What Will the 2020 Census Reveal About America?

By: Shannon Patterson, CPR, CMSR
Kolbe Certified™ Consultant
Director of Practice Opportunities

The new census data will show us that our nation is experiencing stagnate growth, with an aging population and a declining birth rate. With fewer births, more deaths, and uneven immigration the 2010-20 decade was the smallest decade of growth in U.S. history including the Great Depression of the 1930s.

Let’s look at what factors have contributed to the slow growth rate in the U.S. population.

Declining Fertility Rates and More Deaths
Unfortunately, the past decade reveals a nation with unprecedented growth stagnation and a steep decline in the under-18 population. As our nation continues to age and baby boomers reach retirement, the gap between births and deaths narrowed with the number of births outnumbering deaths nationwide by fewer than 1 million for the first time in decades. Between 2010 and 2019, our millennial generation aged into adulthood resulting in an astonishing decline in our under-18 population, and the census projections indicate that our 65-and-over population will have a higher growth rate than our youth in the next decade. If any of you have listened to my lectures in the past you have heard me reference this as the “graying of America.” The newly released data shows that thirty states saw decade-wide population losses in their youth led by California which lost over 400,000. However, Texas gained more than 500,000 young people. We also saw four states Vermont, Maine, West Virginia, and New Hampshire have more deaths than births last year.

Immigration
Our population growth not only comes from natural births but also from foreign immigration. The estimated number of people moving to the U.S. annually from other parts of the world has steadily declined in the last four years. In 2016, the final year of the Obama administration an estimated 1,046,709 people moved to the United States from abroad. In 2019 that number fell to 595,000 due to the federal restrictions during the Trump administration.

Our states also experience population growth and loss by “domestic immigration” or “out-migration” this is when residents move from one state to another. In the past decade, the Northeast lost 2.5 million residents who moved to other regions in the U.S., led by the state of New York which lost over 1.3 million residents over the past nine years. The second-largest exodus of residents due to out-migration is the Midwest, with over 1.6 million people relocating to other states. Of those 1.6 million, over 865,000 residents left the state of Illinois. California ranked third in out-migration losing over 912,000 residents but gained over 1 million foreign immigrates from abroad. Why did these states (California, New York, and Illinois) experience the biggest domestic out-migration shift in the nation? Demographers suggest that we saw this population shift due to the states’ high tax structure and unaffordable housing. Many of these residents relocated to other parts of the country that offered a better economy with lower taxes and affordable homes.

On the flip side, other states benefited greatly as residents crossed state lines. Texas takes the top spot gaining over 1.1 million domestically and another 818,000 coming from abroad since 2010. The state of Florida also saw tremendous growth with 1.2 million residents moving in from other states. Five other states grew by 15% including Utah, Idaho, Nevada, Colorado, and Arizona. The data also shows that Oregon, Washington, North Carolina, South Carolina, Georgia, and North Dakota grew by 10%. States that experienced moderate growth included Virginia, Tennessee, Oklahoma, South Dakota, Minnesota, Nebraska, Montana, and Massachusetts – the only New England state to benefit from out-migration. Four states including West Virginia, Illinois, Connecticut, and Vermont showed absolute population losses over the decade. The state of West Virginia exhibited population losses for seven years in a row, while Illinois and Connecticut did so for six years, and New York for four years.

What Do These Demographic Trends and New Data Show Us?
It certainly indicates that we have an aging workforce. Perhaps more impactful is the shifts in state populations that will likely have consequences when the U.S. congressional districts reappoint seats based on the new census data. After all, the constitutionally mandated purpose of the decennial census is to apportion members of the U.S. House of representatives in each state based on population. Right now, the projected redistribution of our population indicates that Texas could gain three seats and Florida could gain two. Five other states could gain one congressional seat including Arizona, Colorado, Oregon, Montana, and both Carolinas. A whopping ten states are projected to lose a seat including; Minnesota, Illinois, Michigan, Ohio, Pennsylvania, New York, Rhode Island, West Virginia, Alabama, and most notably California which could lose a congressional seat for the first time in history.

It also indicates that, over the next decade, the two factors that contributed to our nation’s slow growth rate – low birth rates and increased deaths – will continue as the population ages. As baby boomers continue to age into retirement our nation will depend on the youth populations to increase, which will most likely come from immigrants and their children. The census bureau projects that after 2030, immigration will account for more than half of our nation’s population growth. This means as we head into the next decade immigration is something, we should all pay attention to because it will be a vital contributor to our nation’s economic health. As our nation continues to age and our population growth stagnates, the 2020s will become a crucial period for all of us to understand the role of immigrants and how they fit into our society and workforce.

As an orthodontist, it is important to understand and pay attention to the changing patient population around your practice. For example, if your target market is based on adolescents watch the population shifts in your elementary and middle schools; if your target market is based on income and jobs in the area be aware of companies’ growth and/or relocation status; or if you experience a population boom from immigration understand those new resident’s ethnic background. As a practice owner understanding the population shifts and demographic character changes in your community is extremely beneficial if not crucial as it allows your practice to make adjustments in marketing for future patient acquisition.

Orthodontic Practice for Sale: Montgomery County, Pennsylvania

An established, multi-location orthodontic practice located in Montgomery County, Pennsylvania is for sale.

An established, multi-location orthodontic practice located in Montgomery County, Pennsylvania is for sale.

Montgomery County is home to Life, Liberty, and Pursuit of Fun. It is the third most populated county in Pennsylvania and in the top 100 most populated counties in the nation. Residents have formed a close-knit community making it a great place to live, work, and play.

The county offers some of the highest-ranked public schools in the area making it a great place to raise a family. Additionally, it’s ranked as one of the best places to live in Pennsylvania, and the residents take pride in their neighborhoods, streets, and many parks. Local shops and restaurants are close enough to walk to in downtown areas and there is easy access to many popular locations such as PhiladelphiaThe Pocono MountainsThe Jersey Shore, and New York City.

This is a great opportunity for someone looking to practice in a welcoming community with doctor mentorship. If you are interested in learning more about this orthodontic career opportunity, please forward your CV and letter of interest to shannon@bentsoncopple.com and shane@bentsoncopple.com.

Click here to view additional practice opportunities available from Bentson Copple & Associates.

Full-Time Orthodontic Associate Opportunity: Philadelphia Suburbs, Pennsylvania

A well-established multi-location orthodontic practice located in the suburbs of Philadelphia, Pennsylvania is seeking a full-time associate.

A well-established multi-location orthodontic practice located in the suburbs of Philadelphia, Pennsylvania is seeking a full-time associate.

This practice serves patients within some of the highest populated areas in Pennsylvania within the northern suburbs of Philadelphia. As a highly desirable place to live and work, the economy is thriving with several major employers driving stability and continued growth. Living so closely to Philadelphia allows access to exceptional schools, both public and private as well as some of the country’s best universities.

Entertainment abounds in the form of historical attractions, professional sports teams including the Philadelphia Eagles, the Phillies, the Fliers, and also in the arts with noteworthy museums, orchestras, and restaurants. Although residents enjoy quick access to the many amenities found in the heart of Philadelphia the northern suburbs of Philadelphia also offer beautiful natural scenery, farmland, and a charming small-town feel just beyond the bustle of the city. This is the perfect combination, allowing for the best of both worlds with quiet and beautiful suburbs just beyond the city.

If you are interested in learning more about this orthodontic career opportunity, please forward your CV and letter of interest to shannon@bentsoncopple.com or shane@bentsoncopple.com.

Click here to view additional practice opportunities available from Bentson Copple & Associates.

Full-Time Orthodontic Associate Opportunity: Columbus, Georgia

Smile Doctors is seeking a full-time orthodontist to join their team in Columbus, Georgia.

Join a great orthodontic team in Columbus, Georgia, as a full-time orthodontist.

THIS REMARKABLE CAREER OPPORTUNITY OFFERS:

  • $50,000 Sign-On Bonus or
  • Tuition Reimbursement ($100,000 over 5 Years)

Columbus is the third-largest city in Georgia. It is home to Fort Benning and full of things to do, great restaurants, and year-round events. The area blends vibrant artsy energy with unique local history. 

Columbus is home to the largest urban whitewater course which is one of the Top 12 Man-Made Adventures in the World according to USA Today. The city offers an eccentric entertainment district where you can visit uptown Columbus, enjoy the diverse nightlife, and experience a variety of entertainment. The locally-owned stores and boutiques welcome shoppers who enjoy the city’s easily walkable shopping district. Locals spend time at the Columbus RiverWalk, a 22-mile linear park located on the banks of the Chattahoochee River; it’s part of an expansive local trail system, that provides a blend of cityscapes and untouched wildlife.

Smile Doctors offers a competitive benefits package that includes:

  • Guaranteed Daily Rate & Production Incentive
  • Full Medical Benefits
  • C.E. Allowance
  • Life Insurance (company paid)
  • Clinical Mentorship & Doctor Coaching
  • Exceptional Clinical Support Team

Smile Doctors Mission:

Our mission is to brighten futures through authentic smiles within our communities. We love people first, straighten teeth second.  At Smile Doctors, we see people as people and embrace authentic smiles. Our people-first culture creates a fun-loving contagious environment with positive interactions that inspire team members and patients to uplift themselves and others within the communities we serve.

If you are interested in learning more about this practice opportunity, please forward your CV and letter of interest to shannon@bentsoncopple.com or shane@bentsoncopple.com.

Click here to view additional practice opportunities available from Bentson Copple & Associates.

Full-Time Orthodontic Associate Opportunity: Bainbridge, Georgia

Live, work, and play in Bainbridge, Georgia as a full-time orthodontic associate

Smile Doctors is seeking a full-time orthodontist to join their team in Bainbridge, Georgia.

THIS REMARKABLE CAREER OPPORTUNITY OFFERS:

  • $50,000 Sign-On Bonus or
  • Tuition Reimbursement ($100,000 over 5 Years)

Discover the true beauty and hospitality of the South, all with modern amenities in Bainbridge. The city is conveniently located in southwest Georgia and is within driving distance to many cities including Tallahassee, Florida. The cornerstones of Bainbridge’s outdoor activities are the Flint Riverand Lake Seminole, both offer abundant fishing and water sports. In fact, the Georgia State Legislature named Bainbridge The Bass Capital of Georgia. Additional outdoor recreation includes world-class hunting and tennis facilities, miles of trails, a BMX Pump Track, and the state’s first National Fitness Court. 

Bainbridge was named one of 2020’s Top 55 Micropolitan Cities in the United States by Site Selection Magazine, a leading economic development publication. Downtown Bainbridge offers quaint boutiques, eateries, and many friendly faces. The area hosts numerous community events throughout the year including family-friendly festivals, holiday parades, the annual Flint River Fair, and River Town Days.

Smile Doctors offers a competitive benefits package that includes:

  • Guaranteed Daily Rate & Production Incentive
  • Full Medical Benefits
  • C.E. Allowance
  • Life Insurance (company paid)
  • Clinical Mentorship & Doctor Coaching
  • Exceptional Clinical Support Team

Smile Doctors Mission:

Our mission is to brighten futures through authentic smiles within our communities. We love people first, straighten teeth second.  At Smile Doctors, we see people as people and embrace authentic smiles. Our people-first culture creates a fun-loving contagious environment with positive interactions that inspire team members and patients to uplift themselves and others within the communities we serve.

If you are interested in learning more about this practice opportunity, please forward your CV and letter of interest to shannon@bentsoncopple.com or shane@bentsoncopple.com.

Click here to view additional practice opportunities available from Bentson Copple & Associates.

Full-Time Orthodontic Associate Opportunity: Douglas, Georgia

Smile Doctors is seeking a full-time orthodontist to join their team in Douglas, Georgia.

Smile Doctors is seeking a full-time orthodontist to join their team in Douglas, Georgia.

THIS REMARKABLE CAREER OPPORTUNITY OFFERS:

  • $50,000 Sign-On Bonus or
  • Tuition Reimbursement ($100,000 over 5 Years)

Live, work, and play in Douglas, the county seat of Coffee County. It has all the amenities you will need to relax and enjoy the simple pleasures of a southern lifestyle. Rich in history and culture, the area offers something for everyone including a peaceful quality of life in an economically robust region. It is home to Broxton Rocks, which was named one of the 30 Natural Wonders in Georgia by the Atlanta-Journal Constitution and WSB-TV. Locals stroll the nature trails at General Coffee State Park and follow the trail of the rare gopher tortoise. For horse lovers, the park offers more than 13 miles of equestrian trails.

Douglas offers what your taste buds are looking for – all kinds of foods and menu options, including the kind grandma used to make. Farm fresh products are available at the Coffee County Farmer’s Curb Market, Red Brick Farm, or Deep South Growers. Shopping is abundant in Douglas with many local specialty retail stores or in the historic downtown which is known for unusual products, boutiques, and antiques.

Smile Doctors offers a competitive benefits package that includes:

  • Guaranteed Daily Rate & Production Incentive
  • Full Medical Benefits
  • C.E. Allowance
  • Life Insurance (company paid)
  • Clinical Mentorship & Doctor Coaching
  • Exceptional Clinical Support Team

Smile Doctors Mission:

Our mission is to brighten futures through authentic smiles within our communities. We love people first, straighten teeth second.  At Smile Doctors, we see people as people and embrace authentic smiles. Our people-first culture creates a fun-loving contagious environment with positive interactions that inspire team members and patients to uplift themselves and others within the communities we serve.

If you are interested in learning more about this practice opportunity, please forward your CV and letter of interest to shannon@bentsoncopple.com and shane@bentsoncopple.com.

Click here to view additional practice opportunities available from Bentson Copple & Associates.

Full-Time Orthodontic Associate Opportunity: Birmingham, Alabama

An amazing orthodontic opportunity with a “legacy doctor” in an orthodontic service organization is seeking a full-time associate in the Birmingham, Alabama area.

An amazing orthodontic opportunity with a “legacy doctor” in an orthodontic service organization is seeking a full-time associate in the Birmingham, Alabama area. 

Want to establish roots in an area ranked as one of the top 100 places to live in the country? Look no further than Birmingham! With a recent increase in dining, entertainment, sports, and job opportunities – many consider the area one of the best-kept secrets of the South! It has even been named one of the most affordable cities in Alabama and has quickly become a major festival destination in the Southeast.

Located at the foothills of the Appalachian Mountains, Birmingham is the largest city in Alabama. It offers easy access to Alabama’s Gulf Coast and other major metropolitan cities like Nashville and Atlanta. The area offers both excellent public and private schools and a major university.

The city has a mild year-round climate that attracts outdoor enthusiasts to play golf, bike, hike, and simply enjoy the outdoors. For individuals who would rather stay indoors – The Birmingham Museum of Art offers an impressive collection from around the world. The Barber Vintage Motorsports Museum is home to over 1,600 motorcycles and is the largest motorcycle museum in the world. Additionally, there are a wide variety of antique shops, upscale shopping opportunities, and small independent boutiques. 

This career opportunity offers the following benefits:

• Very competitive compensation package

• Medical/Dental/Vision/Life Insurance/Supplemental Benefits

• Coaching and Mentoring by “Legacy Doctor”

If you’re looking for a memorable experience to expand your career, please forward your CV and letter of interest to shannon@bentsoncopple.com and shane@bentsoncopple.com.

Click here to view additional practice opportunities available from Bentson Copple & Associates.

Associate/Employee Compensation Models for Orthodontists

Orthodontic Associate & Employee Orthodontist Compensation Models

By: Shannon Patterson, CPR, CMSR
Kolbe Certified™ Consultant
Director of Practice Opportunities

We get at least one inquiry a day about associate compensation either from an associate/employee orthodontist or a potential employer. In the past, the answer to this question wan average salary range, but the pandemic changed the compensation model for many employers. Now in 2021, instead of “What is the average annual salary for an associate?” we are hearing “Is it better to have an income guarantee (salary) or be paid based on a commission of production/collections?” 

One of the first questions I ask a potential associate/employee is “What is most important to you when you consider your overall compensation model?” This is somewhat of an emotional question for many associates because often these two models offer ‘certainty’ versus ‘incentive.’ 

What you have to ask yourself is, “Am I comfortable taking a risk for more income potential?” “Do I want to be compensated more when I increase production?” “Or do I prefer to have a higher daily rate out of the gate and know exactly what my income will be on an annual basis?” 

When considering your compensation model – consider these three areas:

1. Direct Compensation – Income guarantee which is paid either as an annual salary or a per diem 

2. Indirect Compensation – Benefits such as health insurance, continuing education, association dues, licensure reimbursement, and PTO

3. Deferred Compensation – Retirement plans such as 401K or profit-sharing 

When looking at these three factors you must decide what is most important to you. 

Let’s explore the two most popular types of compensation models in the orthodontic industry – production-based (PB) vs income guarantee (IG). It’s critical to understand the difference between these models in order to make an informed decision that’s best for you and your long-term plans and goals.

If you are a highly-motivated orthodontist, the PB compensation model may be very lucrative but you should also understand the model and formula on which you will be paid. I am receiving an increasing number of calls from associate doctors that are being offered to shift to this model after 12 months of employment. This provides you an opportunity to understand what your income potential will be, since you can examine the previous production average for the prior twelve months, minus adjustments (discounts, write-offs and insurances, and your benefits), and calculate the percentage you are being offered with the adjusted production. 

Currently, the most popular model is a hybrid model of both an IG (income guarantee) and a PBI (production-based incentive) plan. This is a shift we have seen employers make post-pandemic. Many potential employers are offering a lower IG rate but a higher PBI plan. How does this plan work and what exactly do you need to know? 

First and foremost, you must understand the production goal and what metrics are available for you to monitor this goal. Second, recognize, how many days per month you will work to meet this goal.

As an example, let’s say your potential employer sets a $100K monthly production goal, and you are working 16 days/per month. Simply divide $100K by 16 (clinical days worked) which equals $6,250/per day. To meet your goal, you must produce $6,250/per day which equals about 1.2 starts per day.

You must also consider the conversion rate in the orthodontic practice. If it’s 60% then you will need to see at least three new patient (NP) consults each day. When an employer hires you, they not only want you to see current patients – which is where the IG comes in – but they also expect you to see NP consults. Can a new orthodontic graduate handle three to four NP consults per day? I am sure many of you look at this and say “Of course I can. That’s easy. I can see two new patients in the morning and two in the afternoon, right?” Well, that depends…

Let’s do a bit more math. How many patients are in the clinic? If there is an average of 50 clinical patients/per day it will allow you to spend more time with each NP consult to warrant a good conversion. But what happens if you are expected to see 80-100 clinical patients/per day? This might cause a bit of a struggle for a new graduate – balancing the clinic and spending the appropriate amount of time with NP exams/consults. 

So, what are some things you should note when visiting a practice to ensure you can handle the patient flow and hit your production goals? Ask any consultant and they will tell you systems, systems, systems! A practice expecting you to hit high production goals must have good systems and teams to help you meet expectations. 

The difference between a well-trained Treatment Coordinator (TC) and a mediocre one can be detrimental for a new graduate. If you have a great TC and you see three-to-four NP consults/ per day, you will most likely be looking at a 70% conversion rate – which makes your target income potential reasonable. If you are considering joining a practice, ask to examine the schedule – not just for that day, but for the week and month. Find out how many NP consults the practice normally sees on a daily or weekly basis, to make sure you have a reasonable opportunity to start new patients. Another consideration is the practice’s target market. Is the practice marketing and advertising to patients who are willing to commit to treatment or are they marketing to attract shoppers? This is important to know before you join, if the majority of your income is production-based. 

If you join a well-established orthodontic practice with a well-trained team that attracts the right new patients, participating in a PB compensation model versus a higher IG can be very lucrative. 

Based on recent trends, the odds are good that associate compensation will continue to shift toward productivity. The more you produce the higher your income potential. Specifically, with DSO and OSO models, paying based on production bonuses shifts the risk from the employer to the associate and helps maintain healthy productivity. 

So, as you interview for potential associate opportunities be sure to weigh the differences between any production-based or income guarantees you may be offered. Do your homework and ask questions of your potential employer to understand whether or not the offer works for you. 

Orthodontic Practice for Sale: Northwest Illinois

Orthodontic Practice for Sale in Northwest Illinois

A private, well-established orthodontic practice located in a rural community in Northwest Illinois is for sale.

The Northwest part of Illinois is an excellent place to be a young professional with its close proximity to the big city draw of Chicago. It is also a great place to raise a family with its noted excellent schools. Most people born in this area remain there for their entire life and most individuals who move to the community never leave. The region offers HUGE homes at an affordable price. The region has great countryside towns with beautiful parks and historical landmarks. 

The northwest part of Illinois is conveniently located near the borders of Iowa, Wisconsin, and downtown Chicago. The region offers four different seasons with a variety of outdoor activities during both the summer or winter months. During the summer take a quick drive to Chicago and enjoy all the activities a metropolitan city offers like professional sports, shopping, restaurants, and museums. During the winter, grab the family and friends and take a short drive to Wisconsin where you can book a weekend trip for a snowmobile getaway.

To learn more about this practice for sale, please forward your CV and letter of interest to shannon@bentsoncopple.com and shane@bentsoncopple.com.

Full-Time Orthodontic Associate Opportunity: Tuscaloosa, Alabama

A growing orthodontic practice is seeking a full-time associate orthodontist in Tuscaloosa, Alabama.

A growing practice is seeking a full-time associate orthodontist in Tuscaloosa, Alabama.

The City of Tuscaloosa is one of the most picturesque college towns in the South, and college football is king. “ROLL TIDE” is the distinctive chant one can hear clearly on Saturdays during fall football season, as it is home to the University of Alabama. The city is conveniently located minutes away from the best water and outdoor activities the state has to offer. Take advantage of 23 miles of hiking and biking paths located at Lake Lurleen State Park. Grab the family and take a stroll along the Riverwalk where you can stop at one of many playgrounds for the kids, enjoy a picnic lunch in the shade, or simply relax in a covered gazebo.

Tuscaloosa is a diverse, family-friendly community offering something for everyone. It is one of the best places to live in Alabama. It has a lively downtown scene, friendly neighborhoods, and excellent schools. With hundreds of restaurants, activities, museums, and parks, it has managed to become one of Alabama’s most progressive cities.

This career opportunity offers:

  • Competitive Compensation Package
  • Income Guarantee + Performance-Based Income
  • Continue Education Reimbursement
  • State Licensure Reimbursement
  • PTO
  • Health Insurance
  • 401K Participation

This is an excellent opportunity for an associate doctor to work in an orthodontic practice focused on personalized care, commitment to excellence, and transforming lives. If you are interested in learning more about this practice opportunity, please forward your CV and letter of interest to shannon@bentsoncopple.com and shane@bentsoncopple.com.

Click here to view additional practice opportunities available from Bentson Copple & Associates.