One Year In

Welcome to the best dentist in billings mt.

I ended my first complete year as a”general dentist” in the end of June.   I know it has been MONTHS since my previous look but I guarantee you, I am very much alive.   So how are things you ask?

Yea, sadly 12 months post treatment, my professional life is still meh.   I am better than I was last fall (jobless!) , but actually it is not THAT much better.   I work in 2 offices.   It’s a long-standing standing overall practice with two proprietor docs and 3 partners.   The other is a Federally Qualified Health Center (FQHC) which caters to low-no income families.   I started at the personal office in January and only started from the FQHC in July.   By the way, for you die-hard lovers, this is exactly the identical FQHC that I temped in final autumn.   They finally made space for a second dentist and that I had been invited back to 1.5 days each week.  

The general practice office is three days per week and when I have anything to do with this, will be zero.   The office is predominantly PPO (Over 90 percent of the patients), and I am paid exclusively on collections (40%).   You see the 40 percent and believe, that ai not half bad.   Well, as I have found out at a painfully slow rate, the annual collections within this office is below 90 percent.   I have not heard of this kind of bad return.   The simple fact that we consider all these dogshit PPOs also cripples the capacity to bill an even’average’ fee.   I am sorry, but only 400 bucks for four wisdom teeth?

To some readers that are a bit miffed by insurance plans, let me summarize (I will probably have an entire post on this later on ).   I will not cope with HMOs today.   So lots of people have PPO programs.   How can they work?   You generally get them via your employer, who will sign up for a strategy to have a particular rate for his/her employees.   You select your plan, cough up a monthly tab, and get your own gains.   Your average plan will cover 1500-2500 bucks yearly.   They generally cover 100% preventative stuff.

Why do they suck?   Because they hamstring the dentist.   PPOs normally raise their fees about 0.5%-1% annually unless the dental practitioner attempts to hardball renegotiate fees.   General inflation in the us is 3-4% annually.   Do you find the issue?   The cost for dental stuff, staff salary, office supplies, etc all increases with normal inflation.   The PPO doesn’t.   So in the event you rely heavily on PPOs, you will begin to see a steady drop in office cash flow.   So how do you fix this?   Oh yea, cram because many patients to your program as possible.   I don’t care how good you’re, you will do some shoddy dentistry whenever you are seeing 14+ patients every day (not like hygiene) just to compensate for fee’s which you have no control over.  

Now of course the perfect world would be a completely fee for support (FFO) practice.   They don’t really exist, but most can’t get by without taking SOME insurance.   The trick is to LIMIT it.   The underlying system is only flawed.   Insurance organizations are NOT dentists, yet they decide how much we should make.   It is bad.  

But I will dissect this stuff in a separate post.   The jist of how it’s been suggested.   So this household clinic is essentially going under.   Office overhead is from the 70 percent range, the clinic generates 2.5 million a year, yet is still fighting to break .   So what has this yielded?   The wise and benevolent clinic management company that the owner docs appear to let conduct the show has indicated they cut associate dentist damages.   How they are doing it really does not matter, but it essentially equates to about 60K gross pay for the oldest partner, 30K for my spouse and 10K for me.   But hah, I make nothing since it is so what’s the diff.   The sole reason I’ve stayed as long as I really have is that the office is normally a positive work environment, I have discovered a good amount, I love working with my spouse (which bodes well for its future), and I was pleased to have a stable work week finally.   I initially planned to stick it out for at least a year.   Now I am hoping to be someplace else by then.   And a huge part of me hopes that other place is owned by ME.   OH SNAP!

The authentic positive of this mess is it is sparked a fire in my dormant self.   I originally thought I would slug it out as an associate for several decades.   Hell no!   We are starting the process of launching our own clinic.   We haven’t determined if we will buy one out, or start from scratch — however I have begun assembling the Justice League to get Dentistry (i.e., my professional group ).   Including a lawyer, CPA, banker, demographics dude, medical builder, oh my god there are a whole lot of those.

We’re hoping to meet with a bunch and find the perfect fit.   We aren’t rushing into anything, but the process has begun!   I am pretty damn excited about it too.    Literally just started, but I expect to update as we go along, as this section of my profession will probably be pretty damn fascinating to the dentists coming forth.

So can I go bankrupt?   Make millions?   Die at a freak accident?   Find balance in most things life?   Stay tuned!

Thus yea, so much as this first season is worried….


OKOK I know I am bitching a little excessively and that I truly HAVE come to be a better dentist regardless of the lack of dentist-like income.   We are not hungry or anything , but the thought of having kids or having a house is much further away than I’d have expected for someone my own age.   I still drive a vehicle with no passenger door handle or driver side mirror.   I mean, I do not need a Maserati or anything, but A/C along with also a non-ruptured washer fluid lineup would be nice.   We’ll get there eventually, but was the five additional years of school + mountain of debt worth it?   Plenty of individuals make a nice living but completely hate their jobs.   I generally enjoy doing exactly what I do at least.   So there’s some positivity!

I shall hopefully arrange some articles about transitioning to ownership in the coming months/years.   I never saw itself as an entrepreneur, but the notion of building something from the bottom up, and being in control, and having to do it MY way seems so freaking amazing after working for other dudes that do a lot of things wrong.   Not that I am perfect or something, but I’m excited about giving it the old school try.

Yikes I am really rambling.

Seriously though, I will attempt to find some thoughtful articles about this transition because it occurs.   Hell, it requires a long time to get rolling anyways so I ought to have the ability to locate some moment.

Good day.

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