orthodontists

[Thebeyonder]

Hi,
Is anyone here an orthodontist?
Do you like it?
How well are you paid?
Is it hard to collect money from people?
Is it stressful if people declare bankruptcy?
Do you do the billing yourself, or do you
hire an outside agency?
Do you get paid during your ortho residency?
Where do you work?

What's the difference between a dentist and an orthodontist?

[Dr. Pedo]

Tony,

The difference is an orthodontist is a specialist with additional years of study. In addition to 4 years of dental school they must take the GRE test (yes the same one that most graduate students take) and then spend another 2-3 years specializing in orthod. Upon completion they receive their Master's degree or certificates. Orthod. and dentofacial orthopedics treat problems related to irregular dental development, missing teeth, and other abnormalities. They establish normal fnx and appearance for their patients. The field is extremely difficult to match-in and if your not in the top of your class with high boards, it will be a up-hill battle.

Hope this helps,
R.R.B

[Hope7]

What are the lowest board scores and GPA you can have in dental school and still be confident about getting into an orthodontic program? Is there anything else besides good board scores, GPA and letters of recommendations that are essential to being admitted?

[DrJeff]

Ortho is one of the most competitive residencies to get into(Ortho and Oral Surgery are the two real competitive ones). Ortho programs range from a 2 year certificate programs to 3+ year combined Master of Science/Certificate programs(Both types will make you a specialist in orthodontics). It is a very attractive specialty since there are very few(if any) emergencies, no anesthesia to administer, generally a friendly/appreciative patient load, and you are very well paid. To get into a program, strong board scores, a very high class ranking, at solid recomendations are needed. I can however add as an aside, that the ortho program that my wife graduated from that the interview and faculty like/dislike of the candidate made a huge difference.(basically if you had huge board scores/rankings, but were so high on yourself that you came off as a real jerk, then a candidate with lower board scores/rankings, but a great personality/outside interests would get the position). Remember, rankings/ board scores aren't everything, you still have to be a desireable candidate to work with for the 2 to 3 years that the program takes.

[GoatBoy]

Obviously the answer will be different for each school and class, but what type of score would usually give you a ranking near the top of the class (eg 95+).

What is the avg salary for an Orthod?

[endoman]

I get the feeling that you are interested in orthodontics just because of the money. Orthodontics can be a very demanding job after hours, and one who is in ortho just for the money will get out soon. This specialty is very cerebral, and one must be able to think out of the box in order to get good results in demanding cases. You should really be asking questions about ortho and its principles instead of about the money. This specialty can be very rewarding to those who are interested, but it can be very boring to those who despise studying cephs and growth principles. Good luck in the future, and research ortho before making any decisions.

[DrJeff]

Endoman hit the nail on the head. Ortho is similiar to a long lasting, very calculating game of chess. New computer analysis programs have made the x-ray analysis factor less, and alot of the best ortho results come from those practitioners who are able to constantly react to the unknown variables (i.e patient compliance, oral hygiene, paranoid parents, etc).
As for the hours involved, my wife typically leaves for the office about 7AM, and on many days won't be home till about 9PM(granted a full work week is 3 days for her), but ortho can be quite tiring, since a busy office will see anywhere between 60 to 100+ patients per day.
Bottom line, if your thinking with your wallet(about ortho, or dentistry as a whole for that matter), you may want to reconsider things, because this profession can be very demanding and mentally trying if you don't really enjoy the concept of dentistry as a whole.

[GoatBoy]

I understand what you are saying, I am definitely not going in this profession for the money, however, compared to the other info, reliable salary info is very hard to get a hold of. Also, there is nothing wrong with trying to find out salary info, especially with the amount of tuition we pay it gives an idea of how long it will take to pay back.

[Thebeyonder]

If you want to answer my questions, then answer them. I am too old for your lectures however. Save the lecture for when you are talking to someone who asks for your opinion. I am interested in the money part of orthodontics because, money is an integral part of life. I don't want to go into a field where all I am doing is tracking down people that refuse to pay. I want to practice dentistry not be a bill collector.
Tim.

[endoman]

If you are that interested in money, then why would you give 7-8 years of earning money in order to become an orthodontist. Not only are you not earning money for 7-8 years, but also, the average student is building significant debt. I think you would be better off being a broker or a banker. I am not saying dentists don't make a great living, but the stress level one endures is very high while practicing dentistry. However, if this makes you feel better, I know several orthodontists in the south that net over $800,000 a year, but I also know several orthodontists that are only netting 150-200K/year. Usually, an ortho practice will take 4-5 years to build a significant patient base. I know you don't want to hear lectures, but you should ask yourself if you would enjoy ortho only if you are one of the guys making 800k/year.

[DrJeff]

If cold hard numbers are what your looking for, you can figure that a full time orthodontist in an established practice depending on the area of the country can net between 250,000 and 750,000+ per year. There are aloot of sacrifices and lower earning times though to get to that income level though. The good thing though is that with anything that resembles even an average economy, orthodontics are almost accepted by all parents as something that their kids will need, and thus the demand is almost always good. In better economic times, that when the parents themselves will also consider treatment for themselves(thats one of the main reasons that the current Invis-align add campaign has generated alot of interest). Plus, orthodontics is almost always a fee for service specialty with little at best insurance coverage, so most families don't hestitate one bit if they find out that their insurance doesn't cover the treatment(this is often quite different if folks find out that their insurance doesn't cover other dental procedures). And, if the HMO trend in the unlikely chance that it gets a grip on dentistry(very, very doubtfull), since ortho is rarely covered now, it wouldn't be affected then.

[peppercat]

I don't think that all of you should be so hard on people inquiring about salary. I mean you want to make an informed decision about a future career and look at it from all angles. It would be foolish IMHO not to be concerned about a future pay. That should not be the deciding factor in determining a career but it should be considered.

[Jamier2]

Originally posted by peppercat:
<STRONG>It would be foolish IMHO not to be concerned about a future pay. That should not be the deciding factor in determining a career but it should be considered.</STRONG>

I agree peppercat. I can't see why everyone jumps on somebody for asking about future salaries. Whether or not it is your motivation, it is an important part of your future. Unless you are already independently wealthy, that is.

[groundhog]

Dr Jeff,
There is one Dental HMO in my area (Columbia Dental Group) that does support orthodontics. Patients are billed a co-pay of $150 for an analytic exam and $1,000 for a complete orthodontia treatment (which seems like a bargain to me).
I think the folks who started Columbia Dental Group recognize the economic sense of getting one's teeth properly spaced and then following through with a life long preventative maintenance program (consistant home brushing/flossing supported by regular professional check ups/cleanings). Unfortunately, most dental insurance companies still seem to be stuck in the old repair as needed mode of business.

[DrJeff]

It depends on the exact type of plan. If its a true dental HMO, then the orthodontist has agreed to treat all the patients in that plan in that area for a set fee(the $1000) that you mentioned. With the average ortho treatment in the US ranging between 2000 to 6000 per case depending on geographic location, and most orthodontists very busy, I wouldn't see too many enrolling to gain more patients for less money. Most likely what that plan is is a PPO(preferred provider option)or a FFS(fee for service). In a PPO, the dentist enrolls with the insurance company and agrees to accept the fee schedule that the insurance company pays which is ususlly based on what is called the usual and customary fees(basically a couple of percent below the average fees for the area). The most common type of insurance for ortho is the FFS in which the insurance company will pay a set amount of the orthodontists fee (the $1000 you mentioned) and then the patient(or more likely the patient's parents) are responsible for the difference between the insurance pay out and the total fees.

Trust me, you'll all see in a short time that the dentistry is the easy part of this profession, its the practice management stuff(staff/scheduling/collections/insurance reimbursement)that is the difficult stuff

[Thebeyonder]

Dr Jeff, The management part was what I was interested in. I shadowed my dentist and he repeatedly explained to me the importance of having a business acumen when going into dentistry. My main point of this post was to determine if this is true or perhaps more true for certain specialities in dentistry. I was not necessarily inquiring about orthodontists salary (actually I was) but my main concern was the amount of time needed to collect from patients and if this was a stressful burden for orthodontists in particular.
Tim.

[Firebird]

For those of you that are harsh to people that ask about salaries, let me ask you this:

What is so wrong about going into a profession for the money? Does it really matter what the Dr's motives are, so long as he/she provides acceptable levels of care? That's the case especially in medicine. I would rather put my life in the hands of an awesome surgeon who went into it for the money, as opposed to a competant surgeon who "wants to help people."

Now, don't get me wrong. I'm not interested in medicine solely for the money. I think it would be a great profession for me because I would enjoy it...and hopefully help people live at a higher quality of life. But I'll be truthful in saying that the level of income increases the appeal.

[DrJeff]

Lets put it this way about how the management side of dentistry is very similiar amongst all the sectors of dentistry. A couple of weeks ago, about 1/2 of my dental school class was at one of our classmates weddings. This included, GP's, oral surgeons, orthodontists, an endodontist, a periodontist and a prosthodontist. Atleast 2/3's of the conversation was about practice management issues(i.e. which software are you using, have you tried this for marketing, I heard this at a management lecture..., etc, etc,etc) Like I saud before, for most dentists, the dentistry is the easy stuff, its the business issues that cause the most amount of stress.

Originally posted by Thebeyonder:
<STRONG>Dr Jeff, The management part was what I was interested in. I shadowed my dentist and he repeatedly explained to me the importance of having a business acumen when going into dentistry. My main point of this post was to determine if this is true or perhaps more true for certain specialities in dentistry. I was not necessarily inquiring about orthodontists salary (actually I was) but my main concern was the amount of time needed to collect from patients and if this was a stressful burden for orthodontists in particular.
Tim.</STRONG>

[stdent9972]

By the way, I just wanted to let you know, I shadowed a GP dentist last summer and she did some light ortho work. Personally, although ortho is very lucrative, I would not want to spend the rest of life around preteens discussing the latest Britney video. I met this GP dentist who did root canals, general dentistry and some ortho work. She would refer out the more difficult cases, but she did do a lot of the same stuff as other people. She told me that she just learned ortho over 2 years on weekends, while she was practicing general dentistry. Has anyone else met someone like this?

[groundhog]

Dr Jeff,
The $1,000 for the orthodontic work is out of pocket (co-pay) by the patient in addition to any insurance premiums. The HMO (Columbia Dental Group) likley looses money on the orthodontic work alone, but comes out ahead (along with the patients) in the long run because proper spacing does so much in helping to prevent future dental problems when patients follow through with a sound preventative maint program.

[DrJeff]

I used to have the same "positive" view of insurance companies until I started having to deal with them and how they affect my patients on a daily basis. The sad part is that most insurance companies aren't the altrusitic bodies that one may think, but really are quite a source of frustration for both patients and doc'c alike. The same reasons that you mentioned, alignment while sounding good on paper, then you will see that in alot of cases that the same insurance will not pay for(or very minimally) the next steps(gingival grafting, guided tissue regeneration, many types of fixed bridges, implants) that may be needed in cases. Additionally, most insurance companies limit ortho coverage to the under 20 crowd, when alot of adults have far more pressing need to fix various occlussal descrepencies that can and do lead to many other and expensive problems.