Recent Graduate--Ask me Anything

[coldicecream]

I'm jealous, being a business major is going to give you a decent leg up in terms of really understanding that side of dentistry.

i'm glad i knew back in high school that I didn't have to major in a science.

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[italianstallion2008]

Hey everyone. Just as a wrap-up for the year and for the sake of transparency..

I was handed my W-2 for 2018 today. First one as an associate dentist.

Total income for 2018: $123,323.11
Weeks worked: 32 (M-F)
Days off within that time: 22 + weekends
Average compensation per day worked: $893.64

Happy New Year to all.

 

[coldicecream]

Hey everyone. Just as a wrap-up for the year and for the sake of transparency..

I was handed my W-2 for 2018 today. First one as an associate dentist aka hired assassin.

Total income for 2018: $123,323.11
Weeks worked: 32 (M-F)
Days off within that time: 22 + weekends
Average compensation per day worked: $893.64

Happy New Year to all.

DANG! So basically 5K a WEEK
How's the buy-in process going?

 

[AppalachianDentalBoy]

I appreciate your willingness to continue answering questions and the updates

 

[Firik]

Hey everyone. Just as a wrap-up for the year and for the sake of transparency..

I was handed my W-2 for 2018 today. First one as an associate dentist.

Total income for 2018: $123,323.11
Weeks worked: 32 (M-F)
Days off within that time: 22 + weekends
Average compensation per day worked: $893.64

Happy New Year to all.

Can you share the total tax you paid? Thanks

 

[REACHOn]

You are an inspiration. Thank you so much for sharing your journey with us and congrats on the baby who is keeping you busy now I've been worried about how I can live with a debt of around 420k. Your success story gives me hope and will allow my brain to put more attention into getting through dental school.

 

[italianstallion2008]

Can you share the total tax you paid? Thanks

I'll be happy to post my taxes as soon as I complete my tax return for this year. Still several tax documents rolling in over the next several weeks, but I know I overpaid by a few thousand and have a couple tax credits for the kiddos coming my way. Stay tuned.

 

[Pedopearls]

Sorry that it's taken a while for me to get back on the thread. New baby boy getting lots of attention.

At this juncture I am very happy with my decision not to specialize. I enjoy general dentistry and the variety it provides to my day. I get to dabble in quite a bit. I'm pretty social with my patients and get to enjoy the relationahips with patients that is more readily built in a general practice. I also encounter patients that I am glad to be able to refer. I look forward to gradually expanding my breadth of procedures, but I personally don't really see the day for myself where I'm keeping absolutely everything in house. I think some particular cases deserve the expertise, efficiency, and tech that specialists can provide, and frankly other cases just aren't necessarily worth (to me) the headache. I'm a big quality of life guy. Grateful for the specialists out there. Especially here where they are gracious enough to help me grow my own skills too. I have a great relationship with my OMFS and Ortho guys. They welcome me in their practices to learn techniques and always emphasize that they're just a phone call away.

The owner and I are discussing buy-in scenarios now. With the practice's current revenue, at a 50% buy-in my share of profits after servicing the business loan would be about $75,000 additional income annually plus an increase in production % for my individual salary. Negotiating that % now but headed toward raising from 30% now to 35% most likely. Plus tax benefits of switching from W-2 to owner. Plus more speed, skill, and patients.

There are no corporate or DSO practices in my region so I cannot really knowledgeably comment on their impact on my practice.

Question: why buy 50% if he is moving out of town and you are the only doc? Why not offer to buy the entire practice or set up shop down the street..., if no other dr is there the patients and staff will follow... unless you have a noncompete but doesn’t seem like that would hold up if the practice closed.... just curious. Also 50/50 partnerships are hard.... they usually don’t end well... Would you buy the other 50% at a designated time? Like 6 months or 1 year later? It sounds like you could run this office on your own...

 

[buffdentist]

How were you able to get this job? When you applied did the employer ask for your gpa or rank? Did they ask to see you do a trial on patients before committing to you? I’m just so curious how you got such an amazing and well paying gig and avoided corporate dentistry. I’m a 3rd Year dental student, and trying to figure out how to bolster my resume. Thanks for taking the time to make this thread! It’s so helpful!


Sent from my iPhone using SDN

 

[Medin2017]

What was the hardest part about transitioning from dental school to practicing in the real world?

If you could go back to dental school, from first to fourth year, what are things you would have done differently to make life easier now?

What are some things that surprised you in the real world as opposed to dental school, both good and bad?

Thanks for doing this.

 

[2TH MVR]

Question: why buy 50% if he is moving out of town and you are the only doc? Why not offer to buy the entire practice or set up shop down the street..., if no other dr is there the patients and staff will follow... unless you have a noncompete but doesn’t seem like that would hold up if the practice closed.... just curious. Also 50/50 partnerships are hard.... they usually don’t end well... Would you buy the other 50% at a designated time? Like 6 months or 1 year later? It sounds like you could run this office on your own...

I'm curious about this also. Especially if the owner is moving OOS. I would buy the entire practice. As for setting up shop down the street .... I would be really surprised if the associateship contract did not include a non-compete covenant. That is just basic knowledge in associateships/buy-sell practices agreements.

 

[Beckwith Wiedemann]

Hey everyone. Just as a wrap-up for the year and for the sake of transparency..

I was handed my W-2 for 2018 today. First one as an associate dentist.

Total income for 2018: $123,323.11
Weeks worked: 32 (M-F)
Days off within that time: 22 + weekends
Average compensation per day worked: $893.64

Happy New Year to all.

Would you mind sharing how much debt you were in after dental school and how much in monthly payment you paid towards student loans?

 

[cloth_alert00]

I remember coming to this website time and time again in the early days of dental school. I wanted to take the opportunity to pop in and offer my willingness to share some of the early returns since I finished dental school and started practicing.

I graduated dental school in May 2018 and started working soon after. I gave a lot of thought to pedo while in dental school but ultimately decided against specializing immediately and entered general practice as an associate.

I practice in a rural community 30 minutes outside of a metropolitan area of about 1.5 million people.

I work M-F from 8-4pm seeing about 6-8 patients a day plus hygiene. I am compensated at a daily rate of $600/day or 30% production, whichever is higher. All lab costs are paid by the owner. After 1 year I will have an opportunity for a buy-in.

That should get things rolling. Ask me anything! And thanks again to all those who came before me.

How did you feel about more complicated procedures when u graduated like molar endo, bridges, veneers, placing/restoring implants, full mouth restos and basically all the stuff dental students don't get much practice on? I'm a D3, and most D4s at my school are about to graduate with not having done any of those mentioned procedures. Do you think AEGD/GPR would be worth it before starting?

 

[italianstallion2008]

Hi All.

Please forgive me for ghosting everyone for the last several months. The Good Life has gotten in the way haha. More like two kids under two.

Just wanted to post a quick update on my progress as a new dentist.

As of May 22, 2019 I entered my second year as a practicing general dentist. It was a great feeling to see all the social media posts of recent graduates and recognize I was no longer the least experienced dental assassin in the nation.

My confidence continues to grow as well as my speed. Probably more aware now of how much I need to learn than ever. I have a long, long way to go. But while plenty of challenging days and patients are out there, I continue to feel richly blessed to be in this profession and to be able to enjoy a decent income to support my family.

A few financial indicators for my first full year of dental practice as well as projections for 2019:

First year (May 22, 2018 - May 21, 2019)

Income: $209,927
Days off within that time: 30 + weekends
Average compensation per day worked: $912.73

2019 Income Projection: $235,000
This average is on the rise because my production is getting higher. Last few weeks paychecks:
$7,195
$5,283
$4,809
$3,000
$4,910
$7,827
Days off within that time: ~30 + weekends
Average compensation per day worked: 1,021.74

Some other tidbits:

-2019's financial projections are poised to change dramatically though because this is based on associate income and... (drumroll) ... I am officially officially in the process of buying into my practice. Stoked! The owner and I have agreed for me to purchase 50% of the practice now, with the additional 50% in three years. Excited for the personal and financial opportunities for growth that await!

-In April, we bought a home (long story!) for $285,000.

-As of today, my other major assets/liabilities summary is roughly as follows:
~$16k investments
~$26k cash/high yield savings

~ -$38k Dental School Federal Loans at 5.06%
~ -$10k Wife's Undergrad Loans at 3%
~ -$76k Loan from my Parents at 0% (paying this back is a top priority as my parents are hoping to retire soonish)

-With the above in mind our short term goal is to be at 0 net worth by this time next year (in the black babbbbbyyy!) Only mildly depressing.


I'll try to get to some of those questions from the last couple months soon. Although odds are you guys have probably gone on and graduated in that time and are killing it.

All the best. AMA.

 

[TanMan]

Random question: Are you italian?

 

[Bugzbunny22]

Any tips for a d2's in regards to procedures that is usually taught during this year? We're still on our summer break but I believe we will start learning pediatric dentistry and path... any tips for that? Tips for the NBDE? (we take that soon ahh)

 

[321931]

thanks for replying!
might do the same as you or work as an associate for 2 yrs, save up for a loan and start my own practice. I think you got really lucky to find that owner.
do you know what the overhead is like? I'm looking at some practices being sold and can't believe they have overheads of 70%.

You have to look at what that 70% really means. I bought a practice that was doing 70% overhead.

1) I cut my supplies overhead from 5% to 2.5% because I order online/in bulk/negotiated with my suppliers.
2) I cut my lab bills from 5% to 2.5% because I negotiated new fees with new labs.
3) I got rid of all the recurring revenue subscriptions that the old doctor just had accumulating constantly. 1000$ advertising here, 1000$ advertising there. Just stuff that wasn't working but was on autopay. I saved a good 2% there.
4) The biggest overhead was staff. I was running on 32% staff overhead but have cut it to 28%-mainly through retirement of the workers. Usually when you buy a practice the highly paid staff will eventually just leave because they cant handle the change. That's fine. You just need them for 1-2 years and then its your practice.
5) Can you boost production up? Is there alot written off? Can you add procedures? Etc Etc.

Today the practice that I bought at 70% runs on 50% overhead on a good month. On an average month 55% overhead. On a bad month 60+.

When you include the practice loan its 50-60% on a good month. Average month 60-65%, bad month 65-70%.

Old practices just let their systems go to waste and older doctors already made their money so they don't care about running a tight ship anymore. When you can buy an "average" 4 day 1 column 2 hygiene practice that does 1-2 crowns a day and 3-5 fillings collecting 800k...and and go from 240k income to 400k income because you just renogiated your lab fees, changed your dental suppliers, got rid of the fat on the practice, and have the staff retire...its a pretty sweet deal. If you can boost production, you can get even higher then that.

These are what you call "gold mine" practices.

 

[2TH MVR]

You have to analyze the stated OH. For tax purposes ... the office OH is usually higher than it actually is. One of the many perks of ownership is that you can run many expenses through your office. My office purchased many items that I could have used personally. Could have. Didn't say I did. Toilet paper, cleaning supplies, stamps, envelops, office supplies, cleaning supplies, light bulbs, TVs, games, tools, computer equipment, computer repairs, printers, etc. etc. etc. Sporting tickets were bought through the office as marketing. I wrote off many, many lunches with other dentists, accts, financial planner, wifey lunches (50%). I leased my cars through the office.

So you see. The stated OH has to be analyzed. For tax purposes .... the OH tends to be higher. If that practice is for sale .... most owners/brokers will itemize out the "fluff" in order to have a more accurate lower OH.

 

[coldicecream]

You have to look at what that 70% really means. I bought a practice that was doing 70% overhead.

1) I cut my supplies overhead from 5% to 2.5% because I order online/in bulk/negotiated with my suppliers.
2) I cut my lab bills from 5% to 2.5% because I negotiated new fees with new labs.
3) I got rid of all the recurring revenue subscriptions that the old doctor just had accumulating constantly. 1000$ advertising here, 1000$ advertising there. Just stuff that wasn't working but was on autopay. I saved a good 2% there.
4) The biggest overhead was staff. I was running on 32% staff overhead but have cut it to 28%-mainly through retirement of the workers. Usually when you buy a practice the highly paid staff will eventually just leave because they cant handle the change. That's fine. You just need them for 1-2 years and then its your practice.
5) Can you boost production up? Is there alot written off? Can you add procedures? Etc Etc.

Today the practice that I bought at 70% runs on 50% overhead on a good month. On an average month 55% overhead. On a bad month 60+.

When you include the practice loan its 50-60% on a good month. Average month 60-65%, bad month 65-70%.

Old practices just let their systems go to waste and older doctors already made their money so they don't care about running a tight ship anymore. When you can buy an "average" 4 day 1 column 2 hygiene practice that does 1-2 crowns a day and 3-5 fillings collecting 800k...and and go from 240k income to 400k income because you just renogiated your lab fees, changed your dental suppliers, got rid of the fat on the practice, and have the staff retire...its a pretty sweet deal. If you can boost production, you can get even higher then that.

These are what you call "gold mine" practices.

thanks for the thorough reply! even though I was a business major, there's still so much I need to understand on the dental office side.

 

[Faux]

Hi All.

Please forgive me for ghosting everyone for the last several months. The Good Life has gotten in the way haha. More like two kids under two.

Just wanted to post a quick update on my progress as a new dentist.

As of May 22, 2019 I entered my second year as a practicing general dentist. It was a great feeling to see all the social media posts of recent graduates and recognize I was no longer the least experienced dental assassin in the nation.

My confidence continues to grow as well as my speed. Probably more aware now of how much I need to learn than ever. I have a long, long way to go. But while plenty of challenging days and patients are out there, I continue to feel richly blessed to be in this profession and to be able to enjoy a decent income to support my family.

A few financial indicators for my first full year of dental practice as well as projections for 2019:

First year (May 22, 2018 - May 21, 2019)

Income: $209,927
Days off within that time: 30 + weekends
Average compensation per day worked: $912.73

2019 Income Projection: $235,000
This average is on the rise because my production is getting higher. Last few weeks paychecks:
$7,195
$5,283
$4,809
$3,000
$4,910
$7,827
Days off within that time: ~30 + weekends
Average compensation per day worked: 1,021.74

Some other tidbits:

-2019's financial projections are poised to change dramatically though because this is based on associate income and... (drumroll) ... I am officially officially in the process of buying into my practice. Stoked! The owner and I have agreed for me to purchase 50% of the practice now, with the additional 50% in three years. Excited for the personal and financial opportunities for growth that await!

-In April, we bought a home (long story!) for $285,000.

-As of today, my other major assets/liabilities summary is roughly as follows:
~$16k investments
~$26k cash/high yield savings

~ -$38k Dental School Federal Loans at 5.06%
~ -$10k Wife's Undergrad Loans at 3%
~ -$76k Loan from my Parents at 0% (paying this back is a top priority as my parents are hoping to retire soonish)

-With the above in mind our short term goal is to be at 0 net worth by this time next year (in the black babbbbbyyy!) Only mildly depressing.


I'll try to get to some of those questions from the last couple months soon. Although odds are you guys have probably gone on and graduated in that time and are killing it.

All the best. AMA.

thanks for the thorough reply! even though I was a business major, there's still so much I need to understand on the dental office side.

Those are biweekly post tax checks?

 

[italianstallion2008]

Those are biweekly post tax checks?

Weekly pre tax.

 

[italianstallion2008]

Random question: Are you italian?

Haha no 100% American. I lived there when I was a boy back when AOL Instant Messenger was king. Never grew up I guess.

 

[italianstallion2008]

Would you mind sharing how much debt you were in after dental school and how much in monthly payment you paid towards student loans?

I graduated with $150k total debt, including school for my wife and I, consumer debt, etc.

Our year one plan was to save $1k/week to be allocated toward savings, investments, and debt servicing.

Our income has been higher than anticipated and so we have increased our savings rate accordingly rather than increase spending.

 

[ToothJockey]

Could you give us an idea how much your income is projected to change once you become an owner of your practice as compared to right now as an associate?

It would be interesting to compare an associate income at a practice and owner income at the same practice.

 

[321931]

Could you give us an idea how much your income is projected to change once you become an owner of your practice as compared to right now as an associate?

It would be interesting to compare an associate income at a practice and owner income at the same practice.

Not to hard to do the math. 30% production is the norm for associates that produce x amount.

Owners take home 30-50% depending on overhead. They also work less because hygiene generates passive revenue. A rule of thumb is that 1/3 hygiene 2/3 doctor revenue is the total collections.

For the same amount of money you collect as an associate, you work 1/3 to 1/2 as much as an owner clinically. In English: you work half as much as an owner.

If you were to clinically work just as hard as an associate add an additional 1/3 income and then take into account the overhead. Which could result in a 1/3-1/2 boost in income for doing the same amount t of work. In English: for the same amount of work as an owner, you would probably take home 30-50% more.

The liabilities come with ownership though and this is not guaranteed. But as you can see ownership has its perks.

 

[pubhealthdent]

I remember coming to this website time and time again in the early days of dental school. I wanted to take the opportunity to pop in and offer my willingness to share some of the early returns since I finished dental school and started practicing.

I graduated dental school in May 2018 and started working soon after. I gave a lot of thought to pedo while in dental school but ultimately decided against specializing immediately and entered general practice as an associate.

I practice in a rural community 30 minutes outside of a metropolitan area of about 1.5 million people.

I work M-F from 8-4pm seeing about 6-8 patients a day plus hygiene. I am compensated at a daily rate of $600/day or 30% production, whichever is higher. All lab costs are paid by the owner. After 1 year I will have an opportunity for a buy-in.

That should get things rolling. Ask me anything! And thanks again to all those who came before me.

6-8 patients per day? Seems pretty low. Is this by choice or because patient population is to low to maintain a steady flow of patients

 

[321931]

6-8 patients per day? Seems pretty low. Is this by choice or because patient population is to low to maintain a steady flow of patients

I see about 6-8 patients a day, but do about 18 hygiene exams.

The 6-8 patients tend to be: 1-2 Crowns, 3-5 Fills, Crown Seats, Limited Exams, Post ops sprinkled in.

For example tomorrow, I only have 2 patients in the morning. 1 Crown Seat, 1 bridge prep with a crown together. Afternoon I have 2 patients which consist of 2 crown seats. So tommorow: 4 patients in "doctor" column. 18 hygiene checks on hygiene section.

One of the reasons why I have 1500+ posts on SDN...lol

 

[pubhealthdent]

I see about 6-8 patients a day, but do about 18 hygiene exams.

The 6-8 patients tend to be: 1-2 Crowns, 3-5 Fills, Crown Seats, Limited Exams, Post ops sprinkled in.

For example tomorrow, I only have 2 patients in the morning. 1 Crown Seat, 1 bridge prep with a crown together. Afternoon I have 2 patients which consist of 2 crown seats. So tommorow: 4 patients in "doctor" column. 18 hygiene checks on hygiene section.

One of the reasons why I have 1500+ posts on SDN...lol

Seems like you'd have a lot of free time, even with the hygiene checks. But at least you're getting some higher-cost procedures to make up for not seeing as many

 

[charlestweed]

According to the Vietnamese hygienist, whom I met at the corp office, it's very rare for the Vietnamese dentists to hire the hygienists to work in their offices. These Vietnamese dentists would rather overbook, work 5-6 days a week, and do all the scalings/root plannings by themselves than losing a portion of their profit to the hygienists. They have to treat high patient volume to make up for the low tx fees here in CA. This hygienist said that only the White docs and corp offices hire hygienists.

 

[321931]

So they load the docs schedule with hygiene 6 mo out? Hard to believe.


These offices are probably catered towards transient, walk in type patients. They don’t hire hygiene because they can’t keep one busy. I’ve seen these offices for sale in CA, huge red flag. Hygiene days are the most valuable part of a practice.

+1.

I am booked out 4 months hygiene- full. Can't find an open spot. Hygiene should be a focused on in a practice purchase- it shows the type of patients you will have (aka patients that care about their teeth- and it also shows that the practice has systems in place to emphasis the importance of dental hygiene), it also keeps the doctor consistently busy on the Doctor column.

I've worked in associateships where the doctor is the hygienist, the doctor, and everything else. On one hand you can have solid days where you are doing root canal, crown, build up, srp, walk in ext...but on the other hand you can have nothing...upon nothing. Some days I would walk in and full, then you flip through the next day or week and total emptiness.

 

[Mason91]

I see about 6-8 patients a day, but do about 18 hygiene exams.

The 6-8 patients tend to be: 1-2 Crowns, 3-5 Fills, Crown Seats, Limited Exams, Post ops sprinkled in.

For example tomorrow, I only have 2 patients in the morning. 1 Crown Seat, 1 bridge prep with a crown together. Afternoon I have 2 patients which consist of 2 crown seats. So tommorow: 4 patients in "doctor" column. 18 hygiene checks on hygiene section.

One of the reasons why I have 1500+ posts on SDN...lol

Would you be able to tell us how much your hygienists produce on an average day and how much is your cut for doing hygiene exams?

 

[TanMan]

+1.

I am booked out 4 months hygiene- full. Can't find an open spot. Hygiene should be a focused on in a practice purchase- it shows the type of patients you will have (aka patients that care about their teeth- and it also shows that the practice has systems in place to emphasis the importance of dental hygiene), it also keeps the doctor consistently busy on the Doctor column.

I've worked in associateships where the doctor is the hygienist, the doctor, and everything else. On one hand you can have solid days where you are doing root canal, crown, build up, srp, walk in ext...but on the other hand you can have nothing...upon nothing. Some days I would walk in and full, then you flip through the next day or week and total emptiness.

Sounds like you need more chairs for hygiene. I would partially agree about the patients who care about their teeth, hygiene is important, not because it shows care, but shows a stable anchor pool of patients to draw upon AND because it's a relatively effortless money making turnkey operation. You also want to attract patients that only care about pain at that moment and use your services like an ER. Those are your walkin rctbucrowns or ext/graft/implant, etc...

 

[penguinbentley]

Making $210k your first full year out with no residency is awesome, congrats! Thanks for sharing!