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Dispel the myth about salary?

Discussion in 'Dental' started by cpwalker, May 16, 2007.

  1. cpwalker

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    OK, so I am seeing in the threads that average salary for starting dentist are ranging from 100-177k. My concern is, is this base salary plus or a commissions based figure. What is the bottom line? I am hearing a lot of negative things concerning dentists not making adequate money, having to take PT jobs, not being able to cover loan payments. I hear that working as an associate the Dr. expects you to produce and will only pay you for what you produce? How do you attract patients and produce when you are just out of d-school. Someone please help me with the hard core facts?
     
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  3. albany11

    albany11 Member
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    dentistry is Not easy. It takes time, work, and motivation to gain skills
    Many are greedy and will offer the least for the most production.
    Find the right practice.



    , if you work for someone else and the practice is slow(many) and you are an average ethical dentist with no post up training, you will not even make those numbers.

    if you luck out and the practice is in a good area with a senior dentist mentoring and pushing you, you will do okay. 100k in most middle class area



    if you take the challenge and start a practice, even at a slow rate
    and loan payments, you'll do 100k-200k
     
  4. albany11

    albany11 Member
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    dentistry is a business: Answer: how good is it?

    just as there are one lawyer making millions, there's another 50
    making $500k, another 1000 making $300k and another 10,000 making $150k

    there is no set number but if you take the risk and start your practice, according to the ADA, GP owners average $177k; employee average much less:

    of course there are some netting
    millions, 500k but it all depends on years of practice, location, skill levels,
    office hrs, etc
     
  5. aphistis

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    Your success out of school will depend on a lot of factors, but for what it's worth, I've never heard of anyone with the troubles you describe here.
     
  6. johntara04

    johntara04 Member
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    If you produce $1500 a day with 4 weeks off (240 working days), then if you take home 35% of that (most associates get this) then you are making $126,000 a year. $1500 a day is a RCT, crown and a couple fillings. Very easy to do. It is not that hard to make money in dentistry.
     
  7. DrJeff

    DrJeff Senior Member
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    Some areas of the country will have you doing $1500 a day in production with just an endo and a couple of fillings, heck, some areas of the country will have you doing MORE than $1500 a day in production with just 1 molar endo.

    If you can work with a full schedule, even on a day where you're just doing basic fillings all day long with no "big " procedures in your schedule, you'll be suprised at how quickly the production mounts up. Then, when you ge to the owner's level, your schedule might not be that different from that of an associates, but you're income then also taps into the pool of money generated by your hygenists, and with a couple of hygenists working for you, that can become quite a substantial pool of $$ too!
     
  8. burton117

    burton117 The Big Kahuna
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    I was under the impression that most offices broke even or came out slightly ahead ($1-5/hr per hygenist) on their hygenists based on dentaltown, but what do I know.. I haven't even started dental school yet.
     
  9. cpwalker

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    But is that based on the existing patients at the practice or the ones I have to bring into the practice?
     
  10. aphistis

    Moderator Emeritus 10+ Year Member

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    Conventional wisdom is that 1/3 of your hygiene production should cover their overhead, another 1/3 goes in their pocket, and the last 1/3 in yours. If someone is only earning a dollar an hour on your hygienists, they're getting hosed.
     
  11. Lesley

    Lesley Member
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    If a dental office, especially a new office with a lot of equipment and start up overhead, participates with a lot of weak plans, HMO's, PPO's or capitation it is very possible that they are making only enough to cover the hygienist's overhead and pay, possibly not even enough to cover that. Some of these plans pay ridiculously low amounts for some services, including prophies.

    Note: Participating with a plan and accepting the plan are two different things. If you participate you agree to accept reduce fees. Some plans are restrictive. If a patients chooses to go out of network, to a dentist that does not participate, the insurance company will cover nothing; however, some plans will allow patients to go out-of-network and still contribute the same amount towards the patient's bill.
     
  12. DrJeff

    DrJeff Senior Member
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    With the fee schedule in my practice, a prophy and if needed 4 bitewings runs about $125. Same basic billed fees for kids with prophy, 2 bitewings and fluoride tx. Even if no films are taken during that visit, it still ends up being around $80 billed by my hygenists per patient visit. Yes, prophy fees will vary around the country, but hygenists wages tend to vary with the prophy fees. Aphistis's 1/3,1/3,1/3 breakdown is pretty close to what it runs in my office, so my partner and I end up splitting a little more than $1 to $5 and hour per hygenist:D And that doesn't even take into account our doctors exam fee that goes along with those previously mentioned billing fees. Multiply that by a couple hygenists, and then 8+ patients per day per hygenist over the course of a year and it adds up.

    If someone is only making $1 to $5 an hour from their hygiene department, they're either a) overpaying their hygenist and b) undercharging for their services(often due to insurance company participation:eek: )
     
  13. burton117

    burton117 The Big Kahuna
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    Very, very informative guys. Thank you! So more like $12 or more an hour.
     
  14. burton117

    burton117 The Big Kahuna
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    So are you making the argument that you can use hygiene "to get the patients in the door" or as a "loss leader." If so, is this realistic or is it best practice to come out with a profit in every category?

    My gut says make everything pay for itself, but if somebody wants a cleaning, they are going to be less likely to shop around for a relatively cheaper service such as a cleaning as opposed to a crown or rct.
     
  15. DrJeff

    DrJeff Senior Member
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    If you choose to participate in one of the HMO type plans, then hygiene may very well operate at a slight loss with what those reimbursement rates are. However, hygiene then will allow you to get a greater volume of patients through your doors, where you will end up finding additional work for you to do on some of those hygiene patients(once again if your in a managed care style plan, your care will be at a discounted rate too:eek: ). This is how the ins. companies market these managed care plans to dentists, as a way to help fill empty chair space. In reality though in many offices, your profit margin in these plans is very minimal(if at all) due to the heavily discounted fees that they have you accepting, and the volume you need to see to make them work goes up, and hence the time you spend with each patient goes down. If you want to practice that way, great, if you don't, be carefullwhen signing up with ins. plans.
     
  16. DrJeff

    DrJeff Senior Member
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    Thats the low end, more often that number is in the $30 to $50+ an hour range. Simply because with the 1/3rd, 1/3rd 1/3rd model, the 1/3 hygienist salary is something that we figure into the overhead portion, and those two combined are most of the time in the 50-55% range, not the 2/3rd's range:thumbup:
     
  17. burton117

    burton117 The Big Kahuna
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    That is excellent news! Something to take into consideration because it isn't "something for nothing".

    Don't you have to spend about 10 minutes on every hour per hygenist doing an oral exam, etc... This eats up pure "procedure time."

    So, if you are supervising the maximum of three hygenists as the regulations were recently changed to. You would be spending about half the day covering "hygeine supervisor" duties?

    Ouch!
     
  18. DrJeff

    DrJeff Senior Member
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    Most hygiene checks can be done in a 2 to 3 minute span. Occassionally if either myself, or my patient gets verbose, then it might be in that 5 to 7 minute range (often during those, either my hygienist or my assistant is looking at me, rolling her eyes, and giving me the "hurry up" look:D
     
  19. OceanDMD

    OceanDMD Rather be fishing
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    During procedures you have down time to do these checks, so in reality you are not wasting any procedure time. Example, while a PVS impression is setting, while your patient is getting numb, when you need an xray to determine an endodontic WL, etc..etc... Hygiene in a good practice is a major money maker, and is where the majority of your production schedule will be filled from.
     
  20. DrJeff

    DrJeff Senior Member
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    Don't forget the biggest benefit, all the running from room to room all day long keeps the extra pounds off:D ;)

    Actually it really isn't that bad do for the exact reasons that OceanDMD said, where the vast majoirty of the time you'll integrate a check into normal treatment "downtime" and if your hygenists are working at roughly the same pace on the same age bracket of patients, it generally limits the number of times/hour you need to leave your operatory/office to do checks.

    When it gets fun is when you have different age groups in your hygenists schedules where one might be booked for 30 minutes with a child, another for 45 minutes for a young teen and another for an hour with an adult, and your partner is out of the office on vacation and you get to manage all the hygenists(Oh wait, that's just my day today:cool: )
     
  21. Cold Front

    Cold Front Supreme Member
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    My local dentist does a single posterior crown for $1,000. She doesn't have CEREC machine, but she would make a killing if she did, and save time for re-scheduling to complete the crown after the lab work.

    On the same day, she was seeing another patient who hasnt seen a dentist for 2 decades... serious anterior restorations and cosmetic work. His bill for this treatment was in the $3,000 range.

    She also has 2 hygienists who see ~6-8 patients a day, and would say the total office production to be about $10k for a typical day. Some days those hygienist have assistants who cut the time to work on patients half.... smart set-up to generate more $$$ for the office (and ultimately for the owner).

    90% of the successful offices I have seen have great management (doctors with great business skills). These dentists mastered the art of customer (patient) service, they have excellent communication skills, they make every patient feel like he/she is the only patient they have. These doctors also keep their staff happy (give them professional courtesy deals- discounted treatments for the staff and their families). As a result, the office functions to its fullest potential, the office markets itself through patients, and so on.

    Bottom line, every dentist is one step away from being rich. That is... being business savvy.
     
  22. Lesley

    Lesley Member
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    No, I was not making the argument that you can use hygiene, "To get patients in the door." I was proposing an explanation why some dentists on Dentaltown are saying they make very little off their hygiene production. Their intention is unknown to you or I.

    Regarding the comment by another poster about the dentist that makes $1000/crown, as we do, we, she, make that amount because we do not participate with PPO's, HMO's and capitation, with the exception of Delta Dental. If we did, if they did, we would not be getting $1000/crown. The secret of this success is simply to not participate with crappy plans. It's very simple.
     
  23. albany11

    albany11 Member
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  24. albany11

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    I disagree, it can be done but it's Not easy. You can only produce if you have the patients and if they accept your treatment and show.
    dentistry is expensive and many cannot afford or don't care
    they are stingy when it comes to dentistry. they expect free work
     
  25. Cold Front

    Cold Front Supreme Member
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  26. docj1

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  27. albany11

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  28. DrJeff

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  29. Dental916

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  30. DrJeff

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  31. OceanDMD

    OceanDMD Rather be fishing
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  32. DrJeff

    DrJeff Senior Member
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  33. hafido

    hafido Member
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    Regarding salary, I have always had a question about the numbers being kicked around. The average salary of $188k from the ADA is a pre-tax average is it not(gross)? Also, what is the rate of tax at this bracket?
     
  34. Lesley

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  35. docj1

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