Need Help with choosing associateship

[denture base maker]

Hi all:
I really need help with deciding which associateship to choose.
A little bio for me: D4 international student in the 4yrs DDS program, will graduate in May. I am looking for private practice which can sponsor my H1B visa and I can stay for the next 4-5 years(due my visa status, changing job is difficult before getting green card). My ultimate goal is to own a practice in Texas. I currently get 3 offers: 2 from Texas, 1 from Pennsylvania. I have visited the Texas practices, the owner in Penn give me a video tour. Below are what I learned about each practice and the pros and cons:

Texas overall pros: great medicaid coverage, it covers many procedures, like root canal, that many other state do not cover. Great weather and food, and less saturation.
Texas overall cons: Only know a few people there. Need to know some Tex-Mex to talk to some patients.

Texas practice1:
A well established practice (34 yrs history) located in a suburban area close to the gulf of Mexican. Owner is also a previous international student. Busy office, the owner see about 15-20 patients a day plus some quick exams after hygiene. The practice was converted from a 100 yr-old house with 10 operatories, 2 hygienists and an orthodontist comes there every week. Has 2 ceph and pan and a X-ray room. Each operatory equipped with X-ray and nitrous Owner is very kind and friendly and understood the difficulties encounter by international student. The owner partner with MB2, a company that help insurance and paper work out side dentistry. I am concerned about MB2 to begin with, but after visit the clinic, I did see that the owner has full autonomy and is happy with the service that MB2 provided.
Pros:

• Owner being international student previously
• Busy clinic, has 40-90 new patients per month
• Good production, the overall production for good month is 200k plus, for bad month is still 120k plus. About 8o% production is from owner dentist
• Very nice and experienced staff. Some of them had been there 30 years ago. They even bought me lunch and give me a ride to airport.
• The practice is very organized.
• Has potential to buy-in
• Owner did full spectrum of dentistry, also do implant, IV sedation, endo and third molar ext. He is very welling to mentoring young dentist. Associates will be work side by side with the own.
• Very good health insurance benefit and CE bonus.

Cons:

• Very old building and worn equipments. Many parts of the dental chairs have the metal and sponge part exposed. Many equipements were from the ex-owner, who sold this practice 10 years ago. I believe the overhead is low is because of that. To be honest, I really do not like that and felt a little disappointed. I believe the owner could invest some money to renovate the building or at least fix the celling light, they are too dim!
• The contract is wrote by the MB2 with the owner's instruction for compensation, termination, etc. but owner does not actually write the contract since it take time.
• Owner is difficult to understand sometime due to his strong accent.

Texas practice2:
A relatively new practice located in northern suburb. Has new equipment but only 4 operatories and no hygienist. The owner has more than 10 practices. He and, sometime, his wife work at this practice now. They wanted to find an associate to take care of this practice so they can help around other practices or open a new one. The owner is younger. He practice most dentistry besides sedation and ortho. The staff are nice, but not at nice as the staff in Texas practice2.
Pros:

• Dentist see 30 + patients a day
• Newer equipments. I really the interior design of practice. I feel refreshed inside.
• Nice and young (but well-trained) staff
• A lot pedo patients, which is a pro for me.
• Could become partner in the group in the future

Cons:

• No one know sedation, need to refer any IV sedation case out
• Less production per month, 70~80k, and less new patient, only about 30 new patients last month.
• No hygienist, the owner does all prophy by himself, he is very efficient though, but not me. I asked owner whether he plan to hire a hygienist and he told me "No". He does not believe hiring hygienist worth the money since most patients here, kids and babies, just need an easy cleaning or brushing.
• The potential to expand the building at that location is low unless the pizza shop next to the practice leaves.
• The owner will be with me for first a few month but after that I will become a solo dentist in that practice. But the owner is willing to come on the days when I have difficult procedure scheduled like 2nd molar endo or 3rd molar extraction, etc, and help me with those procedures. That is why he needs to travel between different clinics and help out other new grad dentist.
• No health insurance benefit, 401k, malpractice insurance. Only 1 week paid leave.

I really do not know whether this is pros or cons. The monthly guarantee is 13k. I will be paid based on production before I get the malpractice insurance. After that, I will be paid by either monthly guarantee or % production. The compensation is gross production based, not adjusted production. I will be paid based on what I produced without other modifying factors. The owner tell me that is why he does not offer all the health benefit since the extra money from % of gross production can make up for that.


Penn 1:
A big group practice with all specialty. They have many locations, all at suburb region. The owner is from the same country that I from. He is also a previous international student. The image of clinic is very nice and new. They had a big hygiene team and many experienced assistant. My friends from UPenn had visited one of the practice and sign the contract right after the visit. I have received the contract and noticed they had good base pay.

Pros:

• Good daily minimum: 700$/day
• Owner from the same country that I from
• Had known friend work for them
• Practice all spectrum of dentistry
• Clinic look nicer and newer that both of the Texas practices
• Mentorship available from international student from my country
• Great insurance benefit and 401(k)

Cons:

• Not in Texas, while my plan is to move to Texas and open a practice.
• Only the first 4 months are covered by the daily minimum, after that, compensation based on 30% collection
• Higher COA in Penn
• Not that great medicaid coverage
• Overall higher saturation of dentists
• Cold winter, which is the reason why I want to move to the South

Could you please give me any suggestions or ideas? Thank you!

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