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Life After Dental School by Todd Cockrell, DMD

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by Todd Cockrell, DMD

In early July 1994, my dad and I were finishing a weeklong fishing trip in Northern Wyoming with my two uncles and my cousins. My dad, a successful dentist and avid fisherman, had recently introduced me to fly fishing and I was completely addicted. The trip was incredible and the fishing was great. When our little group wanted to extend the vacation, I was surprised when my dad didn’t change our travel plans. He pulled me aside and, with a smile on his face, said, “Todd, you don’t quite understand, we have already been gone for a full week and if these hands aren’t working, there is no money being made.”

It was that simple conversation with my Dad that I define as the epiphany moment in my life. On that fishing trip, in Devil’s Canyon, Wyoming, I refined what I wanted to create in a modern approach to practicing dentistry. My focus and determination was to establish a career in dentistry duplicating what my father had done in creating a quality reputation and in developing lifetime relationships with patients, yet incorporating even more freedom and financial diversity in how I would practice dentistry.

As I completed my undergraduate studies, the course of my life and goals evolved once again when I married. I recognized that my personal decision tree was now morphing to fit us instead of just me. I committed myself to a set of focus points for my career:
  1. I wanted to live where I practice and practice where I live.
  2. Reputation in my community is everything.
  3. Patient relationships and top quality care are priceless.
  4. Freedom and financial diversity would be possible in a group practice with associate partners who would work with me and for me.
By 2004, I had just completed my second year of dental school in Florida and my Dad and I were further engaged in conversations of whether I was coming back to Colorado Springs to take over his new practice.

With my focus on pursuing a unique modern practice approach, I decided to pass on the convenient and secure route of being the second-generation Cockrell in my Dad’s dental practice. My wife and I chose to focus on raising our family and practicing in our city of preference. We both had affinities for Phoenix and it also matched a healthy, growing demographic that I felt would enable us to lay the foundation of what I hope will be my future success story. Once we settled on Arizona, everything seemed clear and structured even though I didn’t have any other details finalized

My next step was to find clinicians who had found success in areas similar to my ideal goals and not to reinvent the wheel.

I began a rigorous process of due diligence in my second year of dental school. I intentionally pursued relationships with fourth-year dental students who I knew were going to Arizona. Spanning a period of approximately 17 months prior to graduation, I electively contacted, questioned, interviewed and shadowed five different dentists who had graduated prior to me. I coordinated multiple trips to Arizona, while still in school, which proved to be a challenge with my schedule, and I took notes of everything these young doctors had done and had not done.

Through my efforts I categorized and researched my opportunities as the following:
  1. Buy an old practice at a cheap price then invest to re-vamp the practice.
  2. Buy a newer practice and accept the higher price tag and pre-established reputation of the practice in the community.
  3. Build a practice from scratch and incur all start up costs, stresses and risks.
  4. Associate with an established doctor and look to partner or buy out in the future.
  5. Go into a group practice and hope to buy in as a partner in the future.
  6. Go into a corporate dental practice for a period of time to gain money and experience only long enough to open or buy my own practice.
Each of the opportunities offered an immediate solution to my need to start practicing, but none of them seemed likely to position me for realization of my personal goal to create a modern approach to practicing dentistry.

As I furthered my research of available practice opportunities, I came across and chose a unique group practice model – Dental Service Organization (DSO) – which provides business support services and includes buying power on state-of-the-art technology. This would not only enable my career vision and mitigate my financial risks, but actually propel it beyond what my own abilities could accomplish.

My overall vision was to create three state-of-the art practices in my first 10 years of practice to serve the community where I would live. The first practice would be my foundation practice where I could create my culture for serving patients and train my teams, then disseminate them into the two nearby practices also in my community.

Because I committed myself to a goal to live where I practice and practice where I live, my next step was to research areas of the Phoenix valley that not only appealed to my wife and I, but that could also support and perpetuate my vision for the three future offices. I needed new growth areas with family amenities and continued community growth for a 10-year timeframe.

As I began strategizing my financial needs to execute my business plan, I knew I would need to utilize deferments and forbearances on my student loans. I recognized that I would likely need to do this for as long as allowable so I could set aside as much money as possible to be able to accomplish my first practice. I accepted the necessary evil of allowing interest to accumulate for a period of time, understanding I could accomplish something of much greater value if I could start my first practice as fast as possible right out of school. I knew a couple extra years of maturation and value of a practice would more than cover the interest I was going to accumulate deferring my loan payments.

As for my current standing in my career, I feel fortunate and blessed to have been able to generate an income for my family with the freedom to have balance between my work and family life. I currently practice and have ownership in four practices in the same community in Phoenix where I settled five years ago. Many may say that I was just lucky or that my timing and place were just right, but I hold to the belief that persistence uncovers and creates opportunities. I have seen that calculated decisions can forge our futures and create progression. Intentionality, determination and focus allow us to create a plan for future success and achieve what we want in life. As you look to set your own goals for your future, I believe there are a few decisions you should consider as you plan for your dental career.

Decision 1 – Post-graduate Choices
There are several popular 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 with government
  6. Academic dentistry and/or research
This decision seems to be influenced heavily upon the individual’s preferences for the profession according to someone they know who has pursued a specialty program, gone into a general practice residency, or worked in a dental service organization, etc.

The decision to specialize or not is made early on in most cases or has to be in order to define how and where energy will be focused in dental school to accomplish the grades required in the competitive specialty programs. Waiting too long to decide on this one key point will single out many that wished to specialize but failed to plan appropriately to achieve notable grades to apply and be accepted to respective programs.

Military service is influenced by economic savings in dental school costs or desire to serve in the armed forces as a clinician. Again, this is a decision which requires adequate decisiveness early on in order to yield the full economic benefits.

Choosing to extend ones’ dental experience with additional training typically occurs by way of either genuine interest in a specific treatment field of general dentistry which the dentist has gained exposure to while studying, or is geared around boosting clinical confidence and speed through additional exposure to dentistry in a structured environment and program.

Some clinicians will gravitate toward this practice option after graduating if they have not yet decided on how or where they want to practice. It is in this circumstance that the young clinicians express they were able to constructively use their time directly out of dental school to earn a little money, get more clinical experience, and think out their “game plan” for how and where they want to take their career.

Decision 2 – Geography vs. Opportunity
I was once told by a wise man that you can gauge many choices in life by either geography or opportunity. If you imagine it as a spectrum where geography is on one end and opportunity on the other, you have to gauge where you fall and how that will impact your choices for opportunities. Some will be driven by a location they are committed to and cannot sacrifice and others will be mobile and willing to travel to where the opportunities lie.
This calculated decision, where you want to live, is likely one of the most powerful choices clinicians should make as early on as possible to allow themselves to focus their energy and resources toward their “game plan” while completing dental school.

Decision 3 – Practice Environment
The practice environment one chooses is likely predetermined by previous life experiences with the profession, personal work preference, financial needs, wants and/or demands considered. In addition, rising expenses with dental school education, higher student loan interest rates and limited opportunity for loan forbearance to allow building up new practices have all been factors changing the way young doctors approach this decision.

I am often asked how I determined which practice style was ideal for me. My decisions were based on a combination of the mentioned points, but also seeing my father’s practice and gaining exposure to technology advances in dentistry during dental school.

Many consider practice environments to be defined by one of the following:
  • Scope of treatment (family dentistry, cosmetics, etc.)
  • Location
  • Technology available
  • Patient volume per day
  • Patient demographic
  • Schedule (work/life balance)
  • Access to clinical mentorship
  • Available business support services
With all that has been referenced, regardless of where you stand in the decision-making process, there are some critical steps I would recommend you take into consideration:
  1. Invest time in the process
  2. Determine what is of most value to you for your career
  3. Make a plan and set goals
  4. Seek counsel from expert advisors who are there or have been there
If there is one thing I have learned it is that there is not just one way to begin a career as a dentist. I do believe that in order to achieve success, regardless of the career path one may choose in dentistry, there has to be intentional planning and preparation at all stages in your career.

Reality is that success isn’t happenstance. You are the only one who can plan and create your success story.

Author's Bio
Dr. Todd Cockrell is a 2007 graduate of Nova South Eastern University School of Dentistry. He has been a Pacific Dental Services-supported dentist since 2007, becoming an owner dentist in 2008, a multiple office owner dentist in 2010 and is now a regional owner dentist for the organization in Oregon where new offices are currently being opened. Dr Cockrell teaches and lectures on case acceptance and performance leadership to CE groups in the Western U.S. He is co-founder of Brazilian Smiles (a nonprofit medical/dental group) and a member of the ADA, AZDA and ODA. He, his wife and three children live in Phoenix, Arizona where he currently practices.
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October 2025
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