route. I'm not too sure as to how competitive it is, but I'm quite sure the Scholarship program is VERY competitive. Since the NHSC scholar program covers your full tuition, lab fees, computer, etc...is it safe to say that you only have to give them in return four years of service? Anyone familiar with how the scholarship program works?