This seems like a huge financial advantage that other specialty dentists do not have. Why is it GP's dont out earn specialists? And can you imagine a dentist/RDH couple? If you included debt I bet they would make off better than a dentist/dentist couple.
How much does the average general dentist make?
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hmm it depends on the debt ratio, while an RDH wife is cheaper (because you save $50 an hour) a dentist wife can earn more than $50 an hour. again it just depends on how much debt the other person has to take to be in the business (plus the whole kids and family can be an issue too.)
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Maybe you should think about becoming a dentist for the right reasons rather than think about how much money you will make as a doctor or a dentist? Ever wonder why some dentists get a bad name now a day? Because they decide to take Fridays off instead of seeing a few medicaid patients that day? Or work in a non-profit clinic? By worrying about how much you will make, how many hours you'll work a week, etc. it seems that you are looking at dentistry for the wrong reasons.
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i think his parents are bullying him into an MD profession because they feel dentists aren't making as much as MDs. the OP seems genuinely interested in dentistry. hes got to prove to his parents that d-school is a good choice so they can pay his school bills 🙂 nothing wrong with that they want to make sure their investment pays off.
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Yeaahhh, maybe the frustration should be more directed at his parent 🙂 but I just feel that it is important to think past the money and focus on your duty to serve your community once you are a dentist, not the money you'll make.
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agreed!
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I'm impressed. I'm a little scared of heights so I'd never be able to live on a pedestal like that. Props.
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If by cleanings you mean prophies then *maybe* you could do 2 in 90 min. I've done that but it was in a managed care bust-your-a** clinic that I not-so-affectionately called "Sweatshop Dental".
A normal hygiene recall appt is an hour with exam, prophy, and X-rays totaling $200-$250. So sure, if you're paying your hygienist $50/hr, you are making a profit. However, that is not how you will figure hygiene into your budget. You will take all of your expenses to run the office (rent, utilities, supplies, assistant/front office wage, etc.) and divide that by the number of chairs. The number that you come up with per chair will likely be $150-200 per hour. Hence, you will only be breaking even in the hygiene column.
And for those who are planning to incorporate their spouse into their practice... That is generally a bad idea. Every dental business consultant will advise you against it.
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i guess its different everywhere. In NYC, in most offices where i've been. the hygienist is simply doing cleanings and thats it (no xrays or anything else) she will comment if anything looks odd and will recommend a visit to the dentist. the cleanings can be both superficial or deep (depending on who you get) but for the most part they do not take more than 30 minutes. Plus her chair is meant for her, so in that sense he is making tons of money off her work because he needs a hygienist and that chair would not be occupied by anyone anyway. either way the $50 he pays her is still low-ball compared to what he makes off her. thats why many RDH either switch careers (they get sick of it in general) or go to d-school.
also while i get the logic of expense division (i am a non trad with a finance background) it wouldn't make any sense to lump in the hygienist chair into the general expenses. You have to create allocations and then assign % of expenses to each chair, the RDH chair would have significantly less expenses than a DMD's chair. Therefore, the RDH chair is more profitable on a % basis and as a raw dollar indicator (because the RDH will still bring in way more revenue than her expenses.) Using totals and dividing by a chair is the easy way to do it, but it doesn't explain the picture properly. How can a RDH have equivalent expenses? For example, the basic expenses to the RDH (i.e. utilities) will differ because the RDH is working less hours than a DMD (at most offices) so therefore you cant just say that the RDH expenses are equivalent. Also the remaining expenses (i.e for tools or specific things related to the RDH's job) are still a lot less than the DMD who does all the DMD procedures and incurs higher expenses.
Additionally, if dentists would be breaking even on an RDH's chair, then the salaries of most RDH's would be significantly lower. Yes there is demand, but there are enough qualified RDH's in most areas to fill any gaps.
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That's how every office I've ever seen does it. Practice cost vs. producing providers. It may not seem logical but that's how they do it. Hygiene instruments cost probably more than you know. As for the office where the hygienists just scale scale scale, that model is called "accelerated hygiene" and of course they quit, do you know what that does to your body? Also, hygienists are not licensed to make the decision for the patient to see the dentist. That would indicate that the hygienist is doing a cursory exam (not in her scope of practice) and referring to the specialist (AKA dentist).
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so suggestions to see the dentist are not allowed? hmm interesting.
right well i see the way that the d-offices do the revenue/expense, thats because they're doing the simple mathematical way, but again doesnt make any sense. While hygiene equipment is expensive, it can't be more than the x-ray and other tools used by dentists (at least not more per month).
For the future (when you run your own practice) you should assign Revenue per chair and Expense per chair, then take the general expenses (i.e. rent, utilities, non-chair staff) and allocate them out by % to the chair. So a dentist chair might bring in 10K a month and have 4K worth of expenses and another 2K worth of general expenses to provide a revenue of 4k (for example, there numbers are not real) meanwhile a RDH's chair brings in 5k a month has an expense of 2k a month and a general expense of 0.5k a month, making it 2.5K profitable or 50% profitable vs. a dentist's chair that would be 4K or 40% profitable. As you can see this accurately paints the picture and lets you judge how much you make per chair without lumping in everything together.
While I agree RDH's have their own expenses (that can be quite huge) I dont think that on a percentage basis, their profitability is lower or equal to a dentist (just as I show in my example, you're RDH should be more profitable than your DMD chair.)
Adding things up together is easy but doesnt explain anything and fudges the numbers in such a way that makes RDH's look like a huge expense, if I thought that my RDH is 20% profitable, I would think im overpaying them or they aren't doing enough work. But in reality, i just did a bad analysis.
PS this also gives you a good argument if an office tries to tell you that your work is unprofitable or is "break even". Tell them to take a financial analysis or cost accounting class 🙂
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How can you eliminate financial gains as a wrong reason to become a dentist.
What you say say DOES NOT MAKE sense. I'll bet 95% of us who are out there are in it for the money. You do A->B and you make 150k and its guaranteed. Money makes this world go round, b/c of money people are finding cures for many diseases, i can go on... but you see the point.
When you get out of school you will have two options (red pill & blue pill sort of options) weather you work at place A see less people and get more days off and make good money, or bust your butt see 3-4X more patients and earn equal or less at medicaid office. And the amount of work that they make you do in dental school will change you.
so far what i have observed is that people who work in medicaid clinics are focused on quantity so that they can earn $.
Ps i got soo much to study so i cant go on but i will ask you this question.
Would you help 100 people or would you help 1 person. If you think about it, if you were to just donate like 200 bucks a month to 3rd world countries you can help more than 100 people per year, for their medical and dental. Think about that.
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MrAvicii,
Your argument has validity for sure. This is how a lot of people think about mid-level providers and how they can undermine dentists but any way you slice it dental practices are expensive. If I were to make a list of all of the equipment that is required for me to do traditional hygiene it would include things that one might not consider. For example: the air compressor, the unit (hand piece, suction, etc.), the chair, the xray machine (gotta have xrays to see bone levels), the computer, Dentrix, the Cavitron... these add up.
There have been pilot projects in various states (Colorado is one) where hygienists have tried to operate practices independently. They failed. The truth of the matter is that the office needs to have a healthy amount of crown and bridge procedures to survive. (pedos are an acception because they turn em and burn em).
The main reason why dentists need the hygiene column is that the hygiene exams are what feeds the restorative column. And, unfortunately, they only break even in the cost of running each hygiene chair. (and no, my employer did not feed me this line, my dad is a dentist).
Sorry y'all, this thread is totally hijacked!
Your argument has validity for sure. This is how a lot of people think about mid-level providers and how they can undermine dentists but any way you slice it dental practices are expensive. If I were to make a list of all of the equipment that is required for me to do traditional hygiene it would include things that one might not consider. For example: the air compressor, the unit (hand piece, suction, etc.), the chair, the xray machine (gotta have xrays to see bone levels), the computer, Dentrix, the Cavitron... these add up.
There have been pilot projects in various states (Colorado is one) where hygienists have tried to operate practices independently. They failed. The truth of the matter is that the office needs to have a healthy amount of crown and bridge procedures to survive. (pedos are an acception because they turn em and burn em).
The main reason why dentists need the hygiene column is that the hygiene exams are what feeds the restorative column. And, unfortunately, they only break even in the cost of running each hygiene chair. (and no, my employer did not feed me this line, my dad is a dentist).
Sorry y'all, this thread is totally hijacked!
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So taking Fridays off, according to you, gives dentists a "bad name?" What sense does that make?
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This is legit. I know a dentist in grosses $2 mill and took home ONE MILLION DOLLARS last year. Do you want to be a DO and have the insurance companies rule your life while being on call 24/7 including holidays??????
Dentistry rules!
Dentistry rules!
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i feel like we are back to square one, thus if you and I were to go to dinner and I order a $100 steak and you order a $10 burger. If I ask to split the bill, can you really say that you spent (i.e. incurred an expense) as much as I did?
Again I cant speak for all offices, but I can see how in offices in NYC. Dentists make a boatload of their RDHs. and again you cannot use the argument that the chair would used by a dentist, because it wouldnt be, you need 1 chair for an RDH and thats their expense. Like I said dentists are probably 30% to 40% profitable, while RDHs are probably 60 to 70% protitable. Again a $50 fee for and RDH's time vs. a $300 bill out, already shows you that the dentist bills out at 6 times the hourly expense of an RDH. No way that an RDH's tools cost more than or even close to x-rays and other expenses that a dentist has for running his chair.
So i'm sorry, i'm not quite buying that argument right now. Unless there is something I dont understand or am missing. Mathematically speaking, its impossible. (Assuming you're using the proper analysis. not the lump all expenses and divide by a chair, thats like saying when me and you go to dinner and split the bill that you really spent $55 on your meal, instead of the actual $10 that you incurred.)
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I'm not an accounting expert, but I believe the capital equipment in a practice can be depreciated on your tax returns each year, thus effectively reducing your taxes and ultimately, the net costs on these investments.
For example, say you purchased a panoramic x-ray machine for $100K which is estimated to have a useful life of 10 years. Using straight-line depreciation method, $10K would be written off each year as a depreciation expense resulting in a lower tax liability.
So in the end, even though you spent $100K on this machine, you are getting a certain portion of it back indirectly and thus, your net cost on this machine is much less.
Same goes for the chairs, instruments, auto-claver, furniture and every other tangible asset in the practice.
This needs to be factored too in your debates.
For example, say you purchased a panoramic x-ray machine for $100K which is estimated to have a useful life of 10 years. Using straight-line depreciation method, $10K would be written off each year as a depreciation expense resulting in a lower tax liability.
So in the end, even though you spent $100K on this machine, you are getting a certain portion of it back indirectly and thus, your net cost on this machine is much less.
Same goes for the chairs, instruments, auto-claver, furniture and every other tangible asset in the practice.
This needs to be factored too in your debates.
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agreed. Each line item i.e. person; would have their own Revenue and Expense lines. So an RDH is bringing in 500K in business for the year, I pay her 90K a year in salaries, 25K is spent on her equipment, etc. And then the general office expenses are attributed to her on a percentage basis. i.e rent, utilities, non-revenue driving staff, etc. Therefore it would look something like this:
Revenue for RDH: 500K
Expenses for RDH: 115K
General Expense Allocation for RDH: 50K (this is equal to the RDH's portion of general expenses, she is allocated this expense because its directly attributable to her function; this includes her piece of the rent, utilities, non-revenue driving staff, and other various expenses; but this does not include expenses such as the dentists chair or the dentists xray machine)
Net Revenue: 335K
The office equipment you mention can be tied directly to Expenses for RDH because it doesnt make sense to lump it into the total expenses bucket and make the dentist look less profitable (remember you cannot assign an expense where there is no direct revenue attached to it, except for the General Expenses Allocation.) If the dentist does not use the RDH's equipment, then the dentist should not bear the expense on their P&L statement, because they cannot contribute revenue to offset that chair.
I know im getting very technical on this topic, but it is a very long explanation to a very simple fact that an RDH contributes way more to the office than she is paid. Again I don't see how a dentist is breaking even on an RDH, in fact a dentist makes more off their RDH (on a profitability %) than they make off their associate dentists.
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500K? From one hygienist? Not possible.
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The numbers are hypothetical, yet the point still correct.
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Unless you set up a practice in a saturated area or have no personality, you should make a great living as a dentist. Shadow a dentist or two and make sure you like the environment.
I live in a town of 30,000 that is 30 minutes from a small city. There are a bunch of dentists concentrated in our town but they are doing fine. Our town is surrounded by rural areas with no dentists. I'm not sure exactly how much my dentist makes but she just remodeled her home and spent over 200,000, her husband is a stay at home dad, they have a nice boat and own a house on the lake (at least 300,000). She's been in practice for about 10 years and recently added an associate. I'm sure she's doing as well as a general practice physician and only working 35 hours a week vs their 60+ hours.
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Excuse me but are YOU an associate or an established dentist right now?
And the living cost in NY is much more than houston...
Plus associates nowadays all say that making 6 figures right out of dental school IS unheard of and that is coming straight from NUMBERS of associate.
This is talking about Vancouver but I doubt US will be much different.
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you have no idea what your idea talking bout my friend. NYC region is totally different from the rest of the country due to sheer population size and oversaturation. But no one comes out making 80K a year. Most new grads make at leasttttttttt 115 if not 125. IN NYC Region! I am not from Houston and I dont intend on practicing in TX.
the cost of living in NYC is expensive for those foolish enough to live in the city aka Manhattan. most (smart) people live in Brooklyn or Qnz where rent is 2x to 3x cheaper. i.e. 1bd room apt is usually around 1100 a month in Brooklyn vs the city where you can pay around 2500 a month.
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Pedo Mill: Spoke with the rep yesterday. It's been challenging to find a job looking for the past three weeks. However, the rep from this company seemed to be pursuing me for the interview at least. Keep in mind that the rep gets paid for setting up interviews, he doesn't do the hiring. However, the fact that he was eager to sign me up gives some sign of how hard his job is...
His pedo mill chain wanted to fly me 300 miles away to a small city to do an interview for a job that is actually in my much (10x) larger city. Online reviews of the actual office were negative describing it as "dirty" "run down" and as having six chairs in one room for all patients and dentists.
The rep offered 125k as guaranteed base, plus 25% of production once you reach a certain production threshold. 10 personal days vacation. 9 holidays. 3 CE days. health, 401k.
He told me the office is "fast paced" and sees 11-13 restorative procedures per day plus hygiene. They primarily treat medicaid pedo.
Maybe I'm foolish, but I decided not to interview there.
His pedo mill chain wanted to fly me 300 miles away to a small city to do an interview for a job that is actually in my much (10x) larger city. Online reviews of the actual office were negative describing it as "dirty" "run down" and as having six chairs in one room for all patients and dentists.
The rep offered 125k as guaranteed base, plus 25% of production once you reach a certain production threshold. 10 personal days vacation. 9 holidays. 3 CE days. health, 401k.
He told me the office is "fast paced" and sees 11-13 restorative procedures per day plus hygiene. They primarily treat medicaid pedo.
Maybe I'm foolish, but I decided not to interview there.
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Sorry to interrupt the discussion, but to give another answer to the OP and anyone interested:
http://www.bls.gov/oes/current/oes291021.htm
It breaks down the average salaries pretty nicely based on region, etc... assuming it's accurate.
http://www.bls.gov/oes/current/oes291021.htm
It breaks down the average salaries pretty nicely based on region, etc... assuming it's accurate.
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The BLS underestimates the actual income, as it is the declared income from dentists, who try to lower their income as much as they can so they can pay less taxes. They either give money to charity, buy more dental supplies, lease a lexus as a work car, etc. to claim higher expenses.
So dentistry is in pretty good shape, as the lowest 10 percentile still rakes in at least 70k/year.
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Definitely. When I hover over my area, it says the average annual income is about 150k. That's seems pretty legit. And even if it wasn't any more than that - I would be more than fine with it.
I usually just lurk around here but I have to interject with my knowledge of the business. I have managed dental practices for 3.5 years on the northeast.
We hire associates for 500/day base pay plus the occasional bonus if we have a really strong month. They work 5 days/week with some Saturdays sprinkled throughout. So right out of school these docs are making between 130-150 per year. Not only that, but the practice covers their liability insurance and offers full benefits. Pretty sweet deal.
As far as hygiene is concerned, I've seen hygienists making around 45/hour gross somewhere around 250-300k in revenue for an office.
Just thought I'd throw in my experiences. Certainly doesn't apply to all dental practices or areas of the US but associates rake it in up here
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We hire associates for 500/day base pay plus the occasional bonus if we have a really strong month. They work 5 days/week with some Saturdays sprinkled throughout. So right out of school these docs are making between 130-150 per year. Not only that, but the practice covers their liability insurance and offers full benefits. Pretty sweet deal.
As far as hygiene is concerned, I've seen hygienists making around 45/hour gross somewhere around 250-300k in revenue for an office.
Just thought I'd throw in my experiences. Certainly doesn't apply to all dental practices or areas of the US but associates rake it in up here
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Sorry, i don't mean to bring up this old part of the thread, but i don't see how this is possible. Especially after reading the Hammers thread "lets buy a dental practice" where a healthy amount of practice revenue (25%) should come from hygiene. Not to mention hygiene is one of the main reasons why pedo offices do so well. Just shear volumes of hygiene.
Again no offense, but it seems that if a practice is not making money off of hygiene, something is not being done right.
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Yeah I was just going to say, if you read Hammer's thread, the hygeine should be a healthy amount, not 60-70% of your collections.
Also, those BLS stats are neat, I've never had a look. I wouldn't doubt though if actual income is actually higher.
Also, those BLS stats are neat, I've never had a look. I wouldn't doubt though if actual income is actually higher.
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Pedo is a totally different bag. A child prophy usually takes 30 min (10 of which is spent cleaning). Also, it's usually an assistant that is performing a child prophy.
I'm telling you, though, the only way that (non-pedo) hygiene makes any measurable profit for an office is by getting the patients who are in for 6 mo prophies to enroll in restorative treatment. Once you factor in the cost of overhead for the hygiene chair and hygienist's wage you are at about 25% of gross.
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i hate to bring this old goose up again, but i really want to see the breakdown calculation of the 25%. again i cannot rationalize such a low margin for such a fast and high rate billing procedure such as cleaning.
If possible, can you please provide some #s so we may analyze them and come to some sort of conclusion?
if the above thread (from sdotcopp) is correct and assuming hygienists have an expense of 25K + 100K in salary, while bringing in 300K into the practice. This equals 175K in profits vs. 300K total, equaling 58% percent in profit. What I don't understand is how hygienists that bring in 300K into an office have expenses of 225K (yes 100K is in salary, but is it possible that they have an overhead of 115K? Really?)
Please let me know Seattle. PS please do not use the total number of chairs / by total number of people argument. I hate to be mean, but that argument is grossly incorrect and compares apples and oranges.
Thank you.
Based on the office I currently work at, I produce close to $1300/day as a dental hygienist. At 4 days per week that comes out to $5,200 dollars per week and $270,400 per year in production.
My mentor on the other hand, along with his part time associate produce a little over $1,000,000 per year. He works 3 days per week while she works the other 2 days, plus one day at the same time that he does.
This means that the total yearly production is close to $1.3 million per year. Last year it was just slightly under that number, and our year to date is projecting that we will produce approximately that much. However, what I have to mention is 2 important aspects in which to determine what my mentor actually makes. 1) Collection and 2) Overhead
The office has been collecting at over 95% for over 7 years now, up from the 85% they were collecting before. Both numbers are considered to be on the high end, but it is what our front desk contributes to the office and she is compensated very well for her great work. This means that while producing $1.3 million per year, the office will only see 95% of it, which comes out to $1,235,000 per year.
Now for the overhead in the office, which includes employee salaries/benefits, mortgage payment for the office (my mentor owns his building), supplies, gas/electric, etc. It comes out to around 73% of what the office has been producing annually in the past decade. This means that 73% of the $1.3 million is used in order to have his office operational. That comes out to about $949,000 per year.
Now, if you look at how much was collected ($1,235,000) and subtract the overhead value ($949,000), you get a pre-tax salary of $286,000 per year for my boss.
The fees set in our office are in the 80th percentile of what other GP offices charge within the same zip code, and the demographics of the area is known to be on the upper middle class side.
So based on this evaluation, it would be a safer bet to look at how much an office produces, then collects, and figure out what the overhead is in the office. In regards to what hygiene does in my office, I contribute to about 21% of what the office produces in total. Breaking down my per day production will show that at $1300/day at 73% overhead will yield my bosses wallet $351 per day. It is true that hygienists will be able to note "watch areas" for the dentist to look at while performing their exam, but it is ultimately the dentist that produces the restorative end of the production. I do not truly believe that the hygiene column in our office breaks even, since my boss has told me that we don't. However, to keep this simple, look at production, then collection and subtract the overhead. This will give you a more accurate evaluation of what a GP can make in private office.
My mentor on the other hand, along with his part time associate produce a little over $1,000,000 per year. He works 3 days per week while she works the other 2 days, plus one day at the same time that he does.
This means that the total yearly production is close to $1.3 million per year. Last year it was just slightly under that number, and our year to date is projecting that we will produce approximately that much. However, what I have to mention is 2 important aspects in which to determine what my mentor actually makes. 1) Collection and 2) Overhead
The office has been collecting at over 95% for over 7 years now, up from the 85% they were collecting before. Both numbers are considered to be on the high end, but it is what our front desk contributes to the office and she is compensated very well for her great work. This means that while producing $1.3 million per year, the office will only see 95% of it, which comes out to $1,235,000 per year.
Now for the overhead in the office, which includes employee salaries/benefits, mortgage payment for the office (my mentor owns his building), supplies, gas/electric, etc. It comes out to around 73% of what the office has been producing annually in the past decade. This means that 73% of the $1.3 million is used in order to have his office operational. That comes out to about $949,000 per year.
Now, if you look at how much was collected ($1,235,000) and subtract the overhead value ($949,000), you get a pre-tax salary of $286,000 per year for my boss.
The fees set in our office are in the 80th percentile of what other GP offices charge within the same zip code, and the demographics of the area is known to be on the upper middle class side.
So based on this evaluation, it would be a safer bet to look at how much an office produces, then collects, and figure out what the overhead is in the office. In regards to what hygiene does in my office, I contribute to about 21% of what the office produces in total. Breaking down my per day production will show that at $1300/day at 73% overhead will yield my bosses wallet $351 per day. It is true that hygienists will be able to note "watch areas" for the dentist to look at while performing their exam, but it is ultimately the dentist that produces the restorative end of the production. I do not truly believe that the hygiene column in our office breaks even, since my boss has told me that we don't. However, to keep this simple, look at production, then collection and subtract the overhead. This will give you a more accurate evaluation of what a GP can make in private office.
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Very interesting indeed, but you forgot to include the revenue that the dentist generates from dental procedures.
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He did include it. The yearly production is 1.3 million. That includes the gross from dental procedures and the hygiene gross.
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very interesting thread. but then again what's the actual overhead of your chair and your procedures?
The problem to me seems to be that dental offices are taking overhead as a total % and assigning it to all the chairs. That's like saying that me and 2 friends go out to dinner, they each have a slice of pizza and I have a T-Bone steak. When the check comes, I say "hey guys lets split it?" even if they agree to this, we all know that my "dinner expense" is way higher than their "dinner expense."
Therefore lumping numbers together and saying that everyone shares the 73% overhead is incorrect. The dentist and his associates may make up 50% of the 73% of overhead, while the hygentists only make up about 23%, making them 77% profitable. All of this has to be taken into account because otherwise you are stating a skewed picture. In my former life, I was a financial executive who dealt with profitability, revenue, expense, etc. So I look at it very different than most people. But the truth always lies in the numbers and to make an accurate assessment, one needs accurate revenues/expenses. Again the "one size fits all" explanation is incorrect. It is simpler yes, but does it paint the whole picture? certainly not.
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I've found it depends what "average" means. If average is an associate, working under a dentist, that plays a role. Patient pool plays a role, so making 100k+ wont just happen the year you open an office. Which brings me to my next point, private practice, I would love to open my own office one day! Then overhead for that office can range greatly between dentist A and dentist B.
When I shadowed my family dentist, I would imagine his overhead expenses are moderate. He has a small office, 2 hygienists, 2 assistants, and a receptionist. Then I shadowed another dentist, a specialist. Who has 3 offices, 4 other dentists who work under him, and I don't even know what to guess on the number of receptionists, assistants, or hygienists. The offices are extremely nice, then I shadowed his main office, and when I arrived, it looked like a dental empire this office was HUGE!!! My guess is that his overhead is 10x the amount of my family dentist.
It just depends on so much, so the range, in my opinion, the range is too big to even estimate what I would make.
When I shadowed my family dentist, I would imagine his overhead expenses are moderate. He has a small office, 2 hygienists, 2 assistants, and a receptionist. Then I shadowed another dentist, a specialist. Who has 3 offices, 4 other dentists who work under him, and I don't even know what to guess on the number of receptionists, assistants, or hygienists. The offices are extremely nice, then I shadowed his main office, and when I arrived, it looked like a dental empire this office was HUGE!!! My guess is that his overhead is 10x the amount of my family dentist.
It just depends on so much, so the range, in my opinion, the range is too big to even estimate what I would make.
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Here's a quote from Bill Blatchford's book Blatchford Blueprints, the art of creating practice success. He is one of the prominent dental practice coaches who spoke at a convention I attended last spring:
"OVERHEAD
Blatchford Formula For Determining Overhead Per Hour
This computation allows you to see how much you make per hour.
1. Indetermining what it costs to operate your office, remove from consideration: Capital expenditures (anything over $2000 per month), continuing education courses and travel for those courses, doctor benefits which are legal but do not influence the cost of producing a unit of dentistry in your office (ex; auto, AACD convention in Hawaii, etc.).
2. Total overhead per month and subtract the lab bill. This lab bill should reflect number of units this month multiplied by your lab fee per unit. If you use a Cad/Cam, assign an amount.
3. Divide overhead by total hours seeing patients equals cost per hour without lab.
4. Divide the number of providers; for example one doctor and one hygienist equal two providers.
5. This equals the cost per hour per provider.
6. Time procedures, including diagnostic time, prep time, seat time and add in the lab bill for laboratory procedures.
7. As you can see, once the lab bill is removed, the cost per hour for hygienist is same as for the doctor."
pg. 167
So lets say you have a tight 55% overhead (most practices are around 70%) and your percentages breakdown as so:
5% rent
5% equipment
10% marketing
10% lab
5% dental supplies
20% staff wages/benefits
= 55% overhead
(also from Blatchford's book pg. 168)
Your practice produces 1,000,000. Take 550,000 and subtract 100,000 for lab and 80,000 as the hygienist's wage. Divide by 2. That gives you 185,000. Add back in hygiene's 80,000 wage and you've got 265,000. If hygiene is producing 250,000-300,000 then that's pretty close to breaking even.
Dental supplies and equipment are expensive whether the dentist or the hygienist is using them. I asked the office manager at work today how much the patient chair itself cost. I thought $2000-$3000. Try $6000-$10,000!
"OVERHEAD
Blatchford Formula For Determining Overhead Per Hour
This computation allows you to see how much you make per hour.
1. Indetermining what it costs to operate your office, remove from consideration: Capital expenditures (anything over $2000 per month), continuing education courses and travel for those courses, doctor benefits which are legal but do not influence the cost of producing a unit of dentistry in your office (ex; auto, AACD convention in Hawaii, etc.).
2. Total overhead per month and subtract the lab bill. This lab bill should reflect number of units this month multiplied by your lab fee per unit. If you use a Cad/Cam, assign an amount.
3. Divide overhead by total hours seeing patients equals cost per hour without lab.
4. Divide the number of providers; for example one doctor and one hygienist equal two providers.
5. This equals the cost per hour per provider.
6. Time procedures, including diagnostic time, prep time, seat time and add in the lab bill for laboratory procedures.
7. As you can see, once the lab bill is removed, the cost per hour for hygienist is same as for the doctor."
pg. 167
So lets say you have a tight 55% overhead (most practices are around 70%) and your percentages breakdown as so:
5% rent
5% equipment
10% marketing
10% lab
5% dental supplies
20% staff wages/benefits
= 55% overhead
(also from Blatchford's book pg. 168)
Your practice produces 1,000,000. Take 550,000 and subtract 100,000 for lab and 80,000 as the hygienist's wage. Divide by 2. That gives you 185,000. Add back in hygiene's 80,000 wage and you've got 265,000. If hygiene is producing 250,000-300,000 then that's pretty close to breaking even.
Dental supplies and equipment are expensive whether the dentist or the hygienist is using them. I asked the office manager at work today how much the patient chair itself cost. I thought $2000-$3000. Try $6000-$10,000!
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I dont doubt Mr. Blatchford's work, but I have no idea why he's lumping in a dentist and a hygienist into one category. Is there any follow up in the book that explains this method? He is treating a dentist and a RDH as an equal providers, how can you do this? It makes zero sense! LOL. Plus wouldnt lab fees be an expense purely for the dentist? Does a hygienist incur lab fees? (please let me know if there are any.) It seems like Mr. Blatchford took everything together, lumped in and said this is the profitability by chair. The methodology is flawed (unless I am missing some vital piece of info, plz elaborate if I do.) His formula masks the true profitability of hygienists. Which I would bet, have at least a 40 to 50% profitability %, if the math was done properly. instead of lumping everything together, which is incorrect.
Again I will elaborate my methodology of going out to dinner, if we go out to dinner and I order 90% of the food and you order 10%, how can you take the total and split it by 2? why would that make sense? (if it doesn't, then the argument above doesn't make any sense either.) Again if I am missing anything please let me know, I have not read this book.
PS here the is the proper way to do the formula:
Practice Revenue: 1 Million
Dentist Revenue: 750K
Dentist Expense (expenses incurred by dentists only, including lab fees)) 150K
Dentist Allocation of General Expenses (85% of the 450,000 (lab is already include up top)): 383K
Dentist Net Income: 217K
Dentist's Profitability: 29%
RDH Revenue: 250K
RDH Expense (salary, benefits, etc.) 90K
RDH Allocation of General Expenses (15% of the 450,000 overhead)): 68K
Dentist Net Income: 92K
Dentist's Profitability: 37%
This all varies on Allocation of General Expenses and the true cost of an overhead (which maybe more or less.) The RDH's Allocation of General Expenses has to be properly calculated, the reason I used 15% is because an RDH has a lot less hours a week than the a dentist (hence she is using less of the lights, gas, energy, etc.) and also because her expenses are overall minimum. 15% to 25% is probably the fair amount of allocation for her. I doubt it would make sense to say that her and the dentist share 50% of the general expenses, when the dentist uses way more equipment, lights, gas, and even staff cost (because the staff assists the dentist, not the hygienist.)
Sorry for the majorly long post, but I would like to clarify and show the proper way to look at the numbers. Lumping it all together and dividing by # of providers is easy, but its dead wrong in terms of real %. The goal is not to make a dentist and a RDH equal, but to see a true profatibility and be able to compare. The best example is to compare 2 associates and see which one is more profitable. If you have associate A who spends more hours at the office, but collects less and has a high expense, he/she might not be better than associate B who can spend slightly less hours at the office and collects more. I intend on using such a method in the future to rank and determine my most profitable associates. (there are other factors to take into consideration i.e. one associate gets lucky and gets the most expensive work or has connections and gets more patients in. but then again that's the kind of associate I would want.)
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I have been doing this for 4+ years. I have worked regularly in 4 offices and temped in over 30 additional offices during that time. In every one of them the hygiene column is booked from open to close the same as the doctors column.
The front office staff answers the phone, books the schedule, bills insurance, etc. for all patients in the office whether they are seeing the dentist or the hygienist for their appt.
The assistants do a variety of tasks depending on the office but they almost always are the only ones to run instruments (dr. or hyg) through sterilization, they maintain the equipment for every operatory, they sometimes develop xrays for hygiene, they record the numbers for perio charts (done by hygiene), they order and stock supplies for the entire office, they do much more than sit chairside for the dentist.
The equipment in every operatory is essentially identical: patient chair, provider chair, assistant chair, unit, computer, software for computer, shared xray head, digital sensors, intraoral camera, etc. All instruments need to be sterilized so every piece of equipment in the sterilization room is a shared expense.
As for the instruments that are used for a hygiene procedure vs one for a dentists procedure they are comparable. The hygienist uses the Cavitron (dr does not) which costs $2300 or so. Each Cavitron tip costs about $150 and I need a minimum of three to make sure that there is a sterile one for each patient. Both dr and hyg use a slow speed hand piece. Each instrument (mirror, explorer, scaler, etc.) can be estimated at about $20-40. My prophy setup is 10 instruments whereas my perio setup is about 14. A composite instrument setup is about 10. Disposables are a larger expense on the hygiene side if you include giving out toothbrushes and floss. Restorative materials are a slight cost but if hygiene is also placing sealants then that can balance out as well in the expense of etch, bond, etc.
That is why Blatchford removes the lab bill prior to dividing the overhead. Once you remove that, everything else is about even. And yeah, hygiene is expensive.
One thing that plays a big role in our office is the fact that we are a PPO provider for several insurance companies. We therefore write off a large percentage of hygiene appts due to our agreement with them. So we might charge $110 for a prophy but plan A might reimburse at $93 and plan B might reimburse at $78! So as SLOBrule said above, it's all about collections.
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To have so much more restorative than hygiene doesn't sound right. Thats either a lot of decay (no fluoride in water) or some over-diagnosing. Most of the offices where I work are open 4 days a week. Everyone (hygiene, dr, assistant, front office) works 32 hours a week.
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First of all it depends on your area how much it is expensive. If you are living in a safe zone, you will have to spend a lot of money in your dental matters.
The plaque and stains on teeth are very common is a lot of patients and in order to remove stains and plaque people have only a single option and that is to visit the dentist. We all-time eating and sometimes we eat the food which your teeth does not like. This does not matter if your teeth are not supporting you and as a result, you starting to avoid to take that stuff again. The solution is that to visit a dentist and allow him to examine the teeth and gums condition. READ MORE
The plaque and stains on teeth are very common is a lot of patients and in order to remove stains and plaque people have only a single option and that is to visit the dentist. We all-time eating and sometimes we eat the food which your teeth does not like. This does not matter if your teeth are not supporting you and as a result, you starting to avoid to take that stuff again. The solution is that to visit a dentist and allow him to examine the teeth and gums condition. READ MORE
