wang259

5+ Year Member
May 16, 2009
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Pre-Dental
How hard is it for dentists to practice in California, most notably the Bay Area? I've been to Cali a few times and love the atmosphere and weather but I'm concerned about the difficulty of practicing there, most notably due to saturation of dentists in the area, as well as the high costs to maintain a practice there. For those who have been there, do you feel these tradeoffs are ultimately worth it? Any input would be greatly appreciated.
 

zackyfarms

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10+ Year Member
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Mar 16, 2005
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Everyone loves cali, including dentists.

Know that you are most likely competing with graduates of 6 dental schools plus all those dental students from cali that went out of state for dent school and now want to come back.

Besides that factor, its no secret that Cali is very saturated, its hard for new grads to get stable 5-day/full-time jobs unless you know someone or have a friend/family member that you can get in with. Western dental is an absolute joke, you will hate dentistry (but some unfortunately have to go this route, I have never heard of anyone who thought it was worth it).

Finally, standard going rates for new grads (assuming you can get maybe a few part time jobs to fill your schedule) is about $400/day.

BUT! Having said all that, if you are going to be applying for jobs anyway, why not give it a shot? There are a lot of dentists out here, but there are also a lot of people! There are openings for extremely rural areas and there is always a possibility of getting lucky. I mean, you will be putting together a resume any way right? Why not send it out to places in Cali you would like to live/practice? Its worth a shot and if you score a nice job then youll be in luck. It never hurts to try! You can try contacting regional dental societies, maybe the CDA...give it a shot.
 
Nov 24, 2009
33
1
Status
can someone clarify something for me please...
in the states as an associate you guys get paid daily??? not by percentage of what you do? I am in Canada and we definitely dont get paid daily!!! is it like that every where in the states??
 

Zetch

7+ Year Member
Jan 3, 2010
31
2
Status
I still see dental job ads being posted on indeed.com for my area even though there are many dentists already. So in my opinion, it can't be that hard to find a job.
 

ortho lurker

7+ Year Member
Sep 22, 2010
211
11
Status
Dentist
can someone clarify something for me please...
in the states as an associate you guys get paid daily??? not by percentage of what you do? I am in Canada and we definitely dont get paid daily!!! is it like that every where in the states??
Not only do we get paid daily, but sometimes we even get to name the price! It depends on the employer's desperation to fill the need and the timing. No, you will not ask for and get $5,000.00 a day but if you find out the going rate for your area, then the chances will be higher that you can at least receive that amount or slightly higher. The assumption is that every job listing in a saturated market will have tons and tons of applicants, but at some of my work interviews I felt as if I were their only interviewee.
 
Nov 24, 2009
33
1
Status
mmm interesting!! but doesnt it matter what you do that day? fillings all day vs bridges and crowns?? in Canada we get paid by a percentage of what we do!! and we have a fee guide here that you bill according to that.
Dont you guys have a fee guide that for example the state of California has put out each year?
 

crazy_sherm

å♪▼æ╬‼▄·
10+ Year Member
Jul 18, 2004
1,182
7
San Francisco
Status
Dentist
can someone clarify something for me please...
in the states as an associate you guys get paid daily??? not by percentage of what you do? I am in Canada and we definitely dont get paid daily!!! is it like that every where in the states??
It completely depends on who you work for and how you negotiate your contract. Some will pay a per diem no matter what you do, some will pay a percentage of production/collections, some you have to pay for your own assistant and lab fee, etc. There are also places that will pay you a combination, such as a daily minimum but if you produce over a certain amount, then you get a paid a percentage of production/collections. You also hear a lot of new grads start out getting paid per diem and then transition into a percentage cut as they develop more speed and increase their patient base.

I still see dental job ads being posted on indeed.com for my area even though there are many dentists already. So in my opinion, it can't be that hard to find a job.
I'm sure that's a great indicator. :laugh:vI just looked at monster.com and there are thousands of jobs. I bet this 10% unemployment thing is all imaginary. It is difficult, but not impossible to find full time work as a dentist in the bay area. There's stuff out there, but none of the good jobs are posted on CL/Indeed/CDA website. Seems like the gold mine areas right now are Colorado and Texas. If you can get 5 interviews a month, you're doing pretty good. In Texas, you'll get 5 interviews a day and hire you right on the spot.
 
Sep 18, 2010
11
0
Status
Dentist
pls take this message with lil' grain of salt. this is my exp in cali. one i went to dschool on the east coast, gpr in another state, and then finally to cali. i had no contacts, mom nor dad was a dentist, didn't have a dentist growing up... you get the picture. move to cal with CV and a smile.... that's it. this was last year. the econ was already tanking and i was a new grad. here's what i learned so far in 2 years.....

1) unemployment sucks. took me 3 months to land my first offer, after traveling all over. thank goodness for deferment. it was a corp associateship in the middle of nowhere. but its a job and i was thankful for it!!! it was 4days same office, which i liked.
2) working interviews are worse than boards (maybe). esp for new grads.. hahaha... and you thought a 3 hour session in dschool with not enough for a 3 surface amalgam....hahaha.
3) LA, OC, Bay Area are all saturated. this is true!! you can look at all the websites (monster, indeed, CL) there's really not a whole lot for the past year or two. thoses ads are either old or from the government. (@ztech: dude, indeed.com is worthless, if you were a DMD you'd know that. don't comment on s you don't know, you giving wrong advice) CL has been pretty good for me and generally from small, med private practices. some corp post stuff up but they generally have an HR dept with updated websites of their own. that one guy who says 5 interviews/ month. that's sounds about right. maybe little heavy in cali. def'ly at least 2 or 3. CL worked for me the best. responses fairly quick w/i two weeks. corp websites are good too and it always has a HR rep contact info.
4)as a new grad.... remember you competing with DMDs with alot more years than you. yes for the same job and many times for the same pay. Solution: maybe go where DMDs don't wanna be, bakersfield, central calif, way way up north (sorry bakersfield ppl), corp dentistry, network at mtgs, join the local dental society (not ADA or CDA, but the county one). yes that guy is right about WESTERN. it's lame there. HMOs and the pay.... my goodness what a joke. they not even DMD-owned. i think citigroup owns it now b/c of all the real estate WESTERN owns. lame.
5) if youre foreign trained DMD, you know who you are.... it's hard to avoid corp jigs. sucks i know but thats business and reality of small private practices. but when you open your own practices.... you can do what you want, hire who you want.
6) pay....yes there's a variety of ways to get paid... daily/% of prod, coll/lab fees/merchant fees/etc.... in my opinion, if youre an associate you should NOT have to take on the cost of running the business (meaning merchant fees, assts, labs, etc). it should be a daily, plus bonus of production or production. we need to avoid collections. this is another way of pushing the practice costs to the associate. and a pain in the *****. imagine if someone decides to pay a year from now.... you'll have either trust your employer to pay you correctly from a year ago or you'll have to keep track of that 3 surface amalgam you did, not to mention what insurance plan it was and what that plan pays... it's messy. if i had to put a number on it for a new grad, i think 500 wouldnt be unreasonable but btw 4 to 6 hundred with either prod, daily, coll, whichever... should be btw 4 and 6.
7) two years exp is surprisingly alot of exp. now i'm 'seasoned' (HAHA), i get more, more call backs for interviews. no more working interviews. more nego'ing my salary. have seen alot of crap dentistry. feel more confident. much much much more than when i was just starting out in private practice. not yet ready for my own, but very soon!

so i don't even remember what your post asked, but PM if you want.
bottom line. cali is saturated but you can find something. i probably should say, "GO AWAY!!! and stay away!!!" for my own benefit.

stick to it, be patient. if you have a year or two under your belt, you'll be better off than most here in cali. again you may to sacrifice living in an 'ideal' place, but it's sunny california..... i see from the weather channel it's snow, snow, snow from chicago on to the east coast. yikes. in cali, we play in snow, we don't live in it. we a bunch of babies when it's below 50.
puh puh puh peace
 
Last edited:

OffAngleHatchet

Likes off-angle hatchets
10+ Year Member
7+ Year Member
Sep 18, 2005
98
0
San Diego, CA
Status
Dentist
Seems like the gold mine areas right now are Colorado and Texas. If you can get 5 interviews a month, you're doing pretty good. In Texas, you'll get 5 interviews a day and hire you right on the spot.
I can vouch for Texas right now, but ... hearing from my friends out there, they're getting nervous re; the state's ginormous budget downfall and the current talk about turning Medicare dental coverage into a capitation plan. That'll change the practice environment there right quick.
 

jk5177

Just Kidding
10+ Year Member
Jul 28, 2004
1,562
4
Oregon
Status
Dentist
Seems like the only ones that are hiring are Western Dental and Gentle Dental.
 

beijingdds

10+ Year Member
Jul 21, 2008
88
0
USA
Status
Dentist
6) pay....yes there's a variety of ways to get paid... daily/% of prod, coll/lab fees/merchant fees/etc.... in my opinion, if youre an associate you should NOT have to take on the cost of running the business (meaning merchant fees, assts, labs, etc). it should be a daily, plus bonus of production or production. we need to avoid collections. this is another way of pushing the practice costs to the associate. and a pain in the *****. imagine if someone decides to pay a year from now.... you'll have either trust your employer to pay you correctly from a year ago or you'll have to keep track of that 3 surface amalgam you did, not to mention what insurance plan it was and what that plan pays... it's messy. if i had to put a number on it for a new grad, i think 500 wouldnt be unreasonable but btw 4 to 6 hundred with either prod, daily, coll, whichever... should be btw 4 and 6.
7) two years exp is surprisingly alot of exp. now i'm 'seasoned' (HAHA), i get more, more call backs for interviews. no more working interviews. more nego'ing my salary. have seen alot of crap dentistry. feel more confident. much much much more than when i was just starting out in private practice. not yet ready for my own, but very soon!

Well, i think that it sucks to get paid by production without any daily minium. I think most of the practices want to pay you either a daily rate and work you like a horse(HMO offices) or by production which you can make less than an assistant per day. Yeah, I think these practices owners can care less about you, a dentist. I don't blame them, cause there is always conflict of interest between owners and associates.

Another thing is, practice managers tend to hide things from you( they prevent you from accessing all the insurance and billing data. So when it comes to pay checks, they can find something not paying you.
 

beijingdds

10+ Year Member
Jul 21, 2008
88
0
USA
Status
Dentist
pls take this message with lil' grain of salt. this is my exp in cali. one i went to dschool on the east coast, gpr in another state, and then finally to cali. i had no contacts, mom nor dad was a dentist, didn't have a dentist growing up... you get the picture. move to cal with CV and a smile.... that's it. this was last year. the econ was already tanking and i was a new grad. here's what i learned so far in 2 years.....

1) unemployment sucks. took me 3 months to land my first offer, after traveling all over. thank goodness for deferment. it was a corp associateship in the middle of nowhere. but its a job and i was thankful for it!!! it was 4days same office, which i liked.
2) working interviews are worse than boards (maybe). esp for new grads.. hahaha... and you thought a 3 hour session in dschool with not enough for a 3 surface amalgam....hahaha.
3) LA, OC, Bay Area are all saturated. this is true!! you can look at all the websites (monster, indeed, CL) there's really not a whole lot for the past year or two. thoses ads are either old or from the government. (@ztech: dude, indeed.com is worthless, if you were a DMD you'd know that. don't comment on s you don't know, you giving wrong advice) CL has been pretty good for me and generally from small, med private practices. some corp post stuff up but they generally have an HR dept with updated websites of their own. that one guy who says 5 interviews/ month. that's sounds about right. maybe little heavy in cali. def'ly at least 2 or 3. CL worked for me the best. responses fairly quick w/i two weeks. corp websites are good too and it always has a HR rep contact info.
4)as a new grad.... remember you competing with DMDs with alot more years than you. yes for the same job and many times for the same pay. Solution: maybe go where DMDs don't wanna be, bakersfield, central calif, way way up north (sorry bakersfield ppl), corp dentistry, network at mtgs, join the local dental society (not ADA or CDA, but the county one). yes that guy is right about WESTERN. it's lame there. HMOs and the pay.... my goodness what a joke. they not even DMD-owned. i think citigroup owns it now b/c of all the real estate WESTERN owns. lame.
5) if youre foreign trained DMD, you know who you are.... it's hard to avoid corp jigs. sucks i know but thats business and reality of small private practices. but when you open your own practices.... you can do what you want, hire who you want.
6) pay....yes there's a variety of ways to get paid... daily/% of prod, coll/lab fees/merchant fees/etc.... in my opinion, if youre an associate you should NOT have to take on the cost of running the business (meaning merchant fees, assts, labs, etc). it should be a daily, plus bonus of production or production. we need to avoid collections. this is another way of pushing the practice costs to the associate. and a pain in the *****. imagine if someone decides to pay a year from now.... you'll have either trust your employer to pay you correctly from a year ago or you'll have to keep track of that 3 surface amalgam you did, not to mention what insurance plan it was and what that plan pays... it's messy. if i had to put a number on it for a new grad, i think 500 wouldnt be unreasonable but btw 4 to 6 hundred with either prod, daily, coll, whichever... should be btw 4 and 6.
7) two years exp is surprisingly alot of exp. now i'm 'seasoned' (HAHA), i get more, more call backs for interviews. no more working interviews. more nego'ing my salary. have seen alot of crap dentistry. feel more confident. much much much more than when i was just starting out in private practice. not yet ready for my own, but very soon!

so i don't even remember what your post asked, but PM if you want.
bottom line. cali is saturated but you can find something. i probably should say, "GO AWAY!!! and stay away!!!" for my own benefit.

stick to it, be patient. if you have a year or two under your belt, you'll be better off than most here in cali. again you may to sacrifice living in an 'ideal' place, but it's sunny california..... i see from the weather channel it's snow, snow, snow from chicago on to the east coast. yikes. in cali, we play in snow, we don't live in it. we a bunch of babies when it's below 50.
puh puh puh peace
Well, i think that it sucks to get paid by production without any daily minium. I think most of the practices want to pay you either a daily rate and work you like a horse(HMO offices) or by production which you can make less than an assistant per day. Yeah, I think these practices owners can care less about you, a dentist. I don't blame them, cause there is always conflict of interest between owners and associates.

Another thing is, practice managers tend to hide things from you( they prevent you from accessing all the insurance and billing data. So when it comes to pay checks, they can find something not paying you
 

beijingdds

10+ Year Member
Jul 21, 2008
88
0
USA
Status
Dentist
It completely depends on who you work for and how you negotiate your contract. Some will pay a per diem no matter what you do, some will pay a percentage of production/collections, some you have to pay for your own assistant and lab fee, etc. There are also places that will pay you a combination, such as a daily minimum but if you produce over a certain amount, then you get a paid a percentage of production/collections. You also hear a lot of new grads start out getting paid per diem and then transition into a percentage cut as they develop more speed and increase their patient base.



I'm sure that's a great indicator. :laugh:vI just looked at monster.com and there are thousands of jobs. I bet this 10% unemployment thing is all imaginary. It is difficult, but not impossible to find full time work as a dentist in the bay area. There's stuff out there, but none of the good jobs are posted on CL/Indeed/CDA website. Seems like the gold mine areas right now are Colorado and Texas. If you can get 5 interviews a month, you're doing pretty good. In Texas, you'll get 5 interviews a day and hire you right on the spot.
I think it does not matter what kinda of pay system(production vs daily), the owner has figured out the least expensive way, and they would stick you with that choice. You can get $500 daily but produce over $5000 for the owner or you can get 33% production and average possible production there is only about $1000.

Yeah, I think with this kinda of saturation condition in CA, practice owners have the leverage over dentists. If you don't like it, guess what, stacks of applications are waiting for an interview.

Anyways, I just believe that the most fit will survive, natural selection I guess.
 

ortho lurker

7+ Year Member
Sep 22, 2010
211
11
Status
Dentist
Well, i think that it sucks to get paid by production without any daily minium. I think most of the practices want to pay you either a daily rate and work you like a horse(HMO offices) or by production which you can make less than an assistant per day.
I agree about not working without a daily minimum especially at an HMO office. I have seen $30 1-surface amalgams, $99 crowns, etc. Remember that the owner gets a monthly cap check based on how many patients are assigned to that office (whether or not any service is actually performed on these patients). And if you think that it's so easy to open a dental office in a saturated market and sign up for a few HMOs and expect the patients to start flooding in, think again! Often times the office managers and owners at established dental offices have long term relationships with the paper pushers at the insurance companies so you can say that a little bit of connection goes a long way.
 

beijingdds

10+ Year Member
Jul 21, 2008
88
0
USA
Status
Dentist
I agree about not working without a daily minimum especially at an HMO office. I have seen $30 1-surface amalgams, $99 crowns, etc. Remember that the owner gets a monthly cap check based on how many patients are assigned to that office (whether or not any service is actually performed on these patients). And if you think that it's so easy to open a dental office in a saturated market and sign up for a few HMOs and expect the patients to start flooding in, think again! Often times the office managers and owners at established dental offices have long term relationships with the paper pushers at the insurance companies so you can say that a little bit of connection goes a long way.
Tell me about it. I had someone told me to ask for a percentage of that capitation check, yeah, good luck with that. I don't think any owners would do that kinda of thing....all they want is to exploitate, I mean, EXPLOITATE your labor. They expect you to do all the full bony impactions, molar endos with calcified canals, and other high risk procedures for a ferking minium 400 bucks. Yeah guess what, if something happens, your butt is on the line not the practice.

That said, anybody knows what is considered "usual customary and reasonable" pay system for an experienced dentist? Anybody out there can share this info? I got paid based on production 25% without a daily guarantee. If there are no patients for any given day, it is my liability...there are days I did not even make my gas money.....so, it is tough out here.
 

jk5177

Just Kidding
10+ Year Member
Jul 28, 2004
1,562
4
Oregon
Status
Dentist
Of course working for someone else is not as lucrative, but for a quick gig/fix here and there, moonlight; it's the best deal around.
These corporate/HMO gigs are pretty crazy; saw 20 patients yesterday (bet it is slow), the dental assistants are amazing, they do almost everything except touching handpieces and extraction forcepts.

Market rate $500 for private office, and >$500 for those corporate places. What you guys think?
 

beijingdds

10+ Year Member
Jul 21, 2008
88
0
USA
Status
Dentist
Of course working for someone else is not as lucrative, but for a quick gig/fix here and there, moonlight; it's the best deal around.
These corporate/HMO gigs are pretty crazy; saw 20 patients yesterday (bet it is slow), the dental assistants are amazing, they do almost everything except touching handpieces and extraction forcepts.

Market rate $500 for private office, and >$500 for those corporate places. What you guys think?
Sounds about right. In LA, I think it is more like $450 per day either guarantee or by production. Like I said, the owners have figured it out the cheapest way to pay you. Either way, you will get $450 a day.

Just be careful what your assitants are doing, cause you are liable for what they do. My assistant one time F UP my prep with some resin cement on the temporaries, WTF? I was so pissed and ....
 

DocJL

7+ Year Member
Jan 7, 2011
361
177
Status
Dentist
Tell me about it. I had someone told me to ask for a percentage of that capitation check, yeah, good luck with that. I don't think any owners would do that kinda of thing....all they want is to exploitate, I mean, EXPLOITATE your labor. They expect you to do all the full bony impactions, molar endos with calcified canals, and other high risk procedures for a ferking minium 400 bucks. Yeah guess what, if something happens, your butt is on the line not the practice.

That said, anybody knows what is considered "usual customary and reasonable" pay system for an experienced dentist? Anybody out there can share this info? I got paid based on production 25% without a daily guarantee. If there are no patients for any given day, it is my liability...there are days I did not even make my gas money.....so, it is tough out here.
Geez this sounds pretty grim.

are you in the California Bay area? I thought only Southern Cal was that bad.

are you working corporate or for a private office?
 
Aug 5, 2009
4
0
Status
Sounds about right. In LA, I think it is more like $450 per day either guarantee or by production. Like I said, the owners have figured it out the cheapest way to pay you. Either way, you will get $450 a day.

Just be careful what your assitants are doing, cause you are liable for what they do. My assistant one time F UP my prep with some resin cement on the temporaries, WTF? I was so pissed and ....
Is San Diego as bad as LA or Bay Area? I have some friends in San Diego who dont appear to be too unhappy with the job market for associates.

Thanks!
 
Sep 18, 2010
11
0
Status
Dentist
Tell me about it. I had someone told me to ask for a percentage of that capitation check, yeah, good luck with that. I don't think any owners would do that kinda of thing....all they want is to exploitate, I mean, EXPLOITATE your labor. They expect you to do all the full bony impactions, molar endos with calcified canals, and other high risk procedures for a ferking minium 400 bucks. Yeah guess what, if something happens, your butt is on the line not the practice.

That said, anybody knows what is considered "usual customary and reasonable" pay system for an experienced dentist? Anybody out there can share this info? I got paid based on production 25% without a daily guarantee. If there are no patients for any given day, it is my liability...there are days I did not even make my gas money.....so, it is tough out here.
i work for corp and a percentage of the cap check was built into the contract. i got lucky. but then again 10% of $3/pt.... is ridiculous. i agree, HMO practices do exploit their gps. it stinks but theres a huge dental need for HMOs and there's a potential to do well. it's about the upgrades. i'm sure you know. captek, lavas, comps, bioform.... only thing i don't do is oral irrigation with CHX. i can't believe there's a ADA code for it.

i agree. i never do anything i'm not comfortable with (ie FBIs, horizontal PBIs, sub 200 endo), esp cheap things like $100 PFM crowns, $15 exts, $85 molar RCTs. but in my current practice there's plenty to do, plenty of pts, plenty of crown, BB, comps, dentures to get production upwards of $2.5-3.5k. not worth it. it takes only one crappy endo, one dry socket, one person to call the board and put a damper on your day and your career. i'm learning to hard way. it's upsetting to think we've allowed HMO insurance companies to dictate alot of what we do and what we don't do.

i've had ZERO days. very annoying, esp when the pts who show are the free prophys. not exactly the 3day work week, golfing weekends i expected when i was in dschool. but i've got a great crew: front and back of the house. my tx coordinate rocks and most of my pts show and usually upgrade. i spend alittle extra time with each pt then what there used to. many times pts will trust me if i'm just honest with 'em.

UCR is kinda of a joke, would you agree? if i got UCR on all my pts, i'll retire in 3 years. in my HMO practice, UCR is used to show patients how much a procedure is outside our practice and how much 'cheaper' our composite is with their insurance.

as far as UCR numbers, it varies from area to area. but 1000 for a crown, 250 for a 3-surf fill, 600-900 for endo, 600 for comp denture. somewhere around there. i'm in San Francisco.