Richard, I just got picked up at the airport using a private limo service in a high end Mercedes. It had many controls for comfort in the back seat like heated and multiple adjusted seats like a driver’s seat, along with personal temperature controls. The thing that surprised me the most was the soft closing doors!
I Think the easy solution is just have very rich friends who like to treat you to great vacations or a couple weeks on their yacht. Then you don’t have to worry about tipping the help. I’ve been thinking about becoming a politician or a Supreme Court justice for the perks!😄
I practiced fee for service general dentistry for 45 years. At one time dentists were high on the list of trusted professionals. Because of student loans, less and less dentists start their own practices. They either associate with an older dentist or join a corporate run practice offering retirement, continuing education, and paid vacations. There is pressure under either circumstance to earn a living. Participation in dental insurance plans also reduces income. Insurance companies have to make money and get the dentist to take a reduced fee, sometime substantial, from their standard fee schedule. It all puts the patient at a disadvantage. The patient wants to maximize their benefits and seek out participating dentists. Insurance plans are all different and benefits to the patient and dentist depend on how much the employer is willing to spend on the plan! Insurance tends to force offices to hire additional staff to handle all the different forms. One University had different plans, read different coverage, for the staff and one for administrators but with the same company! So name alone is no indication of coverage. Deductibles and annual limits reduce the care a patient gets in one year.. And, of course, if it is not used the insurance company pockets the premium.
I heard the new owners of an existing practice, known to me, suddenly telling their patients they needed deep scalings 4 times a year and bite guards. They had to generate income to pay for their new practice as the outgoing dentist was excellent and little treatment was needed. As an opposite example, a former student of mine and new owner dentist inherited patients in need of major care due to the fact that the beloved outgoing dentist was a poor operator. Try to convince a patient of their need under those circumstances!
As with any business, overhead requires having good staff with retirement benefits and vacation pay, putting monies away for future upgrades in equipment, computer and software, rent, malpractice and liability insurance, infectious waste removal, etc.. The doctor should have those same benefits. No income is generated when attending required continuing education, vacations, let alone taking advanced courses. Fees need to cover these costs in 45 - 50 weeks of practice, hence, there are more group practices and corporate run practices. Need I mention a young dentist would like a home and support a family. Forty-five years ago it took a dentist 16 years to be on equal footing with a trades person due to college costs and loss of income those eight years. I cannot imagine, with the cost of dental education reaching 90-100 thousand per year with interest, how long it takes today!
I can appreciate the difficulty in finding an honest and quality practitioner today. Word of mouth, the Academy of General Dentistry, the Pankey Institute, and the Spear Dental Education all offer referral sources to help find good dentists and one's committed to continued dental education.
To clarify, Pa requires the tax return to be filed within 9 months. A saving of 5% if you pay the tax within 90 days and can be done in advance of the filing. Just make sure you keep records of payment as the state can be slow in sending a receipt which you would use with the return.
I appreciate the savings at Costco, however being single puts the savings under a different light. If membership costs $60.00 and I purchase 60 items over the year, I would add $1.00 to the cost of that huge pie! Not to mention my added tailor bill due to my increasing waistline by not allowing that extra pie go to waste! LOL!😂
While in my industrial engineering program (electrical was considered the hardest with the smartest students), I realized I did not want to sit behind a desk all day but work with people and with my hands. So I added the necessary courses to satisfy dental school entry. Being an older student it did not sit well with me that my organic chemistry class had 16 as a passing score out of 90! My annoyance with not being taught anything of value but evaluate my ability to memorize was my downfall for my first attempt. There where many grumblings amongst the 200 students because one student consistently got scores of 80 thereby moving the curve up from 12!
Next month I’ll have been retired for a year at the age of 75 after 41 years of practice. I admire those with pensions, paid vacations, and paid sick leave, Paying off practice loans, providing staff with med insurance and retirement monies, dealing with insurance companies, and the public are some of the downsides of private practice. As I look back through all that transpired I am very satisfied with my career change, the satisfaction of the quality of the care I provided, and all the interesting people I had the opportunity to treat.
If the US Navy had trained me to be a jet mechanic instead of a reciprocating engine mechanic, I would have retired maybe 10 years ago with a pension from one of the airlines! 😊
People have asked me what my middle name is? I have told them Nimin and they want to know about such an unusual name. I inform them the US Navy gave it to me as it is on my records and dog tags. It appears as NMN for no middle name! LOL.
“Food insecurity” is a problem with food banks struggling for product. Some of the obesity issues are the foods available at low cost or available in poorer neighborhoods are not necessarily the healthiest. For decades the mini convenience building, with only a few vending machines, on Native American reservations had lots of sugared drinks (soda) and snacks with no alternatives. Hence a lot of tooth decay and calories both contributing to their weight and diabetic tendencies.
New this year for 2023 is a one time max donation of up to $50,000 to fund a charitable gift annuity(CGA) as part of your QCD. The University of Pittsburgh sent information with an annuity through this CGA.. something to look into, it is new and my enrolled agent was not aware of it and just returning from an update course.
As a retired dentist in Pennsylvania in my own practice, that was non-participating I told patients if their employer paid for dental insurance great otherwise they should consider self insurance. Insurance companies have to make a profit and they contract with dentists to take a discounted fee. Most plans that I saw had a maximum of $1000 up to $1500 per year. In recent years, some of these insurance companies have reduced payouts to their participating dentists! So there’s been a tendency for dental offices to do some type of self insurance within the practice to benefit both the patient and the dental office. Insurance driven offices have to increase their production, and reduce the cost of supplies to be profitable. Rents and staff salaries along with benefits continue to increase. Over the years gold prices have forced dentists to find less costly lab bills by making changes in the materials and lab used. Technology and new materials have helped but some offices seek out the cheapest lab they can find. There have been articles questioning the use of labs out of China offering 1/5 (or greater) the price of using a top quality lab! The patient is unaware of the quality of care and materials used and usually respond to the personality of the dentist. luckily, most are ethical, honest, and caring.
Comments
Richard, I just got picked up at the airport using a private limo service in a high end Mercedes. It had many controls for comfort in the back seat like heated and multiple adjusted seats like a driver’s seat, along with personal temperature controls. The thing that surprised me the most was the soft closing doors!
Post: Car talk- Quinn likes friendliness
Link to comment from April 20, 2025
I Think the easy solution is just have very rich friends who like to treat you to great vacations or a couple weeks on their yacht. Then you don’t have to worry about tipping the help. I’ve been thinking about becoming a politician or a Supreme Court justice for the perks!😄
Post: Care to join me on my yacht cruising the Mediterranean? Do you envy the super wealthy? RDQ
Link to comment from March 22, 2025
I practiced fee for service general dentistry for 45 years. At one time dentists were high on the list of trusted professionals. Because of student loans, less and less dentists start their own practices. They either associate with an older dentist or join a corporate run practice offering retirement, continuing education, and paid vacations. There is pressure under either circumstance to earn a living. Participation in dental insurance plans also reduces income. Insurance companies have to make money and get the dentist to take a reduced fee, sometime substantial, from their standard fee schedule. It all puts the patient at a disadvantage. The patient wants to maximize their benefits and seek out participating dentists. Insurance plans are all different and benefits to the patient and dentist depend on how much the employer is willing to spend on the plan! Insurance tends to force offices to hire additional staff to handle all the different forms. One University had different plans, read different coverage, for the staff and one for administrators but with the same company! So name alone is no indication of coverage. Deductibles and annual limits reduce the care a patient gets in one year.. And, of course, if it is not used the insurance company pockets the premium. I heard the new owners of an existing practice, known to me, suddenly telling their patients they needed deep scalings 4 times a year and bite guards. They had to generate income to pay for their new practice as the outgoing dentist was excellent and little treatment was needed. As an opposite example, a former student of mine and new owner dentist inherited patients in need of major care due to the fact that the beloved outgoing dentist was a poor operator. Try to convince a patient of their need under those circumstances! As with any business, overhead requires having good staff with retirement benefits and vacation pay, putting monies away for future upgrades in equipment, computer and software, rent, malpractice and liability insurance, infectious waste removal, etc.. The doctor should have those same benefits. No income is generated when attending required continuing education, vacations, let alone taking advanced courses. Fees need to cover these costs in 45 - 50 weeks of practice, hence, there are more group practices and corporate run practices. Need I mention a young dentist would like a home and support a family. Forty-five years ago it took a dentist 16 years to be on equal footing with a trades person due to college costs and loss of income those eight years. I cannot imagine, with the cost of dental education reaching 90-100 thousand per year with interest, how long it takes today! I can appreciate the difficulty in finding an honest and quality practitioner today. Word of mouth, the Academy of General Dentistry, the Pankey Institute, and the Spear Dental Education all offer referral sources to help find good dentists and one's committed to continued dental education.
Post: Hole Truth
Link to comment from March 1, 2025
To clarify, Pa requires the tax return to be filed within 9 months. A saving of 5% if you pay the tax within 90 days and can be done in advance of the filing. Just make sure you keep records of payment as the state can be slow in sending a receipt which you would use with the return.
Post: A Time to Give
Link to comment from August 24, 2024
I appreciate the savings at Costco, however being single puts the savings under a different light. If membership costs $60.00 and I purchase 60 items over the year, I would add $1.00 to the cost of that huge pie! Not to mention my added tailor bill due to my increasing waistline by not allowing that extra pie go to waste! LOL!😂
Post: Taste Those Savings
Link to comment from December 21, 2023
While in my industrial engineering program (electrical was considered the hardest with the smartest students), I realized I did not want to sit behind a desk all day but work with people and with my hands. So I added the necessary courses to satisfy dental school entry. Being an older student it did not sit well with me that my organic chemistry class had 16 as a passing score out of 90! My annoyance with not being taught anything of value but evaluate my ability to memorize was my downfall for my first attempt. There where many grumblings amongst the 200 students because one student consistently got scores of 80 thereby moving the curve up from 12! Next month I’ll have been retired for a year at the age of 75 after 41 years of practice. I admire those with pensions, paid vacations, and paid sick leave, Paying off practice loans, providing staff with med insurance and retirement monies, dealing with insurance companies, and the public are some of the downsides of private practice. As I look back through all that transpired I am very satisfied with my career change, the satisfaction of the quality of the care I provided, and all the interesting people I had the opportunity to treat. If the US Navy had trained me to be a jet mechanic instead of a reciprocating engine mechanic, I would have retired maybe 10 years ago with a pension from one of the airlines! 😊
Post: Long Time Leaving
Link to comment from October 12, 2023
People have asked me what my middle name is? I have told them Nimin and they want to know about such an unusual name. I inform them the US Navy gave it to me as it is on my records and dog tags. It appears as NMN for no middle name! LOL.
Post: What’s in a Name?
Link to comment from August 26, 2023
“Food insecurity” is a problem with food banks struggling for product. Some of the obesity issues are the foods available at low cost or available in poorer neighborhoods are not necessarily the healthiest. For decades the mini convenience building, with only a few vending machines, on Native American reservations had lots of sugared drinks (soda) and snacks with no alternatives. Hence a lot of tooth decay and calories both contributing to their weight and diabetic tendencies.
Post: Going Bananas
Link to comment from August 24, 2023
New this year for 2023 is a one time max donation of up to $50,000 to fund a charitable gift annuity(CGA) as part of your QCD. The University of Pittsburgh sent information with an annuity through this CGA.. something to look into, it is new and my enrolled agent was not aware of it and just returning from an update course.
Post: Easy to Miss
Link to comment from August 19, 2023
As a retired dentist in Pennsylvania in my own practice, that was non-participating I told patients if their employer paid for dental insurance great otherwise they should consider self insurance. Insurance companies have to make a profit and they contract with dentists to take a discounted fee. Most plans that I saw had a maximum of $1000 up to $1500 per year. In recent years, some of these insurance companies have reduced payouts to their participating dentists! So there’s been a tendency for dental offices to do some type of self insurance within the practice to benefit both the patient and the dental office. Insurance driven offices have to increase their production, and reduce the cost of supplies to be profitable. Rents and staff salaries along with benefits continue to increase. Over the years gold prices have forced dentists to find less costly lab bills by making changes in the materials and lab used. Technology and new materials have helped but some offices seek out the cheapest lab they can find. There have been articles questioning the use of labs out of China offering 1/5 (or greater) the price of using a top quality lab! The patient is unaware of the quality of care and materials used and usually respond to the personality of the dentist. luckily, most are ethical, honest, and caring.
Post: What Medicare Misses
Link to comment from August 16, 2023