Help calculating opportunity cost of Oral Surgery

[321931]

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Once you drive the BMW 7 series and other cars that have comparable qualities, it's hard to go back to drive a Honda. Comfort ride, good handling, strong road grip and safety etc are very important to me, especially with small kids sitting in the back. Driving is stressful. With the autopilot feature in a car, long daily commute is no longer an issue. I used to have plan to buy a retirement house that is closer to my office so I won't have to drive too far to work when I get older. But with the self driving autopilot technology (and it keeps getting better over the years) in some luxury cars, I can live where I want to retire. I don't have to live near my offices. All my offices are located in lower income cities.

When you have a nice car, you tend to find excuses to get out of the house more often 😉😀.

Haha well, I have owned BMW's/Audis and yeah they are nice. But I changed alot when I saw a 70k car sale turn into 10-20k and have expensive upkeep. 50k loss on top of constant expensive fixes.


For reference my 2014 Audi S4 cost 70k, if I had put the money into SP500 index fund I would have 109k today without reinvested dividends. Today it's worth probably 10000$ and the tire/oil changes cost $$$. Cars are the worst investment a person can make.

Buying A Car: The Worst Investment?

Those who know how to build wealth understand that every dollar they spend should be seen as an investment. Even if you don't have a lot of knowledge (or even interest) in how the stock market works, you surely know how to be successful: you buy a stock at one [...]

www.forbes.com

My new car is a Honda CRV and I'm going to drive forever. Fully paid off, 20k, and gets me from A-B safely and cheap fixes...and reliable! I NEVER was that person who would be saying that ever. I always dreamed of a Porsche 911 in college. But today, even if I had the excess money, I would never buy a luxury car ever again.

 

[charlestweed]

Haha well, I have owned BMW's/Audis and yeah they are nice. But I changed alot when I saw a 70k car sale turn into 10-20k and have expensive upkeep. 50k loss on top of constant expensive fixes.


For reference my 2014 Audi S4 cost 70k, if I had put the money into SP500 index fund I would have 109k today without reinvested dividends. Today it's worth probably 10000$ and the tire/oil changes cost $$$. Cars are the worst investment a person can make.

Buying A Car: The Worst Investment?

Those who know how to build wealth understand that every dollar they spend should be seen as an investment. Even if you don't have a lot of knowledge (or even interest) in how the stock market works, you surely know how to be successful: you buy a stock at one [...]

www.forbes.com

My new car is a Honda CRV and I'm going to drive forever. Fully paid off, 20k, and gets me from A-B safely and cheap fixes...and reliable! I NEVER was that person who would be saying that ever. I always dreamed of a Porsche 911 in college. But today, even if I had the excess money, I would never buy a luxury car ever again.

Agree with you about the reliability of the Japanese cars. Some of the BMW 7 series and Mercedes S class that I had driven in the past started giving me some problems after only 10k miles of driving. That's why I only lease these German cars. They are fun and safe cars to drive but do require frequent trips to the dealer's shops for maintenance and repairs....especially if you drive 20+k miles/year like me. I signed short term leases and returned the cars before their warranties expired. Without the good customer services, coutersy loaner cars, free repairs (during the warranty period) and free maintenance (for BMW only), I wouldn't lease them....I would just stick to the more reliable cars like Lexus and Acura.

 

[TanMan]

Ironically I’m total opposite. I always fly economy. I find vehicles and airfare the same. Yes a bmw 7 series is nice and so is first class, but a Honda CR-V and a economy ticket will get you to the same place at most likely the same time. What’s the point of a Audi RS7 or Porsche 911 if you can only go 45 mph on service roads. No thanks.

Whenever I fly Europe/Asia I stay up the night before and when I get on the plane... I knock out like a baby. A drink always helps.

5 min later I’m awake and in London or Asia. I never have trouble falling asleep.

That's why I need a radar detector. Helps spot cops a mile away. Drive to your heart's content, and when that Ka radar band goes off, slow down quickly. Of course, if you look at it in terms of getting from point A to B, they are equivalent. However, you would be a lot more rested in first/business than in coach. That rest is a lot more critical when, for example, you land at 10am and got patients at noon. I sure as hell would not be able to see patients with enough rest if I had rode in coach.

Once you drive the BMW 7 series and other cars that have comparable qualities, it's hard to go back to drive a Honda. Comfort ride, good handling, strong road grip and safety etc are very important to me, especially with small kids sitting in the back. Driving is stressful. With the autopilot feature in a car, long daily commute is no longer an issue. I used to have plan to buy a retirement house that is closer to my office so I won't have to drive too far to work when I get older. But with the self driving autopilot technology (and it keeps getting better over the years) in some luxury cars, I can live where I want to retire. I don't have to live near my offices. All my offices are located in lower income cities.

When you have a nice car, you tend to find excuses to get out of the house more often 😉😀.

This is definitely true. Having a fun car means you're having fun with your car experience. There's a huge difference in buying a car for status v. buying a car for fun. I think buying a car for status is stupid, but if you're buying it to have a better driving experience, then I think it's worth it. With that in mind, it's smarter to buy a slightly used depreciated vehicle if you're going to have the same experience as a brand new vehicle of the same make/model. I wouldn't go back to my Lexus suv after driving my Porsche suv for awhile. There's just no comparison in the experience, luxury, and fun.

Haha well, I have owned BMW's/Audis and yeah they are nice. But I changed alot when I saw a 70k car sale turn into 10-20k and have expensive upkeep. 50k loss on top of constant expensive fixes.


For reference my 2014 Audi S4 cost 70k, if I had put the money into SP500 index fund I would have 109k today without reinvested dividends. Today it's worth probably 10000$ and the tire/oil changes cost $$$. Cars are the worst investment a person can make.

Buying A Car: The Worst Investment?

Those who know how to build wealth understand that every dollar they spend should be seen as an investment. Even if you don't have a lot of knowledge (or even interest) in how the stock market works, you surely know how to be successful: you buy a stock at one [...]

www.forbes.com

My new car is a Honda CRV and I'm going to drive forever. Fully paid off, 20k, and gets me from A-B safely and cheap fixes...and reliable! I NEVER was that person who would be saying that ever. I always dreamed of a Porsche 911 in college. But today, even if I had the excess money, I would never buy a luxury car ever again.

Also true, but you should never buy a car as an investment. Always better to buy a used car that's still in the new model shape and past the steepest depreciation curve. I don't understand why people would buy a car that they couldn't afford in the first place. If you have to think twice and think you cannot afford a vehicle, you probably cannot. Spend as much money you're willing to write off/throw away on a vehicle, because that's pretty much it - you're throwing away money in exchange for a fun depreciating asset. If putting money in an index fund is more satisfying than owning a certain vehicle, then the vehicle was not fun enough to spend money in the first place.

It's why I push people to work hard and develop income streams. Once you have those income streams that don't deplete your assets, that income stream essentially becomes your "play money"

 

[charlestweed]

This is the pay summary for a periodontist who works at the Corp office that I also work for. She works 5 days/month and travels to 4 different offices....7am-2pm on some days and 9am-5pm on other days. The daily pay rate is $800/day or 40% of the production. The pay amount was highlighted in red. This is the pay for a lowly periodontist. I am pretty sure the OS's at this same corp get paid a lot more. The workload of the specialists is also much less. In order to produce that much, they don't need to work non-stop and hop from chair to chair for 8 straight hours like the general dentists.....less strain on the hands and back.

 

[mmc12]

This is the pay summary for a periodontist who works at the Corp office that I also work for. She works 5 days/month and travels to 4 different offices....7am-2pm on some days and 9am-5pm on other days. The daily pay rate is $800/day or 40% of the production. The pay amount was highlighted in red. This is the pay for a lowly periodontist. I am pretty sure the OS's at this same corp get paid a lot more. The workload of the specialists is also much less. In order to produce that much, they don't need to work non-stop and hop from chair to chair for 8 straight hours like the general dentists.....less strain on the hands and back.

View attachment 271984

How does the pay for orthos compare with the other specialties in your corp/>

 

[charlestweed]

How does the pay for orthos compare with the other specialties in your corp/>

About the same per day....maybe slightly more for perio. My corp pays us, orthos, between $1200-1500/day + $75 bonus (for each new start). So if you look at the % of the production, it is much lower than that of the perio's 40%....probably around 20-25% of the production for ortho. Our job, however, is a lot easier than perio (despite having to see 60+ patients a day).....lower liability risk...mostly healthy patients. There are also more ortho days available to keep us busy. Perios have to travel to more offices to get more work days. There are 6 of us, orthos, in the region. For this same region, there are only enough patients to hire 1 periodontist and for only 5 days in a month. More work days = more money.

 

[ToothJockey]

About the same per day....maybe slightly more for perio. My corp pays us, orthos, between $1200-1500/day + $75 bonus (for each new start). So if you look at the % of the production, it is much lower than that of the perio's 40%....probably around 20-25% of the production for ortho. Our job, however, is a lot easier than perio (despite having to see 60+ patients a day).....lower liability risk...mostly healthy patients. There are also more ortho days available to keep us busy. Perios have to travel to more offices to get more work days. There are 6 of us, orthos, in the region. For this same region, there are only enough patients to hire 1 periodontist and for only 5 days in a month. More work days = more money.

Do you know how much % production they pay your Oral Surgeons? I've heard OS in corporate can produce up to 10k per day on average, is that true in your area (Cali)?

From your spreadsheet it seems like the perio is producing about 5k a day on average, although there is the outlier day with only $270 produced (how does that even happen lol what did the perio do all day???). Is it really common for an OS to do double what a perio does in production per day?

 

[omfsing]

Do you know how much % production they pay your Oral Surgeons? I've heard OS in corporate can produce up to 10k per day on average, is that true in your area (Cali)?

From your spreadsheet it seems like the perio is producing about 5k a day on average, although there is the outlier day with only $270 produced (how does that even happen lol what did the perio do all day???). Is it really common for an OS to do double what a perio does in production per day?

Yes. And we can cut a neck open.

 

[2TH MVR]

Hey,
I thought this thread was about cars? . I bought a cheap car to drive to my Corp job. Low income patients don't need to see an expensive car. Plus I worry an expensive car draws too much attention.
Seems like current and future generations are less and less into cars. It's a shame. I grew up with cars and prefer the mechanical systems over Auto pilot stuff. I'm more into the actual act of driving than being driven. As an example .... My play car has NO POWER STEERING.
Of course .... Buy only what you can afford.

 

[321931]

Hey,
I thought this thread was about cars? . I bought a cheap car to drive to my Corp job. Low income patients don't need to see an expensive car. Plus I worry an expensive car draws too much attention.
Seems like current and future generations are less and less into cars. It's a shame. I grew up with cars and prefer the mechanical systems over Auto pilot stuff. I'm more into the actual act of driving than being driven. As an example .... My play car has NO POWER STEERING.
Of course .... Buy only what you can afford.

Haha soooooo true. Even middle income-high income patients do not need to see an expensive car. I alternate between the Audi/Honda, but my next door dentists neighbors drive a Porsche 911 and a Tesla P85D. I HAVE had patients comment on the cars outside and the crowns being done on them. I actually tell them- see that Beautiful Honda outside? That's mine- now that Porsche and Tesla belong to the dentist next door- so you know hes overcharging! And we have a good laugh....and then I say no but seriously- if you want to contribute to his car payments- you can go see him next door! And they are like no...it's ok Doc I'll stick with you.

If you have a standalone building and you are the only dentist- I highly recommend driving a normal car. A porsche or Tesla or whatever just doesn't really work well with your patients regardless of lower, middle or high income.

 

[2TH MVR]

Depends where you’re at. Here in CA a Porsche is nothing noticeable. One of my partners drove a Porsche everyday, nobody cares. Probably don’t park it right in front though.

Very true. During my hay day ... I leased a number of Porsches. These cars were affectionately known as the Doctor lease vehicles. The patient perception can go both ways. If a patient sees your Porsche .... They may perceive that your successful and therefore a good dentist. If you drive a POS . .. well. I guess the safest option is a sensible car that is affordable and not too showy.
I also remember picking dentists up for lunch in my 911 Twin Turbo. Not sure what message that sends. The 911 is gone, but I still love cars.

 

[TanMan]

Haha soooooo true. Even middle income-high income patients do not need to see an expensive car. I alternate between the Audi/Honda, but my next door dentists neighbors drive a Porsche 911 and a Tesla P85D. I HAVE had patients comment on the cars outside and the crowns being done on them. I actually tell them- see that Beautiful Honda outside? That's mine- now that Porsche and Tesla belong to the dentist next door- so you know hes overcharging! And we have a good laugh....and then I say no but seriously- if you want to contribute to his car payments- you can go see him next door! And they are like no...it's ok Doc I'll stick with you.

If you have a standalone building and you are the only dentist- I highly recommend driving a normal car. A porsche or Tesla or whatever just doesn't really work well with your patients regardless of lower, middle or high income.

I've heard of dentists doing that, afraid of giving the image of making too much money. That's a smart idea to avoid the conversation altogether. However, I don't like to be constricted and drive my cars to work anyway and I rarely get comments from patients. When it happens and you know how to present the discussion, driving a nice car can be spun to your favor. The gist of the conversation is, do you want a mediocre dentist driving a mediocre car or do you want a great dentist who can afford to drive a nice car. Patients mentally link that if you're successful, nice, and deliver a great experience, you're successful because you're a great dentist.

I just see it as another way of evolving your practice. Over time, a successful practice will gain/lose patients. You hope to gain good patients, lose bad patients. I keep track of marketing trends to see which marketing subtypes provide good patients and bad patients. There is no one size fits all practice for patients. Think about a patient who cares enough to bring up your car, your fee schedules, and pricing. Do you really want to keep that type of patient? The fact that they would bring it up in a conversation should set off red flags.

 

[321931]

I've heard of dentists doing that, afraid of giving the image of making too much money. That's a smart idea to avoid the conversation altogether. However, I don't like to be constricted and drive my cars to work anyway and I rarely get comments from patients. When it happens and you know how to present the discussion, driving a nice car can be spun to your favor. The gist of the conversation is, do you want a mediocre dentist driving a mediocre car or do you want a great dentist who can afford to drive a nice car. Patients mentally link that if you're successful, nice, and deliver a great experience, you're successful because you're a great dentist.

I just see it as another way of evolving your practice. Over time, a successful practice will gain/lose patients. You hope to gain good patients, lose bad patients. I keep track of marketing trends to see which marketing subtypes provide good patients and bad patients. There is no one size fits all practice for patients. Think about a patient who cares enough to bring up your car, your fee schedules, and pricing. Do you really want to keep that type of patient? The fact that they would bring it up in a conversation should set off red flags.

I can't take that comment seriously. Driving a mediocre car does not mean you are a mediocre dentist.

 

[charlestweed]

Do you know how much % production they pay your Oral Surgeons? I've heard OS in corporate can produce up to 10k per day on average, is that true in your area (Cali)?

I don't know how much they pay the OS's. Yeah, I've also heard from the office managers the traveling OS produces that much per day. There were a few times when the manager couldn't book enough patients for the OS, she came to beg me to refer more 3rd molar cases.

From your spreadsheet it seems like the perio is producing about 5k a day on average, although there is the outlier day with only $270 produced (how does that even happen lol what did the perio do all day???). Is it really common for an OS to do double what a perio does in production per day?

On that slow day, no procedure was performed....mostly perio consultations. She usually spends time on her phone when there's no patient. Again, I don't know how much an OS produces per day. I only ran into an OS few times because he and I work on different days....we didn't have a lot of time to talk.... he was always busy working.

 

[charlestweed]

Honestly this is not really that impressive an income for 3 years of specialty training on top of dental school.

That's probably why 3-4 periodontists before her left this job. It's not impressive to you but to me, it is. I guess she and I have very low expectation. Since we are not picky people, we have no problem finding jobs....and unlike some of our colleagues, we don't come here and write negative posts about how bad it is to be an orthodontist or a periodontist. We are happy with the job offers and would rather have several low paying jobs than staying home making nothing. There are plenty of jobs here in CA if one is not picky. We are both glad that we don't have to do general dentistry.

What does she do the rest of the month?

She has her own practice and she travels to 2-3 other GP offices....she works 2-3 days/week. She requests the Corp to book patients from 7am-2pm so she can pick up her kids after school. Many of her GP friends, who also have kids, don't have such luxury.

There are plenty of GP offices for sale that produce that level of daily income.

True. And there are also plenty of associate GPs here in CA who earn the same amount as this periodontist but they have to work non-stop 8 hours a day 5 days/week.

For me, it's totally worth spending 2-3 extra years (and borrowing more loan money) to specialize...so I don't have to do back breaking general dental procedures for the next 10-20 years...for the rest of my life. Working as a general dentist is hard.

 

[charlestweed]

Hey,
I thought this thread was about cars? . I bought a cheap car to drive to my Corp job. Low income patients don't need to see an expensive car. Plus I worry an expensive car draws too much attention.
Seems like current and future generations are less and less into cars. It's a shame. I grew up with cars and prefer the mechanical systems over Auto pilot stuff. I'm more into the actual act of driving than being driven. As an example .... My play car has NO POWER STEERING.
Of course .... Buy only what you can afford.

I have to have a nice commuting car since I work 22 days a month, travel to 6 offices and drive 20-30 miles each way. My car is like my 2nd house..... I eat and take a nap (during lunch hours or while my wife shopped or while my kids took their piano lessons) in it. So a tiny noisy sport car with rough ride like a Porsche 911 is not for me.

During my HS and college years, I drove a Toyota Celica with a stick shift. At first, I felt it was a cool thing to have because most of my friends have automatic transmissions. I hated it after getting stucked in the LA traffics and had to use both feet to drive. Now with an autopilot car, I can take my shoes off, stretch/ cross my legs, read the SDN forum on a 17 inch screen while the car "drives" me home.

 

[TanMan]

I can't take that comment seriously. Driving a mediocre car does not mean you are a mediocre dentist.

We all know it doesn't, but if your competition is implying that you're overcharging because you have a nice car, it's the flipside of the argument.

 

[321931]

We all know it doesn't, but if your competition is implying that you're overcharging because you have a nice car, it's the flipside of the argument.

Fair enough- although I sincerely doubt there's much upside to having a bright red porsche parked outside. Just my 2 cents.

 

[TanMan]

Fair enough- although I sincerely doubt there's much upside to having a bright red porsche parked outside. Just my 2 cents.

Who parks right in front of the office anyway? Interestingly enough, patients notice watches more than anything else.

I think the whole point of this conversation is not so much what you should and shouldn't bring to the office, but moreso doing whatever you want (from a personal and business standpoint) and learning how to spin everything into a positive. Patient's aren't stupid either. If they see you have an extremely nice car and a dump of an office, they assume that you don't invest in the quality of your facility (and indirectly, the quality of your dentistry). Under those circumstances, I think having a nice car hurts you.

 

[ToothJockey]

I don't know how much they pay the OS's. Yeah, I've also heard from the office managers the traveling OS produces that much per day. There were a few times when the manager couldn't book enough patients for the OS, she came to beg me to refer more 3rd molar cases.

On that slow day, no procedure was performed....mostly perio consultations. She usually spends time on her phone when there's no patient. Again, I don't know how much an OS produces per day. I only ran into an OS few times because he and I work on different days....we didn't have a lot of time to talk.... he was always busy working.

Is there enough work for a specialist to work 5 full busy days a week at corp or would you need to have your own office for 2-3 days a week and supplement with corp?

Also, is a corp a better idea for a specialist than private practice? Dentists often say that in general dentistry your highest potential is in ownership (probably since you can employ hygenists and collect passive income), but for a specialist would potential be maximized in a corp instead since they just line up patients for you for the high profit procedures?

Interestingly enough, patients notice watches more than anything else.

So in other words it's ok to bring your Lambo to your practice, but don't wear the rolex 😉

I think that where your practice is located and who it caters to matters for how much you should show off your riches. For example if you are a boutique practice catering to high income individuals, then maybe showing off your success is a positive since it makes your customers more confident in you.

However if you are catering to a low income crowd, parking your porche in the parking lot is a bad idea, because instead of making your patients feel comfortable, you will alienate them. You want to make yourself look poorer so you can relate better with your patients. Patients aren't dumb, they know you probably make 5x what they make, but atleast you are putting in an effort to be humble and relate to their lifestyle.

YMMV

 

[TanMan]

Is there enough work for a specialist to work 5 full busy days a week at corp or would you need to have your own office for 2-3 days a week and supplement with corp?

Also, is a corp a better idea for a specialist than private practice? Dentists often say that in general dentistry your highest potential is in ownership (probably since you can employ hygenists and collect passive income), but for a specialist would potential be maximized in a corp instead since they just line up patients for you for the high profit procedures?



So in other words it's ok to bring your Lambo to your practice, but don't wear the rolex 😉

I think that where your practice is located and who it caters to matters for how much you should show off your riches. For example if you are a boutique practice catering to high income individuals, then maybe showing off your success is a positive since it makes your customers more confident in you.

However if you are catering to a low income crowd, parking your porche in the parking lot is a bad idea, because instead of making your patients feel comfortable, you will alienate them. You want to make yourself look poorer so you can relate better with your patients. Patients aren't dumb, they know you probably make 5x what they make, but atleast you are putting in an effort to be humble and relate to their lifestyle.

YMMV

Lol, go ahead and wear the rolex. I think the superficiality of changing your displays of wealth is not as important as how you talk to the patient. The ones that notice the rolexes more are either teenagers who want a rolex or similar working professionals who wear a rolex. You can actually bond those demographics due to the interest in watches.

You may be on to something about lower income patients. I don't have much experience with low income patients besides the walk-in emergency ext, so maybe I'm not relating to them at all. However, with middle/uppermiddle, I don't think it matters all too much.

 

[LFA20]

I have to have a nice commuting car since I work 22 days a month, travel to 6 offices and drive 20-30 miles each way. My car is like my 2nd house..... I eat and take a nap (during lunch hours or while my wife shopped or while my kids took their piano lessons) in it. So a tiny noisy sport car with rough ride like a Porsche 911 is not for me.

During my HS and college years, I drove a Toyota Celica with a stick shift. At first, I felt it was a cool thing to have because most of my friends have automatic transmissions. I hated it after getting stucked in the LA traffics and had to use both feet to drive. Now with an autopilot car, I can take my shoes off, stretch/ cross my legs, read the SDN forum on a 17 inch screen while the car "drives" me home.

what kind of car do you drive? 🙂

 

[2TH MVR]

Is there enough work for a specialist to work 5 full busy days a week at corp or would you need to have your own office for 2-3 days a week and supplement with corp?

Also, is a corp a better idea for a specialist than private practice? Dentists often say that in general dentistry your highest potential is in ownership (probably since you can employ hygenists and collect passive income), but for a specialist would potential be maximized in a corp instead since they just line up patients for you for the high profit procedures?


I think that where your practice is located and who it caters to matters for how much you should show off your riches. For example if you are a boutique practice catering to high income individuals, then maybe showing off your success is a positive since it makes your customers more confident in you.

However if you are catering to a low income crowd, parking your porche in the parking lot is a bad idea, because instead of making your patients feel comfortable, you will alienate them. You want to make yourself look poorer so you can relate better with your patients. Patients aren't dumb, they know you probably make 5x what they make, but atleast you are putting in an effort to be humble and relate to their lifestyle.

YMMV

Pretty sure most Corps are GP based with PT specialists bringing in additional revenue. I work 1-2 days a week per location. Orthos can see a butt-load number of pts. We have 1 Perio who services all the locations. Same for OS. Just one. No endos, pros or pedo. A specialist is rarely going to have a Ft time schedule at a single office. Specialists need multiple job scenarios which isn't necessarily bad. The money is good. I make almost twice that of the GPs. A GP needs to be in private practice. A GP can be in one location and have a full schedule.
As for cars and watches. Like you said. Depends on your clientele.

 

[charlestweed]

Is there enough work for a specialist to work 5 full busy days a week at corp or would you need to have your own office for 2-3 days a week and supplement with corp?

No. It's super-competitive here in CA. Like private offices , corp offices are struggling to get patients to fill up the appointment book as well. When the GPs are not busy, there will be less cases for the in-house specialists to treat as well. That's why I only work 5 days/month and one of their offices and travel to another branch office of theirs to work 6 days/month there.

Also, is a corp a better idea for a specialist than private practice? Dentists often say that in general dentistry your highest potential is in ownership (probably since you can employ hygenists and collect passive income), but for a specialist would potential be maximized in a corp instead since they just line up patients for you for the high profit procedures?

I think it's good to do both: part time at your own private office and part time at the corp offices. With the guaranteed daily pay that I get from my P/T job at the corp, I worry less about slow production months (from September thru January)...I worry less about losing a referral either because the GP starts doing ortho or hires an in-house ortho. And when I have my own private offices, I am less concerned about getting laid off. You never know....they can let you go anytime. When SmileCare sold their offices to Coast Dental 7-8 years ago, the new management team came in and fired a few of my orthodontic colleagues without any advanced notice. My friend who had worked for the Pacific Dental for 10+ years and had done well for the company. The company's new regional manager still let him go because he refused to work on certain days of the week....they hired another new grad to replace him.

To protect your family and to maintain the good lifestyle you that currently enjoy, you should have different sources of incomes: different jobs at different offices, investment properties, stock investments, 401k etc.

 

[periopocket]

No. It's super-competitive here in CA. Like private offices , corp offices are struggling to get patients to fill up the appointment book as well. When the GPs are not busy, there will be less cases for the in-house specialists to treat as well. That's why I only work 5 days/month and one of their brand offices and travel to another brand office of theirs to work 6 days/month there.

I think it's good to do both: part time at your own private office and part time at the corp offices. With the guaranteed daily pay that I get from my P/T job at the corp, I worry less about slow production months (from September thru January)...I worry less about losing a referral either because the GP starts doing ortho or hires an in-house ortho. And when I have my own private offices, I am less concerned about getting laid off. You never know....they can let you go anytime. When SmileCare sold their offices to Coast Dental 7-8 years ago, the new management team came in and fired a few of my orthodontic colleagues without any advanced notice. My friend who had worked for the Pacific Dental for 10+ years and had done well for the company. The company's regional still let him go because he refused to work on certain days of the week....they hired another new grad to replace him.

To protect family and to maintain the good lifestyle you that currently enjoy, you should have different sources of incomes: different jobs at different offices, investment properties, stock investments, 401k etc.

Let’s say I have a corporate opportunity for 1 day a week and I plan to have my private practice only 8 miles away - is this a no no? The Corp non-compete is only 2 miles.

 

[charlestweed]

Let’s say I have a corporate opportunity for 1 day a week and I plan to have my private practice only 8 miles away - is this a no no? The Corp non-compete is only 2 miles.

Perfect. I don't see any problem with this plan at all.

 

[321931]

What do you see with endo in SoCal? I hear a lot of different things. I love north SD and OC but not sure I’ll be able to return. I’ve heard it’s a bad idea to buy a practice.

Buying a practice is a smart thing to do.

Buying a practice in california....not the smartest thing to do.

CA sucks for dentists.

You will do fine as a specialist in California, but in general you will lag behind others.

 

[ToothJockey]

Oh thats another thing, some specialties control the # of students they accept, like OS. So you won't have to worry about as much saturation as general dentistry, if you are looking 20 yrs into the future.

It's possible with all these new grads being pumped out at an alarming rate GPs will have trouble finding a job (speculation on my part, too much supply not enough demand), but it doesn't seem likely a specialist like an OS will have trouble finding a job because they limit the number of residents.

Question for you dentists that work 4 days a week or under 40 hrs a week, is it because you don't feel like working more or is it because there isn't enough patients?

 

[charlestweed]

What do you see with endo in SoCal? I hear a lot of different things. I love north SD and OC but not sure I’ll be able to return. I’ve heard it’s a bad idea to buy a practice.

Most of the endodontists I know have done very well here in CA. A lot of HMO GP offices hire in-house endodontists. These GPs know how to tx plan HMO cases and they refer a lot patients to their in-house endos (perios and OS's as well). If you are good and fast and don't mind treating high patient volume every day, you'll do very well.

Endo #1: A former dental classmate and roommate. He was a non-traditional student. He started dental school at 36 and completed his endo residency at 42. He didn't want to set up his own office. He commutes by train from his Irvine house (which he already paid off a long time ago) to Pasadena 2-3 days/week to work at a heavily HMO endo office. He also works at 2 different GP offices in OC. Every time I saw him and asked how he was doing, he always said to me life is good and that he's glad he doesn't have do general dentistry. He and his wife don't have kids and they travel a lot back to their home country to do charity work.

Endo #2: Also a former dental classmate of mine. I didn't know he is an endodontist until he bought a house in my neighborhood. He told me he went back to school for endo after 2 years working as a GP. Since he could afford buy a similar size house like mine, I assume he has done very well. He has his own office. His wife is a pharmacist but she is now a full time stay home mom. They have 2 kids, an Audi Q7 and an Acura MDX.

Endo #3: he used to work for the same GP boss that my wife currrently works for. He left the job and spent about $180k to set up an endo office from scratch in Pasadena 6-7 years ago. I see him every year at my wife's boss' end-of-the year dinner parties. A couple of times at the dinners, he showed up in scrub....he's a very busy guy. He has a house in San Marino, CA, where none of the houses is worth less than a million dollars.

Endo #4: he currently works at my wife's GP boss' office. He replaced the endo #3, who quit his job. He also has a small 2 op private office. That's all I know about him.

Endo #5: he was my little sib in dental school. He also has his own practice. His wife is his receptionist/manager. He is the only endo I know who complained about his office not doing well. My wife's GP friend used to refer her patients to his office but now she refers her patients to the my classmate's (the Endo#2) office. According my wife's friend, the endo #5's chairside manner is not that great and his office doesn't accept many of her patients' insurances.

 

[TanMan]

Oh thats another thing, some specialties control the # of students they accept, like OS. So you won't have to worry about as much saturation as general dentistry, if you are looking 20 yrs into the future.

It's possible with all these new grads being pumped out at an alarming rate GPs will have trouble finding a job (speculation on my part, too much supply not enough demand), but it doesn't seem likely a specialist like an OS will have trouble finding a job because they limit the number of residents.

Question for you dentists that work 4 days a week or under 40 hrs a week, is it because you don't feel like working more or is it because there isn't enough patients?

It's because I can condense the same amount of patients in less days/week. Makes no sense to see 300+ patients in a 7 day work week when you can do it in 4.5 days. Why would I expand my working hours to 56 hours when I can do it in 33 hours? Makes no business sense. Even if you can gather more patients during the 2.5 days, how many more patients will you add? Another thing: staff hours, overtime, and increased variable operating expenses with opening more hours, but incrementally less gain or potential loss.

 

[321931]

Oh thats another thing, some specialties control the # of students they accept, like OS. So you won't have to worry about as much saturation as general dentistry, if you are looking 20 yrs into the future.

It's possible with all these new grads being pumped out at an alarming rate GPs will have trouble finding a job (speculation on my part, too much supply not enough demand), but it doesn't seem likely a specialist like an OS will have trouble finding a job because they limit the number of residents.

Question for you dentists that work 4 days a week or under 40 hrs a week, is it because you don't feel like working more or is it because there isn't enough patients?

It's about being efficient. Tanman hit the nail on the head.

Plus once you get used to 3 days weekends- you never want to work 5 days a week ever again.

 

[charlestweed]

Oh thats another thing, some specialties control the # of students they accept, like OS. So you won't have to worry about as much saturation as general dentistry, if you are looking 20 yrs into the future.

It's possible with all these new grads being pumped out at an alarming rate GPs will have trouble finding a job (speculation on my part, too much supply not enough demand), but it doesn't seem likely a specialist like an OS will have trouble finding a job because they limit the number of residents.

Question for you dentists that work 4 days a week or under 40 hrs a week, is it because you don't feel like working more or is it because there isn't enough patients?

For my sister, who is a GP, it's because she doesn't have enough patients. When she was younger, she worked 7 days/week (3 days/week at her own office, 4 days/week for the corp). As her own office got busier, she quit her corp job. As her kids were getting older and with less debt bills to pay back, she paid less attention to her practice.... she stopped paying for advertisements, worked half day on some weekdays so she could pick up the kids from schools, stopped accepting medicaid, avoids doing high risk complicated procedures and refers more of them out to the specialists. Consequently, her office has lost a lot of patients. She is totally fine with this because she wants to slow down and spends time to teach her kids. She is in her mid 40s and has practiced dentistry for 19 years.

It's the same for me. I can see up to 2000 patients in a month but I don't have that many patients. I only have 800 active ortho patients (all 4 offices combined) to keep me busy 11 days/month. Unlike many, who have bragged about not having to work very hard and have a lot of days off, I feel useless staying home doing nothing. To me, work gives satisfaction. I also want to make as much money as possible so I travel to work for 2 corp offices the other 11 days in the month. I currently see around 1300-1400 patients every month. This is still way below my capacity and that's why I have plenty of time to write posts on this forum to relieve the boredom.

I am with Tanman on condensing as many patients in one day as possible. It's actually boring and more depressing to have a slow non-productive day....and watch the staff sitting around doing nothing. Unlike my colleagues, who spent a lot of money to build a nice private office inside their office so they can relax at work, I don't have a private office...I maximize my office space by putting in as many treatment chairs as possible....so I can see more patients in a day. Busy schedule makes me feel the day goes by faster. By opening my offices to tx patientts 11 days/month, I only need to hire part time employees and cut the payroll (and electricity bills) in half.

 

[ToothJockey]

I agree with you guys, I would like to be busy all the time when I'm working.

I was just wondering why it is so rare to see a dentist working physician hours. Not saying they don't exist, I have shadowed a dentist that works 50+ hrs a week, he just loves dentistry a lot.

Another question for dentists that I've had on my mind a while. Suppose you wanted to work 220 doctor days a year, would you rather work 5 days a week for 44 weeks and take 8 weeks off a year (not all at once, maybe 1 week off every month or so) or would you rather work 4 days a week with pretty much no vacation at all, and why?

 

[321931]

The bottom line is knowing what you want in your professional life and personal life. Some people do three days a week and take a hit on income... because have 4 days off with kids and raising a family is more important. Some people condense to 4 and work hard play hard to have a 3 day weekend and try to make the most of a busy compact schedule... but they do take a hit on income by not opening Friday Saturday. Some people do 5/6 because they don’t mind working that much and they find the income and growth worth it.

When you are 20 you have different priorities then 30, 40, 50. And I can’t answer what your priorities are toothjockey. The orthodontist I refer to works 3 weeks 4 days- then closes for one week. He has 12 weeks off a year. The pediatric dentist, closes a ton especially over the summer. The competing dental group work a 3 week on, 1 week off rotation. Meaning they all have 12 weeks off- however they do work 5 days when they are Doing their rotation. When you are the boss you can cal the shots based on your priorities.

 

[TanMan]

I agree with you guys, I would like to be busy all the time when I'm working.

I was just wondering why it is so rare to see a dentist working physician hours. Not saying they don't exist, I have shadowed a dentist that works 50+ hrs a week, he just loves dentistry a lot.

Another question for dentists that I've had on my mind a while. Suppose you wanted to work 220 doctor days a year, would you rather work 5 days a week for 44 weeks and take 8 weeks off a year (not all at once, maybe 1 week off every month or so) or would you rather work 4 days a week with pretty much no vacation at all, and why?

From a business standpoint and solo practitioner point of view, it's better to have consistent hours that the patients can get used to. If you're off too much, your relevance in capturing the emergency market goes down quite a bit. Ideally, if I could have 2 weeks off, 4 times a year, that would be ideal. It's not too long that your office suffers, but long enough to have a good vacation. I don't take off too much, and I try to position my vacations for 1 week at a time. Losing 50-80k/week is hard to swallow sometimes. Alluding to another thread, that's why I'm a stickler when it comes to being able to get good rest to work as soon as the plane touches down. That extra day of work pays for vacation, flight, and then some. There's no way I could get a good enough rest in coach to where I can function as soon as I land (especially on ultra long haul flights to asia/ME).

 

[2TH MVR]

Your practice hours will vary depending on where you practice and how aggressive you are in making money. If you do not care about making big money ... then you can choose your hours accordingly. If you want to be competitive in a saturated, urban city ... then you will need to have competitive hours (evenings) and days (fri-sat). I can assure you that your competition (other GPs, Corps) will have very convenient hours.

Many patients want convenience. Many patients work. You will have more opportunities to attract patients with offset days and hours. Some of the dentists on this board have it good and can dictate their hours and days worked and still be aggressive in making money, but they are not the majority.

During my private practice years .... my work days were mon-thurs. I did this for years. Never changed. All the competition around me had mon-sat and evening hours. As a result my practice revenue started to decline.

As for vacations. Of course that is going to vary. In a mature practice .... I had staff that had earned 3 weeks of paid vacation. All of them. Very loyal staff that had been with me for many years. Well .... I would take 3 weeks off every year.

How many days to work? Again varies on your need to make money. Some need it (most of us lol) and others (PT spouses, etc) may not need it. Even during my hey day in private practice .... I worked a maximum of 4 days per week. That's it. I was fortunate in that I made enough during those 4 days to be happy. That was back then. Now is probably different in saturated areas. Some need to work more days and actually enjoy it (CharlesTweed maybe). Not myself. 4 days maximum with 3 days off. But that was my situation. 3 days off gives plenty of time for personal, family and re-energizing before the work week start again. Burn out is real and we all know what causes it.

I started in Corp 2-3 days a week. Got seriously bored. I work 4 days a week now. Nothing more.

So in saturated markets .... your days and hours will be dictated more so by your competition and patients. In rural areas ... you will have more control in dictating your hours.

 

[DDS9994]

I agree with you guys, I would like to be busy all the time when I'm working.

I was just wondering why it is so rare to see a dentist working physician hours. Not saying they don't exist, I have shadowed a dentist that works 50+ hrs a week, he just loves dentistry a lot.

Another question for dentists that I've had on my mind a while. Suppose you wanted to work 220 doctor days a year, would you rather work 5 days a week for 44 weeks and take 8 weeks off a year (not all at once, maybe 1 week off every month or so) or would you rather work 4 days a week with pretty much no vacation at all, and why?

I can tell you from my experience as a GP who did a start up 10 years ago, an have been in the field for 15 years, 8 weeks vacation a year for solo starting out is going to be very difficult if not impossible. For me it was about after 2 years of the stat up I was able to take vacations, they are never more than a week and its about 2 to 3weeks a year not even closet 8 weeks. Remember you are pre appointing pt. 6 months out, and if you are not open in dentistry people move on to the next office easily, we are not neurosurgeons with a highly specialized skills, nope we operate in a field where people offer free second opinions with X-rays, get my drift? Also keep in mind 8 weeks closed what about that staff of yours? You are gonna pay them for those 8 weeks off or tell them they don't get paid? They will not be happy to not nana check, remember they live check to check.

 

[ToothJockey]

Hmm I never really thought about staff. I guess taking 8+ weeks off a year would be easier with an associate/partner, but pretty much impossible as a solo practitioner.

I always thought the idea of working 5-6 days per week for 3 weeks and taking the 4th off was more appealing than working 3-4 days a week and not taking any weeks off. If you did have a partner who had the same priorities as you then you could possibly work something out so that the office is running at all times.

I've read the group practice model is taking off in dentistry, sort of like medicine. Maybe this is due to corporate pressure.

 

[DDS9994]

Hmm I never really thought about staff. I guess taking 8+ weeks off a year would be easier with an associate/partner, but pretty much impossible as a solo practitioner.

I always thought the idea of working 5-6 days per week for 3 weeks and taking the 4th off was more appealing than working 3-4 days a week and not taking any weeks off. If you did have a partner who had the same priorities as you then you could possibly work something out so that the office is running at all times.

I've read the group practice model is taking off in dentistry, sort of like medicine. Maybe this is due to corporate pressure.

Thats probably the only way I see that working is group practice, but that can have its own issues as well, some docs thinking the other is working less while expecting same percentage of profit sharing etc, your patients may only want to see you and not like seeing other docs. Not saying it won't work but lots if issues, I am solo, at there are lots of times I would like to have a partner to so the office can stay open, but having a partner is basically like a marriage you know how that goes. You are correct though that group practice is one of the ways to combat the advantage that corporate has. Tooth jockey also keep in mind that a solo GP making 7 figures is highly unlikely, not impossible but unlikely, it takes a special talent for both clinical efficiency, skill set, and business acumen, which I dare say the majority don't have. Solid 6 figure income is very realistic for a solo. As dentist you will be very comfortable, solid upper middle class, perhaps rich by the standards you grew up, BUT as dentist not upper class rich. A BMW and Lexus SUV and carrying a mortgage on 1,000,000 house in Pasadena is not rich, just means you have great cash flow. Remember you and I are basically day laborers who work with their hands, highly educated day laborers with pedigree but day laborers never the less. You know what happens if you and I go to Vail and break our right hand and leg and cant practice for 8 weeks plus? We are scewed big time and disability won't cut it. That hedge fund manger if he breaks his hand won't skip a beat, and will continue making money and earning commission. Hope that helps.

 

[ToothJockey]

Thats probably the only way I see that working is group practice, but that can have its own issues as well, some docs thinking the other is working less while expecting same percentage of profit sharing etc, your patients may only want to see you and not like seeing other docs. Not saying it won't work but lots if issues, I am solo, at there are lots of times I would like to have a partner to so the office can stay open, but having a partner is basically like a marriage you know how that goes. You are correct though that group practice is one of the ways to combat the advantage that corporate has. Tooth jockey also keep in mind that a solo GP making 7 figures is highly unlikely, not impossible but unlikely, it takes a special talent for both clinical efficiency, skill set, and business acumen, which I dare say the majority don't have. Solid 6 figure income is very realistic for a solo. As dentist you will be very comfortable, solid upper middle class, perhaps rich by the standards you grew up, BUT as dentist not upper class rich. A BMW and Lexus SUV and carrying a mortgage on 1,000,000 house in Pasadena is not rich, just means you have great cash flow. Remember you and I are basically day laborers who work with their hands, highly educated day laborers with pedigree but day laborers never the less. You know what happens if you and I go to Vail and break our right hand and leg and cant practice for 8 weeks plus? We are scewed big time and disability won't cut it. That hedge fund manger if he breaks his hand won't skip a beat, and will continue making money and earning commission. Hope that helps.

Yup I agree, partnerships can turn sour just like a marriage, and like a marriage there is lots of money to be lost when things go south. But then again, the model does work as seen in medicine, and as well in dental specialties where group practices are more common. It's probably important to work through the details of the partnership, make sure everyone is on the right page. I feel like a well run group practice can easily rival corporate, since they can offer a more boutique experience while keeping the corp advantages such as office hours/availability.

And I definitely see your point about dental income being based on labor. For a dentist to be truly financially independent and secure, they probably need to invest wisely and have some form of passive income. I know many dentists invest in real estate, buying the strip mall/building their practice is located in etc. The wealthiest dentists are the ones who invest well.

 

[2TH MVR]

Yup I agree, partnerships can turn sour just like a marriage, and like a marriage there is lots of money to be lost when things go south. But then again, the model does work as seen in medicine, and as well in dental specialties where group practices are more common. It's probably important to work through the details of the partnership, make sure everyone is on the right page. I feel like a well run group practice can easily rival corporate, since they can offer a more boutique experience while keeping the corp advantages such as office hours/availability.

And I definitely see your point about dental income being based on labor. For a dentist to be truly financially independent and secure, they probably need to invest wisely and have some form of passive income. I know many dentists invest in real estate, buying the strip mall/building their practice is located in etc. The wealthiest dentists are the ones who invest well.

Group practices work since they offer full scope services in one location. Win for patients and win for dentists and specialists. The other benefit is saving on overhead. I used to have two practices. One practice in an office condo I still own was only open 1 day per week. It sat vacant the rest of the week. I tried to get someone to rent it for the other days, but no success. The only disadvantage is that the specialists may not see referrals outside of the group.

As for outside dental investing. Be careful. Just saying you're going to invest in Real Estate and actually doing well are two different things. We are dentists. Not real estate investors. Real estate investors are very savvy and understand market direction and TIMING. Some dentists are good at this and most are not (like myself lol). I've dabbled in vacation beach condos. Renting them. I sold one and made money and the other ... I lost money. Built a brand new office/condo right before the real estate bubble burst. It's taken years for me to break even on that deal.

 

[321931]

Group practices work since they offer full scope services in one location. Win for patients and win for dentists and specialists. The other benefit is saving on overhead. I used to have two practices. One practice in an office condo I still own was only open 1 day per week. It sat vacant the rest of the week. I tried to get someone to rent it for the other days, but no success. The only disadvantage is that the specialists may not see referrals outside of the group.

As for outside dental investing. Be careful. Just saying you're going to invest in Real Estate and actually doing well are two different things. We are dentists. Not real estate investors. Real estate investors are very savvy and understand market direction and TIMING. Some dentists are good at this and most are not (like myself lol). I've dabbled in vacation beach condos. Renting them. I sold one and made money and the other ... I lost money. Built a brand new office/condo right before the real estate bubble burst. It's taken years for me to break even on that deal.

Dentists and physicians are terrible investors. Terrible. You might find one or two that have some good financial sense, but for the most part we suck. I dunno why, maybe we think the cash flow we make...we can afford to lose/gamble away at high risk investments, but at the end of the day, we lose, and it sets us back years for retirement.

Regarding group practice. It's really a toss-up. As you can tell here, dentists have very different and strong opinions. For some reason, we just always contradict each other. If you go to 10 different dentists- you will get 10 different treatment plans, and explanations why the other dentists are wrong. Going into a partnership with money involved is even riskier. I know more BREAK-UPS of partnerships rather then long term ones that have held through.

The most recent one that comes to mind is a group of 3 doctors in a complex, and they broke up, and the 3 of them continued to stay in the same building, but seperate each other by putting up walls. Must be a great time in the parking lot seeing each other lol.

I would highly recommend against group/partnerships. Even though the benefits are HUGE and GREAT in terms of buying power and being on call, and watching out for each other....there are big drawbacks. Made 100,000 extra profit and you want to split it...however the partner wants to invest in a in house mill unit machine... get ready for some arguments. So you guys settle on the machine, and now the partner is doing alot of, and you aren't and the fees for study club pile up...and the fees for the blocks. Maybe your lab doesn't give that big of a discount now because you are doing in house milling. Maybe you ACTUALLY lose a patient to the other doc because you just don't want to do the in house mill unit machine because you believe PFM's still are superior.

Who knows. But when it comes down to it, partnerships are incredibly hard.

 

[2TH MVR]

Dentists and physicians are terrible investors. Terrible. You might find one or two that have some good financial sense, but for the most part we suck. I dunno why, maybe we think the cash flow we make...we can afford to lose/gamble away at high risk investments, but at the end of the day, we lose, and it sets us back years for retirement.

Regarding group practice. It's really a toss-up. As you can tell here, dentists have very different and strong opinions. For some reason, we just always contradict each other. If you go to 10 different dentists- you will get 10 different treatment plans, and explanations why the other dentists are wrong. Going into a partnership with money involved is even riskier. I know more BREAK-UPS of partnerships rather then long term ones that have held through.

The most recent one that comes to mind is a group of 3 doctors in a complex, and they broke up, and the 3 of them continued to stay in the same building, but seperate each other by putting up walls. Must be a great time in the parking lot seeing each other lol.

I would highly recommend against group/partnerships. Even though the benefits are HUGE and GREAT in terms of buying power and being on call, and watching out for each other....there are big drawbacks. Made 100,000 extra profit and you want to split it...however the partner wants to invest in a in house mill unit machine... get ready for some arguments. So you guys settle on the machine, and now the partner is doing alot of, and you aren't and the fees for study club pile up...and the fees for the blocks. Maybe your lab doesn't give that big of a discount now because you are doing in house milling. Maybe you ACTUALLY lose a patient to the other doc because you just don't want to do the in house mill unit machine because you believe PFM's still are superior.

Who knows. But when it comes down to it, partnerships are incredibly hard.

Agreed. You have to have a certain personality to work with others. Some do. Some don't. I guess I was thinking more like having GPs and specialists all under the same roof. Sharing overhead, but not necessarily individual revenue.

 

[charlestweed]

Dentists and physicians are terrible investors. Terrible. You might find one or two that have some good financial sense, but for the most part we suck. I dunno why, maybe we think the cash flow we make...we can afford to lose/gamble away at high risk investments, but at the end of the day, we lose, and it sets us back years for retirement.

Regarding group practice. It's really a toss-up. As you can tell here, dentists have very different and strong opinions. For some reason, we just always contradict each other. If you go to 10 different dentists- you will get 10 different treatment plans, and explanations why the other dentists are wrong. Going into a partnership with money involved is even riskier. I know more BREAK-UPS of partnerships rather then long term ones that have held through.

The most recent one that comes to mind is a group of 3 doctors in a complex, and they broke up, and the 3 of them continued to stay in the same building, but seperate each other by putting up walls. Must be a great time in the parking lot seeing each other lol.

I would highly recommend against group/partnerships. Even though the benefits are HUGE and GREAT in terms of buying power and being on call, and watching out for each other....there are big drawbacks. Made 100,000 extra profit and you want to split it...however the partner wants to invest in a in house mill unit machine... get ready for some arguments. So you guys settle on the machine, and now the partner is doing alot of, and you aren't and the fees for study club pile up...and the fees for the blocks. Maybe your lab doesn't give that big of a discount now because you are doing in house milling. Maybe you ACTUALLY lose a patient to the other doc because you just don't want to do the in house mill unit machine because you believe PFM's still are superior.

Who knows. But when it comes down to it, partnerships are incredibly hard.

I don't like the partnership thing either. The whole point of seting up my own office is I can do whatever I want, hire whoever I want, work whenever I want etc....and not having to ask someone else (a partner) for approval.

I currently rent an office space from a GP and pay him a monthly rent. He's not my partner. He gives the the key and his alarm code. I can come to work whenever I want and do whatever I want at his office.

 

[ToothJockey]

You could always invest in the S&P 500 long term. Not even a dentist could mess up there.

And isn't partnership common in Oral Surgery? A lot of OS practices have 2+ partners, if I just type in OS practices near me and click on the website probably about 50% of the offices will have multiple partners. Seems to work out well for them otherwise why would it be so common? Is there any difference in a partnership for oral surgeons as compared to other dental specialists and GP's?

 

[2TH MVR]

I don't like the partnership thing either. The whole point of seting up my own office is I can do whatever I want, hire whoever I want, work whenever I want etc....and not having to ask someone else (a partner) for approval.

I currently rent an office space from a GP and pay him a monthly rent. He's not my partner. He gives the the key and his alarm code. I can come to work whenever I want and do whatever I want at his office.

What I typically see is an older dentist brings in a young associate who eventually buys in to a partnership. Not two dentists deciding to be partners day one.

 

[321931]

You could always invest in the S&P 500 long term. Not even a dentist could mess up there.

And isn't partnership common in Oral Surgery? A lot of OS practices have 2+ partners, if I just type in OS practices near me and click on the website probably about 50% of the offices will have multiple partners. Seems to work out well for them otherwise why would it be so common? Is there any difference in a partnership for oral surgeons as compared to other dental specialists and GP's?

Due to the nature of OMFS, it sorta makes sense why there is alot of "partnerships." If you are removing teeth all day, then yes there will be alot of cases that will be taken on-call. Having a partner be on call makes sense when you want to go to Italy- and can't take care of a raging infection that might come up on the weekend from your extraction. Due to the nature of OMFS- there are alot more cases that are on-call.

In all the other jobs/specialty- there isn't that many cases. I get a call maybe once every other month- and for it- I call in antibiotics.

In my area, there are 1 partnership, and 3 other omfs who are solo.

Regardless, its not as a common as you think. Dentists do not work well together. There are more broken and nasty partnerships that cost a ton of money through litigation, lawyers, and lost opportunity cost- then there is positive ones.

 

[321931]

More common with specialists, as they need to maintain coverage. If you are a solo endo, how will you ever take a vacation?

I tried the group thing. It has its challenges as dentists are not generally team players. The main upside is ease of time off. Overhead was not that much better. Meetings all the time.

I would be very hesitant to try it again. I would vet heavily, and have buy in period of 6mo. Otherwise these older docs will simply string you along. For GP I would not do it again.

Yup. What happens to the newly bright eyed specialist in a group setting?

The older OMFS will take all the easy wisdom teeth, and they will pass you all the 70 year old distal curved wisdom tooth #17 ext on coumadin, wheel chair bound, dental phobic, wants to be put to sleep, and on 5000 medications. And or they may say yeahhhhh work 6 more months and I'll give you the partnership contract bud! One of the oral surgeons that I worked with recently left his partnership and is unable to practice within 30 miles of the 3 offices. He said that yep, the older dudes gave me all the hardest exts ever and I had to break the contract. He's looking to do a start-up within the area after his noncompete runs out in 2 years.

That's why whenever someone tells me, oh yeah specialist, you graduate and make big bucks...I really beg to differ. If you join a partnership, expect to do all the **** cases, while the seniors take all the easy cases, and make worse money. Not only that, but you are in debt with the partnership, on top of student loans. If you do a start-up- expect to not break even for 2 years, and well if you do a corporate- it can be lucrative but exhausting driving to different offices everyday and doing alot more dentistry then would be in private practice

That being said- once you get a good thing going in specialty- in your startup- or you work your way up to senior status- and or you have a private practice that is running on all cylinders- being a specialist is awesome.

 

[ToothJockey]

More common with specialists, as they need to maintain coverage. If you are a solo endo, how will you ever take a vacation?

I tried the group thing. It has its challenges as dentists are not generally team players. The main upside is ease of time off. Overhead was not that much better. Meetings all the time.

I would be very hesitant to try it again. I would vet heavily, and have buy in period of 6mo. Otherwise these older docs will simply string you along. For GP I would not do it again.

So to clarify you are a solo endo? How does that work in terms of taking time off, suppose your referring GP needs someone in for a root canal, what happens then?

it can be lucrative but exhausting driving to different offices everyday and doing alot more dentistry then would be in private practice

True, but OTOH you don't need to go around looking for referrals, they have patients lined up for you.

I guess that's why Dr Tweed says to start both private practice as well as work for corporate when starting out, to have income while you grow your practice.

 

[ToothJockey]

Was gp, now in endo school. My observation is solo specialists never take time off.

Ah I see, solo specialist seems very stressful. You always have to be there for your GPs or you risk losing referrals. Income is probably higher though I'm guessing.