Not owning a practice enthusiasm

[dentite24]

I feel like there is a lot of negativity about the future of dentistry. Associate's salaries aren't seeming to go up with inflation, and owning a practice is very close to being an option on its way out with corporate competition. But there is still a lot of push that owning a practice is what HAS to be done.
I feel indifferently about this. In my case, I should be about ~175-200,000 in debt, have a good enough rank to get into a solid/upper GPR/AEGD, and don't know if I want to take all of the stressors/risks/debt/competition involved in owning your own practice. I'll be coming out of school at 26 and don't want to put my life on hold anymore either (house, kids, hobbies).
With good residency training giving me a solid skill set, I would like to find an associate position in the private practice sector or a dentist owned DSO (not like the ASPEN model), where I would probably make ~150,000 coming out and progress as I age into the career (with consistent 4 day/week, 35hr weeks, no work after work, a few weeks of vacation). And, I will continue to be a smart spender and max out all of my retirement accounts (IRA, 401k, HSA)... retiring at a respectable 50-55...

I should feel enthusiasm from a plan like this, right? But why do I feel pressure otherwise, will this put me in a worse situation than I think?

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[charlestweed]

In order to make $150k/year (or $700-750/day…..working 4 days/wk), you have to be good and fast at any procedure that is thrown at you and you have to find a place that gives you enough patients to consistently produce at least $2k a day for the owner. Be ready to deal with some of these problems when work for someone else:
-The owner may keep all highly paid procedures like RCT, implants, crowns etc and let you do the cleanings and fillings all day long. The owner may cut your work days when there are not enough patients to fill the appt book. To cut down operating cost, the owner may not give you the supplies and instruments that you want. The assistants don’t respect you and only listen to the owner.
-When you work for the corp office, you have to deal with the bossy office manager who only has a HS diploma. You have to see a lot of Medicaid and HMO patients…and have to be fast in order to make up for the low pay. They may make you work late hours and on Saturdays.
-When you work at an office that hires multiple associate dentists, you may have to deal with a co-worker who takes good paying patients away from you. If your co-worker is faster and better than you, the manager may assign more difficult (but more productive) procedures to your co-worker.
- Since you work as an independent contractor, you can get fired anytime. You have to buy your own health insurance, malpractice insurance, and save for your retirement.

A salary of $150k/year is not that much if you are married with 2 kids and your spouse doesn’t work. After paying taxes, you will be left with around $110k/year or $9k/month. If you buy a $4-500k house, your monthly payment + property taxes + maintenance will be around $4k/month. Your student loan payment will be around $2k/month if you plan to pay it off in 10 years. The health insurance for a family of 4 will cost you $1.4k/month. Malpractice + disability + life + car insurances will cost you $1k/month. You won’t be able to save much for your retirement. Expect to drive a normal $30-35k car for the rest of your life.

With this $150k/year salary, you won’t be able buy a house until you are at least 30 yo. It will take you 30 years to pay it off….so the earliest you can retire is when you are 60 yo. If you want to retire earlier than this, you either need to work more than 4 days/week or open your own office. If you don’t plan to get married and have kids, you should be fine with this salary.

 

[dentite24]

These are all really great considerations, thank you. Any positive light to shine or advice for non-ownership? Is there any good way to go about this route?

Yes, I wouldn't buy a house until low 30s anyways based on current dating situation smh haha also, my house decision (price) isn't a keeping up with a jones' decision, I know want I want/need isn't a lot. I also live in a very 'millionaire next door' manner, spending habits are very good and will stay that way. Very fine with a car in the 15-20,000 price range for entirety actually ; all cars basically look/perform the same, others owning a cool car gives people like me an edge.
I feel I would have good training if I find the right residency. For a good dentist, money is made through single implants, single crowns, being able to pull 3rd molars, and the occasional large case (full mouth). Also, tx plan acceptance is something I feel is a large issue with a lot of dentists, I think this is solvable via practice and just being a normal person. Obviously, the owner taking the good cases is an issue... But, I know new dentists in this exact situation I'm describing I want to be (skill wise) as 1st or 2nd year associates making 250-350,000 not having much trouble having their bosses taking cases.
I also plan to avoid saturated areas as best I can (Cali, NYC, Chicago, really anywhere too close to a city center really). I think maybe like 45 min to an hour from a city in Texas or North Carolina is a likely landing spot.

What location and fit (type of DSO, type of private sector) would be best fit for me?

 

[charlestweed]

These are all really great considerations, thank you. Any positive light to shine or advice for non-ownership? Is there any good way to go about this route?

Yes, I wouldn't buy a house until low 30s anyways based on current dating situation smh haha also, my house decision (price) isn't a keeping up with a jones' decision, I know want I want/need isn't a lot. I also live in a very 'millionaire next door' manner, spending habits are very good and will stay that way. Very fine with a car in the 15-20,000 price range for entirety actually ; all cars basically look/perform the same, others owning a cool car gives people like me an edge.
I feel I would have good training if I find the right residency. For a good dentist, money is made through single implants, single crowns, being able to pull 3rd molars, and the occasional large case (full mouth). Also, tx plan acceptance is something I feel is a large issue with a lot of dentists, I think this is solvable via practice and just being a normal person. Obviously, the owner taking the good cases is an issue... But, I know new dentists in this exact situation I'm describing I want to be (skill wise) as 1st or 2nd year associates making 250-350,000 not having much trouble having their bosses taking cases.
I also plan to avoid saturated areas as best I can (Cali, NYC, Chicago, really anywhere too close to a city center really). I think maybe like 45 min to an hour from a city in Texas or North Carolina is a likely landing spot.

What location and fit (type of DSO, type of private sector) would be best fit for me?

It’s very important to have good clinical skills (fast, efficient, and quality work) when you work for someone else. Being good at communicating with the patients should help but not very important because there is a manager or tx coordinator who helps sell cases for you. The assistants also prefer to work with the fast associate dentist. I am a shy person…I don’t like talking to the patients. And yet, I am one of the top producers at the corp office I work for. Corp managers love me because I never complain and I am ok with working with any of the supplies/instruments/assistants that they provide me. I am very flexible with the hours that they want me to work. I am ok with staying 15-30 minutes late to start a new case for them. I’ve worked P/T at this same corp office since graduation. If you are an easy-going person, you can find work anywhere.

It’s good that you are ok with having the same lifestyle as a person (ie an engineer, a school teacher etc) who earns 60-70k/year. In this case, making $150k/year (with only $175k in student loan debt) should be plenty for you. Many dentists (myself included) expect a lot more. We expect to have a lifestyle that a doctor or a person, who had gone through 8-10 years of education, is supposed to have. I want to have a nice house in an upscale neighborhood in CA. I want to drive a car that most people my age can’t afford. I want to be debt-free before my 50th birthday. I want to pay off debts for my rental properties, which will help generate enough passive income to maintain the lifestyle that I currently enjoy after I retire. Therefore, I had to work 6-7 days/week……and 12 hours a day on some days when I was in my 30s. Until now, at 48, I still work 21 days/month…..4 hours/day, 10 days/month at my own offices and 8 hours/day, 11 days/month at the corp office. I think most ortho colleagues, who are at the same age with me, don't work as many days as I do now.

Make sure you have enough fund in your bank account that can support you for at least 6 months....just in case you’ll have to face another disaster like this coronavirus outbeak in the future. According to this youtube video, you can earn $140-180k as a new grad if you don’t mind practicing in Milwaukee, WI.

 

[2TH MVR]

Look. Most of us went into dentistry for the autonomy it offers over medicine. Maybe I'm biased but the thought of working for a Corp or another dentist for eternity would drive me crazy. I probably would go postal eventually. Owning your own practice is a dream most dentists want. There is pride in ownership. Equity in ownership. I practiced privately with multiple practices and recently sold everything to simplify my life. I work Corp now. Corp is a **** show lol. There is NO PRIDE in working Corp. It will suck the life out of you. Is being an employee rather than an owner less stress. Of course it is, but there are plenty of disadvantages also.

If going urban, saturated ..... do what @charlestweed does. Best of both worlds. Private and Corp.

My choice though. Go rural or semi-rural. You won't escape the Corps, but there will be less of them. You would have the opportunity to have a simple private practice. Maybe not a high producing practice, but YOUR OWN practice. You will call all the shots.

Yes. There are alot of negatives mentioned here, but mostly directed at those who chose or "had to" attend an overly expensive DS. You are in a great situation with your <200K DS debt.

Forget the AEGD/GPR. Do some research on a good rural area. Associate for 6-12 months giving you time to build speed and also time to research the area for private practice opportunities.

I tolerate Corp employment with the help of prescription medication (just kidding) now because it fits my simple semi-retired life. But I am not proud of it.

 

[P7898]

OP I will graduate with $150k in debt. I am sorry you are getting advice from people that want just the money and have no pure notions when it comes to a profession that helps people. That said, money is an important factor to have a good quality of life. You just have to figure out why you want to go into the dental profession. Me: using my hands, helping people, no life or death situations, home on time. At the end of the day a job is a job. You can make a lot of money doing a lot of other things. But dentistry and a select few specialties in medicine have a good quality of life in terms of work life balance and income. I agree with Charles...... you will be comfortable if you are less than $200k of what you need to pay back. I got lucky honestly and looking back I probably wouldn't have chose dentistry if I had to pay $400-$500k. Mose people are unaware how that effects your quality of life.

Figure out what you want in life and what you like and work towards it. But be smart about how you go about it. Never by anything at full asking price.

 

[charlestweed]

I tolerate Corp employment with the help of prescription medication (just kidding) now because it fits my simple semi-retired life. But I am not proud of it.

Why are you not proud? You continue to get paid very well for doing what you love without the headaches of running your own office (brownnosing the GPs, paying rents, paying staff salaries + other fixed expenses etc). The corp manager respects you and doesn’t pressure you to produce. You have the full autonomy in making all treatment decisions. You don’t do anything illegal or unethical at the corp. You provide the same quality of care for the patients at the corp as you did for the patients at your own private practice. I will probably do the same when I reach your age…..sell my practice and continue to work P/T for the corp. It's like being physician who works for a hospital.

 

[dPseh]

I don’t have much to add to this conversation, but I just want to say that I’m also in the same mindset as OP where private ownership is not for me.
The money, autonomy, and not having someone breathing down my neck are wonderful perks to owning a practice. But dealing with all the headaches of owning one is just not worth it for me.
I want to go to work, do my work, and leave work without having to carry home too much with me.
Chair breaks down, handpiece stops working, pano machine not functioning? Not my problem!
Global pandemic causing business to slow to a snail pace? Not (really) my problem! My boss has been absolutely stressing out over the ramifications to his practices and I've been sitting at home for the last 2 weeks just sipping on my tea and watching Netflix all day.

My long term goal is to work for a FQHC/IHS/dentist owned Corp. A friend of mine recently left his job at an IHS, where they paid him $175k with full benefits, reportedly low stress. Sounds like it’s enough for me.
I’m still young, not married (but plan to with a working spouse), and no plans for kids ever, and a small house may be something I’ll be interested in later. Throw in a Tesla too.
I can’t see myself owning a practice and carrying on that extra stress. The money wouldn’t be worth it for me.
Everyone has their goals. It frustrates me when I see or hear people telling or pressuring *me* that personal practice is the way to go. As of this point in my life, I just can’t see it.

 

[charlestweed]

I don’t have much to add to this conversation, but I just want to say that I’m also in the same mindset as OP where private ownership is not for me.
The money, autonomy, and not having someone breathing down my neck are wonderful perks to owning a practice. But dealing with all the headaches of owning one is just not worth it for me.
I want to go to work, do my work, and leave work without having to carry home too much with me.
Chair breaks down, handpiece stops working, pano machine not functioning? Not my problem!
Global pandemic causing business to slow to a snail pace? Not (really) my problem! My boss has been absolutely stressing out over the ramifications to his practices and I've been sitting at home for the last 2 weeks just sipping on my tea and watching Netflix all day.

My long term goal is to work for a FQHC/IHS/dentist owned Corp. A friend of mine recently left his job at an IHS, where they paid him $175k with full benefits, reportedly low stress. Sounds like it’s enough for me.
I’m still young, not married (but plan to with a working spouse), and no plans for kids ever, and a small house may be something I’ll be interested in later. Throw in a Tesla too.
I can’t see myself owning a practice and carrying on that extra stress. The money wouldn’t be worth it for me.
Everyone has their goals. It frustrates me when I see or hear people telling or pressuring *me* that personal practice is the way to go. As of this point in my life, I just can’t see it.

Completely agree. I am a realistic person.....MONEY. Making money and becoming financially successful were the main reason I took the risk to take out student loans for 4 years of dental school and 2 years of ortho. I knew I couldn't just stop at a BS degree in Biology because it was pretty much a useless degree. You can't be a happy person if you are struggling to pay bills every day and are living paycheck to check. You can't be a happy person if you constantly worry about getting fired....about your job security. Find a hobby if you want to do what you love....and make sure you make enough $$$ to pay for such hobby.

The reason I started my own office was I wanted to work less and make more than what I make working for the corp. I want to be at the point where I no longer need to worry about paying bills....I want to reach this goal long before my 65th birthday. Things like the pride of ownership and freedom to do whatever I want etc were nice but not as important as making MONEY. If I had to work harder and made less at my own office, I would sell the office and just work F/T for the corp so I could reach the goal of becoming financially independent faster. I've met a few associate GPs at the corp, who once owned dental offices but didn't do well and had to sell their practices. Not every dentist has the right skills to run a successful practice.

 

[laundry]

I don’t have much to add to this conversation, but I just want to say that I’m also in the same mindset as OP where private ownership is not for me.
The money, autonomy, and not having someone breathing down my neck are wonderful perks to owning a practice. But dealing with all the headaches of owning one is just not worth it for me.
I want to go to work, do my work, and leave work without having to carry home too much with me.
Chair breaks down, handpiece stops working, pano machine not functioning? Not my problem!
Global pandemic causing business to slow to a snail pace? Not (really) my problem! My boss has been absolutely stressing out over the ramifications to his practices and I've been sitting at home for the last 2 weeks just sipping on my tea and watching Netflix all day.

My long term goal is to work for a FQHC/IHS/dentist owned Corp. A friend of mine recently left his job at an IHS, where they paid him $175k with full benefits, reportedly low stress. Sounds like it’s enough for me.
I’m still young, not married (but plan to with a working spouse), and no plans for kids ever, and a small house may be something I’ll be interested in later. Throw in a Tesla too.
I can’t see myself owning a practice and carrying on that extra stress. The money wouldn’t be worth it for me.
Everyone has their goals. It frustrates me when I see or hear people telling or pressuring *me* that personal practice is the way to go. As of this point in my life, I just can’t see it.

I'm in a contrarian mood today, so allow me to retort

Chair breaks down, handpiece stops working, pano machine not functioning? Not my problem! It is your problem when you can't order it to be fixed or order the right part because your boss (not YOUR boss, I mean a hypothetical boss) didn't get to it in time. Don't care for the assistant? Too bad, you can't fire her.

Global pandemic causing business to slow to a snail pace? Not (really) my problem! My boss has been absolutely stressing out over the ramifications to his practices and I've been sitting at home for the last 2 weeks just sipping on my tea and watching Netflix all day.
I wouldn't be so relaxed with your tea there.....if what your boss is stressing about continues to worsen, you may be left sitting at home with Netflix. Those ramifications = increased overhead and decreased patient flow. Unless your boss is an absentee owner, you would be the first in line to the chopping block.

My long term goal is to work for a FQHC/IHS/dentist owned Corp. A friend of mine recently left his job at an IHS, where they paid him $175k with full benefits, reportedly low stress. Sounds like it’s enough for me.
If 175K/benefits is plenty for you, that's awesome. I hope you get along with your boss well. For me, that was the biggest deciding factor for ownership - I have a pronounced Alpha personality and can't have anyone to answer to. The other reason is 175K/yr wouldn't go very far in Bay Area and def not with my lifestyle.

 

[dPseh]

I'm in a contrarian mood today, so allow me to retort

Chair breaks down, handpiece stops working, pano machine not functioning? Not my problem! It is your problem when you can't order it to be fixed or order the right part because your boss (not YOUR boss, I mean a hypothetical boss) didn't get to it in time. Don't care for the assistant? Too bad, you can't fire her.

Global pandemic causing business to slow to a snail pace? Not (really) my problem! My boss has been absolutely stressing out over the ramifications to his practices and I've been sitting at home for the last 2 weeks just sipping on my tea and watching Netflix all day.
I wouldn't be so relaxed with your tea there.....if what your boss is stressing about continues to worsen, you may be left sitting at home with Netflix. Those ramifications = increased overhead and decreased patient flow. Unless your boss is an absentee owner, you would be the first in line to the chopping block.

My long term goal is to work for a FQHC/IHS/dentist owned Corp. A friend of mine recently left his job at an IHS, where they paid him $175k with full benefits, reportedly low stress. Sounds like it’s enough for me.
If 175K/benefits is plenty for you, that's awesome. I hope you get along with your boss well. For me, that was the biggest deciding factor for ownership - I have a pronounced Alpha personality and can't have anyone to answer to. The other reason is 175K/yr wouldn't go very far in Bay Area and def not with my lifestyle.

1) there are a lot of less than ideal associate positions out there and that is definitely one con to working for someone else. I’ve been in a couple situations like that already. I have friends that have also told me horror stories about their positions, which do include what you say: their bosses refuse to fix XYZ and you have to make do with a poor assistant or broken equipment.
Well, I don’t work for those places any longer, and neither do my friends. I live in an area where I can “shop around” for jobs and am not confined to a single office.
Having to keep employees happy is a stressor of being an owner. If they’re not keeping me happy, then I’ll have to find a place that will. Not a good look for the office when you have constant turnover of your employees either.
(Side note, poor business decision by the boss if they decide to not address the problem. Less working equipment/poor DA = rescheduled patients/longer wait time = unhappy patients = complaints/loss of revenue. Bigger problem for the boss than it is for me.)

2) being first on the chopping block doesn’t sound as bad as having an office that isn’t raking in the proper cash. Increased overhead, decreased patient flow... perhaps bad enough to cause the office to go red? Sounds like a situation I wouldn’t want to be in.
In my specific situation, my boss owns two offices, so is part time absentee. I work at only one location. So unless things REALLY slow down for both offices after the pandemic mandates are lifted (as they are now), then my position is still secure.

3) I live in a small urban area, and with my lifestyle and family status, 175k is more than enough. I’m getting paid a lot less than that now (175k salary is at an IHS office that I do not work for), and still getting by just fine. When you’re used to living poor most of your life, this is actually quite the luxury.
I didn’t go into dentistry for the sole purpose of being my own boss, having to worry about my office 24/7. Too much stress for this little worker bee! XD

 

[yappy]

The reason why being an associate is worse than being an owners is because you do the same, or more, work for a lot less money. You also have zero standing. I am not an owner (yet) but my friends who've done start-ups are doing better in their struggling new practices than they did working for a DSO.

DSOs are a bubble. Private equity is chasing an apprenticing market that is based on gaining instant equity through acquisition rather than revenue. Once all the merging has happened, and the easy money is gone, the bubble will pop.

 

[beannaithe]

I'm a long term associate and will likely never own a practice because it isn't for me. I do freely admit that I have a unicorn associateship. Great percentage, autonomy and a boss who doesn't steal big cases. The downside in a DSO arrangement is the percentage tends to be really low because there's a lot of people who get paid from your production. You may want to look at private practice, if you can find a good one. They are out there, but they don't tend to come up often. Once someone finds a good job, they tend to stay for years. With being an associate, ouu tend to do a lot of work for less pay than you would as an owner. There's nothing wrong with that, but it is what it is.

Remember though, the buck always stops with the owner. Something goes wrong? Owner's problem. Handpiece on the fritz? Owner's problem. Hygienist calls out? Owner's problem. It's not a bad place to be as an associate. You just get less pay for not having to deal with the stress. I like to be able to leave and not have to worry about the office unless I'm on call.

I live below my means and save what I can. I have enough and that works for me. I work part-time and do quite well. If it makes you feel any better, I'm happy with where I am and I would not change anything. The only thing that might be unrealistic is your retirement goal. If you have kids/plan on kids, that will change that number a bit. They are expensive!

 

[yappy]

Remember though, the buck always stops with the owner. Something goes wrong? Owner's problem. Handpiece on the fritz? Owner's problem. Hygienist calls out? Owner's problem. It's not a bad place to be as an associate. You just get less pay for not having to deal with the stress. I like to be able to leave and not have to worry about the office unless I'm on call.

I agree with much of your post but I want to add another data point. In a few jobs I have had the owners make their problems my (the associate's) problem. I have heard phrases like "I'm developing you to be a owner/leader so take care of x" but the truth is it's to serve their interests. When an owner is away they want the associate to be able to handle most things including practice management. In the jobs I had if I just threw my hands up in the air and said "not my problem" I don't think I would have lasted long. Therefore, in my experience, you will be expected to problem solve and manage ownership headaches as an associate.

 

[allDAT]

I feel like there is a lot of negativity about the future of dentistry. Associate's salaries aren't seeming to go up with inflation, and owning a practice is very close to being an option on its way out with corporate competition. But there is still a lot of push that owning a practice is what HAS to be done.
I feel indifferently about this. In my case, I should be about ~175-200,000 in debt, have a good enough rank to get into a solid/upper GPR/AEGD, and don't know if I want to take all of the stressors/risks/debt/competition involved in owning your own practice. I'll be coming out of school at 26 and don't want to put my life on hold anymore either (house, kids, hobbies).
With good residency training giving me a solid skill set, I would like to find an associate position in the private practice sector or a dentist owned DSO (not like the ASPEN model), where I would probably make ~150,000 coming out and progress as I age into the career (with consistent 4 day/week, 35hr weeks, no work after work, a few weeks of vacation). And, I will continue to be a smart spender and max out all of my retirement accounts (IRA, 401k, HSA)... retiring at a respectable 50-55...

I should feel enthusiasm from a plan like this, right? But why do I feel pressure otherwise, will this put me in a worse situation than I think?

Do not rule out ownership. I believe you're underestimating how difficult it is to find a good associate position as a general dentist, but it's hard to explain until you're actually practicing. Many dentists move to ownership because they have to buy a job, not because they want to be an owner. Many associates are treated poorly, have limited autonomy, and have no control over other aspects of their practice (like what lab they use, what armamentarium is available, who your assistants are etc).

 

[Eun-Sol]

It’s very important to have good clinical skills (fast, efficient, and quality work) when you work for someone else. Being good at communicating with the patients should help but not very important because there is a manager or tx coordinator who helps sell cases for you. The assistants also prefer to work with the fast associate dentist. I am a shy person…I don’t like talking to the patients. And yet, I am one of the top producers at the corp office I work for. Corp managers love me because I never complain and I am ok with working with any of the supplies/instruments/assistants that they provide me. I am very flexible with the hours that they want me to work. I am ok with staying 15-30 minutes late to start a new case for them. I’ve worked P/T at this same corp office since graduation. If you are an easy-going person, you can find work anywhere.

It’s good that you are ok with having the same lifestyle as a person (ie an engineer, a school teacher etc) who earns 60-70k/year. In this case, making $150k/year (with only $175k in student loan debt) should be plenty for you. Many dentists (myself included) expect a lot more. We expect to have a lifestyle that a doctor or a person, who had gone through 8-10 years of education, is supposed to have. I want to have a nice house in an upscale neighborhood in CA. I want to drive a car that most people my age can’t afford. I want to be debt-free before my 50th birthday. I want to pay off debts for my rental properties, which will help generate enough passive income to maintain the lifestyle that I currently enjoy after I retire. Therefore, I had to work 6-7 days/week……and 12 hours a day on some days when I was in my 30s. Until now, at 48, I still work 21 days/month…..4 hours/day, 10 days/month at my own offices and 8 hours/day, 11 days/month at the corp office. I think most ortho colleagues, who are at the same age with me, don't work as many days as I do now.

Make sure you have enough fund in your bank account that can support you for at least 6 months....just in case you’ll have to face another disaster like this coronavirus outbeak in the future. According to this youtube video, you can earn $140-180k as a new grad if you don’t mind practicing in Milwaukee, WI.

May I ask you why you decided to choose corp instead of owning a private practice?

 

[charlestweed]

May I ask you why you decided to choose corp instead of owning a private practice?

Right after graduation, I went straight to working for corp offices because:
1. I felt didn’t have enough clinical experience to start my own office. I had only treated 100 cases (started 50 new cases + inherited 50 transferred cases) during my 2 yr ortho residency.
2. I was totally cluesless about starting an office. I shared similar concerns that the original poster of this thread has: overhead, stress, competition etc.
3. I was broke. I owed $150k and my wife owed $308k in student loans. I also had $55k credit card debt because I didn’t received enough student loan for my ortho residency. So I didn’t it’s a good idea to take out additional business loan to set up an office.
4. Excellent pay. During my residency, I heard the average pay for new grad ortho was around $600-650/day. One corp offered me $800/day, 10 days a month. Another corp offered me $950/day, 11 days a month. And the 3rd corp offered me $750/day, 1 day a month. I accepted all 3 job offers because they were all above the amount that I expected.
5. Instant gratification. I felt spending 11 years (4yr undergrad + 4yr DDS + 1yr GPR + 2yr ortho) of schooling were already long enough. A day after I started my first job, I went straight to the BMW dealership to buy myself a used 7 series for $38k.

My wife, who is also a dental specialist, bought an existing practice a year after her graduation. She kept telling me to use her office space to start my ortho business there. But I kept saying no to her because I was very happy with the associate jobs at the corp offices. About 4 years later, I finally listened to my wife and started treating ortho patients at her office 2 Sundays a month…and I still kept my F/T job at the corp. After about a year (in 2006), my wife’s office space became too small for my ortho patients; therefore, I decided to build an office from scratch and moved my patients there. At around the same time, I added another office location by using my sister’s office space. And in 2009, I bought existing office from a retired orthodontist.

Currently, I work 10-11 days/months at 4 of my own offices and 11 days/month at 2 corp offices. It's the best of both worlds. When my own offices don't produce much (especially during the slow months between Sept-Jan), I still have the stable income from my P/T corp job.

 

[Eun-Sol]

Right after graduation, I went straight to working for corp offices because:
1. I felt didn’t have enough clinical experience to start my own office. I had only treated 100 cases (started 50 new cases + inherited 50 transferred cases) during my 2 yr ortho residency.
2. I was totally cluesless about starting an office. I shared similar concerns that the original poster of this thread has: overhead, stress, competition etc.
3. I was broke. I owed $150k and my wife owed $308k in student loans. I also had $55k credit card debt because I didn’t received enough student loan for my ortho residency. So I didn’t it’s a good idea to take out additional business loan to set up an office.
4. Excellent pay. During my residency, I heard the average pay for new grad ortho was around $600-650/day. One corp offered me $800/day, 10 days a month. Another corp offered me $950/day, 11 days a month. And the 3rd corp offered me $750/day, 1 day a month. I accepted all 3 job offers because they were all above the amount that I expected.
5. Instant gratification. I felt spending 11 years (4yr undergrad + 4yr DDS + 1yr GPR + 2yr ortho) of schooling were already long enough. A day after I started my first job, I went straight to the BMW dealership to buy myself a used 7 series for $38k.

My wife, who is also a dental specialist, bought an existing practice a year after her graduation. She kept telling me to use her office space to start my ortho business there. But I kept saying no to her because I was very happy with the associate jobs at the corp offices. About 4 years later, I finally listened to my wife and started treating ortho patients at her office 2 Sundays a month…and I still kept my F/T job at the corp. After about a year (in 2006), my wife’s office space became too small for my ortho patients; therefore, I decided to build an office from scratch and moved my patients there. At around the same time, I added another office location by using my sister’s office space. And in 2009, I bought existing office from a retired orthodontist.

Currently, I work 10-11 days/months at 4 of my own offices and 11 days/month at 2 corp offices. It's the best of both world. When my own offices don't produce much (especially during the slow months between Sept-Jan), I still have the stable income from my P/T corp job.

Wow, thank you very much for sharing! That is great tactic to win both worlds.

One another question, not as ortho but do you think it is possible as general dentist? Meaning, possible for general dentist to have feet on both of corp and own a private practice after yrs out of dental school?


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[charlestweed]

Wow, thank you very much for sharing! That is great tactic to win both worlds.

One another question, not as ortho but do you think it is possible as general dentist? Meaning, possible for general dentist to have feet on both of corp and own a private practice after yrs out of dental school?


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Yes. My younger sister is a GP. She graduated 2 years ahead of me because she didn't do any residency after dental school. She had worked F/T 6 days/week for corp offices for about 2-3 years and then she set up her own office from scratch. She reduced her days at the corp to 4 days/week and she worked 3 days/week (a week day + Saturdays and Sundays) at her own office. She lived with our parents to save money. And our parents helped babysit her 2 kids so she could work 7 days/week. About 2 years later when she was pregnant with her third child, she decided to quit her associate job at the corp and worked F/T for herself. Her office has 6 chairs (because I do ortho there) but most of the time, she only uses 2 chairs. She doesn't hire hygienist and does all the cleanings herself. She owns the office building and paid off all the debts. She has practiced general dentistry for almost 20 years. Last year, she bought a Tesla and this is the most expensive car that she has ever driven. Before that, she drove a Toyota van.

I followed the same path of my successful sister. I hired the same contractor, who built her office, to build my ortho office. The difference was my sister later quit her associate job at the corp and I continue to work P/T for the corp until now.

 

[Eun-Sol]

Yes. My younger sister is a GP. She graduated 2 years ahead of me because she didn't do any residency after dental school. She had worked F/T 6 days/week for corp offices for about 2-3 years and then she set up her own office from scratch. She reduced her days at the corp to 4 days/week and she worked 3 days/week (a week day + Saturdays and Sundays) at her own office. She lived with our parents to save money. And our parents helped babysit her 2 kids so she could work 7 days/week. About 2 years later when she was pregnant with her third child, she decided to quit her associate job at the corp and worked F/T for herself. Her office has 6 chairs (because I do ortho there) but most of the time, she only uses 2 chairs. She doesn't hire hygienist and does all the cleanings herself. She owns the office building and paid off all the debts. She has practiced general dentistry for almost 20 years. Last year, she bought a Tesla and this is the most expensive car that she has ever driven. Before that, she drove a Toyota van.

I followed the same path of my successful sister. I hired the same contractor, who built her office, to build my ortho office. The difference is my sister later quit her associate job at the corp and I continue to work P/T for the corp until now.

Great! all that hard work repays you and your sister. What a great path you guys took.
Ideally, I want to seek for same path. Fingers crossed for the back to normal economy after this covid pandemic.

 

[LaughingGas]

I am generally pretty flexible and easy going guy. I am the only associate working for one of the offices that my owner owns (10+offices ). Pros and cons. There was one incident that made me want to own so I don't have to deal with bs. I was quite stressed about the whole coronavirus and I spent the whole weekend researching. I came to conclusion that practicing dentistry was not safe. I sent all the information to OM and the owner dentist. Monday comes, and my OM gives us the poor ADA recommendation ( the initial one), showing it's safe to practice and to ask one of my assistant to bring her kid to the office since day care has closed due to coronavirus to accommodate the DA. At that point I lost it in my head. CDC in my state also had recommended non-essential healthcare provider to close. This just pushed me a step closer to own.
The question you have to ask is, is monetary stress? autonomy? or both?.

 

[2TH MVR]

Why are you not proud? You continue to get paid very well for doing what you love without the headaches of running your own office (brownnosing the GPs, paying rents, paying staff salaries + other fixed expenses etc). The corp manager respects you and doesn’t pressure you to produce. You have the full autonomy in making all treatment decisions. You don’t do anything illegal or unethical at the corp. You provide the same quality of care for the patients at the corp as you did for the patients at your own private practice. I will probably do the same when I reach your age…..sell my practice and continue to work P/T for the corp. It's like being physician who works for a hospital.

I agree with you. I should be less judgemental about working for a Corp. Yes. I am paid reasonably well without all the hassles of private practice. They treat me reasonably well. It's just not a glamerous job whatever that means. If I could make the same money and work PT .... I would go into teaching. With teaching .... you are helping to educate a young person's life. In Corp .... your are just a mercenary for hire.

But hey. Maybe after all this Corona virus stuff is controlled .... do they hire orthodontists to work on cruise ships?

 

[toothexplore]

It’s very important to have good clinical skills (fast, efficient, and quality work) when you work for someone else. Being good at communicating with the patients should help but not very important because there is a manager or tx coordinator who helps sell cases for you. The assistants also prefer to work with the fast associate dentist. I am a shy person…I don’t like talking to the patients. And yet, I am one of the top producers at the corp office I work for. Corp managers love me because I never complain and I am ok with working with any of the supplies/instruments/assistants that they provide me. I am very flexible with the hours that they want me to work. I am ok with staying 15-30 minutes late to start a new case for them. I’ve worked P/T at this same corp office since graduation. If you are an easy-going person, you can find work anywhere.

It’s good that you are ok with having the same lifestyle as a person (ie an engineer, a school teacher etc) who earns 60-70k/year. In this case, making $150k/year (with only $175k in student loan debt) should be plenty for you. Many dentists (myself included) expect a lot more. We expect to have a lifestyle that a doctor or a person, who had gone through 8-10 years of education, is supposed to have. I want to have a nice house in an upscale neighborhood in CA. I want to drive a car that most people my age can’t afford. I want to be debt-free before my 50th birthday. I want to pay off debts for my rental properties, which will help generate enough passive income to maintain the lifestyle that I currently enjoy after I retire. Therefore, I had to work 6-7 days/week……and 12 hours a day on some days when I was in my 30s. Until now, at 48, I still work 21 days/month…..4 hours/day, 10 days/month at my own offices and 8 hours/day, 11 days/month at the corp office. I think most ortho colleagues, who are at the same age with me, don't work as many days as I do now.

Make sure you have enough fund in your bank account that can support you for at least 6 months....just in case you’ll have to face another disaster like this coronavirus outbeak in the future. According to this youtube video, you can earn $140-180k as a new grad if you don’t mind practicing in Milwaukee, WI.

HAHA that's my video!! I actually moved back to Milwaukee and make 210,000 at my clinic as an associate
And I completely agree, I am easy going and don't complain much and am grateful for what I'm given and the staff enjoy having me around

 

[AONLINE]

HAHA that's my video!! I actually moved back to Milwaukee and make 210,000 at my clinic as an associate
And I completely agree, I am easy going and don't complain much and am grateful for what I'm given and the staff enjoy having me around

Thank you for making those great videos, I really enjoy watching them! I also thought of moving to WI as I heard that’s one of the best market in the country for dentists. Are you working at a DSO and if so how did you connect with them in the first place?

 

[Molar Whisperer]

These are all really great considerations, thank you. Any positive light to shine or advice for non-ownership? Is there any good way to go about this route?

Yes, I wouldn't buy a house until low 30s anyways based on current dating situation smh haha also, my house decision (price) isn't a keeping up with a jones' decision, I know want I want/need isn't a lot. I also live in a very 'millionaire next door' manner, spending habits are very good and will stay that way. Very fine with a car in the 15-20,000 price range for entirety actually ; all cars basically look/perform the same, others owning a cool car gives people like me an edge.
I feel I would have good training if I find the right residency. For a good dentist, money is made through single implants, single crowns, being able to pull 3rd molars, and the occasional large case (full mouth). Also, tx plan acceptance is something I feel is a large issue with a lot of dentists, I think this is solvable via practice and just being a normal person. Obviously, the owner taking the good cases is an issue... But, I know new dentists in this exact situation I'm describing I want to be (skill wise) as 1st or 2nd year associates making 250-350,000 not having much trouble having their bosses taking cases.
I also plan to avoid saturated areas as best I can (Cali, NYC, Chicago, really anywhere too close to a city center really). I think maybe like 45 min to an hour from a city in Texas or North Carolina is a likely landing spot.

What location and fit (type of DSO, type of private sector) would be best fit for me?

If I were to go back 22 yrs and start over in your shoes, I may make some different considerations. I started with 4 yrs in the USAF coming out debt free. I would marry a spouse preferably with a high income career. That would make your financial life so much easier. I'm sorry to sound ridiculous trying to control who you marry. My spouse is a Fresh Off the Boat overseas immigrant providing negative income with no job and needing overseas travel to see her family and not assimilating to American way of life...eating imported ethnic foods, watching subscription foreign tv shows, etc. After 18 yrs, she is still the most beautiful woman that finds me disgusting. I would consider and explore passive income...some kind of property in a LLC or S Corp as advised by an expert. You may keep and retire from the associate job(s) and not worry about finances or BS.

My sister practices in Texas and she is trying to get me to go down but I can't stand the heat...I went to undergrad there. Texas is very tax friendly but their property taxes are very expensive. You don't have state income or food tax (last I heard). I tell my kids that money provides you choices and if you are not desperate for money, you can be selective. If you have numerous income sources, you can afford to be selective.