Entry #28
So, You’re Graduating Dental School? Now What? You’ve Got 5 Choices….
“Everyone is a genius. But if you judge a fish on it’s ability to climb a tree, it will live its whole life believing that it is stupid.” — Albert Einstein
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You’ve been climbing to the top of what seemed like your career mountain top for roughly a decade, only to realize that you’re just now truly getting started. Your journey of formally structured higher education is finally coming to an end. Undergrad, maybe a Master’s Degree, Dental School, maybe a residency afterwards. Some of you have dreamed of this day with a clear vision since the start. Some of you have moved forward full steam ahead and honestly haven’t thought too much about what you’ll do once school is over.
At least not until that moment was inevitably barreling towards you like a train’s loud smokestack blaring ‘Hey what are you going to do with your life next?”
That question may be in the form of the voice of your friends, your family, and that voice within that is always with you.
But it’s finally time to get to work. Everyone’s destination is going to be very different. But the initial pathways we follow will typically be fairly routine – all things considered. As a newly graduated dentist (whether from dental school or from a residency) — there are typically 5 major career pathways to launch you into your working life. For some of you, this could be the first real job you’ve ever had. Despite maybe inching up dangerously close to turning 30 years old.
Your education has put working life on pause for a period of time that some of your old high school buddies wouldn’t even be able to wrap their worldview around.
But the time is now; there are 5 choices; 5 pathways; which pathway will you choose to follow? I have perspectives on all 5. These are just my opinions.
Pathway #1: Private Associateship
A private associate dentist job is thought to be the ‘golden goose’ by many new grads. Most of your classmates would be excited and honored to have a job in private practice to kick off their careers.
The positives are obvious:
-Potential to work under an older mentor
-Potential to earn well financially and get your feet wet0
-Potential to work in an environment with higher-level dentistry and plenty of creature comfort.
-There is also an assumed level of respect from your peers when you work in private practice.
The negatives are less loudly announced:
–Pay can be unpredictable. A private owner is not always as ready to provide for an associate as they think. If you are paid on production or collections; if you lack patient flow, your income could be significantly lower than you expect. Especially in the beginning. Now, you may end up making a LOT – you don’t know for sure, until you actually start working and find out what you can produce – and what the practice can PROVIDE for you in terms of patient flow and quality support and opportunity.
–Limited benefit offers. The private associate dentist typically will have the fewest benefit offers of any of the 5 doorways. This is in terms of healthcare, retirement, sick leave, time off, paid CE, and so on. Often these are not offered in these private jobs.
–Expected ownership mentality. Some owners will expect you to ‘grow your own practice’ within their practice and place a large burden of patient flow and production on you. Even though you have no stake in the business yourself.
–Difficult to find; limited opportunities. Hopefully you’ve been networking throughout school.
-Poor infrastructure. Dentists are not famous for being great business people. Often times the business structure of the private practice is haphazard at best and it can make your life more difficult to say the least. The may include leadership, clinical flow, patient flow, and billing related infrastructure – all things that will directly or indirectly influence your work life.
Pathway #2: Corporate Associateship
Lots of dental students and dentists bash corporate dentistry. However, lots of dental students and dentists end up working for corporate dentistry. This doorway is probably the largest employer of new graduate dentists. The CEOs of these companies are well aware of their negative reputation among the dental community. Yet they continue to thrive. Why is that?
Corporate jobs can be solid, but it was not for me — I quit my corporate job after only 3 days.
Let’s look at the positives:
–They are always hiring; pretty much at all times a corporate job will be available near you as a dentist
–The pay is predictable; the contracts are typically very clear as far as what you will get paid — it is often more competitive than the private job. There may even be benefits.
–The environment is forgiving. Oftentimes the work environment in corporate can be more forgiving clinically. Corporate offices typically serve less high-end clientele. High end cliente are usually more picky clients, particularly when it comes to cosmetic work.
The negatives:
–Your boss is likely not a dentist, and likely someone who doesn’t even understand dentistry. It may at times feel like your clinical judgement and clinical competence are being undermined. When you apply for the job they will of course tell you, “The office manager will never influence treatment…” I can tell you they virtually always do. Whether directly or indirectly with their policies.
–Revolving door of staff. It can be hard to hit your stride when the staff is always changing. Corporate offices are notorious for a high staff turnover rate. That includes the dentists.
–A grueling pace. The rapid and heavy flow of patient treatment is hard for many new graduate dentists to handle. You may be seeing in the realm of 30 patients per day. In dental school you say 2 patients per day. Burnout often occurs. They say corporate is a ‘good place to start off and get some experience’ but how much are you really learning and what habits are being pick up in this environment?
Pathway #3: Public Health
The private associateship is thought to be the golden goose of jobs for a new grad. In my opinion, public health may be the real golden goose. These jobs are often extraordinarily difficult to acquire in a traditionally desirable area to live; and quite easy to acquire if you’re willing to live in a highly remote area.
The upsides are major:
-Good to excellent pay. The more remote the better the pay. There are also typically well established benefit packages which are far superior to the typical associate job offer.
-Well established structure is often found in these organizations. The clinics may be overseen by the government or a university. Oftentimes they are overseen by a dentist with a public healthcare background. Where Corporate jobs are systems typically driven by businessmen in business suits. Public Health dental jobs are typical driven by dentists with public health backgrounds and understand and value your clinical autonomy.
-Respect. This is typically a very well respected job by your peers and by the public. You are doing a public service and helping an underserved population. This is noble and peers, and beyond, will respect that. Look in the mirror, you can be proud of yourself too. You are one of the few actually tackling the access to dental care barriers within dentistry – which all too often is an ‘access to money for dental care’ barrier, Again, there is something noble about providing free or reduced price dental care to those in need. Make a great living on top of it.
-Potential to work your way up in leadership roles. There are often directorial jobs available in which you may be able to influence local resources and public policy within the dental profession in your area. If you aspire to serve something larger than yourself and your clinical chair – the potential is there. There may be a more clear route to have an impact on the community and healthcare where you live on a wider scale.
The negatives are few but clear:
-No potential to own the business
-Difficult to acquire in a traditionally desirable location.
Pathway #4: Practice Ownership
This is what I did. I had applied for my practice loan to open my practice when I was a 4th year dental student and had already cornered the location I would be practicing. My business plan, marketing plan, website, name, and logo were all taken care of by 3rd year. Doing a start-up practice straight out of dental school is rare. But it’s what I did – (there’s a long-form post on that coming up soon). It was right for me. If you want my personal 1-on-1 help, and want to learn my strategy as well as business fundamentals that you didn’t learn in school, the ‘Practice Launch’ AGD accredited CE course (22 credit hours) might be exactly what you need <–That was a shameless plug — shameless because my CE is really good.
Buying a practice out of school is easier, and also a great option. Notice I said buying a practice – not buying into a practice. If you’re thinking about buying into a practice as a new grad, please read the article linked here. I’ll need to first introduce you to someone named ‘Old Doc’ and tell you about the twinkle in his eye….but I digress.
The Pros to Ownership:
-Highest income potential. If you are a good business person, you will make far more money than any of the other doorway options
-Play the game by your rules
The Cons to Ownership:
-The most difficult and stressful path.
-Lowest income potential as well. There is no guaranteed income, if you aren’t a good business person, you could potentially make little to no money.
-Limited mobility. Once you buy a practice, you are tied to that physical location. Be sure this is where you want to live.
Pathway #5: Academics
Some new grads just keep on going to school. Establishing strong rapport and reputation with the faculty at your dental school can open this 5th door. But this door is definitely not open to everyone. You’ll need to have the fortitude to teach a class of dental students and rub shoulders with dental faculty.
Pros:
-Long term security, stability and benefits. More so than any of the other doors. The faculty track could provide you a fulfilling decades long career that could even transition to other Universities if you ever decide to move to another state. You’ll have that resume backing you
-You’ll get to pass your knowledge on and help the next generation of dentists thrive, prepare, and learn
-You won’t be doing as much dental work. If you aren’t a fan of clinical dentistry, you won’t be doing as much physical treatment as a dentist.
Cons:
-You won’t be doing as much dental work. If you enjoy doing clinical dentistry, you’ll be doing a lot less of it.
-You’ll be playing the bureaucratic game to work your way up, if you have the right personality – maybe you turn this into a positive.
So new grads….which door will you choose to START your career?
Kaizen — let’s get a little bit better, every day.
Are you an employee dentist who does not own a practice yet? Not sure where to start? Let’s work together! Check out the most comprehensive Practice Ownership CE available. Included is the full course, toolkit, templates, 1-on-1 help from me, and a supportive peer-mentorship group.
The program will help you go from associate dentist — to owner dentist, built upon lean ownership principles!
This might just be for you…..Click Here to Check out the CE Program
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