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Dental leaders welcome student advocates

ADA and ADPAC leaders joined dentist members of Congress April 13 in welcoming some 380 dental students to the American Student Dental Association’s annual dental student lobby day.

Speaking at the appropriately named Renaissance Arlington Capital View Hotel across the river from the nation’s capital, Association President Maxine Feinberg told today’s student leaders. “Your voice is important for our profession.” The dental students met to share lobbying tips with the profession’s leadership the day before canvassing Capitol Hill congressional offices to lobby student refinancing and Action for Dental Health bills.

“Your being here is such an important step in securing your future as dentists,” Dr. Feinberg told the students. “When you sit down with a member of Congress tomorrow, and you’re discussing issues that affect oral health and dentistry, yes, you’re going to be advocating for dentists everywhere. But you’ll also be advocating for your future, your patients.”

Dr. Bruce Hutchison, chair-elect of the American Dental Political Action Committee, and dentist/Reps. Bruce Babin, R-Texas, and Paul Gosar, R-Ariz., also addressed the students and offered advice on how to lobby the legislation and work with congressional staff.

Grassroots activist dentists attending the April 27-29 Washington Leadership Conference will also lobby members of Congress to support the Student Loan Refinancing Act “so that we can help dental students like you manage their debt when they leave school,” and the Action for Dental Health Act, which “reduces barriers to care and offers solutions for addressing the dental health crisis in America,” Dr. Feinberg told the students.

“When you meet with members of Congress on the Hill tomorrow, ask them for their support,” the

ADA and ADPAC leaders joined dentist members of Congress April 13 in welcoming some 380 dental students to the American Student Dental Association’s annual dental student lobby day.

Speaking at the appropriately named Renaissance Arlington Capital View Hotel across the river from the nation’s capital, Association President Maxine Feinberg told today’s student leaders. “Your voice is important for our profession.” The dental students met to share lobbying tips with the profession’s leadership the day before canvassing Capitol Hill congressional offices to lobby student refinancing and Action for Dental Health bills.

“Your being here is such an important step in securing your future as dentists,” Dr. Feinberg told the students. “When you sit down with a member of Congress tomorrow, and you’re discussing issues that affect oral health and dentistry, yes, you’re going to be advocating for dentists everywhere. But you’ll also be advocating for your future, your patients.”

Dr. Bruce Hutchison, chair-elect of the American Dental Political Action Committee, and dentist/Reps. Bruce Babin, R-Texas, and Paul Gosar, R-Ariz., also addressed the students and offered advice on how to lobby the legislation and work with congressional staff.

Grassroots activist dentists attending the April 27-29 Washington Leadership Conference will also lobby members of Congress to support the Student Loan Refinancing Act “so that we can help dental students like you manage their debt when they leave school,” and the Action for Dental Health Act, which “reduces barriers to care and offers solutions for addressing the dental health crisis in America,” Dr. Feinberg told the students.

“When you meet with members of Congress on the Hill tomorrow, ask them for their support,” the ADA president said. “Ask them to be advocates for you and for the profession.”

Will there be a dentist shortage in 2025?

May 2015 JADACheck out the May issue of The Journal of the American Dental Association to read how falling busyness levels and financial barriers to dental care may challenge predictions of a dentist shortage by 2025. Marko Vujicic, Ph.D., ADA’s chief economist and vice president of the Health Policy Institute, examines the issue in his Health Policy Perspectives column, Rethinking Dentist ‘Shortages.’

And for more highlights, watch JADA Editor Michael Glick’s preview on ADA.org or jada.ada.org.

Understanding small savings, interest and taxes

Time is money. It’s true. Realize that though you may be shouldering debt, most new dentists are young and can take advantage of money saving techniques and the power of compounding interest. Small savings early can really help with BIG decisions later!

Dr. Moon

Dr. Moon

As soon as possible:

  • Learn to manage your limited money to have fun when you need to relax without breaking the bank, or putting $200 at a time on a credit card.
  • Make a goal to save $2,500 cash for moving expenses after school so you can get to that better job. Saving for this transition helps with your personal psychology to travel for a better opportunity.
  • Establish that retirement savings is a budget line item and figure out how to do it sooner. If you can budget $500 yearly when you are taking out student loans, you should be well prepared to max out your retirement savings when you are earning more. Consider $500 in a retirement account at age 23. If you retire at age 65, that is 42 years of compounding interest.
    • At 5 percent average interest, that $500 is $3,880 at age 65; at 10 percent average interest, that $500 is $27,381 at age 65…..and that’s only the first year of contribution of only $500!

Your first professional years:

  • “Real paychecks” mean you will be in a tax bracket that you have never had the privilege of being in before. This means that to put $10,000 per year toward your student loan, you will have to allocate earnings of somewhere from $15,000-$20,000 per year to do this. Keep this in mind if you consider a loan repayment program.
  • If some loan repayment program is going to pay your student loans, that grant or other money is often not taxed, so $25,000 goes straight toward your loan balance. To put $25,000 toward your loan balance yourself you would have to allocate earnings of $35,000-$50,000 income to make that “dent” in your loan depending on your tax bracket.
  • Considering the above, a $90,000 per year job with loan repayment may be a better decision for some than a $130,000 per year job without. You’ve got to understand the numbers.
  • One option is to secure loan repayment and contribute the max yearly to your Roth IRA when you are 26 instead of putting that toward your loan: Compounded,
    • $5,500 into retirement at 26 years old is worth the following at 65 years old:
      • 5 percent interest average compounded 39 years it is $36,876.
      • 10 percent interest avg. compounded 39 years it is $226,296.

Controlling small amounts of money early is key! Look for more ideas in future blog posts. Note that ADA members can access retirement planning tools and resources from AXA Equitable, the only retirement program endorsed by the ADA for its members. Additionally, members may access loan repayment calculators on the Center for Professional Success. State and local dental societies may also have financial and retirement resources available.

Dr. Brendan Moon is a New Dentist Now guest blogger and currently serves as Chair of the Illinois State Dental Society New Dentist Committee and sits on the Board of the Illinois Academy of General Dentistry. He began practicing in western Illinois after completing dental school at the University of Mississippi in 2007, and enjoys participating in organized dentistry on the state and national level. Dr. Moon practices in both Public Health and Private Practice settings and is a Fellow of the Academy of General Dentistry, International College of Dentists, Academy of Dentistry International, and the Pierre Fauchard Academy.

NHSC sets May 7 scholarship application deadline

The National Health Service Corps invites scholarship applications through May 7 for the 2015-16 school year for students pursuing primary care health professions training leading to a degree in dentistry or other specified disciplines.

The scholarship pays tuition, fees and other educational costs and provides a living stipend in return for a commitment to work at least two years in a NHSC-approved site in a community classified as an underserved health professional shortage area. For each year of financial support (up to four years), the student agrees to serve one year (minimum two years) at an approved site in a high-need urban or rural community. Service begins upon graduation and completion of primary care residency training for dentists.

To learn more about the program, visit hrsa.gov, click on National Health Service Corps tab on left of page and select scholarships “learn more.” A customer care center number is available 1-800-221-9393 Monday-Friday 8 a.m.-8 p.m. Eastern time.

Why new dentists need a legal entity

So you’ve decided to open your own dental practice. Now that you’ve told your family, friends, and dental school buddies, it dawns on you…you don’t actually know how to open a practice.

Rich McIver

Rich McIver

In this blog we’re going to walk you through some of the basic requirements needed to open a practice, and provide you practical steps that you can take to get your practice off the ground.

The first step to starting a dental practice is a pretty mundane one: legally forming a company entity. A legal entity is simply a company that is recognized and registered with your state. Your legal entity can be a Corporation, a Limited Liability Company, a Partnership, or any other business type that your state recognizes. It is distinguished from running your business via a sole proprietorship, or other arrangement which is not registered or recognized by your state.

Why do Dentists Need an Entity?

The short answer is you don’t. There’s no law requiring that you run your practice via an entity, you can run it as a sole proprietorship (which in plain English means, “in your own name”). However, here are some pretty good reasons why you’ll want to have an entity:

  • Legal Protection

The biggest reason to form a dental business entity is that it means that your business is separate, legally speaking, from you. That’s useful because if you get sued personally, which could happen for a variety of reasons—such as a guest slipped and fell at your house, you default on your home mortgage, or you get sued for medical malpractice—then the assets of your business aren’t subject to the lawsuit. That is to say, if the lawsuit against you is successful, they won’t be able to take your business. Same thing applies if your business is sued. If the lawsuit is successful, they won’t be able to seize your personal assets. In effect, it creates two separate pots, and a successful lawsuit can only raid one of those pots if you’ve used an entity.

  • Accounting Transparency

A second reason to form an entity is accounting transparency. By having your business run as a separate entity you’ll have separate bank accounts, separate accounting, a separate line on your tax return to report the earnings, etc. That accounting separation is necessary if you’re ever going to try to bring in a business partner, sell a business, or even just properly calculate your taxes. Can you do these things with a sole proprietorship? Technically yes, but it’ll be such a mess trying to disentangle your personal expenses from your business expenses that nobody, whether it be a partner, a buyer, or the IRS is going to believe your calculations and thus your valuation or tax liability will be worse than it otherwise would be.

  • Business Credit Separated from Personal Credit

Another reason you want to create a separate legal entity is that you can start to develop business credit that is separate from your personal credit. In plain English, the loans you take out in the business’ name, whether for equipment, a building, etc. will go on your business’ credit report, and not your own. That’s a good thing for two reasons: first, if either your business or your personal credit isn’t squeaky clean you’ll have fewer problems; second, you can generally borrow more money in total if they’re separated, which as a new dentist trying to start a practice and likely carrying a mortgage, that’s a good thing.

In sum, it’s not legally required, but it’s a good idea to form a separate entity to run your dental practice in.

In the next article, we’ll cover what type of entity you should form, what elections to make, how to actually do it, and how much it will cost you.

For information on ADA legal resources, click here.

Rich McIver is a New Dentist Now guest blogger. He graduated from the University of Notre Dame in 2005 and obtained his law degree at the University of Chicago Law School in 2008. After graduating law school, Rich founded and managed three tech startups that were each acquired through private equity, private sales and a merger, respectively. In 2010, he founded and managed a Houston-based plaintiffs law firm which he sold via a buyout in 2014. In 2013, he and his wife, Holly McIver, an ADA member dentist, founded Kingwood Orthodontics, where he continues to manage back-office operations. His current project is running Merchant Negotiators, a Web startup based in Houston. Rich provides practical actionable advice for new dentists based on his experience starting and building successful businesses.

The purpose of this article is to promote awareness of legal and other issues that may affect dentists and dental practices, and is not intended to provide either legal or professional advice. Dentists are urged to consult directly with a properly qualified professional or with an attorney admitted to practice in their jurisdiction for appropriate legal or professional advice.

New Dentist Conference Joins ADA 2015 – America’s Dental Meeting

The ADA is pleased to announce that for the first time, the New Dentist Conference will be held at the ADA annual meeting from November 5-10 in Washington, D.C.

New Dentist Conference 2015Features of the New Dentist Conference include:

  • Shark Tank co-star Daymond John as keynote speaker.
  • Exclusive, interactive educational offerings.
  • High-level networking opportunities with leadership and peers.
  • New Dentist reception and lounge.
  • Significantly reduced hotel rates.
  • A chance to give back at the ADA Mission of Mercy.
  • We encourage you to share this information with any dentists who have been out of school for ten years or less as this is an experience they won’t want to miss.

Registration for the New Dentist Conference at ADA 2015 opens May 13 — a full week earlier than general registration! For more information, visit ADA.org/NDC.

Take action on dental student debt

2014 Dental Student Loan DebtDid you know the average dental school graduate in 2014 carries $247,227 in student loan debt, up from $221,000 in 2013? While this debt may not be the sole factor in determining whether a new dentist will choose a career of private practice over public service, 61 percent of graduating seniors say it does influence their decision.

The infographic uses data gathered by the American Dental Education Association.  Please take action now and contact your representative about this important issue, please visit ADA.org/Engage.

Medicaid challenges and rewards: One new dentist’s experience

Dr. Chris Hasty, vice chair of ADA’s New Dentist Committee, weighs the challenges and “rewarding” experiences with accepting Medicaid in his practice and says, “As new dentists, we should want to see the Medicaid system fixed and functional.”

Dr. Hasty

Dr. Hasty

We asked Dr. Hasty for his thoughts on accepting Medicaid patients.

He offered a litany of “frustrations” with the system, which includes low reimbursement rates, bureaucratic hoops, closed networks, burdensome filing requirements, limited covered procedures, down coding, endless paperwork and RAC audits, “which is not only aggravating for the provider but very stressful and time consuming.”

“A truly functional and fair Medicaid system is not a bad thing,” said Dr. Hasty. “In addition, as long as the system is fixed and functional, dentistry will be able to decide its fate and role. Sure it is not glamorous, but you do learn valuable lessons from accepting Medicaid.”

“Medicaid provides a consistent influx of patients into your practice. This is the real world. You have a steady stream of patients to help you build your speed, work out of multiple chairs and check hygiene at the same time.

“I used my experiences with my Medicaid patients to determine what I truly like in dentistry, and maybe more importantly what I truly did not like. In addition, when the Medicaid system is functional you can depend on your reimbursement to be in the bank in a timely pattern.

However, one must be very careful to limit the amount of Medicaid in his/her practice. A practice too dependent on Medicaid is very vulnerable to outside influences affecting the growth and sustainability of the practice. One significant fee decrease can cause a practice to close its doors if it becomes too dependent on Medicaid.

“I believe that we, as new dentists, should support the ADA’s effort for Medicaid reform. With the number of graduates entering the workforce today, there will always be providers able to continue dental care to these patients even as others drop off the system. In addition there is a sense of satisfaction providing care to a child whose only hope for dental care came with the Medicaid card he or she brought in. It is very rewarding seeing a child that did not have a chance at good oral health grow into a young adult with good oral health because of a system that was fair to the participant and the provider.”

For more information on increasing provider participation in Medicaid, click here.

If you’re a new dentist, consider these ADA resources

With about 1,000 new dentists graduating from dental school in Virginia alone over the past 10 years, the future of dentistry looks very bright. The hopes of the Virginia Dental Association’s new dentist committee is to keep all of our recent graduates abreast of what is happening nationally as well as in our state and local ADA components.

Dr. Sinclair

Dr. Sinclair

I am a fairly new dentist; I graduated from VCU in 2009 and can hardly believe that I just had my 5-year reunion a few months ago. It was great to visit with my fellow classmates and see just how many different paths had been taken; however, many of us were thriving in general dentistry.

Once you leave the doors of dental school, you quickly realize how career paths are available. You can specialize, attend a residency, become an associate, enter public service or the military and even start your own practice. I have experienced several of those areas myself starting with public health, working as an associate, and finally starting my own practice a few years ago.

Did you know that the ADA can help in almost all of these areas? If we just take a look at my recent journey from student to practice owner, the ADA has been a great resource for me in almost every segment. In the next few issues, I will highlight some of these areas that the ADA has helped out along the way and show a few of the various ways the ADA may be able to help you, the new dentist.

ADA Sponsored Insurance Policies

Did you ever think what would happen if you had some life altering issue while you were in school? How would you pay your loans? What would happen if you injured your hand disabling you from practicing dentistry? I was a young dental student and none of these ideas ever crossed my mind; however, I didn’t need to worry about it!

The ADA had taken care if it for me as they currently do for all dental student members.  When you are student member in the ADA, you are covered in an ADA sponsored policy that not only includes a $500,000 life insurance policy, but also a $2,000 a month disability plan with $150,000 coverage in student loan protection.  There is even a chance to continue on with the policies as your career advances and your need for coverage increases. For more information, click here.

Licensure Maps

Where do you want to practice? One of the main hurdles for many dental students is deciding what regional board is going to be the best one to take. The ADA has a great informational website that lists all of the regional board exams and the states that accept that exam for licensure. There are also links to contact the state’s individual boards as well as state dental components if there are any further questions. For more information, click here.

CV Development

How do you distinguish yourself among your peers for that perfect job?  Not everyone graduating dental schools wants to do the same thing, but how do you get that first interview for your first associateship. As an ADA member, you have access to the group at the Career Transitions Center of Chicago (CTC).  The team at CTC can provide you with general tips for having a successful resume all the way to co-writing that perfect CV to help you land your dream job. For more information, click here.

 

This blog post, reprinted with permission, originally appeared in the Virginia Dental Association journal. Dr. Cappy Sinclair is a New Dentist Now guest blogger and a 2009 graduate of Virginia Commonwealth University. Dr. Sinclair currently serves on the Board of Trustees at the Academy of Cosmetic Dentistry, as member of 3M’s Council for Innovative Dentistry, and as an ambassador for the Dawson Academy. He started his own practice Coastal Cosmetic Dentistry 3 years ago from the ground up and is more than happy to share his success and failures with fellow new dentists. He is a member of the American Dental Association and the Virginia Dental Association. To contact Dr. Sinclair, email him csinclair@smilevabeach.com.

With student loans, consider options in repayment strategy

Dr. Timothy Oh

Dr. Timothy Oh

Dr. Timothy Oh, of Ellsworth, Maine, graduated from dental school in 2008 with over $300,000 in student debt — a mixture of federal and private loans from various lenders, along with an education loan acquired prior to dental school.

“I feel student loan debt is one of the most serious burdens facing today’s graduates,” said Dr. Oh, New Dentist Committee District 1 representative.

He received some help from the Finance Authority of Maine, a state-based financial aid program. He received $80,000 in loan assistance for treating patients at a nonprofit clinic in an underserved and rural area for four years.

“The grant enabled me to get started with my loans,” Dr. Oh said. “But I was still left with a six-figure loan.”

The average dental student in the class of 2014 left school with about $247,000 in student loan debt, according to the American Dental Education Association.

For new dentists seeking ways to ease the burden of staggering student loan debt, there are options — such as loan consolidation, refinancing and government base repayment programs — that are worthy of consideration as part of a repayment strategy. But like all major financial decisions, they come with advantages and drawbacks.

Consolidations vs. refinancing

Federal loan consolidation combines multiple government-sponsored loans into just one loan. It takes the weighted average interest rate of the loans being combined.

Refinancing is when a borrower applies for a loan under new terms, and uses that loan to pay off one or more existing student loans. Unlike consolidation, refinancing is only available from private lenders. Interest rates are not based on a weighted average of the existing loans’ rates. Instead, a private lender will typically use a borrower’s credit score and other financial information to provide a new interest rate on the consolidated loan.

Consolidation: Pros, cons

One good reason to consolidate federal loans is convenience: There is only one loan, one loan servicer, one payment and one place to file forms.

Dr. Oh consolidated a “batch” of his student loans to reduce the number of monthly checks he had to write. Consolidating federal loans also allows borrowers to convert former nondirect loans to direct loans. Only direct loans (Stafford, Grad PLUS and Federal Consolidation Loans borrowed through the federal government’s Direct Loan Program) are eligible for Public Service Loan Forgiveness.

Also, repayment terms may be extended to 30 years, which lowers monthly payments but adds to total repayment costs if it takes the full 30 years to repay.

Drawbacks in consolidating federal loans include a lengthy and cumbersome process (may take 60-90 days), potential for a slightly higher interest rate (interest rate on consolidation loans is a “weighted” rate of all loans being consolidated, rounded up an eighth of a percent then fixed for the life of the loan) and loss of grace periods on loans being consolidated if students consolidate too early.

Refinancing: Pros, cons

Even before graduating from dental school, Dr. Adam Shisler, a pediatric dentist in Houston, had decided to refinance his loans, about $241,000, all of which were Federal Stafford Loans.

Dr. Shisler

Dr. Shisler

In spring 2014, he began the application process to refinance his loans through SoFi, a peer-to-peer lender based in San Francisco. Refinancing can help borrowers pay lower interest rates on their student loans, thus saving thousands of dollars throughout the life of the loan, though it comes with some risks as well. Similar to taking out a mortgage, borrowers can choose between a fixed rate loan and a variable rate loan, or both.

Fixed rate loans typically have higher rates than variable rate student loans but will remain the same over the life of the loan. Variable rate student loans generally are lower but may change, including the risk of going up, on a monthly, quarterly or annual basis.

Dr. Shisler said he was approved for a five year, fixed rate loan in an accelerated repayment program, lowering his interest rate from 6.8 percent to 4.3 percent — saving him about $70,000 in interest.

However, there aren’t many lenders that will include federal loans as part of a refinancing plan. Dr. Shisler found only three to four other institutions that would refinance his loans.

As for disadvantages, graduates who refinance federal student loans will lose many of the benefits that come with federal loans, such as loan forgiveness and income-based repayment programs. If there is hardship, a dentist won’t be able to apply to defer monthly payments.

Federal, state loan repayment options

Federal and state programs offer student loan repayment assistance, often in exchange for services in a health care shortage area.

Federal options include programs sponsored by the Army, Navy, Air Force, Veteran Affairs, U.S. Public Health Service, National Health and Human Services, Indian Health Service and more. States have their own programs — such as the FAME program that Dr. Oh participated in — that are independent of the federal programs.

“(FAME) is a competitive program, with an extensive application and interview process,” said Dr. Oh.

In addition, many dental schools and advanced education programs may have financial assistance and loan repayment options. Contact your school’s financial aid office for more information.

Research and resources

Dr. Oh recommends that dentists conduct research before signing up for a repayment program. He is now considering refinancing as a next move.

“I just started talking to companies about refinancing and haven’t made a decision,” he said. “It’s sometimes too depressing to think about, but there are options that can help.”

In addition, Dr. Shisler said the most important thing a soon-to-be dental school graduate or new dentist can do before making any decisions is to go on a fact-finding mission on the status of their loans.

“They need to ask, ‘Where are all my loans from?’ ‘Are they subsidized, unsubsidized?’ ‘What are the interest rates for each of them?’ ‘What is their loan health?’” said Dr. Shisler. “Know your loans before applying because you’ll need that information in your application.”

For more information on consolidation and refinancing, visit the Center for Professional Success here. You can also find information at ADA.org/student. ADEA also

has educational debt management materials at ADEA.org.