Straight line access to your goals

I walked out of dental school with stars in my eyes and a kick in my step. I tackled the work force head on with a goal of finding “the perfect associateship,” using it to kickstart my career, and start down on a path leading straight to my well-defined goals. These were the goals that I had cultivated during long nights practicing my Class II preps in the Sim clinic and I was seeking a straight line leading right to them. After all, I had the degree in my hand finally. What was stopping me now?

Dr. Singh

Finding work the first year out of school is easy. The profession as a whole has a 0.8 percent unemployment rate. Dentists love doing dentistry and there are more than enough jobs to go around. The kicker? The odds are that the job you find your first year out, will NOT be the job you have five years out of school. I learned the hard way that there is no such thing as “the perfect associateship.” Liken an associateship to the 80-10-10 rule when buying a house. The house (or job) you eventually want to end up with should consist of 80 percent of that which you love, 10 percent of that which you can change, and 10 percent of that which you can learn to live with. Think of the place you start as simply that: a place to start.

Why are so many associates leaving their jobs 1- to 2 years after practicing? It is a combination of a lot of things including insufficient pay, a motivation or obligation to own, less than expected autonomy, a feeling of being undervalued, an inability to treatment plan without “quotas,” a lack of a people focused culture, and many more. Many of the places that become apparent choices for first year graduates within a market do an excellent job of being visible during dental school. Many DSO’s have honed the process of finding new dentists and for good reason. Many of these entities have incredibly high practitioner turnover. And with a high doctor turnover comes the problem of patient retention. Even private practice associateships have a less than 10 percent chance at becoming a practice buyout, even if that was the original intention.

Even with a good faith effort to establish longevity as an initial step, many new dentists are finding themselves closing an emotionally wrought chapter within a few years of starting work. As a new graduate, you can implement a series of steps during your job-hunt process to increase the chances that this opportunity will be a good fit. You can use the interview to not only shine as a candidate, but vet the practice and the clinical culture. You can talk to previous and current associates. You can clearly define your own needs and goals surrounding an opportunity and establish “points of non-negotiation,” things you absolutely need in order to thrive that you will not compromise on.

Complementing an organized job search with a thorough understanding of what it is that causes opportunities to tarnish is a good way to maximize your odds of finding the right fit. Three of the top reasons that many associateships tend to be shortlived, according to a Practice Management report run by Henry Schein, are as follows:

1. Insufficient patient base. New graduates are typically hungry, eager to work, and need to make a good living. With the student debts averaging well over six figures, many new graduates have a monthly payment they need to make before they even begin to think about other expenses. For an associateship in private practice that is destined to be a buyout, it is important to analyze the practice and run a demographic report before entering into a contract. If the current doctor does not have 1,500 or more active patients, even with the seller retiring immediately, you may not have the cash flow needed to make growth and ownership a feasible opportunity. In more traditional associateships without buyout potential, it would be wise to ask for two weeks of average scheduling to see if the schedule is filled or has wide gaps. Also, it is usually a good idea to ask for a list of insurances the office takes and their reimbursement rates to see how much you will be writing off of production, especially if you are paid based on collections.
2. Differences in practice philosophy. It is important to understand the values of the doctor or company you are trying to join. Being perceptive during shadowing and interview time, having a clear discussion on practice philosophies and even potentially doing example treatment plans together can avoid frustrations in the future. Asking about treatment plan autonomy and if all the treatment you will be completing will be diagnosed by you also is important and should not seem like a taboo topic.
3. Fuzzy details are the downfall. If you are an associate with no ownership options, your contract is the ultimate record of what you can expect. Have a professional review the contract. Those details, usually enveloped in obscure language, can be difficult to interpret. Also, if there is a subject not covered in the contract that concerns you (i.e.: vacation time, benefits, maternity leave) you can have your lawyer add details which protect you and guide accurate expectations. If a buy-out is the ultimate goal, then discussing details such as purchase price, practice valuation (before or after you join), patient allocation, and time for seller to remain are all important factors for a successful transition.

And in the end, if despite your best efforts, your first job does not trace a straight line to your goals, then it is important to see the positive lining. You gained an experience and you started your career with a better idea of what you do and do not want. A resilient attitude and a forward trajectory are all you need to ensure that one day, your goals will become an actuality.

Dr. Amisha Singh is a Denver native and loves living in beautiful Colorado. While in dental school, she was the founder of the first diversity oriented, nationally based organization in the school and she currently is a member of the ADA, CDA, and MSCD and serves on the CDA New Dentist Committee as Social Chair. She is also a blogger, writer and speaker who works with IgniteDDS and Ignite DA to inspire other dental professionals and provide them resources to be the best clinicians possible. She is the AVID Healthcare Liaison for Denver Public Schools and teaches a success series integrated into the curriculum of underprivileged middle school youth to aspire them to careers in healthcare. She is also a founder/ board member for Colorado’s first South Asian Chamber of Commerce. Her passion is encouraging entrepreneurial spirit, inspiring others and she wants to dedicate her life to helping make dentists be better, healthier, more empowered people.  When not practicing dentistry she loves to get lost in a good book, cook, and do all things creative.