Work-life balance. A great income. The ability to own a business. The desire to work with your hands. The opportunity to change lives. Whatever your inspiration for pursuing dentistry as your career, you find yourself here, in the midst of the professional life you have crafted from your own desires. Perhaps this is the most obvious beauty of the dental profession; whatever it was that drew you to dentistry, your daily practice life can fit the mould you have envisioned.
This mould is created by you. What is desirable for one dentist is not necessarily desirable for others. Personal preferences, family considerations, risk tolerance, financial considerations, and a wide spectrum of business ownership interest influences the trajectory of every dentist’s career differently. Do you desire practice autonomy where you are the decision maker? Your mould may be private practice ownership. Do you desire to focus solely on clinical dentistry? Your mould may be an associateship. Are you an entrepreneur and envision a workday that doesn’t rein you inside one enclosed space? Your mould may be multi-practice ownership.
My career in dentistry began as an associate dentist, then progressed to private practice ownership as a partner, and now includes multi-practice ownership. This professional path has been personally rewarding; but, this path is not for everyone. Throughout my practice journey, I have confronted doubts, fears, and insecurities resulting from my chosen course. I have also reveled in the enjoyment of a fulfilling career and practice life that is a blessing to both myself and my family. Are you questioning your current practice circumstance? I’ve been there. Do you feel you are living your most desirable professional life? I’ve been there, too, as well as all points between these two extremes.
A career path sculpted from even your most personal best-laid plans can become tortuous and littered with obstacles you are forced to confront and overcome. In dentistry and dental business, no path is easy and no load is light. Our nature as caregivers and healers of the oral cavity sheds light into the dentist’s personality where we also feel the obligation to care for those around us: our patients, our dental team, and our families. We are susceptible to feeling the pressure encroaching on us from all sides. When I feel this pressure, an encouraging word from a mentor or an honest, heartfelt assessment from my wife provides the necessary fuel to propel me beyond whatever obstacle has risen before me. The obstacles that appear along the way don’t change my practice and professional goals; they are merely interfering with the process to achieve them. The path continues beyond the obstacles, but my shortsightedness steals my attention and disrupts my focus. Along the way, these instances of wandering eyes and drifting focus have allowed for tremendous personal growth in preparation for the next practice or professional obstacle. The career path you follow is determined by the goals you set for yourself; any obstacles you encounter on the way to your goal are mere distractions.
Only you can create your most desirable practice mould. Given the current climate in dentistry and dental business, there are more practice options than have been seen previously. No longer is a dentist forced to graduate dental school only to hang out one’s shingle to begin their professional career as a solo practitioner. Is this path still possible for dentists to follow? Sure. However, this isn’t the only path available to dentists practicing today. This evolution embraces the diversity of thought and makeup of the most recent dental graduates, whose ideal practice style differs greatly from the style a generation prior.
Dentistry is changing. The structure of dental practices is evolving, the practice desires of dental school graduates differs from past generations, and fewer dentists aspire to own a private dental practice. Women are now attending dental school in greater numbers than their male colleagues. Student debt has created an entirely new obstacle for dental graduates to overcome and has caused an alteration in what is considered an ideal practice scenario. Through the changes present today, there is no single path a dentist must follow to reach success. A number of options are available, and each individual has the freedom to choose their most ideal style of practice. Through this series, I will detail the path that has led me to my career today.
Your Career Doesn’t Have To Follow The Trends
Perhaps you are professionally burnt out. Or, you feel as if your career has stagnated and you’re open to change. Maybe you’re finishing dental school or a residency program and are searching for a fulfilling practice life. Whatever your reason for contemplating a major career move, a successful and happy resolution most easily comes from making an informed decision. Dentistry allows for you to act as the sculptor of your career. Since this possibility exists, it is beneficial to gain an understanding of the current trends in dental practice and the various directions you can point your career. With this knowledge, you can form the professional career mould that will be filled on your terms.
My professional career began in 2012. Though only 9 years have passed, the changes in dentistry have been great. For my class of 85 graduates, we sifted through the various practice options for where and how we would practice. The most common were entering active private practice, most prominently as an associate dentist, beginning a residency for general practice or a specialty, or practicing as a military dentist. Corporate dentistry was growing in prevalence at this time, but it was not a common pursuit of my classmates. Some were drawn to solo private practice, but it was a large minority who chose that path. Group practices were certainly present, but not to the degree they exist today. In nine short years, the practice options for graduating dentists have changed dramatically. Concurrently, established doctors find themselves in a changing professional climate as dentistry evolves around them. These changes are effectively impacting the careers of dentists at every stage of professional practice. If you’re sculpting your ideal career in dentistry, you may learn these trends and only see roadblocks for your dreams. Conversely, you may learn these trends and see tremendous opportunity to sculpt your most desirable career path.
The rise of dental group practice is perhaps one of the most impactful changes occurring in the profession. Defined as a practice with multiple doctors actively caring for patients or a practice with multiple locations, group practice has risen in prominence and desirability amongst the profession. A 2015 study published in the Journal of the American Dental Association found that dentists in small group practice reported the highest career satisfaction overall as compared to large group practice or solo practice. Those working in large group settings reported the highest satisfaction with their income and benefits received, as well as reduced stress, when compared to dentists in solo practice (1). Twenty years ago, nearly two-thirds of dentists were in solo practice. As of 2017, only 50% of dentists were practicing in solo practice. Among various age groups, the prevalence of solo practice is dropping for each. For dentists less than 35 years old, only 1 in 5 practice as a solo practitioner, and this reflects a 6% decrease from 2010 to 2017. For dentists age 35-44, there has been an over 8% decrease for dentists in solo practice in this same time period. Females are now entering the dental field at a rate equal to, or even greater than, males throughout the United States. Female dentists statistically work fewer hours per week compared to their male colleagues and are in solo practice at a rate nearly 20% less than their male colleagues (2). As for practice ownership, in 2017 dentists younger than age 44 owned practices at a greatly reduced rate when compared to 2005. Dentists younger than 35 showed an ownership drop of 16% in 2017 in comparison to 2005. The above figures only represent dentists in private practice and do not include statistics from dentists practicing in a corporate setting.
In conjunction with group practice, corporate dental practice is growing in prominence amongst the dental community, as well. In 2017, nearly 9% of American dentists were affiliated with a corporate dental practice. Women practice in a corporate setting at a greater rate than men, and nearly 1 out of 5 dentists younger than age 34 practice in a corporate setting. Some American dental schools report nearly 25% of the graduating class beginning their professional career in a corporate dental office. This trend toward a corporate practice structure continues to grow its prevalence in dentistry.
Taking a big-picture view of the trends, we recognize that private practice ownership is decreasing amongst dentists, especially younger dentists and women. We see that practicing as a solo dentist is declining in prevalence as group practices continue to become more common. We find that corporate settings are attracting statistically greater numbers of dentists than ever before, most notably amongst the younger generation and women. The days of most every dentist practicing by themselves as the sole owner of a dental practice are becoming farther and farther away.
You may see these trends and think, “This is where dentistry is going; this is how I need to shape my career to succeed.” However, your career doesn’t have to follow the trends. Are you a 30-year-old female dentist who wants to own a private practice, and you would love to be the sole practicing doctor? Create this mould. Shape this career. Live this dream. You likely did not pursue a degree in dentistry to be told how and where you should practice. The freedom is there to swim against the current and create the professional life of your dreams. If you want it, do it.
For as long as I can remember, I have been a dreamer. And a planner. And a serial goal-setter. I knew prior to gracing my first college class that dentistry was my pursuit. I applied to dental school as a college sophomore. Crazy? Probably. My goal-setting-self wanted to take the DAT early, wanted to “figure out” the application process, and wanted to learn from an interview if I were so lucky to receive the invite. That I did, and it helped me all the more as the more probable dental admissions process commenced following my junior year. Perhaps my tendency to dream has caused me to miss out on the precious present; that would be a fair criticism. Nonetheless, the tendency persists.
During my third year of dental school, my dreaming, planning, goal-setting self began seriously searching for the place I would begin my career. At this point, I knew general dentistry was my pursuit. I tried to maintain realistic expectations for where I could land and build my professional career. However, I believed that starting the search early would expand the potential opportunities to be discovered. Even at this point in dental school, I was sculpting the career I most desired. The pursuit began.
My dad was a business owner for nearly as long as my memory allows. I saw first-hand how rewarding business ownership could be and the community involvement and respect that could follow. I desired the same, but instead of being in the insurance business my pursuit was to own a dental practice. Purchase a dental practice right after school? I can do it, but is it smart? And this student debt… Join an existing practice and learn from a mentor? Sure! If the established doctor would like to sell it to me. Attend a GPR or AEGD and then purchase a practice? Maybe? Hmm…it really depends on if I strike out looking for a position in a private practice. My dreaming, planning, goal-setting self was pointed full steam ahead. Career sculpting was in process.
Every dental student or dentist has a myriad of decision points when determining the direction of his or her career. Where do I want to live? How do I balance cost of living with my debt load? What kind of practice do I want to be in? What procedures do I want to offer? Where does my spouse need to be for their career? Where will my kids, or future kids, be happiest? Should I work as an associate dentist? How quickly can I own this practice? The considerations are daunting. Perhaps women have an even greater amount of considerations while sculpting their career. What if my child is sick and I’m the only dentist in the practice? My childcare fell through at the last minute; what do I do? The recital is today and I have patients; how do I juggle being a mom and a dental practice owner? For any dentist, professional life and personal life is an act of multitasking. It’s yet another consideration that must be addressed as you’re sculpting your career.
Should I join this existing practice and learn from the established doctor? I was nearing the end of my decision. The dreaming and planning paid off; I found the practice I would join. I was in the first month of my fourth year of dental school, and the first recognizable piece of my career sculpture was revealed. The decision tree led me to join an existing practice as an associate; I would learn dentistry from a mentor dentist and gain business knowledge as my clinical skills progressed. One day, I would be an owner. The perfect opportunity for me to grow as a dentist, learn to be a businessman, and build a presence in the community. Dream realized.
1 Lo Sasso, Anthony T., et al. “Practice settings and dentists’ job satisfaction.” Journal of the American Dental Association, vol. 146, issue 8, 2015.
2 ADA Health Policy Institute Distribution of Dentists Survey, 2017. ADA.org/HPI