Working on the road

I'm writing this from a drive-by Starbucks in Stockton.

For this week, I'll be doing some temp work for one of the corporate chains in California.

It's a pretty busy schedule with quasi-borderline treatment planning.
A lot of the work is subpar. A lot of it is rushed.
It'll be things like 4 quadrants of scaling and root planing and a crown in one hour.

In the mornings, there is a "huddle" that consists of assigning each dentist a production number.
We're expected to make that amount of money.

The assistants don't really know what's going on.
It's fun for them, because they do more than the usual suctioning.

However, for us dentists, it's pretty gruelling.
We're expected to do quadruple the usual private clinic production at HMO rates.
We're expected to do it to the minimum standard of care.

It's a numbers game. We are supposed to make at least 4 times what we cost to the company.
Otherwise, it's a loss.

I'm glad that I'm just a temp, an I intend to stay that way...
Because here, you get what you pay for.

Faking it

At the place where I'm renting space, I've been helping out with billing when I'm not seeing patients.

Its a test of patience. I've been learning that insurance seriously screws us over more than I thought. On the patient's side, there are always additional costs: increasing % responsible, increasing deductable limits, and the same coverage cap since the 1970's. On our end, we doctors get paid way less each year.

I'm not going to get myself in trouble by stating the actual amounts in question ("confidential" according to the insurance companies), but it's sometimes as stupid as 30% reimbursement or nothing.

Moreover, the music is driving me nuts!

I really, really can't stand the muzak that is playing down here. As a jazz, R and B, rock, indie, (anything but muzak), it's pure torture to listen to the Chipmunks Christmas carol play every five songs. It's pure smaltz with a double dose high fructose syrup.

While I can't do too much about the ripoff known as insurance, I will try to have music that doesn't suck.

Buying my first practice

For the past 18 months, I've been working as an associate under the pay as an "independent operator."

Essentially, this means that I'm working much harder for far less pay, relatively little control over quality control, and I'm taxed twice thanks to Obama. I've found many, many taxes that I have to pay on many levels that I never knew existed.

On the plus side, this has slowly taught me to think like a businessman. I've learned to think as not only a dentist, but also a receptionist, office manager, assistant, and accountant. I've learned about quality, profitability, and the concept of working capital, as I've scraped by from check to bill, to student loan.

It's about time for me to buy a practice and make it official.
I am a dentist. Hear me squeak.