Why does my motivation dwindle?

[Utdarsenal]

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I'm trying to figure out the science behind all of this..

I'm almost in my 3rd year since I started working as a general dentist. I associate at a medicaid-heavy office and see about 15-20 patients a day (this includes everything. Treatment + exams). We have no hygienist, so I do all tartar removal for each exam as well (of the patients on my schedule, I scale/ultrasonic about maybe 6 of them along with my treatments).

I do practically everything besides pediatrics. I do pretty much any surgical extraction, many impacted wisdom teeth, molar root canals, straight forward implants, etc. I enjoy taking on these treatments. Unfortunately, the daily production usually varies between 2300k-3000k though, due to low reimbursement from gov. aid and PPO plans. I average maybe around 650/day doctor pay (paid on production). (I see so many associates getting paid way more than this (and get benefits/401k, etc.) and it makes me a little annoyed of my current situation. I need to change something.

I've noticed a trend where I take a good two week vacation, come back motivated, work for about 3-4 months and start feeling burnt out again, try repeating the cycle and that feeling keeps on coming back. I feel like I need to do more. I don't know what I need to change. Not sure if I need to see more patients or find a better deal (maybe less medicaid). I don't think I want to be running from room to room more than I am currently doing. Sometimes I wonder if specializing in perio would make me happier long-term since I enjoy surgery, but the thought of 3 less years of income doesn't. Fillings are probably my least favorite procedures but it is the most common one I do. Maybe I need to jump into ownership quicker.. Not sure, a lot of recurring thoughts cloud my mind and it's difficult to choose a direction when there are different options.

I'd appreciate any advice, thanks a lot.

 

[TanMan]

I'm trying to figure out the science behind all of this..

I'm almost in my 3rd year since I started working as a general dentist. I associate at a medicaid-heavy office and see about 15-20 patients a day (this includes everything. Treatment + exams). We have no hygienist, so I do all tartar removal for each exam as well (of the patients on my schedule, I scale/ultrasonic about maybe 6 of them along with my treatments).

I do practically everything besides pediatrics. I do pretty much any surgical extraction, many impacted wisdom teeth, molar root canals, straight forward implants, etc. I enjoy taking on these treatments. Unfortunately, the daily production usually varies between 2300k-3000k though, due to low reimbursement from gov. aid and PPO plans. I average maybe around 650/day doctor pay (paid on production). (I see so many associates getting paid way more than this (and get benefits/401k, etc.) and it makes me a little annoyed of my current situation. I need to change something.

I've noticed a trend where I take a good two week vacation, come back motivated, work for about 3-4 months and start feeling burnt out again, try repeating the cycle and that feeling keeps on coming back. I feel like I need to do more. I don't know what I need to change. Not sure if I need to see more patients or find a better deal (maybe less medicaid). I don't think I want to be running from room to room more than I am currently doing. Sometimes I wonder if specializing in perio would make me happier long-term since I enjoy surgery, but the thought of 3 less years of income doesn't. Fillings are probably my least favorite procedures but it is the most common one I do. Maybe I need to jump into ownership quicker.. Not sure, a lot of recurring thoughts cloud my mind and it's difficult to choose a direction when there are different options.

I'd appreciate any advice, thanks a lot.

You're not making enough money and doing gruntwork. Also, your peers are making a lot more money than you. Probably a combination of overworked and underpaid. You won't mind running from room to room if you're taking home (not just gross producing) 5-10k/day v. 650/day.

You do need to become an owner faster. It's the only fast way to get out of the mediocrity of associateship. You could be a specialist, but that just takes way more time.

 

[Saddleshoes]

You have put your time in on the "Lead Line" (As we used to call it in the old amalgam days.)
It's time to move on to a practice with a "better" patient pool. You have honed your skill set and can be more selective now.

 

[endodonia]

Agree with the above. The skillset you possess is not equaling fair pay. I know people in similar practice models who see less patients, refer root canals and surgical extractions, and have a daily minimum in the ballpark of your 650/day. what geographical region are you in so I don't move there (it doesn't sound like companies are respecting your worth). If practice ownership is not in your short term goal id find another gig- worst case you use the other job offer to up your pay at your current office. fwiw, the place that I envision you working at wants a body in the chair. the fact that you are a competent and relatively high producer means little to them and they'll be on to the next new grad once you "have this other offer" so be prepared to walk.

Best.

 

[charlestweed]

I'm trying to figure out the science behind all of this..

I'm almost in my 3rd year since I started working as a general dentist. I associate at a medicaid-heavy office and see about 15-20 patients a day (this includes everything. Treatment + exams). We have no hygienist, so I do all tartar removal for each exam as well (of the patients on my schedule, I scale/ultrasonic about maybe 6 of them along with my treatments).

I do practically everything besides pediatrics. I do pretty much any surgical extraction, many impacted wisdom teeth, molar root canals, straight forward implants, etc. I enjoy taking on these treatments. Unfortunately, the daily production usually varies between 2300k-3000k though, due to low reimbursement from gov. aid and PPO plans. I average maybe around 650/day doctor pay (paid on production). (I see so many associates getting paid way more than this (and get benefits/401k, etc.) and it makes me a little annoyed of my current situation. I need to change something.

I've noticed a trend where I take a good two week vacation, come back motivated, work for about 3-4 months and start feeling burnt out again, try repeating the cycle and that feeling keeps on coming back. I feel like I need to do more. I don't know what I need to change. Not sure if I need to see more patients or find a better deal (maybe less medicaid). I don't think I want to be running from room to room more than I am currently doing. Sometimes I wonder if specializing in perio would make me happier long-term since I enjoy surgery, but the thought of 3 less years of income doesn't. Fillings are probably my least favorite procedures but it is the most common one I do. Maybe I need to jump into ownership quicker.. Not sure, a lot of recurring thoughts cloud my mind and it's difficult to choose a direction when there are different options.

I'd appreciate any advice, thanks a lot.

Making $650/day or $160-170k/year is actually not a bad associate GP salary for a very saturated CA market. Non-medicaid high end offices have less patients and probably don't need to hire associate dentists. One of the common reasons the owner dentists hire associate dentists is they want their associate dentists to do the procedures that they don't want to do....like doing fillings on medicaid patients. If you want to do whatever you want, start your own office.

If you specialize in perio, you will definitely see fewer patients per day. And you should make more per day as a perio because you can charge the patients much more for implants, crown-lengthening, bone grafts, osseous surgeries than for cleanings and fillings. These are some of the downsides of perio:

1. Like other specialties, you need to go meet the GPs and beg them to refer patients to you. No GP referral = no patient = no money = stress.
2. Most people ignore perio because it's a silent painless disease. They don't want to see you even when their GPs repeatedly tell them to go see you.
3. A lot of times the GPs just want to dump the patients to you.....these tend to be PITA patients.
4. Many of the patients are older (60+ yo) and are taking multiple meds.....you need to get medical clearance from their MDs....additional headache to deal with.
5. You have to travel to multiple offices because there won't be enough patients for 1 office location.

If you are ok with all these downsides, then you should be fine with perio. Nothing is ideal in life. It's still better than working as a GP. Doing general dentistry non-stop for 8 hours every day is hard work.