Experience - First five years out of school

[vasco]

I was an avid SDN reader and lurker in the application process, and a little bit while in dental school. In school I always wished that more dentists would get on a share their experiences in the “real world”. This is an attempt to do so. I’m a terrible writer so please forgive the poorly worded remarks.

I would like to share the career path and financial aspects of my first 5 years as a practicing dentist.

Dental School: I graduated from Case Western in 09. Graduated a notch or two above average. Graduated with 310 in total debt and accrued interest from the four years of school.

Upon graduation I took a job with a corporate company. I did this to make more money right out of school and to see as many patients as I could.

Job offer. 132k per year. Medical Insurance, mal practice insurance, 2 weeks paid vacation, disability insurance all covered. 32% collections.

First 6 Months 2009

Right out of school the first six months I was overwhelmed. Learning how to treatment plan was difficult, learning how to work out of multiple rooms was very difficult. Building up speed was difficult. The first six months was by far the hardest to date. I worked an average of 30 hours a week.

I was paid 73,000 for June – December.

Year One: 2010

Everything got better in year one. I learned more complex procedures, learned how to communicate better with patients, speed increased, and so did my happiness. Still with the same corporate company. I worked an average of 36 hours a week.

This year I made 286k: I made more money this year because I worked more hours. For a few months I worked 5 days a week.

Year Two: 2011

I did a startup for the corporate company. This gave me invaluable experience into starting up a practice. I learned much about practice management and leadership. This education was priceless to me professionally.

I made 230k. I worked an average of 33 hours a week. I made less due to the decreased patient flow from the start up.

Year three: 2012

I made 260k. Still at the same corporate company doing the start up. Made more money this year because the practice grew. Expanded my procedural mix through CE.

Year four: 2013

I made 320k: Still at the same corporate company in the startup office. My record for income to this point. I made more money because I worked an average of 40 hours a week and the practice got busier. In this year clinical dentistry and practice management really began to click.

Year Five: 2014

I made 330. This was a big year for me. I finally left the corporate office and purchased my first dental practice. I purchased an existing dental office. The reason why I left the corporate office is because I felt like I had a good handle on clinical dentistry and practice management. Half of the year I worked at the corporate job and the other half was at my new practice. The practice that I purchased is doing very well. I’m so much happier now. More control brings happiness.

School debt:

I graduated with 310k in school debt. I lived very frugally for the first four years. I was able to pay off all the debt in those first four years. The debt was noxious to me. I hated it. Many of my peers disagreed with my aggressive repayment schedule…but I didn’t care. I wanted it gone. It weighed on me daily. When I at last had it paid off, I felt such relief. I still feel the relief to this day. While the debt was crippling for the first four years, it was manageable. Even though I was aggressively paying down the debt on a yearly basis, I was still able to put a down payment on a house and contribute 15k+ to charity every year.

Practical advice for dental students:

Many people talk and debate how much money a dentist can make. The stark reality is that it depends more on the dentist then the location or the office. Below are listed some of the qualities of the most productive dentists (productive = more money + happiness) I have met. Some were associates and some were owners; however, they shared the following characteristics in common:


a. Great at communication:

i. They love to communicate and make patients feel good. They get excited by working with people.

ii. They are confident and effective treatment planners. When they treatment plan with patients their confidence in their work and their accuracy of their diagnosis can be felt by the patient. Example: There is a patient in for an emergency exam. Tooth 19 has severe caries into the pulpal chamber. I’ve seen a non-confident dentist walk into the room and explain the options for keeping the tooth with a rct/bu/crown, or taking the tooth out. After listening to the doctor, the patient decides to have the tooth taken out. Non-confident doctor attempts to explain to the patient why it’s important to keep the tooth and why taking it out would be a mistake. Patient still desires to have it removed. Subsequently a more confident dentist better at communication, went into the same room and portrayed the exact same information in a more confident way, the patient accepted the treatment for the rct/bu/crown. This happens all of the time. Being able to treatment plan with confidence makes a significant difference in dentistry for you and for the patient.

iii. Great communicators get excellent word of mouth referrals. Your schedule will be busy with referrals from patients who love you.

b. Take excellent CE courses that expand their skill set.

i. The most productive dentists that I know have invested much into CE. They are comfortable doing complicated endo, they do orthodontics, they do surgeries, and they place implants. They all learned these things through great CE.

c. Work ethic:

i. The most productive dentists that I know love to work. They love to be busy. They gobble up exams and thrive on doing as much as they can in a day. They don’t like sitting around. I’ve worked with dentists who don’t like to be busy and shy away from doing extra procedures. These dentists consistently produce less dentistry and always complain about money.

d. High quality work:

i. The most productive dentists do high quality work. If you don’t….then patients come back with future problems and your schedule gets bogged down with re-dos. Re-makes will drive you nuts and decrease your productivity.

e. Take great care of the staff:

i. It doesn’t matter if you are an associate or an owner. The way you take care of your staff helps determine how productive you are.

1. If you staff respects and loves your patients will notice. The patients will feel more comfortable with you as their dentist.

2. As soon as you leave the room after an exam, one of the first things the patient does is ask the assistant or hygienist their opinion of your treatment plan. If you assistant or hygienist is on your side then they boost you up in the eyes of the patient and solidify your treatment plan. Example: You walk out of a room and a patient says, “wow, I didn’t know that I had any cavities. Last time I went to the dentist, they said I was fine.” If the assistant is on your side they would say something like “I can understand your surprise. But Dr. X is 100 percent right, just like he showed you on your x-ray you most certainly do have cavities. The great news is that Dr. X is the most amazing gentle dentist in the area. You are going to love working with him. An assistant who isn’t on your side would either say nothing or steer them towards not getting work done. Its sounds trivial…but makes a massive difference.

3. Even as an associate you can have the staff on your side. Sometime more than the owner.


Dentistry is a great field. It is very rewarding and challenging in many ways. The debt load can be managed properly with a decent income and through a frugal fiscal approach to life. Those of you in school look at some of the above productive dentist characteristics. If you have any of those characteristics then life as a dentist can be very productive for you. If you don’t have those characteristics, then you have a few years to start working on them.

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[Syphilis]

Where did you work? In Ohio? Urban or Rural?

 

[bing12]

also, what corporation did you work for? what did you like/dislike about this particular corporation.

thank you

 

[tooth knockn]

I was an avid SDN reader and lurker in the application process, and a little bit while in dental school. In school I always wished that more dentists would get on a share their experiences in the “real world”. This is an attempt to do so. I’m a terrible writer so please forgive the poorly worded remarks.

I would like to share the career path and financial aspects of my first 5 years as a practicing dentist.

Dental School: I graduated from Case Western in 09. Graduated a notch or two above average. Graduated with 310 in total debt and accrued interest from the four years of school.

Upon graduation I took a job with a corporate company. I did this to make more money right out of school and to see as many patients as I could.

Job offer. 132k per year. Medical Insurance, mal practice insurance, 2 weeks paid vacation, disability insurance all covered. 32% collections.

First 6 Months 2009

Right out of school the first six months I was overwhelmed. Learning how to treatment plan was difficult, learning how to work out of multiple rooms was very difficult. Building up speed was difficult. The first six months was by far the hardest to date. I worked an average of 30 hours a week.

I was paid 73,000 for June – December.

Year One: 2010

Everything got better in year one. I learned more complex procedures, learned how to communicate better with patients, speed increased, and so did my happiness. Still with the same corporate company. I worked an average of 36 hours a week.

This year I made 286k: I made more money this year because I worked more hours. For a few months I worked 5 days a week.

Year Two: 2011

I did a startup for the corporate company. This gave me invaluable experience into starting up a practice. I learned much about practice management and leadership. This education was priceless to me professionally.

I made 230k. I worked an average of 33 hours a week. I made less due to the decreased patient flow from the start up.

Year three: 2012

I made 260k. Still at the same corporate company doing the start up. Made more money this year because the practice grew. Expanded my procedural mix through CE.

Year four: 2013

I made 320k: Still at the same corporate company in the startup office. My record for income to this point. I made more money because I worked an average of 40 hours a week and the practice got busier. In this year clinical dentistry and practice management really began to click.

Year Five: 2014

I made 330. This was a big year for me. I finally left the corporate office and purchased my first dental practice. I purchased an existing dental office. The reason why I left the corporate office is because I felt like I had a good handle on clinical dentistry and practice management. Half of the year I worked at the corporate job and the other half was at my new practice. The practice that I purchased is doing very well. I’m so much happier now. More control brings happiness.

School debt:

I graduated with 310k in school debt. I lived very frugally for the first four years. I was able to pay off all the debt in those first four years. The debt was noxious to me. I hated it. Many of my peers disagreed with my aggressive repayment schedule…but I didn’t care. I wanted it gone. It weighed on me daily. When I at last had it paid off, I felt such relief. I still feel the relief to this day. While the debt was crippling for the first four years, it was manageable. Even though I was aggressively paying down the debt on a yearly basis, I was still able to put a down payment on a house and contribute 15k+ to charity every year.

Practical advice for dental students:

Many people talk and debate how much money a dentist can make. The stark reality is that it depends more on the dentist then the location or the office. Below are listed some of the qualities of the most productive dentists (productive = more money + happiness) I have met. Some were associates and some were owners; however, they shared the following characteristics in common:


a. Great at communication:

i. They love to communicate and make patients feel good. They get excited by working with people.

ii. They are confident and effective treatment planners. When they treatment plan with patients their confidence in their work and their accuracy of their diagnosis can be felt by the patient. Example: There is a patient in for an emergency exam. Tooth 19 has severe caries into the pulpal chamber. I’ve seen a non-confident dentist walk into the room and explain the options for keeping the tooth with a rct/bu/crown, or taking the tooth out. After listening to the doctor, the patient decides to have the tooth taken out. Non-confident doctor attempts to explain to the patient why it’s important to keep the tooth and why taking it out would be a mistake. Patient still desires to have it removed. Subsequently a more confident dentist better at communication, went into the same room and portrayed the exact same information in a more confident way, the patient accepted the treatment for the rct/bu/crown. This happens all of the time. Being able to treatment plan with confidence makes a significant difference in dentistry for you and for the patient.

iii. Great communicators get excellent word of mouth referrals. Your schedule will be busy with referrals from patients who love you.

b. Take excellent CE courses that expand their skill set.

i. The most productive dentists that I know have invested much into CE. They are comfortable doing complicated endo, they do orthodontics, they do surgeries, and they place implants. They all learned these things through great CE.

c. Work ethic:

i. The most productive dentists that I know love to work. They love to be busy. They gobble up exams and thrive on doing as much as they can in a day. They don’t like sitting around. I’ve worked with dentists who don’t like to be busy and shy away from doing extra procedures. These dentists consistently produce less dentistry and always complain about money.

d. High quality work:

i. The most productive dentists do high quality work. If you don’t….then patients come back with future problems and your schedule gets bogged down with re-dos. Re-makes will drive you nuts and decrease your productivity.

e. Take great care of the staff:

i. It doesn’t matter if you are an associate or an owner. The way you take care of your staff helps determine how productive you are.

1. If you staff respects and loves your patients will notice. The patients will feel more comfortable with you as their dentist.

2. As soon as you leave the room after an exam, one of the first things the patient does is ask the assistant or hygienist their opinion of your treatment plan. If you assistant or hygienist is on your side then they boost you up in the eyes of the patient and solidify your treatment plan. Example: You walk out of a room and a patient says, “wow, I didn’t know that I had any cavities. Last time I went to the dentist, they said I was fine.” If the assistant is on your side they would say something like “I can understand your surprise. But Dr. X is 100 percent right, just like he showed you on your x-ray you most certainly do have cavities. The great news is that Dr. X is the most amazing gentle dentist in the area. You are going to love working with him. An assistant who isn’t on your side would either say nothing or steer them towards not getting work done. Its sounds trivial…but makes a massive difference.

3. Even as an associate you can have the staff on your side. Sometime more than the owner.


Dentistry is a great field. It is very rewarding and challenging in many ways. The debt load can be managed properly with a decent income and through a frugal fiscal approach to life. Those of you in school look at some of the above productive dentist characteristics. If you have any of those characteristics then life as a dentist can be very productive for you. If you don’t have those characteristics, then you have a few years to start working on them.

Well written....

Very informative and descriptive....

I give it a 9 out of 10


Congratulations to you being debt free....


How old were you? When you graduated?


Thank you for this insight of post dental school

 

[vasco]

Where did you work? In Ohio? Urban or Rural?

I worked in NC. It was in a metropolitan area of around 300k+ people.

 

[vasco]

also, what corporation did you work for? what did you like/dislike about this particular corporation.

thank you

I worked for a company called Dental One. It was good enough to keep me there for many years. No one ever put pressure on me to do dentistry differently then I wanted. I was in control of that. Wasn't always in control of who they hired or fired. That drove me nuts some times. It was a good way for me to learn dentistry, and "practice" running an office before I was ready on my own. The lack of control and the fact that I was making money for someone else were the biggest dislikes for me.

 

[vasco]

Well written....

Very informative and descriptive....

I give it a 9 out of 10


Congratulations to you being debt free....


How old were you? When you graduated?


Thank you for this insight of post dental school

thank you and you are welcome. I graduated dental school just under 30 years old.

 

[Longbone]

I was an avid SDN reader and lurker in the application process, and a little bit while in dental school. In school I always wished that more dentists would get on a share their experiences in the “real world”. This is an attempt to do so. I’m a terrible writer so please forgive the poorly worded remarks.

I would like to share the career path and financial aspects of my first 5 years as a practicing dentist.

Dental School: I graduated from Case Western in 09. Graduated a notch or two above average. Graduated with 310 in total debt and accrued interest from the four years of school.

Upon graduation I took a job with a corporate company. I did this to make more money right out of school and to see as many patients as I could.

Job offer. 132k per year. Medical Insurance, mal practice insurance, 2 weeks paid vacation, disability insurance all covered. 32% collections.

First 6 Months 2009

Right out of school the first six months I was overwhelmed. Learning how to treatment plan was difficult, learning how to work out of multiple rooms was very difficult. Building up speed was difficult. The first six months was by far the hardest to date. I worked an average of 30 hours a week.

I was paid 73,000 for June – December.

Year One: 2010

Everything got better in year one. I learned more complex procedures, learned how to communicate better with patients, speed increased, and so did my happiness. Still with the same corporate company. I worked an average of 36 hours a week.

This year I made 286k: I made more money this year because I worked more hours. For a few months I worked 5 days a week.

Year Two: 2011

I did a startup for the corporate company. This gave me invaluable experience into starting up a practice. I learned much about practice management and leadership. This education was priceless to me professionally.

I made 230k. I worked an average of 33 hours a week. I made less due to the decreased patient flow from the start up.

Year three: 2012

I made 260k. Still at the same corporate company doing the start up. Made more money this year because the practice grew. Expanded my procedural mix through CE.

Year four: 2013

I made 320k: Still at the same corporate company in the startup office. My record for income to this point. I made more money because I worked an average of 40 hours a week and the practice got busier. In this year clinical dentistry and practice management really began to click.

Year Five: 2014

I made 330. This was a big year for me. I finally left the corporate office and purchased my first dental practice. I purchased an existing dental office. The reason why I left the corporate office is because I felt like I had a good handle on clinical dentistry and practice management. Half of the year I worked at the corporate job and the other half was at my new practice. The practice that I purchased is doing very well. I’m so much happier now. More control brings happiness.

School debt:

I graduated with 310k in school debt. I lived very frugally for the first four years. I was able to pay off all the debt in those first four years. The debt was noxious to me. I hated it. Many of my peers disagreed with my aggressive repayment schedule…but I didn’t care. I wanted it gone. It weighed on me daily. When I at last had it paid off, I felt such relief. I still feel the relief to this day. While the debt was crippling for the first four years, it was manageable. Even though I was aggressively paying down the debt on a yearly basis, I was still able to put a down payment on a house and contribute 15k+ to charity every year.

Practical advice for dental students:

Many people talk and debate how much money a dentist can make. The stark reality is that it depends more on the dentist then the location or the office. Below are listed some of the qualities of the most productive dentists (productive = more money + happiness) I have met. Some were associates and some were owners; however, they shared the following characteristics in common:


a. Great at communication:

i. They love to communicate and make patients feel good. They get excited by working with people.

ii. They are confident and effective treatment planners. When they treatment plan with patients their confidence in their work and their accuracy of their diagnosis can be felt by the patient. Example: There is a patient in for an emergency exam. Tooth 19 has severe caries into the pulpal chamber. I’ve seen a non-confident dentist walk into the room and explain the options for keeping the tooth with a rct/bu/crown, or taking the tooth out. After listening to the doctor, the patient decides to have the tooth taken out. Non-confident doctor attempts to explain to the patient why it’s important to keep the tooth and why taking it out would be a mistake. Patient still desires to have it removed. Subsequently a more confident dentist better at communication, went into the same room and portrayed the exact same information in a more confident way, the patient accepted the treatment for the rct/bu/crown. This happens all of the time. Being able to treatment plan with confidence makes a significant difference in dentistry for you and for the patient.

iii. Great communicators get excellent word of mouth referrals. Your schedule will be busy with referrals from patients who love you.

b. Take excellent CE courses that expand their skill set.

i. The most productive dentists that I know have invested much into CE. They are comfortable doing complicated endo, they do orthodontics, they do surgeries, and they place implants. They all learned these things through great CE.

c. Work ethic:

i. The most productive dentists that I know love to work. They love to be busy. They gobble up exams and thrive on doing as much as they can in a day. They don’t like sitting around. I’ve worked with dentists who don’t like to be busy and shy away from doing extra procedures. These dentists consistently produce less dentistry and always complain about money.

d. High quality work:

i. The most productive dentists do high quality work. If you don’t….then patients come back with future problems and your schedule gets bogged down with re-dos. Re-makes will drive you nuts and decrease your productivity.

e. Take great care of the staff:

i. It doesn’t matter if you are an associate or an owner. The way you take care of your staff helps determine how productive you are.

1. If you staff respects and loves your patients will notice. The patients will feel more comfortable with you as their dentist.

2. As soon as you leave the room after an exam, one of the first things the patient does is ask the assistant or hygienist their opinion of your treatment plan. If you assistant or hygienist is on your side then they boost you up in the eyes of the patient and solidify your treatment plan. Example: You walk out of a room and a patient says, “wow, I didn’t know that I had any cavities. Last time I went to the dentist, they said I was fine.” If the assistant is on your side they would say something like “I can understand your surprise. But Dr. X is 100 percent right, just like he showed you on your x-ray you most certainly do have cavities. The great news is that Dr. X is the most amazing gentle dentist in the area. You are going to love working with him. An assistant who isn’t on your side would either say nothing or steer them towards not getting work done. Its sounds trivial…but makes a massive difference.

3. Even as an associate you can have the staff on your side. Sometime more than the owner.


Dentistry is a great field. It is very rewarding and challenging in many ways. The debt load can be managed properly with a decent income and through a frugal fiscal approach to life. Those of you in school look at some of the above productive dentist characteristics. If you have any of those characteristics then life as a dentist can be very productive for you. If you don’t have those characteristics, then you have a few years to start working on them.

For year 5, is the $330K income after or before practice debt service? Also, will you be as aggressive with your practice debt as you were with your student debt?

 

[THS]

What changes have you made to the practice since purchasing it? Staff changes? Decor? Equipment? Fee schedule? Were you able to add procedures that the selling doc did not do? What is your overhead?

It's always nice when SDNers stick around long after they've gotten in to their desired school. Thanks for this write-up, this will be an interesting thread to follow.

 

[cacajuate]

For year 5, is the $330K income after or before practice debt service? Also, will you be as aggressive with your practice debt as you were with your student debt?

I'd guess before practice debt. Why would he tell you his income minus all of his debts? Doesn't really make sense.

 

[kenny878]

This post is excellent. Thank you very much!

 

[Longbone]

I'd guess before practice debt. Why would he tell you his income minus all of his debts? Doesn't really make sense.

I am not asking his income minus ALL his debts, just the practice debt which is a cost associated with making the income. I am curious to know to better compare the transition from corporate practice the year before making 320K to owning a practice and making the 330K (with associated practice debt). I think its a fair question.

 

[jeffk805dent]

Well written post (I think you went to hard on yourself regarding writing skills, they are as good as any skilled lawyer's writing skills). Good to hear you got rid o your debt.

Only thing I would disagree with is location. Some places have a large number of low income patients and therefore rely on insurance to pay for dental services (which means you have to do a LOT of hours to make a lot of money). Plus competition with other dentists in cities means patients are at liberty to choose who they want to go to, and there are likely to be a good number of nice patient-friendly efficient dentists around.

Even with that disagreement on location being not important, I give your post a 10/10

 

[The Incisor]

Very well written post! Thank you! I'm getting ready to start dental school in the Fall and I'm glad that you came back to share your tips and experience with us.

 

[Incis0r]

Thank you for sharing, @vasco . How does your success relate to that of your classmates? Would you consider your success to be the norm or the outlier?

 

[Miley Cyrus.]

How are your classmates from dental school doing? Are they struggling?

Thanks for the post.

 

[vasco]

For year 5, is the $330K income after or before practice debt service? Also, will you be as aggressive with your practice debt as you were with your student debt?

That is a good question. It can get confusing when dentists talk numbers. 330k is what was left for me after my practice note was paid. On paper it showed that I made over 400k. But I don't count that for myself because I never saw that money.

Its a 10 year note for the practice and I plan on paying it off quicker then that. I would like to have it paid off in less then 5 years. That would be great.

 

[vasco]

What changes have you made to the practice since purchasing it? Staff changes? Decor? Equipment? Fee schedule? Were you able to add procedures that the selling doc did not do? What is your overhead?

It's always nice when SDNers stick around long after they've gotten in to their desired school. Thanks for this write-up, this will be an interesting thread to follow.

You're welcome.

I purchased a failing practice. So the first thing that I did was cut the dead weight. He was very overstaffed and they were very well compensated. I fired some people within the first week. I let a couple dentists go as well. He was an absentee owner and I needed room for myself to practice. Gave the practice a face lift. Got some new equipment for the dental side that i had gotten used to (omnicam, implant set up, endo equipment, intra-oral cameras, Nomad, patient education software). Left the fee schedule alone. The previous doc didn't do any molar endo, implants or ortho. So i was able to add those procedures.

The overhead when I purchased the office was 92 (high due to him being an absentee owner)%. I now have it down to 65% with the note for the practice and the omnicam included in that.

 

[vasco]

Thank you for sharing, @vasco . How does your success relate to that of your classmates? Would you consider your success to be the norm or the outlier?

Hard to measure myself to all of my classmates. I keep in touch with four of them.

1) has been making 400+ for the past few years. He is in corporate in AZ . He works for aspen

2) One owns a private practice in AZ. He just purchased it last year and it ramping things up. My guess is he probably takes home less then 200k due to the start up. He made right around 200k a year for the past few years at aspen dental before he left to do a startup.

3) One is an endodontist in Ohio and does 300k -350k depending on the year.

4) One is an associate in group practice out in WA. He does 220-250 depending on the year.

 

[bjpenn]

Dentist here. I've been trying to find a good practice to buy. ? Why not buy a practice with a healthy cash flow instead of a failing practice? Can you recommend some implant/ortho/endo CE?

 

[punchdrunk7]

Great thread and congrats on the success @vasco

 

[Incis0r]

Hard to measure myself to all of my classmates. I keep in touch with four of them.

1) has been making 400+ for the past few years. He is in corporate in AZ . He works for aspen

2) One owns a private practice in AZ. He just purchased it last year and it ramping things up. My guess is he probably takes home less then 200k due to the start up. He made right around 200k a year for the past few years at aspen dental before he left to do a startup.

3) One is an endodontist in Ohio and does 300k -350k depending on the year.

4) One is an associate in group practice out in WA. He does 220-250 depending on the year.

Do you recommend an AEGD or should new grads launch straight into corporate to gain speed and comfort with various procedures?

Is corporate the best way to start the career? How about community health centers (which pay less but can come coupled with nontaxable loan repayment and don't have a pressure to produce)?

CE-wise, have you gone to Scott leune's course or to dental maverick? Any other recommendations during DS?

 

[dentheartthrob]

I was an avid SDN reader and lurker in the application process, and a little bit while in dental school. In school I always wished that more dentists would get on a share their experiences in the “real world”. This is an attempt to do so. I’m a terrible writer so please forgive the poorly worded remarks.

I would like to share the career path and financial aspects of my first 5 years as a practicing dentist.

Dental School: I graduated from Case Western in 09. Graduated a notch or two above average. Graduated with 310 in total debt and accrued interest from the four years of school.

Upon graduation I took a job with a corporate company. I did this to make more money right out of school and to see as many patients as I could.

Job offer. 132k per year. Medical Insurance, mal practice insurance, 2 weeks paid vacation, disability insurance all covered. 32% collections.

First 6 Months 2009

Right out of school the first six months I was overwhelmed. Learning how to treatment plan was difficult, learning how to work out of multiple rooms was very difficult. Building up speed was difficult. The first six months was by far the hardest to date. I worked an average of 30 hours a week.

I was paid 73,000 for June – December.

Year One: 2010

Everything got better in year one. I learned more complex procedures, learned how to communicate better with patients, speed increased, and so did my happiness. Still with the same corporate company. I worked an average of 36 hours a week.

This year I made 286k: I made more money this year because I worked more hours. For a few months I worked 5 days a week.

Year Two: 2011

I did a startup for the corporate company. This gave me invaluable experience into starting up a practice. I learned much about practice management and leadership. This education was priceless to me professionally.

I made 230k. I worked an average of 33 hours a week. I made less due to the decreased patient flow from the start up.

Year three: 2012

I made 260k. Still at the same corporate company doing the start up. Made more money this year because the practice grew. Expanded my procedural mix through CE.

Year four: 2013

I made 320k: Still at the same corporate company in the startup office. My record for income to this point. I made more money because I worked an average of 40 hours a week and the practice got busier. In this year clinical dentistry and practice management really began to click.

Year Five: 2014

I made 330. This was a big year for me. I finally left the corporate office and purchased my first dental practice. I purchased an existing dental office. The reason why I left the corporate office is because I felt like I had a good handle on clinical dentistry and practice management. Half of the year I worked at the corporate job and the other half was at my new practice. The practice that I purchased is doing very well. I’m so much happier now. More control brings happiness.

School debt:

I graduated with 310k in school debt. I lived very frugally for the first four years. I was able to pay off all the debt in those first four years. The debt was noxious to me. I hated it. Many of my peers disagreed with my aggressive repayment schedule…but I didn’t care. I wanted it gone. It weighed on me daily. When I at last had it paid off, I felt such relief. I still feel the relief to this day. While the debt was crippling for the first four years, it was manageable. Even though I was aggressively paying down the debt on a yearly basis, I was still able to put a down payment on a house and contribute 15k+ to charity every year.

Practical advice for dental students:

Many people talk and debate how much money a dentist can make. The stark reality is that it depends more on the dentist then the location or the office. Below are listed some of the qualities of the most productive dentists (productive = more money + happiness) I have met. Some were associates and some were owners; however, they shared the following characteristics in common:


a. Great at communication:

i. They love to communicate and make patients feel good. They get excited by working with people.

ii. They are confident and effective treatment planners. When they treatment plan with patients their confidence in their work and their accuracy of their diagnosis can be felt by the patient. Example: There is a patient in for an emergency exam. Tooth 19 has severe caries into the pulpal chamber. I’ve seen a non-confident dentist walk into the room and explain the options for keeping the tooth with a rct/bu/crown, or taking the tooth out. After listening to the doctor, the patient decides to have the tooth taken out. Non-confident doctor attempts to explain to the patient why it’s important to keep the tooth and why taking it out would be a mistake. Patient still desires to have it removed. Subsequently a more confident dentist better at communication, went into the same room and portrayed the exact same information in a more confident way, the patient accepted the treatment for the rct/bu/crown. This happens all of the time. Being able to treatment plan with confidence makes a significant difference in dentistry for you and for the patient.

iii. Great communicators get excellent word of mouth referrals. Your schedule will be busy with referrals from patients who love you.

b. Take excellent CE courses that expand their skill set.

i. The most productive dentists that I know have invested much into CE. They are comfortable doing complicated endo, they do orthodontics, they do surgeries, and they place implants. They all learned these things through great CE.

c. Work ethic:

i. The most productive dentists that I know love to work. They love to be busy. They gobble up exams and thrive on doing as much as they can in a day. They don’t like sitting around. I’ve worked with dentists who don’t like to be busy and shy away from doing extra procedures. These dentists consistently produce less dentistry and always complain about money.

d. High quality work:

i. The most productive dentists do high quality work. If you don’t….then patients come back with future problems and your schedule gets bogged down with re-dos. Re-makes will drive you nuts and decrease your productivity.

e. Take great care of the staff:

i. It doesn’t matter if you are an associate or an owner. The way you take care of your staff helps determine how productive you are.

1. If you staff respects and loves your patients will notice. The patients will feel more comfortable with you as their dentist.

2. As soon as you leave the room after an exam, one of the first things the patient does is ask the assistant or hygienist their opinion of your treatment plan. If you assistant or hygienist is on your side then they boost you up in the eyes of the patient and solidify your treatment plan. Example: You walk out of a room and a patient says, “wow, I didn’t know that I had any cavities. Last time I went to the dentist, they said I was fine.” If the assistant is on your side they would say something like “I can understand your surprise. But Dr. X is 100 percent right, just like he showed you on your x-ray you most certainly do have cavities. The great news is that Dr. X is the most amazing gentle dentist in the area. You are going to love working with him. An assistant who isn’t on your side would either say nothing or steer them towards not getting work done. Its sounds trivial…but makes a massive difference.

3. Even as an associate you can have the staff on your side. Sometime more than the owner.


Dentistry is a great field. It is very rewarding and challenging in many ways. The debt load can be managed properly with a decent income and through a frugal fiscal approach to life. Those of you in school look at some of the above productive dentist characteristics. If you have any of those characteristics then life as a dentist can be very productive for you. If you don’t have those characteristics, then you have a few years to start working on them.

Were you an associate at the start up or were you also managing, how does it work if you don't mind me asking? I'm only on my second year at a corporate office here Nor Cal and I'm projecting the same numbers you posted on your second year as well but this is from 40 hour work week with the occasional 6 days a week schedule-as an associate. And I'm considered one of the top 3 producer in the region in regards to being a G.P.

 

[joiedevivre86]

Really cool thread OP, thanks for doing this! What is your average production per day or per week, what is the hygiene production, and how does that compare to when you were at the corporate office? Do you have any issues with neck/back/hand pain and how do you deal with it? What's the hardest non-dental part of running a practice?

 

[gn4]

nice thread...thanks for coming back to tell us your experience. If you don't mind us asking, did you take any CE courses on practice management?

 

[deadragonz]

Dentist here. I've been trying to find a good practice to buy. ? Why not buy a practice with a healthy cash flow instead of a failing practice? Can you recommend some implant/ortho/endo CE?

I could think of a couple reasons: 1) It would be very hard to find/expensive to purchase & 2) Why would anyone sell a thriving business with a healthy cash flow.

 

[bjpenn]

I could think of a couple reasons: 1) It would be very hard to find/expensive to purchase & 2) Why would anyone sell a thriving business with a healthy cash flow.

Yea but he was making good money with dental one without any headache.

 

[yeslek88]

You're welcome.

I purchased a failing practice. So the first thing that I did was cut the dead weight. He was very overstaffed and they were very well compensated. I fired some people within the first week. I let a couple dentists go as well. He was an absentee owner and I needed room for myself to practice. Gave the practice a face lift. Got some new equipment for the dental side that i had gotten used to (omnicam, implant set up, endo equipment, intra-oral cameras, Nomad, patient education software). Left the fee schedule alone. The previous doc didn't do any molar endo, implants or ortho. So i was able to add those procedures.

The overhead when I purchased the office was 92 (high due to him being an absentee owner)%. I now have it down to 65% with the note for the practice and the omnicam included in that.

If you don't mind my asking, how did you go about selecting the practice that you would purchase? Why did you select one that was failing, and what made you confident that you could turn it around?

 

[yeslek88]

I could think of a couple reasons: 1) It would be very hard to find/expensive to purchase & 2) Why would anyone sell a thriving business with a healthy cash flow.

This is true. Especially in the years following the economic downturn, I would imagine few successful practices would be for sale. Perhaps they will in the upcoming years as more people feel comfortable retiring.

 

[vasco]

Dentist here. I've been trying to find a good practice to buy. ? Why not buy a practice with a healthy cash flow instead of a failing practice? Can you recommend some implant/ortho/endo CE?

1) There are many ways to evaluate practices to purchase. I've seen dentists lean towards purchasing a proven practice and I've seen dentists go after the under performing. I personally wanted to purchase a practice that was under performing of which I was confident I could drastically improve year one. A scenario like this presents the buyer with a lower purchase point, and generally speaking a greater ROI.

 

[vasco]

Do you recommend an AEGD or should new grads launch straight into corporate to gain speed and comfort with various procedures?

Is corporate the best way to start the career? How about community health centers (which pay less but can come coupled with nontaxable loan repayment and don't have a pressure to produce)?

CE-wise, have you gone to Scott leune's course or to dental maverick? Any other recommendations during DS?

I would most certainly recommend a GPR or AEGD. Go to one that teaches advanced procedures, IV sedation, impacted 3rds removal, complicated endo, ortho, general surguries, and surgical and restorative aspects of implantology. In retrospect I wish I had done one.

I haven't done the Leune's or the maverick course but I hear great things about them. Any of those CE would be a great starting point even as a dental student. But to be honest....most of the things they cover won't really click until you've been out a few years. But they would start the foundation for the future.

 

[vasco]

Were you an associate at the start up or were you also managing, how does it work if you don't mind me asking? I'm only on my second year at a corporate office here Nor Cal and I'm projecting the same numbers you posted on your second year as well but this is from 40 hour work week with the occasional 6 days a week schedule-as an associate. And I'm considered one of the top 3 producer in the region in regards to being a G.P.

I was just an associate during the start up for the corporate company. I knew that one day I would own my own practice; therefore, I learned as much as I could and helped out when possible. I fired and hired people, corrected staff, held motivational staff meetings. I didn't have to do those things; however, I used it as my chance to practice before going "live" in the future.

Sounds like you are doing great at your job. Keep up the good work! Is practicing in Cali as bad as they say?

 

[bjpenn]

what was percentage of gross revenue did you purchase the practice for?

can you recommend any implant/ortho/endo ce?

 

[bjpenn]

what was percentage of gross revenue did you purchase the practice for? what percentage of patients left after you acquired the practice?

can you recommend any implant/ortho/endo ce?

 

[vasco]

Really cool thread OP, thanks for doing this! What is your average production per day or per week, what is the hygiene production, and how does that compare to when you were at the corporate office? Do you have any issues with neck/back/hand pain and how do you deal with it? What's the hardest non-dental part of running a practice?

Your welcome. I do about 20-25k a week. Its about the same as when I was in corporate.

I just started to get back pain. I get a massage every other week and it takes all the pain away. Practicing great ergonomics is very important while you are working.

The hardest part for me is letting people go.

 

[vasco]

nice thread...thanks for coming back to tell us your experience. If you don't mind us asking, did you take any CE courses on practice management?

No CE courses on practice management, but I did get my undergraduate in business management with an emphasis on finance. I find both of those very useful.

 

[vasco]

If you don't mind my asking, how did you go about selecting the practice that you would purchase? Why did you select one that was failing, and what made you confident that you could turn it around?

I was looking specifically for a practice that was under performing. I had talked to the main practice brokers for the area and let them all know what I was looking for. I was also working with the local reps as well. It took me a year of looking to find the right one.

I personally wanted to find an under performing practice so that I could get a cheaper selling price and a larger ROI on the back end. I was confident that I could turn it around once i met the selling doc. That sealed the deal. He was a great dentist but hated making the hard decision needed to run a business.

 

[vasco]

what was percentage of gross revenue did you purchase the practice for?

can you recommend any implant/ortho/endo ce?

70% of the net collections. Bucannan has great endo CE, ortho tip edge, I did a local implant CE. Most of them teach the same things. Key is to get hands on experience with someone over your shoulder guiding you.

 

[tooth knockn]

What are the negative things you see in dentistry ?

What do you hear about New York dentistry?

Any dental specialty losing its steam?

 

[bjpenn]

Can you describe the practice you bought? How many chairs ? Digital ? How many staff? any associates ? How many active patients ? How many patients did you lose/gain after the sale? How was the transition? How long did the doctor stay on ?

 

[BrazilianRider]

Well, I'm gonna be coming out of school with (hopefully) around $320-$330k in debt, so you really helped calm my nerves

 

[dentheartthrob]

I was just an associate during the start up for the corporate company. I knew that one day I would own my own practice; therefore, I learned as much as I could and helped out when possible. I fired and hired people, corrected staff, held motivational staff meetings. I didn't have to do those things; however, I used it as my chance to practice before going "live" in the future.

Sounds like you are doing great at your job. Keep up the good work! Is practicing in Cali as bad as they say?

Thanks! I'm just surpirsed you were able to reach the 300k mark with the hours you've mentioned. I guess each company has their own ways of calculating their incentives. To answer your question, I'd say it's pretty much bottoms down to location and the comfort of doing bread and butter procedures.

 

[Incis0r]

Well, I'm gonna be coming out of school with (hopefully) around $320-$330k in debt, so you really helped calm my nerves

Hot damn. Good luck man. Judging from your communication skills though, I know you won't have any problems with explaining TX to patients/getting a high case acceptance rate.

@vasco I'm considering the HPSP- Think that would set me back?

 

[DentalDoge]

Hot damn. Good luck man. Judging from your communication skills though, I know you won't have any problems with explaining TX to patients/getting a high case acceptance rate.

@vasco I'm considering the HPSP- Think that would set me back?

Ive been thinking about this alot. And Im going to assume yes.

During your pay back pretty sure you earn your pay grade, which is around 60k as an O-3. You get a bit more if you get promoted. You do that for 4 years, not really gaining any business experience but tons of exclusive military experiences.

At year 4 @vasco has already accrue lots of business and leadership experiences and making 300k+. That's alot of momentum.

 

[Incis0r]

Ive been thinking about this alot. And Im going to assume yes.

During your pay back pretty sure you earn your pay grade, which is around 60k as an O-3. You get a bit more if you get promoted. You do that for 4 years, not really gaining any business experience but tons of exclusive military experiences.

At year 4 @vasco has already accrue lots of business and leadership experiences and making 300k+. That's alot of momentum.

This helps Dentaldoge. Thank you. I still get the feeling that Vasco is more of an outlier than the norm though. For the last ten months on this board, I have repeatedly read the message to not to expect to set the world on fire in your first few years out while you develop your skills. It's somewhat hard to resolve this general message and Vasco's astonishing success unless we see Vasco as an exception (and rightfully so, as his been demonstrated by his/her excellent work ethic, intelligence, and ambition).

 

[jmh018]

Ive been thinking about this alot. And Im going to assume yes.

During your pay back pretty sure you earn your pay grade, which is around 60k as an O-3. You get a bit more if you get promoted. You do that for 4 years, not really gaining any business experience but tons of exclusive military experiences.

At year 4 @vasco has already accrue lots of business and leadership experiences and making 300k+. That's alot of momentum.

You get a bonus for being a health care professional too. It comes to around $90,000 plus or minus a little depending on where you live. In my opinion that's a decent amount considering you also have no debt/health care costs. If you think about it, if you would have $300,000 in student loans without the scholarship, you would have to pay $75,000 a year to pay those off in 4 years not even including interest. So it's like you are paid an extra $75,000 per year in addition to the $90,000. You also have to apply to an AEGD too which is great experience.

 

[vasco]

What are the negative things you see in dentistry ?

What do you hear about New York dentistry?

Any dental specialty losing its steam?

Negative things in dentistry that I see....

1) You have to work with people. Some people just suck. They suck the life out of everyone and the entire practice feels it. If you don't like working with all types of people....dentistry will bleed you dry.
2) High school debt
3) Generally speaking to make a lot of money in dentistry you need to do a lot of dentistry. That can take a toll during the day. Especially as an associate.

I don't have any knowledge on dentistry in NY

Not sure about the specialties either. But I will tell you this. I was brain washed at my dental school regarding specialties. They indoctrinated us into believing that the only way to make big money in dentistry you had to be a specialist. The big money lies with GPs who own and operate multiple dental offices.

 

[vasco]

Can you describe the practice you bought? How many chairs ? Digital ? How many staff? any associates ? How many active patients ? How many patients did you lose/gain after the sale? How was the transition? How long did the doctor stay on ?

1) Large insurance office. Hardly any fee for service. Around 20 or so staff including dentists. There were 3 associates when I purchased it. Not sure how many patients we lost. I imagine a few. We have increase the new patient flow dramatically since I took over ownership. Transition was rough for me. Took a solid two months before I started liking my new gig. I didn't want the owner to stay. He was an absentee owner so it wasn't a big deal.

 

[vasco]

Well, I'm gonna be coming out of school with (hopefully) around $320-$330k in debt, so you really helped calm my nerves

That is still a lot of debt. It will haunt you. Make sure you manage it well, and if you have a high income and low expenses you can knock it out relatively quickly. The debt that we take on as dental students puts us significantly behind the rest of our peers. I still feel behind some of my friends because of the debt I had to pay off. I think about how much I could have done with the 310 that I paid off in student loans if I did something else with the money.

 

[vasco]

Hot damn. Good luck man. Judging from your communication skills though, I know you won't have any problems with explaining TX to patients/getting a high case acceptance rate.

@vasco I'm considering the HPSP- Think that would set me back?

Possibly. I have many friends who are in the military. From a financial standpoint it is very attractive. The biggest part of the financial package to me is that you will not be accruing interest in school or when you get out. I paid so much extra money in interest it was crazy.

I have friends in the army that only place amalgam restorations. They are amazing at it; however, they are not allowed to do endo and they send out their crowns to civilian dentists. They are behind from a clinical stand point and from a practice management standpoint. They complain constantly about how little control they have and how their assistants get to boss them around. I have four friends who tell me these stories. Keep in mind that they are all at the same post. I'm sure there are amazing army jobs out there with the exact opposite experience.

I also have three friends from the air force. They came out with all the skills needed to start practice right away. Implants, complicated 3rd removal and complicated endo.

So the answer could be yes or no! Thats the scary part.