How easy is it to find work as a specialist after graduating from residency?

[Utdarsenal]

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Lets say you just graduated from residency a week ago. As an example, lets use Perio (although any specialty can be used as reference). How easy is it to find a full-time job once you graduate? What do most people usually do in this regard or how do they manage to get their schedule filled asap?

For example, when one graduates dental school as a GP, i’d say its relatively easy finding a full time position. Is it a different ball park as a specialist, though?

In general, what is the life of a 1-year out graduated resident like? Thanks.

 

[Masterus]

Perio is super regional specific. You most likely will have a hard time finding private practice work for it.

 

[charlestweed]

Lets say you just graduated from residency a week ago. As an example, lets use Perio (although any specialty can be used as reference). How easy is it to find a full-time job once you graduate? What do most people usually do in this regard or how do they manage to get their schedule filled asap?

For example, when one graduates dental school as a GP, i’d say its relatively easy finding a full time position. Is it a different ball park as a specialist, though?

The chance for a specialist to get a full time position at 1 office location is zero percent. Even at a very busy corp like mine, there are only enough patients to keep an OS busy 2 days/month, an ortho busy 6 days/month, a perio busy 1 day/month and an endo busy 1 day/month. Because the office saves all the highly paid procedures for specialists to perform on those days, the specialists usually make more per day than what the associate GPs make in 3-4 days. My wife used to travel to 9 different offices in the past. Now she only works 2-3 days/week and travels to 5 offices: her own office, 2 corp offices and 2 GP offices. I work 5 days/week and travel to 6 offices: 4 of my own and 2 corp offices.

In general, what is the life of a 1-year out graduated resident like? Thanks.

Beautiful. I get to do things that I am good at and don't have to do the procedures that I suck at like extractions, molar endos, making dentures, dealing with nervous young kids etc. It's been good for my wife and me because we are not very picky people. We can tolerate working with low tech equipment, traveling to multiple offices, treating low income patients, working with corp assistants and managers, brown-nosing the GPs, getting paid less when we were new grads and didn't have any experience etc. Some specialists couldn't tolerate these and had much harder time to find the jobs that they liked.....and they felt they made a wrong decision

 

[Utdarsenal]

Thank you for the responses everyone.
So, would you guys say most new graduates are driving from location to location trying to fill their schedule?

how long did it take you guys to build up to working full time? How common is it for one to directly buy into a specialty practice? Thanks all.

I guess my main concern is how fast a specialty student loan could be paid off, but, that would come down to how fast you could fill your schedule up. Thanks again.

 

[FutureDent020]

The 9 Endo residents who preceded me at my program all have full time jobs at one office 4-5 days a week. Small sample size, but just some facts to share.

 

[charlestweed]

Thank you for the responses everyone.
So, would you guys say most new graduates are driving from location to location trying to fill their schedule?

how long did it take you guys to build up to working full time? How common is it for one to directly buy into a specialty practice? Thanks all.

I guess my main concern is how fast a specialty student loan could be paid off, but, that would come down to how fast you could fill your schedule up. Thanks again.

It depends on how efficient you are at runing your office. The previous owner, who sold the office to me, worked 16 days/month but she only saw 10-12 patients a day. When I took over the practice, I reduced to 6 days/month and saw 30-35 patients a day. A few months later, I got bored for having too many empty slots and reduced to 4 days/month. I produced the same amount in 4 days as what the previous owner could produce in 16 days.

Working more days doesn’t necessarily mean you make more. It depends on the number of patients you treat per day, your chair time management skill, and your clinical skills. Higher efficiency = higher production = higher salary.

My wife and I both bought an existing practice. I also set up one from scratch. I have 4 offices. Regardless of which option (purchasing or starting from scratch) you choose, you have to go door to door to meet the GPs to introduce yourself. No GP referral = no money.

 

[P7898]

If people were smart, they would do demographic analysis and find out where the most ideal spot is to place an office. But then you'd have to find out where you want to settle. Sometimes being an aossicate in an area you want to settle in might make more sense then starting from scratch. Because then you can get a feel for the area and buy an existing office if there are a lot of providers and the ration of dentists per population doesn't add up.

 

[ibuprofen400mg]

It was very easy for me.

 

[bracketbuster68]

If people were smart, they would do demographic analysis and find out where the most ideal spot is to place an office. But then you'd have to find out where you want to settle. Sometimes being an aossicate in an area you want to settle in might make more sense then starting from scratch. Because then you can get a feel for the area and buy an existing office if there are a lot of providers and the ration of dentists per population doesn't add up.

Can you work in an area where you associate? What about non-compete clauses?

 

[charlestweed]

Can you work in an area where you associate? What about non-compete clauses?

You sure can. It's so saturated here in CA. There are dental/ortho offices everywhere. It's hard for the employers to forbid their associate doctors to set up offices nearby. I didn't have to sign any non-compete clause when I applied for jobs at corp offices. My wife recently joined the same corp that I work for 2 work days/month and they didn't ask her to sign any such clause either. They desperately need the specialists. My wife told them that she could only work until 2pm.... and I couldn't believe that they were ok with her demand.

My offices are in the same county with the corp offices that I work for. My friend's ortho office is less than 5 miles away from the corp office that he works for. Both my friend and I hire the corp's assistants to work at our own offices on the weekends. Since the corp offices can't give their assistants enough work hours, they don't mind if we hire their assistants to work part time for us.

 

[Cold Front]

The 9 Endo residents who preceded me at my program all have full time jobs at one office 4-5 days a week. Small sample size, but just some facts to share.

How is their average starting salary between the 9 of them (If you had to guess)? Keeping in mind, first couple of years is more of a transition out of school - in terms of speed and experience.


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[FutureDent020]

How is their average starting salary between the 9 of them (If you had to guess)? Keeping in mind, first couple of years is more of a transition out of school - in terms of speed and experience.


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Sure, I’ve asked 2 and I have a general idea about the rest. For the associates, it sounds like it’s $250K right off with a range up to $400K early on. That’s what they were told at least regarding the range, but the guarantee is $250K. Partners are generally ($400K-$600K) and then I’ve heard full owners are doing more than that. I don’t have facts about that, just hearsay. But basically, if you want to be an associate close to or in a bigger city, you’ll be between $200K-$250K base right out.


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[FutureDent020]

The lowest proposal I have seen was one in the JOE and it was for $180K base starting out. This included working at 2 different offices 50 miles apart with call. Probably the most unappealing I have seen yet.

 

[Cold Front]

But basically, if you want to be an associate close to or in a bigger city, you’ll be between $200K-$250K base right out.

Is the $200-250k income based on a % of production? As in, 40-45% of what they produce?

I have seen Endo practice owners complain about Endo new grads at their office starting very slow in their first year, averaging 2-3 cases a day. Which is probably common?


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[FutureDent020]

Is the $200-250k income based on a % of production? As in, 40-45% of what they produce?

I have seen Endo practice owners complain about Endo new grads at their office starting very slow in their first year, averaging 2-3 cases a day. Which is probably common?


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I know one for sure is $250K for 45% production. So yea, if the associate is working too slow then that could effect the agreed upon take home. I was just given $$ values for the others. No specifics on percentages. I’m continuing to ask around and will have more info soon enough. I’ll be going through the process myself here in the next year or so and will give as much info as I can.


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[Cold Front]

I know one for sure is $250K for 45% production. So yea, if the associate is working too slow then that could effect the agreed upon take home. I was just given $$ values for the others. No specifics on percentages. I’m continuing to ask around and will have more info soon enough. I’ll be going through the process myself here in the next year or so and will give as much info as I can.


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That’s some good info for anyone looking into Endo. Do you think those 9 people are all 1099 employment under those figures? If so, their FICA taxes would be higher for Medicare and social security.

I hope the Endo person you know making $250k first year or 2 makes more pretty soon. With student loan debt payments + inflation + stagnant insurance reimbursement = the opportunity cost to specialize might end up being in the red for a while. DSO’s are paying general dentists $250k a year with benefits, some as high as $350k+, depending on location and market.


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[endodonia]

DSO’s are paying general dentists $250k a year with benefits.

Where? I know for exceptional generalists this was the case in years past, however, as DSO's grow they don't hand those contracts out anymore except to maybe a select few. At least that's been my experience in witnessing the changing market forces out west.

is the 250k a guaranteed salary? FWIW, if I got paid 250K for doing 2-3 root canals a day I'd feel like I hit the lottery. I'd imagine those DSO general dentists work a little harder.

 

[Cold Front]

Where? I know for exceptional generalists this was the case in years past, however, as DSO's grow they don't hand those contracts out anymore except to maybe a select few. At least that's been my experience in witnessing the changing market forces out west.

is the 250k a guaranteed salary? FWIW, if I got paid 250K for doing 2-3 root canals a day I'd feel like I hit the lottery. I'd imagine those DSO general dentists work a little harder.

DSO’s in the suburbs pay the $250k+ numbers to their associate GPs.

I agree, you have to earn it. It’s not really hard to produce $3k day and take 33% at DSO’s. That’s about $1k a day, or $5k a week, or $250k a year on a 50 weeks a year work schedule. Those are averages - and with a quadrant dentistry, you would only need to see 3-4 patients in the morning and 3-4 in the afternoon with $400 production/patient. Remember, a crown + build up averages about $900-1k at most DSO offices. I have worked at a DSO office before (granted it was 9 years ago and in rural Midwest), the $250k income a year is very doable for a GP.

Endodontists making $250-300k a year income is still good, but when you factor in opportunity cost to specialize - they should be making $350k a year from day 1. Then again, no matter what area of dentistry you are in, you make what you produce. No guarantee income like medicine.



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[endodonia]

Then again, no matter what area of dentistry you are in, you make what you produce. No guarantee income like medicine.

For sure! It's great to see this DSO you know of respecting our profession. That day you laid out sounds like a great gig. Is this an established DSO? (aka a large DSO). My recommendation to anyone getting into the DSO game is the smaller the better. the bigger they get the more power they have and their rates of pay start going down. again, at least this has been my experience out west.

Thanks for the info!

 

[Cold Front]

For sure! It's great to see this DSO you know of respecting our profession. That day you laid out sounds like a great gig. Is this an established DSO? (aka a large DSO). My recommendation to anyone getting into the DSO game is the smaller the better. the bigger they get the more power they have and their rates of pay start going down. again, at least this has been my experience out west.

Thanks for the info!

Yes. Aspen Dental, which has over 800 locations now. Back in 2010, when I worked for them, they had about 300 locations and have since almost tripled their growth in practice locations. They heavily rely on CareCredit - the out of pocket financing option that comes with high APR if a patient defaults, although only 1 in 3 of patients get approved for CareCredit financing.

I still think the vast majority of DSO’s in this country stay out of cities due to saturation of private dental offices. For that reason, they heavily focus on suburbs and rural areas - and those positions pay well above averages, not just for GPs, but for specialists too.

Going back to Endo - I think the same rules probably apply, they won’t make good income if they are in saturated urban markets. So the $250k a year Endo income and offers are probably within big cities.


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[tombradyschin]

What are starting salaries looking like for Peds? I have heard from 2nd year residents to expect a minimum gaurentee of 1k/day, but production usually puts them higher. I have talked to a few 1 year out residents who claim 300k year one, some have said higher, some a bit lower

 

[Anondds87]

What are starting salaries looking like for Peds? I have heard from 2nd year residents to expect a minimum gaurentee of 1k/day, but production usually puts them higher. I have talked to a few 1 year out residents who claim 300k year one, some have said higher, some a bit lower

I'd like to hear this for ortho too

 

[P7898]

What are starting salaries looking like for Peds? I have heard from 2nd year residents to expect a minimum gaurentee of 1k/day, but production usually puts them higher. I have talked to a few 1 year out residents who claim 300k year one, some have said higher, some a bit lower

Truth. It is around there $200-$300k depends on the region though.

 

[spdental]

I'd like to hear this for ortho too

I’d like to hear this for oral surgery as well

 

[mmc12]

I'd like to hear this for ortho too

On ortho town, there are Some users staying they are paid as little as 700 a day.

 

[gumtee]

Can someone list opinions and points for all the specialities pls lol

 

[Pickprostho]

How about prostho and oral medicine and radiology?

 

[011110]

On ortho town, there are Some users staying they are paid as little as 700 a day.

if you are getting $700 as an ortho you are either getting hosed, extremely slow, or working 3 hours a day. You should get double that as an ortho associate

 

[mmc12]

if you are getting $700 as an ortho you are either getting hosed, extremely slow, or working 3 hours a day. You should get double that as an ortho associate

Or maybe there are not enough patients for the surplus/saturation of associate orthodontists and thus the relatively low pay

 

[011110]

Or maybe there are not enough patients for the surplus/saturation of associate orthodontists and thus the relatively low pay

i call BS, $700 per day for an ortho is laughable. All offers I have seen are $1000+ and I am in a saturated area. Psh

 

[Cold Front]

i call BS, $700 per day for an ortho is laughable. All offers I have seen are $1000+ and I am in a saturated area. Psh

Demand and supply. You can’t call anything BS until you know where the demand is high or low. No two markets are alike. I have seen $700 a day offers for Ortho.


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[Anondds87]

Demand and supply. You can’t call anything BS until you know where the demand is high or low. No two markets are alike. I have seen $700 a day offers for Ortho.


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Which cities?

 

[AppalachianDentalBoy]

Truth. It is around there $200-$300k depends on the region though.

I’ve met a few peds dentists that are slamming SSCs and crushing out fillings alllllll day on Medicaid patients here who are doing much better than that.

 

[charlestweed]

I’ve met a few peds dentists that are slamming SSCs and crushing out fillings alllllll day on Medicaid patients here who are doing much better than that.

An office that has a steady patient flow and treats high patient volume at low medicaid tx fee can produce more than a high end high overhead office that is struggle to fill the appt book. Sitting around due to high fees, being overstaffed and not having enough patients = inefficiency = lower salary pay. So don't expect to get paid much if you want to have an easy job at a slower office. This is why associate orthos who work at the busy corp offices usually make more than orthos who work at slow private ortho offices.

Like I said before, your income depends on how efficient and fast you are. You can work more days in a week and still make less than a guy who works fewer days but is faster and has more patients than you.

 

[Cold Front]

I’ve met a few peds dentists that are slamming SSCs and crushing out fillings alllllll day on Medicaid patients here who are doing much better than that.

I would be very careful with the words “crushing it” under medicaid. They are a slippery slope insurance and they can throw the book at anyone as they see fit. A lot of DSO medicaid chains were closed because they were “crushing it” with SSC’s and fillings all day.


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[2TH MVR]

Thank you for the responses everyone.
So, would you guys say most new graduates are driving from location to location trying to fill their schedule?

how long did it take you guys to build up to working full time? How common is it for one to directly buy into a specialty practice? Thanks all.

I guess my main concern is how fast a specialty student loan could be paid off, but, that would come down to how fast you could fill your schedule up. Thanks again.

Not sure about perio, but ortho in a saturated area .... plan on travelling. Probably true for most specialties. Travelling is not a bad thing. I travel to 3 offices. I actually enjoy the change in scenery. Change in staff. Change in patients. Even during my private practice days .... I had two locations and at one time 3. This issue of working out of multiple offices is not new nor do I find it a disadvantage. I actually enjoy my commute (45 mins each way) to give me time to wind down. If the commute was longer than 1 hr each way ... well .... not sure I would like it at this point in my life.

At least in Phoenix ... there must be plenty of opportunities for travelling specialists. There are dental offices EVERYWHERE and most advertise specialty services. Private and Corp. EVERYWHERE.

How hard is it to find a job with Corp companies? Anecdotally .... I work for a mid to large sized Corp with practices in 6-7 states. During my almost 3 years with this Corp ... they've hired many general dentists (many quit after 2-4 yrs) and only ONE specialist. An ortho grad right out of school. The specialists tend to stay whereas the gps look for better pastures.

Bottomline. Look for multiple opportunities. Network. Keep your name in front of the recruiters. Be willing to travel. You're first gig with a Corp is probably the location that none of the other company specialists want .... but that is how you get your foot into the Corp door.

 

[P7898]

I’ve met a few peds dentists that are slamming SSCs and crushing out fillings alllllll day on Medicaid patients here who are doing much better than that.

I am talking about base salary. Producers will always produce GP or Pedo.

 

[KMMG]

I'd like to hear this for ortho too

Ortho is 250k right out of residency if you work 14- 16 days a month (in Texas). 280k-300k if you worked 20 days a month (in Texas). This includes all bonuses and incentives any company can give you. But also if any company faced a financial hardship, ortho is the first specialty to cut down their days/ per diem or incentives. So your salary is always fluctuating. Hope that helps!

 

[Anondds87]

Ortho is 250k right out of residency if you work 14- 16 days a month (in Texas). 280k-300k if you worked 20 days a month (in Texas). This includes all bonuses and incentives any company can give you. But also if any company faced a financial hardship, ortho is the first specialty to cut down their days/ per diem or incentives. So your salary is always fluctuating. Hope that helps!

Can it go up much from there? As an associate?

 

[KMMG]

Can it go up much from there? As an associate?

No. Actually ortho is different. In most states working as an associate in private practice pays less than corporate. Old orthos take advantage of us suffering with corporate to pay you less and delegate more tasks to you. Remember in most private offices you will be seeing 80+ patients in addition to working after hours on your clinchecks and other digital work. I would say 70-80% of orthos in their first 5 years make 250k or below.
Also, you have to be very careful choosing which corporate u work for. Some like PDS and MB2 in Texas pays you only 25% of production and their model can’t support large number of patients+ the inherited patients you already have who are out of contract and don’t pay. So you can end up easily making $700/day after seeing 40+ patients.

 

[LFA20]

Not sure about perio, but ortho in a saturated area .... plan on travelling. Probably true for most specialties. Travelling is not a bad thing. I travel to 3 offices. I actually enjoy the change in scenery. Change in staff. Change in patients. Even during my private practice days .... I had two locations and at one time 3. This issue of working out of multiple offices is not new nor do I find it a disadvantage. I actually enjoy my commute (45 mins each way) to give me time to wind down. If the commute was longer than 1 hr each way ... well .... not sure I would like it at this point in my life.

At least in Phoenix ... there must be plenty of opportunities for travelling specialists. There are dental offices EVERYWHERE and most advertise specialty services. Private and Corp. EVERYWHERE.

How hard is it to find a job with Corp companies? Anecdotally .... I work for a mid to large sized Corp with practices in 6-7 states. During my almost 3 years with this Corp ... they've hired many general dentists (many quit after 2-4 yrs) and only ONE specialist. An ortho grad right out of school. The specialists tend to stay whereas the gps look for better pastures.

Bottomline. Look for multiple opportunities. Network. Keep your name in front of the recruiters. Be willing to travel. You're first gig with a Corp is probably the location that none of the other company specialists want .... but that is how you get your foot into the Corp door.

Would you say there are more opportunities to find GP jobs /make more in major cities?
I really don’t want to go back to specialzie and have to live rural lol to make significantly more than a GP

 

[Anondds87]

No. Actually ortho is different. In most states working as an associate in private practice pays less than corporate. Old orthos take advantage of us suffering with corporate to pay you less and delegate more tasks to you. Remember in most private offices you will be seeing 80+ patients in addition to working after hours on your clinchecks and other digital work. I would say 70-80% of orthos in their first 5 years make 250k or below.
Also, you have to be very careful choosing which corporate u work for. Some like PDS and MB2 in Texas pays you only 25% of production and their model can’t support large number of patients+ the inherited patients you already have who are out of contract and don’t pay. So you can end up easily making $700/day after seeing 40+ patients.

So what would be the best path for an ortho that doesnt want to open their own clinic?

 

[KMMG]

So what would be the best path for an ortho that doesnt want to open their own clinic?


If you are lucky and have flexibility to move between states, I have seen some went for better corporates where they negotiated for $1500/day and $100 for every bonding and debonding.
otherwise, you have to be content with the ortho income bracket working for corporates. If you are happy with that you will be fine. But generally speaking, no one in ortho enjoys corporates. Unfortunately freelancing in ortho is not very profitable. It’s like GP, you make the most when you open your practice. If you can’t see yourself doing anything other than ortho and understand your income bracket you will be the happiest person on earth. You are dealing with clean mouths, lovely teenagers who are excited about their appointment and the parents are your actual customers lol. Your appointment per patient doesn’t exceed 15 minutes outside bonding and debonding/appliances. But in corporate I do a lot myself as well since assistants are not very trained and at the end it’s your license. Most of us orthos like to live above our means. You will see OS parking his old Toyota in front of the office, and ortho is parking is BMW or g-wagon lol!!
If you really want to freelance I advice you to shadow Endo, OS and Perio.
Don’t only shadow a well established famous 80 yrs old specialist. His days are different than ours. Also, go and shadow someone in his first 3 years of practicing. I didn’t do that and I sometimes regret it. Look at the corporate numbers for all specialty. I have some orthos travelling as far as 95 miles and staying overnight in hotels away from their families trying to get better rates for their work. And now almost every new ortho practice is open on Sundays trying to compete for patients with older well established offices nearby and corporates.

 

[KMMG]

Think or ortho like that, you are getting paid to think while other specialty is doing much more themselves. And if you kept negotiating so hard sometimes it’s dangerous because if I had a couple of tough months where you are not bringing new patients. They will eventually let you go and bring someone who is willing to pay for less. No corporate is going to pay you more than what they make. And there are plenty of ortho and Pedo out there.

 

[KMMG]

Thank you for the responses everyone.
So, would you guys say most new graduates are driving from location to location trying to fill their schedule?

how long did it take you guys to build up to working full time? How common is it for one to directly buy into a specialty practice? Thanks all.

I guess my main concern is how fast a specialty student loan could be paid off, but, that would come down to how fast you could fill your schedule up. Thanks again.

It took me and almost most of my colleagues in ortho 6-9 months to get to a full time 18 days of work per month except those internationals who needed green card sponsorships. They agreed for decent money, longer contracts in return of sponsorship.

 

[Anondds87]

It took me and almost most of my colleagues in ortho 6-9 months to get to a full time 18 days of work per month except those internationals who needed green card sponsorships. They agreed for decent money, longer contracts in return of sponsorship.

Thanks for all that info, so useful!

 

[mmc12]

Think or ortho like that, you are getting paid to think while other specialty is doing much more themselves. And if you kept negotiating so hard sometimes it’s dangerous because if I had a couple of tough months where you are not bringing new patients. They will eventually let you go and bring someone who is willing to pay for less. No corporate is going to pay you more than what they make. And there are plenty of ortho and Pedo out there.

True. Ortho is a lot more about thinking whereas the other specialties are much more physically involved.