Welcome to the February edition of The Paper Point!

Greetings and welcome to the winter issue of The Paper Point! This is my favorite time of year, as goals are set, files are cleaned out and newness is taking shape. I am sure that many of you are feeling the same. Some of you will be completing your practice residency this year; others will be starting your second or final year and will begin thinking about life beyond school. Others have been out practicing for a year or two and might be mulling a location to settle down or a practice to buy. Whatever the new year brings to you, our committee members are ready to help you meet your goals.

In keeping with our financial theme, we've got some great content in this issue that can help keep you on track. Treloar & Heisel has graciously written a piece with information about how to plan for your future, covering all of the "small" details that we sometimes overlook. Several of our committee members dug into their personal experiences to share them with you—what it's like to return to residency after practicing as a dentist in the private sector, how starting your own practice is sometimes a bit longer and drawn out and some personal tips on managing your financial affairs on a daily basis. We hope this issue helps you come closer to your goals in 2012, whatever they may be!

Best Regards,

Kerri L. Lawlor, D.D.S.
Chair, Resident and New Practitioner Committee

Making Ends Meet
Submitted by Kimberly A. Lindquist, D.D.S., M.S.D.

BankEach of us has a unique story about our life before, during and after endodontic training. I share my story because it involves having an income prior to the graduate program, then becoming a resident without an income and the financial realities of that transition. This is my story:

I began my graduate endodontic education at Case Western Reserve University on July 1, 2003. I graduated from the program in June 2005. I experienced the same classes, literature reviews, oral examinations and course work as my co-residents. What was different for me was that I had been a practicing general dentist for several years and had an income that my family and I felt was comfortable. Suddenly, I was a student again, using student loan monies to pay for my education and to feed, clothe and house my family.

My husband and I moved our four children from Rochester, Minn. to Cleveland, Ohio. We sold our home, our property and many of our possessions to put together a small savings for my two years of unemployment. A small stipend had been offered to the incoming graduate endodontic residents, which would help with the unpredictable needs of a family of six. However, I was informed the week before my residency began that the funds for the stipend were no longer available. The department chairman asked me if I wanted to keep my spot as one of the incoming residents. I wanted to become an endodontist, so of course I'd stay.

We planned for my husband to secure a job in Cleveland and to care for our toddler while the older three children were in school. Unfortunately, in 2003, the unemployment rate was already in the double digits in Cleveland. My husband searched for a job, but was unsuccessful. While that meant we did not need childcare, it meant we would need student loan money not only for my education costs but also for family needs.

At the time, I was unconcerned about the amount of student loan debt I was accumulating. I figured I'd be able to pay the debt off just like I had previously. What I did not factor was the cost of purchasing an endodontic practice after graduation. I did not factor in the expense of selling our Cleveland home and re-locating my family of six yet again. I did not consider the added expenses of a new home for my family, new schools for my children and new employees for the new office.

Even though I had practiced general dentistry for several years, I was never a solo practitioner. I did not realize the expense of running one's own business, and I did not consider lenders would be looking at my employment history. I didn't know that a two-year gap in my work history would be a barrier to funding. Not only that, but I would be self-employed, another barrier to overcome for financing.

There are finance companies that offer money to healthcare professionals for practice start-up. They serve a purpose, but at a cost. Usually, the interest rates are high, and there are pre-pay back penalties, but they are willing to give health professional "entrepreneurs" the money needed to get started. These companies provide the start-up income a new practitioner needs.

Seven years later, I am still paying off debt, and sometimes I feel overwhelmed by the numbers, but I am working hard and continue to pay it down.

I share my story, not to scare or depress, but to bring some important points to your attention. Look closely at your debt and consider what you'll need to do in your practice to pay it off.

The Circuitous Route Back to Specialize
Submitted by Mike Reynolds, D.D.S.

Dental OfficeAfter two years of private practice in Minnesota, I decided that I wanted to specialize in endodontics. My wife is from Minnesota and was not thrilled about the idea of moving away, again, but nevertheless, she was very supportive. My love for endodontics really began early in my private practice career. I began mainly seeing emergency patients, so I found myself doing a lot of root canals and absolutely loving it. It wasn't until a year later (and after my wife and I bought a house) that I began to consider the option of going back to school to specialize. Timing isn't my thing, apparently. At my office there was discussion of a buy-in, but I had a gut feeling that this was not right for me. After a month of going back and forth about finances and our new home, we decided to take a leap of faith and I would go back to school.

I will never forget the day in July that I walked into my boss's office and told him that I did not want to buy into his practice, and that I wanted to go back to school for endodontics. I told him I wanted to be upfront and honest about this decision. My experience working at his office had been great, but endodontics had become a passion that I had to pursue. He was visibly disappointed but handled the situation well and said we would talk more about this after I put in my applications. About two months later, I found out that I was accepted into a residency program and I was ecstatic, followed by an overwhelming feeling of anxiety that I would, again, have to sit down with my boss. The next day I sat down and had one of the most difficult conversations I have ever had. I told him that my plan was to go back to school in July, and I would love to continue working with him until that time. I also told him that if he was uncomfortable with our situation, then I will look for employment elsewhere until I went back to school. He told me to "honor our contract" until July, and he would do the same.

In December of the same year my boss informed me that he had found someone to replace me, and they would start on January 1. I think my jaw hit the floor. I am not sure if it was a breakdown in communication or if "honoring a contract" can have multiple meanings, but all I knew was that in a few weeks I would be unemployed. Things were looking pretty bleak at this point, and I was beginning to question my decision to go back to school. Then, by the grace of God, I received an e-mail from a friend who practices an hour and a half away. She was pregnant and needed someone to cover her maternity leave; I jumped at the opportunity. I ended up working from January until the time I left for school. I don't know what I did to deserve such a blessing, but I am forever grateful. Other than working 12-hour days and spending nearly three hours a day commuting, it was a wonderful experience.

So how did everything else turn out? Well, we were able to rent out our house to a nice family, who signed a two-year lease. My wife was able to get a job as a nurse at the university hospital to supplement the aid that we receive from student loans. Although our budget is much tighter now than when I was working, we are still getting along just fine. If I had to do it again I would approach it the same way. Honesty is always the best policy, even if you end up getting burned. The best part is that now, every day, I get to wake up and go do what I love. That is something that money can't buy.

In Due Time
Dr. Kerri L. Lawlor, D.D.S.

If you're still unsure as to what you're going to do about a job when you finish your residency, my No. 1 piece of advice is to keep an open mind.

I've been out of residency for about two and a half years, and those years have been invaluable to me because they have narrowed down what I want long-term as well as what I don't want. Let me explain—I was a general dentist for eight years prior to my residency. I started my dental office from scratch and sold it to another dentist when I decided to return to school. At the time I sold it, I swore I would never own another dental office again. All I wanted to do was work for someone. No more stress of employees, patients, building and equipment issues, payroll and paying bills. That was my plan. Finish residency, find a job and I did. I've been with my employer for the full two and a half years now.

But as I practice, I am discovering that I want to own my own practice again. Not immediately, but at some point in the future. If I hadn't worked for someone else, and started my own practice again right out of the gate, I'm not sure I would know this. I went into my employment situation with a very open mind. I wanted to test it and see how it fit for me and my family. It's a great job, but it's not for me, for the rest of my practice-life. And now I get the excitement and fun of planning and creating my own practice in the future. In my experience, you should try to envision your career as a process. Doors will open and others will close. Try not to panic and think any choice you make is permanent; you can always move, try something or somewhere different. Your goals and desires will change and your practice-life should reflect that and be a part of that. My path is a bit slower and is evolving, compared to others that immediately know how they want to practice when they complete their program.

If you are in this boat, enjoy the ride and don't rush! What is meant to be, is meant to be, and it all comes in due time.

Debt Resources

CalculatorThe Resident and New Practitioner Committee would like to share the following debt calculation resources with you in order to help you analyze when and how much to pay and save as well as to determine how much you can money you can borrow. These resources have been added to the Resident and New Practitioner section of the AAE website. Please stay tuned for these and other financial resources.

Debt Calculators

Debt/Salary Wizard

Five Financial Steps for Graduating Residents
Submitted by Jeffrey E. Wherry, CFP©, CLU, ChFC
Treloar and Heisel, Inc

Endodontic residents typically receive little training in how to handle money once they enter practice and sometimes view it as an imposing challenge. In reality, new practitioners should start by building a firm financial base comprised of these five steps:

1. Buy insurance. Just like brushing your teeth is the foundation of good oral health, protecting current and future assets by purchasing insurance forms the foundation of a strong financial plan. Insurance policies that newly graduated residents often need include:

    • Disability Income Insurance to provide income if you cannot work due to an illness or injury. Consider a non-cancellable guaranteed renewable policy with guaranteed contract language and level premiums. Also, you should include provisions that protect your occupation, enable you to collect benefits while working but suffering a loss of income due to disability, increase benefits while disabled such as cost-of-living benefits, and a future increase option that allows you to increase benefits irrespective of health.
    • Professional Liability Insurance to protect you from malpractice claims. Pay close attention to the difference between "claims-made" and "occurrence" forms of coverage, and evaluate which might be best for you over the long-term. The best policies offer a "pure consent" clause, which state that a claim cannot be settled without your consent. In addition, make sure your insurance company has a strong financial rating.
    • If you have dependents, then the need for Life Insurance may be apparent. However, even those who are single with no children may need coverage as collateral for a practice loan or to cover a buy-out agreement between business partners.

2. Establish an emergency fund of three to six months of spending. Everyone should create a cash cushion before worrying about retirement plans or other investments.

3. Write a budget that includes a plan to pay taxes. Your budget should include a surplus of funds in the range of 20% of gross income to apply towards reducing debt and long-term savings, including establishing an emergency fund. Furthermore, you should project income and taxes at the beginning of each year and withhold or escrow enough money to cover these potential taxes.

4. Create a plan to pay off loans. Generally, loans should be accelerated if:

    • Monthly loan payments exceed 30% of gross income
    • Loan interest rate exceeds what could reasonably be earned in a moderate investment portfolio over the same period of time as the loan term.
    • Consider "stacking" loan payments to accelerate loan repayments. When you pay off a loan, layer the amount of that payment on top of the next loan payment and continue to do so until all loans are retired.

5. Write a basic will. Although you may not have much now, having a will enables your loved ones to handle your estate with the least amount of resistance from the courts. A will is critical if you have a family.

Financial planning success is really more about making good decisions with basic spending, saving and protection options. Once the financial base is laid, you can move on to other more exciting choices such as investing.

Treloar & Heisel Inc.Securities, investment advisory and financial planning services offered through qualified Registered Representatives of MML Investors Services, LLC, member SIPC. Treloar & Heisel Inc. and T&H Financial Group is not a subsidiary or affiliate of MML Investors Services or its affiliate companies. Supervisory Office: 11 Stanwix Street Suite 1200 Pittsburgh PA 15222, 412/562-1600.

BU Campus
The Boston University campus, site of APICES 2012.

Join us at APICES 2012, August 3-5, Boston University

  • World-class speakers and presentations
  • Opportunity to meet and socialize with other residents from across the nation
  • Free to all residents

Watch for details to come in the coming months. Please direct any questions you have about the program to Alyson Hall at ahall@aae.org.

JOE Flies High with U.S. Army's Golden Knights

The Journal of Endodontics went airborne – along with 2011 graduates of the endodontic residency program at Fort Bragg, N.C. – during an annual celebratory outing with the Golden Knights, the Army's elite precision parachute team. Since 2009, the graduating residents have been taking the JOE along for the jump.

The Golden Knights, headquartered in Fort Bragg, travel the country performing parachute demonstrations at air shows and sporting events, as well as tandem jumps with celebrities, former presidents and other soldiers. Noteworthy passengers include Chuck Norris, Geraldo Rivera and 41st President of the United States George H.W. Bush.

The residents were grateful for the experience and the time spent with such highly trained and skilled professionals.

Dr. Worrell Residents
Dr. Dentonio Worrell and Golden Knights member Staff Sergeant Jared Zell fall through the sky with the Journal of Endodontics. Drs. Dentonio Worrell, Joe Dutner, Justin Naylor and Nathan Lund, residents of the endodontic program at Fort Bragg, before the skydive.
Do You Have News to Share?

The Resident and New Practitioner Committee is looking for fun news about your program to include in the next issue of The Paper Point, the quarterly e-newsletter sent to all residents and new practitioners.

  • Have any exciting happenings in your program?
  • What were your residents up to this fall and winter?
  • What types of groundbreaking research are happening at your institution?
  • Any famous alumni?

Please direct all questions or send any news items to Alyson Hall, AAE development coordinator, at ahall@aae.org, or by calling 800/872-3636 (U.S., Canada, Mexico) or 312/266-7255 ext. 3008.

© 2012 American Association of Endodontists. All Rights Reserved.
American Association of Endodontists
211 E. Chicago Ave., Suite 1100
Chicago, IL 60611-2691
Phone: 800/872-3636 (U.S., Canada, Mexico) or 312/266-7255
Fax: 866/451-9020 (U.S., Canada, Mexico) or 312/266-9867