How to Survive and Thrive in Uncertain Economic Times
A Recent Graduate's Perspective on the Recession's Impact on Career Challenges and Opportunities

"Ruben Cohen, DDS Class of 2002"

When I was in dental school, all I could think about was graduating. Then I enrolled in a residency program in oral and maxillofacial surgery, and sure enough, I couldn't wait to finish the program and start practicing. Little did I know that being out of school and in the “real world” wasn't as glamorous as it seemed. Unlike dental school, which gives you a place to practice, the equipment you need, and assigns patients to you, the real world requires you to secure a well-located, well-equipped office in an area with good potential for building a practice; demonstrate patient marketing skills; and develop the ability to look not just at immediate circumstances, but also at the big picture involving long-range planning.

I completed my residency in 2007, when the costs of purchasing and equipping office space were sky high. So rather than look into opening my own practice, I took a somewhat unconventional route, which has worked out quite well for me. I hope that my experiences - seen through the lens of the current economic climate - may be of interest to other young dentists.

Rather than join an established oral surgery practice or open my own practice, I chose to begin my professional life by practicing oral surgery in general dentists' offices. In addition to not wanting to take on the financial burdens involved in opening my own office, I did not want to sign a non-compete clause, which I would have had to do if I had elected to join someone else's oral surgery practice. As an independent contractor, I avoided having to sign an agreement that would have significantly restricted my future ability to practice in Manhattan. As it turned out, this was a good decision not only for me, but also for the dentists in whose offices I practice, since they were thrilled to be able to increase their productivity.

As someone who had been in school nonstop since childhood, I found myself enjoying an interlude of relative freedom and the concomitant opportunities it provided for me to explore new interests. My experience as a freelancer also started me thinking that even dentists who own their own practices, and have all the responsibilities that ownership entails, can take heart by remembering that this recession will end, and that, in the interim, she or he can still maintain a comfortable income, seize the opportunity to explore new pathways to personal renewal, and also make necessary changes to jump-start future practice growth. Some suggested ways to go about this are discussed below.

Teaching, doing volunteer work, and getting involved in your community are all great ways either to supplement your income during a recession or to find personal renewal, while at the same time giving back to your community and the profession. In light of the shortage of dental faculty in dental schools and residency programs aound the country, teaching in a local dental program is a wonderful way to augment your income and also make new contacts that can ultimately help build a practice.

Donating your professional services is also a great way to give back to your community and help those in need. There are a number of local organizations that provide free dental care to the needy. While you will not get paid for your services, you can talk to your tax advisor about writing off most of your expenses associated with donating your services.

There are also many opportunities for volunteering overseas. Having personally volunteered for such programs in Central America and Africa over the past few years, I can attest that this is probably one of the more rewarding experiences a healthcare provider can have. For more information on overseas programs, a good place to start is by contacting Health Volunteers Overseas at

Volunteering for community activities, such as school fairs where you might talk to youngsters about the dangers of smoking, will also increase your visibility in your community and allow you to build goodwill and visibility for your practice. While it will not increase your income, spending time with your family and doing things you've always wanted to do but never seemed to have the time for offers another significant upside to finding yourself in a situation when office production may be lower than in previous years. Having a newborn at home, I cherish every moment I get with her, and look forward to going home and spending a few extra hours with her everyday before she goes to sleep.

Finally, while it may sound counterintuitive to recommend starting a new practice or investing in new equipment during a recession, an economic downturn can offer excellent opportunities to establish or enhance a practice. That has certainly been my experience. With construction costs at an all-time low, real estate sales down, and leases more negotiable than ever before, it's actually a good time to renovate your office, get deals on new equipment, or start a practice. Dental equipment distributors and manufacturers are eager to sell their products, and there are great deals out there.

I am living proof of that, having recently negotiated the price of a dental office space for almost 10 percent less than what I would have had to pay last year. Now that I have an office space picked out, I've started to look for promotions that dental equipment distributors are offering to increase sales. For example, the financial services division of Henry Schein, Inc., is offering dental professionals loans with unusually low interest rates to encourage equipment sales. While some may question whether this is the right time to spend money, I see it as an extremely opportune time to spend so that by the time the economy blooms again, my practice will be ready to take advantage of an increased demand for dental services. My path to opening my own practice has not been traditional, but it has been enlightening for me, both as a person and as a health professional. If you'd like to share your experiences as a recent graduate, please visit me onFacebook at