Rate this job offer--Advice on Negotiating

[ChessMaster3000]

For a friend---
Very busy dental practice, currently with only one dentist (the owner), several hygienists and assistants
Entirely insurance-based (FFS, affluent population).
Open 6 days a week--relatively low overhead expenses

Offer: $102,000 base salary. Bonus paid out quarterly based on collections (unclear what this means just yet).
5 days, 40 hours a week

The point in giving the background of the clinic is that it seems like it's pretty successful and aren't paying any other associates. What is a reasonable counter-offer for base salary? Don't want to turn them off since this is the only offer he has that isn't corporate

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[Muggsy Bogues]

102 base is pretty much crap, especially at 40h/week. But without info on potential additional income from collections, it doesn't mean much. ""Bonuses paid out quarterly based on collections" doesn't excite me though but that absolutely needs to be explained.

 

[joh02034]

You said entirely insurance based and FFS in the same sentence. That doesn't make any sense.

 

[ChessMaster3000]

You said entirely insurance based and FFS in the same sentence. That doesn't make any sense.

It does--my point was simply that they dont accept HMO, only insurers that pay using a FFS model

 

[joh02034]

But FFS isn't accepting discounted fees with PPO/HMO/state plans. FFS may bill a patients insurance for convenience but your full fee is expected for treatment.

 

[CMistry]

E. Not enough information provided.

 

[ChessMaster3000]

E. Not enough information provided.

okay. you are right, not enough info. i'll come back with more if I get any. thanks for your help thus far

 

[deleted158872]

How long has your friend been out of dental school?

 

[ChessMaster3000]

How long has your friend been out of dental school?

completing one year GPR. I know $104 base is crap in the long term but unsure if it's standard for straight out of GPR

 

[vaarax]

Dentists are not even real doctors, therefore you are being over paid. Have a good day, sir.

 

[yappy]

Dentists are not even real doctors, therefore you are being over paid. Have a good day, sir.

Lol. Bro, do you even lift? Much less doctor?

 

[vaarax]

Lol. Bro, do you even lift? Much less doctor?

I doctor enough to drive a lamborghini aventador passed your trailer house on the way to my fat bank account. #conquered

 

[DaleDoback]

I doctor enough to drive a lamborghini aventador passed your trailer house on the way to my fat bank account. #conquered

God, I hope this is real.

Edit: Oh my god, after reading his other posts, this guy is fantastic.

 

[AlbinoPolarBear]

I doctor enough to drive a lamborghini aventador passed your trailer house on the way to my fat bank account. #conquered

Why would you drive your lambourghini around a trailer park?

 

[DaleDoback]

To pick up chicks........

Anyways, he didn't drive around it......he drove "passed it." Stupid dentist.

Please tell me this guy isn't banned yet. I need more gold!!!

 

[GGYY]

guyss, how you boys doing??

what do you all think about this offer i got for an oms associateship in the midwest:

busy multispecialty practice that is looking for an oms to establish its oms arm. i was VERBALLY offered 40% of collections, straight up. no base.

then, on the day of contract negotiations, employer looked me in the eyes and said, i'm going to give you 35% of collections, and anything over 100k in collection for that month you get 40% (no, i didn't ask for explanation for the sudden change).

what you guys think, seriously please.

thanks boys muahhh

 

[ChessMaster3000]

To update on that offer, it's 102000 or 33% of collections (minus 1/3 lab fees). The employer claims average associate pay is 150-200k. any thoughts?

 

[bjpenn]

guyss, how you boys doing??

what do you all think about this offer i got for an oms associateship in the midwest:

busy multispecialty practice that is looking for an oms to establish its oms arm. i was VERBALLY offered 40% of collections, straight up. no base.

then, on the day of contract negotiations, employer looked me in the eyes and said, i'm going to give you 35% of collections, and anything over 100k in collection for that month you get 40% (no, i didn't ask for explanation for the sudden change).

what you guys think, seriously please.

thanks boys muahhh

Are you an OS? Is this only for OS procedures ?That sudden change seems shady. I would see who else is offering ? Are you an employee or independent contractor? Lab fees? Termination notice ? Collections is just a small part. You need a base even if you will make way more, it's just a sign of good faith. You need to get a lawyer, preferably a dental lawyer to look at it. Verbal means nothing. What's on the paper is what will protect you.

 

[DaleDoback]

guyss, how you boys doing??

what do you all think about this offer i got for an oms associateship in the midwest:

busy multispecialty practice that is looking for an oms to establish its oms arm. i was VERBALLY offered 40% of collections, straight up. no base.

then, on the day of contract negotiations, employer looked me in the eyes and said, i'm going to give you 35% of collections, and anything over 100k in collection for that month you get 40% (no, i didn't ask for explanation for the sudden change).

what you guys think, seriously please.

thanks boys muahhh

You have to ask why it is 35% now instead of 40%. That's on you.

I agree that you need a lawyer with experience to review the contract. I had three different offers this year and it was tough to get through the lingo of them all. My advice is to live where you want. We are really lucky that we can just hang a sign and do really well, but you have to be happy about where you are.

Good luck.

 

[OhioDMD]

For a friend---
Very busy dental practice, currently with only one dentist (the owner), several hygienists and assistants
Entirely insurance-based (FFS, affluent population).
Open 6 days a week--relatively low overhead expenses

Offer: $102,000 base salary. Bonus paid out quarterly based on collections (unclear what this means just yet).
5 days, 40 hours a week

The point in giving the background of the clinic is that it seems like it's pretty successful and aren't paying any other associates. What is a reasonable counter-offer for base salary? Don't want to turn them off since this is the only offer he has that isn't corporate

If my math is correct 102,000 amounts to a base salary of $425 daily. With a little research I think you'll find many associates are compensated at 500 a day or 30% of adjusted gross production ( applies to ppo's, medicaid & DMO's and any refunds). Some use 35% of collections instead ( this is the work that you have done that has been paid) The more efficient the office is at collecting fees theoretically the more you make.
Using your number of 102,000 and my 35% you will get $0.35 of every dollar your work has brought in over $72,857 every quarter. Also be cognizant of whether hygiene exam fees will be assigned to you.

 

[DocJL]

For a friend---
Very busy dental practice, currently with only one dentist (the owner), several hygienists and assistants
Entirely insurance-based (FFS, affluent population).
Open 6 days a week--relatively low overhead expenses

Offer: $102,000 base salary. Bonus paid out quarterly based on collections (unclear what this means just yet).
5 days, 40 hours a week

The point in giving the background of the clinic is that it seems like it's pretty successful and aren't paying any other associates. What is a reasonable counter-offer for base salary? Don't want to turn them off since this is the only offer he has that isn't corporate

Not even near enough info.

Geographic location? Pay does vary widely depending on saturation of dentists.

I see you added your friend is just finishing his GPR, which does prepare a dentist much more than dental school does for practice, but he/she is still very inexperienced, certainly not enough to demand or command a much higher salary in many areas.

I would also NEVER work for collections. Too many chances for the owner, whether corporate or private, to cheat/screw you on your pay, especially if the deal doesn't work out and you leave. I know many guys this has happened to. After they leave an office, suddenly "collections" seem to dry up and they only get a small bit of their last several weeks of work. And for most, it would cost more to hire a lawyer to fight it than the lost pay is.

Always negotiate a percentage of adjusted production. Always.

guyss, how you boys doing??

what do you all think about this offer i got for an oms associateship in the midwest:

busy multispecialty practice that is looking for an oms to establish its oms arm. i was VERBALLY offered 40% of collections, straight up. no base.

then, on the day of contract negotiations, employer looked me in the eyes and said, i'm going to give you 35% of collections, and anything over 100k in collection for that month you get 40% (no, i didn't ask for explanation for the sudden change).

what you guys think, seriously please.

thanks boys muahhh

Are you an OS? if so you are being ripped.

If you are a general dentist, even with additional surgical training, you are being offered a lot.

See my note above though on working for a percentage of collections.

 

[bjpenn]

Most offices won't pay you on production because the office only makes money on what they collect. Don't be so fixated on the percentage. I get a lower percentage based off collection, but I'm sure I make more than people with high pct based on production. Ideally negotiate for the production, but if not make sure you have a good idea of how much the offices collect off production and how much the previous dentists produced (past 3 months is good). Also make sure the numbers they show you were like the best months. For example, March,July, August are usually the best months for my office, but June and September sucked.

 

[ChessMaster3000]

If my math is correct 102,000 amounts to a base salary of $425 daily. With a little research I think you'll find many associates are compensated at 500 a day or 30% of adjusted gross production ( applies to ppo's, medicaid & DMO's and any refunds). Some use 35% of collections instead ( this is the work that you have done that has been paid) The more efficient the office is at collecting fees theoretically the more you make.
Using your number of 102,000 and my 35% you will get $0.35 of every dollar your work has brought in over $72,857 every quarter. Also be cognizant of whether hygiene exam fees will be assigned to you.

hygiene exam fees--as in, if you do a hygiene check, then that production should be assigned to you?

 

[ChessMaster3000]

Not even near enough info.

Geographic location? Pay does vary widely depending on saturation of dentists.

I see you added your friend is just finishing his GPR, which does prepare a dentist much more than dental school does for practice, but he/she is still very inexperienced, certainly not enough to demand or command a much higher salary in many areas.

I would also NEVER work for collections. Too many chances for the owner, whether corporate or private, to cheat/screw you on your pay, especially if the deal doesn't work out and you leave. I know many guys this has happened to. After they leave an office, suddenly "collections" seem to dry up and they only get a small bit of their last several weeks of work. And for most, it would cost more to hire a lawyer to fight it than the lost pay is.

Always negotiate a percentage of adjusted production. Always.



Are you an OS? if so you are being ripped.

If you are a general dentist, even with additional surgical training, you are being offered a lot.

See my note above though on working for a percentage of collections.

how comfortable are you negotiating hard for % of adjusted production when it's the only offer you have? it's easy to do that when you have other offers--how can you do it when you really have nothing to fall back on?

 

[DocJL]

Most offices won't pay you on production because the office only makes money on what they collect. Don't be so fixated on the percentage. I get a lower percentage based off collection, but I'm sure I make more than people with high pct based on production. Ideally negotiate for the production, but if not make sure you have a good idea of how much the offices collect off production and how much the previous dentists produced (past 3 months is good). Also make sure the numbers they show you were like the best months. For example, March,July, August are usually the best months for my office, but June and September sucked.

That's why I was talking about "adjusted production", meaning production adjusted to what is actually expected, i.e., based on ins plan fee schedules, discounts negotiated with patients, etc. If an office has their front office together, they should be collecting 95-99% of adjusted production. When I was looking for my first associate job, right out of the military, I spent a lot of time at a very nice multi-location non-corporate private group practice. The owner was very smooth, he offered me 28% of collections, and assured me that his office collected 98% or better of production. Something about his manner gave me pause, as he was a little too slick. I countered that I would take 28% of collections, provided he guaranteed in writing that my pay would never be less than 25% of adjusted production (which is much less than 98% of 28%). He wouldn't do it. When asking around, I got the name of one of his past associates, who I called up. Nice guy, prior military also, so he confided in me that he got SCREWED over in his year of working there, and got MUCH LESS than what he was "promised". Once he put in his notice, he told me his "collections" dropped way off and he was basically cheated out of most of his last 2 paychecks.

hygiene exam fees--as in, if you do a hygiene check, then that production should be assigned to you?

Yes, just the fee for the periodic exam, usually just $20-40 bucks based on most ins fee schedules. If hygiene took the X-rays, you don't get the production. When I was an associate, I DID get credit for the X-rays taken by the assistants working for me for new pt exams, limited exams, etc, but I had a very good relationship with a private practice owner. YMMV.

how comfortable are you negotiating hard for % of adjusted production when it's the only offer you have? it's easy to do that when you have other offers--how can you do it when you really have nothing to fall back on?

That's why I was asking about specific geographic location.

If this person really doesn't have anything to fall back on, then I would say take the job, but be careful about restrictive covenants, and make the term short, so that if they are either unhappy, or they are doing very well, they can either leave, or renegotiate.

I also consider that his friend doesn't have that much negotiating leverage, being a new dentist with only a GPR for experience (which is still worlds better than being right out of school - I did a GPR in the military)

 

[bjpenn]

Even with all that's been said its impossible to track collections and probably hard to track adjusted production. Expect to do lots of work that u might not 100% get compensated for.

Make sure there's also a policy in place so you get paid something when you have to redo previous associates crowns/fillings/dentures .

 

[DocJL]

Every place I've worked it is very simple to track adjusted production, as that is how most offices (again, just my experience) have it on their schedule/ office software.
I am on Eaglesoft in my practice, at the top of every day's schedule is a dollar amount for how much adjusted production is on the schedule for the whole office. Very simple to run a report for individual providers at any time to see what the actual end of day production was. I took less than a minute every day for the several years as I was an associate to run a quick report and print a single page. I checked this against my paycheck. Actually after working for the same office for a couple of years with never a single problem I only sporadically checked it.

Good luck trying to track collections. It's basically impossible, even IF you have full access to the office financial software, as most clinicians won't be adept enough with the software to track it, and any unscrupulous owner or manager could very easily modify the numbers. It does happen. There are many great docs who will treat an associate like family, but to my experience there are just as many sharks who will chew you up and spit you out, and screw you over for a dollar. If an office has high turnover of associates, I would be wary.

 

[GGYY]

Are you an OS? Is this only for OS procedures ?That sudden change seems shady. I would see who else is offering ? Are you an employee or independent contractor? Lab fees? Termination notice ? Collections is just a small part. You need a base even if you will make way more, it's just a sign of good faith. You need to get a lawyer, preferably a dental lawyer to look at it. Verbal means nothing. What's on the paper is what will protect you.

Hiii bjpenn!
yes i'm in my final yr of oms res. i guess my point in posting this is to see how you all would react if someone offered you 40% then on the day of actual negotiations, they say "i'm going to cut it down to 35%." i mean, the intention is clear, but what would you say?

i will be an employee.

thank you for your opinion though, just wondering what others out there are experiencing.

g

 

[GGYY]

You have to ask why it is 35% now instead of 40%. That's on you.

I agree that you need a lawyer with experience to review the contract. I had three different offers this year and it was tough to get through the lingo of them all. My advice is to live where you want. We are really lucky that we can just hang a sign and do really well, but you have to be happy about where you are.

Good luck.

Hey Dale,
no no you are absolutely right. i didn't ask why the sudden change, that's my fault. but, i did not ask b/c don't you think the intention is pretty clear? why bother asking if one already know what happened. i was just wondering how others would handle this situation when a change from a previously agreed upon condition occurs this suddenly.

thus far i've found that the midwest seems to have the best opportunities. texas seems saturated what do you all think?

thanks,
g

 

[GGYY]

are there any oms guys/gals here that have worked in a corporate oms setting? for example aspen, pacific dental, kool smiles, etc? can you tell me what your experience with them was like. i heard 400k/yr easy, they work you hard lol, etc.

 

[bjpenn]

Most corporate gigs are medicaid, but heres an example of how much medicaid pays for partial bony 3rds: $176. I guess if u can knock those out in 30-45 min, and you have a full schedule, with multiple offices near by, and getting 40 pct of that ..hmm. sounds pretty good.

 

[ChessMaster3000]

That's why I was talking about "adjusted production", meaning production adjusted to what is actually expected, i.e., based on ins plan fee schedules, discounts negotiated with patients, etc. If an office has their front office together, they should be collecting 95-99% of adjusted production. When I was looking for my first associate job, right out of the military, I spent a lot of time at a very nice multi-location non-corporate private group practice. The owner was very smooth, he offered me 28% of collections, and assured me that his office collected 98% or better of production. Something about his manner gave me pause, as he was a little too slick. I countered that I would take 28% of collections, provided he guaranteed in writing that my pay would never be less than 25% of adjusted production (which is much less than 98% of 28%). He wouldn't do it. When asking around, I got the name of one of his past associates, who I called up. Nice guy, prior military also, so he confided in me that he got SCREWED over in his year of working there, and got MUCH LESS than what he was "promised". Once he put in his notice, he told me his "collections" dropped way off and he was basically cheated out of most of his last 2 paychecks.





Yes, just the fee for the periodic exam, usually just $20-40 bucks based on most ins fee schedules. If hygiene took the X-rays, you don't get the production. When I was an associate, I DID get credit for the X-rays taken by the assistants working for me for new pt exams, limited exams, etc, but I had a very good relationship with a private practice owner. YMMV.



That's why I was asking about specific geographic location.

If this person really doesn't have anything to fall back on, then I would say take the job, but be careful about restrictive covenants, and make the term short, so that if they are either unhappy, or they are doing very well, they can either leave, or renegotiate.

I also consider that his friend doesn't have that much negotiating leverage, being a new dentist with only a GPR for experience (which is still worlds better than being right out of school - I did a GPR in the military)

so this is a 6 month trial period after which the contract will be negotiated--I take that as to be a good thing, right, because than you actually have some leverage (if you were on your A game during the first 6 months and had respectable numbers)?

 

[DocJL]

so this is a 6 month trial period after which the contract will be negotiated--I take that as to be a good thing, right, because than you actually have some leverage (if you were on your A game during the first 6 months and had respectable numbers)?

That's what I was getting at, yes.

Because in this case his friend doesn't have alot of experience, the onus is on he or she to show the practice owner their skills and clinical speed.

I also think a short contract is beneficial in case he just isn't happy there, and wants to move on. The important part is to make sure you aren't agreeing to any unreasonable restrictive covenant, especially for such a short term of guaranteed employment.

 

[OhioDMD]

Just be aware a 6 mo agreement goes both ways. If you aren't on your A game or perhaps they decide you aren't a good mix you could be gone when your just getting started. A longer contract term with specified ways for terminating the agreement are in your best interest. Assuming there is a restrictive covenant you may be able to negotiate a period of time (6mo) before it becomes effective.

 

[ChessMaster3000]

Just be aware a 6 mo agreement goes both ways. If you aren't on your A game or perhaps they decide you aren't a good mix you could be gone when your just getting started. A longer contract term with specified ways for terminating the agreement are in your best interest. Assuming there is a restrictive covenant you may be able to negotiate a period of time (6mo) before it becomes effective.

yeah of course, it does go both ways. but if that was really how they felt about you, then you'd be gone after a year anyway (assuming you signed a one year contract at the start). you have a good point, but I feel that this is the only way for someone coming straight out of GPR to have some marketable skills. and again, he can also look for other jobs around nov/dec and use that as leverage (if he does it the right way)