I started this blog in February 2010 with the intention of chronicling my journey as an Air Force dentist and being a resource to help out people who had questions.
I was "scratching my own itch", if you will. I didn't see anything on the internet like what I wanted to read. So I made it myself.
500 emails, 250,000 page views, and a few phone calls later, I'd say it was quite a success.
After a long 10 years, I am finally in the process of leaving the military and acquiring a dental practice for myself. I can't say really anything more than that, but now you know. I've already learned a ton along the way, and I'm hoping to help military dentists get over the fear of transitioning into practice.
If you're a dentist (military or otherwise) considering transitioning to ownership, please contact me (my email is on the right side of the page)!
I would love to help you better understand if this is the right step for you and even do some help you look at different practice offers, associate contracts, or just brainstorm your next steps.
As for the future of this blog...
I've struggled recently trying to decide what direction to take it, if any, given the facts that:
1. I'm leaving the military (so the title doesn't work super well)
2. It makes me no money (so I can't sell it)
3. It's a very narrowly focused/designed blog (so there's not much else to explore)
However, I think it may be beneficial to continue my story in some way and I haven't quite decided if that will happen here at this domain or on some other blog that is tailored more towards my next phase in life. Stay tuned.
I've received literally hundreds of emails over the last decade and this blog has been a central location for those looking for information about military dentistry, the Air Force HPSP, dental school, and life in the military.
My email is still live, so keep the questions coming! Like I said at the top of the page, I'm welcoming any and all questions from those looking to transition to ownership.
It's been an honor and a pleasure, and I'm excited for the next step in my journey and helping you with yours.
Showing posts with label AFIT. Show all posts
Showing posts with label AFIT. Show all posts
Monday, June 24, 2019
Saturday, December 29, 2018
10 Books that Have Helped - Part 1/3 of Organizing a Military Dental Clinic
Organizing a Military Dental Clinic - 3 part series
This is part 1 of a 3 part blog series called "Organizing a Military Dental Clinic"
I'm going to talk about what I've learned from running logistics at 2 bases over the last several years, and hopefully it will help some military (and even civilian) dental clinics! I was fortunate enough to be part of some awesome teams that have won MAJCOM and Air Force level awards, but those victories were a testament to the systems and habits we created, not the will of the people in the clinics. I don't claim to have all the answers, but I have tried a lot of different things and I'm a relentless experimenter so hopefully these posts can help spark some new ideas for you and your clinic.
Ordinary people can do extraordinary things with the right habits and systems.
You don't need "superstars"; leaning on them may work in the moment, but things will crash when they are gone.
Let me say that one more time: this is not about the PEOPLE, it's about the SYSTEMS and HABITS you create and enforce over time.
There is a basic level of competency required, obviously, but I'm betting that most of the things your clinic does could be simplified significantly, making everyones job and life much more enjoyable.
10 Books that Have Helped- Part 1/3 of Organizing a Military Dental Clinic
Books are the #1 way I've learned (with podcasts coming in at a close #2) what you're about to read in this 3 part blog series. Obviously, the knowledge must be applied, but I firmly believe that you can only imagine combinations of that which is already in your mind, and the best way to add new things to your mind is to digest knowledge from the great thinkers via books and podcasts.
Here's my list of 10 books, in no particular order, that can help you become a better thinker when it comes to organizing your clinic.
1. The Power of Habit - Charles Duhigg
A modern classic on "how" to think about what we do every day. We are our habits. Instead of trying to change people, change the structure and incentives to drive them to the result they want. We aren't trying to change people, we are changing their habits. This is not a "quick fix" book, but it can lead to permanently new habits, which is the ultimate goal.
2. Extreme Ownership - Jocko Willink
Stop blaming other people for failings that happen on your watch. If you're in charge, own it. This extends to your personal life as well, but is relevant here for your work, too. Discipline = Freedom.
3. The Goal - Eliyahu Goldratt
This is a business book disguised as a novel (or maybe the other way around). It's a fun read that makes you think about how you can pull what you're learning into some real life actions for your business or clinic. This book gave me an actual idea for our supply chain at my first base that we ended up implementing and utilizing. For that reason, it had to make the list.
4. The E-Myth Revisited - Michael Gerber
I wish this was mandatory reading for all Air Force officers. This is the bible for how to think about any organization, even in a 1-person shop. The basic premise is to imagine your business/clinic as a prototype model for thousands more (even if you never plan to build a thousand more). The reason? This will force you to simplify things so aggressively that your business/clinic will start to run well almost regardless of who you plug into those spots. People will need less and less training and expertise to run your ever simpler clinic as you trim waste and make things better. This is a vital concept for military leaders when we don't know who will come and go.
5. Principles - Ray Dalio
Another modern classic. This will be a book that will go down in history as one of the most dense and actionable books ever written. I can't say enough about it. It's a big book, but it gives so many unbelievable mental models to think about your life and business/clinic. I wanted to dip the whole thing in highlighter. My favorite concept? Imagine yourself as 2 people (because you ARE 2 people -- reptilian brain and neocortex). Most people run life on autopilot (reptilian brain) without stepping back and imagining themselves from the outside.
If you've ever played a video game, this concept comes easily. You are the person playing the game and you are the character participating. Most don't realize this and just behave like the character, reacting to everything in life, without stepping back and making intentional choices. It's very akin to the concept of working "on" the business and not just "in" the business, as laid out in Michael Gerber's The E-Myth Revisited.
6. The Life Changing Magic of Tidying Up - Marie Kondo
Nope, not a joke. This book was written to help people organize their homes, but I can tell you, it is much more than that. This book helps you re-think about how you see "stuff" in general. This is an essential read for those wanting to organize anything in their life, and I'm dead serious. This will change your relationship with "things" forever, and by extension, dental supplies. You'll be much more decisive at ridding waste from your life, leaving room for the things that really matter. What could be more critical when trying to organize a dental clinic? Trust me on this one.
7. The Checklist Manifesto - Atul Gawande
Ugh, not another checklist. Ok, look. I hate being told what to do with those silly things, too. But dammit, they work. I love it when a patient can get a consistent experience and ultimately, checklists are the best way to focus new hires, establish consistent protocols, and enforce processes. Checklists save brain power, they put everyone on the same page, and they eliminate confusion. This book will make you smile every time you see a well designed checklist, and it will make you much better at making them yourself to systematize your clinic. I love sneaking checklists onto all sorts of things without people even realizing what it is. More on that in part 2/3.
8. Essentialism - Greg McKeown
This book is all kinds of awesome from every angle. The big takeaway here is to help your mind focus on what's really important. Too many of us treat our entire to-do list as an emergency and we end up freezing or just getting the wrong stuff done. It will help you think more about first-order problems instead of fixing the surface-level issue (you know, like the problems you "solve", only to watch them pop up again in a month?).
9. Switch - Chip and Dan Health
I love this book so much. It was one of the first books I read on the subject, and I've gone over it several times since then. It will help you think more deliberately about how changing the environment itself can help drive the behavior you want. It's not just about changing the people, which often doesn't work, but changing the way they work to eliminate ways they could get off course. This book has been pivotal in my work over the last few years. Another book I wish was a mandatory read for Air Force officers. Shape the path!
10. Ego is the Enemy - Ryan Holiday
You're not that special. Seriously. Once you can separate your ego from what you're trying to do or create, the sky is the limit. The harder you hold onto what people think of you, the lower opinion they will hold of you. Strip your ego away, be definitive, make the hard decisions, and own the results. Apologize when you screw up, be transparent, and don't skirt responsibility. Those with inflated egos are typically the kinds of people that don't build systems, because they don't trust other people to run them or they are too insecure about what other people will think if it fails. Get over yourself ;)
Bonus! The Power of Consistency - Weldon Long
This was the book that convinced me I had to read more books. It's the best. I'll leave it at that.
I have a lot more books, so if you want more recommendations, don't hesitate to email me (see the right side of my blog for my email address).
This is part 1 of a 3 part blog series called "Organizing a Military Dental Clinic"
I'm going to talk about what I've learned from running logistics at 2 bases over the last several years, and hopefully it will help some military (and even civilian) dental clinics! I was fortunate enough to be part of some awesome teams that have won MAJCOM and Air Force level awards, but those victories were a testament to the systems and habits we created, not the will of the people in the clinics. I don't claim to have all the answers, but I have tried a lot of different things and I'm a relentless experimenter so hopefully these posts can help spark some new ideas for you and your clinic.
Ordinary people can do extraordinary things with the right habits and systems.
You don't need "superstars"; leaning on them may work in the moment, but things will crash when they are gone.
Let me say that one more time: this is not about the PEOPLE, it's about the SYSTEMS and HABITS you create and enforce over time.
There is a basic level of competency required, obviously, but I'm betting that most of the things your clinic does could be simplified significantly, making everyones job and life much more enjoyable.
-------------
10 Books that Have Helped- Part 1/3 of Organizing a Military Dental Clinic
Books are the #1 way I've learned (with podcasts coming in at a close #2) what you're about to read in this 3 part blog series. Obviously, the knowledge must be applied, but I firmly believe that you can only imagine combinations of that which is already in your mind, and the best way to add new things to your mind is to digest knowledge from the great thinkers via books and podcasts.
Here's my list of 10 books, in no particular order, that can help you become a better thinker when it comes to organizing your clinic.
1. The Power of Habit - Charles Duhigg
A modern classic on "how" to think about what we do every day. We are our habits. Instead of trying to change people, change the structure and incentives to drive them to the result they want. We aren't trying to change people, we are changing their habits. This is not a "quick fix" book, but it can lead to permanently new habits, which is the ultimate goal.
2. Extreme Ownership - Jocko Willink
Stop blaming other people for failings that happen on your watch. If you're in charge, own it. This extends to your personal life as well, but is relevant here for your work, too. Discipline = Freedom.
3. The Goal - Eliyahu Goldratt
This is a business book disguised as a novel (or maybe the other way around). It's a fun read that makes you think about how you can pull what you're learning into some real life actions for your business or clinic. This book gave me an actual idea for our supply chain at my first base that we ended up implementing and utilizing. For that reason, it had to make the list.
4. The E-Myth Revisited - Michael Gerber
I wish this was mandatory reading for all Air Force officers. This is the bible for how to think about any organization, even in a 1-person shop. The basic premise is to imagine your business/clinic as a prototype model for thousands more (even if you never plan to build a thousand more). The reason? This will force you to simplify things so aggressively that your business/clinic will start to run well almost regardless of who you plug into those spots. People will need less and less training and expertise to run your ever simpler clinic as you trim waste and make things better. This is a vital concept for military leaders when we don't know who will come and go.
5. Principles - Ray Dalio
Another modern classic. This will be a book that will go down in history as one of the most dense and actionable books ever written. I can't say enough about it. It's a big book, but it gives so many unbelievable mental models to think about your life and business/clinic. I wanted to dip the whole thing in highlighter. My favorite concept? Imagine yourself as 2 people (because you ARE 2 people -- reptilian brain and neocortex). Most people run life on autopilot (reptilian brain) without stepping back and imagining themselves from the outside.
If you've ever played a video game, this concept comes easily. You are the person playing the game and you are the character participating. Most don't realize this and just behave like the character, reacting to everything in life, without stepping back and making intentional choices. It's very akin to the concept of working "on" the business and not just "in" the business, as laid out in Michael Gerber's The E-Myth Revisited.
6. The Life Changing Magic of Tidying Up - Marie Kondo
Nope, not a joke. This book was written to help people organize their homes, but I can tell you, it is much more than that. This book helps you re-think about how you see "stuff" in general. This is an essential read for those wanting to organize anything in their life, and I'm dead serious. This will change your relationship with "things" forever, and by extension, dental supplies. You'll be much more decisive at ridding waste from your life, leaving room for the things that really matter. What could be more critical when trying to organize a dental clinic? Trust me on this one.
7. The Checklist Manifesto - Atul Gawande
Ugh, not another checklist. Ok, look. I hate being told what to do with those silly things, too. But dammit, they work. I love it when a patient can get a consistent experience and ultimately, checklists are the best way to focus new hires, establish consistent protocols, and enforce processes. Checklists save brain power, they put everyone on the same page, and they eliminate confusion. This book will make you smile every time you see a well designed checklist, and it will make you much better at making them yourself to systematize your clinic. I love sneaking checklists onto all sorts of things without people even realizing what it is. More on that in part 2/3.
8. Essentialism - Greg McKeown
This book is all kinds of awesome from every angle. The big takeaway here is to help your mind focus on what's really important. Too many of us treat our entire to-do list as an emergency and we end up freezing or just getting the wrong stuff done. It will help you think more about first-order problems instead of fixing the surface-level issue (you know, like the problems you "solve", only to watch them pop up again in a month?).
9. Switch - Chip and Dan Health
I love this book so much. It was one of the first books I read on the subject, and I've gone over it several times since then. It will help you think more deliberately about how changing the environment itself can help drive the behavior you want. It's not just about changing the people, which often doesn't work, but changing the way they work to eliminate ways they could get off course. This book has been pivotal in my work over the last few years. Another book I wish was a mandatory read for Air Force officers. Shape the path!
10. Ego is the Enemy - Ryan Holiday
You're not that special. Seriously. Once you can separate your ego from what you're trying to do or create, the sky is the limit. The harder you hold onto what people think of you, the lower opinion they will hold of you. Strip your ego away, be definitive, make the hard decisions, and own the results. Apologize when you screw up, be transparent, and don't skirt responsibility. Those with inflated egos are typically the kinds of people that don't build systems, because they don't trust other people to run them or they are too insecure about what other people will think if it fails. Get over yourself ;)
Bonus! The Power of Consistency - Weldon Long
This was the book that convinced me I had to read more books. It's the best. I'll leave it at that.
I have a lot more books, so if you want more recommendations, don't hesitate to email me (see the right side of my blog for my email address).
Tuesday, November 27, 2018
8 Year Recap Post, FAQ, and My Future
This is an ambitious post. My goal is to make this post a very concise summary of my experiences over the last 8 years and answer some of the most common questions I receive via email, as well as an update on my future plans.
Before dental school
Recruiters
If you have even the slightest inclination that you might want to pursue the Air Force HPSP (Health Professions Scholarship Program) for dental school, contact a recruiter. There is a link on the right side of my blog, or you can find it HERE and select "Healthcare Student or Professional".
Unfortunately, the recruiting system gets a bad rap for being unresponsive and often unhelpful, so if you're having trouble getting in contact with a recruiter in your area, start looking outside your area and contact one of those instead. They can probably help you get in touch with your actual recruiter who isn't returning your calls and emails.
Application process
Everything flows through the recruiter. You need to be in decent shape, have excellent grades and DAT, and nail your interview.
For the interview, focus on all the generic questions (strengths, weaknesses, etc), but be prepared for additional questions like: Why do you want to be in the Air Force? Why do you think you would make a good Air Force officer? What leadership experience do you have?
You're an officer candidate, not just a potential Air Force dentist.
Choosing a school
Go to the school in the area with the cheapest cost of living! Your stipend does not change based on where you live, and you'll devour the stipend if you're living in Los Angeles vs living in Oklahoma. I spoke about this on the Choose FI podcast, episode 99R at minute 57:40.
During dental school
Money!
You get paid about $2,000/month during school, and the Air Force will pay all your other required bills directly. Some things (scrubs, loupes, books) will be on you to buy, and then you will submit some reimbursement paperwork to the Air Force. You should have some information of some contacts at AFIT that can help you out.
Military obligations
You don't have any! Yay!
After dental school/AEGD-1
COT
The timing of COT depends on your school summer schedule and when you commission, but most dentists go after dental school. You may find the COT Survival Guide helpful, but keep in mind that it was written in 2014. Also, check out the newest Air Force PT Test Score Charts to get an idea of where you'll land and start training for this test during dental school! Here's a good pushup and situp video to help you out, but remember, the official Air Force guidance on fitness is found here at A5.3 and A5.4.
AEGD-1
Unfortunately, my AEGD-1 experience was not all that great, but most students love their experience. Having said that, despite my misgivings about the training I received, the year itself was very formative for me personally and the experience was one that I count as one of the most pivotal in my life. I certainly must recommend the AEGD-1 for the sheer fact that it's going to be difficult to operate as an Air Force dentist without this advanced training, since the Air Force has their own system to "allow" you to do certain procedures (called "credentialing"). Even if you did a procedure in dental school, a residency may be required to do it in the Air Force (restoring implants, for example).
You are required to apply for, and accept, an AEGD-1 now. Not everyone will be accepted by the Air Force, but there's enough spots for most applicants. Plan on going.
As far as what base you get, you'll fill out a preference sheet just before your 4th year of dental school, but they could send you to any of the 12 or so AEGD bases. I don't really have any insight as to why they send people where they do.
Specializing
I get asked this question a lot, and it's a bit of a moving target. Some specialties do allow you to apply right out of dental school, while others want you to have a few years of experience (or an AEGD-1) under your belt first. Your AFIT contacts should have this information.
After residency/Being a dentist in the Air Force
Where will they send me?
Assuming you do an AEGD-1 like most Air Force dentists, you'll get a list of bases (in February-ish of your AEGD year) that need dentists and you'll get to rank them based on where you want to go. Unfortunately, while you do get a say, you're not guaranteed a top choice. I got my 16th choice, but it ended up being the best thing for me and my career.
I got to go to a small and remote base that was in dire need of organization and streamlining, as we were updating and planning for the arrival of a new F-35 squadron in the coming years. Previous officers hadn't systematized the clinic functions, but instead just relied on the people to run the place. When those people left, so did their ideas and processes, and the clinic was constantly starting over on processes when people would leave! I stepped into some roles that most young Captains don't get to experience, and got to hone my organizational and systematizing skills that would ultimately prove very valuable for my life and career.
What's a normal day like?
It depends on what base you go to, but a fresh Captain out of residency will usually be doing dentistry about 80% of the week. The rest of the time is set aside for training, PT time, or lunch. Expect to do a lot of restorative, with some single unit crowns sprinkled in as the mission permits and requires, and exams. If you did an AEGD and have the training, you'll probably be doing some IV sedation and restoring implants as well! Elective procedures (anterior crowns, veneers) will depend a lot on what the mission of your base is, and how well staffed the clinic is to suit your desires. I did almost no esthetic work at my first assignment, but a dentist at my new base is doing lots of anterior crowns and veneers because the mission is much less strenuous here.
What's the best part about being an Air Force dentist?
This depends on how you look at it. The normal answer is that you get to do dentistry without being pressured to produce a certain level of $, while having a nice slow pace to the day and getting lots of vacation time (as compared to a typical civilian corporate job). I think the "bad" things are actually good, and I detailed them a bit more in this post.
As far as vacation days go, you get 30 days per year that accumulate at a rate of 2.5 per month. It depends on the base's specific rules, but this 30 days usually does count the weekend.
If you leave on a Friday and come back Monday, that's 4 days you have to take off. Monday-Thursday would also be 4 days. Your "leave" days start and end in your local area. The definition of "local area" depends on your base's rules.
What's the worst part about being an Air Force dentist?
Again, this is going to be very personal, but I think the worst part is the slow pace and the lack of incentive to produce. However, there are lots of dentists that love this part of the job and would consider this a benefit, since they can take their time on their dental work and typically don't have to work any harder than they want to. You just need to know what Air Force dentistry is like and weigh your personality against it.
(If you didn't notice, I cheated here by using the same answer -- no pressure to produce -- for best and worst part, which leads me to...)
How is Air Force dentistry difference than civilian/private practice?
*These are my opinions from having worked in 2 civilian practices during my time as an Air Force dentist*
-Quality of work - I believe the Air Force tends to have higher work quality than most civilian providers. We don't have time pressures or too many cost pressures, so we typically get to spend as much time as we need to get things done the right way. Also, most of our dentists are a few years removed from a 1 year AEGD, which lends to even higher quality knowledge and care.
-Patient experience - I'll give the edge to private practice. I think most Air Force bases do not put enough emphasis on customer service, and our outdated charting system results in far too many records errors. However, there's a host of different ways this is managed on the civilian side, but at least on the civilian side, a dissatisfied patient can choose to take their business elsewhere. This is where the Air Force slips behind: our patients don't have options so we aren't incentivized to give them a good experience and we too frequently miss the mark.
-Clinic organizational structure - Unbelievably, I give the edge to private practice here, and it's not even close. One of the most surprising things to me about Air Force dentistry is how disorganized the organizational and accountability structure is at the clinic level. There's usually some holes in accountability and organization at some level that lets a litany of small problems leak through constantly. There's very little focus on creating good systems. Instead, most clinics rely on strong-willed individuals to run large portions of the clinic that end up suffering mightily when they depart for a new base. It seems there's no real training on "systems thinking" that would alleviate so much of the constant stress and little mistakes that occur daily in military dentistry. Everything I've learned about how to lead people, implement systems, and build/design a clinic has come almost exclusively from books I've chosen to read on my own. The military doesn't teach you this.
The biggest problem here is that, contrary to popular belief, there's just no incentive to be organized in the military because our patients are walking through the door and our appointment books are filled no matter what we do. Most are content to do "enough" and never really get to the point of optimizing and organizing things so they actually run as smoothly as possible. Things run satisfactorily, and that's all that matters to most.
For example, both bases I've been at didn't even have a consistent system to ensure the same items were reordered properly each time something ran out! There aren't even consistent locations for some items to be stored, so if they're out, it's impossible to know what was there without consulting someone who had the room memorized. (This is one area I've worked on at both of my bases to eliminate waste and confusion. It's usually just as simple as placing the order number and item name on standard containers and ensuring that 100% of items coming into the clinic have a permanent location, that everyone agrees on 1 method for altering the Logistics person that an item is low, and items don't just get tossed on a shelf or into a room.) If a certain person out for the week, good luck.
Often, an item would run out and there would be no accountability until the clinic was in an "emergency shortage" and had to rush order the item to the clinic. Fortunately, we have all the time in the world to do dentistry so typically these errors just result in rescheduling the patient or doing some less efficient procedure to get the job done. The minimal consequences of being disorganized tend to perpetuate the "good enough" mindset.
*Caveat: Most military clinics are far larger than civilian clinics, and the disorganization is far more obvious the bigger you get. Small civilian clinics can often survive (and typically do) just on the personality of the lead dentist, with little regard for attempting to imagine the business as a prototype model for a franchise (a la "The E-Myth"), but this fails in a military setting because there's always more than 1 dentist. Large civilian clinics that are poorly organized simply can't maintain their business structure and end up closing or restructuring. Large military clinics, on the other hand, stay open no matter what. In my experience, the larger the civilian clinic (if it's been open for a few years), the more organized it is vs a smaller 1-doctor civilian clinic.
-Employees - This is a touchy subject, so I'll tread lightly. I'm calling this one a tie. Here's why.
In the military, we sometimes get people that just flat out don't want to be in the dental field. Some have personalities and skillsets that are more well suited for some non-medical field. These kinds of people probably wouldn't last long in private dentistry (but to be fair, they would have never wanted to work there in the first place!). But, in the civilian world, you have an outrageous 60% (or more) of dentists that will be subject to embezzlement at some point in their career. That sucks! Civilian employees are no more saints than the military employees that don't care about their job but at least the military ones aren't stealing money from you.
Here's a huge positive with the military side: sometimes you get outstanding coworkers that have big dreams and aspirations and they understand that their performance in whatever job they have is an important stepping stone to the life they want. These are true gems and a total win for the military. Many civilians aren't thinking about the next thing, but in the military, some are constantly focused on learning and growing and getting to the next step, and it makes them valuable assets to your clinic.
In the end, people are people, including dentists. If you don't want to worry about hiring and firing, but also can't cultivate the team you want, the military is the way to go. If you're able to have those hard conversations, listen to your employees, facilitate their personal growth, and have studied and practice leadership and management, private practice is the way to go because you can create the office culture you want with the people you hire vs using the people you're given that may not want to be there. It's up to YOU as the dentist (and the officer) to create the culture you want and use the strong ones as your pillars while you build a new culture (military) or team (civilian).
Are you going to stay in the military? Why/why not?
I'm not staying in. I have a lot of personal reasons for this, but here are the top 3:
1. I believe that my experiences and skills can better serve humanity in a civilian setting
The Air Force is great, but it has its limitations. I can't run a clinic how I want to, I can't hire and fire, and I can't do the dentistry I want to do. Promotions happen in a stepwise manner, and your leadership skills don't really have any bearing on how quickly you can get into a command position. It has to do with your rank, which has to do with your time in service. I'm not a huge fan of the "wait and get promoted" style that the military uses to choose their leaders. Even if I could get into a command position, I don't get to choose who works at the clinic, and that can be a big hindrance to the development and progression of a clinical mission.
At the end of the day, I have a strong will and lots of leadership experience that is just going to take me far too long to manifest in the military setting. The limitations of the military also come with a lot of safety nets that suit many dentists very well, but not me. If they would make me commander of a clinic and double my pay, I'd think about it ;)
2. More time freedom
Notice how I did not say "more money". That's not a typo. I don't necessarily want more money, but what I want is more choices.
One "benefit" of the military is getting 30 days paid vacation every year plus a lot of federal holidays. But you know what? I still have to come to work 5 days per week, do a lot of non-dental stuff, and generally spend a lot of time doing dental work at a slow pace that I could accomplish in half the time. Lots of dentists in the military do less dentistry than me (and many do more), but we all still have the same schedule.
I could walk out right now and work 3 days a week and easily make the same amount of money. Or, I could work 5 days/week and make 2x as much as I'm making now. So what's the big deal about all these "days off" in the military? It's a logical fallacy in my opinion.
Which one is better -- making more money or working less? It's personal. It's about having the options.
Right now, my plan is to leave, buy a practice, implement my vision and systems, maximize productivity and systematize an outstanding patient experience using new technology and beautiful office esthetics, serve my community well, and have the freedom to work far less than I do right now.
Time is the currency of life. Don't let someone in the military use the "days off" argument as a way to convince you that you have more time freedom as a military dentist, because it's not true. Your skills have an extremely high value in the civilian world that, when leveraged properly, is far more valuable than what the military can offer you.
It takes more work to be a leader in the civilian sector than the military sector, but it's worth it. Read some leadership books, work on your management and leadership skills, and build a practice that lets you build a life of your choosing and take off half the year if you want to. We can't get our time back.
3. Self-actualization
I've read about 100 books in the last 2 years. I firmly believe that knowledge without action is worthless, so I've put a lot of action behind what I've learned. I've completely changed my diet, my workout routine, my morning routine, my habits, my beliefs about myself, and the way I handle stress (among many other things). I've also come to the realization that the life I envision for myself is not possible in the military.
Despite my emphatic shouts of "you must do the military for dental school", I firmly believe that a 3-4 year commitment, when utilized properly, is plenty of time to wrap your head around what it is you want for your life, your family, and your legacy on this planet.
This is getting a bit philosophical, but I mean it wholeheartedly. I have big plans and visions for my life, and I personally feel I would be doing a disservice to myself and those around me if I stayed in the military at this point. What I want for my life can't be accomplished in a military setting, and I feel it's time to break free and start to build that new life.
I must admit, when I graduated from my AEGD-1 residency, I was lost. I hadn't read more than a couple books that year, I was not confident in my dental or leadership skills, I had failed part of a PT test (and had it wiped from my record on a technicality), and I was generally confused about my future and what I had to offer.
But, over the course of the last 2-3 years, I started following and listening to leaders from all walks of life and came across a common theme: leaders are readers. So I started reading again.
It became an obsession that has continued to this day. I don't recognize the lost, confused, and complacent version of myself from 2014 and 2015. I'm a new person and I have books to thank for it. Those that know me from back then would be shocked at this statement, because I've always been driven, but I had lost my personal identity on what, exactly, I was driving towards.
I can't unread what I've read, or unthink the thoughts these authors have given me. I have a new confidence in my life and in my future, and I'm excited for the next step of my journey.
It is with no bitterness or resentment that I will wave goodbye to the Air Force, but instead, give it a warm farewell for a phase of life that broke me down, reshaped me, and sent me on my way with the confidence to design a life well lived.
--
As always, feel free to email me with any questions!
Before dental school
Recruiters
If you have even the slightest inclination that you might want to pursue the Air Force HPSP (Health Professions Scholarship Program) for dental school, contact a recruiter. There is a link on the right side of my blog, or you can find it HERE and select "Healthcare Student or Professional".
Unfortunately, the recruiting system gets a bad rap for being unresponsive and often unhelpful, so if you're having trouble getting in contact with a recruiter in your area, start looking outside your area and contact one of those instead. They can probably help you get in touch with your actual recruiter who isn't returning your calls and emails.
Application process
Everything flows through the recruiter. You need to be in decent shape, have excellent grades and DAT, and nail your interview.
For the interview, focus on all the generic questions (strengths, weaknesses, etc), but be prepared for additional questions like: Why do you want to be in the Air Force? Why do you think you would make a good Air Force officer? What leadership experience do you have?
You're an officer candidate, not just a potential Air Force dentist.
Choosing a school
Go to the school in the area with the cheapest cost of living! Your stipend does not change based on where you live, and you'll devour the stipend if you're living in Los Angeles vs living in Oklahoma. I spoke about this on the Choose FI podcast, episode 99R at minute 57:40.
During dental school
Money!
You get paid about $2,000/month during school, and the Air Force will pay all your other required bills directly. Some things (scrubs, loupes, books) will be on you to buy, and then you will submit some reimbursement paperwork to the Air Force. You should have some information of some contacts at AFIT that can help you out.
Military obligations
You don't have any! Yay!
After dental school/AEGD-1
COT
The timing of COT depends on your school summer schedule and when you commission, but most dentists go after dental school. You may find the COT Survival Guide helpful, but keep in mind that it was written in 2014. Also, check out the newest Air Force PT Test Score Charts to get an idea of where you'll land and start training for this test during dental school! Here's a good pushup and situp video to help you out, but remember, the official Air Force guidance on fitness is found here at A5.3 and A5.4.
AEGD-1
Unfortunately, my AEGD-1 experience was not all that great, but most students love their experience. Having said that, despite my misgivings about the training I received, the year itself was very formative for me personally and the experience was one that I count as one of the most pivotal in my life. I certainly must recommend the AEGD-1 for the sheer fact that it's going to be difficult to operate as an Air Force dentist without this advanced training, since the Air Force has their own system to "allow" you to do certain procedures (called "credentialing"). Even if you did a procedure in dental school, a residency may be required to do it in the Air Force (restoring implants, for example).
You are required to apply for, and accept, an AEGD-1 now. Not everyone will be accepted by the Air Force, but there's enough spots for most applicants. Plan on going.
As far as what base you get, you'll fill out a preference sheet just before your 4th year of dental school, but they could send you to any of the 12 or so AEGD bases. I don't really have any insight as to why they send people where they do.
Specializing
I get asked this question a lot, and it's a bit of a moving target. Some specialties do allow you to apply right out of dental school, while others want you to have a few years of experience (or an AEGD-1) under your belt first. Your AFIT contacts should have this information.
After residency/Being a dentist in the Air Force
Where will they send me?
Assuming you do an AEGD-1 like most Air Force dentists, you'll get a list of bases (in February-ish of your AEGD year) that need dentists and you'll get to rank them based on where you want to go. Unfortunately, while you do get a say, you're not guaranteed a top choice. I got my 16th choice, but it ended up being the best thing for me and my career.
I got to go to a small and remote base that was in dire need of organization and streamlining, as we were updating and planning for the arrival of a new F-35 squadron in the coming years. Previous officers hadn't systematized the clinic functions, but instead just relied on the people to run the place. When those people left, so did their ideas and processes, and the clinic was constantly starting over on processes when people would leave! I stepped into some roles that most young Captains don't get to experience, and got to hone my organizational and systematizing skills that would ultimately prove very valuable for my life and career.
What's a normal day like?
It depends on what base you go to, but a fresh Captain out of residency will usually be doing dentistry about 80% of the week. The rest of the time is set aside for training, PT time, or lunch. Expect to do a lot of restorative, with some single unit crowns sprinkled in as the mission permits and requires, and exams. If you did an AEGD and have the training, you'll probably be doing some IV sedation and restoring implants as well! Elective procedures (anterior crowns, veneers) will depend a lot on what the mission of your base is, and how well staffed the clinic is to suit your desires. I did almost no esthetic work at my first assignment, but a dentist at my new base is doing lots of anterior crowns and veneers because the mission is much less strenuous here.
What's the best part about being an Air Force dentist?
This depends on how you look at it. The normal answer is that you get to do dentistry without being pressured to produce a certain level of $, while having a nice slow pace to the day and getting lots of vacation time (as compared to a typical civilian corporate job). I think the "bad" things are actually good, and I detailed them a bit more in this post.
As far as vacation days go, you get 30 days per year that accumulate at a rate of 2.5 per month. It depends on the base's specific rules, but this 30 days usually does count the weekend.
If you leave on a Friday and come back Monday, that's 4 days you have to take off. Monday-Thursday would also be 4 days. Your "leave" days start and end in your local area. The definition of "local area" depends on your base's rules.
What's the worst part about being an Air Force dentist?
Again, this is going to be very personal, but I think the worst part is the slow pace and the lack of incentive to produce. However, there are lots of dentists that love this part of the job and would consider this a benefit, since they can take their time on their dental work and typically don't have to work any harder than they want to. You just need to know what Air Force dentistry is like and weigh your personality against it.
(If you didn't notice, I cheated here by using the same answer -- no pressure to produce -- for best and worst part, which leads me to...)
How is Air Force dentistry difference than civilian/private practice?
*These are my opinions from having worked in 2 civilian practices during my time as an Air Force dentist*
-Quality of work - I believe the Air Force tends to have higher work quality than most civilian providers. We don't have time pressures or too many cost pressures, so we typically get to spend as much time as we need to get things done the right way. Also, most of our dentists are a few years removed from a 1 year AEGD, which lends to even higher quality knowledge and care.
-Patient experience - I'll give the edge to private practice. I think most Air Force bases do not put enough emphasis on customer service, and our outdated charting system results in far too many records errors. However, there's a host of different ways this is managed on the civilian side, but at least on the civilian side, a dissatisfied patient can choose to take their business elsewhere. This is where the Air Force slips behind: our patients don't have options so we aren't incentivized to give them a good experience and we too frequently miss the mark.
-Clinic organizational structure - Unbelievably, I give the edge to private practice here, and it's not even close. One of the most surprising things to me about Air Force dentistry is how disorganized the organizational and accountability structure is at the clinic level. There's usually some holes in accountability and organization at some level that lets a litany of small problems leak through constantly. There's very little focus on creating good systems. Instead, most clinics rely on strong-willed individuals to run large portions of the clinic that end up suffering mightily when they depart for a new base. It seems there's no real training on "systems thinking" that would alleviate so much of the constant stress and little mistakes that occur daily in military dentistry. Everything I've learned about how to lead people, implement systems, and build/design a clinic has come almost exclusively from books I've chosen to read on my own. The military doesn't teach you this.
The biggest problem here is that, contrary to popular belief, there's just no incentive to be organized in the military because our patients are walking through the door and our appointment books are filled no matter what we do. Most are content to do "enough" and never really get to the point of optimizing and organizing things so they actually run as smoothly as possible. Things run satisfactorily, and that's all that matters to most.
For example, both bases I've been at didn't even have a consistent system to ensure the same items were reordered properly each time something ran out! There aren't even consistent locations for some items to be stored, so if they're out, it's impossible to know what was there without consulting someone who had the room memorized. (This is one area I've worked on at both of my bases to eliminate waste and confusion. It's usually just as simple as placing the order number and item name on standard containers and ensuring that 100% of items coming into the clinic have a permanent location, that everyone agrees on 1 method for altering the Logistics person that an item is low, and items don't just get tossed on a shelf or into a room.) If a certain person out for the week, good luck.
Often, an item would run out and there would be no accountability until the clinic was in an "emergency shortage" and had to rush order the item to the clinic. Fortunately, we have all the time in the world to do dentistry so typically these errors just result in rescheduling the patient or doing some less efficient procedure to get the job done. The minimal consequences of being disorganized tend to perpetuate the "good enough" mindset.
*Caveat: Most military clinics are far larger than civilian clinics, and the disorganization is far more obvious the bigger you get. Small civilian clinics can often survive (and typically do) just on the personality of the lead dentist, with little regard for attempting to imagine the business as a prototype model for a franchise (a la "The E-Myth"), but this fails in a military setting because there's always more than 1 dentist. Large civilian clinics that are poorly organized simply can't maintain their business structure and end up closing or restructuring. Large military clinics, on the other hand, stay open no matter what. In my experience, the larger the civilian clinic (if it's been open for a few years), the more organized it is vs a smaller 1-doctor civilian clinic.
-Employees - This is a touchy subject, so I'll tread lightly. I'm calling this one a tie. Here's why.
In the military, we sometimes get people that just flat out don't want to be in the dental field. Some have personalities and skillsets that are more well suited for some non-medical field. These kinds of people probably wouldn't last long in private dentistry (but to be fair, they would have never wanted to work there in the first place!). But, in the civilian world, you have an outrageous 60% (or more) of dentists that will be subject to embezzlement at some point in their career. That sucks! Civilian employees are no more saints than the military employees that don't care about their job but at least the military ones aren't stealing money from you.
Here's a huge positive with the military side: sometimes you get outstanding coworkers that have big dreams and aspirations and they understand that their performance in whatever job they have is an important stepping stone to the life they want. These are true gems and a total win for the military. Many civilians aren't thinking about the next thing, but in the military, some are constantly focused on learning and growing and getting to the next step, and it makes them valuable assets to your clinic.
In the end, people are people, including dentists. If you don't want to worry about hiring and firing, but also can't cultivate the team you want, the military is the way to go. If you're able to have those hard conversations, listen to your employees, facilitate their personal growth, and have studied and practice leadership and management, private practice is the way to go because you can create the office culture you want with the people you hire vs using the people you're given that may not want to be there. It's up to YOU as the dentist (and the officer) to create the culture you want and use the strong ones as your pillars while you build a new culture (military) or team (civilian).
Are you going to stay in the military? Why/why not?
I'm not staying in. I have a lot of personal reasons for this, but here are the top 3:
1. I believe that my experiences and skills can better serve humanity in a civilian setting
The Air Force is great, but it has its limitations. I can't run a clinic how I want to, I can't hire and fire, and I can't do the dentistry I want to do. Promotions happen in a stepwise manner, and your leadership skills don't really have any bearing on how quickly you can get into a command position. It has to do with your rank, which has to do with your time in service. I'm not a huge fan of the "wait and get promoted" style that the military uses to choose their leaders. Even if I could get into a command position, I don't get to choose who works at the clinic, and that can be a big hindrance to the development and progression of a clinical mission.
At the end of the day, I have a strong will and lots of leadership experience that is just going to take me far too long to manifest in the military setting. The limitations of the military also come with a lot of safety nets that suit many dentists very well, but not me. If they would make me commander of a clinic and double my pay, I'd think about it ;)
2. More time freedom
Notice how I did not say "more money". That's not a typo. I don't necessarily want more money, but what I want is more choices.
One "benefit" of the military is getting 30 days paid vacation every year plus a lot of federal holidays. But you know what? I still have to come to work 5 days per week, do a lot of non-dental stuff, and generally spend a lot of time doing dental work at a slow pace that I could accomplish in half the time. Lots of dentists in the military do less dentistry than me (and many do more), but we all still have the same schedule.
I could walk out right now and work 3 days a week and easily make the same amount of money. Or, I could work 5 days/week and make 2x as much as I'm making now. So what's the big deal about all these "days off" in the military? It's a logical fallacy in my opinion.
Which one is better -- making more money or working less? It's personal. It's about having the options.
Right now, my plan is to leave, buy a practice, implement my vision and systems, maximize productivity and systematize an outstanding patient experience using new technology and beautiful office esthetics, serve my community well, and have the freedom to work far less than I do right now.
Time is the currency of life. Don't let someone in the military use the "days off" argument as a way to convince you that you have more time freedom as a military dentist, because it's not true. Your skills have an extremely high value in the civilian world that, when leveraged properly, is far more valuable than what the military can offer you.
It takes more work to be a leader in the civilian sector than the military sector, but it's worth it. Read some leadership books, work on your management and leadership skills, and build a practice that lets you build a life of your choosing and take off half the year if you want to. We can't get our time back.
3. Self-actualization
I've read about 100 books in the last 2 years. I firmly believe that knowledge without action is worthless, so I've put a lot of action behind what I've learned. I've completely changed my diet, my workout routine, my morning routine, my habits, my beliefs about myself, and the way I handle stress (among many other things). I've also come to the realization that the life I envision for myself is not possible in the military.
Despite my emphatic shouts of "you must do the military for dental school", I firmly believe that a 3-4 year commitment, when utilized properly, is plenty of time to wrap your head around what it is you want for your life, your family, and your legacy on this planet.
This is getting a bit philosophical, but I mean it wholeheartedly. I have big plans and visions for my life, and I personally feel I would be doing a disservice to myself and those around me if I stayed in the military at this point. What I want for my life can't be accomplished in a military setting, and I feel it's time to break free and start to build that new life.
I must admit, when I graduated from my AEGD-1 residency, I was lost. I hadn't read more than a couple books that year, I was not confident in my dental or leadership skills, I had failed part of a PT test (and had it wiped from my record on a technicality), and I was generally confused about my future and what I had to offer.
But, over the course of the last 2-3 years, I started following and listening to leaders from all walks of life and came across a common theme: leaders are readers. So I started reading again.
It became an obsession that has continued to this day. I don't recognize the lost, confused, and complacent version of myself from 2014 and 2015. I'm a new person and I have books to thank for it. Those that know me from back then would be shocked at this statement, because I've always been driven, but I had lost my personal identity on what, exactly, I was driving towards.
I can't unread what I've read, or unthink the thoughts these authors have given me. I have a new confidence in my life and in my future, and I'm excited for the next step of my journey.
It is with no bitterness or resentment that I will wave goodbye to the Air Force, but instead, give it a warm farewell for a phase of life that broke me down, reshaped me, and sent me on my way with the confidence to design a life well lived.
--
As always, feel free to email me with any questions!
Wednesday, May 18, 2011
The End of the Beginning
Well... that does it. It seems like just yesterday I was stressing out about the start of summer anatomy and here I am. My first year of dental school is done! It's hard to really comprehend the fact that's it's over because it just went by so unbelievably fast.
Here are some things I learned about the Air Force, dental school, and life in general, during my first year.
1. The Air Force are emailing professionals:
These people are so efficient at answering questions and replying to emails, it's staggering. I'm not exaggerating either. Only twice have I sent an email during business hours and not gotten a reply in 15 minutes. They're extremely helpful and professional and get stuff solved ASAP. Great people.
2. Dental school is way more than grades:
So many people in my class, including myself, have missed certain grades by a fraction of a point, but when it comes down to it, that's not what really matters. Sure, some may be wanting to specialize, but in the end, it's about learning as much as you can to be a competent dentist. This is especially true with science classes. Yes, these are tough and often worth quite a few credit hours, but they have little to no bearing on how you will perform as a dentist. Take it easy, and focus energy on doing well in the dental classes if you are taking them simultaneously.
3. If you have 55 people in your class, you'll have 55 personalities to deal with:
This is pretty obvious, but it's an interesting dynamic in dental school. Never since elementary school are you with the exact same people all day, every day, taking the same classes with the same teachers. Amazing friendships are born, and some strange dynamics take shape. Some like to isolate themselves, while others will make a scene just to make a scene. In the end, you have to learn to respect each person for who they are or else you won't be able to fully appreciate anyone. Everyone has their strengths and weaknesses and just because someone isn't like you, doesn't mean they're doing something wrong. In fact, the only person like you, is you.
4. Finals week is 50% studying and 50% what you did leading up to finals:
What I mean is this. If you have a strong cushion going into finals week, you will hate your life far less. If you are stressing about a final because you need a 90 to get a B, while your friend needs a 70 to get a B, that sucks. Work your butt off during the semester when tests are more spread out to give yourself the luxury of picking and choosing where to concentrate during finals instead of worrying about just passing every class. Even if you could care less about getting an A, B, or C, study for the highest grade you can going into finals. Then you can slack off. You don't want to be the person that needs an A on a Biochemistry final just to pass the class and not get it.
5. Find what works for you:
Don't feel pressured to study in a group if you study better on your own. Don't feel obligated to use someone else's study notes just because they made a study guide for everyone. Don't feel like you have to stay isolated if you want a group to study with; just ask someone! Long story short, do what works for you.
6. Work together:
Like I said earlier, some in your class may want to specialize and that's fine. The way I see it is this: those that want to specialize will figure out how to. The more you all work together, the better you class will collectively do. Those at the top will still rise to the top, but those at the bottom will be a little higher as well. Don't let your ego get in the way of helping others and enjoying your time.
7. Your brain is not a to-do list or a calendar:
So don't trust it to be either. Get a to-do list app (I recommend wunderlist) and a sync-able calendar if you have a smartphone (Google Cal). Put EVERYTHING on there so you won't have that lingering thought in your head wondering if you've missed something.
Well that's about it for me. One quick note is that I ran for and was elected class president a couple weeks ago! I'll start serving in that capacity beginning June 6 and will end my term at the end of next spring. At that point, I can either run again or step away.
As always, email me if you have any questions!
Wednesday, February 9, 2011
Moving right along (sort of)
Well I'll start this post by saying this. Because of the snow, we have officially had 6 days of school cancelled so far. That's not 6 days since August, that's 6 days in the last month. It's hard to believe, but it's true. It's really messed up our schedule too because we've missed several hours of pre-clinic time that we just can't get back. Some other classes with just lecture have been able to reschedule just fine, but the pre-clinic and lab classes are really taking a hit. As I sit here now, in fact, we are out of school. Today is day #6 and the odds are about 50/50 that we'll be out tomorrow as well.
Anyway, about this semester. Last semester we had about 80-90 tests and quizzes, but this semester we'll have about 45. As you can tell, a much lighter schedule. It's nice to have a more relaxing semester after how crazy it was last fall. I felt like I could barely take a breath between tests last semester, but now we only have a couple things a week, if that. Most of our tests are crowded during the week before spring break or during finals week. Two of our classes are actually pass/fail and we have about 4 hours of pre-clinic time each week which has been a lot of fun.
As for the Air Force scholarship, not much new here. I sent in my reimbursement for loupes back in mid-December and still have not gotten paid back for them. I e-mailed AFIT a couple weeks ago and I was told that it was basically a problem of understaffing and the big holiday break. My reimbursements typically come back between 15 and 25 days, so this will hold the record for sure. Luckily I don't need the money right now so it's fine as long as it does come at some point. I had $13k+ of charges at the beginning of the year, only to see them all magically wiped away a few weeks ago. I sure do love this scholarship!
Sorry I don't have much more to say, but I'm pretty well adapted to the groove of dental school and this Air Force HPSP so there's not much "new" stuff going on right now. As always, feel free to e-mail me with any questions you may have!
Thursday, August 5, 2010
Stage 1: Complete
Well, I did it! Today I took my anatomy final and I am officially done with my first class of dental school. It was a bit weird because I've pretty much been doing nothing but anatomy for a bit over a month so it seemed to come to a very abrupt end. I don't have my scores from my test yet, but I'm almost 100% certain that I'll end with a B in the class. I needed a 98-100% to get an A, so I can bet that didn't happen. We start up again August 18th will our fall classes, so I have a small little break and I hope to let of some steam and just hang out (and maybe study ahead?) until then.
A quick word about grades for everyone...
I was the kind of guy that HATED getting B's in college and I managed to stay in the A range all but twice. In dental school your mindset has to change a little because it's just not the same game anymore. Not only are your classmates far more intelligent/hardworking than your peers in undergrad, there is more material in less time and it's often more difficult. You've made it to dental school, and now all you have to do is pass to become a dentist. If you get bent on getting A's, you'll kill yourself trying to get them. Now, with that, you need to do your VERY BEST to get good grades if your intent is to specialize. As another side note, getting a C is alright, but odds are you know much less than people making A's and B's and thus, theoretically, they'll be a better dentist. In reality though, just relax and do your best. Remember, your best is ALWAYS good enough!
My 3rd reimbursement came in the other day (for health insurance) as well as my 2nd stipend. All of my tuition/fees for the fall have been deferred and everything is still running unbelievably smoothly. I had my doubts coming into this thing, but I'm truly blown away with how great the Air Force has been. I just e-mailed out a reimbursement for my fall semester books so I'll keep you all updated on how that goes. So far, it looks like it's taking roughly 20 days to get money from a reimbursement from the time I send it to AFIT and the time the money appears in my bank account.
(AFIT stands for Air Force Institute of Technology. They are my point of contact while I'm on scholarship. In other words, they handle everything other than my stipend stuff)
Off to do a whole lot of nothing for a while!
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