What’s It Like Owning a Dental Practice in California? (Rural vs Urban)

[btd1908]

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What’s It Like Owning a Dental Practice in California? (Rural vs Urban)


Post:


Hi everyone,


I’m fresh out of dental school and currently exploring options for where to practice after graduation. California has been on my radar—not just for the unbeatable weather and lifestyle, but also as a place I might want to live long-term and eventually own a dental practice.


Given the saturation in major metro areas like LA and the Bay Area, I’ve been considering rural California as a potentially smarter move. But I know practice ownership out here comes with its own unique mix of challenges—higher taxes, cost of living, employee benefit requirements, and regulatory hurdles.


So for those of you who own or have worked in dental offices in California, especially in rural vs urban settings:

• How’s the business side of practice ownership in California?
• Are the overhead and tax burdens significantly tougher than in states like Texas?
• What incentives (if any) exist for practicing in underserved/rural areas?
• How do staffing, patient flow, and insurance plans compare between rural and city practices?
• Any insights on work-life balance or community involvement?

I’d love to hear your personal experiences, whether you’re a new owner or a seasoned doc. Any red flags or underrated benefits I should be aware of?


Thanks in advance for any thoughts and advice!

 

[charlestweed]

It’s tough to own a business in CA because of the oversaturation. Even if you accept DentiCal (Medicaid), your appt book will still not be full because a lot of other dental offices also accept DentiCal. For some procedures, DentiCal pays better than Delta Dental. For example, DentiCal pays $90 for cleaning while only pays Delta $70.

The % of the overhead depends on how much you pay rent for your office, the number of staff you hire, and the equipment you purchase. An associate GP, who works at the same corp with me, has just bought an existing office that has to pay $7000/month in rent. The rent for my main office is only $3000/month because it’s inside a professional building and is not very visible to the general public. My wife's former dental classmate keeps his overhead low by renting out his office space to me (I am an orthodontist and I travel to work at multiple offices) 1 day/month. My sister, who is also a GP, does the same….she lets me use her facility to do ortho there 1 day/month and I pay her the % of my production. Staff salaries are the biggest part of the overhead. The more things you can do and can cross-train your existing staff to do things for you, the fewer employees you will have to hire.

Employee benefit requirements are not too bad here. You have to give them 5 sick pay days (or 40 hours) per year. You have to pay them OT hours if they work beyond 8 hours/day or beyond 40 hours per week. You are not required to provide health insurance for your employees.

As for the work-life balance…..it depends on the amount of student loan debt you owe and the income you earn. The more debt/bills you have to pay, the more you’ll have to work and thus, have poorer work life balance. Home prices and rents are very high here. It’ll take you a long time to save for a down payment for a house. My nephew is a recent grad GP (graduated 1 yr ago). He couldn’t find any good full time job in OC and LA areas. After about 3 months of job search, he got a full time job offer from Western Dental in rural CA, where no one wants to live. They pay him a guaranteed per diem rate of $750/day + bonus (based on the % production) + 401k + health/vision + malpractice insurance. This is not bad for a new grad who has zero experience. With all the benefits that my nephew receives, it’s equivalent to an independent contractor dentist who makes $220-230k/year. With the amount of student loan debt that he has, I don’t think he’ll be looking for a house to buy anytime soon. He currently pays $1800/month for renting a tiny apartment near work…and this is in rural CA. It would be a lot more if it’s in OC or LA.

I have another nephew who has just completed his perio training….and so far, he only gets 2 job offers…..only 1 day/month at each of these 2 offices.

 

[btd1908]

Thank you for being honest and providing detailed information about the life of a dentist in California. It’s challenging for a recent graduate with debt to build equity and a substantial principal at first to establish stability and afford a comfortable lifestyle.

 

[charlestweed]

Thank you for being honest and providing detailed information about the life of a dentist in California. It’s challenging for a recent graduate with debt to build equity and a substantial principal at first to establish stability and afford a comfortable lifestyle.

It’s hard but hard doesn’t mean impossible. There are plenty of practice owners who are doing very well here in CA. Keeping the overhead low is key. By keeping it low, you get to keep more of your hard earned money. Practicing dentistry becomes more enjoyable when you have fewer/less fixed business expenses to pay.