Can You Afford to Get Hired?

The road to finding my first associateship has been full of twists, turns and surprises.  Perhaps the one that caught me most off-guard was how expensive it can be to get hired!  A new dentist soon learns the meaning of the phrase, “It takes money to make money”–and it can be a painful realization.

The job search experience can vary greatly depending on the type of position you’re looking for, where it’s located, and more.  The price tag for landing your gig will vary with these factors, too.

Take my advice and, if at all possible, make room in your budget well in advance.  I’m 30 days away from entering private practice–I’m happy to share some of my own numbers below:

NPI Number = $0.  God bless you, HHS Department.

DEA Number = $731.  God damn you, Justice Department.  Luckily, not every practitioner will need to purchase a DEA number, such as those working for a clinic with an institutional DEA number or those who do not prescribe any medications requiring a DEA number.  A DEA number is renewed every three years, and is required by my employer before I can begin working.

Interviews = $1000?.  Unfortunately, my job search was not local.  While completing a residency in Arizona, I simultaneously coordinated  interviews back home in Milwaukee.  In the end, it totaled to 11 interviews over three different trips.  Each trip meant a 150-mile drive to Phoenix, airport parking, a flight to Milwaukee, the gas money that fueled my fiancee’s car to and from interviews as far as 80 miles from home, a flight back to Phoenix, and another 150-mile drive back to Flagstaff.  Any vacation day I took for travel was also $120 in extra earnings lost.

Granted, not all job searches will present these same challenges, but I didn’t see how I could possibly find the right fit without meeting hiring docs face-to-face, seeing the office, and interacting with staff and patients.  Thankfully, I was able to kill two birds with many trips by overlapping interview dates with holidays or family celebrations.  Consider the fact that you’ll need to show up for an interview (and hopefully more than one!) if looking to start your career out of state.

Relocation = $600+.  These results will come in next month…and mostly consist of the cost of driving a Jeep from AZ to WI.  So glad I’m not hiring a moving company…

State License = $150.  Having talked with colleagues, I feel so fortunate to purchase a license in the state of Wisconsin!  For example, the state of Washington charges $700 for initial licensure, and the state of North Carolina charges $2000 for a license by credentials.

Also, consider added fees for “jurisprudence” exams (and travel costs that may accompany it, if required in person), fingerprinting and fingerprint processing fees, etc.  Find out how much your state charges for a license, as well as any other states you may be considering.  A Wisconsin dental license is renewed every two years.

See any quarters?

NPDB Self-Query Report= $8.  As part of a licensure application, a practitioner must purchase this report from a national data bank…then pay to have it notarized.

Professional Advisers = $1000.  Again, this can vary greatly depending on your current needs.  The most expensive scenarios are those in which new dentists are looking to evaluate and possibly purchase a practice in a buy-out scenario.  Making serious plans early in your career for partnerships and purchases can be excellent, but this also means that the accountants, attorneys and other transition coordinators are getting involved.  Brace yourself for steep hourly rates, but keep in mind, good advice is a solid investment that can help you avoid many costly mistakes.  One of my colleagues invested over $25,000 for his practice acquisition.  Know the limits of your knowledge and respect the value of advisers (don’t try to do too much on your own), but also earn as much as you can from colleagues and mentors to minimize these expenses.

Health Insurance = $250.  As a young dentist, I just recently left my family’s coverage for health insurance.  My wedding isn’t for another year.  My hiring dentist cannot legally offer me coverage with the practice for six months.  This leaves me with the issue of health insurance.  Until certain benefits kick in, new practitioners may have to carry their own high-deductible short-term health insurance policy.  Proof of health care coverage is required by my employer before I can begin working.

Disability Insurance = unknown.  Still working on this one…

Professional Liability (Malpractice) Insurance = $50 – 250.  Thankfully, this is an expense that will be reimbursed after a probationary period at my practice.  Even so, it’s money that has to be made available up-front, prior to the start date at the associateship.  Proof of malpractice coverage is required by my employer before I can begin working.


This list can go on and on…purchasing a professional wardrobe, moving to a new home, and oh yeah, student loan payments coming due!

The prospect of becoming gainfully employed can be sobering.  Surely, this is not meant to deter emerging dentists from putting their education to work, nor should the realities of becoming a health care professional cause you to lose sleep.  I simply want to highlight the need to anticipate the up-front expenses for entering practice.  The cost to position yourself for that first paycheck can pose a daunting financial challenge.

By-and-large, this is money well spent.  But even money well spent is money spent.

New grads…start saving those pennies.

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5 responses to “Can You Afford to Get Hired?

  1. I pay $125/mo for some excellent disability coverage that will roll over to an even better benefit upon completing my residency. A great piece of advice I heard was to definitely not cheap out on this stuff. Our hands, wrists, elbows, shoulders and backs need to keep us going for years! It’s also crazy to hear how different each state is with regards to fees. Great post, Doc!

    • Great ideas! My girls are so young that it is still easy to tuck the candy away and they (mostly) forget about it in a few days. I am going to try the same tact this year and see how suescscful I am. When I need to I will start working on a trade-in system.

  2. Fantastic post! I have another year in my pedo residency, I am already starting to think of these things.

    I have a wife and 3 kids, health insurance is well over $1000.

    • Thanks for your post! Great that these items are already on your mind–best of luck with your residency!

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