Now that you graduated, it is finally time to start looking for that “BIG GROWN-UP” job! These are exciting times! But where do you start? What do you even look for? Here are my tips for you!
Also, for tips on when to start applying, read, “Find a Job Before You Graduate“.
The Basics
How many patients will you see a day?
Being fresh out of school, it’s understandable that your speed will be slower than a well seasoned dentist. With that being said, do you want to be placed in a practice that makes you see 20-30 patients a day? Perhaps, but will it be a positive and productive environment for you to grow? Will you be able to sit down and debrief with your mentor to see what could have gone better with each patient? All things to consider when joining a practice.
Non-Compete
When I received my first contract as an associate dentist, I was ecstatic about the opportunity. However, knowing that I should do my due diligence, I went to an attorney to see if there were any red flags. To my surprise, the contract had a non-compete clause. Now a non-compete is normal in any contract but the zinger was that it was set at 10 miles. Normally, if you’re going to be practicing within a city, the non-compete may be set at 2-3 miles. But say that you’re out in the suburbs, 5 – 10 miles is expected. Since this contract was for a practice out in the middle of nowhere, 10 miles was something I was willing to work with for a number of reasons. I never saw myself moving within a 10 mile radius of the practice nor did I envision setting up a practice in that part of the state. For those reasons, I decided not to negotiate this part of my contract and focused my attention toward negotiating pay. It’s all about picking and choosing your battles.
The Things You Need to Know
W2 VS. 1099
There’s a lot of debate on whether or not W2 or 1099 employment is better for a new grad dentist.
For starters, a W2 employee is a salaried employee. This means you will have an employee agreement including, but not limited to, health insurance, retirement, etc. (The normal thing you would think about when signing up for a job).
1099 independent contractors are not employees and do not receive employment benefits listed above. They are hired for specific dates and specific patients. (You could think of a traveling dental anesthesiologist as an independent contractor).
At the end of each year, the independent contractor will receive a 1099 from whichever office they worked at. This 1099 shows how much the independent contractor was compensated during their time at the specific office. It is then the independent contractors job to pay their own employment taxes (both federal and state).
Since taxes aren’t my strongest suit, here’s a great blog on 1099 taxes from the American Student Dental Association.
In my opinion, there are far more benefits to being signed on as a W2 employee for your first job as an associate dentist. As a W2 employee, your employer may also pay for malpractice insurance and all of your credentialing. As a 1099, you have to worry about a lot more than just taxes. You may also be liable for hiring your own assistant, ordering your own instruments, and incorporating (creating an LLC) so you could provide yourself a layer of legal protection and deduct business expenses so that you aren’t taxed on that.
Confusing right? Just go for the W2.
Collections Vs. Production
You deserve to finally be compensated for the hard work you put in during the past three to four years. But what does a doctor salary even look like? What we’re asking is, “how do dentists get paid?”.
Well, with the rise of corporate dentistry, payment plans for new grad dentists have been gradually changing. While most associate dentists may get a base rate ($400-550/day), some may also be paid on a percentage of what they do. This is where the concept of Collections Vs. Production comes into play. What we’re talking about is if you’re paid on a percentage of what the insurance pays (collections) vs. if you’re paid on a percentage of what the procedure costs the patient.
The nuances are very slight but could change how each paycheck looks! For example, say that the office you work at only has a 70% collection rate. That is, for whatever reason, the office is only able to collect money from the insurance company 70% of the time you do a procedure. This means, the other 30% of the time, your money is tied up with the insurance company for a number of reasons (rejected claim, insufficient information supporting claim, etc).
With production pay, you don’t have to worry about how well your office collects from the insurance company. You are simply paid a percentage from the procedures that you do! Furthermore, you don’t have to keep track of which procedures got rejected from the insurance company because that is for your employers team to worry about.
So why would anybody be on collections? Say that your clinic has a collection rate of 95% and also gives you the ability to take home 28-33% from the collection. Your paycheck may be far higher than if you were paid 22-28% on production. Depending on the office, you may also be able to take a percentage from the x-rays and fluoride treatment. This could quickly add up!
Lastly, there are hybrid payment systems in which the dentist gets a lower base rate and a lower percentage tied onto that. In my opinion, this is the best system that any new grad dentist could be on. You get a percentage from what you do plus you’re guaranteed a base pay for all of the days you work! A business owner (your employer) may disagree with this because a new grad dentist is generally slower. This means that the new associate dentist will not be able to produce as much and essentially cost the owner doc money whenever the new doc is just sitting around. This is why a lower base and a lower percentage may be negotiated to compensate and ease the owner docs mind.
The right environment
This next item could be an entire blog post within itself but I’ll give you the run down here. Essentially, it’s very important to scope out the environment of the clinic before signing on. You could do this in a number of ways just by asking the right questions. I have these questions down below and the reasons why they’re so important.
- What is the production and collection rate of the clinic?
- This is important for you to find out for a number of reasons. You want to know that the clinic is making enough to be able to support an associate dentist. Also, the collection rate is important for the reasons we explained above.
- What’s the turn-over like?
- You could tell a lot about a clinic just by asking how frequently the team turns around. Meaning, how frequently employees are leaving! After all, there’s a reason why employees leave.
- Does the clinic offer any benefits?
- It’s always important to see if the clinic offers medical, vision, and dental. On top of that, some bonuses may be if they match retirement plans (401K) and if they’re willing to pay for CE’s.
- What type of procedures does the practice do?
- Ideally, you want a position in which you will learn a lot. If you’re interested in doing botox, find a practice that does a lot of botox! If you’re interested in implants, find a dentist that does a lot of implants. If you’re interested in endo, you get the point.
- What type of procedures will I be doing?
- The dentist you’re about to work for does a lot of amazing procedures. Implants, dentures, botox. Great! But does this mean you will be able to partake in those procedures? Or are you being hired to simply do recare exams and fillings?
- Will there be mentorship? What will that look like?
- Many owner docs may promise mentorship but what does that exactly mean? That they will be there whenever you have questions? Will they even be at the clinic or be at another location managing that? Will they take you under their wings and imbue you with all of the knowledge they accumulated over the years? Very important to ask what this will look like so that you at least have some knowledge of what your growth may look like.
- How many active patients does the clinic have?
- On average, a dental office will have anywhere from 1300-1500 active patients. If the owner doc has anything lower than that, you need to ask yourself, are there enough patients at this clinic to support two doctors?
- What kind of materials do you use?
- Every office does things differently. Some may even choose not to use garrison rings for class II’s! (Only tofflemire). For that matter, it will be very important to know how the owner doc likes to do class II’s, crown prep impression, crown cementation, etc.
- Would you be willing to sit down with me and go through your lab process?
- Every clinic has different ways of doing crowns, partial dentures, and dentures. It will be nice to sit down with the owner doc to go through how they like doing things. If the response you get from asking this question is, “why would I do that? or “do you not know how to do dentures?” It’s probably best that you find a different practice that’s willing to show you how their clinic runs rather than being thrown in to figure it out on your own.
- Do you plan on expanding to different locations?
- This is important for a number of reasons. Many times, your contract will have a non-compete clause. This clause indicates that once you leave the practice, you can’t practice in a 5-10 mile radius.
- Secondly, it’s important to ask this because if the doctor plans on expanding, you may be interested in also asking, if they’re willing to expand with you and make you the part owner of a separate practice. It helps to have mentorship every step of the way, even when starting up your own practice.
Conclusion
In the end, find the dental clinic that matches your career goals and the environment that will support that. A doctor that I follow on instagram (@mogaj) put it nicely when I asked him what tips he had for new doctors. He said, “every experience is a good experience. Don’t ever regret taking a bad job or working somewhere. You always end up learning something valuable along the way.” Going into any interview with this type of mentality will set you up for success and a lifelong career of learning and joy.
For all the tips I received from current dentists, view my instagram story highlight here or by visiting @smilesforyoo.
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