Congratulations! You’ve worked hard to earn your dental degree. Now it’s time to choose your own path. There are so many ways to practice dentistry, and in a variety of settings, that sometimes it can be stressful to decide what’s right for you.
Check out the information and resources here, which may help you with your decision. Additionally, the American Dental Education Association may also provide helpful information.
All dentists must go through the licensure process at least once during their professional careers. If you are considering moving to a new state, you may need to repeat the process to meet different requirements.
Your state dental board can provide specific information about licensure requirements, the dental practice laws that apply in your state and other licensure-related information. The ADA maintains a Dental Licensure Map that can help you find basic licensure information by state.
An interest area in general dentistry is a well-defined body of evidence-based scientific and clinical knowledge underlying general dentistry, but is a more focused, complex and distinct field identified by advanced knowledge, techniques and procedures.
Today’s rapidly emerging technologies and science are providing more sophisticated and complex solutions to problems encountered in general dentistry.
The advances are changing and enhancing the dental practice environment. Interest areas in general dentistry must meet the specified Criteria for Recognition of Interest Areas in General Dentistry (PDF) in order to be formally recognized by the American Dental Association.
Operative Dentistry, Cariology and Biomaterials has met the Criteria and is formally recognized by the American Dental Association. Operative Dentistry, Cariology and Biomaterials is that branch of general dentistry concerned with the advanced knowledge, expertise and clinical skills in operative dentistry, restorative dental materials, educational theory, techniques, and teaching skills. It includes scientific research and knowledge in the areas of cariology and advanced scientific clinical training in restorative materials and biomaterials.
For more information about interest areas in general dentistry, contact the ADA Council on Dental Education and Licensure at 312.440.2698.
The ADA believes that the public is best served when dentists focus on the general practice of dentistry. However, the recognition of specialties within dentistry offers benefits for patients and professionals alike. Accordingly, there are 12 recognized dental specialties within the dental profession.
The National Commission on Recognition of Dental Specialties and Certifying Boards is the official body that reviews and formally recognizes dental specialties and their certifying boards based on the ADA Requirements for Recognition of Dental Specialties and National Certifying Boards (PDF).
Dr. Joy Poskozim chats about her efforts treating the geriatric population, and the nuts and bolts on weaving those patients into her practice.
Betsy Shapiro: Welcome to the American Dental Association's practice podcast, Beyond the Mouth, where we won't discuss clinical dentistry, but everything else is fair game. I'm Dr Betsy Shapiro, a director with the Practice Institute of the ADA. In this episode we're talking about treating the senior population in various places other than an office. Joining me today is Dr Joy Poskozim. Dr Poskozim wanted to be a dentist in the eighth grade when she had her braces. She's since graduated from New York University College of Dentistry and completed a general practice residency at Woodhull Hospital in Brooklyn. She's been practicing in her own office, Joyful Dental Care in Chicago for the last 20 years and for the last 10 has focused more of her practice on serving patients in a less traditional manner. Joy, welcome to the program.
Joy Poskozim: Thank you for having me.
Betsy Shapiro: I said less traditional manner. Mind to explain how you're stretching your practice outside your office walls for us?
Joy Poskozim: Absolutely. It's actually started with my grandmother. My grandmother needed a new lower partial denture and lived 10 minutes from my practice. Had children, countless grandchildren, eager and willing to help her, but she had horrible sciatica. Having her even leave her easy chair was difficult for her. I decided to go to her and during lunch breaks I was taking the impressions and doing everything I needed to do to make her a new lower partial. I did it outside the office. I did it in her easy chair and to make her feel as guilty about it, I call it easy tear dentistry. I remember inserting the partial denture on a Friday and the following Sunday, the one place that she would go to would be church. The following Monday I got a phone call from a fellow parishioner asking if I could do the same thing for her grandmother who is also house bound, which opened up a whole new world for me. I had no idea there was such a need and it's been an incredible journey ever since.
Betsy Shapiro: Had you had a lot of exposure to geriatric patients before this?
Joy Poskozim: The regular geriatric population in my practice, patients that could come to me either with walker or with cane, sometimes they were coming by themselves. Sometimes they were being brought by loved ones. But no, working outside of the dental office in a traditional setting, no, I had no real exposure to that.
Betsy Shapiro: How did it grow from your grandmother to then the fellow parishioner's grandmother, and what are you doing now? What does it look like now for you?
Joy Poskozim: It really was grassroots, word of mouth. It kind of spread. Unfortunately, we have a senior population that aren't necessarily being treated for oral care. There are other things that kind of a more of a priority without the realization that there really is a connection with oral health, with overall health, but the problem becomes, can my loved one eat? Can my grandmother eat? Can my grandmother even brush their teeth appropriately anymore? I smell an odor from my grandmother, my mother's mouth. And who would we call about that?
I got involved with an organization called Continuity of Care, and it's an organization that focuses on nursing homes, administrators. So these are people that are working. They're allied staff and assisted care facilities, hospice care. I presented in front of them about the importance of oral care for their residents and the urgency of the need for me to come and provide dental care in their facilities was overwhelming and that's what I began to do. One at a time creating dental days, so that I could see residents as many as I could, as many as the loved ones wanted me to treat them, in the comfort of their own room or in a specific area in the assisted care facility to provide dental care.
Betsy Shapiro: Do most nursing homes have someone like you or a dentist on staff? Is there provision for care?
Joy Poskozim: Great question and the answer is no. I work as an independent contractor. I come in with the idea that I am providing care for personalized care. I don't try to do everything for everybody. That being said, I do not fall under anybody in the...
Betsy Shapiro: Hierarchy.
Joy Poskozim: Hierarchy, great word. I try to work with the director of nursing. That would be the first point of contact that I like to have to go over the work with the residents, but no, in fact, the majority of the nursing homes do not have a dental chair, dental room. I've come to try to practice more in the comfort of their own rooms. It's easier on most of my memory care patients. It's what they're familiar with. Then, I can set up and have it appropriately and set up for the way I want it to be.
Betsy Shapiro: You are working as an independent contractor.
Joy Poskozim: Yes.
Betsy Shapiro: And you don't fall into the hierarchy.
Joy Poskozim: No.
Betsy Shapiro: How do you get paid?
Joy Poskozim: I get paid by the loved ones, powers of attorney and/or if they have dental insurance. We will handle all the dental insurance for them and we process the claims.
Betsy Shapiro: Is your first contact with most of these patients come through their loved ones who are seeking you out or is the nursing home steering them towards you?
Joy Poskozim: It's pretty much 50/50. A loved one will reach out to the nursing home saying my mom has having a problem with their partial denture. Sometimes the floor nurses aren't even aware of it. They catch it before it becomes a serious problem and so then they will provide me as a resource and we have a conversation. Sometimes it is the actual nursing home staff that they decided that it's a good idea to have me come in to treat a wing or a certain floor of their residence. It really is 50/50.
I also work with an organization called MD at Home. These are medical doctors that will go into people's homes. I am their point of contact for oral care, so in that situation I'm getting all the information and then we then call the loved one and saying it is the recommendation of the medical doctor that is treating your loved one, that they get oral care as well.
Betsy Shapiro: In either situation, the nursing home or when you're working in someone's home, do you have trouble getting access to their medical records or do you treat it just as you would in your office? They fill out a health history beforehand and you rely on that. Are you allowed to see what's happening in their day to day life in the nursing home?
Joy Poskozim: All of the documents, all of the medical histories are the property of the assisted care facility.
Betsy Shapiro: Gotcha.
Joy Poskozim: So it stays on premises, so therefore when I come in, I already had been given permission by both the POAs as well as the nursing staff to have access to their "face sheet" as well as are there are any medical problems that they may have as well as medications that they're on. I have all that information prior to me coming in, which I have been reviewed and potentially if necessary, discussed with the loved ones saying, "Well, your grandmother for example, is on blood thinners. There's a potential that she may need an extraction." I have to have a conversation with the MD regarding that just so that the right hand knows what the left hand is doing. We communicate as much as possible. I try to gather as much information as possible prior to me even walking into the facility so that I can provide as good as care as I can without being stuck when I'm with this particular resident. But yes, all that information is provided for me prior to the appointment.
Betsy Shapiro: That's handy to have it ahead of time.
Joy Poskozim: Yes, and they're very good about that.
Betsy Shapiro: The drug world changes way too rapidly and you need to know what's happening.
Joy Poskozim: Absolutely, 110% yes. I'd been in one assisted care facility where the medical doctor comes once a month. I was just in one yesterday where the medical doctor comes once a week or there is a plethora of medical doctors. In under one roof there might be three or four different physicians that are working with the residents and this is all they do is they go into the assisted care facilities, so it's making sure that I am communicating with the right one and that we are on the same page when it comes to oral care.
Betsy Shapiro: Who assists you when you do this?
Joy Poskozim: A lot of times I'm doing it by myself. There is also help from the CNAs, the certified nursing assistants, that provide care for them to dress, bathe, brush her teeth. They provide assistance upon request and then a lot of times too, the loved ones want to be there. They want to see what's going on, they want to know for themselves. And so they're helping me along to, if nothing else, just to hold their hand. Yeah.
Betsy Shapiro: As long as you don't have to spend time taking care of the loved ones, if they get a little freaked out by something.
Joy Poskozim: And that does happen sometimes. We take a pause and then we have a conversation or we have a conversation prior if I notice that the daughter or son is extremely nervous. What I see a lot is they want to do as much as they possibly can for their loved one, but there are certain limitations in what we can do. That could be said even if they came into the dental office.
Betsy Shapiro: Sure.
Joy Poskozim: So, it's a matter of what can we do to provide the best oral care? So number one, they're comfortable. Number two, that they can eat and number three, that they smile and they feel good about smiling. In one situation, I had one resident that did not want to eat with the others in the dining room because she couldn't smile because her upper partial didn't fit, so her son called me, we relined it and a week later she's back in the dining room because she can smile. It was beautiful.
Betsy Shapiro: When you traveled to someone's home, do you take any of your office staff with you?
Joy Poskozim: No, I don't actually. And I go by myself. There really hasn't been a need. When I go to someone's home, it is the loved one that is helping out and they, for the most part, they're eager and willing to help. They want to be able to provide this additional care for their loved one. If they are in their beds, then yes, I'm on one side and the other one might be helping me keep their mouth open or just talking to them to make sure that they're still with us, not falling asleep. Sometimes it's just they're at the foot of the bed massaging their foot, but the work that I do fortunately does not really require the traditional chairside dental assisting.
Betsy Shapiro: Is it mostly dentures, partials, extractions?
Joy Poskozim: Cleanings, a lot of cleaning. A lot of, yeah, a lot of oral hygiene. When people get older there is more of a chance of getting gum disease and the loved ones aren't really so sure what their oral care was prior to being in need. There has been certain situations where I'm cleaning their teeth and all of a sudden I realize it's an upper complete denture and the loved one had absolutely no idea and they couldn't understand why there was an odor and brushing their teeth was not sufficient. It's like, "Well let's talk about what she really has on top." A lot of it is education as well, so I'm really glad when I do go to a home and I'm with the POA because there can be educating on how to improve the oral hygiene so that they can keep their teeth.
Betsy Shapiro: What's the balance for you between time in your office and time either in a facility or in someone's home?
Joy Poskozim: I do have a brick and mortar practice in Chicago and I love it. I love doing traditional dentistry. That being said, every other Wednesday and every Friday now I do go out into the field as I call it and I'm going into, it's pretty much 50% homes, 50% assisted care facilities. I have my traditional patients Mondays and Tuesdays, Thursdays and then two three days a month I am specifically working in assisted care facilities. Sometimes however, if there's an emergency, I go after work. If I'm planning a vacation, I will go after work on a Monday or Tuesday to make sure the dentures have been inserted and the follow up has been performed prior to me leaving. So sometimes, there's overlap on my days that I'm working in the office.
It's worth it to me. I'm married, no kids, no pets. So for me to go and treat these people is very helpful.
Betsy Shapiro: I'm envisioning a sport utility vehicle and a lot of Rubbermaid tubs in the back of... This is the denture tub. This is the prophy tub. This is the whatever. Is that how it works? Joy Poskozim: For me they're different bags but yes, yes, it's a lot. It's definitely along those lines. The idea is the more information I can get from the loved ones as possible or from the nurses as possible, then I know specifically what instruments and armamentarium to bring, but yes, you should see my trunk.
Betsy Shapiro: I know you've mentioned this a couple of times just in reference as you're talking about getting up the power of attorney, getting permission from the power of attorney.
Joy Poskozim: Yes, yes.
Betsy Shapiro: Is that challenging or is that easy?
Joy Poskozim: A lot of times, especially in assisted care facilities, the POAs have already been informed by the nursing staff that there is an oral care problem and the loved one needs to be seen by a dentist and Dr. Joy's the one that comes in for us. So, they're already been informed about this. However, there are times that I have been turned down. They did not want any additional care in general for their loved one, let alone oral care. A lot of times those loved ones are in hospice. In that situation, I skip that room. It's not for me to go in there, but having the acknowledgement and the verbal okay from the POA is imperative in order for me to treat these people.
Betsy Shapiro: I can guess the answer, but I'll ask the question. Is this side of your practice growing rapidly? That is the outreach side.
Joy Poskozim: Absolutely. If I really wanted to, I could probably have 75% of my working month in assisted care facilities and in homes. I'm in the process of hiring dentists to work in my practice, so that I can be able to do so.
Betsy Shapiro: Wonderful.
Joy Poskozim: The need is there. I want to be there. I want to help, but I also want to make sure that my practice is in good hands too. As I focus more on the geriatric side of dentistry, going out into their homes, I want to make sure that I have a solid base for my own practice and that anybody that can come to my practice. I've had several residents that even though they're in a wheelchair or whatnot, they require care in a traditional dental office. We are able to provide that and I'm currently building out a new practice where it's going to be ADA compliant, American Disability Act compliant, so that people of all disabilities are able to come to my practice to have treatment for those that I can't do the work in their home.
Betsy Shapiro: When you're looking for your associate, is it important to you that they have an interest in this aspect too or are you comfortable if they just are more traditional bricks and mortar?
Joy Poskozim: I'm okay if they're traditional. That is okay with me. Would I like them to have an interest sparked when I bring it up? Sure, but at this point in time, I know there are other dentists out there that do what I do. I would love to collaborate and work with them. However, at my practice right now I'm looking for someone who will like to do root canals, who want to focus on children.
Betsy Shapiro: That is wonderful. My husband's an endodontist. We'll talk after this show.Joy Poskozim: Yeah, sounds great.
Betsy Shapiro: We'll make a connection there. Overall, what's been the toughest challenge for you in adopting this style of practice?
Joy Poskozim: Gaining and earning the trust of the nursing care facilities. That has been the biggest obstacle and the biggest struggle. There is a state statute that every assisted care facility must have a dental day of education and I am more than willing and capable of providing that type of orientation or education. However, actually, having the directors of nursing to find the "time" to be able to provide that for their CNAs or their floor nurses, it's still difficult. There is no definition in the statute that's saying how long that class has to be. It could be a lunch and learn, so it's still an ongoing struggle for me.
However, providing the care has been relatively easy after treating one. Working with the CNAs, working with the floor nurses and the allied staff, it's been an absolute pleasure working with them. I think they can see that I'm so passionate about this and so, therefore we have created relationships on our own and I've also been able to get patients in my brick and mortar from the allied staff. They want to come see me as well, which is a beautiful side effect. Not something I was focusing on, but it's come to that as well. But ultimately speaking, now that I have "proven myself", it's much easier now for a floor nurse to say, "No, we've got someone. Dr Joy, we'll call her right now." Or I'll get an immediate fax with a face sheet explaining what this person may need, but it's taken about 10 years to have that happen.
Betsy Shapiro: Things progress slowly.
Joy Poskozim: Yes.
Betsy Shapiro: But it's good progress.
Joy Poskozim: Good progress.
Betsy Shapiro: Very good progress.
Joy Poskozim: It's very good progress, yes.
Betsy Shapiro: Any big goals for the future?
Joy Poskozim: Oh, well pie in the sky goal is to see a dental chair and every single nursing home in this country. If we can have a hair salon, I would love to be able to see a dental chair as well. We require the same things, water, electricity. That being said, I hope to have more dentists realize the importance of geriatric care. That it is possible to provide really good oral care outside of a dental office and that the residents that are there are incredibly loving, accepting and so incredibly grateful for the oral care that they get and especially the new toothbrush at the end. That is a really big thing for me. I would love to see more dentists focus on the possibility of treating our population that are in their third third.
Betsy Shapiro: You spoke about the statute that exists about having inservice training for nursing home staff on oral care and that that's a little bit challenging to get that on the schedule or to deliver it effectively. What are the big messages you would like to put forward when you get a chance to do that training?
Joy Poskozim: Currently, the certified nursing assistants or the CNAs are required to brush the residents teeth once a day. Unfortunately, there are some residents that aren't really willing to have that performed, especially in memory care services. I've had more than one CNA say to me, "Well doc, I've only learned in CNA school how not to get bit." So training one-on-one on how to properly brush a resident's teeth has been an eye opener for me. I had no idea that they weren't being trained to do that. That being said, once I show them how really simple it is for first of all, not get bit, but also to effectively brush their teeth, maybe not getting the two minutes, two times a day, we can definitely make sure that they're being brushed appropriately and effectively so that the resident feels comfortable as well as a CNA does.
Another thing when it comes to dentures, I just inserted an upper partial lower partial on a resident two days ago. I literally had to draw out the upper partial to show that the upper partial has three clasps and the lower partial has two clasps to differentiate the upper from the lower. I showed for the upper partial, how it had groups and the acrylic and I had the CNA run her tongue over the roof of her mouth to show that this is for the upper partial to fit into the roof of their mouth. I also try to as often as possible remind them that these partials and complete dentures need to come out every night, so reinforcing that as well as showing them how to take them in and out. Every partial is different. Every complete denture is different. There are easy ways to take them in and out and also how to properly store them. A lot of times too, a lot of the CNAs work part time. Who they have Monday night to put them to bed is not necessarily who's going to be there for the rest of the week.
For example, the one I just inserted the partial dentures for, that particular CNA that I showed them how to take in and out was not going to be there again until Friday. So having that continuity of communication and education for each one who helps the residents is incredibly important as well.
Betsy Shapiro: I know we're not supposed to talk about clinical dentistry here at all, but here is my practice tip on the upper and lowers.
Joy Poskozim: What's that?
Betsy Shapiro: When I used to be in private practice and provide care at the local nursing home, I learned very early on to when I was inserting the label with their name on the denture slash U or L so that then the staff and the nursing home and knew it was upper or lower because they often get them confused even though it seemed very clear to those of us who have had four years of extensive experience telling top from bottom.
Joy Poskozim: Yes.
Betsy Shapiro: It made it easier for them.
Joy Poskozim: Absolutely. What I'm seeing though, unfortunately is they get wiped off. They get rubbed off over time.
Betsy Shapiro: Oh, there you go.
Joy Poskozim: Cleaning them with the denture brushes instead of a toothbrush. So I completely agree with you. I feel like the first five years, absolutely. But then as they were away, so some of the residents that I'm coming in to see their names still is there, but that extra part-
Betsy Shapiro: Is gone.
Joy Poskozim: ... gone.
Betsy Shapiro: Oh well. It was worth a try.
Joy Poskozim: I hear that. It's all good.
Betsy Shapiro: This has been incredibly helpful, Joy. Thank you so much for being here and for sharing your experiences with us. I think you may have planted a seed for a few of our listeners about how to expand their practice and do a good thing all at the same time.
Joy Poskozim: Thank you so much. It's been a pleasure to be here.
Betsy Shapiro: We're now at the part of our program where we answer the question of the day. These are questions that come from our member dentists into the staff at the Practice Institute and they have a wide variety of practice management questions. Since we've got you here, we'd just like to ask you a little bit about non traditional practice modes. Clearly you chose that path. Do you have any advice you might offer to someone who's looking for something different?
Joy Poskozim: Absolutely. When it comes to the senior population, making sure that there is really good communication between myself and the power of attorney, the POA, as well as the nurses, not just the director of nursing but the nursing staff and as well as the ones who work with them on a daily basis. The CNAs, our certified nursing assistants. That continuity of communication is imperative in order to make sure that proper oral care is being provided for the resident. The second thing I would say is making sure that having the power of attorney's approval that I can actually provide care. It's one thing to say your mother needs a new upper partial because she is missing some additional teeth. It's another thing to actually say, "Yes, go ahead and yes, you may provide this treatment for my mother." Those are two completely different things. I've learned that lesson and so therefore, to make sure that they have approved this care.
Then, the third thing would be the followup. Last Friday I was in Lake Bluff extracting a tooth. I don't leave the assisted care facility until I have made sure that I have at least left a message with the power of attorney or loved one if the power of attorney's out of state to say, "Things went really well and your mom is in excellent hands." She is outside reading her books again and she's biting on that guys and she's going to be reviewed every 15 minutes to make sure she's okay. Having that final bit of communication, even if it's just being left a message is so important to make sure that even if they can't be there for them, they know that the care has been provided for them and I also specify when I'm going to be there again for an actual visit follow up. The followup is incredibly important for the staff, for the resident and for the loved ones.
Betsy Shapiro: Thank you. I think we've been very lucky to have you here today. I think your patients are even luckier.
Joy Poskozim: Thank you very much.
Betsy Shapiro: If you want more information on the practice or to speak with Dr Poskozim, you may contact her through her website, Joyful Dental Care. That's all one word, joyfuldentalcare.com. If you want more information on any other practice management resources, you can visit our website at success.ada.org or contact us at our email address centerforprofessionalsuccess@ada.org. We want to thank our sponsor, ADA Member Advantage, for their support and to Sandburg Media for producing this podcast. Thank you for listening to Beyond the Mouth.
Betsy Shapiro: Welcome to the American Dental Association's Practice Podcast, Beyond The Mouth, where we won't discuss clinical dentistry, but everything else is fair game. I'm Dr. Betsy Shapiro, a Director with the Practice Institute of the ADA. In this episode we're talking about federal dentistry, which is the broad term for dentists serving in some sort of governmental capacity, such as branch of the military, the Public Health Service, Veterans' Affairs or the like, and we're going to talk about what it's like changing between some sort of federal dentistry and going into private practice.
Joining me today is Dr. Julia Mikell. After graduating from the University of North Carolina, Chapel Hill, Julia accepted a commission in the United States Navy Dental Corps, next came a term as an associate dentist, followed by finding her current dental home in Columbia, South Carolina, when she purchased a practice from a retiring dentist and made it her own.
Julia, welcome to the show.
Julia Mikell: Thank you. It's nice to be here.
Betsy Shapiro: We are delighted to have you. You have kind of done it all, worked for the government, worked for someone else and now working for yourself, so I'm looking forward to a really interesting conversation, kind of about how that all went. I'd like to start with your time in dental school and ask you when and how you started thinking about going into the military?
Julia Mikell: Well, that probably started with how I ended up in dental school and that came from, I was the first person in my family to go into healthcare. My parents worked and helped me with college expenses, but when it came to coming to dental school, that was all something that I took care of. So I worked, I had a job, I had some grants, I had some loans, but when it came time to get out of dental school, I knew that I was going to have to be able to find something that was financially viable.
I didn't have a dentist at home that wanted to take me into the practice. I could have found something, but I didn't have a mentor, I didn't have someone that brought me along. A lot of my classmates had a dentist that over the four years that they were in dental school was sort of mentoring them and leading them towards an opportunity in a private practice. So when I looked at my options, I knew that there were quite a few faculty members at my school, and a few people who had graduated in the years ahead of me, who had all had very good things to say about the Navy Dentist Corps. So I looked into it and I decided that it really suited me. It solved my financial concerns, it was a very admirable job, I thought, and then it also solved my interest of wanting to be able to travel. It sort of looked like a right fit for me.
Betsy Shapiro: Did anyone try to talk you out of it?
Julia Mikell: would say no. I think that people that knew me felt that it was a good fit for me. Certainly the financial part was a big aspect of it. I was coming out of dental school with, at that time what was considered to be a lot of loan debt, and I needed a job and I needed a job that was going to have good benefits. This was a way to go into dentistry without taking out any more debt. But that was probably the biggest aspect of it from the people that I would have wanted to hear their opinion on.
Betsy Shapiro: Well, in full disclosure, my husband made the same choice except he went with the Air Force, I have to tell you that. Although he thought the Navy, what was his phrase? He thinks the Navy has the coolest uniforms.
Julia Mikell: But in my opinion they also have the best locations.
Betsy Shapiro: Well, there's a whole other story about his choice and wanting to see the world and then ending up in Southern Illinois for the entire term that he served, which is an unhappy tale on his part. But yeah, that's okay.
Julia Mikell: I can imagine.
Betsy Shapiro: Did you know that you wanted to do general practice dentistry at that point?
Julia Mikell: I think that at the time when I was in dental school, that again was a financially based decision, that when I was going into the Navy, I knew there would be opportunities to investigate, to specialize because they have excellent opportunities for that. But I was very happy with general dentistry, and I knew that I could strategically position myself in locations in the Navy that had large dental clinics, where I could get the opportunity to do little mini residencies in all the specialties, and then if one of these specialties kind of peaked my curiosity, I could investigate that. But coming out of dental school, I was content with a general practice.
Betsy Shapiro: I asked that because that's what Bob was thinking too, and in fact for him it worked out to then go on and enter an endodontic program through the military. I mean that was very helpful for him. He got a broad exposure to a lot of things in general dentistry, and then little mini residencies, just as you described it. I mean, not formal residencies, but he'd be taken under the wing of whoever was at the base and do a little more oral surgery, do a little more of this and that.
Julia Mikell: Right, in my large practices in the Navy Dental Corps, I was six months in oral surgery every day, six months in endodontics every day, six months in pediatrics every day. I did all the specialties that anybody could do in a regular advanced education general dentistry program. But it was not a graduate program, it was just my daily job.
Betsy Shapiro: Where all where you based through your time?
Julia Mikell: Well, I went into the Navy hoping that I could take advantage of a lot of things, so I did. I first started out in Charleston, South Carolina. That was for a year, and then they ask you to take what they call an operational billet, which means they want you to either go overseas or on a ship. At the time that I was doing this, ship options for a female dentist were a little limited.
So I went to Japan, and I was in Japan for a little over two years in a little town South of Tokyo. Then from there I came back to South Carolina and went to Buford, where the Marine Corps Recruit Depot at Paris Island is located, and served there in the interesting environment of a recruiting station, where you're seeing mostly these young 18 and 19 year old people that are coming into the military for the first time. Then towards the end of that tour and towards the end of my time in the military, I was on a ship for four months in the Mediterranean. So I kind of did a little bit of everything.
Betsy Shapiro: I'm just guessing from the tone of your voice, but did you enjoy that aspect of traveling around a little bit and seeing the different areas, and what the practice was like in those different locations?
Julia Mikell: I loved it. I think that was definitely one of the high points of being a military dentist was, for me, I took the advantage of the opportunities when they were offered. I ended up on the ship because they put out a request for a volunteer who wanted to do four months on the ship at the drop of a hat, and I raised my hand and went for it.
I thought the working with Marines was a new experience, very interesting. They have a slightly different way of doing things than the rest of the Navy. Then of course working overseas, and I traveled all over Asia while I was there. Because of course when you're in the military there's a pretty generous amount of personal leave time that you can take, and if you work that out with your Dental Department, then you have lots of time to travel.
Betsy Shapiro: My husband is going to be so jealous. I can't wait for him to listen to this. You obviously got some great clinical experiences and some good travel experiences and just exposure to different styles of practice. I mean, you probably did a whole bunch of wisdom teeth when you were working at the recruiting base and all kinds of other things elsewhere. Was there anything else that you can think of that came out of the military experience that you really enjoyed?
Julia Mikell: Well, the facilities were excellent. The equipment, the materials were excellent. The mentoring opportunities, all of the senior officers in the dental clinics are interested in helping the new dentist. So when you come into a new dental practice and you're one of the new kids on the block, you have all these other dentists that have been through that and want to mentor you, and help you learn the ropes, and help you have a positive experience.
The Navy Dental Corps emphasized continuing education. They brought speakers in, but they also sent you to excellent continuing education, at least for a week once a year. There were just so many things about it. The comradery. I mean right now I'm in a private practice. I'm the only dentist in my office and when I was in the dental clinic, and granted you can set yourself up in a Navy dental clinic that's a two dentist clinic, but I set myself up in clinics that had 10, 12, 20 dentists in it, and I really enjoyed that.
Betsy Shapiro: A built-in study club, right over the lunch table.
Julia Mikell: Exactly.
Betsy Shapiro: So what impacted your decision to get out of the military, when you finally decided to leave the military?
Julia Mikell: That was probably more a personal choice of wanting to be able to be with the man who is now my husband, and we met while we were in the Navy in Japan. I was very happy in the Navy, I felt like I was doing well and getting good feedback, but I realized that I did want to settle down, have a family, and be in one place, and not be uprooting and moving every two to three years when the Navy needed me to.
Betsy Shapiro: I would tell you that the same thing happened with my husband and I. I met him when he was studying in the endo program and he made the decision to leave that so that we would end up being married and being together, but it's a love conquers all.
Julia Mikell: Absolutely.
Betsy Shapiro: Beautiful part about dentistry is you can accommodate those choices and still make a living and make an impact and be helping people, which is what it's all about for me.
Julia Mikell: That's right.
Betsy Shapiro: I like that. So you've made this decision you're leaving, and you went into an associateship. How did you find the associateship and was it a challenge?
Julia Mikell: Well, I was living a few hours away from where my destination was going to be when I got out of the Navy, because we had decided we would live in Columbia, South Carolina. So I contacted the major dental supplier for that city and asked them if they had any way to help me find a associateship.
Betsy Shapiro: Brilliant.
Julia Mikell: They said, "Absolutely." So I made an appointment with one of their representatives and he took me around. He made some phone calls with some dentists who were looking for someone to come in, and he took me around and I interviewed with those, and then I got to pick who I wanted to go back and talk to. That worked out to be a nice associateship to start out my first year of private practice.
Betsy Shapiro: I'm telling you, those sales reps know everything. They know...
Julia Mikell: They know everything.
Betsy Shapiro: They do. They are the best pipeline for who's ordering fewer supplies and maybe getting ready to slow down, and who's ramping up and ordering more and looking for another person. It's a really good resource that goes undervalued, I think sometimes, by our newer members.
Julia Mikell: They also know the personality of the dentist as well. He asked personal questions, tried to get to know me a little bit, and I think he took me to offices where he felt like it would be a good personal fit.
Betsy Shapiro: Yep. Well, and it's to his benefit, you're going to be a good customer for him if he can help you make this transition, right?
Julia Mikell: Right.
Betsy Shapiro: Do you recall anything about what was the hardest part about your first steps, your starting out year in private practice?
Julia Mikell: It's a very exciting time and there's a lot of changes that are going on. If you enjoyed the military aspect of lifestyle, you miss a little bit of that order and discipline and structure, but you like a little bit of the freedom. I would say the biggest difference for me was the fact that I now had to take into consideration how much the dental procedures cost, and could my patients afford them. So treatment planning and communication with the patient about insurance and what their out-of-pocket expense would be, all of a sudden became really important in order for me to be able to do dentistry.
Betsy Shapiro: Was that a skill that came innately to you, kind of doing the checks and balances on financials, what your office overhead was versus what your patients could afford?
Julia Mikell: Luckily that was one of the things that my boss and my associateship was really interested in trying to help his associates learn. For instance, overhead, that never occurred to me when I was associate, that was not my concern, that wasn't until I got my own practice. I had a couple years before I had to worry about that, but the dentist who owned the practice that I was in, he helped me learn how to treatment plan, how to put the options together and how to present it to the patient so that they could make a good decision and be a partner in the process. But that was a lot to learn. That was probably the hardest part for me.
Betsy Shapiro: I know my husband has often said that one of the things he loved about the military, that helped him when he went into practice was process. We grouse a lot, as human beings, about process in governmental regulations, but he felt like he learned processes and structure in the military that really helped him in private practice. Now for you, you were going into someone else's practice who already had their processes in place. Were there frictions there or were you able to slowly introduced some new things, or how did that go?
Julia Mikell: I definitely agree with everything you said. I think that the Navy dentistry gave me the opportunity to understand that systems in a dental office are very important. When I went into the associateship, I was fine with accepting that person's systems just like I had accepted the Navy's systems. Then when it came time to have my own private practice, I knew it was time for me to organize the systems that suited the way I like to do things.
Some of those I adopted from the Navy, some of those I adopted from the dentist that I worked for, and then some of them I created myself. I think any dentist would agree that you have to have systems in place, or processes in place in order for everything to work, because there's so many different aspects to dentistry in private practice besides just doing the clinical work.
Betsy Shapiro: Absolutely. So how long were you in the associateship before you then went out on your own?
Julia Mikell: I ended up being in two associateships. My first one, I was in for a little over a year, and then a colleague of mine who I went to school with at Chapel Hill, she was also living in Columbia and her husband became terminally ill and she asked me to come and help her out for a little while. The first dentist was kind enough to let me out of that contract and I went and worked for her for about a year and a half, and then went into my own private practice.
Betsy Shapiro: I think that's a great example of the comradery, and we focus a lot sometimes on the competitiveness in the profession, but stories like that really bring it home that we do help each other out.
Julia Mikell: Absolutely. I think if you're honest and fair, I remember going to that boss for my first associateship, a little nervous about the conversation. But he knew the dentist that I was going to try to help and he'd gotten to know me and he wasn't threatened by that. He knew I was being honest about the situation and so was that other dentist, and it all worked out and we're all still friends now, 20 years later. We're in the same study club in fact.
Betsy Shapiro: Perfect. So, starting your own practice, you bought an existing practice, I believe, from someone who was retiring. Did they stay for a little while or did you just jump right in as they exited?
Julia Mikell: Yeah, this is a little bit different than most situations because this dentist was retiring for health reasons, had a brain tumor. He wasn't that old, he was only 54, was going to be able to live but wouldn't be able to practice dentistry. So he had to give up his practice and he had given it up nine months before he decided to sell it, so he never did practice with me. We did get to have a party together, he and his wife and me and my husband had a party to welcome the patients and let him introduce them to me. That was nice to have that turnover, but he never did get to practice with me.
Betsy Shapiro: That's an interesting situation though, an unfortunate one of course, but an interesting one because the practice has been inactive for about nine months and then you're coming in, how did it go?
Julia Mikell: Well, I accepted the fact that the practice had dwindled, because over those nine months he had asked other friends in town to help him with his patients. A number of the patients who were active with him had already developed a relationship with the new dentist. So the practice that I took over, he had a small practice to start with, but the practice that I took over really only brought on about 200 or 300 patients. It was a pretty small, it was a mostly building opportunity, let's put it that way.
Betsy Shapiro: Well you get to build it the way you want it then, right?
Julia Mikell: Well and the people that came, a lot of them are still patients of mine and they're just the salt of the earth, most wonderful people, and they make me enjoy my practice every day. It was a gift.
Betsy Shapiro: Was building the practice the most challenging part, or what else were stumbling blocks or a little bit frustrating for you?
Julia Mikell: I'd say, one of the things I like about dentistry other than the actual clinical doing the dental part, is my patient interaction. Usually, for most people, and it is true for me, the things you like are the easy things. So meeting people, getting to know them, developing relationships, establishing a trust, those are all things that I enjoy and I'm good at and so that's not hard. To me, the hard part is managing the office, managing the personnel, getting them all on board with a common way of thinking about things, all of them buying into a team concept and a purpose. That's the challenging part for me.
Betsy Shapiro: You had some good background in systems and procedures and you'd been in a couple of private practices at that point. Did you rely mostly on the lessons you'd learned there, or did you have other resources that you tapped into as you were growing and developing your own practice?
Julia Mikell: I definitely have tapped into different things. I've hired a couple consultants over the last couple years, gone to some classes, taken the dental team to some motivational practice management speakers. I don't really feel like my experience in the Navy really is anything I can draw on for that. Maybe for team morale, but not for the day to day management of work and responsibility and accountability and things like that.
Betsy Shapiro: If you look back over your career to date, would you have changed anything about the path you went through?
Julia Mikell: I wouldn't have changed anything about dental school or the Navy. I would have taken more business classes in undergraduate, or I would wish that they would give more business classes in dental school.
Betsy Shapiro: Amen, yeah.
Julia Mikell: For the most part I would say I wouldn't change pretty much anything. I'm very happy with how things have gone. I have no regrets about the fact that I've raised a family while I was trying to run a small business. I have two children, the younger one went to college this week. So that part of my life, running my small dental practice and raising a family, and so there are certain challenges that you face when you try to do that. That have made it where my practice wasn't maybe my sole focus, like it might've been if I wasn't trying to tackle both of those important things at the same time.
Betsy Shapiro: Well, it's all about balance, for everyone I think, regardless of if it's children they're raising or elderly parents they're trying to take care of or nurturing other relationships and other roles in life, but dentistry has flexibility, which I love.
Julia, we want to thank you so much for joining us today. This has just been an excellent conversation. I think your perspective is really helpful to a lot of our dentists, especially newer ones who are sort of looking at the broad field ahead of them and trying to figure out where they want to land. And seeing how one aspect, going into federal dental services, can be useful at one point in time, and how transitioning out can be done and can be successful as well. Is there anything else you'd like to close with Julia?
Julia Mikell: I just think, if you're willing to consider the military for your dental career, go ahead and give it a try, take a look at it. It has so many different things to offer beyond what you see on the surface. So I think even though it's been a long time since I was a Navy dentist, from what I hear, it's still a great opportunity.
Betsy Shapiro: Thank you very much, Julia.
Julia Mikell: You're welcome. Thank you.
Betsy Shapiro: Now we're at the part of the show where we answer a question we've received from a member. In the practice Institute here at the ADA we answer member questions every day and wanted to share one we've received with our listeners. To help us out we have Katie Call with us. Katie is an integral part of the Center for Professional Success and is often the first point of contact for our members when answering calls or emails.
Here's the question: When I leave the military, how do I transfer or change my membership to the state in which I'm going to be practicing?
Katie Call: There are really two ways that you can do this. First and easiest would be to call the American Dental Association and speak with our Member Service Center. The staff there can help with all the steps and make sure that you don't skip a beat in your membership during the transfer. The number to call is, 1 800 621 8099.
Secondly, also effective, if you know where you're going to be practicing, you can call that State's Dental Society and they'll also be able to help you.
Betsy Shapiro: If you want more information on federal dentistry, you can visit the ADA at ada.org, and type in federal dentist in the search box to find all the resources available. If you're transitioning out and going into private practice, be sure to visit the Center for Professional Success website for all types of useful materials on going into an associateship, being an employee, starting a practice, and then the other practice management issues that come with those choices.
Find all of this at success.ada.org or contact us at our email address, centerforprofessionalsuccess@ada.org that's all one word, centerforprofessionalsuccess@ada.org.
We want to thank our sponsor, ADA Member Advantage, for their support and to Sandburg Media for producing this podcast. And thank you for listening to Beyond The Mouth.
One dentist owner. This may include an employee dentist with or without a path to ownership. Could be a general dentist or specialist and is usually a single location. Solo ownership requires a commitment to business operations beyond clinical dentistry, including a dedication to non-clinical tasks such as HR, operations, cash flow, marketing, IT, equipment & materials, etc. It also requires relationship building to establish a patient base. Methods of entry include:
Ownership
One dentist owner with option of employee dentist, may have path to ownership if owner had retirement plan
Brand or identity
Buy a practice OR start new one
Number of dentists
May have an employee dentist
Specialty collaboration, or potential to specialize
General dentist or specialist owner/ employee
Location
Most likely one location, can have more if rotates themselves or with employee dentist
Mentoring opportunity
If start as employee or partnership may experience clinical and operational mentorship, may seek consultant guidance or through association
Perks, employment opportunities
Complete charge of direction of time, hours, fees, purchasing etc
Residence
Limitations if want opportunity to move out of state, etc as need time to build practice and then sell.
Patient care
Requires relationship building to establish patient base
Facility/Program oversight and standards
Usually not accredited
Financial considerations
Full ownership, budget directs income, some use sale of practice as retirement, financial planning
A small group practice is typically two to five dentists in a single location or multiple locations. These are usually local and are not likely to be a DSO (example: endodontists/oral surgeons). They could be mix of general dentists and specialists, with full or part-time opportunities. Small groups may offer clinical mentorship. They often require relationship building to establish a patient base. Types of small group practice are:
General Overview
May have more leadership or operational duties as owner vs employee dentists. Two to five dentists in a single location or multiple locations, usually local; usually not DSO or DMO supported
"Ownership"
One or more dentist owners, may have path to ownership
Brand or identity
Merger or new offices, Usually same brand practice name, philosophy, etc
Number of dentists
May have multiple dentist employees
Specialty collaboration. or potential to specialize
Common to specialty services or growing general practice groups with specialty. Allows for specialty services in house and specialist may have built in referrals.
Location
Usually single location but if multiple usually regional
Mentoring opportunity
Clinical mentorship and operational decision making opportunities, internal study club, staff cross training
Perks, employment opportunities
Full/Part time
Residence
Considerations for ability to move depend if you are an owner (contract/penalty for sell out) vs Employee term based on employment contract.
Patient care
Requires relationship building to establish patient base
Facility/Program oversight and standards
Usually not accredited
Financial considerations
Ownership models impact equity in practice(s) or increase production model or salary. some use sale of equity/shares as retirement
An outside business entity that provides non-clinical business support. Could be a Dental Support Organization (DSO), Dental Management Organization (DMO) or Dental Partnership Organization (DPO). This is a good fit for dentists who don’t want to handle non-clinical functions like hiring, marketing, ordering products, etc. Requires relationship building to establish a patient base. Characteristics common to this type of group practice:
General overview
Business entity that provides non-clinical business support to dentists, Dentists leadership opportunities and operational duties depending on "ownership" definition
"Ownership"
One or more dentist owners or regional owners at the DSO allow for employment of dentists, employee dentists may also have option to purchase ESOP/stock of DSO and tiered purchase/buy in impacts production model
(note that state laws on practice ownership vary)
Brand or identity
Can have same brand regionally, national or state wide or supported dentist keeps own practice name, may treat each location as own business entity for decision making, support therefore may have same brand but culture location specific
Number of dentists
Dentists are employees , Clinical and other operational, leadership roles within DSO
Specialty collaboration or potential to specialize
May include specialty within general
Location
Usually multi-regional or national
Usually multi location, can be nationwide
Mentoring opportunity
Structured mentoring with Clinical Directors and nonclinical Operational Team, internal CE, leadership opportunities
Perks, employment opportunities
Commonly provide benefits. Full/ part time
Residence
Considerations for ability to move if stock or ESOP owner (contract/penalty for sell out) or if full time paid on production moving will require time to rebuild practice patient base, Employee term based on contract.
Patient care
Requires relationship building to establish patient base
sometimes accredited
Financial considerations
Ownership models impact equity in practice(s) or increase production model or salary.. Some use sale of equity/shares as retirement.
An outside business entity that provides non-clinical business support. Could be a Dental Support Organization (DSO), Dental Management Organization (DMO) or Dental Partnership Organization (DPO). This is a good fit for dentists who don’t want to handle non-clinical functions like hiring, marketing, ordering products, etc. Requires relationship building to establish a patient base. Characteristics common to this type of group practice:
General overview
Business entity that provides non-clinical business support to dentists, Dentists leadership opportunities and operational duties depending on “ownership” model.
"Ownership"
One or more dentist owners retain a higher ownership percentage of the business and have service agreement with DMO (note that state laws on practice ownership vary.)
Brand or identity
Can have same brand regionally, national or state wide or supported dentist keep own practice name, may treat each location as own business entity for decision making, support therefore may have same brand but culture location specific
Number of dentists
Dentist are employees of the dentist owner group supported by DMO, Clinical and other operational, leadership roles
Specialty collaboration or potential to specialize
May include specialty within general
Location
Usually multi location. Can span different states.
Mentoring opportunity
Structured mentoring with Clinical Directors, internal CE, leadership opportunities
Perks, employment opportunities
Commonly provide benefits. Full/ part time
Residence
Considerations to ability to move if partner or equity in dentist group (contract/penalty for sell out). Employee term based on contract.
Patient care
Requires relationship building to establish patient base
Facility/program oversight and standards
Sometimes accredited
Financial considerations
Ownership models impact equity in practice(s) or increase production model or salary. Some use sale of equity/shares as retirement.
A group of independent practices that share non clinical functions without external DSO or DMO support. “Hybrid”, culture location specific. Requires relationship building to establish patient base. Characteristics include:
General overview
Group of independent practices that share non clinical functions without external DSO or DMO support. “hybrid”, culture location specific
"Ownership"
Multiple dentist owners or regional owners.
Brand or identity
Can have same brand regionally, nation or state wide or supported dentist keep own practice name
Number of dentists
May have numerous small med sized locations as one entity
Specialty collaboration or potential to specialize
May include specialty within general
Location
Usually multi location. Can span different states
Mentoring opportunity
Clinical mentorship and operational decision making.
Perks, employment opportunities
Full/Part time
Residence
Considerations to ability to move if partner or equity in dentist group. Employee term based on contract.
Patient care
Requires relationship building to establish patient base
Facility/program oversight and standards
Usually not accredited
Financial considerations
Full ownership, budget directs income, some use sale of practice as retirement, financial planning.
A relatively new model that features a combination of physician and dentist practices; could include collaboration and patient record sharing between physicians and dentists. Characteristics include:
General overview
Integrated model within healthcare system, sharing services with medical, pharmacy, specialty, etc
"Ownership"
Hospital system based
Brand or identity
Part of health system with unified core values and mission
Number of dentists
Dentists are employees, and opportunities for non chairside health initiatives
Specialty collaboration or potential to specialize
General dentist work with specialists for ease of referral
Location
One location or more locations. Can span different states.
Mentoring opportunity
Mentoring interdisciplinary as access to colleagues, specialty, medical
Perks, employment opportunities
Commonly provide benefits, full/part time.
Residence
Employment terms depend on contract to allow to change residence.
Patient care
Patient base based on insurance/location
Facility/program oversight and standards
Accredited
Financial considerations
Employee budgeting determines financial planning opportunities, non-owner but may have 401k.
A traveling dentist is usually an employee of a mobile dentistry service, temp agency or self-employed, which provides great flexibility.
General overview
Usually employee of mobile dentistry service or temp agency or self-employed, providing great flexibility.
"Ownership"
Location varies by assignment (fill in for medical leave, or addition of hours.) Locations may be in dental clinic or services brought to patients (schools, nursing homes.)
Specialty collaboration or potential to specialize
May have multiple dentist employees as part of temp agency, or solo as contractor.
Perks, employment opportunities
Commonly provide benefits, as locum tenens may have more flexibility with location and hours, contractor is self-employed.
Patient care
Varies depending on assignment
Facility/program oversight and standards
Not accredited
Financial considerations
Dentist's own budgeting determines financial planning opportunities.
Part of the dental safety net, these centers serve locations or populations with limited access to care. They may be located in urban or rural areas. An FQHC is often an integrated medical facility, where a patient has a single chart encompassing all care, including medical, dental, and behavioral health. FQHC's are included under Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services.
General overview
Health Resources and Services Administration is agency of US Dept of HHS, community health clinics often an integrated medical facility.
"Ownership"
Federal funded
Brand or identity
Federal funded
Number of dentists
Dentists are employees
Specialty collaboration or potential to specialize
General Dentists coordinate care with expanded function dental assistants, dental therapist, hygienists, depending on state regulations
Location
Facilities are located nationwide
Mentoring opportunities
Mentoring interdisciplinary as access colleagues, specialty, medical.
Perks, employment opportunities
Student loan reimbursement. Part time options
Residence
Employment terms depend on contract to allow to change residence.
Patient care
Patient base based on needs.
Facility/program oversight and standards
Accredited
Financial considerations
Employee budgeting determines financial planning opportunities. Dentist is a non-owner, but may have 401k and loan repayment.
General overview
Agency of the US Department of Veterans Affairs
"Ownership"
Usually integrated within the VA hospital system
Brand or identity
Federally funded
Number of dentists
Dentists are employees, residents. The VA is an option for dentists even if they have no affiliation with military (civilian service.)
Specialty collaboration or potential to specialize
Collaborate with medical, and opportunities to specialize. Opportunity for paid Advanced Education in General Dentistry (AEGD). to learn more about specialties.
Location
Nationwide
Mentoring opportunities
Mentoring as also part of residency option, interdisciplinary as the dentist has access to dental colleagues, specialists, and medical.
Perks, employment opportunities
Student loan reimbursement and part time available.
Residence
Employment terms depend on contract to allow to change residence.
Patient care
Patient base determined by assignment.
Facility/program oversight and standards
Accredited
Financial considerations
Employee budgeting determines financial planning opportunities. Dentist is a non-owner but may have 401k or loan repayment options.
General overview
Dentist provides for the oral health care needs of over 1 million active military personnel, and their families. Allows full focus on dentistry, not administrative or business operations.
"Ownership"
International and national
Brand or identity
Army, Navy, and Air Force actively recruit dental professionals. (The Marine Corps uses Navy doctors and dentists.)
Number of dentists
Can join before dental school through scholarship program or commissioned after dental school, and option even if have no affiliation with military.
Specialty collaboration or potential to specialize
Collaborate with medical, and opportunities to specialize. Opportunity for paid Advanced Education in General Dentistry (AEGD) to learn more specialty.
Location
International and national
Mentoring opportunity
Mentoring interdisciplinary as access to colleagues, specialty, and medical.
Perks, employment opportunities
Health Professions and Scholarship Program, tuition reimbursement, retirement path, full time as active duty or part time as reservist.
Residence
Allows for travel (great for someone who doesn't want to commit to same place for 20 years). Can be deployed.
Patient care
Patient base determined by assignment
Facility/program oversight and standards
Accredited
Financial considerations
Retirement planning opportunities. Dentist is a non-owner but may have 401k, loan repayment, or pension at a younger age.
U.S. Public Health Service Commissioned Corps are uniformed dental officers, serving in the Indian Health Service, U.S. Coast Guard, Federal Bureau of Prisons, and the National Health Service Corps. While their uniforms are derived from the uniforms of the U.S. Navy, the Commissioned Corps is under the Department of Health and Human Services, overseen by the Surgeon General, rather than under the Department of Defense.
General overview
Uniformed officers, serving in Indian Health Service, U.S. Coast Guard, Federal Bureau of Prisons and Immigration and Customs Enforcement allows full focus on dentistry, not administrative or business operations.
"Ownership"
Can be global
Brand or identity
As a branch of the U.S. Department of Health and Human Services, Surgeon General, USPHS Commissioned Corps, the dental officers embody the core values of their service: leadership, service, integrity, and excellence.
Number of dentists
Dentists serve terms. This is an option even if the dentist has no affiliation with military (civilian service).
Specialty collaboration or potential to specialize
Collaborate with medical, and opportunities to specialize
Location
International and national
Mentoring opportunity
Mentoring interdisciplinary as the dentist has access to dental colleagues, specialty, and medical.
Perks, employment opportunities
Many benefits, including tuition reimbursement, loan assistance, tax free housing, or pension.
Residence
Can be deployed to a public health crisis. Location depends on agencies.
Patient care
Patient base determined by assignment.
Facility/program oversight and standards
Accredited
Financial considerations
Retirement planning opportunities. dentist is a non-owner but may have a 401k or pension at a younger age.
Faculty - May involve a career that combines teaching, research, community service, and patient care in a dental school, hygiene, or assisting program.
ADA Practice Transitions (ADAPT): Buying or selling a practice? Looking for new associates — or a new role for yourself? Get step-by-step guidance.
Starting a new job search? Here are tools and perspectives to help you succeed.
Use the ADA’s interactive Practice Location Map for Dentists (member login required) tool to get location-based demographic information. Find data on the distribution of active dentists, population median income, as well as the number of federally qualified health centers with dental services in each state.
Every associateship and every dental practice is different. But generally, hiring organizations are looking for:
The ADA offers hiring resources for dentists, including:
Check out the ADA job board for openings across the country or check out ADA Practice Transitions for step-by-step guidance to find the right practice for your goals.
