Describe your graduating class demographics.
William (Penn Class of 2021) – “Our class has 155 dental students total—130 traditional dental students (80 female, 50 male) and 25 Program for Advanced Standing Students (PASS) who are foreign-trained dentists who want to practice dentistry in the United States.”
Kevin (Temple Class of 2022) – “140 dental students, 55 percent female to 45 percent male.”
Michael (Pitt Class of 1983) – “85 percent male, 15 percent female. Two African-American males, and two Asian-American males.”
Ann (VCU Class of 1996) – “76 students, 14 women, 62 men.”
Dan (Maryland Class of 1985) – “About 30 percent female, 70 percent male. And maybe 10 percent minority students.”
Carol (Penn Class of 1988) – “We were the first year that they decreased the enrollment by half. I only had 75 students in my class. There were 13 girls.”
Do you or did you have a dentist mentor? How did you find this relationship?
Amy (Penn ‘20) – “I have had multiple dentist mentors throughout the years. Each mentor has individually shaped my career and dental school experience in every phase of my education. I would not be as prepared, creative, or successful without them.”
Carol (Penn ‘88) – “While I was in dental school, I spent a summer working in the dental clinic. Here, I met a local oral surgeon who ran the residency program. Upon graduation, he invited me to come to the study club that met every Tuesday over lunch at the hospital. He is the one who told me there was a practice for sale and that it would be a much better opportunity than the current associateship that I was in.”
Dan (Maryland ‘85) – “No. As a matter of fact, I was looked on as competition by nearby practices.”
Ann (VCU ‘96) – “The senior partner at my group practice. He retired my third year there. He was the one who encouraged me to leave the group practice and start my own practice. He was a strict but fair person. He even came to the satellite office on his day off to help me with my first implant crown.”
Describe your career path to this point. Where did you start practicing? How has it led to where you are now?
Carol (Penn ‘88) – “I practiced for one year as an associate. At the end of that year, I bought my own practice. I was working for two dentists who formed a partnership to buy a third office. They each had their own offices and went into a partnership to buy this office from a retiring dentist. So, basically, I was alone in the office because they were both running their own practices… They couldn’t agree on anything… And considering that I was working by myself anyway, I figured I could buy my own practice. So that’s what I did and I haven’t looked back!”
Jack (Temple ‘81) – “Directly into practice without GPR. My father, a dentist in Northeastern Pennsylvania coal region, was sick and I came back to work with him. However, the practice only had two chairs and no suction, one front desk person, no assistants.”
Dan (Maryland ‘85) – “My wife and I began setting up a new private practice while I was a resident. We started with one patient the first day… We grew the practice, bringing on staff and two associates. The first one moved away, the second became a full partner. After about 30 years, we sold the practice to my partner and I associated with him for two years.”
What do you feel is your ideal work situation as a dentist?
Amy (Penn ‘20) – “As a soon-to-be dentist, I am seeking an environment with the time, resources, and patience to mentor me in my transition into private practice. In return, I hope to offer the office a fresh perspective, techniques based on latest research, and young enthusiasm.”
William (Penn ‘21) – “My ideal work situation would entail a private, small-town general dentist practice model in which I have a close association and strong working relationships with nearby specialists as well as a dedicated team of associates and hygienists working together to care for our patients.”
Who is the ideal candidate to buy your practice?
Ann (VCU ‘96) – “Someone who has been in an associateship who is ready to own their own business. They have good dental skills and speed but need a business transition.”
Dan (Maryland ‘85) – “Someone who has a similar practice philosophy with great clinical skills. I was fortunate.”
What do you find potential practice purchases are lacking? What would make a practice appealing to you to purchase? What would be a deal breaker in a purchase proposition?
William (Penn ‘21) – “I feel that location would serve as the most important factor in any practice purchase, as well as factors such as insurances accepted, net income, and active patients.”
Amy (Penn ‘20) – “A potential deal breaker would be poor staff cooperation and office environment. Taking on improving an office culture to be collaborative and efficient is an extra endeavor that does not seem appealing in what is already such a large investment.”
What was the cost of your practice? Describe your practice when you purchased it.
Ann (VCU ‘96) – “I started the practice from scratch in November 2002. I built the unit with four operatories. I only equipped two to start. Within six months, I equipped the third and by the end of year one, I had all four equipped. I started with an assistant and a receptionist and my husband doing the office manager. Three months in, I hired a full-time hygienist. Eight months in, I hired another receptionist. By month twelve, I hired my second full time hygienist. I did not take a salary the first six months.”
Dan (Maryland ‘85) – “Startup cost was about 100K, but the buildout of the office was covered by a community association. We had one fully equipped operatory and another with a chair and light to screen emergency patients. We had no staff, my wife assisted. She learned quickly and we’re still married.”
Carol (Penn ‘88) – “The cost of my practice was $230,000. The building was $110,000 and the practice was $120,000. The practice building was 800 square feet and had three operatories. No hygienists and only one 60-year-old office employee. I don’t remember the exact number of patients because back then there weren’t computers, so the data wasn’t easily available.”
What struggles did you have or anticipate having when looking for a job or purchasing a practice as a young dentist?
Monica (Temple ‘23) – “I anticipate having over $500,000 in undergraduate and graduate student loans. The prospect of owning a practice is particularly daunting with this in mind.”
William (Penn ‘21) – “I anticipate that as a young dentist, there will be a period of time following graduation in which I will be acclimating to the business side of dentistry while simultaneously developing my skills and speed as a provider in practice. Ideally, I would like to practice in an environment with a support system in place that allows me to hone those skills.”
Do you expect/hope to work in the same location for more than ten years, or do you think you will have to jump around for most of your career?
Monica (Temple ‘23) – “Though I would like to avoid frequent moving, the reality is that oversaturation of certain areas tends to correlate with lower provider income. With student loan debt, I will need to heavily weigh the pros and cons of various options and consider moving away from familiar places where demand for dentistry is greater.”
William (Penn ‘21) – “One of the most rewarding aspects of dentistry that I am looking forward to is developing lifelong relationships with my patients and extending beyond the role of ‘dental care provider’ and into that of an overall ‘health care provider’ as a member of the community with whom patients feel a true sense of openness and trust.”
Describe your ideal retirement situation.
Carol (Penn ‘88) – “My ideal retirement situation is to one day retire and still be able to practice a day or two a week.”
Ann (VCU ‘96) – “I would love to either mentor someone for three years. This person would purchase 50% at year one, then purchase the remaining at year three. That would be my idea. I want to teach a new dentist or new owner how to run the business aspect. Otherwise, I am willing to sell and stay on for six months to help the new owner transition and maintain patients.”
Jack (Temple ‘81) – “I would like to continue to work and utilize my skills, as far as my physical abilities (eye sight, etc.) allow. I presently have associates who share our ethic and philosophy of practice. This culture of service can continue.”
What future struggles do you think you will have that previous generations of dentists have not or will not have?
Monica (Temple ‘23) – “In the case of single payer healthcare system, private insurance would not likely be competitive. If this trickles over into dental care the possibility of decreased reimbursement rates in the absence of loan forgiveness may push some dentists out of the profession.”
William (Penn ‘21) – “I believe that navigating the insurance landscape will serve as an emerging obstacle for the next generation of dentists, as the Fee-for-Service model continues to drift into the background.”
Kevin (Temple ‘22) – “The sheer amount of new technology that needs to be learned to stay up-to-date.”
What skills are you finding that graduating or younger dentists are lacking?
Ann (VCU ‘96) – “People skills and relationship skills. They are so worried about doing high dollar procedures and making money, they forget to develop relationships. Relationships with your patients and helping them understand what is important and needed for dental health is the key to everything. Patients who trust the doctor will do the suggested dental treatment.”
Jack (Temple ‘81) – “It has always been the case that young dentists do not arrive in practice totally competent. It is their commitment to constant and never-ending improvement that accelerates their competency. Quality continuing education is the key to clinical advancement. You must be a perpetual student of your craft. You can take your practice in whatever direction you desire based on your clinical interests. This is the beauty of the profession.”
Michael (Pitt ‘83) – “The low experience level of many new dental graduates is unsettling. Some will graduate having done only one crown of an anterior root canal or a single denture while in dental school. They can, and do, go right into corporate dental practices which will soon require them to perform at a high level of production.”
Describe the lifestyle that you hope to attain as a dentist.
Kevin (Temple ‘22) – “I hope to be able to be worry free and be happy with the work I provide. Working ‘X’ number of days a week would depend on my schedule at the time, but more or less is not important to me as long as I am happy.”
Amy (Penn ‘20) – “I aim to have a light-hearted, friendly office environment with a team that understands, respects, and enjoys being with each other. Outside the office, I want to be able to raise a family as a working mother.”
What struggles have you encountered when talking to younger dentists about potential associateships, partnerships, or purchase propositions?
Dan (Maryland ‘85) – “Years ago, the first question asked was how much I was going to pay them. They did not ask about the practice or do any research on it. I know income is important, especially with the debt load students carry these days, but it shouldn’t be the first question in an interview. On the other hand, speaking with recent graduates, it seems that practice owners are trying to lowball the percentage of collections to associates, and instead build in somewhat unrealistic bonus schedules. What is most important is finding a comfortable philosophical match for both parties.”
Michael (Pitt ‘83) – “Many are first looking for high-paying jobs to pay down enormous student loan debt rather than go into a residency program or post-graduate program to further develop their skills. Many more are reluctant to buy in to a practice and further add to their debt burden.”
What skills are you finding that established dentists are struggling with that you could bring into a practice?
Ellen (Temple ‘22) – “Using new techniques, materials, and technology. I feel that older generations can use older techniques and materials because that is what they’re comfortable with.”
Monica (Temple ‘23) – “It may be my personal bias that the older generation of dentists do not as readily accept new technology or treatment options into their practice. There is definitely risk involved with accepting and incorporating new treatment methods. History has shown us that the newest is not always better, such as compomers, self-etching bonding, and early feldspathic CAD/CAM restorations. This conservatism can be balanced with newer dentist involvement in the current research to further advance dental science.”
Kevin (Temple ‘22) – “Language and cultural barriers. Coming from a bilingual background, I feel I can provide and expand the scope of my practice to understand the needs of more people.”
What skills do younger dentists have that you did not have when you graduated or do not have now?
Jack (Temple ‘81) – “Younger dentists have more implant driven clinical options. Implants were not common or predictable. Also, access to computer software programs that improve business systems and patient communication.”
Michael (Pitt ‘83) – “They are comfortable with the internet and most computer technology, and do plan to better implement technology into their practices.”
What challenges do you think older generations of dentists have experienced that you have not or will not experience?
Monica (Temple ‘23) – “I’ve been told stories of physical assault by faculty, racist comments, and general insults that have occurred to women and minority dentists of my parents’ generation. The dialogue now between students and faculty is more constructive in my opinion and I think that ultimately leads to better-trained dentists.”
Amy (Penn ‘20) – “I think the previous generation of dentists have had to deal with the inconveniences of pen and paper: Charts, lab communication, and appointment reminders. I am very grateful for the digital EHRs, CAD/CAM, and text reminders!”
What challenges do you think younger dentists are facing as they move into their future dental career path?
Jack (Temple ‘81) – “Demographics can dictate the type of practice you have (par / non-par) and the competitive challenge you face (number of dentists in your area). Dentistry is one of the last bastions of autonomy. Being your own boss has its price, but the freedom is priceless.”
Michael (Pitt ‘83) – “Student loan debt may prohibit some from pursuing continuing education to learn about our rapidly evolving practice technologies and new materials. New dental graduates are viewed as ‘low hanging fruit’ for employment by corporate dental practices due to their large student debt. The lure of a quick salary may limit their personal growth as dental professionals.”
Dan (Maryland ‘85) – “The changing scope of the practice setting. Dealing with corporate practice ownership and being an employee, decreasing insurance reimbursement and deceptive practices, and the push for increased independent mid-level providers.”
What challenges do you think established dentists are facing as they move into retirement?
Ellen (Temple ‘22) – “None, because retirement is great.”
Monica (Temple ‘23) – “I would imagine that with the increase in student loan debt among newer dentists, those seeking retirement are having a more difficult time selling their practice. The frequency of nomadic dentists temporarily working to pay off student debt may also discourage settling down or buying established practices.”
Amy (Penn ‘20) – “As new dentists graduate and are more and more interested in joining multi-doctor offices or DSOs than owning their own individually-owned practice, I think solo dentists will have a harder time marketing to the next generation that may not particularly want to acquire a single-doctor practice.”
Kevin (Temple ‘22) – “Finding young talent that have the drive to be better dentists over paying off loans.”
What do you look forward to doing after completing your career as a dentist?
Jack (Temple ‘81) – “We hope to leave the planet a little better than when we arrived…. not worse. If we have properly taken care of our family, staff and patients, (in that order), then we should be in a position to flatten the learning curve for the next generation through our example of effort and service.”
Michael (Pitt ‘83) – “Traveling with my wife to places we have always wanted to visit. Staying active, volunteering with church and community.”
Dan (Maryland ‘85) – “I’m pretty much there… It’s been a good career. It wasn’t easy, but through hard work and perseverance I can now relax. I like the term ‘delayed gratification’!”
At what age would you hope to retire from dentistry? How do you envision yourself getting there?
Monica (Temple ‘23) – “I would hope that financial stability from an estimated 20 years of working in practice would allow me to pursue other interests that may not provide the same level of stable income.”
Kevin (Temple ‘22) – “I am not sure. I will not retire until I feel I can no longer provide the quality and standard of care that I hold myself to.”
What has changed about your practice in the time that you have owned it?
Dan (Maryland ‘85) – “Over the years, we built out to six operatories and incorporated technology with Er:YAG and Diode lasers, Panorex, Cerec. We also stayed up to date with techniques and materials… Patient numbers grew as word of mouth was our best referral source.”
Carol (Penn ‘88) – “I now have 3400 square feet of space. I also now have 20 employees—a big jump from the one I started with. Also, I use a lot of technology. I got rid of the charts in 1995 when we went paperless, 1998 brought on digital x-rays, Cerec, Itero, Solea laser.”
Michael (Pitt ‘83) – “++ Light cured composites! Rotary endodontics! Digital dentistry, glass ionomer restoratives, VPS impression materials, and other new materials.”
What skills or experiences do you find earlier generations of dentists had learned that you wish were taught?
William (Penn ‘21) – “I find that earlier generations of dentists have an incredibly sound understanding of the principles underlying each procedure and every facet of the dental process, from simple operative procedures to lab fabrication of advanced prostheses. Though I currently have an understanding of these concepts on a fundamental level, I look forward to gaining more experience as a provider and seeing them come to life with each patient I treat.”
Amy (Penn ‘20) – “I do wish I could learn more of the techniques and intricacies of lab work to be able to better provide labs with quality impressions and instructions to ultimately improve the efficiency of my own practice.”