Owner of a private practice office 6 years out from dental school, AMA.

[Screwtape]

My first post on this website was 15 years ago when I was in high school, which is wild for me to think about. It was helpful throughout my academic career and I feel like it’s time I give back with an AMA. I don’t come here very often anymore, but I am happy to hopefully answer some questions.

Some background about me:
Been in the Midwest my entire life including schooling and practicing
Graduated from a public dental school in 2017
Did a one-year VA GPR
Went into private practice as an associate for 2.5 years
Have been 50% owner of a 2-doctor office for the past 2.5 years

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[Teeth and Titanite]

How did you choose your GPR and how was the experience it gave you?

 

[Ryxndek]

Would you say the midwest is a pretty good place to practice? does it feel like there’s a lot of dentists or a shortage?

 

[Screwtape]

How did you choose your GPR and how was the experience it gave you?

I was looking for implant placement experience, molar RCT, and bigger pros cases. I also had a location preference (major city in the Midwest). I got enough experience to start placing easy/moderate implants after residency. My program director was a prosthodontist and I was able to do a few bigger pros cases although not enough to do them confidently on my own (except overdenture cases, including bars. I did get proficient with those, which is nice). My RCT experience was pretty meh in residency although it was good in dental school so I started out doing easier molar RCTs in PP.

 

[Screwtape]

Would you say the midwest is a pretty good place to practice? does it feel like there’s a lot of dentists or a shortage?

I would say yes overall it’s a good place to practice. The Midwest is a big place and the denser urban areas are more saturated than the rural areas. It does seem like the Midwest is a much better to practice than the coasts generally speaking.

 

[smiletiger98]

My first post on this website was 15 years ago when I was in high school, which is wild for me to think about. It was helpful throughout my academic career and I feel like it’s time I give back with an AMA. I don’t come here very often anymore, but I am happy to hopefully answer some questions.

Some background about me:
Been in the Midwest my entire life including schooling and practicing
Graduated from a public dental school in 2017
Did a one-year VA GPR
Went into private practice as an associate for 2.5 years
Have been 50% owner of a 2-doctor office for the past 2.5 years

As someone who wants to own a private practice one day, I always have anxiety over the financial aspect of both paying off loans and buying into a practice simultaneously after graduation. How did you go about that aspect of both managing loans and buying into your practice? Would you recommend focusing on paying off as much of the loans as possible before buying into a practice?

 

[Screwtape]

As someone who wants to own a private practice one day, I always have anxiety over the financial aspect of both paying off loans and buying into a practice simultaneously after graduation. How did you go about that aspect of both managing loans and buying into your practice? Would you recommend focusing on paying off as much of the loans as possible before buying into a practice?

It all comes down to budgeting and cash flow/income. You should make more as an owner after servicing your practice loan debt than as an associate, which then should make it easier to pay your student loans.

There’s a balance between paying loans and putting money aside. It’s best to be able to put some money into savings/investments so when you look for a loan you have some liquidity that shows the bank you have a safety net/can budget well. This formula of paying loans vs saving really depends on your loan amount and income amount. The loose rule of thumb is you need 10% of liquidity when getting a loan. For example, you would need $100k in the bank if you are looking for a $1M loan. Although if it’s considered a lower risk to the bank (strong practice, strong production record, etc) then that 10% can be reduced.

If you find the right practice for the right price and can hack it, then your financial situation should be easier as an owner. Unless you are in a unicorn associateship, but have you ever seen a unicorn?

 

[AONLINE]

How much did you make as an associate during your first 2.5 years out of school? Thank you!

 

[Screwtape]

How much did you make as an associate during your first 2.5 years out of school? Thank you!

~$150k the first year
~$225k the second year
I then took a chill position outside of town so I didn’t have to deal with a non-compete and had time/energy to find a good practice that had a set salary of $170k.

 

[Boofy]

How much of an increase in salary did you see after gaining 50% ownership? Was it hard to determine if you wanted to own prior to doing so, or were you always considering? Ive heard of some owners wanting to return back to associating, as they did not like the business side of practicing, but Ive always wanted to own, particularly in a way you have done.

 

[Screwtape]

How much of an increase in salary did you see after gaining 50% ownership? Was it hard to determine if you wanted to own prior to doing so, or were you always considering? Ive heard of some owners wanting to return back to associating, as they did not like the business side of practicing, but Ive always wanted to own, particularly in a way you have done.

I work 3.5 days/week as an owner, as an associate I always worked 4 days/week. You can see my associate numbers above. In 2022 my gross income was $495k. Through Q2 of 2023 I am at $260k, so on track for $520k/year roughly.

I do pay $140k/year in practice loan debt, and that’s post-tax. It’s a 10-year loan.

I always wanted ownership, that’s honestly a large part why I chose dentistry over medicine. I have never looked back—I like to control my own destiny. There are definitely headaches and stresses that come with ownership, but the numbers speak for themselves. It’s not for everyone and I feel lucky I found myself in such a great partnership. I do wonder if I would be as happy as I am in a solo office. It’s nice to have some shared responsibility and another “equal”/dentist in the office. Although I’m sure I’d adapt to being a solo doc too.

YMMV with associateship vs ownership. There is a huge range of income, stresses, workloads of owner general dentists as well as associateships. I can’t say every dentist should own, because some probably shouldn’t. I am very happy with my professional life as an owner (personal too!).

 

[deleted1166024]

What are your most significant financial concerns as a new owner? Business and personal.

 

[Screwtape]

What are your most significant financial concerns as a new owner? Business and personal.

I would say trying to balance paying down my loans (practice loan, practice real estate loan, home mortgage), saving for retirement, and living my life. I have a very healthy income, but I also pay nearly $20k in loans each month. I have found a happy balance and the fact that my wife makes a very healthy income as well helps a lot.

 

[PerioDont]

How did you find an office that you partner you were willing to be 50-50 with? seems more risky than being a solo owner.

 

[dentalchamp98]

Does it get better after dental school? I'm a third year who even transferred dental schools cause my clinic experience was horrible at my previous school, lost a semester, now thinking is it really worth it?

 

[Screwtape]

How did you find an office that you partner you were willing to be 50-50 with? seems more risky than being a solo owner.

The office was an existing two-doctor practice where the older dentist was looking to retire. So I immediately bought into 50% of the practice and took over his half of the practice. The other dentist is now my equal partner.

When I was searching my focus was on profitable, tightly OH controlled, lower volume offices in the area I was already living (pretty much what everyone looks for lol). I honestly thought I’d most likely end up in a solo office but this opportunity presented itself and after meeting with the two dentists it seemed like a good fit. It’s great to share OH and responsibility. It was initially a higher risk in some ways, but the positives greatly outweighed the negatives. I did spend a fair amount of time with my now business partner before taking the plunge.

An attorney who works with dentists only once said “most partnerships in dentistry fail, but the happiest dentists I know are all in partnerships”. I’m very happy with my practice, my business partner, and my work life balance. Partnership isn’t for everyone, but it’s been good for me.

 

[Screwtape]

Does it get better after dental school? I'm a third year who even transferred dental schools cause my clinic experience was horrible at my previous school, lost a semester, now thinking is it really worth it?

I would say most likely it will be better, but hard to say without knowing more about you and your experience.

Do you enjoy the clinical aspect of dentistry? I overall enjoyed my dental school experience, although that was more related to my friend group and the minimal amount of responsibility compared to now. Life was easy back then and I saw my close friends every day and partied hard every weekend .

Being a dentist clinically in the real world is way better than dental school. Although there were a few people in my class who pretty much hated dentistry since sim clinic. They still hate it and some have already left the profession entirely.

 

[dentalchamp98]

I would say most likely it will be better, but hard to say without knowing more about you and your experience.

Do you enjoy the clinical aspect of dentistry? I overall enjoyed my dental school experience, although that was more related to my friend group and the minimal amount of responsibility compared to now. Life was easy back then and I saw my close friends every day and partied hard every weekend .

Being a dentist clinically in the real world is way better than dental school. Although there were a few people in my class who pretty much hated dentistry since sim clinic. They still hate it and some have already left the profession entirely.

I guess since I transferred the clinical experience has been better but I do not have close friends now and don't really party on weekends lol, so not much going on from my side of things. I don't hate dentistry but I dont see myself wanting to be a GP for my whole career, would want to specialize in something like dental anesthesia

 

[Screwtape]

I guess since I transferred the clinical experience has been better but I do not have close friends now and don't really party on weekends lol, so not much going on from my side of things. I don't hate dentistry but I dont see myself wanting to be a GP for my whole career, would want to specialize in something like dental anesthesia

Yeah being a GP ain’t always easy and isn’t for everyone. Dental anesthesia is a sweet little (but growing) niche! Shadow multiple dental anesthesiologists if you can (if you haven’t already) and try to get the best all-around view of your potential future career. The more realistic your expectations are the more likely you will be happy with your decision if you move forward. Cheers!

 

[D1Bound]

Does it get better after dental school? I'm a third year who even transferred dental schools cause my clinic experience was horrible at my previous school, lost a semester, now thinking is it really worth it?

I’m curious how you pulled off a transfer

 

[rafacena]

Yeah being a GP ain’t always easy and isn’t for everyone. Dental anesthesia is a sweet little (but growing) niche! Shadow multiple dental anesthesiologists if you can (if you haven’t already) and try to get the best all-around view of your potential future career. The more realistic your expectations are the more likely you will be happy with your decision if you move forward. Cheers!

Is that an actual specialty of dentistry now where we need to do a 2-3 year program after graduating from dental school?

 

[Ryxndek]

Is that an actual specialty of dentistry now where we need to do a 2-3 year program after graduating from dental school?

Dental anesthesia is a newer specialty. Only 8 programs available right now

 

[dentalinthemental]

Looking back, was the GPR a good decision for your future income potential or do you think you would have been better off going straight into PP and taking CE?

 

[rafacena]

Dental anesthesia is a newer specialty. Only 8 programs available right now

I just checked and it shows 9 programs but the funny thing is, they are all pretty much in the NE except for 3 of them.

 

[Screwtape]

Looking back, was the GPR a good decision for your future income potential or do you think you would have been better off going straight into PP and taking CE?

For me the GPR was better for me than taking CE. I learned implants right away and started placing them with confidence right after residency. The GPR also made me more comfortable with larger and more complex cases. I’m sure I could have winged it without residency but one bad case can really sour you. YMMV with GPR vs PP since both are so variable.