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Special Section for New Dentists: 19 Financial and Clinical Lessons for New Grads by Dr. William Jacobson

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19 Financial and Clinical Lessons I Wish I Knew as A New Dental Grad

by Dr. William Jacobson

I graduated from dental school 10 years ago, so I can relate to being a new grad. I remember embarking on the job search. My start was bumpy. I was promised a full-time job at the Veterans Affairs (VA). Thrilled for this, I moved to Los Angeles to begin work, and while my paperwork was being processed at the VA, there was an immediate hiring freeze! I had an apartment, no income to pay rent, and a landlord telling me I must continue paying rent even if I moved out until she was able to find a new tenant. But what incentive would she have to find a new tenant? How could I afford this?

This was the start of many painful lessons. I want to share 19 of these lessons with you in two categories: financial and clinical.

Financial advice
*Disclaimer, I’m not a financial advisor but I’ve learned a thing or two about a thing or two.

1.  Have an emergency account!
Life is an unpredictable adventure. You could become unemployed, have an unexpected expense (car problems, health care-related expense, theft), and need money. Calculate your monthly living expenses (rent, utilities, food, gas, renters’ insurance, auto insurance, etc.) and multiply them by six months. The total is the amount you should strive to save up. Do not touch it unless it is a true emergency.

2.  Checking accounts collect dust.
If you have money for your emergency account, do not let it sit in a checking account. These do not grow. It’s analogous to keeping this money in a shoe box. Don’t let the money sit in a bank savings account either; these grow only 0.01% per year. If your emergency account is $30,000, then it grows $300 per year. Instead, open a high yield savings account where it can grow about 5.1% per year, which would be $1,530 a year for that $30,000.

3.  Buy a pre-owned car.
If you need a car and decide to buy a brand-new one from a dealership, the instant you drive off the lot, it will depreciate by about 10%. Do you want to throw thousands of dollars out the window? And when it’s time for oil changes and tire rotations, avoid dealerships. They will over-diagnose and over-treat; instead, find yourself a trusted local mechanic.

4.  “You’re way too young to be saving for retirement.”
This was the wrong advice given to me. Because of “compounding interest,” you are never too young to begin saving for retirement. If you start putting money away for retirement at age 40, you could never catch up to what you could have if you started at age 30.

5.  Ask yourself, “Is it a want or a need?”
This simple question was popularized by financial advisor and author Suze Orman. Try not to become a victim of consumerism and materialism, and embrace a minimalist lifestyle. I know, it’s not for everyone. Things you want now will not be important to you later. Think of a child wanting a specific toy. Do you want that same toy now as an adult? It’s OK to buy wants, but try to limit these.

6.  Say “yes” to a 401(k).
If your job offers a 401(k) with a matching percent, accept it. Otherwise, you leave free money on the table. My goal was to maximize my 401(k) contributions every year, until I learned the next valuable lesson.

7.  Have a non-retirement brokerage account.
There are major financial penalties and taxes if you take money out of your retirement plan early (before 59.5). Imagine this scenario: all your savings have gone into your 401(k) retirement account, you’re not yet 59.5 years old, and now you want to put money down for a house! This is where a non-retirement investment account can really help. And it can grow about 10% a year if invested in the S&P 500.

8.  Do not lend more money than you are willing to gift someone.
So now you’re a dentist, congrats. However, now your family and friends assume you are “rich” and minimize the burden of student debt (which most of us have) and life’s expenses. Siblings and friends may ask you to lend them money. If you lend them money and they are unable to pay you back, this can erode the relationship. Sometimes people don’t pay you back because they’re never financially caught up, while others have zero intentions to pay you back.

9.  Other expenses you cannot overlook in addition to living expenses:
  • Disability insurance: If you become disabled (physically/mentally) and cannot work to pay your bills, you will be in a dire situation. Sign up for long-term disability insurance. I use Principal. While I dread paying it every year, I know I am protected until I reach the age of 70.
  • Malpractice insurance: If you work for a federally qualified health center, you have great malpractice insurance through the government at no additional cost. If you work for a private practice or own a practice, this expense is on you, and it’s crucial to have.
  • Medical insurance, prescription insurance, and dental insurance. You could be healthy today, and tomorrow have expensive medical bills that push you into poverty. This is not an area you want to skimp on.
  • Life insurance: Especially if you have children.
  • Student debt. Everyone’s situation is different. Maybe your parents paid for dental school, perhaps you’re on a scholarship, maybe you have $100K in debt, or $700K in debt. You cannot file bankruptcy on student debt. Find what works best for your situation, whether it’s public service loan forgiveness or refinancing your loans with a lower interest rate with a private company, and calculate this into your monthly budget.
10.  Find out what happens if you must break a contract early.
This could be a one-year apartment lease or an employment contract. I had a friend who worked at an office that required a four-month notice to quit. She was unhappy at the job, but when she looked for other job openings, none were willing to wait four months for her to join, which made it difficult for her to leave the practice. Plus, if it’s a bad situation, imagine being stuck there for another four months.


Clinical advice
11.  Don’t focus on regrets.
The practice of dentistry is humbling. It can be so deeply disappointing to make a mistake when you’re expected to be perfect. My best friend told me once, “You made the best decision you could at the time with the knowledge you had.” Her words of radical acceptance were truly helpful, and perhaps they will help you, too. Just try to learn from errors so you don’t make the same mistake twice.

12.  Learn how to manage dictators.
While this confused me as a new grad, it is crystal clear now. Some patients will try to tell you what to do. You’re so used to being told what to do since you were born, whether from parents, “grownups.” teachers, professors, etc. Suddenly, now you hold a dental license; however, doing what your patients demand can put your license at risk, along with their health. So, remember this: You must be able to diagnose and treat disease. If a patient is preventing this, seek to understand their reasoning, educate them, but if all else fails, recommend the patient seek care elsewhere. Some things are optional in dentistry (ortho treatment, crown material type, cosmetics), and some things are not optional (obtaining a full health history, taking radiographs to diagnose, endo testing, periodontal charting, deep cleanings, fillings, and extracting non-restorable teeth). If someone is trying to twist your arm into doing something, just say no; it is not worth the sleepless nights and worrying about your dental license. Don’t just listen to your gut, act on it.

13.  Do not take things personally.
People’s opinions of you are not facts or truths. You will meet people who have a lot of baggage. You will meet people on days when they are not the best versions of themselves, because they’re phobic, in pain, or a combination of these two. Take a deep breath in and out. It is not you, I promise.

14.  Learn how to project confidence.
Some of you already do this, but for most, it can be very hard to project confidence when you’re a new dentist. You’re overwhelmed, anxious, and inexperienced. Discover the benefits of power poses and effective body language.

Two reasons you should project confidence are the following:
  • Most patients are anxious to go to the dentist, so if you don’t project confidence, they will have even less trust in you and feel more anxious. This, in turn, will make you even more anxious.
  • Sadly, people will treat you worse. It could be your assistant, your boss, or your patients. So, stand tall (keep your ears far from your shoulders), take up space, don’t have dodgy eyes, and stop apologizing to the world for existing.
15.  “Patients don’t care what you know; they want to know that you care.”
My dad taught me that phrase. You will not know everything. No one does. But you have to know where to get the answer. It’s OK to tell your patients, “I’m not sure, but I will get back to you.” Do your research and get back to them. While I thought saying this would make me look unqualified as a dentist, to my shock, patients respected me even more. They appreciated my honesty, that I cared enough about them to do the research, that I was reliable, and got back to them.

16.  Don’t forget about evidence-based dentistry (EBD) and primary sources.
For example, if a child comes in with an avulsed tooth, go to the International Dental Traumatology Guidelines. If you don’t know how long to light-cure a product, go to the product’s manufacturer’s guidelines. Do not just ask whoever is closest to you (coworker, assistant); this is your dentistry, license, and reputation. I recommend creating a binder that contains all the package inserts for your dental materials and equipment.

17.  Find a mentor.
It’s hard to find someone who is willing to spend their time mentoring you. Also, someone could be a great clinician, but a bad teacher, which doesn’t help you if you’re trying to learn. You will likely learn things of value from many different people and, over time, piece these things together. Since I couldn’t find a mentor, I focused my energy on the next lesson.

18.  Become self-sufficient.
No one is looking out for you. It’s a dog-eat-dog world. Put in the work, invest in your education and additional training, consult specialists, consult physicians, consult pharmacists, go to the literature, and become the dentist you’d like to go to.

19.  Learn from every patient encounter.
This was my mantra in dental school to help reframe my anxiety to focus on a positive outcome. So, I typed this mantra, printed it, and taped it to my apartment door. Every day after school, residency, or work, I’d ask myself, “What went well? What would I do differently? What is the answer to the question I asked myself while drilling that tooth? What is the answer to the question the patient asked me, which I need to research?” Make a commitment to lifelong learning. That is what we do as dental professionals. This is not just a job where you clock in and out.

Advice #18 and 19 are close to my heart because this is how I wrote my book, Clinical Dentistry Daily Reference Guide. I wrote the book I wanted to read. I was running around the clinic constantly looking things up in various resources like my phone, textbooks, dental school notes, and consulting specialist colleagues. This was not an efficient use of time. I needed all this information in one resource. So, I put in the time and wrote this book from scratch. All my daily lessons, all my knowledge and experience, clinical pictures, EBD guidelines, collaborations with specialists and pharmacists, procedural steps, and real-life patient questions and answers. It is a resource I rely on daily to this day in the clinic for clinical decision-making. Someone told me, “If you have dreams, chase them.” Writing this book was one of my dreams as a new grad. If you have dreams, I encourage you to chase them, too.
Author Bio
Author Dr. William Jacobson, DMD, MPH is a general dentist, clinical assistant professor, curriculum consultant, and the author of Clinical Dentistry Daily Reference Guide, a book to help dental students and dentists with day-to-day decision-making for a myriad of clinical scenarios. The book is available on Amazon.com. He is also a member of the Dentaltown Editorial Advisory Board. Website: williamjacobson.net.
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