new grad don't know what to do

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fakebun

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Hi all. I don't really know whether this post is asking questions or just writing my frustration out but feel free to pitch in your constructive $0.02

I'm a new grad (june 2017) and I've been working as a solo provider in Peoria, AZ until 11/28/17. The office I work for is one of the five offices owned by the same owner but managed by a management company. I got a phone call from the CEO of the management company saying that it would be better for me to work at the Scottsdale, AZ office so I can get faster and more daring on procedure like molar endo and surgical extractions. He also said I can take time off work to think about it and I said I'll think about it but no need to take off work and he insisted I take off work. My assistant at the old office told me they found a new doc to take over already. This Peoria office that I worked at is located near Sun City, where it's 80-90% geriatric population and it has been hard to get them to accept treatment plan. I am to blame here because I'm new and don't know how to sell tx plan well, but 90% of the new patients either say "how much longer do I have to live? not very long so I don't want to waste money" or "I'm not hurting, you said no cavities, it's just a crack. I'll take my chance". The Scottsdale office is for two provider and it already has two providers. CEO told me to go there to "learn" but there just wont be enough pts for me to learn and make any living (they pay 28% collection). I've been looking for private jobs forever and can't seem to find any private offices looking. Is gentle dental/aspen really my only hope or relocate to Midwest rural farm town? Honestly I'd like to stay near where I am because my gf has 1.5 more years to go until she graduates from dental school and long distance never works imo.

TL/DR got fired from job and can't find any private offices. $1300 paycheck before tax for the month of November. What can I do?
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Corp isn't that bad. You can work on your speed and confidence. Plus if you and your gf move out of state ... and there is the same Corp firm in the new state ... presto .... you can have a job waiting for you.

Private is not going to waste their time with you if they know you may not be sticking around.
 
Right and I understand private won't waste time with me. I'm just hesitant with working for Aspen/Gentle/Western because I've heard bad stuff about all three of them. I just need an office where it won't force me to sell tx plan and has the freedom to take days off. Sounds like I'm chasing an unicorn huh...
 
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A GPR will teach you how to do ext/graft, molar endo, restoring/placing implants in a truthful manner. A weekend courses do not exist to teach you, they exist to make the faculty rich. What happens to you and your patients the day the course ends is not their concern or liability.
 
Thank you for the reply. I'm too late to apply for a GPR/AEGD already and I have no desire to do molar endo anyway, but office sees it as lost income and they're not wrong. Maybe I'm too pessimistic but it's been a very rough 4 months.
 
They are actually really nice to you offering you to work at another office. I personally would just let you go.
What does it mean "I have no desire to do molar endo? " You have to. You have to produce, it's a busyness not a play
To be able to sell, you need to know indications and contraindications of each procedure as well as local and systemic consequences of treating or not. At the same time you have to believe in what you are saying and be confident.
I bet there are CE courses, which teach all that
 
I was just like you, fakebun! Then I bought a dental office! Now, I just want to work in a community clinic and make just 100k/yr. You should go work in a community clinic, they won't make you sell, you see patients that only wants what's free, you won't do molar endos, you will have your day off if you want it, and life is pretty easy. It's not a high earning job, but it beats what you're doing.
 
fakebun said:
Right and I understand private won't waste time with me. I'm just hesitant with working for Aspen/Gentle/Western because I've heard bad stuff about all three of them. I just need an office where it won't force me to sell tx plan and has the freedom to take days off. Sounds like I'm chasing an unicorn huh...
Click to expand...

If you stay in an enclosed shell and work for some non-busy private practice...you will never make money, you will never learn how to do dentistry quick and efficient and sell...you will always be the same.

If you work in Aspen, Gentle....you will probably make more money...do a ton of dentistry...learn how to be a dentist...and evolve as a person/clinician which eventually will lead to ownership.

If you work for community health...you will probably have a cush job...do a bunch of amalgams and extractions...and just exist. It may lead to ownership or it may not, but don't expect 200-300k out of it.

What's wrong with going long distance and working afar? I worked "long distance" and made it work. I drove 300 miles one way, stayed 4 days, drove back 300 miles on the weekend to see my GF. I did that for 1 1/2 years. I then moved states and would fly back every two weeks to see my GF until she felt ready to move out with me. I did that for 1 year until she moved out with me.

I did this because in order to make money...and do what your dream is...which is own a practice...take days off...make a good living....you have to SACRIFICE.

You graduated with a degree in DDS. It's only worth what you put into it. If you want to exist and just do cleanings/hygiene checks all day...then hey it's your choice! Don't expect to be given a 4 day week with 200-300k earnings with freedom to take days off in your first year. You need multiple years of experience to get to that point in life. Get your experience, and make the most of your degree.

Today I have 1 1/2 weeks that I'm off. I'm going back to work on Jan 3rd. Closed the office and chilling for 1 1/2 weeks. Last year I work Dec 26-Dec 30. The year before that...the same....the year before that... I worked on the 24, had the 25 off, and had to come back to work on the 26. That's life man. If you want to have those days off, go ownership, and work hard for it. It wasn't given, it was earned.
 
Last edited by a moderator:
dreaming2k5 said:
I was just like you, fakebun! Then I bought a dental office! Now, I just want to work in a community clinic and make just 100k/yr. You should go work in a community clinic, they won't make you sell, you see patients that only wants what's free, you won't do molar endos, you will have your day off if you want it, and life is pretty easy. It's not a high earning job, but it beats what you're doing.
Click to expand...
What was the problem with owning the dental office?
 
InformMe123 said:
What was the problem with owning the dental office?
Click to expand...

Prob the fact that worrying never stops. It’s always on your mind and on top of that you have to do one of the most stressful jobs in life: dentistry.

Owning a business isn’t easy. It’s much easier to check in at 8 do a bunch of fills and check out at 5 and not care afterwards. I miss those days sometimes.
 
Great thread, Really shows what it is like to get out of school and start paying bills. I'm just a dental student so no advice to offer but I wish you the best of luck in this dilemma.
 
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Owning is tough. I agree that the worry, or at least the running of the business (not office, business) is always in the back of your mind. Unfortunately, dental school does practically nothing to prepare you for private practice and business ownership. If that is the end goal for many, why are there no business courses in dental school? Most D schools are affiliated with large universities which have an associated school of business. Would it be too much to have some of the B school professors give courses to the D students on: accounting, marketing, small business administration, tax codes, etc.? All that tuition, and yet this is left out. Could it really be that difficult to include in Senior curriculum? Does administration think the students could not handle the material? I am looking for a rational answer. Having a private practice dentist give a seminar on practice management is not the solution.
 
fakebun said:
Hi all. I don't really know whether this post is asking questions or just writing my frustration out but feel free to pitch in your constructive $0.02

I'm a new grad (june 2017) and I've been working as a solo provider in Peoria, AZ until 11/28/17. The office I work for is one of the five offices owned by the same owner but managed by a management company. I got a phone call from the CEO of the management company saying that it would be better for me to work at the Scottsdale, AZ office so I can get faster and more daring on procedure like molar endo and surgical extractions. He also said I can take time off work to think about it and I said I'll think about it but no need to take off work and he insisted I take off work. My assistant at the old office told me they found a new doc to take over already. This Peoria office that I worked at is located near Sun City, where it's 80-90% geriatric population and it has been hard to get them to accept treatment plan. I am to blame here because I'm new and don't know how to sell tx plan well, but 90% of the new patients either say "how much longer do I have to live? not very long so I don't want to waste money" or "I'm not hurting, you said no cavities, it's just a crack. I'll take my chance". The Scottsdale office is for two provider and it already has two providers. CEO told me to go there to "learn" but there just wont be enough pts for me to learn and make any living (they pay 28% collection). I've been looking for private jobs forever and can't seem to find any private offices looking. Is gentle dental/aspen really my only hope or relocate to Midwest rural farm town? Honestly I'd like to stay near where I am because my gf has 1.5 more years to go until she graduates from dental school and long distance never works imo.

TL/DR got fired from job and can't find any private offices. $1300 paycheck before tax for the month of November. What can I do?
Click to expand...
How much were you making at that office before you were asked to leave? Just curious..
 
setdoc7 said:
Owning is tough. I agree that the worry, or at least the running of the business (not office, business) is always in the back of your mind. Unfortunately, dental school does practically nothing to prepare you for private practice and business ownership. If that is the end goal for many, why are there no business courses in dental school? Most D schools are affiliated with large universities which have an associated school of business. Would it be too much to have some of the B school professors give courses to the D students on: accounting, marketing, small business administration, tax codes, etc.? All that tuition, and yet this is left out. Could it really be that difficult to include in Senior curriculum? Does administration think the students could not handle the material? I am looking for a rational answer. Having a private practice dentist give a seminar on practice management is not the solution.
Click to expand...

At stony brook we take some courses in business in dentistry during our 3rd and 4th years and we are encouraged to keep updated on the outlook of private pratice in the future.
 
setdoc7 said:
Owning is tough. I agree that the worry, or at least the running of the business (not office, business) is always in the back of your mind. Unfortunately, dental school does practically nothing to prepare you for private practice and business ownership. If that is the end goal for many, why are there no business courses in dental school? Most D schools are affiliated with large universities which have an associated school of business. Would it be too much to have some of the B school professors give courses to the D students on: accounting, marketing, small business administration, tax codes, etc.? All that tuition, and yet this is left out. Could it really be that difficult to include in Senior curriculum? Does administration think the students could not handle the material? I am looking for a rational answer. Having a private practice dentist give a seminar on practice management is not the solution.
Click to expand...

I honestly don't know if the business schools teach what a person needs to own a small business, my wife has an MBA and it sounds like it was a lot of theory, not hands on practical stuff. To be honest you would be better off doing a one day seminar at Breakaway and seeing the ins and outs of starting a practice and all the little stuff, as well as studying the BOgleheads website to learn about basic investing, and reading Whitecoat investor, physician on FIRE on a daily basis. I mean this respectfully but I'm rather surprised at how financially illiterate a lot of dentist are, that's why they are ripe for the pickings by financial advisors selling whole life.
 
Can you just hire someone to do the business side of things for you? seems like a less stressful way
 
InformMe123 said:
Can you just hire someone to do the business side of things for you? seems like a less stressful way
Click to expand...
Every office has an office manager, who helps with the insurance billings, collecting payments, making appointments, selling cases for the doctor, dealing with patients’ complaints etc but the job is still stressful. You stress out when you don’t have enough patients because you worry about how you are going to pay for all the fixed expenses (rent, staff salaries, property tax, worker comp, etc) when you have so little revenue coming in. You stress out when you are super busy with patients on all the chairs because having more patients means you have to assume greater responsibility. Greater responsibility = more stress.
 
InformMe123 said:
Can you just hire someone to do the business side of things for you? seems like a less stressful way
Click to expand...

The moment you take your hands off the wheel... that’s when the ARs go up, potential embezzlement, writes offs etc

You have to know everything as a business owner. You cannot sit back and expect everyone to do their jobs. Take your eyes off the front and I guarantee it’s not going to go well.

Corporate is a great solution to just practicing dentistry and work 8-5.
 
DDS9994 said:
I honestly don't know if the business schools teach what a person needs to own a small business, my wife has an MBA and it sounds like it was a lot of theory, not hands on practical stuff. To be honest you would be better off doing a one day seminar at Breakaway and seeing the ins and outs of starting a practice and all the little stuff, as well as studying the BOgleheads website to learn about basic investing, and reading Whitecoat investor, physician on FIRE on a daily basis. I mean this respectfully but I'm rather surprised at how financially illiterate a lot of dentist are, that's why they are ripe for the pickings by financial advisors selling whole life.
Click to expand...
My point exactly. Without the basic theory/knowledge behind you, how can you run a business hands on? Once you know the basics, the rest can be learned in a more advanced setting. I find investor platforms for physicians/dentists way too conservative and many are commission based. How many touted Bitcoin 4 years ago? Those who invested early are millionaires now, and are not really worrying about working.
 
oralcare123 said:
They are actually really nice to you offering you to work at another office. I personally would just let you go.
What does it mean "I have no desire to do molar endo? " You have to. You have to produce, it's a busyness not a play
To be able to sell, you need to know indications and contraindications of each procedure as well as local and systemic consequences of treating or not. At the same time you have to believe in what you are saying and be confident.
I bet there are CE courses, which teach all that
Click to expand...

All too often new grad GP (most GP for that matter) are not skilled enough to complete molar RCT to standard. Therefore, IMO it is not unreasonable to refer those procedures to endodontists. This is especially true since the OP is treating a geriatric population.
 
Rainee said:
The moment you take your hands off the wheel... that’s when the ARs go up, potential embezzlement, writes offs etc

You have to know everything as a business owner. You cannot sit back and expect everyone to do their jobs. Take your eyes off the front and I guarantee it’s not going to go well.
Click to expand...

Yep.

Woman stole $400,000 from dentist, spent it on Disney World and other vacations

Embezzlement Nets Prison, $350,000 Repayment for Carthage Woman - Hiltz & Associates
 
yappy said:
All too often new grad GP (most GP for that matter) are not skilled enough to complete molar RCT to standard. Therefore, IMO it is not unreasonable to refer those procedures to endodontists. This is especially true since the OP is treating a geriatric population.
Click to expand...
New grads have enough knowledge and skill to perform uncomplicated RCT. Obviously not at the speed of experienced Endodontist. They absolutely must not “have no desire to perform” certain procedures, otherwise they are doomed to a life of poverty.
If someone doesn’t feel confident, they should attend CE courses
 
Hello,

I will be graduating after 5 months. I am looking to practice in midwest. Can anybody guide me how to search for jobs?

Thank you.
 
oralcare123 said:
New grads have enough knowledge and skill to perform uncomplicated RCT. Obviously not at the speed of experienced Endodontist. They absolutely must not “have no desire to perform” certain procedures, otherwise they are doomed to a life of poverty.
If someone doesn’t feel confident, they should attend CE courses
Click to expand...

I've known too many successful GP dentists that didn't do RCT to know that isn't true. How often do you obturate MB2?
 
oralcare123 said:
New grads have enough knowledge and skill to perform uncomplicated RCT. Obviously not at the speed of experienced Endodontist. They absolutely must not “have no desire to perform” certain procedures, otherwise they are doomed to a life of poverty.
If someone doesn’t feel confident, they should attend CE courses
Click to expand...
I agree. If you avoid treating challenging cases, you will never learn to become a good dentist. You will have a hard time getting a good paying job and asking the boss for a raise. Taking CE classes helps but is not good enough. You have to learn to deal with the real stress of working on the real patients.

This is why many practice owners prefer hiring associate dentists with 2-3 years of experience. The more experienced ones already know all the pros and cons of working for someone else and they don’t complain much. They made some clinical mistakes and learned from those mistakes. Imagine if you were the owner. You book an endo case that you think your associate dentist can handle. But your associate doesn’t want to treat the case and refers to the endodontist. The patient gets upset and decides to get care at another GP office because he/she has to miss work for this and he/she no longer has trust in your office. If you were an owner, how do you feel?

It’s hard to please people. Your associate complains when you book most of the difficult cases for yourself to treat and you only give him the easy cases. When you give your associate difficult cases, he says he can’t do them and has to refer to the specialists. And when you fire your associate because of his lack of experience, he complains that you are a mean greedy boss.
 
Last edited:
yappy said:
I've known too many successful GP dentists that didn't do RCT to know that isn't true. How often do you obturate MB2?
Click to expand...

When your name is on the line, alot of GP's drop root canals. The bottom line is that doing good ENDO is hard. Doesn't matter if someone gives you a cbct and rotary, if you don't do it day in and day out, most of your root canals in my opinion will fail.

It doesn't matter when you are associating and pumping out production for corporate, but when you own a practice and your job is to retain patients, doing rcts....is very questionable as the results tend to suck. I wouldn't mind getting a surgical extraction from a GP, I wouldn't mind getting a 6-11 crowns or implants by a GP, but RCT and Perio...I would go see a specialist way over a GP. Just way to many crappy Root Canals that fail within <5 years running around.

I do maybe less then 2-3 rct a month, maybe none. Back when I did corporate it was 1-2 a week molars and premolars and through the crown. It's way different when you own a practice and the goal is patient retention and happiness.
 
Rainee said:
When your name is on the line, alot of GP's drop root canals. The bottom line is that doing good ENDO is hard. Doesn't matter if someone gives you a cbct and rotary, if you don't do it day in and day out, most of your root canals in my opinion will fail.

It doesn't matter when you are associating and pumping out production for corporate, but when you own a practice and your job is to retain patients, doing rcts....is very questionable as the results tend to suck. I wouldn't mind getting a surgical extraction from a GP, I wouldn't mind getting a 6-11 crowns or implants by a GP, but RCT and Perio...I would go see a specialist way over a GP. Just way to many crappy Root Canals that fail within <5 years running around.

I do maybe less then 2-3 rct a month, maybe none. Back when I did corporate it was 1-2 a week molars and premolars and through the crown. It's way different when you own a practice and the goal is patient retention and happiness.
Click to expand...
When you are a practice owner you can do or not do whatever you want, but OP can't, if he wants to have a job. He can buy a practice, but I seriously doubt it will be successful with he's present mentality
 
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