working in a hospital vs private practice

[Lethstang]

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I talked to a few docs at a local hospital today. Dentists that is. I asked them what the main reason they chose over working in a hospital over private practice and they all kind of dodged the question. One did mention though (the head of oral surgery) that there was much more money in private practice.

Im wondering, for those who choose to practice dentistry in a hospital or a clinic, what the draw is?

Thanks!

Steve

 

[omaralt]

There is much more mney in private practice, but also more stress and responsibility. There is no liability in a hospital and u get paid a set salary no matter what. In private practice u have to sell dentistry. U have good months and bad months (ur worst month is still gonna be better than working in a hospital)

 

[Slack3r]

For both med and dent, being an "employee" (i.e. working for the hospital) is often advantageous over being your own boss. No overhead, no insurance hassle, usually work on salaries, vacation/benefits, and they pay your malpractice.

Upsides to private practice: be your own boss, increase earning potential, that kind of thing.

 

[reapply2007]

Do dentists get treated poorly by the MD/DO "peers" in hospitals?

 

[jrdds]

I have my own practice and I still got hospital once a week to teach GPRs. As a part timer, Its great. I love teaching new GPRs every year and they always call me up when they need help or have questions about job or practices. My friend works at hospital. dont pay that well as private office but gets 3week off days, sat. day off, all the holidays off.

 

[redrocksdentist]

I work at an IHS hospital in the painted desert of northern Arizona. I worked briefly in private practice before working for the Indian Health Service. I love being a part of medical staff and making friends with those in my department and with others who I consult with and see in the wards. I also feel like I get to see treat some cases I wouldn't otherwise see in PP, just because I have in-house patients who are sick and special needs patients. Plus, I tend to see my fair share of severe oro-facial infections which are scary and exciting at the same time.

Someone asked above if I've ever been treated as "just a dentist" or something like that? Never. Most physicians are happy to have us deal with toothaches, pedos ect since they just don't get that training in med school. All of us dentists and physicians are on a first name basis, we all have our area of expertise--mine is the mouth.

Some of the pros:

1) very good salary and no money worries about no shows
2) 5 weeks paid vacation + 10 federal holidays
3) very low cost health care contribution
4) 5 days PTO for CE + 2,000k in allowance
5) access to all the IHS free CE I can handle
6) Med staff lunch and learns on various medical and medical-legal topics
7) a free disability policy (not so great so I also have my own)
8) I have peers/boss who periodically review my work
9) loan repayment through IHS

Cons:

1) I'm not doing roundhouse bridges or dropping implants left and right.

My first year out, financially, I'm doing very well, but long term there is more money in PP. However I think it will be hard to ever beat this quality of life.

 

[anonymousername]

There is no liability in a hospital......

that's inaccurate

 

[VCUDDS]

While I cant say that i've worked in a hospital, i did my GPR at a VA hospital and did contemplate joining the staff after finishing.
I'm in private practice right now and from paycheck presepective I do agree that the worse month in private practice still pays more than a hospital. The difference is in a hospital you know what you are getting paid every couple of weeks. The VA offers good compensation package in terms of insurance, malpractice, holidays and pension (provided you stay for the long haul), you will do tons and tons of procedures and not just drill and fill or extractions and dealing with infections. you will actually deal comprehensively with all the pt's dental needs. You will have to jump through some hoops with department chair to make it happen but most of the time if you have a solid tx plan that's not an issue. I also enjoyed working on vets and 90% of them do appreciate the job you do.
The downside, other than not being compensated well enough and not having any loan repayment, is the politics at the VA, you have to make the numbers look good for the department and what that mean sometimes is a whole lot of patch up work and not addressing what the patients want.
I have to say if there are incentives offered by the VA, I would strongly consider it, the offer I would have gotten was around 100k, first year in pvt practice was really bad for me, but i still made 122k.

 

[setdoc7]

I do both, 3 days at the hospital and 3 days in my office. Six figures at the hospital. I make a lot more at my office, but I am responsible for everything. Best of both worlds.
The staff at my hospital treats the dentists as colleagues and are happy to have us there.

 

[redrocksdentist]

...I'm in private practice right now and from paycheck presepective I do agree that the worse month in private practice still pays more than a hospital. ...the offer I would have gotten was around 100k, first year in pvt practice was really bad for me, but i still made 122k...

My first year hospital salary is in excess of your bad first year --by a little. I'm sure it doesn't compete with your current PP earnings though.

 

[VCUDDS]

redrock,

Not to sound sour or anything!....but it has not gone up by much. if you factor in the headaches of associateship it's a lot of stress.
Are you in a community hospital or VA?, how do you like the experience?

 

[omaralt]

that's inaccurate

ya ur right, sorry for saying that. what i meant to say is that there is less liability in a hospital setting. a patient is less apt to sue you when they have to sue the hospital as well, which usually have a team of lawyers on retainer. suing a private practice is much more likely to happen.

but the money in private practice is much more. i'm in my first year out of school and am happy to be in private practice. however, as my debts are paid off and i get older 🙂 i'll probably move to a hospital/dental school setting just because the lifestyle is much more relaxed. and it's nice to have a guaranteed steady income vs having your income fluctuate based on production. it's also nice to be able to take a two week vacation without worrying that your not going to be making any money (actually losing money because you still have overhead). also keep in mind that many times to work in a hopsital/dental school they usually want somebody to have a little more experience

omar

 

[redrocksdentist]

redrock,

Not to sound sour or anything!....but it has not gone up by much. if you factor in the headaches of associateship it's a lot of stress.
Are you in a community hospital or VA?, how do you like the experience?

community hospital -- like it and glad I'm not jumping at PP just yet..too many bad stories on dentaltown...don't need all that just yet. soon enough though.

 

[omaralt]

community hospital -- like it and glad I'm not jumping at PP just yet..too many bad stories on dentaltown...don't need all that just yet. soon enough though.

just warning you, it's going to be hard to move to a pp setting after you've been in a hospital. your doing it backwards. right now your working in an environment where production is not as important, your learning to do things that may not work in a pp setting. i would do it the other way around. i'm currently a partner in a practice, while it's stressful, it's very rewarding. in a few years when my debts are paid off i'll move on to a hospital/dental school setting to slow down and live out the rest of my years in relative ease 🙂

omar

 

[redrocksdentist]

... in a few years when my debts are paid off i'll move on to a hospital/dental school setting to slow down and live out the rest of my years in relative ease 🙂

omar

You're paying your debts off in a few years? that is so stupid! .. I just bought a motorcyle, hottub and jetski. 😉

Seriously... just got a raise this week, it will be difficult to get back to PP so soon. My Pedos were BA this morning. I surfed the web and got paid $70 an hour to do so.

 

[VCUDDS]

Not too bad of a deal there redrock....now did you join them right after D school did you do gpr/aegd?.

 

[transmutase40]

Do you need recommendations or references to get employment at a hospital? Are they ever willing to consider dentists without references?

 

[Demeter]

Hospital dentistry is great when you want to retire or if you like a slow lazy pace. I have worked in a few public health clinics and hospitals both as a dental student doing rotations and as a resident. In the typical hospital dental setting you will find tons of no shows, everyone doing the minimal amount of dentistry they can, and procedures limited to simple stuff such as amalgams and extractions. This is not the place to sharpen your skills as a new graduate. In fact, I have seen several dentist struggle as they have tried to move on to a private practice setting because their skill set died during their time in a public health clinic. Find someplace where you will be busy and you can learn and then open your own practice.

 

[Lethstang]

I can second Demeters post to an extent

our residents see maybe 3-4 patients a day, vs PP of 8-10

 

[redrocksdentist]

VCUDDS,

I did not do a GPR. I went straight into seeing 10-15* patients a day in a hospital. I really respect GPR training and I feel like the exposure (OR, peds, consults, coagulopathies, OS) I get in this facility is much like a GPR but with a public health aspect. Last month, I traveled out to do sealants on kids way out on the rez with 5 DAs and an adex chair.

Demeter,

I respect your view and I'm sure your experience is nothing but honest. I'm not going to prove to you if my skills are good or bad. My patients leave happy and almost never come back for retreats. I'm happy with my work. I delivery anesthesia and prep teeth, do endo, ect. I fix problems.


Transmutase,

Yes, you need to get credentialed at a hospital and its time consuming, but its not all that difficult. First, you need to get an offer and then its 3 letters of recommendation saying you're a good person. priviledges are based on education and experience. In my case getting hired means being willing to go where most people won't go...the rural west. Most don't want to do this so jobs are easier to come by. Did they ask Wyatt Earp if he went to sherrif school when he got into Tombstone?

I like hiking canyons and looking a snow capped mountains. I drive to work looking at shooting stars dashing over the mesas. Well, got to run. I'm off tomorrow ... its Friday and I always have Fridays off.😀

http://www.dental.ihs.gov/index.cfm?module=vacancies



* I'm in a federal service which means I have expanded function DAs. That means if I want, I can prep the tooth and say good bye and they will fill. I fill half of my teeth and they do the others. I like doing anterior composites so that's what I usually keep for myself.

 

[datdat]

I do both, 3 days at the hospital and 3 days in my office. Six figures at the hospital. I make a lot more at my office, but I am responsible for everything. Best of both worlds.
The staff at my hospital treats the dentists as colleagues and are happy to have us there.

are you a GP? how could you work in both? do you need addtional skill or something to work both in hospital and your office?

 

[Shoushu]

are you a GP? how could you work in both? do you need addtional skill or something to work both in hospital and your office?

I'd like to repeat the above question, asked in POST#21. How can one do both?

How can a doctor be both a hospitalist and a private practitioner? Do you draw a salary from hospital, say a $100,000/Year, and make a killing on your own too, say $150,000 a year for a total of $250,000? That's a lot of money, and how do you manage two jobs.

Does the contract not limit you from having another job in private practice? How many practices is a doctor allow to maintain?

What about doctors like dermatologists and surgeons, are they mostly hired by hospitals or just do Private Practice? interesting thought, do many hospitals even have dermatology wards/"skin departments"?

 

[Shoushu]

So I was still curious about the hospitalist vs. Private Practice specialist Q above.

If one is hired by hospital as Fulltime Employee, then can one also maintain outside office?

To me, there's clear demarcation btw having a boss, or be your own boss. And do hospitals not care if you are both?

Using analogy, in corporate world, if a person is hired by a corporation fulltime, does their company allow them to work in a competing job?

 

[setdoc7]

Don't know where anyone gets the idea that hospital dentists only see a few patients at day with lots of no shows. And amalgams and extractions? We do comprehensive care at my hospital which does include amalgam and extractions, but also includes endo, perio, fixed, removeable, pedo, implants, etc.
I work both PP and hospital. Different, but both very busy. The hospital salary is good, with lots of perks....sick days, vacation pay, medical and dental plan, 401k, paid ce, no malpractice to worry about. Direct the GP program and see select patients (difficult or administration). Great collegial atmosphere and chance to make a difference for our patients and post doctoral dental education.
PP much more money, harder clinical work, and lot more responsibility. Fun when days go well. Hard when they don't.

 

[ricardo12]

Hospitals provide all facilities to the patients but in private practice you have to invest lot of money in starting.

 

[housie07]

I'm having trouble finding numbers on hospital dentists' salaries. Is the $120k that was floated earlier in the thread fairly typical? How great is the difference between PP and hospital income? And what, if any, is the difference in hours per week? Thanks in advance, and sorry for all the questions.

 

[Lethstang]

a buddy of mine quoted me 150k starting salary at a hospital after completion of an aegd/gpr program after d school .

 

[housie07]

good to know. ty!