MY FIRST JOB: A retrospective blog

[NileBDS]

RECESSION 2009 - Health.⋅.care job se.⋅.cu.⋅.ri.⋅.ty [helth-kair] [job] [si-kyoo] [r-i-tee]


.I hope this adds yet another dimension and depth to the discussion about new dentist/recent graduate compensations and what sort of opportunities may lie ahead for you to contemplate as you drill your way through your last test case or competency exam.

Keep in mind that I have been planning hard and working even harder on my job search, which may be reflected in the diverse mix of dental practices I've visited (owner vision, setting, compensation, ....) and the opportunities which I have been offered. All of them are located in Connecticut (which may also be relevant to New England and most of the Northeast/Mid Atlantic region).

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[NileBDS]

City – Avon, CT

Setting – Picturesque, upper-middle-class suburban location, 15 minutes west of Hartford

2 year vision - Associate
5 year vision - Associate

Pros

• Brand new office and equipment
• Healthy patient flow
• Great working environment
• Compensation
• All digital

Cons

• Dead end associateship
• Not comfortable with staff (also, high turnover – as with any new office)
• Owner is not a dentist

Compensation - $600 daily minimum guarantee, %35 production in excess of that, no lab fees, some benefits

 

[NileBDS]

City – Monroe, CT

Setting – Suburbia all the way, borderline rural, upper middle class


2 year vision - Associate
5 year vision - Partner


Pros

• Compensation
• CAD/CAM, digital, perio surgery
• Mentoring
• Business model ($2.8 mil gross practice – 2 providers)

Cons

• High emphasis on production. Outgoing associate of 4 years producing $750k+, yet owner implying that he was working neither hard nor fast enough
• Too much pressure for a “starter job”
• Isolated location
• Owner aggressive in treatment planning (potential conflicts)
• Almost exclusively CAD/CAM

Compensation - %38 production, no lab fee, some benefits

 

[NileBDS]

City – Vernon, CT


Setting – Small (and I mean small) sized suburb of greater Hartford metro, blue collar


2 year vision - Owner
5 year vision - Owner

Pros

• Nice location (professional park, plenty of parking, restaurants nearby, … )
• Tremendous fixer-upper potential for new owner (owner pretty much sticks to hygiene and restorative – no fixed, endo, pedo, implants, surgery, … yup &#8230
• Owner possibly sticking around for transition (I would need to fire and re-hire him)

Cons

• Outdated equipment (not kidding, pano looks like an electric chair, the advertised "hi-tech digital office" turned out to be scheduling appointments on a 1980's computer, &#8230
• Owner saves on lab bill by doing denture set-ups, wax-ups
• Practice grossing $400k (including hygiene) … ouch
• Creepy staff

Compensation - I was not keen on discussing at the time … almost no point
.
.

 

[NileBDS]

City – North Haven, CT

Setting – Small suburb of New Haven (with rural feel), odd mix of white collar (Yale scientists) and blue collar workforce


2 year vision - Associate
5 year vision – Owner

Pros

• Tightly-nit community
• Great senior dentist mentor and coach
• Clearly defined path to ownership
• Progressive owner, great staff (average tenure 10 years)
• Almost all digital office

Cons

• Location
• Current associate (prosthodontist) leaving behind several major re-dos (full mouth, implants, …)

Compensation - $600 per day minimum first 90 days, 30% production after 90 days, no lab bills, some benefits

 

[NileBDS]

City – Hartford, CT

Setting – Urban (ghetto, south end of city)


2 year vision – Associate/Partner
5 year vision – Owner


Pros
None … really, none

Cons

• Exclusive in-house lab
• Location
• Patient mix (100% state insurance)
• Old equipment (plumbing pipes run in operatories)
• Front desk window is bullet proof … enough said !

.Compensation – At that point in my interview, I was pre-occupied with peeping through the window to make sure my car was not being put on cement blocks, but I think he mentioned 40% collections, minus lab fees.
.

 

[NileBDS]

City - West Hartford, CT


Setting – Snobville central (by Connecticut standards), green picturesque Hartford suburb, upper middle class.

2 year vision – Associate
5 year vision – Partner

Pros

• New office
• Mentorship (once a week senior dentist in office)
• Full control of schedule
• Extremely supportive staff
• Location

Cons

• Compensation
• Ownership potential not clear
• Paper office (not even digital x-rays)

Compensation – $500 per day or $125k per year, no benefits, no bonus/production incentives for first year

 

[NileBDS]

Some food for thought; the majority of employers described here would not even consider someone out of school. All required some sort of experience, and seemed to prefer AEGD/GPR over private practice. Otherwise, 2 year experience stipulation was the norm.

Also, where I went to school did not seem to have much play in their decision. One interviewer doubtfully whispered halfway through my interview, "is your school accredited?", in reference to Pacific … I chuckled, and calmly replied that they're working on that. But then again, she was not a dentist, so I didn't expect her to know any more than the run-of-the-mill nor'eastern schools she traditionally would get applicants from.

I love Pacific … that is one great school. Go Tigers !



Now I just need to find a place to stay …

 

[xhamburgersamx]

$600/day is pretty high actually but your aegd/gpr warrants that i suppose. Is this full time or part time? Considering a guaranteed pay of 144k / year that is pretty good, although 38% of 375k production / 12 months is average of $31500 production per month which is an average of 1578/day on a 20 working days month which isn't that much if you're busy.

 

[wigglytooth]

This is really interesting, even though I'm only finishing up my first year. I don't really have a good sense of what is out there. Thanks for posting! Still looking I suppose?

 

[Cold Front]

City – Avon, CT

Setting – Picturesque, upper-middle-class suburban location, 15 minutes west of Hartford

2 year vision - Associate
5 year vision - Associate

Pros

• Brand new office and equipment
• Healthy patient flow
• Great working environment
• Compensation
• All digital

Cons

• Dead end associateship
• Not comfortable with staff (also, high turnover – as with any new office)
• Owner is not a dentist

Compensation - $600 daily minimum guarantee, %35 production in excess of that, no lab fees, some benefits

Owner is not a dentist? I thought to own a dental office, owner has to be a dentist.

BTW, blog thread is a great idea.

 

[iverson3504]

great blog, please keep us updated!

and lol at the bullet-proof front window! I think that would have ended my interview right there

 

[diagnodent]

Just remember your ultimate goal should be to own your practice. Your first job will probably not suceed long term. I have never met one dentist whose first job was where they stayed and became partner. So you should not be factoring in the partner idea.

One of the things I regret is not going to a high volume office with high pay right out of school. I chose small offices with a reasonable schedule with much less money. I think you can learn a lot of clinical dentistry in the high volume managed care offices. It's not something you want to do forever, but for a year or two it could work.

 

[La fea]

V interesting.
Thanks for sharing. Good Luck.

 

[Oracle DMD]

great blog thread! thanks for the insight!

 

[NileBDS]

$600/day is pretty high actually but your aegd/gpr warrants that i suppose. Is this full time or part time? Considering a guaranteed pay of 144k / year that is pretty good, although 38% of 375k production / 12 months is average of $31500 production per month which is an average of 1578/day on a 20 working days month which isn't that much if you're busy.

All full time positions.

 

[NileBDS]

This is really interesting, even though I'm only finishing up my first year. I don't really have a good sense of what is out there. Thanks for posting! Still looking I suppose?

Well, I've signed a contract with an office I am very happy and excited about, so I'm not really looking anymore. I always am looking though, just to have a good feel of the "market". I'll be hiring one day too, right ?

 

[NileBDS]

Owner is not a dentist? I thought to own a dental office, owner has to be a dentist.

BTW, blog thread is a great idea.

You are absolutely right. I should have made my self a bit more clear. The person running the operation is the dentists husband. She was out on maternity leave or something, and they have both come to the conclusion that it was more profitable for them (not to mention a more suiting lifestyle with an infant) if she stays home, and he hires some associates for the office. You can imagine that the likes of this arrangement comes with plenty of advantages and disadvantages. But hey, it works for some people ...

I'm glad this blog thread idea is taking off ... more to come.

 

[NileBDS]

Just remember your ultimate goal should be to own your practice. Your first job will probably not suceed long term. I have never met one dentist whose first job was where they stayed and became partner. So you should not be factoring in the partner idea.

One of the things I regret is not going to a high volume office with high pay right out of school. I chose small offices with a reasonable schedule with much less money. I think you can learn a lot of clinical dentistry in the high volume managed care offices. It's not something you want to do forever, but for a year or two it could work.

Very true (practice ownership). At one point in my job search, it was one disappointment followed by another ... interviews got somewhat depressing, very tiring (driving from Boston ~ 4 hours round trip) and I was thinking to myself (literally, this is what I was thinking), "What were you expecting ?? No one is out there building your dream office, keeping it warm for you, anxiously waiting for you graduate and walk right into it! No one but yourself can carry out your vision of how you would like to practice, what your office and working environment should look like and what sort of team will help you fulfill your dreams along the way! So suck it up buddy, this is life ... besides, we're in the midst of a pretty deep and uncertain recession, and you should be grateful just to have all these opportunities to pick from anyways ... " (I know, I can be a jerk sometimes). It was an aha! moment for me. But then again, I get into arguments like that quite often with myself ...

But see, on the flip side of that coin, some of the offices I've visited have had associates (and still do) for tens of years ... I'm thinking either these are very happy individuals (and yes, making serious bank by the practice owners own account), or they must be sedate individuals with no ambitions or vision of their own of what their future should look like ... it makes me wonder sometimes ...

 

[aphistis]

Good thread, Nile.

 

[ncalcate]

Awesome thread Nile! This has been very helpful. I am starting my GPR in Hartford in one week and will be scoping out associate positions in CT in about 9 months. Did you evaluate the southeastern corner of CT at all? New London, Norwich, Old Saybrook, Stonington? Your choices seem to be centered on the Hartford metro area or directly west or south of Hartford.

 

[DrJeff]

City – Vernon, CT


Setting – Small (and I mean small) sized suburb of greater Hartford metro, blue collar


2 year vision - Owner
5 year vision - Owner

Pros

• Nice location (professional park, plenty of parking, restaurants nearby, … )
• Tremendous fixer-upper potential for new owner (owner pretty much sticks to hygiene and restorative – no fixed, endo, pedo, implants, surgery, … yup …)
• Owner possibly sticking around for transition (I would need to fire and re-hire him)

Cons

• Outdated equipment (not kidding, pano looks like an electric chair, the advertised “hi-tech digital office” turned out to be scheduling appointments on a 1980’s computer, …)
• Owner saves on lab bill by doing denture set-ups, wax-ups
• Practice grossing $400k (including hygiene) … ouch
• Creepy staff

Compensation - I was not keen on discussing at the time … almost no point
.
.

If you think Vernon is small, you shoudl head out to the Northeast Corner (AKA "The Quiet Corner") where I practice + live, makes Vernon look like a mega-metropolis
Don't knock this practice though because it's small + old - probably a ton of work waiting to be done on the patient base there, and the surrounding area is a desireably community to live in (and not as "snooty" as West Hartford or Avon )

 

[DrJeff]

Well, I've signed a contract with an office I am very happy and excited about, so I'm not really looking anymore. I always am looking though, just to have a good feel of the "market". I'll be hiring one day too, right ?

You tell us you sign a contract and then don't tell us atleast which city you chose Come on Nile, the suspense is killing me

 

[Shingo123]

you tell us you sign a contract and then don't tell us atleast which city you chose Come on nile, the suspense is killing me

+1

 

[NileBDS]

Awesome thread Nile! This has been very helpful. I am starting my GPR in Hartford in one week and will be scoping out associate positions in CT in about 9 months. Did you evaluate the southeastern corner of CT at all? New London, Norwich, Old Saybrook, Stonington? Your choices seem to be centered on the Hartford metro area or directly west or south of Hartford.

Congratulations ! I hope you are excited to start your GPR. What hospital/school did you choose and why ? I have a buddy at the St. Francis GPR, and chances are he will be your chief ! Obey !

I think for the most part Connecticut is a promising job market for dentists, once you get over the insane taxes ! I can't say that I took any of the job openings in eastern (southeast and northeast) CT seriously. I know for a fact that there were some jobs in that region (maybe 5 or 6 last time I checked). I can tell you that there is probably a greater demand for dentists, and chances are you will be getting better offers in those locations. I limited myself to the wetsern/southwest part of Connecticut in mysearch.

http://csda.com/placement/placement4.html

http://www.towniecentral.com/ClassifiedAds.aspx

http://www.pointandpost.com/jobs/search.asp?dn=www.etsdental.com

http://www.mydentaljobs.com/search_jobs.php?type=3

http://www.careersindental.com/index.cfm/fuseaction/jobsearch.htm

http://www.indeed.com/jobs?q=DENTIST&l=CONNECTICUT


Since you're planning on practicing in Connecticut, my best advice for you would be to get your full CT license. Your best chance at finding a associateship (or even practice) that works for you would be to pick up one or 2 Saturdays a month, or offer to cover for the senior dentist and basically get a better feel for the practice and patient pool. Working interviews are the way to go. You'd be surprised to find out that many associateships start part time anyways, until you have sufficient patients on your schedule to hold a full time schedule.

Good luck. Keep me posted, and let me know once you're all settled in. We can grab lunch or coffee sometime.

 

[NileBDS]

If you think Vernon is small, you shoudl head out to the Northeast Corner (AKA "The Quiet Corner") where I practice + live, makes Vernon look like a mega-metropolis
Don't knock this practice though because it's small + old - probably a ton of work waiting to be done on the patient base there, and the surrounding area is a desireably community to live in (and not as "snooty" as West Hartford or Avon )

Oh yeah, I agree. This practice has tremendous potential (read: fixer upper). I mean the retiring dentist is a "let's watch it" dentist if you know what I mean. Which again is fine, but not very healthy for the practice. Again, almost limited to hygiene and garden variety restorative. Nothing progressive. I personally was just not sure Vernon was the right fit for me, and did not want to be tied down to that location through the practice. Also, I just can't find the energy in me at this point to overhaul the whole practice (which is what it would take). Dental school and GPR can be very tiring. I'm taking it easy for a couple of years with a nice associateship.

 

[NileBDS]

You tell us you sign a contract and then don't tell us atleast which city you chose Come on Nile, the suspense is killing me

I don't sign and tell

 

[NileBDS]

So, now I'm in the process of getting my disability insurance papers straightened out. It's such a long and boring process, albeit necessary (yes, necessary). You'll get better rates and coverage if you sign up while in school or residency.

Some things to look for in a disability insurance:

• Own profession definition (how they define your capacity to make a living as a dentist)

If you are considered to be disabled as a clinician/dentist (however it is defined in your policy), but are able to produce an income in a different capacity in your same field; ie; teaching, corporate, practice owner/manager ... in that case are you considered disabled, do you still qualify for benefits, or is your new income subtracted from your disability payment ? This is a big one ...

• Benefits age

Most policies pay benefits until the age of 65

• Coverage limits

How much do you qualify for per month ? How is it calculated ? Based upon your income, overhead, years in practice ? It may depend on where you practice also ...

• Medical conditions exclusions

Some of us are already considered un-insurable due to certain medical conditions. You may be surprised what the list entails. I think heart conditions, chronic illnesses, debilitating disease are just a few. You need to check with them if you suspect you may be disqualified

• Unisex rates

Rates are gender biased, in favor of males. If you're a female, you would be better off seeking a policy/insurer that has a unisex rate, which actually would save you quite a bit on premiums.

• Whether policy is cancelable and/or guaranteed

Can they cancel your policy 5 or 10 years down the road, if an once you've filed a claim or if for any reason they find out that you've become a higher risk to them. It's sort of like a bank canceling your credit card, upon learning that you defaulted on your car loan payments.
Also you want to ask them if the rates/premiums you are quoted do not go up after filing claims, and are guaranteed the same rates and level of coverage throughout the policy duration. Benefits are sometimes reduced.


Once you're ready to sign on, expect it to be 6-8 weeks before your policy actually kick in (that's also provided that everything goes smoothly). You will be asked to fill out a lengthy application, go through a 30 minute exhaustive personal and medical interview (over the phone), and submit blood and urine samples as part of your application process. Not cool !

 

[NileBDS]

This part is actually not bad at all. This may be the easiest and most expedient part of your whole licensure process (yes, you need to produce proof of professional liability before you can be hired).

Once you have your license number, call your insurance company (state and regional dependent) and ask them to e-mail/fax you an application. Fill it out, fax it back, and you should have your application processed on the spot ! Not bad at all ... at least one thing us new dentists don't have to worry about.

A couple of things to look for:

• Does your policy include a "tail". A tail is mainly to cover any claims filed against you even after your policy has been terminated. It's really not a big deal for us newbies, but may become an issue upon retirement, or if you decide to switch carriers. At that point, you also want to ask your new carrier if they cover prior occurrences, or if the policy is limited to a specific duration. Tails are very expensive, so you want to read more about this whole topic before getting yourself into anything you may regret later.

• It's not for if you get sued, IT'S FOR WHEN !

• Does it cover you for moonlighting ?(if you're in a residency, and your hospital does not extend your benefits to non-specific locations)

• Is it a claims made or occurrence based policy ... you'll need to google that one.

Generally, premiums for new general practitioners run anywhere from $1,300 to $1,800 per year.

 

[Locutus of Borg]

This part is actually not bad at all. This may be the easiest and most expedient part of your whole licensure process (yes, you need to produce proof of professional liability before you can be hired).

Once you have your license number, call your insurance company (state and regional dependent) and ask them to e-mail/fax you an application. Fill it out, fax it back, and you should have your application processed on the spot ! Not bad at all ... at least one thing us new dentists don't have to worry about.

A couple of things to look for:

• Does your policy include a "tail". A tail is mainly to cover any claims filed against you even after your policy has been terminated. It's really not a big deal for us newbies, but may become an issue upon retirement, or if you decide to switch carriers. At that point, you also want to ask your new carrier if they cover prior occurrences, or if the policy is limited to a specific duration. Tails are very expensive, so you want to read more about this whole topic before getting yourself into anything you may regret later.

• It's not for if you get sued, IT'S FOR WHEN !

• Does it cover you for moonlighting ?(if you're in a residency, and your hospital does not extend your benefits to non-specific locations)

• Is it a claims made or occurrence based policy ... you'll need to google that one.

Generally, premiums for new general practitioners run anywhere from $1,300 to $1,800 per year.

Hi NileBDS,

Sincere appreciation to you for posting up your experiences and insight.
Regarding your second point: Are you implying that dentist typically do get SUCCESFULLY sued by a patient sometime(s) in their career span? If it is so easy for dentists to get in trouble, then the typical physician, based on their malpractice premiums running into the tens or hundreds of thousands of $, must have like an average of 10 successful lawsuits made against them in the span of their career!?!?

Just want to clarify. Thanks.

 

[NileBDS]

Hi NileBDS,

Sincere appreciation to you for posting up your experiences and insight.
Regarding your second point: Are you implying that dentist typically do get SUCCESFULLY sued by a patient sometime(s) in their career span? If it is so easy for dentists to get in trouble, then the typical physician, based on their malpractice premiums running into the tens or hundreds of thousands of $, must have like an average of 10 successful lawsuits made against them in the span of their career!?!?

Just want to clarify. Thanks.

Sure. I think the general consensus is that physicians are more likely to be sued than dentists (hence the massive difference in malpractice premiums). $1,500 per year is peanuts in medical malpractice terms, which all of us should be grinning about.

Remember, patients are more likely to sue a provider (dentist/physician) which they do not like (yes, sometimes it is as simple as that). When you reflect on that, and you think of the very personal relationship that most dentists have with their patients, it may explain the discrepancy to some extent.

Moral of this post, BE NICE AND PERSONABLE to your patients. It's the best defense you can practice. It's also just smart internal marketing.

 

[NileBDS]

Made my first student loan payment today and it FEELS GREAT ! Its a feeling similar to a cluttery pile of papers and bills sitting on your desk for several weeks needing to be sorted out, and you've finally gotten to them ... except this has been much much longer ...

This would perhaps be the best time for you (new grads/new residents) to get in touch with your lender, and get on top of student loan stuff such as forberrance, deferments and what not. DO NOT ASSUME that your school will take care of it. Never ...

I personally have Stafford (subsidized, un-sub) and Grad PLUS loans, both from the same lender. I deferred them both while I was in my GPR, and have just now entered re-payment (graduated again this month)

... and here's where it gets tricky ...

Since the GradPLUS does not allow for grace periods, but the Stafford does, they have different re-payment schedules (Grad PLUS enters re-payment effective last day of residency, but Stafford will not until December - 6 months grace period). What I did is I called my lender, applied for another forberrance on the GradPLUS loan, pushing its repayment back 6 months to align with the Stafford. I really did not need to do that, but I did, just because I could.

It's important to point out however that all these loans are accruing interest, but it's even more important to point out that the GradPLUS interest accrued during forberrance can (and will) be capitalized AGAIN at the end of the forberrance period (yes, they can do that) ... not cool. It would now become part of the new "principal balance", and hence, I would pay interest on that interest later down the road. Since the Stafford is in Grace, and not actual deferment, it can not and will not be capitalized. SOLUTION: Pay off GradPLUS interest accrued during forberrance period (before it enters re-payment), so they have nothing to capitalize (or if you want to get technical, they will capitalize/add $0.00 of accrued interest into your new "principal balance"). And that's a deal for me ...


Back to packing ...

 

[Cold Front]

Made my first student loan payment today and it FEELS GREAT ! Its a feeling similar to a cluttery pile of papers and bills sitting on your desk for several weeks needing to be sorted out, and you've finally gotten to them ... except this has been much much longer ...

This would perhaps be the best time for you (new grads/new residents) to get in touch with your lender, and get on top of student loan stuff such as forberrance, deferments and what not. DO NOT ASSUME that your school will take care of it. Never ...

I personally have Stafford (subsidized, un-sub) and Grad PLUS loans, both from the same lender. I deferred them both while I was in my GPR, and have just now entered re-payment (graduated again this month)

... and here's where it gets tricky ...

Since the GradPLUS does not allow for grace periods, but the Stafford does, they have different re-payment schedules (Grad PLUS enters re-payment effective last day of residency, but Stafford will not until December - 6 months grace period). What I did is I called my lender, applied for another forberrance on the GradPLUS loan, pushing its repayment back 6 months to align with the Stafford. I really did not need to do that, but I did, just because I could.

It's important to point out however that all these loans are accruing interest, but it's even more important to point out that the GradPLUS interest accrued during forberrance can (and will) be capitalized AGAIN at the end of the forberrance period (yes, they can do that) ... not cool. It would now become part of the new "principal balance", and hence, I would pay interest on that interest later down the road. Since the Stafford is in Grace, and not actual deferment, it can not and will not be capitalized. SOLUTION: Pay off GradPLUS interest accrued during forberrance period (before it enters re-payment), so they have nothing to capitalize (or if you want to get technical, they will capitalize/add $0.00 of accrued interest into your new "principal balance"). And that's a deal for me ...


Back to packing ...

Great feedback, thanks for sharing.

Do you think have a GPR diploma made a difference in your current associate position, versus if you just applied to the same position right after dental school? income wise.

I always assumed doing GPR/AEGD (besides being more proficient in dentistry) only increases your chances for being a more qualified candidate for associate positions, but the salary is still going to be entry level, just like fresh grads.

 

[NileBDS]

Great feedback, thanks for sharing.

Do you think have a GPR diploma made a difference in your current associate position, versus if you just applied to the same position right after dental school? income wise.

I always assumed doing GPR/AEGD (besides being more proficient in dentistry) only increases your chances for being a more qualified candidate for associate positions, but the salary is still going to be entry level, just like fresh grads.

Well again, in my experience you will be getting job interviews/offers not available (in most cases) to new grads. I do not think any prospective employer will willingly offer you more money just because you've completed a GPR/AEGD, although many employers (non-mills) will advertise that compensation is commensurate with experience ... which lends itself to interpretation. What I do know for a fact is that you certainly have more leverage negotiating a job offer/contract than you would as a new grad.

In the big scheme of things, your qualifications are one thing, and your ability to conduct yourself in a professional manner during and after your interview is another. Qualifications (on paper) will only get you so far ... the interview is what closes he deal. Sound familiar ? Remember dental school application and interviews ?

 

[NileBDS]

Got a Connecticut license through PGY-1. Let me know if you have any related questions.

It's a long but fairly straightforward process, for Connecticut at least.

 

[DrJeff]

Got a Connecticut license through PGY-1. Let me know if you have any related questions.

It's a long but fairly straightforward process, for Connecticut at least.

Nile, get ready to shell out a bit more $$ (like maybe an extra $225 or so) for when you renew that CT license of your the next time your birthday come around I've heard from a bunch of folks with close ties to not just the state dental association, but also the state itself, that our annual license fee will be going up 50% as a way to help generate $$ for the state and it's budget crisis Welcome to life in CT

 

[aphistis]

Well again, in my experience you will be getting job interviews/offers not available (in most cases) to new grads. I do not think any prospective employer will willingly offer you more money just because you've completed a GPR/AEGD, although many employers (non-mills) will advertise that compensation is commensurate with experience ... which lends itself to interpretation. What I do know for a fact is that you certainly have more leverage negotiating a job offer/contract than you would as a new grad.

In the big scheme of things, your qualifications are one thing, and your ability to conduct yourself in a professional manner during and after your interview is another. Qualifications (on paper) will only get you so far ... the interview is what closes he deal. Sound familiar ? Remember dental school application and interviews ?

This is consistent with my experience as well.

I don't know how Nile is getting paid (maybe he said, sorry, didn't reread the thread), but having a good GPR or AEGD under your belt can make a significant difference in your earnings, depending on how your pay is structured. I would have been comfortable seeing perhaps 3-4 patients a day right out of dental school, but by the end of my GPR I was routinely seeing 10-15 patients a day. My pay is calculated as a percentage of my production, so that added proficiency translates to a significant increase in earnings (for myself and my employer alike) compared to someone coming straight out of school.

 

[jay47]

This is a great thread! As a first year, I too am interested in the things other than anatomy, and physiology. Keep up the good work and business aspects (loans, opportunities, AEGD, etc...) of the conversation, i'm in for the long haul!

 

[Sweeti8286]

Thanks for starting this thread. I'm searching for a job myself in Michigan either in public health clinics or private practice. I've been trying to some math in terms of determining what a "fair" percentage of production/collection for compensation in private practice. The number I've been hearing is ~30% production or 35-40% collection, plus lab fees, etc. Can you tell me in a typical week in terms of what kind and how many procedures you do? I'm just trying to see how much the owner doc actually earns from my work. I understand the whole point is making some money off the work the associate does, but I don't want to be taken advantage of either. Any input would be appreciated. Also, I've heard both ways of hiring doc paying for malpractice insurance and some CE courses but some do not...is this reasonable? or will most people require me to buy my own? Thanks in advance!

 

[yayforcoffee]

Bookmarking this thread. Thanks for all the info! Good luck starting your new position!

 

[ddsintx]

bookmarking this too

 

[NileBDS]

Nile, get ready to shell out a bit more $$ (like maybe an extra $225 or so) for when you renew that CT license of your the next time your birthday come around I've heard from a bunch of folks with close ties to not just the state dental association, but also the state itself, that our annual license fee will be going up 50% as a way to help generate $$ for the state and it's budget crisis Welcome to life in CT

Wow Jeff ! Interesting ... I actually came THIS close to paying a double license fee with my initial application fr CT license. It sounds ridiculous, but oh so very true.
My birthday is in July, but my since I applied for my license June 22nd, they told me I would need to renew my license again in July, and yes, pay the full renewal fee. So in effect, the first licensure fee would have been for the last 10 days of June only. And you know what, I was ok with it, since I needed the piece of mind of actually having a license, and not having to worry about what may or may not go wrong with the paper work. Keep in mind it takes 10 business day for the application processing, which means I probably wouldn't have a license number until July anyways. I already had a job lined up (and patients scheduled) for July, and did not want to risk having to reschedule patients had it taken them longer than 1 week to process my paper work, had I waited until July 1st to apply (avoiding the first licensure fee).

So ... what I did is put the ball in the practice owners court (since they traditionally pay for professional license renewal fees). I explained what happened, and told him I would pay the first fee, but would ask him to pick up the renewal fee (since technically I would be his associate come July). It worked out.

 

[NileBDS]

This is consistent with my experience as well.

I don't know how Nile is getting paid (maybe he said, sorry, didn't reread the thread), but having a good GPR or AEGD under your belt can make a significant difference in your earnings, depending on how your pay is structured. I would have been comfortable seeing perhaps 3-4 patients a day right out of dental school, but by the end of my GPR I was routinely seeing 10-15 patients a day. My pay is calculated as a percentage of my production, so that added proficiency translates to a significant increase in earnings (for myself and my employer alike) compared to someone coming straight out of school.

That's another excellent point. My GPR made me more efficient and productive. I guess that is another hidden benefit of a post grad program. Once you've negotiated the terms with the practice owner, it's up to you to produce.
Say you have two applicants, and ;et's assume that both have negotiated similar contracts (also assuming that your GPR/AEGD training really did not help you in scoring a better compensation package). Say 30% of productions. Coming out of a GPR will hopefully make you more efficient, in a wider number of procedures which will in turn pay you back many times over for the one years investment.
30% of $400k is not the same as 30% of $500k

 

[NileBDS]

Thanks for starting this thread. I'm searching for a job myself in Michigan either in public health clinics or private practice. I've been trying to some math in terms of determining what a "fair" percentage of production/collection for compensation in private practice. The number I've been hearing is ~30% production or 35-40% collection, plus lab fees, etc. Can you tell me in a typical week in terms of what kind and how many procedures you do? I'm just trying to see how much the owner doc actually earns from my work. I understand the whole point is making some money off the work the associate does, but I don't want to be taken advantage of either. Any input would be appreciated. Also, I've heard both ways of hiring doc paying for malpractice insurance and some CE courses but some do not...is this reasonable? or will most people require me to buy my own? Thanks in advance!

I think the number of procedures you do is irrelevant to whether you are being taken advantage of or not. I think a percentage of your production/collections is a more fair assessment. How productive you are is really up to you, unless the owner is delegating tedious non-profitable tasks to you (recalls, emergencies, no fixed, no endo, ...), in which case you should either speak up, or move on to a different associateship.

Having said that, 30% productions and 35-40% collections both sounds pretty reasonable (given the collection rate is 90% at the very least). All the other perks and benefits are also negotiable, as with any contract. Speak up. If it is something that is really important to you, then you may be better off with a different employer, even if it means a pay cut/more hours (if you have a family/dependents, and a private health insurance plan would otherwise cost you an arm and a leg).

 

[NileBDS]

New DDS on the Block: Private Practice Blogumentary 1


One word - hectic. I've been in practice now for not even two weeks, but it feels like months ! It has seriously been overwhelming for me. I also think part of it has to do with my move, since I moved to a new city/state/apartment/new job/new commute/new staff/new friends/new everything ... and it all came together at the same time.

It's not an easy starter job either, but at least they're paying me for it. I work for a group practice, but am the only full-time provider at my office. The owner picks up a half day a week, and there is another part time dentist for two full days, but otherwise ... it's all me ... emergencies, hygiene checks, new patients, scheduled patients, lab calls, med consults ... it takes a lot of stamina. But most surprising of all to me is that at the end of the day, when I', finally home and kick my feet up on the coffee table and, I am happy. It is a very fulfilling feeling, which reminds me that every turn I took on the way that brought me to where I am right now was the right one. If only there were a better way to describe it.

My schedule is pretty interesting, but also oddly comfortable. We work every otehr Saturday, and take every other Tuesday off. Weekdays start on Friday (is it getting odd enough ? I can stop now ...). I work 6 straight days (Mon-Sat), and then work 4 days the following week (Mon, Wed, Thu, Fri). Interesting, huh ? Thursdays are my killer days, 8am - 7 pm. What makes it all manageable, is that they are able to keep me busy. I think I am booked through August already. My fist opening is maybe the last week of August or early September. Patients are pretty chill, not very demanding, some PITA, but that is life in a nutshell. It's very manageable, and do not let anyone tell you anything otherwise. I mean come on ... we've pretty much seen what kind of crazies there are out there in dental school ... private practice rejects, lawsuit hunters, drug shoppers, and just straight crazy demanding unreasonable manipulative patients wanting to dictate treatment .... it doesn't get much worse than that.

What was probably a bit nerve wrecking (and I do not know if anyone has had this sort of bad mojo their first few weeks of practice or if it;s just me), but I would have the most odd complaints from patients. Things that I would have never expected ... for example, a patient calls the office 4 times complaining of sensitivity on her tooth which I restored the day before (#3-OL PRR - very shallow), to both cold and air. Sounds like occlusion right ? WRONG ! I saw her the day after, and went through all the motions ... occlusion (yes, including excursions), cold test, PA x-ray, precussion ... nothing. I polished the restoration, and told her to avoid chewing on it, and watch it for a few more days, and call me on Monday. She kept asking all these questions like "did you use a base, what brand name of composite did you use, did you check my bite again, ..." (WTH ?) I called her Friday before heading out, and she said it was perfectly fine. It turns out that she just wanted to gather all this information for her mom, which wanted to know exactly what we did - I told her to give my phone number to her mom, and have her call me if she had any additional questions. It turns out her mom directs one of the pedo residencies in New York City ! Go figure ... all this headache, for an OL sealant.

In the mean time though, I'm on dental town, going through searches and threads about post-op composite sensitivity and what not, second guessing my whole technique ! I'm also thinking what the front desk girls might be thinking when I walk out to lunch ... like "does this new guy know what hes doing ?".

Just random things like that ... things that came to me naturally, and have never had a problem with (and have performed hundereds of), have all of a sudden become and issue. Little nuisance, like not being able to get a patient numb, not getting good contacts on class II resins, not enough retraction on impressions ... little things add up. But it seems to have gone away since that first dreadful week. Things are already looking up. I have patients asking for me by name, complimenting the front desk and asking whether I'm single ... (wink wink).

Another thing which both dental school and residency did a poor job on preparing me for, is the use of different materials. I was handicapped from day one, with my limited knowledge of different materials. Remember, the owner did not go to the same schools I did, nor does he share any background whatsoever with myself ... in fact, we are separated by several generations of dentists and schools of thoughts. I was too comfortable using all the materials I had been trained on, and was getting good results with. Now, the whole game has changed ... different rotary files, different compsite and bonding systems, different crown and bridge cements, new impression materials ... everything. Probably the only thing that has been constant is the lidocaine! It's like learning about materials all over again. I'm constantly on google looking up manufacturers and instructions, and all sorts of other odd stuff I need to know. With not much time to spare, jumping back and forth between rooms, its been crazy. Somehow ... we manage.

With everything sinking in now, and all the dust settled ... it's been a roller coaster, but what a ride. Learning, growing, accomplishing, making a decent living after living on so little for such a long time ... it's rewarding. But it's only been two weeks ! Will keep you posted ...

 

[jay47]

Awesome man. I'm glad that your are happy with your decision. I will probably be in an associate position much like yourself in my home town after I graduate; my dentists (both of them) already told me they wanted me to take over, lol.

That is another thing I wondered about as well, how changing from DS to the real world and the change of materials mattered. I guess it's just one of those things where you have to do the research and the work yourself to get it done right. Thanks for the update.

 

[papaki]

To NileBDS, Congratulations man on your job. It seems you are doing fine! I wanted to ask you when you were looking for an associate position how did you go about it? I mean where did you look for job openings? And then what? did you send them your cv and wait to hear from them? Or did you email them/called them again etc?

Also did you send your CV only to the job postings or did you send it to all of the professionals in the area ?

 

[ads1792]

This has to be the single most useful thread in SDN history. I can't believe the amount of useful information here. Thanks for taking the time to share your experiences with all of us!

 

[Cold Front]

I think the number of procedures you do is irrelevant to whether you are being taken advantage of or not. I think a percentage of your production/collections is a more fair assessment. How productive you are is really up to you, unless the owner is delegating tedious non-profitable tasks to you (recalls, emergencies, no fixed, no endo, ...), in which case you should either speak up, or move on to a different associateship.

So, how's your daily production numbers holding up in your first couple of weeks? I am not looking for exact numbers, we would like to have a rough idea on where you started as a doctor with GPR experience.

I agree with everyone else, your feedback is very valuable.

 

[DrJeff]

New DDS on the Block: Private Practice Blogumentary 1


One word - hectic. I've been in practice now for not even two weeks, but it feels like months ! It has seriously been overwhelming for me. I also think part of it has to do with my move, since I moved to a new city/state/apartment/new job/new commute/new staff/new friends/new everything ... and it all came together at the same time.

It's not an easy starter job either, but at least they're paying me for it. I work for a group practice, but am the only full-time provider at my office. The owner picks up a half day a week, and there is another part time dentist for two full days, but otherwise ... it's all me ... emergencies, hygiene checks, new patients, scheduled patients, lab calls, med consults ... it takes a lot of stamina. But most surprising of all to me is that at the end of the day, when I', finally home and kick my feet up on the coffee table and, I am happy. It is a very fulfilling feeling, which reminds me that every turn I took on the way that brought me to where I am right now was the right one. If only there were a better way to describe it.

My schedule is pretty interesting, but also oddly comfortable. We work every otehr Saturday, and take every other Tuesday off. Weekdays start on Friday (is it getting odd enough ? I can stop now ...). I work 6 straight days (Mon-Sat), and then work 4 days the following week (Mon, Wed, Thu, Fri). Interesting, huh ? Thursdays are my killer days, 8am - 7 pm. What makes it all manageable, is that they are able to keep me busy. I think I am booked through August already. My fist opening is maybe the last week of August or early September. Patients are pretty chill, not very demanding, some PITA, but that is life in a nutshell. It's very manageable, and do not let anyone tell you anything otherwise. I mean come on ... we've pretty much seen what kind of crazies there are out there in dental school ... private practice rejects, lawsuit hunters, drug shoppers, and just straight crazy demanding unreasonable manipulative patients wanting to dictate treatment .... it doesn't get much worse than that.

What was probably a bit nerve wrecking (and I do not know if anyone has had this sort of bad mojo their first few weeks of practice or if it;s just me), but I would have the most odd complaints from patients. Things that I would have never expected ... for example, a patient calls the office 4 times complaining of sensitivity on her tooth which I restored the day before (#3-OL PRR - very shallow), to both cold and air. Sounds like occlusion right ? WRONG ! I saw her the day after, and went through all the motions ... occlusion (yes, including excursions), cold test, PA x-ray, precussion ... nothing. I polished the restoration, and told her to avoid chewing on it, and watch it for a few more days, and call me on Monday. She kept asking all these questions like "did you use a base, what brand name of composite did you use, did you check my bite again, ..." (WTH ?) I called her Friday before heading out, and she said it was perfectly fine. It turns out that she just wanted to gather all this information for her mom, which wanted to know exactly what we did - I told her to give my phone number to her mom, and have her call me if she had any additional questions. It turns out her mom directs one of the pedo residencies in New York City ! Go figure ... all this headache, for an OL sealant.

In the mean time though, I'm on dental town, going through searches and threads about post-op composite sensitivity and what not, second guessing my whole technique ! I'm also thinking what the front desk girls might be thinking when I walk out to lunch ... like "does this new guy know what hes doing ?".

Just random things like that ... things that came to me naturally, and have never had a problem with (and have performed hundereds of), have all of a sudden become and issue. Little nuisance, like not being able to get a patient numb, not getting good contacts on class II resins, not enough retraction on impressions ... little things add up. But it seems to have gone away since that first dreadful week. Things are already looking up. I have patients asking for me by name, complimenting the front desk and asking whether I'm single ... (wink wink).

Another thing which both dental school and residency did a poor job on preparing me for, is the use of different materials. I was handicapped from day one, with my limited knowledge of different materials. Remember, the owner did not go to the same schools I did, nor does he share any background whatsoever with myself ... in fact, we are separated by several generations of dentists and schools of thoughts. I was too comfortable using all the materials I had been trained on, and was getting good results with. Now, the whole game has changed ... different rotary files, different compsite and bonding systems, different crown and bridge cements, new impression materials ... everything. Probably the only thing that has been constant is the lidocaine! It's like learning about materials all over again. I'm constantly on google looking up manufacturers and instructions, and all sorts of other odd stuff I need to know. With not much time to spare, jumping back and forth between rooms, its been crazy. Somehow ... we manage.

With everything sinking in now, and all the dust settled ... it's been a roller coaster, but what a ride. Learning, growing, accomplishing, making a decent living after living on so little for such a long time ... it's rewarding. But it's only been two weeks ! Will keep you posted ...

Congrats on getting up and running in the "real world" Nile!

This post is great to in that it shows all too well what "real world" dentistry is like.

You're dealing with patients, and not unlike in dental school, some have issues, and very often about things that you'd never anticipate

Also materials wise, it's amazing how many are out there and how while generally speaking they'll accomplish the same thing, how they get from start to finish and PERFORM in YOUR hands makes a huge difference (for example, my partner and I use COMPLETELY DIFFERENT composite systems, but the same of everything else)

I'm eagerly awaiting updates from you in this thread, and in all seriousness, a great resource for you as a new dentist practicing in CT is the New Dentist Committee that the CT State Dental Association has and the programs it offers (not to mention the CE package that the CSDA offers)

Enjoy