What It's Like Being a Dentist

There are some professions that all of us feel familiar with, even if we've never lived them personally. At least, this is David Blackman's sense every time he tells someone that he is a dentist. "I would not say that they would basically have any more of a reaction than if I were to say I were an accountant, or I was a teacher," Blackman, who runs a private practice in Illinois, told ValuePenguin. Still, there's a lot more to the working life of a dentist than a patient knows. To fill in the gaps, Dr. Blackman will see you now.


Why did you become a dentist in the first place?

To be quite honest, when I was in college back in the day, I really didn’t know what I was going to do. I had taken a lot of science-based classes, so I had had a pretty good background in chemistry, biology and had taken physics and calculus, basically as a core curriculum. And then started thinking about, “OK, what do I really want to do?” As I looked through options, I was thinking about going into architecture. At the time, at the school I was going to, it was a seven-year program. I had three years in as a liberal arts major with a science background, and basically figured I’d have four more years to go through to get an undergraduate degree, and then the rest of it, so I ended up going to dental school. Kind of fell into it.

Did you ever question your decision?

Not necessarily in the education part of it. I think you always have some ambivalence about, "Is this the right decision?" I think it was more predicated on, "When you get out, am I going to make a go of it?" You have other things that are part of it. There’s always that degree of uncertainty.

What was life as a dental student like?

Dental school is challenging. I think that’s part of what it is. I tell all the younger people who come into the office -- and there’s no small number of them -- that pretty much everything that you do in school is challenging. I always look at it as, if it was easy, everybody would be doing it. So whatever their choice of job or vocation is, and however they go through life, nothing is ever easy.

That being said, dental school is difficult. I don’t think that, for the most part, my experience talking to other dentists has been that people go, “Dental school is great, I really liked the grind of it.”

How has dental education changed in recent years?

It’s changed from when I was in school. Basically, we would, as freshmen and sophomores in dental school, we didn’t really have a whole lot of dental experience, because most of the curriculum was based on your basic background classes, and you really didn’t get into the clinical aspect of it as much until you were a junior.

Now, I think they mix things up a lot, so you kind of have a different approach. You get a little bit more of the dental exposure earlier on than you did back when I was a student. So you’re a little more exposed to it. I think that’s actually a better situation, because there were some people I went to school with who basically didn’t graduate from dental school because of the way it was set up at the time, as opposed to how it is now.

What did you do when your degree was in hand?

I graduated in 1981. Back at that time, there was a recession. We had student loans, it was a little easier to get the student loans and to get through school; it was not as restrictive. However, interest rates were also very high at the time. So to go out and set up an office was a little bit more problematic. Everybody looks for the ideal situation, where there’s an office and somebody’s going to take you on, who’s a mentor, and going to show you the ropes, and let you transition in and be ultimately the person that takes over their office, or buys them out. In my case that didn’t happen. I went out, I opened an office. I had a partner — who I just recently split from — and we went out and built up a practice from scratch.

What were the initial steps of getting your office going?

I was lucky enough that I didn’t have to deal with living expenses per se; I had still not gotten married, and I was living with my parents for the first year. I was able to scrape together enough money; we bought an office, or we got a location. We went into a community that was growing. There was a lot of building going on. The town’s name was Carol Stream. In this community, they built two schools, they were putting up tons of housing developments, and they had just built a new shopping mall right on the border of the town. You come out here from where I had grown up, and it’s a different area in the suburbs of Chicago. And you say, “All right, there’s upside in this area by virtue of the building; there’s got to be a lot of people who are going to be moving out here." We ended up growing with the community over time and ended up building up a practice that way.

So you run the same practice today, but now on your own?

Yes, we had a corporate split within the last few months. This partner that I had has moved on, and he has taken the patients that wanted to go with him, and the patients who have stayed here have stayed here at this location. When we started, and that was in 1981, we had a 1,000-square-foot office in a strip shopping mall. About 12 years later, I bought a piece of property that had a building on it and converted the building to a dental office, and it was about 2,000 ft. That was in 1993. And then about five or six years ago, there was an addition that was put onto the existing 2,000-square-foot building. We put a couple of operatories in and expanded the office. It’s about 3,100 square feet, and I own the location.


What's a typical day at the office like?

We have a set schedule. So there’s a hygienist who will see people, clean their teeth and all that. Basically, we try to have a set schedule for a game plan, as far as how we’re dealing with people. So a treatment plan: It might be fillings or crowns or root canals. We’re continually changing and doing stuff on the fly based on what transpires with that person’s needs. So you might say, “I’m going to do a filling on the top right,” and they say, “This one on the bottom left broke,” so you say, “OK, the one on the bottom left.” And so we’re continually adjusting and dealing with stuff, even though we try to have a degree of continuity to keep sanity. But that’s just the nature of what the business is.

They will have to come and get me and say, “When you got a minute, could you come and check my patient?” So we try to incorporate that into the flow and logistics of the office. We have only so many patient treatment rooms and chairs, so at some point we have to have a degree of efficiency to get those people out, to get the next patient in. That’s just part of teamwork and cooperation, and efficiency, and making everyone fit in the flow, and make it workable.

Being a dentist is different than being in dental school. Most of us who are independent -- or are not part of a corporate structure -- have to deal with not only the dental aspect, but the management aspect. So you’ve got the staff, or you’ve got the accounts payable. Indirectly, the accounts receivable as they come in. I don’t deal with that directly; I have staff that deals with the receivables and the collections and the billings and the insurance. But that’s all encompassed in the operation of running the dental practice.

Doing this as long as you have, how has heightened technology affected your day-to-day in recent years?

It’s night and day. Back when I had first started, we would have regular X-rays; now everything is digital. Most of the cements are light-curable; most of the filling materials are light-curable, so that basically gives you a greater workability with the materials, because they’re so much better than what they were. Everything is computerized; I have a paperless office. So we don’t have a patient chart per se; I mean, we do, but it’s in the computer. We have patient tutorials that we can pull up and show them, so we can educate people. We have a laser, we have X-ray machines that are incredibly accurate and comprehensive. We have the ability now to replace teeth with implants, which really was not a viable option maybe a generation ago. We deal with filling materials that come in more colors than I can even see. It’s almost a total polar opposite from it was when I was in school. We still do basically the same things, but the technology has really facilitated all of that immensely.

Do you go through self-training on new, higher-tech products that you implement into the office?

Absolutely. You get the X-ray machine, and the company will train you on the X-ray machine. Of course, we are continuously going to seminars; I’m sure that Illinois is no different than most any other state, where we have to keep up with our continuing education. We have to do that on a yearly basis, and continually we do do that. That’s part of what the training always is; it’s a continual learning experience.

The office's longevity must help, but how else do you attract new clients?

The most important one source of referrals, that we are most concentrated on, is patient referrals. That’s still number one. Where somebody has gotten good service and a good result, that is the best source. You can also do mailers; you can do online advertising. We have done a little bit of that. I’ve never really been one that’s been totally based on that.

Now it’s a little bit different, with regard to insurance. You have other types of managed-care insurance plans that basically send patients to you by virtue of the fact that you’re a provider in their plan. I don’t typically want to do a whole lot of those. I will do some of the preferred provider plans, but not any of the HMO plans, because it just isn’t worth the aggravation of dealing with them, from my perspective. There are people who will; that’s a way that a lot of younger dentists seem to try to get their foot in the door and develop a niche, and move on to where they’re not necessarily needing to deal with those, as their career advances.

Speaking of young dentists, what separates a good one from an average peer?

The two things that kind of resonate with me with regards to that are having a passion for doing it, and attention to detail. As dentists, we’re pretty detail-oriented people as a rule. I think the people who get good results have this passion for wanting to excel and wanting to do well and wanting to have people be happy. Those are the two criteria, I think, that really kind of separate the people who are going through the motions from the ones where it’s their essence, part of their fabric.

Having "fell" into the profession yourself, did your passion develop over time?

I think that it’s been growing. There are tough days sometimes. You go, “Ugh, I’ve got to go in the office today.” It’s like that with every job, I guess. But once I get here, I have a great team that helps me out. I wouldn’t be able to do it without them. And they facilitate a lot of what I do. I’m a manager, but I’m not a micro-manager, and I give them the autonomy to do what they need to do. They look out for me in the same way that I look out for them. They get their stuff done, and it gives me the ability to focus more on the dental part of it than some of the management part of it.

For me, the fun part is sitting there and having somebody come in and putting their new smile in; or even doing a filling and giving them the mirror,and having them go, “Oh my god,” or, “Which tooth did you fill?” or whatever . To me, that is pretty self-satisfying.

Does a particular success story come to mind?

I had one recently where I had a lady who hated her smile. And she was hemming and hawing for years about whether she was going to do anything about it. When she had a job and insurance, she never had the time to deal with it. It never really happened. Then she got laid off, and now she had the time to deal with it, but now she didn’t have the finances. So nothing really happened. Then I think she came into some money because one of her relatives passed away, and she got some inheritance. So we went ahead and we started doing her smile. Generally when I do that, I put the teeth in and I’ll walk out of the room, and I’ll have my staff come in and see what they think. So I did that. I walked back into the room and she was sitting there crying. I was like, “What did I do wrong?” She said, “I can’t believe how great I look.” So that’s the thing that really makes it fulfilling. I take photos of the cases that are like that; I have a portfolio. It’s fun when you’re sitting there and you’ve got that, and I can say to somebody, “This is what I did. And so, this is what I’m going to do for you.” That is what I find to be the most fulfilling.

What advice do you have for future dentists?

I know one of the things that is concerning to a lot of younger dentists is the cost; dental school is expensive. It’s the type of thing that some people are sort of looking at having a mortgage when they graduate, but not really having a house, between their undergraduate costs and their dental school costs and all the living expenses that are associated with that. It’s a tough thing. There are articles all the time about the trade-off of going into dentistry, knowing that you’re going to have a degree of debt that might seem insurmountable when you’re first starting out. That’s something that I think people would have to analyze on an individual basis.

That being said, there are a lot of upsides to being a dentist. You have control of your life, your schedule; you’re basically autonomous in that regard. If you’re not comfortable with doing certain types of treatment, you don’t have to do it. If you wanted to focus on a certain type of treatment — if you wanted to do aesthetics or you wanted to do root canals or whatever it is, you could do that. I would still, in spite of any of that negativity financially, would still say that the upsides, in my mind, outweigh it. If somebody is considering this as a vocation, I would advocate that they pursue it.