Everyday Workflow by Kalyan Voruganti

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28/06/2022

Hey everyone,

I’ve recently had a few people asking me and my wife contract questions, so I thought I’d just do a quick post with a few simple thoughts.

First thing - ALWAYS make sure you have a written contract. Do not ever, ever start a job without one. If you are in an existing job and you don’t have one then make sure you get one. Why? You’ve got a good relationship right? Because if there is ever a disagreement it becomes a lot more costly and messy to sort it out if you don’t have a written contract. Have you ever seen a poor divorce lawyer? Exactly.

I’ve had people message me saying they have transitioned from newgrad to SFA and the terms are completely different and also there are crazy exclusion zones etc on them. This should have all been worked out beforehand. If it’s not in writing this is where it gets messy.

Get the ADA to check your contract or a good lawyer. (The ADA is generally an excellent resource for this and very cost effective). They will advise you what is and isn’t reasonable. One thing to remember is that things are mostly negotiable. If you’re not sure whether it is or not then just ask the person giving the contract.

For newish grads typical percentages vary now from what I’ve seen from 30 percent up to about 38 ish. This is quite often on a sliding scale based on hourly, daily or monthly production. Corporates seem to screw their dentists with this the most (obviously dependent on the corporate). There are very, very few people offering a straight 40 percent these days for newish grads. Especially if they require frequent case discussion and mentoring etc.

Remember though it’s not all about the percentages. A well set up practice will be providing mentoring and CPD and may be sending you more of the type of work you want to do. So keep it in perspective. It may also be worth asking associates who work at the practice what it’s like.

One big thing I hear too is that associates are paid late and if they discuss this / have pay questions or ask for a contract that their boss gets angry. This is complete BS as far as I’m concerned and I’d even go so far as to say it’s abuse. Don’t listen to sob stories that they can’t pay you or need to pay you late. You should be paid on time.

Don’t be scared to discuss your pay or your contract. It should be written in your contract by when you should be paid by in business days. Pay should be transparent too. Any calculations and invoices etc should be provided if requested.

If you need to have a difficult conversation then come at it from a place of mutual agreement. Eg “I’ve noticed on the contract you’ve provided that it says this. I’d like to change it to x. What can we do?”

Before the conversation literally just do 3 or 4 bullet points and put it on a sheet of paper so you’re clear and concise with what you want to say before you have the conversation. Don’t go into these conversations demanding things because it will only sour your relationship. Happy practices are built on good relationships. Newgrads in particular are really scared about these difficult conversations and waffle a lot but using the bullet point method seems to work with the ones I’ve dealt with.

The next thing is always, always protect yourself. What do I mean by this? Well it’s like writing good patient notes. Any conversations you have regarding pay etc ideally need to be documented by email or if you have a verbal chat ask them to follow it up with an email summary unless you are getting a contract sorted. (You can always email yourself a quick summary of a conversation if they won’t send you one). This again is to protect you should they try and pull something. I’ve heard of people getting percentages changed, retention amounts being added out of the blue and money withheld etc and so everything needs to be documented.

Finally, if none of the clinicians in your practice have a written contract then please encourage them to all get them asap. You’ll hear a lot of horror stories about owners screwing OHT’s and associates etc. That does happen, in some cases it can be as simple as the owner is just really laid back. So don’t assume that every owner is out to screw you. Older owners in particular will be more laid back with this I find.

Bit of a long post (sorry) - these are just some musings off the top of my head. TL:DR version - make sure you have a written contract.

Disclaimers - I’m a General Dental Residency(GDR) tutor and have also been mentoring with some of the Melbourne Uni OHT’s, so I deal directly with a lot of newgrads and hear the good and the bad.

My wife Lavania Voruganti also runs Here Write Now for Dental a business to help dentists, newgrads and OHT’s with their cover letters, resumes and interview coaching etc. If you need some help with this reach out to her at lavania@herewritenow.com.au

If you found this post helpful please like and share it!

16/02/2022
A simple case with a couple of crowns. I kept these again fairly conservative. I try not to go on root dentine where pos...
20/09/2019

A simple case with a couple of crowns. I kept these again fairly conservative. I try not to go on root dentine where possible as I know the bond isn't as good there (as long as the patient is happy).

I don't do tabletops as much these days as I prefer the circumferential coverage giving a small amount of retention form which I like.

A double emax case - because, why not?
07/08/2019

A double emax case - because, why not?

I'm pretty happy with Celtra but thought I'd give Emax a go, here's one of my first forays into it.The patient presented...
30/07/2019

I'm pretty happy with Celtra but thought I'd give Emax a go, here's one of my first forays into it.

The patient presented with a 46 with a very large filling. the 47 has some wear to it so we agreed to fill that at the same visit.

Another routine cerec case. A large composite with a heavy occlusion starting to fracture.Celtra duo, Cemented scotchbon...
17/07/2019

Another routine cerec case. A large composite with a heavy occlusion starting to fracture.

Celtra duo, Cemented scotchbond and Nexus and oxyguard. Core venus flowable

Apologies - accidentally deleted the photo of what was left after I took out the filling!

Thoughts and comments welcome

Another routine cerec, except for a slight hiccup!Celtra duoNexus cement
26/06/2019

Another routine cerec, except for a slight hiccup!

Celtra duo

Nexus cement

Another case for you lot... pretty straightforward. P2PNew patient presented with an RCT on the 36. The filling was brea...
28/05/2019

Another case for you lot... pretty straightforward. P2P

New patient presented with an RCT on the 36. The filling was breaking and we agreed a full coverage restoration.

Prepped as conservatively as I dared with his occlusion.

Celtra duo. Nexus cement. All went to plan.

Should have done a bit more polishing of the adjacent teeth in hindsight, otherwise I was quite happy.

Thanks to Alejandro Alves for the polishing and staining etc

03/06/2017

It's been a while since I've posted. After kindly being nagged by Aodhan Docherty I thought I'd post something useful.

Here is a case of a leaking crown. A younger colleague of mine was struggling to remove one and followed DPR's advice to use multiple sections etc and it took almost an hour. So I took these pictures to help her, which I thought may also be useful to people who don't remove crowns that often.

This is my technique - refined by the beloved NHS. It requires no fancy tools other than a sharp fissure bur. 10 minutes start to finish. About 40 with the photos.. haha.

There are many ways to skin a cat but this works for me.. enjoy & hope it's helpful.

An interesting case - this patient had resin retained bridges to replace his congenitally missing laterals over 10 years...
07/07/2016

An interesting case - this patient had resin retained bridges to replace his congenitally missing laterals over 10 years ago. The last few years he was getting fed up that they were repeatedly coming off.

After a long discussion we agreed to replace them and we have conventional bridges or implants as our backups should these fail. I always warn patients redoing resin retained bridges you can never guarantee how well they bond the second time round.

Aesthetically it was challenging as the centrals were much lighter than the remaining teeth.

I know a lot of people shy away from resin retained bridges due to complications but if you're careful with your cases and you follow the right protocol they can work very successfully.

Please like, share and feel free to comment. Be kind :)

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