Experience - First five years out of school

[agent2362]

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.

It depends on where you are stationed and what you are interested in. I was at a large clinic with 20 military dentists, 2 periodontists, 2 endodontists, multiple 2 yr AEGD and an oral surgery program. I sharpened alot of my skills from fellow dentists on the basics and was able to take specialty days days from the periodontist for bone grafting, crown lengthening, esthetic crown lengthening, distal wedges ect. I also did endo with the endodontists and learned system B, and a couple different system aside from the wave 1 I learned in school. I spent 1 month rotation with the OMS program and worked on impacted molar extraction with the 2 AEGD dentist. I also went for a 1 week course for CEREC provided by the army and feel fairly proficient with producing 3-4 crowns or multiple bridges a day on the cerec machine. I didn't even go to a 1 year AEGD, but I feel that I received a comparable amount of information just working alongside specialist in the army. All this and I have only been in the army about 27 months and I'm getting out in 9 months. One glaring deficiency of my experience is the lack of implant related work in the military. Typically all the prosth, 2 yr AEGD, OMS and perio guys hog up all that work.

Ultimately I think it all comes down to personal motivation in the end if you want to keep learning. Plenty of lazy guys in the military haven't had an equal experience even though they work at the same clinics or the same base. If you have 400K of debt, it is the notable exception if you can pay it off in 3-4 years like we do in the military...and I rarely work a stressful day.

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[Incis0r]

It depends on where you are stationed and what you are interested in. I was at a large clinic with 20 military dentists, 2 periodontists, 2 endodontists, multiple 2 yr AEGD and an oral surgery program. I sharpened alot of my skills from fellow dentists on the basics and was able to take specialty days days from the periodontist for bone grafting, crown lengthening, esthetic crown lengthening, distal wedges ect. I also did endo with the endodontists and learned system B, and a couple different system aside from the wave 1 I learned in school. I spent 1 month rotation with the OMS program and worked on impacted molar extraction with the 2 AEGD dentist. I also went for a 1 week course for CEREC provided by the army and feel fairly proficient with producing 3-4 crowns or multiple bridges a day on the cerec machine. I didn't even go to a 1 year AEGD, but I feel that I received a comparable amount of information just working alongside specialist in the army. All this and I have only been in the army about 27 months and I'm getting out in 9 months. One glaring deficiency of my experience is the lack of implant related work in the military. Typically all the prosth, 2 yr AEGD, OMS and perio guys hog up all that work.

Ultimately I think it all comes down to personal motivation in the end if you want to keep learning. Plenty of lazy guys in the military haven't had an equal experience even though they work at the same clinics or the same base. If you have 400K of debt, it is the notable exception if you can pay it off in 3-4 years like we do in the military...and I rarely work a stressful day.

Hi there,

Thank you for this information!
A few more questions for you- can you please shed some light on them?:

1) What are "specialty days?" Are those just days when you can take a break from operative and book endo, OS, perio etc to keep your skills up? Is it hard to get these days?
2) What are your plans once you get out? Associate? Own?
3) Did you do a "Credentialing tour?" What was that like? Was it hard to get the OK to do specialty procedures since you hadn't done a 1-year? Or were you OK'd to do endo, OS, etc. as soon as you proved you could do it (how long did it take to prove this)?
4) Have you deployed yet? Is there any indication that you will, if you have not? Are you worried about being stop-lossed?
5) You mentioned you got to attend a week-long CEREC course. Did you use up some leave for that? How frequently do you get such CE opportunities?
6) Did you do a ton of endo and perio in school to make you confident enough with these procedures to not need an AEGD?
7) Are you looked down upon by senior officers because you didn't do an AEGD?
8) Have you considered moonlighting?

 

[matty675]

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.

Pay would be more along the lines of 90-95k, with about 25% of that being non-taxable. When you throw in free health insurance, no malpractice insurance costs, and 30 days paid vacation per year; that comes pretty close if not equal to what a new dentist going into private practice can expect to make right out of school. Statistics would indicate that Vasco is likely the exception, not the rule.

 

[shallsen]

Pay would be more along the lines of 90-95k, with about 25% of that being non-taxable. When you throw in free health insurance, no malpractice insurance costs, and 30 days paid vacation per year; that comes pretty close if not equal to what a new dentist going into private practice can expect to make right out of school. Statistics would indicate that Vasco is likely the exception, not the rule.

Why is 25% tax free?

 

[Incis0r]

Why is 25% tax free?

The BAH and BAS are non-taxable.
Also, if you contribute to tax-deferred retirement vehicles, that further reduces your taxable income.

 

[matty675]

Exactly. And depending on location BAH/BAS will be around 25k annually.

 

[agent2362]

Hi there,

Thank you for this information!
A few more questions for you- can you please shed some light on them?:

1) What are "specialty days?" Are those just days when you can take a break from operative and book endo, OS, perio etc to keep your skills up? Is it hard to get these days?
2) What are your plans once you get out? Associate? Own?
3) Did you do a "Credentialing tour?" What was that like? Was it hard to get the OK to do specialty procedures since you hadn't done a 1-year? Or were you OK'd to do endo, OS, etc. as soon as you proved you could do it (how long did it take to prove this)?
4) Have you deployed yet? Is there any indication that you will, if you have not? Are you worried about being stop-lossed?
5) You mentioned you got to attend a week-long CEREC course. Did you use up some leave for that? How frequently do you get such CE opportunities?
6) Did you do a ton of endo and perio in school to make you confident enough with these procedures to not need an AEGD?
7) Are you looked down upon by senior officers because you didn't do an AEGD?
8) Have you considered moonlighting?

1) specialty days - days we get to book specialty work like crown lengthening, molar endo, 3rd molar ect and work alongside the specialists in that field. This is not given to everyone or present at all bases. At large bases, it can be possible. However, expect to be on the amalgam line for some period of time in the military.
2) Getting out to go into OMS or private practice if I don't get into OMS. Might associate for a few months until I see the practice I want to buy. No point in associating longer than necessary. The only point is to make some money on the side while looking for my dream practice. I'm not going to jump at the first practice I see.
3)I'm army, no credentialing tour. You are credentialed to do a basic set of operative, prosth, removable, anterior endo automatically. You earn the ability to do other stuff like CEREC by doing a few under their supervision (aka. they know you are working on 'X' procedure and will bail you out if you run into problems. However, credentialing in the military can be annoying at times. You can essentially do anything you want, but if you run into trouble on something you aren't credentialed to do, then you can face administrative actions or other punishments.
4) Haven't deployed. There was a large lull in deploying for the last few years, but it is starting to slowly pick up again now with the trouble in the middle east.
5) The week long CE course was at my base, so no vacation taken. I have gone on CE courses for 2 week long oral surgery courses at military bases in N. Carolina and Washington in the last two years. Army gives you a certain number of CE days a year (5 days??), but they do not pay for civilian courses (fees and flight), only army courses.
6) Yes I was fairly confident on endo from my dental school training. Didn't do much perio, so the AEGD would have been useful for that
7) Not really looked down upon for not doing the 1 year AEGD after you have been in for several years. After several years, my skill level is very, very close to the 1 year AEGD grads.
8) Yes I have thought about it and will probably moonlight at some point. It is useful to transition out of the military more smoothly or to get additional experience (say with pediatrics) or to make a little extra cash.

 

[Incis0r]

1) specialty days - days we get to book specialty work like crown lengthening, molar endo, 3rd molar ect and work alongside the specialists in that field. This is not given to everyone or present at all bases. At large bases, it can be possible. However, expect to be on the amalgam line for some period of time in the military.
2) Getting out to go into OMS or private practice if I don't get into OMS. Might associate for a few months until I see the practice I want to buy. No point in associating longer than necessary. The only point is to make some money on the side while looking for my dream practice. I'm not going to jump at the first practice I see.
3)I'm army, no credentialing tour. You are credentialed to do a basic set of operative, prosth, removable, anterior endo automatically. You earn the ability to do other stuff like CEREC by doing a few under their supervision (aka. they know you are working on 'X' procedure and will bail you out if you run into problems. However, credentialing in the military can be annoying at times. You can essentially do anything you want, but if you run into trouble on something you aren't credentialed to do, then you can face administrative actions or other punishments.
4) Haven't deployed. There was a large lull in deploying for the last few years, but it is starting to slowly pick up again now with the trouble in the middle east.
5) The week long CE course was at my base, so no vacation taken. I have gone on CE courses for 2 week long oral surgery courses at military bases in N. Carolina and Washington in the last two years. Army gives you a certain number of CE days a year (5 days??), but they do not pay for civilian courses (fees and flight), only army courses.
6) Yes I was fairly confident on endo from my dental school training. Didn't do much perio, so the AEGD would have been useful for that
7) Not really looked down upon for not doing the 1 year AEGD after you have been in for several years. After several years, my skill level is very, very close to the 1 year AEGD grads.
8) Yes I have thought about it and will probably moonlight at some point. It is useful to transition out of the military more smoothly or to get additional experience (say with pediatrics) or to make a little extra cash.

Thank you so much!
I'm sending you a PM with a few follow-up questions. I'd really appreciate any light you could shed on them!

 

[jwdent]

1) Would you say that your success is somewhat an anomaly?
Is sortof an answer? There are plenty of associates out there that earn that much money. The ones that I have worked with and have knowledge of have the "productive characterists" that I detailed in this post. I know more associates that make less then I did, than make in the 300 range. Here is a list of friends that I know who are associates and what they made last year. All in different parts of the country. One is in corporate and the rest are in private practice.

1) 250 molar endo, c and b
2) 200
3) 320 molar endo, heavy c and b
4) 350 implants, six month smiles, invisalign, molar endo, heavy c and b
5) 300 implants, six month smiles, molar endo, heavy c and b
6) 210
7) 200
8) 400 (corporate) mostly extractions and dentures
9) 170
10) 200
11) 250 molar endo, c and b

The ones that made the most all have in common those "productive characteristics". The rest of them either are missing a couple characteristics or don't have any of them. The best way to be successful in life is to spend your time learning from other successful people. My original post was based on what I learned from watching and listening to highly successful dentists. Some were practice owners and some were just associates.

2) Financially speaking, would specializing be a better option or is general dentistry (with a bit of elbow grease) capable of earning equal or greater amounts of money

It is so hard to play the income game. I understand why we do....its just so hard to get concrete data that translates to individuals. I can tell you what I have seen personally. On average my friends who are specialists make more money then my friends who are GPs. The dentists that I know that make more money then the specialists are excellent GPs that own their own office and offer a broad procedural mix and have low overheads, or large offices that have an economy of scale.

If you want to make more then everyone then you are a GP who owns and operate many practices. The people that I know that do this make 7 figures.

3) Also, are pediatric dentists able to work on adults as well? A pediatric dentist I shadowed worked on both and also did implants + invisalign, which likely upped his income by a lot.

I've never seen or heard of a pediatric dentist that works on adults. I've seen some work on teenage kids; however, they usually age out at 18 or so. I guess every state is different, but that would be really odd in my neck of the woods. GPs are very territorial when it comes to the people they refer to infringing on their possible revenue. For example I wouldn't refer any of my pediatric patients to a pediatric dentist who was doing implants, braces on adults. You wanted to devote your life to pedo....do pedo.

Are most of the friends you mentioned about 5 years out? And how are your friends in specialties doing? Do any specialty areas seem to be doing particularly well?

 

[vasco]

Are most of the friends you mentioned about 5 years out? And how are your friends in specialties doing? Do any specialty areas seem to be doing particularly well?

Two are only three years out the others are all 5 years or greater. Some are 10 years plus.

My friends who are specialists are all doing great and are very happy with their careers. All the specialties are doing well in my area.

 

[Justdontblink]

@vasco Great thread with a ton of insight!

I'm a non trad applicant hoping to be accepted into a Dental School program this coming cycle. Being older, I am definitely more worried about the debt situation coming out of school, because I theoretically would not be working as long as my future classmates (hopefully if get accepted first), but reading your through your experiences I see that it is possible to pay off said debt fairly quickly.

My question, which I hope is not too personal, focuses more of the business side of dentistry when you purchased you practice. I understand that you were taking over a failing practice so in order to turn it around you needed to make some necessary but probably unpopular changes.
1) What was your processes in vetting the current staff?
1a- Did you interview them or hire someone to do so?
1b- What was your criteria on who to keep and who to let go? (Resume, amount of time working at the practice, abilities etc.)
2) How was the atmosphere in the office after the decisions were made (more so of the remaining staff)?
2a- I see that you value your staff and understand the impact that they can have on your own success, so was there a transition period before that happened? (Were they put off by you at first because you made the decisions that you did?)

I understand that by owning a practice, you are a business owner and needing to make changes in personnel is part of the game, but reading your post I immediately put myself in that situation and asked myself could I do it? I'd like to think that I would do what needed to be done, but that would not mean that it would be easy. Having to tell one person that they can stay and another that they needed to go is not something that I look forward to doing. Aside from that I'd also be worried about the atmosphere in the office after and my relationship with the remaining staff.

 

[vasco]

@vasco Great thread with a ton of insight!

I'm a non trad applicant hoping to be accepted into a Dental School program this coming cycle. Being older, I am definitely more worried about the debt situation coming out of school, because I theoretically would not be working as long as my future classmates (hopefully if get accepted first), but reading your through your experiences I see that it is possible to pay off said debt fairly quickly.

My question, which I hope is not too personal, focuses more of the business side of dentistry when you purchased you practice. I understand that you were taking over a failing practice so in order to turn it around you needed to make some necessary but probably unpopular changes.
1) What was your processes in vetting the current staff?
1a- Did you interview them or hire someone to do so?
1b- What was your criteria on who to keep and who to let go? (Resume, amount of time working at the practice, abilities etc.)
2) How was the atmosphere in the office after the decisions were made (more so of the remaining staff)?
2a- I see that you value your staff and understand the impact that they can have on your own success, so was there a transition period before that happened? (Were they put off by you at first because you made the decisions that you did?)

I understand that by owning a practice, you are a business owner and needing to make changes in personnel is part of the game, but reading your post I immediately put myself in that situation and asked myself could I do it? I'd like to think that I would do what needed to be done, but that would not mean that it would be easy. Having to tell one person that they can stay and another that they needed to go is not something that I look forward to doing. Aside from that I'd also be worried about the atmosphere in the office after and my relationship with the remaining staff.

Great questions. How non-trad are we talking about? What type of occupation do you have now?

1) I kept it very simple. Didn't have money to pay someone to vet or interview the team. I just wanted hard workers and no drama. I worked in the office for a week, watched everything. Informally interviewed the team through "getting to know you" conversations. Gained a lot of input from the office manager. Week one I let five team members go, and in the coming months a few more. I let some go just based on being over paid. I let some go based on being dramatic and so go based on lack of work ethic. I'm sure I could have done a more systematic or analytical approach....but I just kept it simple. Most of it was my gut.

2) Atmosphere was surprising good. Most of the people I let go the rest of the team wanted gone as well. The other owner just couldn't do it. The important part of the atmosphere is the owner. I quickly developed a harder working, more exciting and fun place to work in just a few weeks. Your dental office will take on your personality as an owner. We only lost one team member who left on their own. It was an older front desk person who didn't like the direction I was taking the office (translation...she didn't want to work that hard).

Correcting and letting staff go is so hard. The first few times you do it, you wont sleep the night before. However, eventually you get used to it and it becomes easier. If you are not a fan of holding your team accountable and firing poor performing employees there are options for you. If you have an office manager you can have them do it. You can even hire an HR company to do it. You tell them what you want them to say and do and they will show up at your office and do it for you. Its not too expensive either. I personally believe that if its my idea to let someone go, then they deserve to hear it from my mouth. Now that I have been in it a year....I correct people as follows:

I have very clear cut and simple staff member agreements/policies that the whole team knows.
1) First violation: sit the team member down and inform them of which agreement is in violation, and see how I can help them keep the policies.
2) Second violation: Written warning and see what I can do to help them follow the policy that is in violation.
3) Third violation: Suspension without pay, with understanding that the next time will be the last.
4) Fourth violation: Termination.

By the time I let someone go....they know it is coming and have no augments about it. This method takes the emotion out of it.

The atmosphere of the office will entirely depend on you as the owner. If you have a solid vision, active true leadership, and take care of your team....they will be fiercely loyal. Your climate and culture of your office will be amazing...even if a team member is let go.

 

[GoldenDomer11]

How do you deal with competition from other businesses?

 

[Justdontblink]

Great questions. How non-trad are we talking about? What type of occupation do you have now?

1) I kept it very simple. Didn't have money to pay someone to vet or interview the team. I just wanted hard workers and no drama. I worked in the office for a week, watched everything. Informally interviewed the team through "getting to know you" conversations. Gained a lot of input from the office manager. Week one I let five team members go, and in the coming months a few more. I let some go just based on being over paid. I let some go based on being dramatic and so go based on lack of work ethic. I'm sure I could have done a more systematic or analytical approach....but I just kept it simple. Most of it was my gut.

2) Atmosphere was surprising good. Most of the people I let go the rest of the team wanted gone as well. The other owner just couldn't do it. The important part of the atmosphere is the owner. I quickly developed a harder working, more exciting and fun place to work in just a few weeks. Your dental office will take on your personality as an owner. We only lost one team member who left on their own. It was an older front desk person who didn't like the direction I was taking the office (translation...she didn't want to work that hard).

Correcting and letting staff go is so hard. The first few times you do it, you wont sleep the night before. However, eventually you get used to it and it becomes easier. If you are not a fan of holding your team accountable and firing poor performing employees there are options for you. If you have an office manager you can have them do it. You can even hire an HR company to do it. You tell them what you want them to say and do and they will show up at your office and do it for you. Its not too expensive either. I personally believe that if its my idea to let someone go, then they deserve to hear it from my mouth. Now that I have been in it a year....I correct people as follows:

I have very clear cut and simple staff member agreements/policies that the whole team knows.
1) First violation: sit the team member down and inform them of which agreement is in violation, and see how I can help them keep the policies.
2) Second violation: Written warning and see what I can do to help them follow the policy that is in violation.
3) Third violation: Suspension without pay, with understanding that the next time will be the last.
4) Fourth violation: Termination.

By the time I let someone go....they know it is coming and have no augments about it. This method takes the emotion out of it.

The atmosphere of the office will entirely depend on you as the owner. If you have a solid vision, active true leadership, and take care of your team....they will be fiercely loyal. Your climate and culture of your office will be amazing...even if a team member is let go.

@vasco having written guidelines on what you expect from our staff, detailing disciplinary action is actually a great idea. As you mentioned, I figure that it makes these instances a lot easier.

I am currently in my late 20's, and if accepted I'd be in my early 30's by graduation. Thus, I'd have lost a few years practicing in the field compared to traditional applicants. Right now I'm working in the pharmaceutical industry (quality sector for about a year), which has given me an opportunity to have somewhat of a contribution to healthcare, but its still very far removed from what I want to be doing obviously. Now here I am in the application process.

When I was selecting schools to apply to, the cost of attendance was something that I paid attention too. Truthfully I'd be happy anywhere that gives me an opportunity, but I do worry about the more expensive schools and how much of a hassle my education loans will be after graduation. I'd rather not be in my 50's still paying off education loans.

 

[vasco]

How do you deal with competition from other businesses?

Someone will always have a competitive advantage over you or I from a business or a dental standpoint. I'm probably just a few notches above average in everything that I do. I've found in my meager years of practice that two things really help me personally cope with competition: 1) maintaining an "abundance" mentality rather then a "scarcity" mindset. 2) Take such good care of patients that they will never leave you and will refer their friends. Word of mouth referrals are so cheap and powerful. Take great care of your patients and then they will tell friends, family and anyone they can that they should go to "their" dentist.

Develop and learn "best practices" from not only other dentists but from industries outside of dental.

 

[vasco]

@vasco having written guidelines on what you expect from our staff, detailing disciplinary action is actually a great idea. As you mentioned, I figure that it wakes these instances a lot easier.

I am currently in my late 20's, and if accepted I'd be in my early 30's by graduation. Thus, I'd have lost a few years practicing in the field compared to traditional applicants. Right now I'm working in the pharmaceutical industry (quality sector for about a year), which has given me an opportunity to have somewhat of a contribution to healthcare, but its still very far removed from what I want to be doing obviously. Now here I am in the application process.

When I was selecting schools to apply to, the cost of attendance was something that I paid attention too. Truthfully I'd be happy anywhere that gives me an opportunity, but I do worry about the more expensive schools and how much of a hassle my education loans will be after graduation. I'd rather not be in my 50's still paying off education loans.

The loans that we take on as dental students are intense. You are ahead of the game by being worried about it now. Don't let the non-trad thing get you down at all ( I started dental school when I was 25 - I couldn't help but feel behind). You will have plenty of time to practice dentistry and have a long fulfilled career. A good friend of mine's first degree was a masters in mechanical engineering. She worked in that field for while. Then she decided for a career change. She went to law school. Did the law thing for a while....then decided on dental. Went to dental school, and now she has been out for four years loves her career choice and makes around 300k on 32 hours a week. She is so much happier now that she is in dental and she doesn't regret a thing.

 

[CareerNumTwo]

A good friend of mine's first degree was a masters in mechanical engineering. She worked in that field for while. Then she decided for a career change. She went to law school. Did the law thing for a while....then decided on dental. Went to dental school, and now she has been out for four years loves her career choice and makes around 300k on 32 hours a week. She is so much happier now that she is in dental and she doesn't regret a thing.

Thank you for this. These are the stories that help me remain optimistic about the decisions I've made and the hours I'm dedicating to studying that I could/should be spending with my family. Especially after reading threads like the "Do NOT go into Dentistry" one that is floating around the pre-dental forum right now.

 

[Sanducan]

Vasco,

I really enjoyed reading this thread, you shared a wealth of information that a lot of people wanted to know. I appreciate it.

I'm currently a D2, and am interested in starting a dental practice ASAP when I graduate. However, I think acquiring a practice loan will be a challenge for me being that I won't have enough work experience initially.

I'm planning on taking one of 3 routes to hopefully solve this problem:

1. Do a GPR/AEGD and use production #'s from there to get a loan (don't know if this is possible)
2. Get an associate position temporarily or at free clinic to bide time before I apply for a loan. (Non compete clause may be an issue)
3. Wing it by start applying for loans in my 4th year and see if I get lucky

What are your thoughts on this? I do have a very extensive background in business btw. Thanks.

 

[vasco]

Vasco,

I really enjoyed reading this thread, you shared a wealth of information that a lot of people wanted to know. I appreciate it.

I'm currently a D2, and am interested in starting a dental practice ASAP when I graduate. However, I think acquiring a practice loan will be a challenge for me being that I won't have enough work experience initially.

I'm planning on taking one of 3 routes to hopefully solve this problem:

1. Do a GPR/AEGD and use production #'s from there to get a loan (don't know if this is possible)
2. Get an associate position temporarily or at free clinic to bide time before I apply for a loan. (Non compete clause may be an issue)
3. Wing it by start applying for loans in my 4th year and see if I get lucky

What are your thoughts on this? I do have a very extensive background in business btw. Thanks.

If purchasing a practice or doing a start up is what you want after school...there are banks that will loan you the money. Just to check I emailed my guy from Wells and he said that they have special departments for this.. that It can be done.

I personally recommend doing a GPR or AEGD that gives you experience in IV sedation, Implants, Ortho, Complicated endo, 3rd molar extraction. I would do this for a year and then go out and either work for someone for a year (just to see how things are done) or go ahead and buy your practice or start up if you feel ready. Seems like you have the business skills to succeed. I can't tell you enough how that will set you apart from your peers. If you don't want to do a residency then as the years go on you take the CE that you need to diversify your procedural mix. That works as well!

Read Dental Town and follow some of the successful dentists out there. Find a dental mentor in the area where you are in school. Learn as much as you can from them. It will make a significant impact on your development as a young dentist. My favorite type of mentor is someone that is so much better then you that it makes you uncomfortable. They are the ones that you want to learn from and want to mimic their success.

Keep plowing through school. It will be over before you know it.

 

[JakeSill]

Is OP a GP?

 

[CanaDMD]

Is OP a GP?

yes

 

[longhornpride]

Vasco, this is an absolutely great thread. I've been working 2 years now and feel that many of my experiences/thoughts are similar to yours. I have my debt down to 150k, down from 300k when I graduated. I, like yourself, hate producing 100k+ a month for someone else while having the headaches of being an associate. I've been lucky and am making about 320ish a year and I have about 100k saved up just for a down payment for a future practice, but after speaking to BoA rep, they said just to keep it liquid. Did you put down a downpayment for your practice or did you finance 100% of it? I also want to find a practice that is on a decline due to the owner referring out too many procedures or decreasing hours due to age. What were some indicators that caught your eye when you found the practice you were interested in? I basically want to buy a practice that is "on sale" bc I feel confident I can ramp up the revenue with better marketing, treatment presentation, keeping cases inhouse and extending hours. I'm debating whether to pay off my loans first or to just go ahead and buy next year and saving up. Also, did you use a broker? I'm being advised to work with National Dental Placements and am being told to hire a dental attorney and a dental cpa by BoA. I know it's important to do due diligence and to have experts on your side but I also don't want to be taken of advantage of by these guys. I know they will prey on newer dentist and bleed them for thousands of dollars. What your experience with brokers, cpa's, attorneys? What can I expect to pay for such services during a practice acquisition? Do you know the reputations of NDP? Also, who did you go with as a lender and what is a good rate I can expect or hope for?

Thanks in advance and congrats on the success.

 

[InformMe123]

Any tips or books you suggest on building those important attributes, particularly people-social skills/productivity?

 

[vasco]

Is OP a GP?

I'm a GP

 

[vasco]

Any tips or books you suggest on building those important attributes, particularly people-social skills/productivity?

Sorry I don't know of any books that would help in this area. The best thing for you to do is if you are in dental school...find a preceptor or a dentist that helps in your clinic that is great at communicating. Spend time listening to the way they communicate to patients and what are some of their best practices. Maybe some of your classmates are excellent at communication. Listen to them and soak in as much as you can.

 

[vasco]

Vasco, this is an absolutely great thread. I've been working 2 years now and feel that many of my experiences/thoughts are similar to yours. I have my debt down to 150k, down from 300k when I graduated. I, like yourself, hate producing 100k+ a month for someone else while having the headaches of being an associate. I've been lucky and am making about 320ish a year and I have about 100k saved up just for a down payment for a future practice, but after speaking to BoA rep, they said just to keep it liquid. Did you put down a downpayment for your practice or did you finance 100% of it? I also want to find a practice that is on a decline due to the owner referring out too many procedures or decreasing hours due to age. What were some indicators that caught your eye when you found the practice you were interested in? I basically want to buy a practice that is "on sale" bc I feel confident I can ramp up the revenue with better marketing, treatment presentation, keeping cases inhouse and extending hours. I'm debating whether to pay off my loans first or to just go ahead and buy next year and saving up. Also, did you use a broker? I'm being advised to work with National Dental Placements and am being told to hire a dental attorney and a dental cpa by BoA. I know it's important to do due diligence and to have experts on your side but I also don't want to be taken of advantage of by these guys. I know they will prey on newer dentist and bleed them for thousands of dollars. What your experience with brokers, cpa's, attorneys? What can I expect to pay for such services during a practice acquisition? Do you know the reputations of NDP? Also, who did you go with as a lender and what is a good rate I can expect or hope for?

Thanks in advance and congrats on the success.

You are way ahead of the game. 320 a year is awesome early on in your career, and it has nothing to do with you being lucky! Great job reducing your school debt also. It feels good huh?

I did a small business loan and only had to put down 25k. Regarding where to put the 100k you have now, I would work towards owning as soon as possible. With your ability to produce you will be shocked with how little you will have to produce in private practice to keep your income static....and then if you continue to produce like you are now your income will go up significantly. So I would keep as much liquid as you can for the searching process, just to make sure you can get the loan that you want. I would also finance as much as you can so if you wanted to you could pay off your student loans with the residual. The key for you is to get into ownership as soon as you find the right practice.

Finding a practice for sale is hard to do. Sometime dentists think that they have found one, buy it, and it turns out to not be what they thought. So hard to predict the future. I think that you are looking along the right lines. A practice that has limited hours, poor procedural mix, favorable demographics, strong financial history. The key is the procedural mix. If you find a dentist that doesn't do endo, much c and b, minimal surgery, no implants or ortho...you can step in and immediately step up production by just being you. Extend hours and then you have an even greater leg up.

I think you are ready to roll! Look for the right opportunity and jump out of the plane. You will be surprised how much more you will enjoy life.

 

[vasco]

Thank you for this. These are the stories that help me remain optimistic about the decisions I've made and the hours I'm dedicating to studying that I could/should be spending with my family. Especially after reading threads like the "Do NOT go into Dentistry" one that is floating around the pre-dental forum right now.

I haven't read that thread....but I do know that dentistry isn't for everyone. What is a shame is there is no way to tell if you are going to like it. I remember telling my dad about a year out of school, how relieved I was that I actually like dentistry. You just don't know until you are there. School is so different then practice. I have some friends that love dentistry and some that just cope with it. It will always be that way. The biggest predictor for me if you will like dentistry is if you like to take care of people, you are good with your hands, business oriented, and quick on your feet. If those describe you, then you will be very happy with your career choice. If that doesn't describe you, then you can still have a very fulfilling and rewarding career. You may just be like most people out there and just treat it like a job and nothing more.

 

[iZodliquify]

The year you made 260k and 330k, how many hours per week did you work?

 

[JakeSill]

Your friend that made 200k at the start up, is this after the practice note was payed off? Friend 1 that earns 400k, is he or she just an associate? Isn't 400k for a high salary if you're working for someone?

 

[sloken]

Any tips or books you suggest on building those important attributes, particularly people-social skills/productivity?

I wrote a section that included some good books for associates in my own book. Here's a sample of them

•How to Win Friends and Influence People in the Digital Age, Dale Carnegie
I really don’t like the title as it sounds cheesy and fake, but the information that follows the title is anything but. There’s great tips on strengthening your relationships and building trust and loyalty - good things to have with your team and patients!

• What Clients Love: A Field Guide to Growing your Business, Harry Beckwith
Short snippets make for an easy read on how to treat clients (ie. patients) well.

• The Checklist Manifesto, Atul Gawande
Gawande is a surgeon who writes on the importance of developing operational systems and checklists to improve efficiency and minimize complications. Exactly what you want when doing dental procedures!

•White Coat Investor, James Dahle
An overview of the information contained on the website. If you don’t want to read through all the blog posts, read this. Personally, I find the website more useful.

• The E-Myth Revisited, Michael Gerber
Work ON your business, not in it. While dentistry will never be an industry where you can train someone to do all of your daily tasks for you, this books helps you realize how to create systems to free you up from certain tasks.

• Fresh Out of Dental School
This is my ebook - go to the fb page in my sig, PM me, or go to the thread I started for more info

 

[vasco]

The year you made 260k and 330k, how many hours per week did you work?

260 was 33 hours a week.

330 was 36 hours a week.


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[vasco]

Your friend that made 200k at the start up, is this after the practice note was payed off? Friend 1 that earns 400k, is he or she just an associate? Isn't 400k for a high salary if you're working for someone?

My friend made 200 before the start up. I'm. Not sure what he is doing is doing now....but I know it's below 200 start ups can take a while

400 as just an associate. That is very high. To get that level on 30% production you have to produce 1.3 mil ish all by your self. Not many dentists can do that.




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[BeaverLover]

My friend made 200 before the start up. I'm. Not sure what he is doing is doing now....but I know it's below 200 start ups can take a while

400 as just an associate. That is very high. To get that level on 30% production you have to produce 1.3 mil ish all by your self. Not many dentists can do that.




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Is your friend in corporate or private? Is 30% production on the high end?

 

[dentistreason]

Where do you see dentistry headed in 5-10 years? Is it harder nowadays to generate the income you and your friends did when graduating?

 

[gatorfan99]

Lots of BAD info about military dentistry here - if you guys have question about military dentistry then post them in the military forum (here in SDN) - lets not hijack this thread

 

[deleted390966]

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.

I wish I had done Dental But I know I can't deal with teeth

 

[IHavePotential]

So what car do you have?

 

[vasco]

Is your friend in corporate or private? Is 30% production on the high end?

He works for a privately held group practice. the comp percentage depends on your area. There are some areas that only offer 25% and some that do 35%. I would say that 28-32% have been a non scientific average from what i've seen around the country.

 

[vasco]

Where do you see dentistry headed in 5-10 years? Is it harder nowadays to generate the income you and your friends did when graduating?

In my opinion dentistry is headed towards a tipping of the scale in regards to the solo practitioner, corporate run offices, and large private group practices. Right now the scale tips towards more solo offices then corporate offices/group practices. In the future I believe that the scale will shift towards the corporate model and the large group practice. The large group practices will increase from non-corporate dentists uniting to compete with the corporations. It will take some time to get to that point......but from what I've seen that will most likely be the progression. I also see an influx of mid-level providers at some point as well. If the trend of high educational debt and more dental school opening continues....i see the average income decreasing. I also see the wage of non - owner gp increasing and the wage of owner gps decreasing.

Those that will make the most money in dentistry will be those that own multiple offices and who can take advantage of the mid-level providers when the come more fully to the field and who are able to compete with corporate dentistry. Dentistry will still be one of the better american occupations with above average income and lifestyle . It will just be harder for average/below average dentists to make as much money as they have in the past. The high achievers will still be able to make the same amount of money as they always have.

Keep in mind that it is impossible to predict the future...these are just trends. Markets tend to work themselves out and there will always be peaks and troughs though out time...the adaptable tend to handle the troughs the best.

I don't think that today it is any harder then it was when I graduated to produce that level....at least from what i can see. However, those that produce in that level are very productive dentists!

 

[vasco]

So what car do you have?

435 i hard top convertible. Right out of school i purchased a new honda accord for 18k. I paid it off in four months or so. I remember thinking...wow dentistry is pretty cool if I can pay off a car in four months!

I waited until I had paid off all of my school loans and then I leased this. I wanted a convertible but it had to be a hard top. This was the best one out of all the ones I looked at. Lease is up in a year...I'm ready for something with more HP.

 

[iZodliquify]

435 i hard top convertible. Right out of school i purchased a new honda accord for 18k. I paid it off in four months or so. I remember thinking...wow dentistry is pretty cool if I can pay off a car in four months!

I waited until I had paid off all of my school loans and then I leased this. I wanted a convertible but it had to be a hard top. This was the best one out of all the ones I looked at. Lease is up in a year...I'm ready for something with more HP.
View attachment 206682

You talked the dealer down into getting a brand new Accord for 18k? How?

On another note, do you have time outside of work to engage in other activities such as hobbies, etc? Or are you consumed by dentistry related stuff like CEs that stops you from doing your hobbies.

 

[JakeSill]

1. How possible is it to operate multiple offices during one's lifetime when it's difficult already paying off your school loan and office note?
2. Do you find dentistry stressful?

 

[Outlanding]

So you mention you have a 10 year practice note but you're going to pay it off aggressively...How quickly (in years) are you looking into paying it off? What are the monthly payments?

 

[Cold Front]

435 i hard top convertible. Right out of school i purchased a new honda accord for 18k. I paid it off in four months or so. I remember thinking...wow dentistry is pretty cool if I can pay off a car in four months!

I waited until I had paid off all of my school loans and then I leased this. I wanted a convertible but it had to be a hard top. This was the best one out of all the ones I looked at. Lease is up in a year...I'm ready for something with more HP.
View attachment 206682

Be careful with leasing, they can get you in the end with wear and tear on the vehicle, and will pick on any inch of the car that may appear damaged.

I had 3 cars since I graduated from d school, averaging 2-3 years per car...

2010-2012: Pre-Owned Infiniti 35x Sedan. It had 22k miles on it. Fully loaded. I paid it off.
2012-2015: Pre-owned Audi S5 Coupe. It had 5k miles on it. Fully loaded too. I paid it off.
2015-Now: Porsche Macan Turbo. Brand New. Financed it at 1.5%. I used the paid off Audi S5 as a down-payment. Will pay it off in 2017.

I still have some school loans, but I used the money I would have paid off the student loans on opening more offices - which in return pay off my student loan payments and additional income.

 

[vasco]

You talked the dealer down into getting a brand new Accord for 18k? How?

On another note, do you have time outside of work to engage in other activities such as hobbies, etc? Or are you consumed by dentistry related stuff like CEs that stops you from doing your hobbies.

it was a 2009 accord lx. It wasn't fully loaded and we used USAA car buying service. They pre-negotiate the price of new vehicles and then get dealers to agree to the price. Some of their cars they can negotiate down much lower then other cars. The accord was a great deal at that time.

The outside of work time varies per dentist. I feel like I have plenty of time to engage in outside the office activities. However, I have colleagues who don't do anything outside of office work... so I would say it depends more on the dentist and how much he or she wants to be involved with outside activities.

 

[vasco]

1. How possible is it to operate multiple offices during one's lifetime when it's difficult already paying off your school loan and office note?
2. Do you find dentistry stressful?

1) It is very possible to operate multiple offices during ones lifetime. Dental is the perfect blend of medicine and business. If you want to scale quickly as a dentist you have to be tolerant of debt. If you are ok scaling slow, you pay down your debt and scale as finances permit. The more offices you have the more you add to your plate and the chance of diluting yourself and your brand exists.

2) I don't personally find dentistry stressful; however people are very stressful. Managing your team is stressful, and dealing with some patients will send your stress levels through the roof.

 

[vasco]

So you mention you have a 10 year practice note but you're going to pay it off aggressively...How quickly (in years) are you looking into paying it off? What are the monthly payments?

I would like to have it paid off in under 5 years.

 

[vasco]

Be careful with leasing, they can get you in the end with wear and tear on the vehicle, and will pick on any inch of the car that may appear damaged.

I had 3 cars since I graduated from d school, averaging 2-3 years per car...

2010-2012: Pre-Owned Infiniti 35x Sedan. It had 22k miles on it. Fully loaded. I paid it off.
2012-2015: Pre-owned Audi S5 Coupe. It had 5k miles on it. Fully loaded too. I paid it off.
2015-Now: Porsche Macan Turbo. Brand New. Financed it at 1.5%. I used the paid off Audi S5 as a down-payment. Will pay it off in 2017.

I still have some school loans, but I used the money I would have paid off the student loans on opening more offices - which in return pay off my student loan payments and additional income.

This is my first lease rodeo.....I hope it turns out ok!

Fantastic auto choices. I've got the following in my "differential" when my lease is up next year.

- Audio rs7
- Jaguar f-type r
- porsche panamera 4s
- Tesla model s

I'm already excited to upgrade. That is one of the negatives that I've seen so far with my first lease is that i'm locked in for three years.

 

[Cold Front]

This is my first lease rodeo.....I hope it turns out ok!

Fantastic auto choices. I've got the following in my "differential" when my lease is up next year.

- Audio rs7
- Jaguar f-type r
- porsche panamera 4s
- Tesla model s

I'm already excited to upgrade. That is one of the negatives that I've seen so far with my first lease is that i'm locked in for three years.

Those are all great choices for your next lease car. The RS7 and Panamera 4S are similar cars, and more practical than the Jag. If you just want to go for just pure sports car and looks, then the f-type R is the obvious choice. Tesla is way overpriced and doesn't come close to any of the good interior finishes of the other cars.

I have to admit, I miss my 2dr sports car, and will probably get Targa 4 GTS in couple of years. You can't go wrong with a Porsche, both in performance and service.

 

[charlestweed]

Be careful with leasing, they can get you in the end with wear and tear on the vehicle, and will pick on any inch of the car that may appear damaged.

I had 3 cars since I graduated from d school, averaging 2-3 years per car...

2010-2012: Pre-Owned Infiniti 35x Sedan. It had 22k miles on it. Fully loaded. I paid it off.
2012-2015: Pre-owned Audi S5 Coupe. It had 5k miles on it. Fully loaded too. I paid it off.
2015-Now: Porsche Macan Turbo. Brand New. Financed it at 1.5%. I used the paid off Audi S5 as a down-payment. Will pay it off in 2017.

I still have some school loans, but I used the money I would have paid off the student loans on opening more offices - which in return pay off my student loan payments and additional income.

If you like to drive new and different cars every 2-3 years, it's better to lease than to buy. With the lease option, the initial down payment and the monthly payments are significantly lower. You can switch to a newer better car 3-6 months before the end of your lease and not have to pay any penalty, if you lease it from the same dealership.

I've leased 9 different German cars in the past 15 years. I can tell you that all Mercedes and BMW cars are very unreliable. And they depreciate in value so fast. My current 750Li only has 54k miles and I have had to bring it in for repairs at least 8 times. The reason I keep on coming back to lease them is I pay nothing during the warranty period (4 years or 50k miles). By the time the warranty expires, I return the car and get a new one. I got numerous scratches on the cars and my kids spilled drinks and food everywhere. The most I had to pay for wear and tear on a vehicle was only $800. The excess mileage fee is not too bad either: 5000 miles x 25 cents/mile = about 100 bucks a month.

Vasco, sorry for derailing this thread but I can't resist when talking about cars. I've heard most Model S owners have been very happy with their cars and they all swear that they will never go back to drive a gasoline car again. I recently ordered a model S and am waiting for it to be built in Fremont. And I lease this one also.