How often does an orthodontist get off for vacation?

[btd1908]

Seeing as most orthodontists own their own practice, I'm curious about how taking vacation works. The orthodontist I shadowed today talked about not being able to take much vacation ( only 1 time - 2 weeks off during Christmas and several maximum 3-4 days off to go to conference etc...). He works 5 days a week, goes to work from 7:30 am to 5 pm. His office is busy often seeing 40-50 pt a day.

Is there an average number of weeks of vacation in ortho? Does this situation change much as an associate vs. owning your own practice?

Any thoughts? In an ideal situation, I'd like to be able to take a couple 2-3 weeks vacation a year with my family. Just curious if ortho will allow this, or at what cost. Thanks!

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[DrJeff]

You can take what you feel comfortble with doing. Often for many what they feel they can take off and have it not be an issue to their practice, is far less than it actually is.

Also, the longer you've been in practice, often you realize that it is OK to take more time off, especially when/if one has their own kids.

For many solo owners, it is a bit of a process over time to figure out what that time off balance is, and regretably, some may never be able to do this, whereas others figure it out quite quickly

 

[allDAT]

Associates don’t usually get any PTO. Taking time off as an associate is often frowned upon if it’s more than a week. Even a week is pushing it because it shuts the revenue off for the owner.

For owners - it just depends, but when you take a break, the majority of the money stops coming in so that’s a real challenge you have to navigate as a business owner where the top chef has to be present and can’t delegate much of what he does because … he’s the only one licensed to do the duties. All dentists have to balance this.

 

[allDAT]

Seeing as most orthodontists own their own practice, I'm curious about how taking vacation works. The orthodontist I shadowed today talked about not being able to take much vacation ( only 1 time - 2 weeks off during Christmas and several maximum 3-4 days off to go to conference etc...). He works 5 days a week, goes to work from 7:30 am to 5 pm. His office is busy often seeing 40-50 pt a day.

Is there an average number of weeks of vacation in ortho? Does this situation change much as an associate vs. owning your own practice?

Any thoughts? In an ideal situation, I'd like to be able to take a couple 2-3 weeks vacation a year with my family. Just curious if ortho will allow this, or at what cost. Thanks!

2 week vacations…doable but very hard for most dentists. 3 weeks…you have to build a business model that would accommodate this. What do your employees do for 2 or 3 weeks while you’re gone? You can’t expect them to not get paid for that long several times a year.

 

[btd1908]

You can take what you feel comfortble with doing. Often for many what they feel they can take off and have it not be an issue to their practice, is far less than it actually is.

Also, the longer you've been in practice, often you realize that it is OK to take more time off, especially when/if one has their own kids.

For many solo owners, it is a bit of a process over time to figure out what that time off balance is, and regretably, some may never be able to do this, whereas others figure it out quite quickly

Thank you Dr. Jeff. The reason I asked that question is because often orthodontists have to deal with so many pt in a day. And I think that with that huge amount of pt pool, an orthodontist won't be able to get a time off from the practice except for holidays. With braces, pt need to come back 4-8 weeks so if I choose to left 2-3 weeks at a time, the time of treatment for my pt is gonna be extra long.

2 week vacations…doable but very hard for most dentists. 3 weeks…you have to build a business model that would accommodate this. What do your employees do for 2 or 3 weeks while you’re gone? You can’t expect them to not get paid for that long several times a year.

Thank you for your input! I get what you mean. In my naive mind, I just think that I can afford to pay them but thinking back, orthodontist need a lot of DAs so it would not possible if I do multiple vacation like that!

 

[allDAT]

Thank you Dr. Jeff. The reason I asked that question is because often orthodontists have to deal with so many pt in a day. And I think that with that huge amount of pt pool, an orthodontist won't be able to get a time off from the practice except for holidays. With braces, pt need to come back 4-8 weeks so if I choose to left 2-3 weeks at a time, the time of treatment for my pt is gonna be extra long.

Thank you for your input! I get what you mean. In my naive mind, I just think that I can afford to pay them but thinking back, orthodontist need a lot of DAs so it would not possible if I do multiple vacation like that!

it’s not only the employee compensation, it’s all your fixed overhead that you have to pay. Turning the cash tap off is stressful. One of the major downsides to our profession.

 

[DrJeff]

Thank you Dr. Jeff. The reason I asked that question is because often orthodontists have to deal with so many pt in a day. And I think that with that huge amount of pt pool, an orthodontist won't be able to get a time off from the practice except for holidays. With braces, pt need to come back 4-8 weeks so if I choose to left 2-3 weeks at a time, the time of treatment for my pt is gonna be extra long.

Thank you for your input! I get what you mean. In my naive mind, I just think that I can afford to pay them but thinking back, orthodontist need a lot of DAs so it would not possible if I do multiple vacation like that!

As someone who is married to an orthodontist (my wife is in a 2 doc practice so it isn't the solo situation you inquired about) most of the working around the patients and their regular adjustment visits happens via having the daily scheduling template for the practice set up 6+ months in advance. For example, right now in my wife's office, they have the scheduling template set up through the end of March 2023, and they're working on April 2023 now, so if my wife wants to take a vacation, 6 months out, her schedule is blocked out for that week and in the case of her office, the daily volume is reduced from a 2 doc schedule to a 1 doc schedule, and on the rare occassions when both her and her partner are out of the office at the same time, unless it's an emergency, those days are known months in advance and the office scheduling template is closed for those days.

In this profession, you often are thinking about what you will be doing 6 to 9 months in advance and adjusting your schedule accordingly. Which reminds me that I need to block my own schedule off for my youngest kids April vacation week in 2023 now!

 

[2TH MVR]

In private practice ... I typically always took 3 weeks off. 1 week around xmas and new yrs. 2 weeks during the summers.
Most of my staff had accrued vacation time. My 3 weeks were known way in advance. The staff were asked to take their vacations at the same time. If a staff member didn't have vacation time or needed to take a different time for their schedule ..... they would be asked to work at the office. Answer the phones. Post payments. Take emergencies. Etc. Etc.

If the entire staff and myself were out of the office on vacation ..... I had another ortho colleague take my emergencies.

As for collections. Money is always coming in even when I'm not in the office due to the monthly payments.

Now I work for a DSO. I can take as many vacations as I want.

 

[charlestweed]

Seeing as most orthodontists own their own practice, I'm curious about how taking vacation works. The orthodontist I shadowed today talked about not being able to take much vacation ( only 1 time - 2 weeks off during Christmas and several maximum 3-4 days off to go to conference etc...). He works 5 days a week, goes to work from 7:30 am to 5 pm. His office is busy often seeing 40-50 pt a day.

The reason the orthodontist, whom you shadowed, has a busy and successful practice is he works hard to take good care of his patients and to keep them happy. Nobody wants to see an ortho who takes vacations all the time. General dentists won’t refer patients to an ortho office whose owner takes vacations all the time. Keep in mind that if your office is struggling financially, you can't afford to travel.

Any thoughts? In an ideal situation, I'd like to be able to take a couple 2-3 weeks vacation a year with my family. Just curious if ortho will allow this, or at what cost. Thanks!

It depends on how much you make and how much you owe (in student loans, home loan, and practice loan etc). If you only make $250-300k and you have a total debt of $8-900k, you are a broke orthodontist. You are actually poorer than my office manager makes $45k/year and has zero debt. You can’t afford to take even a 1 wk vacation a year. My office manager has never taken a fancy vacation trip (like going to Hawaii) in her life because she can’t afford it.

 

[charlestweed]

As someone who is married to an orthodontist (my wife is in a 2 doc practice so it isn't the solo situation you inquired about) most of the working around the patients and their regular adjustment visits happens via having the daily scheduling template for the practice set up 6+ months in advance. For example, right now in my wife's office, they have the scheduling template set up through the end of March 2023, and they're working on April 2023 now, so if my wife wants to take a vacation, 6 months out, her schedule is blocked out for that week and in the case of her office, the daily volume is reduced from a 2 doc schedule to a 1 doc schedule, and on the rare occassions when both her and her partner are out of the office at the same time, unless it's an emergency, those days are known months in advance and the office scheduling template is closed for those days.

In this profession, you often are thinking about what you will be doing 6 to 9 months in advance and adjusting your schedule accordingly. Which reminds me that I need to block my own schedule off for my youngest kids April vacation week in 2023 now!

If you plan things ahead, you can take vacations as many times in a year as you can even when you work 6-7 days a week. I know an ortho, who travels back to his native county very frequently to do charity work there. Before he took an entire month off for traveling, he worked 20-25 days straight (including Saturdays and Sundays) to take care of all of his active patients.

It's the same for me. I can't just take vacation anytime I want to. I can only travel during the time that my kids are off (summer, Spring break, Chrismas break etc) because I don't want them to miss schools. So I have to plan my vacations at least 3 months in advance.

 

[charlestweed]

When I take vacations, I can only ask my P/T assistants to stay home without pay. I still have to pay my 2 F/T employees because neither of them can afford to take time off. They’re both living paycheck to paycheck. So both of my F/T get paid 54 wks (the regular 52 work weeks + 2 wk vacation pay).

I am not too excited about taking vacation anymore. I hate flying. I take vacation just to make my wife and kids happy. It’s a big waste of money. A 1wk trip to Hawaii for a family of 4 easily costs me $12-15k. I’d rather use this same amount to pay a monthly lease on a nice car, which I can enjoy every day, for an entire year. With this same amount, I can take my family out for a nice expensive steak dinner at Ruth’s Chris at least 40 times in a year. I enjoy eating good food a lot more than traveling.

 

[Molar Whisperer]

I would prioritize taking some time off with the family. Sorry I'm not an orthodontist nor a practice owner. My father was a solo OB-GYN practitioner. He worked 7 days a week, 24 hrs a day (babies like to come out complicated and at 3:30 am). He is the reason I didn't go to Medical School. He doesn't know how to relax on vacation as he is always in a rush. We grew up very dysfunctional and I watched him deteriorate physically and mentally. A wise poster once mentioned on your death bed, you're not going to wish you made every monthly goal (or that extra $100k +). As we all mentioned numerous times, keep your loans, expenses, overhead, etc as low as possible so you won't fall into that financial abyss (slavery).

 

[allDAT]

In private practice ... I typically always took 3 weeks off. 1 week around xmas and new yrs. 2 weeks during the summers.
Most of my staff had accrued vacation time. My 3 weeks were known way in advance. The staff were asked to take their vacations at the same time. If a staff member didn't have vacation time or needed to take a different time for their schedule ..... they would be asked to work at the office. Answer the phones. Post payments. Take emergencies. Etc. Etc.

If the entire staff and myself were out of the office on vacation ..... I had another ortho colleague take my emergencies.

As for collections. Money is always coming in even when I'm not in the office due to the monthly payments.

Now I work for a DSO. I can take as many vacations as I want.

I think the OP is talking about taking 2 or 3 weeks per vacation, not 2-3 weeks off per year.

 

[2TH MVR]

I think the OP is talking about taking 2 or 3 weeks per vacation, not 2-3 weeks off per year.

You're right.
I've never in 30 yrs of practice taken 2-3 weeks off in a row. A week and a half. Yes.

 

[charlestweed]

I would prioritize taking some time off with the family. Sorry I'm not an orthodontist nor a practice owner. My father was a solo OB-GYN practitioner. He worked 7 days a week, 24 hrs a day (babies like to come out complicated and at 3:30 am). He is the reason I didn't go to Medical School. He doesn't know how to relax on vacation as he is always in a rush. We grew up very dysfunctional and I watched him deteriorate physically and mentally. A wise poster once mentioned on your death bed, you're not going to wish you made every monthly goal (or that extra $100k +). As we all mentioned numerous times, keep your loans, expenses, overhead, etc as low as possible so you won't fall into that financial abyss (slavery).

OBGYN is a tough profession, but someone’s got to do it. To you, he may not be a good father. But to many of his patients, he’s their hero. I really admire my wife’s OB doctor for putting in a lot of her time to take good care of my wife and her other patients. That’s why we chose her to help deliver both of our kids. We wouldn’t want to pick an OB doc who took vacation all the time. The OB doc is an unmarried woman. I guess it’s probably because of her busy job, which makes it very hard for her to meet other people. I later heard that she retired because of her chronic back problem. I have a lot of respect and admiration for all the physicians. They have much more difficult jobs than us, dentists. And not a lot of people, including their own family members, appreciate their sacrifices.

 

[charlestweed]

You're right.
I've never in 30 yrs of practice taken 2-3 weeks off in a row. A week and a half. Yes.

2-3 weeks is way too long, especially for the kids. You will run out of things to entertain yourself and the kids when you have such long vacation. As both of my kids are getting older, they seem to be less excited about vacation. They’d rather be with their friends than with us, old boring adults. At least my son and I have one thing in common. We both love football. Can't wait to go see my LA Rams playing against his Denver Broncos this coming Xmas Day.

 

[Molar Whisperer]

OBGYN is a tough profession, but someone’s got to do it. To you, he may not be a good father. But to many of his patients, he’s their hero. I really admire my wife’s OB doctor for putting in her a lot of her time to take good care of my wife and her other patients. That’s why we chose her to help deliver both of our kids. We wouldn’t want to pick an OB doc who took vacation all the time. The OB doc is an unmarried woman. I guess it’s probably because of her busy job, which makes it very hard for her to meet other people. I later heard that she retired because of her chronic back problem. I have a lot of respect and admiration for all the physicians. They have much more difficult jobs than us, dentists. And not a lot of people, including their own family members, appreciate their sacrifices.

You're absolutely right when physicians can be heros to patients. Once the patients leave their care, most patients will forget all about them and go about their business/families. Most won't care if the physicians have chronic back problems or other difficulties...that is their family's problem if they have one.

Seeing as most orthodontists own their own practice, I'm curious about how taking vacation works. The orthodontist I shadowed today talked about not being able to take much vacation ( only 1 time - 2 weeks off during Christmas and several maximum 3-4 days off to go to conference etc...). He works 5 days a week, goes to work from 7:30 am to 5 pm. His office is busy often seeing 40-50 pt a day.

Is there an average number of weeks of vacation in ortho? Does this situation change much as an associate vs. owning your own practice?

Any thoughts? In an ideal situation, I'd like to be able to take a couple 2-3 weeks vacation a year with my family. Just curious if ortho will allow this, or at what cost. Thanks!

Taking 2-3 weeks off per vacation is not realistic for any industry where you are the small business owner unless you have staff that can take in new business and or continue to generate income/production without your presence. I had a Pedo colleague in the Corp who loves to travel the world taking 2 weeks off 3 to 4 times a year. She's starting her own practice next week and she is sad she won't be able to continue those trips. I think starting a practice is like marriage. You signed up for it and you must commit unless you're planning on selling it/flipping it.

 

[DrJeff]

2-3 weeks is way too long, especially for the kids. You will run out of things to entertain yourself and the kids when you have such long vacation. As both of my kids are getting older, they seem to be less excited about vacation. They’d rather be with their friends than with us, old boring adults. At least my son and I have one thing in common. We both love football. Can't wait to go see my LA Rams playing against his Denver Broncos this coming Xmas Day.

I guess it depends on what your kids are used to. My kids used to go away to Summer Camp for 2 -4 weeks at a time, as they got older, some of that time was also as a junior camp counselor, and now one of them actually works a Summer job as a camp counselor (that kid also just got dropped off at College for her Freshman year a week ago), so a multi week vacation wouldn't be a big deal for them.

Additionally, if I was doing a multi week vacation with my family (something I now more than ever wish I did, and get that I could of done and my practice would stlll be there and be fine especially after how Covid affected "normal life" and now having to walk by and empty room with my daughter off at college and not home now), that vacation would likely be a mix of say touring a few National Parks as well as sometime at either a beach resort or theme park.

And has been said before in this thread, ultimately when you look back on things, especially with a family and over time, I can certainly say that I have way more vivid and enjoyable memories of vacations my family took from say 10 years ago, than anything I did work related that long ago.

Ultimately, whenever my time on Earth is done, I want to be remembered way more for the husband, father, son, brother, and friend that I was than as a dentist, and I do enjoy being a dentist, it's just simply a portion of who I am, and to me, especially as I get older, I really get that, and certainly would of done a few things differently in the past that would of created more time with my family and less time in the office

 

[2TH MVR]

Ultimately, whenever my time on Earth is done, I want to be remembered way more for the husband, father, son, brother, and friend that I was than as a dentist, and I do enjoy being a dentist, it's just simply a portion of who I am, and to me, especially as I get older, I really get that, and certainly would of done a few things differently in the past that would of created more time with my family and less time in the office

Well said.

 

[charlestweed]

I guess it depends on what your kids are used to. My kids used to go away to Summer Camp for 2 -4 weeks at a time, as they got older, some of that time was also as a junior camp counselor, and now one of them actually works a Summer job as a camp counselor (that kid also just got dropped off at College for her Freshman year a week ago), so a multi week vacation wouldn't be a big deal for them.

Additionally, if I was doing a multi week vacation with my family (something I now more than ever wish I did, and get that I could of done and my practice would stlll be there and be fine especially after how Covid affected "normal life" and now having to walk by and empty room with my daughter off at college and not home now), that vacation would likely be a mix of say touring a few National Parks as well as sometime at either a beach resort or theme park.

And has been said before in this thread, ultimately when you look back on things, especially with a family and over time, I can certainly say that I have way more vivid and enjoyable memories of vacations my family took from say 10 years ago, than anything I did work related that long ago.

Ultimately, whenever my time on Earth is done, I want to be remembered way more for the husband, father, son, brother, and friend that I was than as a dentist, and I do enjoy being a dentist, it's just simply a portion of who I am, and to me, especially as I get older, I really get that, and certainly would of done a few things differently in the past that would of created more time with my family and less time in the office

When the kids were little, they tended to cling on to you and want to play with you more…..it’s much easier to entertain them. IMO, it’s better to take vacations when your kids are between the ages of 6-16. My kids have been through several vacation trips and they begin to grow tired of them. On our most recent trip to Miami, which was only a month ago, I could tell that they didn’t have the same excitement as when they were younger. They spent much less time swimming at the pool/beach. They were more excited when I took them out to eat….and getting ice cream, boba drinks afterward. At this senior HS/college age, they’d rather spend time with their friends/cousins than with us, old boring adults. This summer....before going college this coming Fall, my son had come back a few times to play (and train) tennis with the younger students at his former high school. The good thing is both of my kids love eating good food. And I can still entertain them by taking them out to eat 5-6 times a month. I am glad that with my good stable income as a dentist, I am able to do that for my kids. I hope they will do well in school and become successful because my wife and I can’t live forever to take care of them. At least they won’t have any student loan debt to pay back.

Now, it’s time for my 17 yo son to learn how to grow up and become more mature. He will have to share a room with another roommate in a college dorm room that has neither AC nor heater.

 

[LFA20]

When I take vacations, I can only ask my P/T assistants to stay home without pay. I still have to pay my 2 F/T employees because neither of them can afford to take time off. They’re both living paycheck to paycheck. So both of my F/T get paid 54 wks (the regular 52 work weeks + 2 wk vacation pay).

I am not too excited about taking vacation anymore. I hate flying. I take vacation just to make my wife and kids happy. It’s a big waste of money. A 1wk trip to Hawaii for a family of 4 easily costs me $12-15k. I’d rather use this same amount to pay a monthly lease on a nice car, which I can enjoy every day, for an entire year. With this same amount, I can take my family out for a nice expensive steak dinner at Ruth’s Chris at least 40 times in a year. I enjoy eating good food a lot more than traveling.

I agree that they can be expensive but I think experiences and spending time with family/wife/kids are much more memorable than let say driving an expensive car to work everyday. Do you not get bored of the car? lol I know you get a new leased car every 2-3 years but I got really bored like 3 months after buying my new car (granted it's only a Lexus). Also, going out to eat gets very tiring after sometime. You don't know the whole ingredients that they put it in. You start to feel unwell (at least for me lol..). I prefer following a specific cooking/eating and exercise routine and maybe eat out once every 3-4 weeks or during special occasions.

To each his own I guess but I feel like traveling and seeing new things are much more fun/interesting I have to say that people who get really expensive cars care more about what other people think of them haha and want to show off.

Experience>materialstic things

 

[charlestweed]

I agree that they can be expensive but I think experiences and spending time with family/wife/kids are much more memorable than let say driving an expensive car to work everyday.

You don’t necessarily have to travel in order to spend time with your family. There are plenty of ways to spend quality time with your family. I don’t think a 6 yo kid would appreciate you if you make him fly 12+ hours to Paris just to see the Eiffel Tower or Notre Dame Catheral. He’d love you more if you take 3-4 days off to swim/play with him in your own backyard’s swimming pool……or if you take him to a local Disneyland theme park….or to a local indoor water park at a fraction of the cost of a Paris trip. You can put a big smile or the kid’s face when you take him to a nice restaurant….and what’s nice about it is you don’t have to cook nor wash dishes afterward.

Also, going out to eat gets very tiring after sometime. You don't know the whole ingredients that they put it in. You start to feel unwell (at least for me lol..). I prefer following a specific cooking/eating and exercise routine and maybe eat out once every 3-4 weeks or during special occasions.

Don’t underestimate the power of good food. People have paid us, dentists, a lot of money to maintain their teeth and to replace their missing teeth so they can enjoy eating good food. My wife has changed a lot of people’s lives when she replaced their ill-fitting dentures with implant supported/implant retained overdentures.

To each his own I guess but I feel like traveling and seeing new things are much more fun/interesting I have to say that people who get really expensive cars care more about what other people think of them haha and want to show off.

In order for the trip to be fun, the place, where you travel to, has to be better/more interesting than what your home town has. I guess I am spoiled for living in the best country in the world. I am spoiled for living in CA, where we have everything here…..good food, good weather, good theme parks etc. It’d be a downgrade for me if I have to travel to a poorer country where the food, the local politics, and the mode of transportation are not as great as in the USA. Hawaii is nice and has much warmer beaches but the food over there are not as great as in CA. Hawaii is too hot in the summer…..it’s still a good compromise…at least the kids enjoyed their time there.

A car is like my 2nd house. I spend at least 2-3 hours in it every day (30-40min commute each way + 1.5 hour during lunch time). I eat/sleep/browse the web in it during my lunch hour. It’s my precious personal space that no one can take it away from me. So it’s important to have a good reliable new car every 2-3 years that has all the high tech features like self-driving (autopilot), autopark, 360 camera, remote cooling/heating system, surrounded sound stereo etc. A nice car makes the daily commute (especially in CA) a lot less stressful. I just get into a slower truck lane (so no other cars will cut in front of me), and the car's autopilot system drives me home.

Experience>materialstic things

And to gain the experience, you will need money to pay for all these trips.....a lot of money.

 

[Chief's Pineapple]

I have to say that people who get really expensive cars care more about what other people think of them haha and want to show off.

Sure, that may be true for so, but it isn't for all. I grew up in an area where the middle class was dominant, but the upper class was prevalent too. I remember as a small child, every time I'd be in the back seat of our family's car as we were driving through the night on the highway, I would always look at the taillights of cars surrounding us or passing us, and try to identify them. These were everyday normal cars mixed with the occasional Viper or Lamborghini or such. Nice cars just fascinated me. I'm not sure what the car scene was like in Fairbanks, but I'm sure young and small 2TH MVR could relate to this. I told myself when I was growing up, that when I went to college and got a good job, I would get a nice car. And I did. It took me several years after college to have the funds available (I prioritized a minimal life style so I wouldn't have any loans and put whatever I could into retirement investing), but eventually I got a nice car. It isn't as nice as TanMan's, 2TH MVR's, or charlestweed's, but I don't care. Because it puts a smile on my face, I worked hard for it so I wouldn't have to take out a massive loan to be paid off in several years (basically I only bought it until I knew I could "afford" it), and most importantly of all, IT'S MINE. Sure, some people will compliment me on it, but that's just the icing.

As Jeremy Clarkson said, "we don't buy these cars with our brains...we buy them with our hearts." We don't see them as appliances from point A to point B, to analyze its MPG values and legroom numbers...no, we buy them because of an emotional connection. And no amount of "oh, you just bought that to impress people" talk will ever sway me on this.

And I agree, traveling and seeing new stuff is worth more than the cost of hotels and plane tickets. We should always strive to see and experience new places/things.

 

[2TH MVR]

As Jeremy Clarkson said, "we don't buy these cars with our brains...we buy them with our hearts." We don't see them as appliances from point A to point B, to analyze its MPG values and legroom numbers...no, we buy them because of an emotional connection. And no amount of "oh, you just bought that to impress people" talk will ever sway me on this.

And I agree, traveling and seeing new stuff is worth more than the cost of hotels and plane tickets. We should always strive to see and experience new places/things.

There is a generational component to those who love cars and those who don't. My late father was a mechanic/bodyman in Alaska .... so I grew up with cars and trucks. I customized every car I had while in high school. I have the same attitude about cars even now as I approach 60 yrs old.

I don't buy cars to impress others. I could care less. Interestingly ... all those expensive Teslas, BMWs, Merc, Audis, Range Rovers, etc. sedans/suvs do NOTHING for me. Instead. I prefer to drive my Jeep Gladiator Rubicon.

Big fan of Jeremy Clarkson. My favorite quote from him. "You can't be a true petrolhead until you've owned an Alfa Romeo." After having driven many sportscars .... he is RIGHT.

 

[gryffindor]

If you are an owner, you can take off whenever. I think 3 weeks would be the max before patients start getting worried. Four might be pushing it since patients are usually on a 4+ week cycle of appointments. You would schedule your patients according to your absence. You would likely have to work harder in the first week or two back to catch up. If you hire an associate to work in your practice, they can cover your absences so your office won't ever be without a doctor for the week and you could take more than 3 weeks off.

If you are an associate, same thing. Just understand that as an associate, you don't get paid if you don't show up and put fingers in peoples mouths.

The issue with the above answers is that they result in potential lost income and/or cost money and therefore orthodontists don't like to entertain these ideas. And instead they complain about how hard they work. They also don't like to give up control so sometimes the associate positions don't work out well either. The truth is in offices where the cases are controlled and the doctors have the same philosophy and mindset, the patients don't actually care which doctor does the procedures, the owner or the associate. You will be lucky if they remember your name. Yes, the name thing also goes for long standing private practices and not just corps that shuffle through 5 orthos in 1 year.

I believe in paying staff even if the doctor is not there for the week. I personally would quit a job if I was told I had to take my vacation when the boss takes his vacation. Yes it costs extra in payroll that week but the employees you depend on appreciate a regular paycheck. It means you as the owner have to plan ahead and have savings to pay the staff on a week with no clinical days.

 

[gryffindor]

Seeing as most orthodontists own their own practice, I'm curious about how taking vacation works. The orthodontist I shadowed today talked about not being able to take much vacation ( only 1 time - 2 weeks off during Christmas and several maximum 3-4 days off to go to conference etc...). He works 5 days a week, goes to work from 7:30 am to 5 pm. His office is busy often seeing 40-50 pt a day.

How many treatment chairs does this office have? If you say any number more than 3, there are a ton of inefficiencies happening in this schedule that the doctor doesn't want to address.

 

[DrJeff]

How many treatment chairs does this office have? If you say any number more than 3, there are a ton of inefficiencies happening in this schedule that the doctor doesn't want to address.

100% agree with this!

I know for a fact that my wife describes (even the days she's solo in her offices) a 40-50 patient as an "easy" day, and often those are the ones where I hear her say at home that evening that she was able to accomplish so many other things (non work related) while in the office on those days

 

[charlestweed]

Being more efficient and treating more patients per day doesn't necessarily mean making more money. The production (or gross income) of an office depends on the total number of active patients an office has. If this ortho sees 40-50 patients a day and has enough patients to fill all 5 days in a week, he should have at least 800 - 900 active patients...that's a pretty good number.....easily $1.5-2 million a year. He should make way more than an ortho who sees 70-80 patients a day but only has enough patients to work 1-2 days a wk.

Another important thing to look at is the overhead. Less overhead = higher net income. This ortho may choose to keep the overhead low by hiring fewer assistants and doing more manual work by himself. I know plenty of Asian dentists in my area who do dental hygiene by themselves and keep all the hygiene money instead of hiring and splitting the money with the hygienists. This is still way better and more money than working at the Corp as an associate. It only makes sense to hire a hygienist if you are too busy to do other more productive procedures. It doesn't make sense to hire a hygienist when you have free time sitting around doing nothing.

I remember when I first started my own office, I didn't hire any ortho assistant to keep the cost down. I was sweating like a pig even when I only had 20-25 patients a day because I had to do all the work by myself.....but I was happy because it's my own practice.

 

[Chief's Pineapple]

I remember when I first started my own office, I didn't hire any ortho assistant to keep the cost down. I was sweating like a pig even when I only had 20-25 patients a day because I had to do all the work by myself.....but I was happy because it's my own practice.

My father owns his own business (not in dental/healthcare) and when he bought the place he was the only one who worked in it, mostly to keep costs down as well. He told me, once he had enough business to warrant employees/delegate tasks, that you need to be able to do everything that your employees can do. That way, you know everything about your business and your employees can't hold you "hostage", so to speak. They can't be like, for example, "I'm the only one here who knows how to do this one thing, and if you don't let me keep my job even though I'm always late/have a drinking problem/etc., then you're screwed, so pay me!"

When I used to work in fast-food/retail-like restaurants during college, they were privately owned franchised businesses. But I guarantee those owners would have been screwed if all the employees were crap, or if we all walked out at once, as an example. They weren't willing to put in the hours and 6-7 day work weeks like my dad did. I guess it's just the immigrant Asian attitude to hustle.

Granted, running an ortho office is much different than running a completely different business my dad did (and still does), but if I showed him your post about how one day in the office it was just you and your wife, and the part where you mentioned how you've personally never used your credit card machine, he would be almost mortified . "Never let your employees think that you need them to run your business," he would say, "business can be more productive with them without a doubt, but it is YOU who runs it, not them."

 

[2TH MVR]

I remember when I first started my own office, I didn't hire any ortho assistant to keep the cost down. I was sweating like a pig even when I only had 20-25 patients a day because I had to do all the work by myself.....but I was happy because it's my own practice.

You and I started private practice differently. As you may recall .... I bought into a practice and became a 50% partner/owner. At that time (1994) our practice employed about 10-12 employees. We even had a full time accountant who did all the book work. We easily saw over 100 patients a day in a large 2 story facility. After 18 months .... I bought my partner out. I cut the staff down to 8 and let the accountant go. Things were golden back then.

 

[gryffindor]

Being more efficient and treating more patients per day doesn't necessarily mean making more money. The production (or gross income) of an office depends on the total number of active patients an office has. If this ortho sees 40-50 patients a day and has enough patients to fill all 5 days in a week, he should have at least 800 - 900 active patients...that's a pretty good number.....easily $1.5-2 million a year. He should make way more than an ortho who sees 70-80 patients a day but only has enough patients to work 1-2 days a wk.

Another important thing to look at is the overhead. Less overhead = higher net income. This ortho may choose to keep the overhead low by hiring fewer assistants and doing more manual work by himself. I know plenty of Asian dentists in my area who do dental hygiene by themselves and keep all the hygiene money instead of hiring and splitting the money with the hygienists. This is still way better and more money than working at the Corp as an associate. It only makes sense to hire a hygienist if you are too busy to do other more productive procedures. It doesn't make sense to hire a hygienist when you have free time sitting around doing nothing.

I remember when I first started my own office, I didn't hire any ortho assistant to keep the cost down. I was sweating like a pig even when I only had 20-25 patients a day because I had to do all the work by myself.....but I was happy because it's my own practice.

This math doesn't sound right. Office #1, 50 patients a day, 5 days a week (250 appointments) should be around the same amount of production as Office #2, 80 patients a day, 3 days a week (240 appointments). This is assuming a similar amount of starts and similar technology and treatment philosophies. . Maybe office #2 has a higher overhead because they need more staff to get through 80 people in 1 day compared to 50 in 1 day. But the doctor at office #2 also gets 4 days of seeing no patients versus the other doctor at office #1 who only gets 2 days of no patients.

So if this ortho chooses to see 50 patients a day, 5 days a week, and control overhead by not hiring another assistant, then he (or she) should not complain that they don't have time to take a vacation. If you need to have a low overhead to pay off massive student and build out loans then fine. But if you otherwise live a comfortable life, spend some of that money saved in overhead by hiring another assistant to see 70 patients in 4 days or even 80 patients in 3 days. Give yourself a break to be able to take that 5th day off and have a 3 or 4 day weekend. YOLO.

 

[charlestweed]

My father owns his own business (not in dental/healthcare) and when he bought the place he was the only one who worked in it, mostly to keep costs down as well. He told me, once he had enough business to warrant employees/delegate tasks, that you need to be able to do everything that your employees can do. That way, you know everything about your business and your employees can't hold you "hostage", so to speak. They can't be like, for example, "I'm the only one here who knows how to do this one thing, and if you don't let me keep my job even though I'm always late/have a drinking problem/etc., then you're screwed, so pay me!"

When I used to work in fast-food/retail-like restaurants during college, they were privately owned franchised businesses. But I guarantee those owners would have been screwed if all the employees were crap, or if we all walked out at once, as an example. They weren't willing to put in the hours and 6-7 day work weeks like my dad did. I guess it's just the immigrant Asian attitude to hustle.

Granted, running an ortho office is much different than running a completely different business my dad did (and still does), but if I showed him your post about how one day in the office it was just you and your wife, and the part where you mentioned how you've personally never used your credit card machine, he would be almost mortified . "Never let your employees think that you need them to run your business," he would say, "business can be more productive with them without a doubt, but it is YOU who runs it, not them."

Running an ortho office is not very different from running a business like your dad’s. As an owner, it’s important that you have to know everything so you can train the new employees when the old ones quit. You are able to step in to perform the duties of the assistants at any time, when one of them called in sick (or quit) without any advanced notice.

I am glad that I went to an ortho program that made us, ortho residents, do everything. Like when we were in dental school, we had to call the patients to schedule the appts, make our own ortho appliances, take x rays on patients, pour/trim study models, trace ceph films by ourselves. There were only 2 ortho assistants for the 12 of us; therefore, I had to do pretty much everything by myself. I had learned a lot. When I opened my own office, I could do everything and didn’t need to hire anyone at the beginning. I asked my wife’s office manager to help in the front. As my ortho practice got busier and my wife’s practice was on the decline, this office manager became my F/T manager. She is the only person whom I trust and depend heavily on. For other employees, they can quit anytime. I can easily find new ones to replace them.

I hate to rely on outside services. That’s why I keep everything simple….no digital, no high tech computer, no intraortal scanner, 3D printer etc. I make most of the ortho appliances in house. I do most of the minor repairs on the dental chairs and the delivery system. It’s much more convenient when you can take care of the problems yourself and not have to call/wait for a repair technician to come.

 

[charlestweed]

This math doesn't sound right. Office #1, 50 patients a day, 5 days a week (250 appointments) should be around the same amount of production as Office #2, 80 patients a day, 3 days a week (240 appointments). This is assuming a similar amount of starts and similar technology and treatment philosophies. . Maybe office #2 has a higher overhead because they need more staff to get through 80 people in 1 day compared to 50 in 1 day. But the doctor at office #2 also gets 4 days of seeing no patients versus the other doctor at office #1 who only gets 2 days of no patients.

Yes, the production should be the similar if office #2 has enough patients to fill 3 days/wk. But on my previous post, I said office # 2 would produce less if it only had enough patients to fill 1-2 days/wk. The overhead for office #2 is definitely higher because it needs more staff. The problem is many of the staff demand the full time 5-day pay even though they only assist the doctor to treat patients 2-3 days/week. This means the doctor still has to pay them for sitting around doing nothing during the days the office doesn’t have patients. I am glad that I practice in an area, where I can easily find P/T assistants. Some only work for me as little as 2 days per month. The P/T assistant that has the most work hours only works for me 9 days/month.

So if this ortho chooses to see 50 patients a day, 5 days a week, and control overhead by not hiring another assistant, then he (or she) should not complain that they don't have time to take a vacation. If you need to have a low overhead to pay off massive student and build out loans then fine. But if you otherwise live a comfortable life, spend some of that money saved in overhead by hiring another assistant to see 70 patients in 4 days or even 80 patients in 3 days. Give yourself a break to be able to take that 5th day off and have a 3 or 4 day weekend. YOLO.

No, he should not complain. Being too busy from having too many patients is a problem I'd love to have. This would be the dream for every business owner. Who doesn’t want to have a busy successful practice? You can always hire more employees to help with your growing practice. It’s much easier to say no to accepting new patients than to get the new patients to accept the treatments at your office. All 4 of my offices don’t have enough patients and therefore, I still have to work P/T for the corp to keep myself busy 5 days/wk. I am in a very competitive area.

No matter how busy you are, you can always make time for vacation with your family if you plan things ahead. Compare to general dentists, orthodontists actually have more time for vacation. Unlike general dentistry, ortho offices don't have emergency walk-ins.....all ortho appointments are scheduled in advance.

 

[charlestweed]

Running an ortho office is not very different from running a business like your dad’s. As an owner, it’s important that you have to know everything so you can train the new employees when the old ones quit. You are able to step in to perform the duties of the assistants at any time, when one of them called in sick (or quit) without any advanced notice.

I've just received this message from an assistant today. It was sent to me at 9:52 am and we start seeing patients at 1:30pm. I get this type of message at least 5-6 times in a year. Looks like I have to work hard today to cover for that assistant.