Determining Your Career Path After Orthodontic Residency

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

You have taken that step in identifying a career that appeals to you, but deciding your next step may still be the missing piece of your puzzle. There are many factors you need to examine and decisions you need to make as you approach your final year. You should be asking yourself a few questions:
 
Where Do I Want to Live?
This is extremely important for those who have a family. Being in agreement about where you would like to practice is a decision that should be made with your spouse. Does the community culture align with your beliefs and values? Ask yourself if the area meets your interests and financial needs. Making sure you and your family will be “happy” is a key factor when deciding where you want to practice. 
 
What Are My Short-Term and Long-Term Goals?
Making a career plan takes time and effort on your part. Commit to establishing your expectations and objectives as you seek an opportunity. Remember who you are and why you chose this career.
 
Do I Want to Practice as an Associate in a Private Practice?
Ask yourself if you desire mentorship from a senior doctor. Do you see yourself working with this potential employer? Do your personalities “mesh”? Make it a point to visit the practice and see if the culture is a good fit for you. Observe the interaction between the staff and the patients. Can you see yourself practicing in that environment?
 
Am I Willing to Work for a DSO (Doctor Service Organization)?
If you are wanting to focus solely on orthodontics, corporate may be a better choice. In some cases, you can negotiate a schedule and salary that are guaranteed regardless of the organization’s ups and downs. As with a private practice, just be sure to find the right fit.
 
Would I Like an Equity-Minded Associateship Opportunity?
This is an opportunity to consider for an orthodontist that desires to own their own practice in the somewhat near future. You are able to come in as an associate and “get your feet wet” by getting to know the patients and learning about the ins and outs of the practice you would one day be a partner in. Understand that non-competes in most states will be required and are enforceable.
 
Should I Purchase an Orthodontic Practice?
Financially speaking, is this possible for you? This path does allow you the ability to control your own schedule and usually maximize income. However, the freedoms of having your own practice come with a price. As a small business owner, you have many responsibilities that come along with that title and there are many resources available for you to get help in these areas.
 
This is an important decision that simply comes down to making sure you stay true to yourself by seeking the best opportunity for you and your family. Know who you are, choose a location, identify the right practice, and begin your journey in confidence.


The insights above address many questions to ask yourself when determining a long-term or short-term orthodontic career path. You are not alone on this journey, there are many reputable companies providing guidance when exploring all the available career options, including Bentson Copple & Associates! 

Whether you are a new resident, a resident approaching the completion of your orthodontic program, an experienced doctor seeking a new opportunity, or looking to purchase a practice – our experienced placement specialists are here to help you!
 
Our Placement Services are provided at no cost, and our candidates can expect a high-level engagement process with our recruiters, who are knowledgeable about the opportunities they represent and current industry trends. Our team is here to help make your future orthodontic journey as successful as possible! We also have an up-to-date, comprehensive list of available orthodontic jobs and career opportunities on our website, that range from orthodontic practices for sale, associateship positions, and orthodontic employment opportunities – both full-time and part-time.

Physician Mortgage Loans: Flexible Home Mortgage Lending for Doctors & Dentists

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

You just finished orthodontic residency. You have borrowed hundreds of thousands of dollars to pay for your education and you are about to move to start your new career. Can you afford to buy a home when you get there?

Many of you have borrowed more for school than you will earn in your first two years of your employment but you are about to start a career that promises job security and a high salary, so can you afford to buy a home? What are your options? One option I recently heard about is a “physician mortgage loan” and I want to share this information with young doctors who are starting their careers but also have a desire to have some equity in a home.  

What is a physician mortgage loan?

A physician or “doctor” mortgage is a special loan program that a lender puts in place to attract high-income clients by allowing health care professionals such as doctors and dentists to secure a mortgage with fewer restrictions than a conventional mortgage. The physician loan program is a low to no down payment mortgage designed for physicians, dentists, and other eligible medical professionals. The program is a great home financing option for doctors because they offer jumbo loan balances and relaxed debt-to-income ratios without private mortgage insurance (PMI). PMI is typically required for loans where the down payment amount is less than 20%. Physician home loans are also known as doctor loans, doctor home loans, and doctor mortgage loans. 

Does an orthodontist qualify for physician loans?

Yes, all physician loan programs are available to medical doctors with M.D. or D.O. degrees and some are available to dentists and orthodontists with D.D.S. or D.M.D. degrees. Lenders and banks realize that becoming a doctor or dentist is a long process, so the lending criteria can vary depending on how far along the borrower is in training or career development. Physician mortgage loans are primarily for doctors purchasing their first home or refinancing a primary residence. They are not intended for purchasing a second or vacation homes. 

How does a physician mortgage loan work?

Physician loans differ from conventional mortgages in three ways: They don’t require PMI, which traditional loans do require.  On large loan amounts, the PMI can add hundreds of dollars to the monthly payment, a physician loan frees up that money so it can go toward other expenses including student debt.  Physician loans are also more flexible with debt-to-income ratios and they accept residency contracts as verification of employment. 

Debt-to-income ratio: When lenders review a mortgage application, typically they scrutinize the borrower’s debt-to-income (DTI) ratio, which is the percentage of monthly income that goes toward paying off debts.  Applicants with a high DTI are flagged riskier than applicants with a low DTI.  We are all well aware that orthodontists, especially early in their careers, will have a high DTI ratio due to education debt in the six-figures, making it difficult to qualify for a mortgage.  However, some physician loan programs do not count medical/dental school debt if the payments are deferred or in forbearance for a certain period, this reduces the DTI making it easier to qualify for a loan. 

What do you need to qualify for a physician loan?  

You will need employment verification and proof of income. Mortgage lenders typically require borrowers to prove that they’re working and earning income. Typically, loan applicants that are about to be hired but have not actually worked do not qualify for a loan. However, physician mortgage loans are the exception. Lenders will allow the borrower to show an employment agreement as proof of employment even before their job begins and some lenders will even lend to borrowers that work as independent contractors.  

How do you find a physician loan?

When getting any type of mortgage, it is always best to shop around, starting with the bank or credit union with which you already have a relationship. Unfortunately, many lenders tend to keep this program secret and the information is not easy to find, below is a list of Physician lenders who extend their programs to Dentists (DMD/DDS):

Bank of Nashville (AL, FL, GA, SC, TN, NC, and MS) 

Bank of America (All 50 states) 

Regions Bank (TX, IA, MO, AR, LA, IL, IN, KY, TN, MS, AL, GA, FL, VA, NC, and SC) 

SunTrust Bank (AL, AR, DE, FL, GA, MD, MS, NC, SC, TN, VA, WV, and DC parts of NJ and PA) 

Lake Michigan Credit Union (Michigan Only) 

BBVA/Compass Bank (AL, AR, AZ, CA, CO, FL, GA, ID, KS, LA, MA, NM, NV, OK, OR, PA, RI, TN, TX, VA, and WA) 

Horizon Bank (MI, IN, and IL)

 

Shannon Patterson Featured in Orthodontic Products Magazine

Addressing Dental Gap Pay Written By Shannon PattersonIn the new issue of Orthodontic Products Magazine, Shannon Patterson, Partner at Bentson Copple & Associates, addresses the dental gender pay gap and provides six tips for advocating better pay.

During the past few decades, there has been a significant increase in the number of women entering the dental industry. While pediatric dentists continue to lead the charge with a whopping 52% of providers being female, the orthodontic industry is also making headway with females representing 31% of the workforce.

According to the 2019-2020 Survey of Advanced Dental Education, females represent 69% of all pediatric dental residents and 52% of all orthodontic residents. And for the first time in history, more females (195) than males (193) graduated from orthodontic residency in the United States in 2019-2020.

It’s projected the percentage of female providers in these specialties will increase in years to come. What effect has this growth had on gender gap earnings? The answer may surprise you.

Read the entire article in the August/September 2020 issue of Orthodontic Products Magazine.

Burnout Syndrome: Signs, Symptoms, & Strategies

Orthodontist Burnout Syndrome - Signs, Symptoms, & StrategiesBy: Shannon Patterson, CPR, CMSR
Kolbe Certified™ Consultant
Director of Practice Opportunities

Practicing orthodontics is an important and rewarding career path that attracts some of the nation’s brightest and most driven individuals. Unfortunately, it is also an increasingly challenging and stressful profession with a high rate of job burnout. Sadly, through the years our firm has been involved with transitions that lost an orthodontist due to suicide, and it’s absolutely heart-wrenching. Something I have noticed in the last year is that burnout is on the rise for younger orthodontists and even residents due to financial stressors, student loans, uncertain work future, and the ever-changing dental landscape.

Let’s start with understanding why dental providers are more prone to professional burnout, anxiety, and depression. Two major reasons are the nature of their practice and their personality traits. Orthodontists work in a high risk and emotionally charged profession, characterized by long hours and physical demands, but most importantly many of you have a self-imposed unrealistic demand for precision and perfectionism. A research study conducted on dentists based on the Meyers Briggs personality test showed that dental providers tend to be ISTJ or ESTJ, which are often considered to be the “type A” personalities. Don’t take that the wrong way, that “type A” personality is what got you through years of a demanding education but also means you may be more likely to experience burnout.

Burnout Syndrome is characterized by emotional exhaustion, loss of enthusiasm for work, feelings of depersonalization, and a low sense of accomplishment. Unfortunately, it doesn’t take years to develop this syndrome, younger doctors, and even residents can experience these feelings. Staying self-aware and learning to identify the emotional, physical, and behavioral signs of burnout will help, the most common symptoms of burnout are:

• Loss of motivation
• Feeling helpless, trapped, or defeated
• Detachment
• Increased cynical or negative outlook
• Decreased satisfaction or sense of accomplishment
• Feeling tired and drained most of the time
• Tiredness that does not respond to adequate rest
• Withdrawal from responsibilities
• Isolating from others
• Procrastinating
• Skipping work or coming in late and leaving early

How can you combat burnout? First, do not be reluctant to ask for help or more importantly be ready to offer support to a colleague who is showing signs of burnout. At some point in your dental career, you will experience burnout and it is important to remember this does not make you a bad or weak leader/orthodontist. What you are experiencing is temporary and treatable and you should not fear negative professional repercussions for seeking guidance and mentorship if you are struggling with these feelings. There are excellent self-assessment tools on the internet that can help you recognize whether you are suffering from burnout, just google “professional quality of life scale”. The assessments are often free and can give you valuable insight into your current state of mind.

As a new orthodontist, you can be proactive as you start your career by remembering that burnout is easier to prevent than to treat, so practice self-care and recognize the symptoms. If you start to feel twinges of procrastination, exhaustion and isolation seek guidance whether it’s with books, podcasts a mentor or a friend find a way to inspire yourself to get back on track and back to doing what you love “straightening one smile at a time”!

Video: How COVID-19 is Impacting Orthodontic Residents

Shannon Patterson talks with Orthodontic Products’ Chief Editor, Alison Werner, about how the crisis is affecting residents – including the impact on classes, graduation, and licensure exams. She also focuses on how COVID-19 is affecting their job search and pending employment offers. Moreover, she offers advice to residents about how to manage this time and to established doctors who are wondering if they should be hiring now. Watch The Interview Here.

Chris Bentson Featured on The Propreneur Podcast

The Propreneur Podcast Chris BentsonChris Bentson was recently featured on The Propreneur Podcast with Dino Watt. The 36-minute episode focuses on the question, “What Is Disruptive Innovation?” Chris shares insights regarding practice growth, profitability, and provides an overview of practice modality changes and shifts that are taking place in the orthodontics industry. Additionally, Chris chats about the forecasted 2020 dental industry trends. The tidbits of knowledge shared in the podcast provide listeners with an understanding of how practices are currently performing and encourage listeners to think strategically about changes needed in their practice to remain successful in the future.

Show Notes:
One of the greatest challenges that private practices are now facing is Growth. Here are three things that you can do to make your practice grow:
1. Communicate differently to your patients.
2. Create a culture in the office that feels like you.
3. Prepare two-tiered pricing.

The Propreneur Podcast:
The Propreneur Podcast is a show dedicated to building entrepreneurial skills in private practice owners. You’ll hear from industry experts, orthodontists, and dentists on topics like sales, marketing, leadership, and systems. For all the business and leadership strategies you wish they’d taught you in graduate school. New episodes are released every Tuesday and Thursday.

Click here to listen to the podcast.

People & Practice: Talking with Chris Bentson

People_&_Practice_Podcast_Chris_Bentson

Chris Bentson is featured in the new episode of People & Practice, LLC‘s The Survival Guide For Orthodontists podcast, hosted by Dr. Leon Klempner and Amy Epstein. Chris discusses how orthodontists can take the disruption in the industry and use it to their advantage by offering the same convenience patients are seeking from mail order alignment companies.

This episode digs deep into the nuts and bolts of what forces are affecting the industry and the tools available right now to help independent and small group practices beat the big box orthodontic companies.

  • How has disruption by Smile Direct Club and Invisalign affected small independent practices
  • The future of orthodontics is bright for the practice that adopts teledentistry technology
  • Address the growth of corporate dentistry and consolidation of practices

Listen here: https://pplpractice.com/episode-5/

About the Podcast:
The Survival Guide for Orthodontists, is the podcast that makes YOU the authority in Orthodontics in your community. Get ready for insights on how to compete on expertise and trust against mail order and retail orthodontics. It’s not always about the lowest fees. Dr. Leon Klempner and Amy Epstein, co-founders of People & Practice, know the business of orthodontics. They bring you insights, tips, and guest interviews focused on helping you thrive in a massively disrupted industry. Put more patients in chairs by competing on expertise and trust, not the lowest fees. The podcast is available on the People & Practice website, Apple Podcasts, and Soundcloud.

New U.S. Census Data and Trends to Watch

By: Shannon Patterson
The population changes every year in the United States. Generally we see a positive change with the overall populations meaning more births and deaths, however, a few states had more deaths than births according to the U.S. Census Bureau.

According to the Bureau’s factors that contribute to the 2016-2017 estimates for populations for the 50 states results are international and domestic migration and the “natural population change,” which is the net births minus deaths.

The results showed that two states, Maine and West Virginia, actually saw more deaths than births. Maine’s natural population went down by 0.9 residents per 1,000, while West Virginia’s dropped by 1.7 residents per 1,000. However, Utah had an excess of births over deaths contributing to why it’s ranked the third fastest growing state with natural increase.

Idaho was the nation’s fastest-growing state over the last year. Its population increased 2.2 percent to 1.7 million from July 1, 2016, to July 1, 2017. The next largest percentage increases in state population were; Nevada (2.0 percent), Utah (1.9 percent), Washington (1.7 percent), and Florida along with Arizona (1.6 percent).

The two fastest growing states Idaho and Nevada experienced “domestic migration,” which is defined by the number of residents who move into a state from another, minus the people who moved out of that state. The census showed that the Northeastern and Midwestern states tended to lose population due to domestic migration as more residents moved out of the state than into the state. By region, the Western and Southern states mostly saw gains from other parts of the country. States that saw dramatic increases due to domestic migration were Idaho, Nevada, Oregon, Washington, Arizona, and Montana.

Overall, the southern and western regions led America’s population growth. In 2017, 38 percent of the nation’s population was in the Southern states and 23.8 percent in the Western states.

A number of common factors affect migration patterns throughout the country. Residents move from state to state for economic and educational opportunities as well as quality of life factors and the cost of living. Many of the fastest growing states have midsize cities with quality school systems, low unemployment rates, and offer affordable housing.

To determine the fastest growing and shrinking states, the WSJ reviewed the one-year population change of all 50 states from 2015 to 2016 with data from the U.S. Census Bureau. Below is a list of the fastest growing and shrinking states in the U.S.

Fastest Growing
Idaho
The population of Idaho increased by 1.8% in 2016. Idaho has a relatively high birth rate, and natural growth accounting for about one-third of all new Idahoans in 2016. The remaining population growth was due to the large influx of residents from other parts of the country. A net total of 17,143 Americans relocated to Idaho in 2016, far more than in most states.

Utah
The population of Utah grew by 2.0% in 2016, nearly three times the 0.7% national population growth rate and the fastest pace of any state. Unlike most fast-growing states, the majority of Utah’s population increase was due to natural growth. Utah has the largest average family size in the country. While Utah’s high birth-to-death ratio accounted for most of the state’s population growth, Utah’s population also grew more from inbound migration than many other states.

Nevada
The population of Nevada increased by 2.0% in 2016, The state has sustained strong population growth over the past decade, growing by 16.5% from 2006 to 2016, nearly twice the 8.3% national growth rate.

Florida
Like many of the fastest-growing states, Florida’s rapid population growth was largely due to migration. About 9 in every 10 new Floridians either moved from another state or from another country.

Washington
Washington state’s population grew by 1.8% in 2016, more than twice the 0.7% national population growth rate. The state’s strong population growth over the past decade was accompanied by a large increase in their GDP. The states information sector such as industry giants including Microsoft, Amazon, and Expedia ignited the growth.

Oregon
Since 2006, Oregon’s population has grown at an average rate of 1.1%. Approximately 3 in every 4 new Oregonians in 2016 moved to the state from another state (domestic migration), with the remaining population increase due to natural growth. Many new residents likely came to Oregon for economic opportunity.

Colorado
Colorado’s population grew by 1.7% in 2016, among the fastest pace of any state. Like many of the fastest growing states, domestic migration contributed the most to the states rapid population growth. A net influx of 50,216 Americans relocated to Colorado in 2016.

Arizona
Arizona’s population grew by 1.7% in 2016, more than twice the 0.7% national population growth rate. Most of the state’s growth was again due to new residents migrating from another state. A net total of 61,544 Americans relocated to Arizona that year in 2016.

Fastest Shrinking States
West Virginia
West Virginia was one of two states to see both negative natural growth and net migration loss in 2016. West Virginia, which has one of the oldest populations of any state, has the highest death rate and one of the lowest birth rates in the country. Approximately 2,700 more West Virginians died than were born in 2016, accounting for one-fourth of the state’s total population loss. Most of the population loss was due to people leaving the state. Major factors causing people to migrate out of West Virginia were the high unemployment rates and poverty. In total, West Virginia’s population decreased by about 10,000 residents in 2016, the most of any state relative to population size.

Illinois
While the population of Illinois has increased nearly every year in the past five decades, the state’s population declined in 2014, 2015 and 2016. The state’s population shrank by 0.3% in 2016, the second fastest pace of decline of any state. A large share of the population loss was due to residents leaving the Chicago-Naperville-Elgin metro area. In a survey conducted by the Chicago Tribune, residents who had moved out of the city in recent years cited high taxes, unemployment, poor weather, and violent crime as primary reasons for leaving Chicago. The population decreased by over 37,508 residents with the majority of them being from the city of Chicago (19,570).

Vermont
The population of Vermont declined by 0.2% in 2016, the third largest contraction of any state. Most of the population decline was largely due to outbound migration. Approximately 2,000 more residents moved out of Vermont in 2016 than moved in, nearly the largest loss of any state when adjusted for population size. Vermont’s population growth was also impacted by the state’s low birth rate.

Connecticut
The state’s population shrank by 0.2% in 2016, the fourth largest decline in the nation. Connecticut’s population has declined substantially in recent years, with approximately 20,000 residents exciting since 2013. Unfortunately, many of the residents leaving the state are young, college-educated professionals. The population loss will likely hurt the state’s economic potential.

Wyoming
Wyoming was the only state to grow more from natural growth than the United States as a whole in 2016 and still have population loss overall. Approximately 2,800 more new Wyomingites were born than died in 2016, however, heavy outbound migration led to negative population growth in Wyoming overall. Overall 3,823 more residents moved out of Wyoming in 2016 than moved in, more than in any other state relative to population size.

Pennsylvania
While the U.S. population grew by 0.7% in 2016, the population of Pennsylvania shrank by 0.1%. The change was largely due to residents who moved out of the state; approximately 45,600 more residents exited the state than moved in making it one the largest domestic outflow states in the nation. Pennsylvania’s population loss was also partially due to the state’s low birth-to-death ratio. Overall, Pennsylvania grew less from natural growth than any state other than New Hampshire, Maine, and West Virginia.

Mississippi
The population of Mississippi declined by approximately 660 residents in 2016. The population loss was largely due to outbound migration to other states. Roughly 7,500 more Mississippi residents moved out of the state than moved in during 2016. While Mississippi had positive natural growth in 2016, the state’s death rate was relatively high, and the natural population growth was lower than the national average. Many residents exited the state due to the state’s low quality of life, and depressed economy. Today, over 20% of state residents live in poverty, the largest share in the country.

New York
New York is one of many Northeastern states whose populations are rapidly declining due to outbound migration. While the state gained a net total of 118,478 new residents from other countries, over 190,000 residents moved out of New York to another state in 2016 than moved in.


This article was featured in the August 2018 edition of The InSight, our monthly email published for orthodontic residents and doctors seeking practice opportunities. This monthly email provides news and information focused on the fast-changing orthodontic industry and its relation to current and future orthodontic careers, highlight commonly asked questions that are timely to the young orthodontic community, and provide a current list of available practice opportunities. Click here to sign up for the email.