- Joined
- Apr 13, 2020
- Messages
- 513
- Reaction score
- 635
I signed on my first DMO after USAF in 2002. I had moved to a desirable area in the Pacific NW and my intentions were to scope the market and get my own practice. I knew this job would be crap. It's a 2 yr contract and they started me out on 3rd yr associate salary of $95k with increase to $100k the following yr. We lived in a nice apt for $850 a month. $95k was OK for someone out of the military with no loans so I know my situation is different than many.
The goal of a DMO is to under-treat with minimal procedures, crowns and specialty work (not extracting asymptomatic 3rds). After 9 mos, they decided to lay me off, but were desperate to keep me to do full time endo at increased pay and production. We had 2 endodontists in the local metro area and with the increased demand, it was cheaper to hire a GP than another specialist. Later on I realized that the DMO is always guessing their budget because they don't know many procedures will lose money. So they get rid of dentists left and right. Before my new position, I hated root canals. They were very accommodating and promised the managing endodontist will mentor me. Great, get good and fast with root canals and go to private practice! I was stoked. I needed to travel to 6 locations, but I ended up loving it and forgot about private practice. A side story involved an older assoc that wanted my job. They asked for his xrays but didn't ask to see my 2 not so good cases...very interesting. Perhaps he may be asking for more. After my mentor retired, new folks closed my GP endo position and moved me to GP practice again.
Compensation formula was strange and they just implemented it during my transition in 2012. Before was just your base and the number of patients of record. The new metrics are:
1. Customer Surveys 25% If your scores are 89.9% and below, no pay. The pay scale fluctuates with the bell curve...91.7% was ~$25k give or take.
2. Patient Count 25% 2000 patients of record is usually the median. If your count is 2178 multiplied by some number is your pay.
3. Access 25% If you are so booked out past 2 weeks, you get penalized. I don't know how they determine the numbers here. A managing dentist would book her full mouth extractions with a buddy of mine. He gets no credit because the pt is not his and he must double or triple book his own pts so he wouldn't get too booked out. Other dentists' emergency pts booked on your schedule is wasted this way as well...it's effed up.
4. Quality 25% This means if you are following phase dentistry...no crowns unless they are in phase 4. There is an algorithm to determine which phase the pt is in. If they have certain amount of perio attachment loss but normal probings, they may still never reach phase 4.
These metrics benefit the long term dentist (managing) staying at one location. If the same pt sees the same dentist for 10+ years, that pt will usually give the dentist a perfect score (4/5 will kill your score). That pt will not need much work (easy pt count), no access problem if they don't need any work, easy 25% quality metric for not needing to phase any work. Since they transitioned me to various offices, I will never achieve these metrics. Fortunately the owner likes me and pays me like a mgr dentist because he thinks I'm top dog. The individual Office Mgrs get hurt by my high pay because I negatively affect their bottom line...EBIDTA. It took various OMs about 5 years to fire me because I could never reach those metrics while getting paid more.
The goal of a DMO is to under-treat with minimal procedures, crowns and specialty work (not extracting asymptomatic 3rds). After 9 mos, they decided to lay me off, but were desperate to keep me to do full time endo at increased pay and production. We had 2 endodontists in the local metro area and with the increased demand, it was cheaper to hire a GP than another specialist. Later on I realized that the DMO is always guessing their budget because they don't know many procedures will lose money. So they get rid of dentists left and right. Before my new position, I hated root canals. They were very accommodating and promised the managing endodontist will mentor me. Great, get good and fast with root canals and go to private practice! I was stoked. I needed to travel to 6 locations, but I ended up loving it and forgot about private practice. A side story involved an older assoc that wanted my job. They asked for his xrays but didn't ask to see my 2 not so good cases...very interesting. Perhaps he may be asking for more. After my mentor retired, new folks closed my GP endo position and moved me to GP practice again.
Compensation formula was strange and they just implemented it during my transition in 2012. Before was just your base and the number of patients of record. The new metrics are:
1. Customer Surveys 25% If your scores are 89.9% and below, no pay. The pay scale fluctuates with the bell curve...91.7% was ~$25k give or take.
2. Patient Count 25% 2000 patients of record is usually the median. If your count is 2178 multiplied by some number is your pay.
3. Access 25% If you are so booked out past 2 weeks, you get penalized. I don't know how they determine the numbers here. A managing dentist would book her full mouth extractions with a buddy of mine. He gets no credit because the pt is not his and he must double or triple book his own pts so he wouldn't get too booked out. Other dentists' emergency pts booked on your schedule is wasted this way as well...it's effed up.
4. Quality 25% This means if you are following phase dentistry...no crowns unless they are in phase 4. There is an algorithm to determine which phase the pt is in. If they have certain amount of perio attachment loss but normal probings, they may still never reach phase 4.
These metrics benefit the long term dentist (managing) staying at one location. If the same pt sees the same dentist for 10+ years, that pt will usually give the dentist a perfect score (4/5 will kill your score). That pt will not need much work (easy pt count), no access problem if they don't need any work, easy 25% quality metric for not needing to phase any work. Since they transitioned me to various offices, I will never achieve these metrics. Fortunately the owner likes me and pays me like a mgr dentist because he thinks I'm top dog. The individual Office Mgrs get hurt by my high pay because I negatively affect their bottom line...EBIDTA. It took various OMs about 5 years to fire me because I could never reach those metrics while getting paid more.