The future of a graduating dental student can look very blurred.  Often times graduates will enter the work force with an average educational debt of $170,000 and that can be a very stressful given the fact that most will have to borrow money to begin or buy into a practice.  

The recent recession and uncertain future hasn’t helped clear the future, either, but there is good news on the horizon.  By developing a plan of action, marketing yourself properly, being flexible about where you practice and developing the proper development team you too can confidently begin to shape your vision.

The next four entries will begin the discussion on how to get your dental career off on the right foot.  This profession can provide a fantastic living but it will require a great deal of patience, planning, and execution.  

 

#1 Not Having a Plan of Action?

One of the main causes of stress for professionals is when the expectations of life do not meet the realities of life.  In order to make sure that your expectations meet your realities, you need to develop a vision for what type of practice you want to be involved with.  Vision is routinely recognized as the key pivot point for great projects…and the lack of a clearly defined vision is often cited as the failing point to potentially great projects. 

 

Growth

 

Traditionally, there are four types of practice structures that you need to become familiar with as you develop your vision.                                           

  1. Hanging the Shingle:  This is starting your own practice from scratch.  
  2. Corporate Dentistry: This is working in the world of mass produced dental healthcare.  This means that you are an employee of a large firm that manages dental practices for you, or more likely someone else.  
  3. Associate-ville:  This means you are working for a private practice that is traditionally owned by a single doctor or multiple doctors who tend to work on site alongside you.  This type of work can often times lead to a buy-in of that practice(s).  
  4. The Big Buy-In: The final practice structure is a partnership or single ownership of a dental practice already in existence.  

 

Let’s look at some of the pros and cons that go along with each of these practice structures. 

Hanging the shingle, or starting your own practice, can be a very appealing option due to one particularly inviting perk- being your own boss with the freedom to create your own vision.  This excitement must be tempered given the current state of dentistry and our economy.  Starting your own practice means that income will be tight for the first several years.  Start up costs can be large, ranging from $450,000 to as high as you can dream.  Interest rates have been low over the last two years but most economists suggest they will begin to rise again as early as 2014.  In addition to the debt service due each month, you will be responsible for creating the operational and financial systems of your practice.  This can be a daunting task to people that have relatively little business experience.   This type of practice structure requires a unique individual that has an extreme amount of perseverance and resiliency, and the ability to be frugal, because it will probably be slow going at first.

Corporate Dentistry A corporate job can be a viable option if you have a vision for something greater.  Traditionally in a corporate job you are overworked and underpaid.  These practices have taken on a stereotype for being low cost low quality options for individual’s dental needs.  The idea of building another persons (owner of the practice) “ark” can sometimes be difficult to swallow.  This type of job also limits your exposure to the business side of dentistry, with trade off being a lot of clinical experience.  Those reasons are why I am a little sour on the corporate job option but I need to realize that for some it can be a great short term option.

Associate-ville: Working as an associate allows for growth in your clinical skills and can provide a little more exposure to the business side of dentistry when compared to a corporate job.  This type of career position often times leads to a buy-in situation that can be very beneficial.  The one thing you need to look out for is getting caught in a situation that has no end.  If you have a desire to buy-in have a provision for it.  Remember the only way you can alter a plan is if you have one to begin with.  One final thought on working as an associate, if there is no chance for a buy-in you can work as an associate and open you own practice on the side.  This is one way to make money and ease the burden of hanging a shingle.

The Big Buy-In: The final practice structure is a partnership or private ownership of a dental practice.  This goes beyond just the purchase of an active patient base.  Think maintenance contracts, equipment, leasehold improvements, space for growth and buildings.  Think staff attachments, patient acceptance, styles and speeds of work.  The great thing about this opportunity is you have an experienced staff, with established processes and procedures, and the senior doctor can act as a mentor during the transition. You acquire immediate cash flow that will help fund the practice purchase.  If the purchase price is fair, the financial rewards comes a lot faster and often times in a greater amount.  But keep in mind, the vast majority of partnerships do NOT work out.  Think through your buy-in from a standpoint of 1) What is the length of the buy-in and can you be locked out during this period, 2) Is there a push-pull sell agreement once you become partner, 3) What are the decision making requirements for the practice when partners don’t see eye to eye on purchases, practice systems, upgrades and staffing issues, 4) What is your and your partner’s exit options/strategies?  

Reviewing these practice structures and determining your best fit scenario will help you create your vision.  Your next job is to go make it happen and the following blogs will help shape that journey.  Remember, when expectations meet reality your life will be happier and healthier.  It takes a lot of thought and hard work to make that happen but that is what makes the journey such a fun ride!

 

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