Entrepreneurial dental residents game plan re student loans

[Noah Littell]

Food for thought- how would you think a GP/ortho/perio/endo/pedo resident looking to own a practice at some point post associating would triage their debt as opposed to a resident planning to associate with no desire to be an owner..

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[Saddleshoes]

Food for thought- how would you think a GP/ortho/perio/endo/pedo resident looking to own a practice at some point post associating would triage their debt as opposed to a resident planning to associate with no desire to be an owner..

Noah
I don't understand the term "Triage thier debt". Can you explain, please?

 

[Noah Littell]

Noah
I don't understand the term "Triage thier debt". Can you explain, please?

Of course.. in terms of “do I pay down the loans as fast as possible or do I need to build up a war chest to seize on practice ownership opportunities”. Often their is a permutation of this based on your specific goals and realistic time frames etc. much more too it, but that’s a glimpse into concepts you may want to start thinking about

 

[321931]

Food for thought- how would you think a GP/ortho/perio/endo/pedo resident looking to own a practice at some point post associating would triage their debt as opposed to a resident planning to associate with no desire to be an owner..

I would say that GP/Ortho/Perio/Endo/Pedo would basically factor in their student loans into their cash flow prospectus in practice ownership in order to pay it all off along with their house/living/practice loan.

As opposed to a associate no desire to be an owner?

They just waddle through life and say I'll pay IBR, everything will be fine in the end, and I'll figure out the tax bomb at the end of my career.

See the difference between the two is that one guy will have a plan and a actual roadmap to paying off everything within 10 years and the other will just chill and let the debt accumulate and not get ahead.

If you never have a plan or gameplan- you will never get ahead in life. If you say you are going to run a marathon one day...and just go to the gym and do a few exercises and run around a bit...you might do it in a 3-5 years (when you feel like it sorta deal) and prob have a crappy time. But if you have a plan, wake up at 4:30 run 5 miles, eat right, go after work to run more and stick with it- you will run a marathon in 6 months and do well at it.

That's the difference.

 

[Noah Littell]

I would say that GP/Ortho/Perio/Endo/Pedo would basically factor in their student loans into their cash flow prospectus in practice ownership in order to pay it all off along with their house/living/practice loan.

As opposed to a associate no desire to be an owner?

They just waddle through life and say I'll pay IBR, everything will be fine in the end, and I'll figure out the tax bomb at the end of my career.

See the difference between the two is that one guy will have a plan and a actual roadmap to paying off everything within 10 years and the other will just chill and let the debt accumulate and not get ahead.

If you never have a plan or gameplan- you will never get ahead in life. If you say you are going to run a marathon one day...and just go to the gym and do a few exercises and run around a bit...you might do it in a 3-5 years (when you feel like it sorta deal) and prob have a crappy time. But if you have a plan, wake up at 4:30 run 5 miles, eat right, go after work to run more and stick with it- you will run a marathon in 6 months and do well at it.

That's the difference.

Spot on.. but a few subtleties you may have overlooked in terms of how having that extra cash on hand instead of paying down the loans may fuel the acceleration of your new practice early on..

 

[321931]

Spot on.. but a few subtleties you may have overlooked in terms of how having that extra cash on hand instead of paying down the loans may fuel the acceleration of your new practice early on..

Of course- you have to always weigh everything. I slowed down my extra payments to my practice loan because I'm renovating and that should bring in more cash in the future.

Not all gameplans are solid, just have to adapt as you go. But the bottom line is the owner will have a generalized plan, while the associate will most likely not. You can't run a business on a whim.

It just makes no sense to me why some of my friends chill at associateships...when if they really put their mind to it could develop a gameplan to be debt free..house...practice..student loans within 10-15 years with a good practice purchase. But I guess we don't see that til later in life when we are 50 and worrying about a 300k tax bomb, trying to save for retirement, trying to pay off a house, and the kids expenses.

 

[321931]

Of course.. in terms of “do I pay down the loans as fast as possible or do I need to build up a war chest to seize on practice ownership opportunities”. Often their is a permutation of this based on your specific goals and realistic time frames etc. much more too it, but that’s a glimpse into concepts you may want to start thinking about

In my opinion- you get the most experience and then seize practice ownership opportunities. Forget about paying down loans as fast as possible as an associate. It's a waste of time. The best thing you can do is get experience, and then find a well producing practice that cash flows well in order to pay off everything within 5-10 years. At the end of 10 years, you have practice equity, loans paid off, and freedom. The ownership route in a well producing practice will dwarf any associate income. That's why saving/paying off loans as fast as possible as an associate is pretty negligible in the beginning. Plus lets say you did do the pay everything off associate route- at the end of 10 years- you have no equity, probably no maxed out 401k, and prob no house/savings. It's rough to pay off everything associating 10 years with a large student loan tab.

Banks will loan you money. Dentistry is one of the safest investments for any banker. The only hiccup you may run into obtaining a bank loan is if you overleveredged with a big house, large amount of student loans, and other frivilous debt like a bmw car payment on top of it all...in that case...well stick with associating because managing money isn't what you are good at.

 

[Noah Littell]

Of course.. in terms of “do I pay down the loans as fast as possible or do I need to build up a war chest to seize on practice ownership opportunities”. Often their is a permutation of this based on your specific goals and realistic time frames etc. much more too it, but that’s a glimpse into concepts you may want to start thinking about

Allow me to further explain to be more helpful.. a practice loan will cover buying or starting a practice. Reason you may like to have built up savings is if you start a practice you’d likely be initially spending a day and a half to two days and the rest associating to cover your overhead while your practice slowly grows organically. With excess savings, your more likely to take the advice of your dental specific advisor when he says to take half or one day off a week from associating (lose that per diem) and go market yourself to GP, pediatricians, events etc. without a cushion and savings going to loans, you may be less inclined to lose the per diem to do that, which would accelerate the trajectory of your practice faster and be the engine that repays your loans. Hope that rambling makes some sense!

 

[321931]

Allow me to further explain to be more helpful.. a practice loan will cover buying or starting a practice. Reason you may like to have built up savings is if you start a practice you’d likely be initially spending a day and a half to two days and the rest associating to cover your overhead while your practice slowly grows organically. With excess savings, your more likely to take the advice of your dental specific advisor when he says to take half or one day off a week from associating (lose that per diem) and go market yourself to GP, pediatricians, events etc. without a cushion and savings going to loans, you may be less inclined to lose the per diem to do that, which would accelerate the trajectory of your practice faster and be the engine that repays your loans. Hope that rambling makes some sense!

Starting a practice really is a shot in the dark- and yes- you best believe you better have some savings for some slower months- and or if the practice just doesn't come online til year 2-3.

That being said, buying a well producing practice and maintaining the course basically means instant cash flow injection and never having to dip into savings. I never was on the ropes with my first few years. Instead we actually grew the practice 10%. Boom. Even better.

So yes, I do agree that having some savings built up as a nest egg is wise- especially with a startup. But with a good cash flow practice- it's honestly not necessary as you can take out working capital "to use" as savings. Just my 2 cents.

Nice bouncing around ideas, you seem to know your stuff.

 

[Noah Littell]

Starting a practice really is a shot in the dark- and yes- you best believe you better have some savings for some slower months- and or if the practice just doesn't come online til year 2-3.

That being said, buying a well producing practice and maintaining the course basically means instant cash flow injection and never having to dip into savings. I never was on the ropes with my first few years. Instead we actually grew the practice 10%. Boom. Even better.

So yes, I do agree that having some savings built up as a nest egg is wise- especially with a startup. But with a good cash flow practice- it's honestly not necessary as you can take out working capital "to use" as savings. Just my 2 cents.

Nice bouncing around ideas, you seem to know your stuff.

Starting a practice really is a shot in the dark- and yes- you best believe you better have some savings for some slower months- and or if the practice just doesn't come online til year 2-3.

That being said, buying a well producing practice and maintaining the course basically means instant cash flow injection and never having to dip into savings. I never was on the ropes with my first few years. Instead we actually grew the practice 10%. Boom. Even better.

So yes, I do agree that having some savings built up as a nest egg is wise- especially with a startup. But with a good cash flow practice- it's honestly not necessary as you can take out working capital "to use" as savings. Just my 2 cents.

Nice bouncing around ideas, you seem to know your stuff.

We have a wide vantage point from working with dentists for so long. So we are able to bring some hindsight to those just getting their feet (or fingers) wet.

 

[Screwtape]

I would say that GP/Ortho/Perio/Endo/Pedo would basically factor in their student loans into their cash flow prospectus in practice ownership in order to pay it all off along with their house/living/practice loan.

As opposed to a associate no desire to be an owner?

They just waddle through life and say I'll pay IBR, everything will be fine in the end, and I'll figure out the tax bomb at the end of my career.

See the difference between the two is that one guy will have a plan and a actual roadmap to paying off everything within 10 years and the other will just chill and let the debt accumulate and not get ahead.

If you never have a plan or gameplan- you will never get ahead in life. If you say you are going to run a marathon one day...and just go to the gym and do a few exercises and run around a bit...you might do it in a 3-5 years (when you feel like it sorta deal) and prob have a crappy time. But if you have a plan, wake up at 4:30 run 5 miles, eat right, go after work to run more and stick with it- you will run a marathon in 6 months and do well at it.

That's the difference.

It seems you have a very limited view of dental associateships. Some pay well enough that the associate can be debt free in 5-10 years no problem. These are honestly not that rare either... And with no risk of failure, no headaches of staffing/running a business, and the ability to move across the country or state whenever you want. I personally plan on owning soon (I’ve been out 2 years), but I definitely have considered staying an associate for the flexibility and less headaches.

 

[2TH MVR]

Outliers exist in any situation. The Corp ortho I replaced worked 6 days a week and was starting 5-6 new ortho patients every day. If I extrapolated from what I make on my best producing weeks .... this ortho was making as much, if not more than I was at my peak in private practice. I'm sure the same could be said for outlier associateships, outlier partnerships and outlier private practice.

But a bell curve has two sides to it. Even before Corps became mainstream .... the many private GP practices I was familiar with were doing ok, but not necessarily outlier stuff.

That said ..... owning a private practice should always be the end goal for a new, young dentist. This is a no brainer. There's no future in associateships with no partnership or ownership potential .... or working Corp.

Ask the wealthy. Wealth is not built on being an employee, but on having equity, stock options, and vesting in your own dental practice.

There is still time for private practice in this generation, but ..... the clock is ticking as the dental model is changing towards retail.

 

[Screwtape]

Outliers exist in any situation. The Corp ortho I replaced worked 6 days a week and was starting 5-6 new ortho patients every day. If I extrapolated from what I make on my best producing weeks .... this ortho was making as much, if not more than I was at my peak in private practice. I'm sure the same could be said for outlier associateships, outlier partnerships and outlier private practice.

But a bell curve has two sides to it. Even before Corps became mainstream .... the many private GP practices I was familiar with were doing ok, but not necessarily outlier stuff.

That said ..... owning a private practice should always be the end goal for a new, young dentist. This is a no brainer. There's no future in associateships with no partnership or ownership potential .... or working Corp.

Ask the wealthy. Wealth is not built on being an employee, but on having equity, stock options, and vesting in your own dental practice.

There is still time for private practice in this generation, but ..... the clock is ticking as the dental model is changing towards retail.

I am playing a little devil’s advocate here since I do want to own, BUT the bolded statement only applies if potential income is what the dentist desires most. There are many positives and negatives of being an associate, and the same for being an owner. Everyone has their own preferences so no, owning a private practice should not be the end goal for every new dentist grad. That totally depends on what they want out of life and their career.

 

[321931]

I am playing a little devil’s advocate here since I do want to own, BUT the bolded statement only applies if potential income is what the dentist desires most. There are many positives and negatives of being an associate, and the same for being an owner. Everyone has their own preferences so no, owning a private practice should not be the end goal for every new dentist grad. That totally depends on what they want out of life and their career.

I would play devils advocate and say that money isn't really the only thing. It's about living to. I have 5 weeks off this year...I took off specific times because I can. Being your own boss you can do whatever you want. Family event, function, marriage, kids soccer game. I leave early when I need to, come in later when I want to, take off as much as I want. My next longer vacation is July 3- 8th. You best believe that as an associate- they would want me working 3, 5, 8. Sometimes I just block out Thursday afternoon and go home early. That kind of flexibility as an owner- you can't put a number to. As an associate- you have to produce. I agree though yes you do have a point that you have no responsibilities as an associate and can live life on a whim- and that technically is living to.

The freedom associated with being your own boss...once you do it- it's very very hard to go back to employee later. When you become an owner as you stated- you will understand.

 

[Screwtape]

I would play devils advocate and say that money isn't really the only thing. It's about living to. I have 5 weeks off this year...I took off specific times because I can. Being your own boss you can do whatever you want. Family event, function, marriage, kids soccer game. I leave early when I need to, come in later when I want to, take off as much as I want. My next longer vacation is July 3- 8th. You best believe that as an associate- they would want me working 3, 5, 8. Sometimes I just block out Thursday afternoon and go home early. That kind of flexibility as an owner- you can't put a number to. As an associate- you have to produce. I agree though yes you do have a point that you have no responsibilities as an associate and can live life on a whim- and that technically is living to.

The freedom associated with being your own boss...once you do it- it's very very hard to go back to employee later. When you become an owner as you stated- you will understand.

Are you a solo owner ? What does your staff do when you go on vacation? Do they also get 5 weeks of vacation then too? Do they really want that much vacation- not everyone makes a dentist’s hourly rate ? Are they paid during the days you leave early because you feel like it ? I have 3 weeks vacation as an associate and can take them whenever I like. The office keeps producing since I’m not the only dentist there and the owner and staff is still happy. We are closed all major holidays and peri-holidays like you too. Not all owners who have associates are slave drivers like you portray them. A smart owner values a good associate and wants to keep them long-term and acts accordingly. Some owners work a lot more than me (I’m 4 days a week) some less. Some make more than me, some less. It’s more about the position, the practice, and the person than owner vs associate. But we both know that, I think.

 

[TanMan]

I would play devils advocate and say that money isn't really the only thing. It's about living to. I have 5 weeks off this year...I took off specific times because I can. Being your own boss you can do whatever you want. Family event, function, marriage, kids soccer game. I leave early when I need to, come in later when I want to, take off as much as I want. My next longer vacation is July 3- 8th. You best believe that as an associate- they would want me working 3, 5, 8. Sometimes I just block out Thursday afternoon and go home early. That kind of flexibility as an owner- you can't put a number to. As an associate- you have to produce. I agree though yes you do have a point that you have no responsibilities as an associate and can live life on a whim- and that technically is living to.

The freedom associated with being your own boss...once you do it- it's very very hard to go back to employee later. When you become an owner as you stated- you will understand.

Lucky. It is definitely nice to be able to take that much time off. I feel like even after a week of vacation, I am rusty from doing dentistry. Do you have heavy days (i.e friday or saturday) that you feel bad taking off due to consistently high production on a specific day? It sucks to lose 10k+/day from being off. I have that guilt that I'm losing a good amount of money not working on a specific day.

You're right that freedom as an owner is the best feeling ever. Not just in flexibility of days, but also how you run the office.

Are you a solo owner ? What does your staff do when you go on vacation? Do they also get 5 weeks of vacation then too? Do they really want that much vacation- not everyone makes a dentist’s hourly rate ? Are they paid during the days you leave early because you feel like it ? I have 3 weeks vacation as an associate and can take them whenever I like. The office keeps producing since I’m not the only dentist there and the owner and staff is still happy. We are closed all major holidays and peri-holidays like you too. Not all owners who have associates are slave drivers like you portray them. A smart owner values a good associate and wants to keep them long-term and acts accordingly. Some owners work a lot more than me (I’m 4 days a week) some less. Some make more than me, some less. It’s more about the position, the practice, and the person than owner vs associate. But we both know that, I think.

If your priority is maximum income, own a practice (or chain). Being an associate for life works if you are content in what you're doing with less regard for the financial aspect and prefer not to deal with the administrative aspect. However, you forgo the financial benefits of practice ownership and not being a slave to dentistry for a lot longer period of time. There's plenty of terrible owners of dental practices and maybe you got lucky with your associateship.

How long have you been an associate that your current office? Sometimes, there's a honeymoon period or antagonistic period in the beginning.

 

[Screwtape]

Lucky. It is definitely nice to be able to take that much time off. I feel like even after a week of vacation, I am rusty from doing dentistry. Do you have heavy days (i.e friday or saturday) that you feel bad taking off due to consistently high production on a specific day? It sucks to lose 10k+/day from being off. I have that guilt that I'm losing a good amount of money not working on a specific day.

You're right that freedom as an owner is the best feeling ever. Not just in flexibility of days, but also how you run the office.



If your priority is maximum income, own a practice (or chain). Being an associate for life works if you are content in what you're doing with less regard for the financial aspect and prefer not to deal with the administrative aspect. However, you forgo the financial benefits of practice ownership and not being a slave to dentistry for a lot longer period of time. There's plenty of terrible owners of dental practices and maybe you got lucky with your associateship.

How long have you been an associate that your current office? Sometimes, there's a honeymoon period or antagonistic period in the beginning.

I agree with you all the way. Different priorities in life mean different paths of personal success in dentistry. That’s all I’ve been trying to say here. And I actually do want to own myself, hopefully in about 2 years or so. I’ve been at my associateship for 1 year, the other year I was in a GPR. My boss owns several practices and no longer practices so I have a lot of freedom being the “head dentist” at my office.

 

[2TH MVR]

I am playing a little devil’s advocate here since I do want to own, BUT the bolded statement only applies if potential income is what the dentist desires most. There are many positives and negatives of being an associate, and the same for being an owner. Everyone has their own preferences so no, owning a private practice should not be the end goal for every new dentist grad. That totally depends on what they want out of life and their career.

Agreed. Again .... I practiced in an era where almost EVERYONE owned a private practice. You're still young and what you're doing is fine. You've got time. Under "most" situations ..... you will be better off with your own practice. Again .... I preface in the right location. But like you said .... there's more to life than $$$. There's freedom.

True that as a practice owner .... you get to take as much time off as you want. But it does come with a price (lost production, vacation pay for staff, ongoing expenses, etc. etc.). What someone like @Rainee isn't telling you is that owning your practice will take MORE of your time that you can imagine. I've was the 1st to get to the office and the last to leave. I spent many sats at the office working on stuff. Spent many off days meeting with IT people, maintenance, financial accts, financialadvisors, etc. etc. etc. The countless hours dealing with insurance premiums for the building, leaseholds, business car, etc. etc. Dealing with staff. There are times it feels like EVERYONE has their hand out for your money. You will spend MORE of your free time in your own practice. But it will be worth it in the long run.

I work Corp now because the private practice routine gets old after awhile. I have more free time now than I ever had in private practice. But I'm also in my late 50's. But no way I would have been a longterm associate or Corp employee for the entirety of my career.

 

[321931]

Are you a solo owner ? What does your staff do when you go on vacation? Do they also get 5 weeks of vacation then too? Do they really want that much vacation- not everyone makes a dentist’s hourly rate ? Are they paid during the days you leave early because you feel like it ? I have 3 weeks vacation as an associate and can take them whenever I like. The office keeps producing since I’m not the only dentist there and the owner and staff is still happy. We are closed all major holidays and peri-holidays like you too. Not all owners who have associates are slave drivers like you portray them. A smart owner values a good associate and wants to keep them long-term and acts accordingly. Some owners work a lot more than me (I’m 4 days a week) some less. Some make more than me, some less. It’s more about the position, the practice, and the person than owner vs associate. But we both know that, I think.

1) Solo,
2) Staff get between 3-4 weeks vacation depending on length of employment. If staff wants to come in and do stuff to get a paycheck- I allow them to come in and do the mail/post checks. If the staff need money- they do temp work. There's always a need for temp hygienist/assistant. Ironically- when they come back from their temp jobs at some random corp clinic- they are very thankful for a chill private practice.
3) I structure the majority of vacation on school holidays, labor day, spring break, memorial day, july 4th, thanksgiving, christmas. They do like it because they get to spend time with kids/grandkids.
4) Yes of course, they are still working when I leave early.
5) It's good that you have a decent associate. My first associateship worked in HMO 4 man clinic- was given all the worst paying insurances while owner would cherry pick the big cases. Lasted 6 months. Second associateship relegated to hygienist and 18/31 DB amalgam specialist while the owner cherry picked all the easy cases. Lasted 3 months. Third associateship worked like you solo in an absentee owner office. Owner let me do anything- and it was nice. Was paid 25% collections, until she friended me on FB/instagram...and saw literally every month she was traveling to Europe/Asia/Carribean and was invited to the house for Christmas....it wasn't a house it was a mansion. I realized that literally- all those vacations were on my dime. I was like huh...where is she getting all this time and money...then I realized I was the one drilling and doing all the hard labour while she would just pay the bills. I got to know how absentee offices were ran, the profit loss of ownership, and I was like wow now it makes sense how she goes on vacations. Anyways That's when I got hungry for ownership.

Lucky. It is definitely nice to be able to take that much time off. I feel like even after a week of vacation, I am rusty from doing dentistry. Do you have heavy days (i.e friday or saturday) that you feel bad taking off due to consistently high production on a specific day? It sucks to lose 10k+/day from being off. I have that guilt that I'm losing a good amount of money not working on a specific day.

You're right that freedom as an owner is the best feeling ever. Not just in flexibility of days, but also how you run the office.

I had two-three weeks off last year. I I know that every week I have off, I lose about 30k production. It's a big number. Over the course- that's alot of money lost. But you know what, the biggest blessing of dentistry is being able to be your own boss and call your own shots. I have many patients that work in Tech. 40...50...60 hour work weeks and traveling all the time...they wish they had time off. You know how it is, you see patients that were one day standing, and the next recall they are disabled, in an accident, cancer, or even death....at a young at like 50. The most recent passing was a young lady that was killed in a car accident at 24. Point is, you are given an opportunity to make a good living, help people, call the shots, and also to enjoy the money that you make. So yes accumulating more and more money is nice, -but you only have one life- so it's nicer to take time off and experience life. At the age of 30... I realize that literally half my life could be over. So enjoy everyday like your last and do the most good you can everyday.

With all that being said- even taking 5 weeks off- an owner is still light years in terms of income compared to associate. That's the true cherry on top.

Anyways, I am watching the economy pretty heavily. If there is a downturn- I would like to buy building, and or expand- hire associates and quit actually working dentistry- become an absentee owner. Makes no sense to expand right now when everything is peaking. Just my opinion.

True that as a practice owner .... you get to take as much time off as you want. But it does come with a price (lost production, vacation pay for staff, ongoing expenses, etc. etc.). What someone like @Rainee isn't telling you is that owning your practice will take MORE of your time that you can imagine. I've was the 1st to get to the office and the last to leave. I spent many sats at the office working on stuff. Spent many off days meeting with IT people, maintenance, financial accts, financialadvisors, etc. etc. etc. The countless hours dealing with insurance premiums for the building, leaseholds, business car, etc. etc. Dealing with staff. There are times it feels like EVERYONE has their hand out for your money. You will spend MORE of your free time in your own practice. But it will be worth it in the long run.

I totally agree, but it comes with the territory. But at the same time, its a marathon- not a sprint. Open the mail- pay the bills right away- file it away. If I get an insurance premium- I take care of it in between patients. IT in between patients. I also have an accountant that audits and takes care of my books every month. Yes that is costly- but makes my life easier. Anyways- If you just shove everything to the side and look at your phone- then yes it will compound and you will be sitting on Fridays doing paperwork and cursing. I would say the 1st to get into office/last to leave is not to true here. I would say that having a very very very competant staff will make or break your private practice. My staff is top notch- and yes I pay the 99.99% in pay but they do such a good job that it uncomplicates my life- that you will have more free time in your own practice then associating. But if you have worthless staff, yes that will break your practice and make you wish you were associating. I remember a few December’s ago... I had to let go of two front for incompetence... that was a rough month. Lotta sleepless nights and crappy temps... but January came and found two rockstars.

Anyways, hope that gives some insight. I know some posters here that knew me back then- I was always the first to say dentistry sucks...but I actually love my job now. Best wishes to your future practice Screwtape.

 

[Screwtape]

1) Solo,
2) Staff get between 3-4 weeks vacation depending on length of employment. If staff wants to come in and do stuff to get a paycheck- I allow them to come in and do the mail/post checks. If the staff need money- they do temp work. There's always a need for temp hygienist/assistant. Ironically- when they come back from their temp jobs at some random corp clinic- they are very thankful for a chill private practice.
3) I structure the majority of vacation on school holidays, labor day, spring break, memorial day, july 4th, thanksgiving, christmas. They do like it because they get to spend time with kids/grandkids.
4) Yes of course, they are still working when I leave early.
5) It's good that you have a decent associate. My first associateship worked in HMO 4 man clinic- was given all the worst paying insurances while owner would cherry pick the big cases. Lasted 6 months. Second associateship relegated to hygienist and 18/31 DB amalgam specialist while the owner cherry picked all the easy cases. Lasted 3 months. Third associateship worked like you solo in an absentee owner office. Owner let me do anything- and it was nice. Was paid 25% collections, until she friended me on FB/instagram...and saw literally every month she was traveling to Europe/Asia/Carribean and was invited to the house for Christmas....it wasn't a house it was a mansion. I realized that literally- all those vacations were on my dime. I was like huh...where is she getting all this time and money...then I realized I was the one drilling and doing all the hard labour while she would just pay the bills. I got to know how absentee offices were ran, the profit loss of ownership, and I was like wow now it makes sense how she goes on vacations. Anyways That's when I got hungry for ownership.



I had two-three weeks off last year. I I know that every week I have off, I lose about 30k production. It's a big number. Over the course- that's alot of money lost. But you know what, the biggest blessing of dentistry is being able to be your own boss and call your own shots. I have many patients that work in Tech. 40...50...60 hour work weeks and traveling all the time...they wish they had time off. You know how it is, you see patients that were one day standing, and the next recall they are disabled, in an accident, cancer, or even death....at a young at like 50. The most recent passing was a young lady that was killed in a car accident at 24. Point is, you are given an opportunity to make a good living, help people, call the shots, and also to enjoy the money that you make. So yes accumulating more and more money is nice, -but you only have one life- so it's nicer to take time off and experience life. At the age of 30... I realize that literally half my life could be over. So enjoy everyday like your last and do the most good you can everyday.

With all that being said- even taking 5 weeks off- an owner is still light years in terms of income compared to associate. That's the true cherry on top.

Anyways, I am watching the economy pretty heavily. If there is a downturn- I would like to buy building, and or expand- hire associates and quit actually working dentistry- become an absentee owner. Makes no sense to expand right now when everything is peaking. Just my opinion.


I totally agree, but it comes with the territory. But at the same time, its a marathon- not a sprint. Open the mail- pay the bills right away- file it away. If I get an insurance premium- I take care of it in between patients. IT in between patients. I also have an accountant that audits and takes care of my books every month. Yes that is costly- but makes my life easier. Anyways- If you just shove everything to the side and look at your phone- then yes it will compound and you will be sitting on Fridays doing paperwork and cursing. I would say the 1st to get into office/last to leave is not to true here. I would say that having a very very very competant staff will make or break your private practice. My staff is top notch- and yes I pay the 99.99% in pay but they do such a good job that it uncomplicates my life- that you will have more free time in your own practice then associating. But if you have worthless staff, yes that will break your practice and make you wish you were associating. I remember a few December’s ago... I had to let go of two front for incompetence... that was a rough month. Lotta sleepless nights and crappy temps... but January came and found two rockstars.

Anyways, hope that gives some insight. I know some posters here that knew me back then- I was always the first to say dentistry sucks...but I actually love my job now. Best wishes to your future practice Screwtape.

Staff definitely makes a world of difference, thanks for the insight and kind words !

 

[charlestweed]

I had two-three weeks off last year. I I know that every week I have off, I lose about 30k production. It's a big number. Over the course- that's alot of money lost.

That's indeed a lot of money. That's amount is equal to 20-25 monthly lease payments for a $100k car. I'd rather not take those days off and work hard so I can lease a car that I can enjoy everyday...instead of just a few days in a year. Having a self-driving car makes the daily commute less stressfull. With kids, I can't just take vacation anytime I want to. I can only take vacations during the summer, Xmas break, Spring break etc when the kids don't have school. Having had several of these long flight trips since they were little, my kids don't want to travel far anymore....I guess they've seen enough. Last summer, I gave them the choice of either going to Hawaii or a short roadtrip to the San Diego bay area and have fancy dinners at Ruth Chris, Flemmings + boba drinks afterward. My kids chose the latter. As long as the hotel has a nice pool and fast wifi, they are happy. We won't take any vacation this summer because they need to study for SAT, ACT, and AP exams. Since America is the best country that has given me everything, I become spoiled.....I don't want to travel poorer countries with inferior healthcare and safety system. The recent sad story of an American tourist who died in the Dominican Republic made me feel less safe about traveling abroad

 

[charlestweed]

I work Corp now because the private practice routine gets old after awhile. I have more free time now than I ever had in private practice. But I'm also in my late 50's. But no way I would have been a longterm associate or Corp employee for the entirety of my career.

My very first job after graduation was at a corp office. And I don't have any problem working for the corp for the rest of my practicing career. It's an easy job that pays very well. I think it's a huge loss for the new ortho grads who refuse to work for corp offices. With stable associate salaries at the corp, opening my own office from scratch was a lot less stressful. With stable pay from the P/T corp job, I worry less when my own offices have fewer new starts and don't produce much during the slow months from Sept to January. I can charge lower fees, I don't need to advertise, and I don't need to sell cases. I worry less when some of the referring GPs stop referring because they started doing ortho themselves.

 

[321931]

That's indeed a lot of money. That's amount is equal to 20-25 monthly lease payments for a $100k car. I'd rather not take those days off and work hard so I can lease a car that I can enjoy everyday...instead of just a few days in a year. Having a self-driving car makes the daily commute less stressfull. With kids, I can't just take vacation anytime I want to. I can only take vacations during the summer, Xmas break, Spring break etc when the kids don't have school. Having had several of these long flight trips since they were little, my kids don't want to travel far anymore....I guess they've seen enough. Last summer, I gave them the choice of either going to Hawaii or a short roadtrip to the San Diego bay area and have fancy dinners at Ruth Chris, Flemmings + boba drinks afterward. My kids chose the latter. As long as the hotel has a nice pool and fast wifi, they are happy. We won't take any vacation this summer because they need to study for SAT, ACT, and AP exams. Since America is the best country that has given me everything, I become spoiled.....I don't want to travel poorer countries with inferior healthcare and safety system. The recent sad story of an American tourist who died in the Dominican Republic made me feel less safe about traveling abroad

Yeah, I think when kids come along- which we are looking at in 1-2 years, I might change it up- and yes the production loss hurts- but for now, I just want to travel as much as possible with the wife and enjoy life. You only live once and when you don't have kids or pets- yet- you can sorta travel on a whim without guilt, worry, and also having to wonder who will baby sit the kids. We have Italy, Taiwan, Japan, New Zealand, and UK this year. Next year we have another list of places to go. All my friends that have kids told me to travel the world before you have one. All of them.

 

[2TH MVR]

Yeah, I think when kids come along- which we are looking at in 1-2 years, I might change it up- and yes the production loss hurts- but for now, I just want to travel as much as possible with the wife and enjoy life. You only live once and when you don't have kids or pets- yet- you can sorta travel on a whim without guilt, worry, and also having to wonder who will baby sit the kids. We have Italy, Taiwan, Japan, New Zealand, and UK this year. Next year we have another list of places to go. All my friends that have kids told me to travel the world before you have one. All of them.

Very wise. Enjoy your time now before your life becomes more complicated with kids and pets. Kids change everything ... in a good way ..... mostly 😉. My LAST child is off to college in a couple of months. My wife and I will be true empty nesters. We're hoping to do what you are doing now. Travel as a couple. Enjoy life as a twosome once more.

 

[charlestweed]

The pathway to become a dentist is quite long. By the time a person earns his/her DDS/DMD degree, he/she will be at least 26-27 yo....assuming that there is no gap year. It'll take another 2-3 years of school if one decides to specialize. And for those dentists who don't specialize, it'll take 2-3 years to work for someone else to gain the experience and to save enough $$$ to start own office. At 29-30, a female dentist should start thinking about having kid soon....to minimize the chance of having birth anomalies. You also wouldn't want to have kids at older age. It's not a good thing when you still have to worry around raising your teenage kid(s) when you are in your mid 50s, early 60s. A lot of people start having health problems after 50. I hope I can live long enough to see my kids earn their college diplomas, get married, and give me a lot of grandkids.

You can still have a lot of fun traveling with kids. When your kids have fun, you have fun. There are baby sitting services that send baby sitters to your hotel room to look after your kids. There are kid clubs/programs at most resorts and cruise ships that help entertain them.

 

[321931]

The pathway to become a dentist is quite long. By the time a person earns his/her DDS/DMD degree, he/she will be at least 26-27 yo....assuming that there is no gap year. It'll take another 2-3 years of school if one decides to specialize. And for those dentists who don't specialize, it'll take 2-3 years to work for someone else to gain the experience and to save enough $$$ to start own office. At 29-30, a female dentist should start thinking about having kid soon....to minimize the chance of having birth anomalies. You also wouldn't want to have kids at older age. It's not a good thing when you still have to worry around raising your teenage kid(s) when you are in your mid 50s, early 60s. A lot of people start having health problems after 50. I hope I can live long enough to see my kids earn their college diplomas, get married, and give me a lot of grandkids.

You can still have a lot of fun traveling with kids. When your kids have fun, you have fun. There are baby sitting services that send baby sitters to your hotel room to look after your kids. There are kid clubs/programs at most resorts and cruise ships that help entertain them.

Most def looking forward to kids...just trying to get some major life journeys out of the way before settling. Went cycling Italy in the Dolomites 50-100 miles a day. Can't beat that...also can't really do that with a 5 year old in tow. Anyhow, we just trying to get some youth goals out of the way before we settle on disney cruises with kids, and the like.

 

[AONLINE]

Anyways, hope that gives some insight. I know some posters here that knew me back then- I was always the first to say dentistry sucks...but I actually love my job now. Best wishes to your future practice Screwtape.

I knew you from back then. It sounds like you have found your niche in dentistry. That's really awesome, so congratulations Doc!

 

[321931]

30k/week is pretty good, wow. 1.5m if u only took 2 weeks off. . one or two s.d. above the mean.

With writeoffs and what not, its less as that is production- and not collections. Either way, everyone gets there eventually in owning a business. Some go on to open more practices and create a dental chain...wrap it up and sell it off as equity...some go on to absentee owner status...and some just stay solo and are happy that way. Some sooner and some later. Some never take the jump into ownership...and that's ok- however I do think with today's student loans...you have to jump into ownership sooner then later. Regardless, I think being self employed is one of the best jobs in the world- and one of the reasons why Dentistry is a great job.

 

[2TH MVR]

With writeoffs and what not, its less as that is production- and not collections. Either way, everyone gets there eventually in owning a business. Some go on to open more practices and create a dental chain...wrap it up and sell it off as equity...some go on to absentee owner status...and some just stay solo and are happy that way. Some sooner and some later. Some never take the jump into ownership...and that's ok- however I do think with today's student loans...you have to jump into ownership sooner then later. Regardless, I think being self employed is one of the best jobs in the world- and one of the reasons why Dentistry is a great job.

So what turned it around for you? Just 6-12 months ago .... your attitude was less than positive about dentistry.
Regardless .... pretty sure everyone likes this version of a happy Rainee.

 

[charlestweed]

So what turned it around for you? Just 6-12 months ago .... your attitude was less than positive about dentistry.
Regardless .... pretty sure everyone likes this version of a happy Rainee.

I think Rainee was just worried for the new grad dentists, who would be in much worse situation than what he has gone through such as higher student loan, oversaturation (due to openings of new dental schools), and insurance companies cutting payments etc.

ColdFront, who is another very successful dentist on this forum, doesn’t recommend dentistry either. He also thinks that it’s not worth borrowing $400-500k to become a dentist anymore and that there are better career options out there.

I have said positive things about dentistry, especially about ortho, because I am doing very well. But I am afraid that my son will not be as successful as I am if he chooses to become an ortho like me because I don’t think my son will be willing to do things that I am doing right now such as working for the corp, working for a GP, traveling to multiple offices, working on the weekends, low tech, low overhead, low treatment fees etc. I don’t mind mopping my own office’s floor, sterilizing the instruments, taking x rays and fixing things at the office. I actually feel good because I save money for not having to hire an extra assistant or having to pay a handyman. I don’t think my son can do these stuff….he doesn’t even know how to hold a hammer correctly. That’s why I want him to pursue medicine…..and dentistry as a backup plan. I hope I am wrong about my son.

 

[321931]

So what turned it around for you? Just 6-12 months ago .... your attitude was less than positive about dentistry.
Regardless .... pretty sure everyone likes this version of a happy Rainee.

What's to complain about, we literally live in the best country in the world. If you have traveled- which I'm you have- you understand that the U.S. really does have a plethora of opportunities where if you work hard- you are rewarded for it. Some people never have that opportunity in Indonesia...in Hong Kong...in Taiwan....even in Europe. The U.S. for what it is- is the best place in the world. On top of all that, you are given a degree that allows you to work for someone, to work for yourself as much as you want....as less as you want. Want to be an absentee owner and chill- do it! Want to be a solo owner and have a family practice seeing the same people for 30 years- do it! If you want to own multiple practices, build equity, sell it off and buy a lake house...do it! If you want to just work 1-2 days and have an associate do the grunt work while you take care of kids and travel- do it! Dentistry is one of the best degrees for being able to control your life and your schedule. It is either number 1 or number 2 small business in a sense- its very very very hard to fail at it. Restaurants operate at 5% margins. That's stressful. Dentistry operates from 30% margin to even 60+% margin.

You cannot beat those numbers. You are in the best country in the world, and have the best opportunities in a field that is thriving. Get your finances in order, get a plan together, and enjoy the ride.

With all the being said- life is short. Life is SHORT. Just this week, I had two patients one diagnosed stage 4 cancer at the age of 47...the other dead from a heart attack at 60 years old. Family called to cancel the appointments for future as he is dead.

So whats the turning point? Perspective, growth, maturity, and goals. Life is short. Make the most of it.

 

[beannaithe]

I didn't read the whole thread, but I would say build a war chest if you're thinking about ownership. Banks want to see cash in the bank and you'll also need a down payment and to pay advisors. You also want the emergency fund in case it takes some time for you to start seeing income from your practice (normal for a start-up.)

I'm likely a forever associate. Ownership just isn't for me. I would rather spend time with my kids and enjoy my life than worrying about my dental practice. I like getting my hands wet with doing treatment and talking to patients, but I don't like staff management, dealing with insurance companies, worrying about OH, etc.

And I agree that anymore I don't think dentistry is worth the investment. I think $250k is about the point where it stops being a decent investment and more of a problem. $450k-$500k is just basically buying a job that pays semi-well. I do quite well for a part-time and have a great work/life balance, but my loans were low by todays standards ($275k) and managable. Anything more than that is insane.