After I graduated dental school and a general practice residency, I was full of youthful optimism. I was ready to join a practice as an associate and take on the world. Unfortunately, some of that optimism was misplaced. There were a few realities that were waiting to hit me in the face…
(1) I am going to make lots of money
Not fresh out of dental school, nope. Some new graduates do extremely well in their first couple of years, but they are the exception. You will make a good living but don’t assume that piles of cash are about to fall upon you until they actually do. Which leads me too…
(2) I should buy lots of nice things
Enjoy your life. Money is meant to be spent. I appreciate the finer things in life like good food and better wine. And you should spend your hard-earned money on the things you need and want. But for heaven’s sake don’t go crazy. I know… it’s been many years of education and we’re excited to finally earn a paycheck. But be smart with your money. Wait at least 6 months before you make any major purchases (or lots of little ones).
When I started as an associate, I was promised a lot more money than I actually made. Good thing I didn’t buy a house or car I couldn’t afford based upon a couple of paychecks and promises of glory. I waited to see what my real earnings would be and held them against my expenses. Then I had fun with what was left over.
(3) Right and wrong is as different as black and white
It turns out there is a lot of grey. I consider myself to be an ethical dentist. I don’t lie, cheat, or steal, which is a good start. I heard in dental school about unethical dentists who committed insurance fraud or broke the law in some naughty way. “I would never do that,” I told myself. And I haven’t.
But I didn’t realize that there are numerous scenarios that I would be faced with that were on vague moral ground. For example:
A patient presents with a two surface amalgam with small recurrent decay. You treatment plan a two surface resin restoration but the owner dentist tells you that the tooth should get a crown. The width of the amalgam is a little more than a third of the occlusal plane; not massive, so you thought a resin would be fine. But the owner dentist insists that a crown is the better choice. He explains that he’s been around a long time and medium-sized composite resins tend to fail in a few years. Why not do a restoration that has a better prognosis and will ultimately save the patient money, assuming the failed resin would then require a crown in a few years anyway?
I’ll go into my solution to this problem in future post, but suffice it to say that each of us must face decisions like this where there is no clear cut, “correct” answer. We must rely upon our clinical judgment and personal moral compass to guide us through the grey areas. And when all else fails, contact your fellow dentists and dental society for advice. By the way, check out this post for some scary associate stories.
(4) I will eventually own the practice I join
Finding the right practice is like dating. Did you marry your first girlfriend/boyfriend? There are a number of factors that will influence your decision to stay with your job and see it through to ownership (check out this post for some guidance). Many dentists bounce around a few different gigs until they find the right fit. In my case, I never did find the right fit, so I opened my own office.