Monday, November 5, 2012

The Current State of Blah

When I got into dentistry, every person in the field that I shadowed/spoke with was so excited about my decision.  They all claimed it was perfect timing.  I would be graduating just in time for all those baby boomers to retire and sell their lucrative practices to me.  If I had known this was total BS, I may have chosen a different career path.  Well, not really.  I do think this job in itself is awesome.  I truly enjoy being a dentist; however, the actual state of our profession for young dentists is absolutely atrocious at the moment.

Firstly, the cost of becoming a dentist is unrealistically absurd.  I went to a freakin’ state school, was a resident of said state, had my parents PAY for housing, and still left with 250,000 in debt.  My wife is from New Jersey, so her out of state tuition was about 500,000.  Do the math people, with the friendly interest rate of 6.8%, we will essentially be paying back well over a million.  A MILLION!!!!

But hey, dentists are rich right?  They make tons of money right?  WRONG.

ESTABLISHED practices that are OWNED by a dentist make money (usually).  New graduates make very little in comparison.  Now money is all relative I suppose and if some dude who manages a McDonalds read this, he would tell me to shut the hell up.  The amount of money I make is a lot more than most people, this is true.  However, most people aren’t crippled with 5K in loan repayments every month either.  They also didn’t spend an extra five-years after college to earn that debt reward.  We essentially are paying for two houses at the tender ages of twenty-eight.  What’s tougher is that the job market (particularly in Chicago) is non-existent.  Nobody wants to retire, and nobody wants to hire.  New grads are essentially shoe-horned into corporate dentistry which is a topic for another day.

The extreme debt also makes it nigh impossible to buy/start your own practice.  No bank is going to loan you 500k-1mil when you already owe the government 750k.  And hell, I would probably go insane with that much debt.  This leads me to a quote one of our instructors said in school.  “As a dentist, you are always going to be in debt, you just learn how to manage it.”  Depressing…but seems true at this point.

You know what else nobody tells you? How much money it costs to stay a dentist after you graduate – having lawyers bleed you for incorporation/contracts. Paying for your license, malpractice, paying for CE, paying for paying, everyone wants a piece of you because you’re a dentist and you’re supposedly wealthy.
Now my original job was lined up nicely, I was going to come back from my honeymoon and start in August. Basically, we couldn’t come to terms on a contract. The reason we couldn’t, was because the owner did not understand the concept of negotiation but led me along like he did. The original contract had me as an Independent Contractor which essentially lets your employer skimp on paying any of your taxes. Most contracts for associates have you as an independent contractor and I understand this. I figured it couldn’t hurt to ask though, so I inquired if he would be willing to make me an employee instead. He offered NO resistance whatsoever to this suggestion and even asked me to have a contract drawn up. So after shelling out hundreds of dollars for a lawyer to do just that, he calls me up and tells me has another applicant in mind who IS willing to be an independent contractor and I would need to take the original contract to be on ‘level playing ground. 
Horseshit good sir. Horseshit. I forgot to mention that he told me point blank he was not interviewing anyone else. So was I applying other places during this 4-week negotiation-nope. So I bowed out. Frustrating as hell, but an excellent learning experience. I learned that most dentists don’t know anything about business. They just do whatever their lawyers or accountants tell them to do. I can’t blame them either, I know nothing at this point myself but I definitely hope to learn.  

This was all back in September so I’ve been scouring the lands trying to find another opportunity ANYWHERE. Nobody replies to classifieds, I have been mailing my resume to tons of local doctors in hopes of finding a lead. Nothing. Zero. Zilch.

OK, it is rough, but I am also complaining more than necessary.  We aren’t being starved out or anything, but we really aren’t able to save or plan or do any of the things most young married couples get to do.  Kids?  Hell no, can’t afford that.  Buy a house?  Same thing.  Now obviously this will change in the coming years, but these are issues I wish I had been more prepared for.  I did five extra years of education so that I could enjoy a career and have a life outside of work, it seems like that isn’t on the table currently.

But hey, my life mantra is that “everything will work itself out in the end.”  And guess what, it seems to be happening.  The office my wife works at is owned by an older doc who wants to cut back.  This equals job opening for me.  The place is established and successful.  We aren’t really interested in buying-into it because it's on a larger scale than we are currently interested in, but it will be a great place to learn both the clinical and business ends of dentistry.  It also pays better than any other office I have looked at.  I start in January 3-days a week (plus more when the head doc is on vacation). 

I am working part-time in a public health clinic right now, filling in for a dentist on maternity leave.  I’m actually enjoying it more than I expected (namely because the staff is fantastic).  Public health is a whole other can of worms though that we will not broach today.
I guess the frustrating part is that I don’t feel the residency helped me at all in terms of finding a job.  However, I still wouldn’t change my original stance.  I feel the learning I did in that short year will translate positively into my clinical interests, strengths and goals as I develop throughout my career.
So 2013, the year I actually start a solid, not transient job – hooray!  2012 has been tough these last few months – but it has thickened my skin and made me stronger and smarter.  I realize now that dentistry is a lot like any other job.  You still have to pay your dues and work the trenches as a newcomer.  And hey, having so much time off these last few months has helped me develop important life skills such as cooking and exercising regularly.  I have probably never lived so healthily in my entire life.  Of course now that I am getting older, this is far more necessary as my metabolism can no longer support fast food every week.

So to all the aspiring young pre-dents out there.  This post is not intended to scare you away.  This profession still is great and has so much to offer.  However, it would be wise to have your expectations tempered just a bit so that reality doesn’t crush your skull in after graduation.  If you don’t have family in dentistry, and aren’t willing to move ANYWHERE in the country, finding a good job takes time.  Most associateships don’t work out either, it’s like dating – awkward, fun, frustrating all at once.  You need to spend within your means as well.  I still drive the same POS I had in college and I’m fine with that.  All the extra money goes into slaying the debt monster before he devours me whole.

And I’m spent.