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Five Lessons Learned After Graduation by Christopher Mazzola, DDS

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As young professionals, we often assume that dentistry is easy - that the lessons we learned in school will be the pillars on which we build our careers. Over time, you will amass a multitude of these pillars. Dental school is outstanding in providing baseline knowledge to succeed, but the problem with this knowledge is that all dentists are compared on the same scale. Young dentists need to have proper resources - learning and advancing quickly - to decrease the separation between seasoned practitioners and themselves.

Your patients and staff want to feel that you love your career. Furthermore, you should be passionate about what you do. This idea may seem simple, but many practitioners rarely focus on it until they reach the twilight of their careers. Why is this important? So that your staff, patients and colleagues understand your drive for clinical excellence with every completed procedure, leading to unparalleled office cohesion and creating emotional momentum - the driving force that brings patients back to your office. Unfortunately, dentistry has become a commodity, meaning patients do not have to return to you. It's your responsibility to make them understand why they should.

The following are five significant lessons that I learned as an associate and practice owner.

Evolution, not Revolution

As young dentists, we want to hit the ground running after school. We hope to establish ourselves as bright, confident and clinically excellent providers. Often young dentists try to accomplish too much too soon, leading to board problems and selfconfidence issues. The meaning of the subheadline, "Evolution, not Revolution," is to take your career and grow with it. Allow yourself to be humbled, ask for help on a regular basis, learn, and create an environment where you may bounce ideas off of peers.

A dentist's personality can be described in one word: driven. We persevered through rigorous undergraduate studies, were successfully admitted to post-graduate work, and are now figuring out what dentistry will do for us. We like to assume we have the skills to complete any and all aspects of dentistry.

As young dentists, you need to critically evaluate yourself as a practitioner. Where do your skills lie? Are you skilled enough technically to take on a difficult case, or is the patient better served seeing a more experienced colleague? Diagnosing a patient's needs and reflecting on how to best serve the patient will help you grow. You'll recognize the aspects of dentistry that you need to improve on, and your patients will see that you care more about their health than their payment.

Patient Acceptance vs. Case Acceptance

As young dentists, we love to prove that we are knowledgeable and trustworthy. We enjoy explaining the intricacies of prep design or the stress strain curves of certain materials that make them a great crown choice. Truthfully, none of this matters to most patients.

The four years spent learning the language of this profession might hinder you when it comes to conveying the urgency of oral disease to patients in a way they'll understand. One way to create trust with patients is by making yourself interesting! Interact with them on a non-clinical level, injecting details of your personal life and keeping record of their response. Use that data the next time they return to reaffirm that you were listening.

No part of the dental boards tests your communication abilities. You must work diligently to develop these. Communication relies on your personal skills and your ability to connect, gaining patient acceptance. Believe it or not, your patient simply wants you to understand their circumstances. Ask, "How can I help you today?" The response will be overwhelming. You'll see higher case acceptance, allowing you to treat more.

As an owner dentist, earning patient acceptance is what facilitates your office's excellence each year. Many seasoned doctors leave personal connection to their hygienist or front staff - a dying method in our current market. Patients come to see you, after all!

Creating Financial Independence

Achieving financial independence in our current economy is unfortunately very difficult. The average graduating DDS is $250,000 in debt. The following charts illustrate the difference in debt payment when paid in 15 years vs. 30 years.

Debt Payment When Paid in 15 Years Debt Payment When Paid in 30 Years
Loan Balance
Adjusted Balance
Loan Interest Rate
Loan Fees
Loan Term
Minimum Payment 		$250,000.00
$250,000.00
6.80%
$0.00
15 years
$50.00 		Loan Balance
Adjusted Balance
Loan Interest Rate
Loan Fees
Loan Term
Minimum Payment 		$250,000.00
$250,000.00
6.80%
$0.00
30 years
$50.00
Monthly Loan Payment
Number of Payments 		$2,219.21
180 		Monthly Loan Payment
Number of Payments 		$1,955.78
360
Cumulative Payment
Total Interest Paid 		$399,457.00
$149,457.00 		Cumulative Payment
Total Interest Paid		 $704,075.00
$404,075.00

These charts are important, particularly to those graduating soon. Let's use the 15-year plan with a monthly loan payment of around $2,000. The average associate might have an agreement entitling them to 25 percent of production. For example, if production is $30,000, 25 percent would be $7,500. Let's assume 40 percent withholding for taxes, leaving $4,500 of post-tax dollars. After the $2,000 student loan payment, we're left with $2,500 to live with that month. Most of us have fixed expenses such as medical insurance, car payments, and mortgages that can pick away at that $2,500 very quickly.

How do we become financially independent? As young dentists, we need to forge and find a pathway to ownership. Financial independence as an associate is possible, but will take much longer, and you'll lack control of certain variables within your office. As a young owner, financial independence can be achieved through brand recognition. People will not know who you are - they'll know the dentist who has been on the same corner for 35 years. You need to get involved, join local young professional networking groups or a running club, and/or establish yourself as an active parishioner at a local church. The best advertising will come from your interactions with the community. Building these relationships allows others to gain trust in you, bringing them to your office and patient base. Then, as you evolve as an owner, you may be given the opportunity to invest in satellite offices and share your knowledge with younger associates.

Life-long Learning

There are many levels to life-long learning. At the most basic level, evaluate yourself critically, both in clinical work and patient interactions. How can you grow from each patient experience? How can you grow as an owner and boss from your staff interactions? The number-one reason why people leave a position has nothing to do with money and everything to do with their leader.

On a grander scale, seek out different forms of continuing education. You will soon discover a facet of dentistry that you are passionate about - then you may focus on developing your continuing education curriculum.

Make Your First Career Choice the Best Career Choice

There are several choices post-graduation:
  1. Specializing
  2. General practice residency or advanced education in general dentistry
  3. Independent private practice
  4. Group practice
  5. Public health or military service
  6. Academic dentistry and/or research
Finding the right fit can be difficult - I can speak for three of these six. My experience in a private practice was outstanding as far as learning goes. The market focused on comprehensive casework, and I learned the principles of smile design and fullarch therapy. However, there are many older dentists looking for an associate or partner who have been practicing their way since they opened their office, holding certain beliefs on how dentistry should be practiced and certain expectations for how patients will be treated under their roof. Assessing the morals and ethics of an office can be difficult until you are immersed in its clinical culture, and it's alright if you do not fit into it.

Unfortunately, a reputation in dentistry takes years to build and seconds to destroy. You have to be careful if you stay somewhere where the work does not meet your clinical standards, and you'll need to discuss these issues and quickly resolve them. If not, you need to think about whether or not you want to stay. Even though you are not treating the other doctor's patients, you are still under the umbrella of the office's name.

Leaving an office is difficult, but can be refreshing, allowing you to learn from seeing how another office is run, how patients are treated, and what other treatment philosophies exist. My fit was - and is - a group practice supported by a dental support organization. I am given the business support I need managerially, the ability to own multiple offices, and the ability to mentor new graduates. I am also a clinical instructor presenting on patient interactions and treatment planning, and finally get to practice dentistry the way that I was taught.

Author's Bio
Dr. Christopher Mazzola is a general practitioner and an owner of The Springs Modern Dentistry in Colorado Springs, Colorado. He is a graduate of the University of Michigan School of Dentistry. His accolades include winning the University of Michigan 2009 Academy of Cosmetic Dentistry Award. His practice is supported by Pacific Dental Services.

Dentaltown Magazine
April 2024
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