MY FIRST JOB: A retrospective blog

[NileBDS]

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Great post as always Niles. Quick question for you. Is the practice you're working in a Fee For Service or something else?

Thanks

It's pretty rare in this day and age to find a true fee for service dental practice. The one I currently work for is sure not one of them. This practice is mostly insurance driven (PPOs), with a few big capitation contracts (DMO) from large corporations in the states of Connecticut and New Jersey (Aetna employees, Government and State of Connecticut employees, Pratt & Whitney employees, ...)

Hope that helps.

 

[NileBDS]

Lol, the last part is sometimes how I feel about things. Keep it in perspective, having a happy marriage (future for you) will be imperative to being happy and keeping a good relationship. Marriage takes work, but put in the effort and time and you'll be rewarded. Thanks again Nile and good luck!

👍👍👍

 

[NileBDS]

great post as always! not that I know anything about this matter yet, but if your dream is to have that high-tech office with all the bells and whistles, wouldn't it just be better to buy an existing practice and redesign everything? i mean sure it would be a pain to compile all the stone age records into digital ones, and sure you might have to make a few trips to the furniture store, but at least you can get an existing patient base right?

Yes and no. It's a headache, and the bills can really add up. If you talk to CPA's, they tend to advise practice appraisals while blindfolded (meaning going by the numbers only, not by how it looks, feels or appears). When you talk to brokers, they tend to value location and facilities more, believing that the growth will always follow from there.

Nonetheless, great points. If I were to come across a home run location that's crappy on the inside and just needs a fresh layer of paint, new carpeting and some toys, I would consider it. Sure.

 

[NileBDS]

I see this a lot in New Jersey, much more than I expected. Maybe it's because construction in the Northeast is much older. I'm in the same boat with the marriage thing. I'm trying to do a startup but had to put it on hold because the wedding planning completely consumed my life.

Wow, congratulations gryffindor! I know we're not buddies or anything, but I've always seen your posts on SDN, for years now, so naturally I feel like I know you 😉 I'm happy for you! Please, let me know how it goes (for both wedding and startup)!

 

[NileBDS]

Season I: Act II


[YOUTUBE]http://www.youtube.com/watch?v=tjQSF1bFMsk[/YOUTUBE]


Details to follow! 😀

 

[BiomajorPreDent]

great posts as always!

 

[Blue Panther]

Nile, do you feel more prepared in private practice after doing the GPR?

 

[NileBDS]

Nile, do you feel more prepared in private practice after doing the GPR?

Absolutely.

Pacific was just an amazing experience for me all around, and I find it hard to believe any other school can do much better in preparing you as a dentist, be it private practice or whatever. I feel like I was ready to jump in the pool and very confident in my clinical abilities and competency the day I left San Francisco, but there is something to be said about post-graduate residencies. I matured a lot professionally during my GPR year. I could give you ten different reasons why, but can't put my finger on one.

 

[NileBDS]

Thought I'd share some more of my interview horror stories ... I mean experiences ... 😉

 

[NileBDS]

City – West Haven, CT


Setting – Rough suburb of New Haven, ghetto-ish, looks shady.


2 year vision - Associate
5 year vision - Associate


Pros

• Brand new office and equipment
• Tons of patients
• Flexible schedule
• Compensation
• All digital

Cons

• Dead end associateship
• Owner is never there
• Almost exclusively Medicaid
• High no show and cancellation rate
• Stressful. Because of the high no shows, they are booking 3 or 4 patients per hour
• Since treatment has to be pre-authorized by the state, you can only do what they approve. If they don’t think the tooth needs a root canal, then it’s coming out. You get the idea

Compensation – 40% collections (which is the same as production since everything is pre-approved by Medicaid, claims are filed and paid electronically)

This actually may have been a not-so-bad-if-you-don’t-mind-the-medicaid-patients starter job. The money is pretty good. The current associate is taking home upper 100’s lower 200’s K per year. Yup.

 

[NileBDS]

City – Several locations, CT


Setting – At the mall!


2 year vision - Associate
5 year vision - Associate


Pros

• New office and equipment
• Super close to where I live. Almost no commute

Cons

• You work at the freakin mall! (DOWN BY THE RIVER!)
• Owners a practically hiring cheap labor to staff their new locations
• Mostly Medicaid patients

Compensation – I don't remember the specifics, but I don't remember it being terrible


I really felt like punching the guy at the end of my interview. The ad made no mention of the fact that this position was for their new location at the mall. They have a decent private practice which is the one they originally advertised (website info, interview location, contact info). Then at my interview, he went on to explain how they're adding a location to their practice and need an associate to get it going, and I thought OK, this may not be that bad. And that is when I was run over by the "it's at the mall" train. I'm sorry to anyone who works at a mall dental office, but to me personally, it's just demeaning. I actually told him that.
Towards the end of our meeting I told him that I would have to think about it and get back to him later (more like never), he said "well what's your first impression, what do you think of it"? I know the polite thing would be to bite my tongue, go home and try and forget about the whole interview, but I didn't … and I'm glad I didn't. I just told him how I felt, and it felt soooooo good! LOL! Let's just leave it there …



DOWN BY THE RIVER!

 

[NileBDS]

City – Orange, CT


Setting – Really nice and scenic, upper middle-class suburb of New Haven. Pretty houses, good schools and feel-good neighborhood.


2 year vision - Associate
5 year vision - Associate


Pros

• Digital with paper charts
  
• Nice professional park location
  

Cons

• Dead end associateship
• The patient waiting area is in the building hallway entrance? Really.
  
• Owner practices in New Jersey, and is only there once a week to "cash his check"
• Poor compensation
  

Compensation – 30% collections, you pay 50% of your lab bill, no benefits. Wow. This guy is just shameless!

 

[NileBDS]

City – New Haven, CT


Setting – Your run of the mill, middle class suburb


2 year vision - Associate
5 year vision - Partner


Pros

• Lots of toys!
• Great new patient numbers and growing
• Established practice, long term staff tenure (10-25 years)
• Compensation
• Digital
• Knowledgeable mentor
• Partnership track
  

Cons

• 30 minute commute
• High buy-in price
• Would rather be compensated on production, but his collections for the past 12 months have been pretty consistent (upper 90's) so it probably would not have made a difference

Compensation – 40% collections, 50/50 lab bill, no benefits

 

[NileBDS]

.You know, I think the reason some of these clowns are so aggressive in their offers (low-balling interviewees) is the economy. It got me thinking “who the heck would ever work for that low” ... and then I thought, that’s right, someone who doesn’t have a job. Definitely better than nothing, but absolutely opportunistic.

Job seekers beware ... sharks in the water!


.

 

[DMD 4 Me]

great thread!

 

[7 Iron]

Hey Nile, this thread is great. I was thinking: now that you are in your second year of practice, could you give us an update about what you've been up to? Looks like earlier this year you were looking at additional offices.

Thanks!

 

[odontogram]

NILE! Where have you been the last 5 months???

 

[lekso]

BUMP..

Where are you Niles?

 

[odontogram]

? bump !

 

[ItsGavinC]

Here is a random little tidbit for you … as it turns out, specialists and GP’s both make the same amount of money!

Uhhh, no they don't. Our production on a bad day is likely more than the production of a GP on a pretty good day.

 

[NileBDS]

Holy cow! I'm back!

Where did we leave off here?

 

[NileBDS]

Uhhh, no they don't. Our production on a bad day is likely more than the production of a GP on a pretty good day.

Is that right? 🙄

 

[Lethstang]

How is it going now Nile? Update!? What job did you take? Did you even take a new one? Any closer to taking the plunge of ownership? What did you eat for dinner last night?