Job offer....what do you all think?

[jh1581]

Hey everyone,

I've been interviewing for jobs and the last one, I have a good feeling about. I want to give you all the details to see what you all think about it in case I may be missing something:

- The practice is 2 years old and is the only dental office in the area where it's located so it has LOTS of patients who need treatment.

- It is about 50% Medicaid, 50% Insurance/Fee-for-service.

-The office grossed 1.4 million dollars last year (only it's second year open).

- The hours are 9am-4pm with a quick grab & go lunch.

- I would be 1 of 2 dentists (one dentist is leaving because she got married and has to move to where her fiance is); as a dentist, you never have to stay after 4pm and leave immediately after seeing your last patient.
Usually one dentist works Monday-Thursday and the other works Tuesday-Friday (I would be the dentist who works Monday-Thursday, but I want to work 5 days a week to get my speed up).

- Because it is the only dental office around, the patients are VERY appreciative of the care they receive.

- They do restorative (99% composites), extractions, anterior endo, perio, crown & bridge, partial dentures (no complete dentures are done but only because neither dentist want to do them; but if I worked there, I could do them if I wanted to).

- I would be seeing anywhere from 15-22 patients per day.

- Salary is based on 30% production. The office manager/receptionist showed me the numbers and even during the slowest month, one of the dentists (who is only 2 years out of dental school) still produced $40,000 in one month.

- The office manager told me that both dentists grossed over $200,000 last year.

- 4 registered assistants, no hygienists at this time so the dentists also do cleanings, scaling and root planing, etc.

- The office has a pan machine, all x-rays are digital.

- The staff is GREAT and everyone is like a big family (I met them yesterday); the office manager really cares about everyone being happy and truly cares about the people who work for him at the office (he owns another practice with his wife in another town as well and she's the dentist at the other office).

I like this opportunity because it does give me the chance to sort of be my own boss and provide dental care to those who may not otherwise get it. More and more people in this community are finding out about the office and the area itself is growing so they're seeing anywhere from 20-30 new patients a week. My goal financially is that I would like to make about $140,000 my first year out. I understand that I will be somewhat slow for about 3 months, but that I will gain speed soon after that.

Do you all think this job sounds okay and are my goals feasible in relation to the type of practice it is based on my description (basically do you all think it's possible for me to reach my goal if I work here)?

And are there any reservations that I may not be seeing that you all notice?

Thanks and sorry for the long post!

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[muberrymolar]

why dont you just open another office in that neighbourhood. please PM me the location

 

[jrd29]

It sounds like a good opportunity. I just glanced quickly, but the fact that there is no hygiene and yet you are still seeing 22 pts/day seems pretty high. If you work 9-4 with a small lunch that is ~6.5 hrs/day which is over 3 patients/hr. I have a hard time seeing you be able to do great work with that many patients, especially if you are doing quads.

Maybe you have expanded function assistants that can get the patient numb and also place the restoration, so you are only seeing your restorative patiets for 10 minutes to cut the tooth, and then can go and prep a crown and then finish the prophy.

But, any office that grosses 1.4 is doing great and I would be very interested.

 

[DrJeff]

It sounds like a good opportunity. I just glanced quickly, but the fact that there is no hygiene and yet you are still seeing 22 pts/day seems pretty high. If you work 9-4 with a small lunch that is ~6.5 hrs/day which is over 3 patients/hr. I have a hard time seeing you be able to do great work with that many patients, especially if you are doing quads.

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That was the biggest potential issue I thought of too. Roughly 20 min a patient for all work being done is really challenging to keep up with. Just think mentally of all the steps/waiting time to do a composite, or cleaning + charting + radiographing 28 teeth in 20 minutes.

I'd be worried that the owner might be using you a bit to move some of the hygiene and/or medicaid out of his/her schedule to free up more time for the endo/crown needs and fee for service patients.

Otherwise the numbers seem good, and if they're doing 1.4 mill, and your seeing that many patients a day, a hygienist or 2 is really needed! (See the recent thread about hygienist salaries for hygienist earning potential). Plus, you'll never hear a bad word out of my mouth about practicing in a small town! Any way you could talk to the former associate to get her "real" take on the practice, that might help a bit too!

 

[aphistis]

What everyone else said. 15-22 patients a day is going to be hella busy starting out, but you'll ramp up your speed in no time if you can hang on during the learning curve.

 

[gottago]

If you have the flexibility of determining how many patients you see a day and how much time you want to spend for a given procedure then it maybe a good opportunity. However if you have no say in shceduling and ur schedule is packed, then it will be challenging to do the kinda work you wanna do to take care of people.

 

[jh1581]

I'd be worried that the owner might be using you a bit to move some of the hygiene and/or medicaid out of his/her schedule to free up more time for the endo/crown needs and fee for service patients....

Thanks everyone for the responses Actually, the only concern I have is that I don't know if I'll have time to do top notch dentistry that fast. Maybe in a few months, but not now. I guess there's a learning curve for everyone when you first get out of dental school and begin working though.

As far as the owner using me to move the hygiene or medicaid out of his schedule, the owner actually doesn't even work at the office. He and his wife own both the practices, but neither of them work there. He works as an office manager in the other office they own and his wife is the only dentist at that office. They just wanted to open a practice in an area where it was needed to provide care for people who would otherwise have no where else to go. So I'd be one of two associates that work there. They made it clear that there is no preference as to who gets what type of work. It's basically on a whoever-has-free-spaces-in-their-schedule type deal. And once I see a new patient the first time, the receptionist makes it a point to schedule that patient with me again in the future.

So basically this practice is one in which two associates share the work with the help of 4 assistants. Also, they all assured me that they would help me adjust if I take the position because they believe that working as a team is key.

 

[albany11]

good offer depending what you want

ANY benefits?

if you want to slow down and see 8-10 pts in 8 hrs ; that fine--I graduated this year too and
accepted an offer; 4 days/wk with 1 week paid vacation and guaranteed pay of $400/day= 198 working days excluding holidays+vacation=
$81,200==sounds low but it's $100k in a 5day week; offers health, ,malpractice, $1000 for CE==not bad
for new grad w/o experience



-The office grossed 1.4 million dollars last year (only it's second year open).

$700k /year gross/ dentist in a 4 days, 6 hr day wow
---that more than 50% of established practices working 5 days/wk
what's their secret?
so:
dentist 1= 200k
dentist 2=200k
overhead=60-70% ? including salaries--
owner keeps 350-500k by not doing much--


so to net 200k you need to produce $3500/day in 20 pts=$175 per pt avg
to net 140k you need to produce $2300/day in 20 pts=$117 per pt avg

as a note :medicaid has usually 50% no-show rate; 15-22 can turn to 8-10

- The hours are 9am-4pm with a quick grab & go lunch.

wow--those are easy hrs




- I would be seeing anywhere from 15-22 patients per day.

a lot but with 2 assistants and 2 chairs with extended duty; won't be too bad; from the start ;be firm and demand a lot from the assistant
within legal limits

- still produced $40,000 in one month.
wow

- The office manager told me that both dentists grossed over $200,000 last year.


200k in 4 days, 6 hrs/day as an associate---incredible

 

[DrJeff]

overhead=60-70% ? including salaries--
owner keeps 350-500k by not doing much--
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Let that one sink in a bit If that business model works, and the demand is there(a 2 year start up with a 1.4million gross would suggest it is!), and you know where it is, and haven't signed anything, in all seriousness if you like that area, look into opening up your own practice there, better you take home some of the "administrative salaries" that the owner couple are doing for not working there.

Seriously though, if 2 associate Docs grossed 1.4 million, and assuming they were compensated at the 30% you stated, with gross pay of over 200K for both, figure max 500K the owners paid in salaries, probably atmost another 500K to staff and supply the office, factor in the tax benefits of rapid depreciation of new equipment for a new office (Thank you George Bush and the Republicans ) and those owners are probably bringing home atleast 400K from that office Ask to see the financial info pertaining to the operating expense of the practice, if they won't show it to you, not a good sign. If you want to work for them, negotiate a higher percentage, because they can afford to pay it to you!

One other thing to consider and get in writing NOW in your initial contract if you choose to work at that practice. Is there a partnership possibilty for you?? If so, get a set timeframe for minimally when an offer will be on the table and the mechanism for how the practice will be valued for buy-in price consideration(very, very, very important!)

 

[albany11]

and those owners are probably bringing home atleast 400K from that office

you are right, 400k at least by doing nothing is great:=smart business people
add 2-4 hygieniest= $1.7-2.3 million practice with owners taking= $700k-1 million ;

in a small town ;overhead and new practice in not too high

--I assume they spent $250k-400k for a 5-8 chair office--which is probably
paid off already.

 

[jh1581]

Yeah, they really are excellent business people. He has his phD and even wanted to teach a business management class at my dental school for free (because our school doesn't touch on the business aspect of dentistry too much and he REALLY felt like he could teach us how to avoid many mistakes a lot of dentists make when they open their own practice). But my school didn't want to take on trying to fit the class into the curriculum.

They actually bought the practice from another dentist who needed to change location. But the first office in which his wife works has been up and running for several years now and she's been a dentist for at least 20 years.

He told me that in the other office, his wife works as the DDS alone and she grossed 1.2 million by herself last year. I think that office is only fee-for-service though with no medicaid.

I have no idea how she pulled that off, but they definitely know what they're doing!!

In terms of benefits, I have full health coverage, but no paid vacation (it's kind of like I can take my vacation when I want but, of course, since it's based on production, I would just get paid less if I took too much time off). The office itself is closed though for major holidays and for one full week during Christmas. It's kind of like I set my own days in which I work and have the option of working 4 or 5 days a week (I prefer 5 at first).

CE isn't paid for and I have to pay for my own liability and disability insurance. He said that he's working on getting these things paid for though. I guess since the office is just entering it's second year, he's still working out some of the technicalities.

But I will definitely ask to see the financial info pertaining to the operating expense of the practice. I was already surprised when they volunteered to show me the numbers they already did show me! But I DEFINITELY want to see more. It makes sense, but I just want to see it on paper.

Thanks again for the responses! It's helping me out a lot!!

 

[DrJeff]

CE isn't paid for and I have to pay for my own liability and disability insurance. He said that he's working on getting these things paid for though. I guess since the office is just entering it's second year, he's still working out some of the technicalities.

Given in all likelyhood the large sum of $$ they'd make for running the office and NOT WORKING THERE asking for CE(especially if your state has a mandatory number of CE hours needed to maintain your license) and minimallly your malpractice insurance(once again something that is mandatory for many if not all enrollees dental insurance companies) is a very small (5 grand a year tops) and reasonable request to make. Afterall, if you don't have either of those, you can't practice an dif you can't practice, then you can't pad the owner's income. Plus, they'd take it as a business tax write off anyway.