Will mid-level practitioners (ie. dental therapists) significantly affect income

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Worried about whether the introduction of mid-level dental practitioners in several states will affect dentist salaries. With 350K debt and four years of specialized education, I hope I will do at least decent financially.

Mid-level practitioners will serve those who can't afford dentists. They fill a much needed hole in dentistry. Pun intended. I don't really think it'll affect income, but who knows? ADA is fiercely protesting dental "therapist"


Does anyone know how much dental therapist make?

Originally Posted by Parklife

Mid-level practitioners will serve those who can't afford dentists. They fill a much needed hole in dentistry. Pun intended. I don't really think it'll affect income, but who knows? ADA is fiercely protesting dental "therapist"


Does anyone know how much dental therapist make?

How will a mid-level be economically viable?

if there is a market or niche for it. it will be filled. That is how basic econmics works. I havn't heard of dental therapist. What can they exactly do procedure wise?

Originally Posted by theleatherwalle

if there is a market or niche for it. it will be filled. That is how basic econmics works. I havn't heard of dental therapist. What can they exactly do procedure wise?

It is a new type of practitioner, but there are plans to open up training programs all over the country. A dental therapist may do procedures ranging from preventative care, to simple "irreversible" procedures such as fillings, extractions, and crowns. They may or may not be required to work under a dentist depending on the specific state's model.

The education they receive ranges from a masters level program, to a mere two years of post-high school training.

Originally Posted by DMDWANNABEE

It is a new type of practitioner, but there are plans to open up training programs all over the country. A dental therapist may do procedures ranging from preventative care, to simple "irreversible" procedures such as fillings, extractions, and crowns. They may or may not be required to work under a dentist depending on the specific state's model.

The education they receive ranges from a masters level program, to a mere two years of post-high school training.

WHAT!!!

How can they do filling or crowns 2 years after high school. An extraction is insane!

With a masters degree it would make sense if they did some preventative care.

I am sure if this happens they will be trained well. I mean how would a two year course after college even work? Do they take the GRE or DAT? I've honestly never heard of this.

So after a little research it seems that dental therapists currently serve small, remote, or under-served areas. I honestly believe dental salaries will go slightly down in the future. Given the trends in corporate dentistry, where health care is going, and once the baby boomers go there will be no replacement. I don't think dental therapists will be affect dentists too much. From what I read they sound like nurse practitioners. Oh well the industry evolves. We will have to evolve with it.

I have a question in response: could therapists be beneficial to dentists? I'm assuming that dental therapists make roughly as much as dental hygienists (we'll say around 60-70k/year although I'm not real sure). An entry level associate dentist would be doing a lot of the same procedures from what I understand, but would cost almost twice as much to have on salary (guessing around 100k). So, if you COULD get an associates amount of work while only paying a hygienist level salary, wouldn't that substantially increase production by freeing up the dentist for higher paying cases? Also, would the competition from therapists drastically decrease the starting pay for most recent dental school grads? Feel free to completely tear apart my idea, I am really unfamiliar with the business aspect of dentistry. Also, I have no idea what "dental therapists" make.

According to ehow.com, very accurate I know...ha, dental therapists make anywhere from 48k (Fl) to 72k (Az). So it depends on what state you're in. Oh and to my understanding a dentist must oversee their work, so as right now, they would have to work under a dentist.

Dental therapists have been used in New Zealand for decades. The pay for a general dentist, according to NZ government website, is in the range of 100k-250k USD for those who own their own practice. The dental therapists earn between 30-60 dollars per hour which is at parity with dental hygiene wages.

If their government salary reports are anything like the US labor and statistics this is an under reporting. This doesn't seem too out of line with what US dentists are paid despite their having dental therapists. Though, I think that limiting the presence of a mid-level provider is in dentists best interests.

It seems like many of the professional duties in health care are being watered down so more people can participate. I guess it's appropriate for our immediate-gratification-anti-intelligent-society. Why study the basic sciences when all you need to do is work the drilling thing, apply the gooey stuff to the hole, then shine that really bright light.

Sucks for new zealand. Well, in that case, they're basically PAs of dentistry. I don't mind that.

Originally Posted by yappy

Dental therapists have been used in New Zealand for decades. The pay for a general dentist, according to NZ government website, is in the range of 100k-250k USD for those who own their own practice. The dental therapists earn between 30-60 dollars per hour which is at parity with dental hygiene wages.

If their government salary reports are anything like the US labor and statistics this is an under reporting. This doesn't seem too out of line with what US dentists are paid despite their having dental therapists. Though, I think that limiting the presence of a mid-level provider is in dentists best interests.

It seems like many of the professional duties in health care are being watered down so more people can participate. I guess it's appropriate for our immediate-gratification-anti-intelligent-society. Why study the basic sciences when all you need to do is work the drilling thing, apply the gooey stuff to the hole, then shine that really bright light.

hahaha....telling people not to look at the light never works.

Well if the ADA takes charge of the issue and creates a new dependent provider in the model of the PA, then it could significantly increase the amount of income of a dentist.

Originally Posted by Fido00

Well if the ADA takes charge of the issue and creates a new dependent provider in the model of the PA, then it could significantly increase the amount of income of a dentist.

be careful what you wish for.

The chains will TOTALLY take advantage of this. Just like ortho practices (why hire ortho associates when you can hire more RDAs to do the work for you), what is the incentive for a managing dentist to hire associate dentists when they can hire mid-level providers as cheaper labor? More and more new grads nowadays get their start by working for a chain straight out of school to build up hand speed, learn business acumen, and to save up/supplement capital for their start-up practices. If these associate positions no longer exist for dentists, then the future is very bleak for future grads considering the skyrocketing rise in education loans. Future grads will have no choice but to sign their life away as a managing dentist for a chain and the days of dentistry joining pharmacy and optometry will be near! Time to save up for that Aspen Dental IPO!

Originally Posted by ortho lurker

The chains will TOTALLY take advantage of this. Just like ortho practices (why hire ortho associates when you can hire more RDAs to do the work for you), what is the incentive for a managing dentist to hire associate dentists when they can hire mid-level providers as cheaper labor? More and more new grads nowadays get their start by working for a chain straight out of school to build up hand speed, learn business acumen, and to save up/supplement capital for their start-up practices. If these associate positions no longer exist for dentists, then the future is very bleak for future grads considering the skyrocketing rise in education loans. Future grads will have no choice but to sign their life away as a managing dentist for a chain and the days of dentistry joining pharmacy and optometry will be near! Time to save up for that Aspen Dental IPO!

This is pretty much like looking into the future. I already feel this will happen, but I don't think it will be catastrophic for salaries. Dentistry is a profession that requires people skills. You may take your car to wal-mart for an oil change, but if you need major body work done you'll likely go to a well known mechanic. That's how I see corporate dentistry and private dentistry in the future. You may go in for general cleaning at the aspen or all smiles or another chain. When a patient needs major work done they'll go to someone they know does quality work and is not just fresh out of school and working to hit quotas.

Originally Posted by theleatherwalle

This is pretty much like looking into the future. I already feel this will happen, but I don't think it will be catastrophic for salaries. Dentistry is a profession that requires people skills. You may take your car to wal-mart for an oil change, but if you need major body work done you'll likely go to a well known mechanic. That's how I see corporate dentistry and private dentistry in the future. You may go in for general cleaning at the aspen or all smiles or another chain. When a patient needs major work done they'll go to someone they know does quality work and is not just fresh out of school and working to hit quotas.

This has some merit, but at the same time, probably 50% of Americans don't go to the dentist at all, of those that do, about 75% of those probably just go for maintenance/preventative care, and so probably somewhere around 10% go for the type of work that you are referring to.
Truly, dental therapists would mean total devastation for new graduates. In areas with a high provider saturation, dentists would be out of work. All of this boloney about dental therapists going to underserved areas is total crap. They will go to the same desirable areas that dentists want to go to now, further saturating and flooding the market (just like for nurse practitioners, did that solve any problems?). With the major shift to corporate dentistry already happening, corporate offices will FIRE all but a few dentists and hire dental therapists. Why you ask? Because now they just need a minimum number of dentists to diagnose and treat advanced cases, and all the other work will be done by therapists, and at probably half the cost or less.

Well, hopefully they won't spread to the rest of the US. Thus far, they are only allowed in 2 states. I'm sure they'll spread. Pretty soon America will be run by nurses, pharmacy technicians, PAs, and dental therapists.

Originally Posted by jay47

This has some merit, but at the same time, probably 50% of Americans don't go to the dentist at all, of those that do, about 75% of those probably just go for maintenance/preventative care, and so probably somewhere around 10% go for the type of work that you are referring to.
Truly, dental therapists would mean total devastation for new graduates. In areas with a high provider saturation, dentists would be out of work. All of this boloney about dental therapists going to underserved areas is total crap. They will go to the same desirable areas that dentists want to go to now, further saturating and flooding the market (just like for nurse practitioners, did that solve any problems?). With the major shift to corporate dentistry already happening, corporate offices will FIRE all but a few dentists and hire dental therapists. Why you ask? Because now they just need a minimum number of dentists to diagnose and treat advanced cases, and all the other work will be done by therapists, and at probably half the cost or less.

As far as I know in the legislation regarding dental therapists, they are only restricted to practicing in rural areas.
There is a big thread about this from a while back and that's what I recall from there.

My question is: why are people still thinking about dental school when it costs 350K. Do you realize that if you didn't go to dental school and invest that money instead that you would probably be light years ahead financially down the road? It totally is NOT worth it! Trust me! I'm doing it now.

Originally Posted by suarez 7

As far as I know in the legislation regarding dental therapists, they are only restricted to practicing in rural areas.

You REALLY think thats going to stick?

The same thing was true of PAs and NPs in teh beginning -- restricted to rural/underserved areas. DONT BUY THE LIES!

Even if you lived in the rural areas with dental therapists - you wouldn't get paid. Medicare reimbursements only? What makes you think that people who are uneducated and desperate enough to go to dental therapists will pay the prices dentists ask?

Second of all, dentists in the US are on a whole overpayed. Perhaps it's relative to the education, the degree, the cost, etc. If you look at other countries - dentists will and do make bank. Now, if you go to USC can graduate will you be in the same situation as a Texas native coming from a Texas school? No, but you probably should've gotten better grades or picked a different career that is more suited to you. If you had to resort for USC or NYU, you clearly did not do well in school.

Personally, my dental school is one of the cheapest in the countries so maybe I'm biased or apathetic.

Even with mid-level providers. I don't believe dentists have anything to worry about. BLS says the middle 50% for dentists salary in the US is 146k. Really? Is it going to kill you to make 120-30k? You will still be in the top percentile(making more than the middle 50% of CEOs). You will still make more than enough to provide for your family, live in a great area, send your kids to great schools, travel, purchase and build your practice, and buy nice things.

http://www.bls.gov/ooh/Healthcare/Dentists.htm


I don't think the concern is about the "people". This is where people get the notion that health professionals are also corrupt. We want to make money. It isn't such a bad thing. I made a comprehensive post about other health professions in the Obamacare thread. Read it and let me know what you think.

The question honestly is how much not if and when

Originally Posted by Socrates25

You REALLY think thats going to stick?

The same thing was true of PAs and NPs in teh beginning -- restricted to rural/underserved areas. DONT BUY THE LIES!

We still have an under-supply of doctors. Do you really think PAs and NP are such a bad thing? MDs need NP and PAs for their private practice. Guess who drives the Benz on the way to work only to swap out with a BMW for a cruise to the country club.

If they have to be supervised by a DMD/DDS we're good. If it turns out that we can settle for being "trained" for so many procedures, then we're overpaid the the pay will accommodate. As I've said, dentists in other countries make far less than dentists in the US. Just adapt. Mob rule. The elite will never survive. Doom and gloom thanks to the evil uneducated poor people. Look at the bright side of things. Be a health professional. Money isn't everything. It's most of everything, but not everything.


Jeeze, America. The land of Life, Liberty and the pursuit of Money.

Originally Posted by Parklife

Even if you lived in the rural areas with dental therapists - you wouldn't get paid. Medicare reimbursements only? What makes you think that people who are uneducated and desperate enough to go to dental therapists will pay the prices dentists ask?

Second of all, dentists in the US are on a whole overpayed. Perhaps it's relative to the education, the degree, the cost, etc. If you look at other countries - dentists will and do make bank. Now, if you go to USC can graduate will you be in the same situation as a Texas native coming from a Texas school? No, but you probably should've gotten better grades or picked a different career that is more suited to you. If you had to resort for USC or NYU, you clearly did not do well in school.

Personally, my dental school is one of the cheapest in the countries so maybe I'm biased or apathetic.

Even with mid-level providers. I don't believe dentists have anything to worry about. BLS says the middle 50% for dentists salary in the US is 146k. Really? Is it going to kill you to make 120-30k? You will still be in the top percentile(making more than the middle 50% of CEOs). You will still make more than enough to provide for your family, live in a great area, send your kids to great schools, travel, purchase and build your practice, and buy nice things.

http://www.bls.gov/ooh/Healthcare/Dentists.htm


I don't think the concern is about the "people". This is where people get the notion that health professionals are also corrupt. We want to make money. It isn't such a bad thing. I made a comprehensive post about other health professions in the Obamacare thread. Read it and let me know what you think.

The question honestly is how much not if and when

although i agree with some of points. The NYU and USC statements are really blanket comments. I know a guy at USC who made a 24 on his DATs and had like a 3.7. He went to USC because he loves the atmosphere and hes loaded.

Originally Posted by theleatherwalle

although i agree with some of points. The NYU and USC statements are really blanket comments. I know a guy at USC who made a 24 on his DATs and had like a 3.7. He went to USC because he loves the atmosphere and hes loaded.

The guy you know is among the minority at USC. He must also not value his dental education. USC is riddled with problems. I guess to live in Cali is priceless. Understandable.

the NYU and USC wasn't an attack at those schools btw. It was more of a breakdown of the situation. Not all dental school education sticker their prices at 300k.

I will be attending NYU, and I'm certain that I did much better than you. I had 3.6 from Ivy League undergrad, 25AA on DAT. (I had 1540 on SAT, three 800s on SAT 2., rank #2 in high school) So, Mr. Parklife, please tell me where did you go for undergrad? How well did you do in your undergrad? Did you score above 25 on DAT? How about SAT? Your misconception that ""If you go to expensive private school, you are pretty dumb" gets me really angry. I went to NYU even though I got into other cheaper schools because I fell in love with the school when I interviewed. And I can guarantee you that there are LOTS of smarter people than you at NYU. Sure, there are dumb people here too. But please stop making generalized comments that bash NYU, USC and other private school students.

Originally Posted by Parklife

Even if you lived in the rural areas with dental therapists - you wouldn't get paid. Medicare reimbursements only? What makes you think that people who are uneducated and desperate enough to go to dental therapists will pay the prices dentists ask?

Second of all, dentists in the US are on a whole overpayed. Perhaps it's relative to the education, the degree, the cost, etc. If you look at other countries - dentists will and do make bank. Now, if you go to USC can graduate will you be in the same situation as a Texas native coming from a Texas school? No, but you probably should've gotten better grades or picked a different career that is more suited to you. If you had to resort for USC or NYU, you clearly did not do well in school.

Personally, my dental school is one of the cheapest in the countries so maybe I'm biased or apathetic.

Even with mid-level providers. I don't believe dentists have anything to worry about. BLS says the middle 50% for dentists salary in the US is 146k. Really? Is it going to kill you to make 120-30k? You will still be in the top percentile(making more than the middle 50% of CEOs). You will still make more than enough to provide for your family, live in a great area, send your kids to great schools, travel, purchase and build your practice, and buy nice things.

http://www.bls.gov/ooh/Healthcare/Dentists.htm


I don't think the concern is about the "people". This is where people get the notion that health professionals are also corrupt. We want to make money. It isn't such a bad thing. I made a comprehensive post about other health professions in the Obamacare thread. Read it and let me know what you think.

The question honestly is how much not if and when

Wow, you even PMed me to reply to your post.

"You immature pathetic human being, leave a reply to my comment in the thread that talks about mid-level practitioner."

Guys, guys, I only used NYU and USC as examples for the pricy dental education. Fourth on the pricey list is upenn. There is always a justification. Trust me, I transferred to a harder, more expensive school only for the experience it would give me. I understand that there are reasoning for attending said schools(location, specializing, family, friends, etc). However, the fact is, NYU and USC are massive schools with huge student bodies for high cost with lower requirements.

Btw, NYU is on the top of the list for most withdraws/repeats. http://www.ada.org/ada/prod/survey/survey_ed_vol1.pdf
My reasoning is not wrong. Stop being butt-hurt jerk.

I always see 400k price tags cited everywhere. News flash, the average is not 400k. It's not fair. That's what I was getting at. Thank you for cherry picking everything that didn't matter from my post. You win nothing.

cleorkwk honestly? I'm a pathetic human being for having an opinion? You even cited your SAT score and ivy undergrad. cute. Please be rest assured, that your NYU name will carry you far farther than the Georgia Health Science University. If that is what you value.

It's not my fault you picked the most expensive school in the country with your amazing stats. Btw, undergrad means nothing wannabe gunner. My two cousins went to NYU and they're the ones who inspired me to pursue a healths-science profession. Don't think I don't know about NYU. Your statements are stupid. It's like me saying I probably know more people attending NYU undergrad and grad than you know people. You don't know me. I don't know you.

But this pathetic human being who went to a state university ranked in the 50s(on scholarship) is still paying 1/4 of your price with a higher scoring peer base. I know what I said was a blanket statement. There are anomalies everywhere. Everyone has a mom's cousin's friend's hairdresser's sister's dog-walker's brother who went to xxx school with xxx grades varying on both spectrum. Not all students who go to San Deigo State University are drunken idiots who spend too much time on the beach. Not everyone who goes to Harvard is a genius prodigy.

Now, if you're done being so sensitive Dr. Ivy league, I would like to get back on topic.

First, thank you for giving us "page not found" link. Very helpful.
Second, read carefully what you wrote. At first, you wrote as if NYU and USC students are there because they had low grades and those schools were the only choices. And I can tell you that Predents.com is very outdated and we have much higher GPA/DAT average now. And people like you just don't know that NYU/USC tend to have more people from top undergrads who value name of schools, and that's why GPA average is a little lower than Georgia Health Science University where most of the D-students are probably from universities in Georgia (mostly crappy state schools, and thus easier to get high GPA). You only wrote only later that some people are there for other reasons (location, prestige of the school, etc like myself). And I called you "immature pathetic human being" on purpose. Why? I'm sure it kinda set you off to pinpoint you, even PM you. Just telling you that using NYU or USC, even when you are only using us as examples, pisses us off. So don't do it next time. And as you mentioned, I didn't even apply to Georgia Health Science University. Don't want the name near my resume

Originally Posted by Parklife

Wow, you even PMed me to reply to your post.

"You immature pathetic human being, leave a reply to my comment in the thread that talks about mid-level practitioner."

Guys, guys, I only used NYU and USC as examples for the pricy dental education. Fourth on the pricey list is upenn. There is always a justification. Trust me, I transferred to a harder, more expensive school only for the experience it would give me. I understand that there are reasoning for attending said schools(location, specializing, family, friends, etc). However, the fact is, NYU and USC are massive schools with huge student bodies for high cost with lower requirements.

Btw, NYU is on the top of the list for most withdraws/repeats. http://www.ada.org/ada/prod/survey/survey_ed_vol1.pdf
My reasoning is not wrong. Stop being butt-hurt jerk.

I always see 400k price tags cited everywhere. News flash, the average is not 400k. It's not fair. That's what I was getting at. Thank you for cherry picking everything that didn't matter from my post. You win nothing.

cleorkwk honestly? I'm a pathetic human being for having an opinion? You even cited your SAT score and ivy undergrad. cute. Please be rest assured, that your NYU name will carry you far farther than the Georgia Health Science University. If that is what you value.

It's not my fault you picked the most expensive school in the country with your amazing stats. Btw, undergrad means nothing wannabe gunner. My two cousins went to NYU and they're the ones who inspired me to pursue a healths-science profession. Don't think I don't know about NYU. Your statements are stupid. It's like me saying I probably know more people attending NYU undergrad and grad than you know people. You don't know me. I don't know you.

But this pathetic human being who went to a state university ranked in the 50s(on scholarship) is still paying 1/4 of your price with a higher scoring peer base. I know what I said was a blanket statement. There are anomalies everywhere. Everyone has a mom's cousin's friend's hairdresser's sister's dog-walker's brother who went to xxx school with xxx grades varying on both spectrum. Not all students who go to San Deigo State University are drunken idiots who spend too much time on the beach. Not everyone who goes to Harvard is a genius prodigy.

Seriously, this thread is about midlevels, which will get locked if you two wont shut up. Take it to the pm's because no one else cares.
Bottom line, dental school is competitive anywhere and stats don't lie so no need to attack people who attend XXX school.

You REALLY think thats going to stick?

The same thing was true of PAs and NPs in teh beginning -- restricted to rural/underserved areas. DONT BUY THE LIES!

Yes I do, by law they have to. Originally dental therapists had freedom to practice anywhere, but the ADA managed to insert a clause that would only limit their field of practice in certain regions. The ADA never supported, nor will they, the expansion of dental therapists. Unfortunately they still cannot stop the dumb politicians who run this government, but they are still influential to some extent.

haha don't worry the ADA will feel the push of corporate dentistry. It hasn't happened yet, but im sure it will.

I agree take this school vs other school discussion to another place.

People have different backgrounds, monetary situations, and residencies. The faster you learn not to judge people the farther you'll get in life.

Earlier in this thread it was mentioned that dentists make less in other countries. Implied was that dentist salary was on a bubble in the US and would soon fall because of this bubble. If we look at the other countries with lower salaries we can conclude that eventually the US dentist will fall to meet them at that level.

The problem with that statement is that in many countries analogous to the US dentists salaries are at parity with our own. Above I provided the example of NZ where there are mid level dental providers. By running a simple search I saw that in canada, aus, and the UK dentists tended to make ~150k. These were employed dentists. The salary surveys noted that many dentists were actually self employed.

Many of the posts on this thread and the health care reform board do not seem indicative of young professionals. They remind me of rantings of scared children - full of hyperbole, assumptions, and apocalyptic predictions.

most people here are D1 or D2...

We're getting in debt and we are scared of the future

The future is unpredictable. Expect the worst, but hope for the best. I always expect the worst. I'm a realist .

I think you just described a pessimist. Anyone who talks about "the good ol' days" is selling you something or has made choices that has left them in a situation they dont enjoy. The future doesn't need to be scary. Though if you assume it will always be worse than today I can understand how you would feel that way - even if there is not much merit to it.

Originally Posted by theleatherwalle

most people here are D1 or D2...

We're getting in debt and we are scared of the future

The future is unpredictable. Expect the worst, but hope for the best. I always expect the worst. I'm a realist .

If such a forum existed 25 years ago, I would have been interested in hearing what the D1's and the D2's were talking about then. I am sure the ones who went on to experience the "golden age" of dentistry had their fears and concerns then. Take any profession and analyze it enough and I am sure you can find reasons to be skeptical about it in the future.

Wow. What a guy. Yeah you're right I PMed him. Hopefully he'll get the message and leave me alone.


Well the question still remains, how much are we looking to lose? Let's speculate the answer. Honestly, this is the only thing that is worrying us. Dentistry is not going to end up like pharmacy anytime soon. We're going to have jobs. We're really only looking at making less right now. And when and if the economy bounces back - we'll bounce back with it.


The doom and gloom is overstated as said before. Hope for the best, but expect the worst?

Originally Posted by jwdent

If such a forum existed 25 years ago, I would have been interested in hearing what the D1's and the D2's were talking about then. I am sure the ones who went on to experience the "golden age" of dentistry had their fears and concerns then. Take any profession and analyze it enough and I am sure you can find reasons to be skeptical about it in the future.

This. I think ultimately any career has a seed of doubt that goes along with it but I think most people get by just fine.

A physician once told me when he was graduating medical school all his class mates were told they would not make much money in medicine. In the end he ended up doing fairly well through the ,80's, 90's,00's. It's tough to predict the future for sure.

i heard from a good number of people that many possible future dentists avoided dental school because of the HIV scare.

Yeah its tough to tell. The problem is today were pumping out graduates with a good amount of debt. So more and more people want a guarantee of a high paying job when in reality the guarantee of one is going down.

Originally Posted by theleatherwalle

i heard from a good number of people that many possible future dentists avoided dental school because of the HIV scare.

Yeah its tough to tell. The problem is today were pumping out graduates with a good amount of debt. So more and more people want a guarantee of a high paying job when in reality the guarantee of one is going down.

Yes. Thank you. I agree 100%
This is the problem.

It's sort of tiering listening to people warn about how an entire profession is going to collaps on itself. Honestly, think things through first. Y2K mentality.

Since D1 and D2 is basically lecture+sim lab

Shouldn't we get a little money for working on patients in D3 and D4

Oh FAFSA you make me happy yet so sad.

Soo...who wants to buy some aspen stock and retire?

What is it that aspen does that dentists cannot? For example - admittedly there is not a large corporate dentistry presence in my region - however there are some group practices. One interesting one consists of an OMFS, orthodontist, and 2 GP's. They have essentially built a very handsome looking commercial building and have segregated the structure into different areas off of the main hall on the basis of specialty. This place has its own parking lot and is always full. The branding and experience of the office is amazing.

Why cant dentists pool a group practice like this and take a huge bight out of crappy looking places like Aspen that tends to not be able to hang onto the higher performing staff? One could say that there are good providers everywhere and there is most likely some truth to that; but, I have not been impressed with the ancillary staff or customer service at these places - in fact there has always been an angry person at the counter every time I went in.

Originally Posted by yappy

What is it that aspen does that dentists cannot? For example - admittedly there is not a large corporate dentistry presence in my region - however there are some group practices. One interesting one consists of an OMFS, orthodontist, and 2 GP's. They have essentially built a very handsome looking commercial building and have segregated the structure into different areas off of the main hall on the basis of specialty. This place has its own parking lot and is always full. The branding and experience of the office is amazing.

Why cant dentists pool a group practice like this and take a huge bight out of crappy looking places like Aspen that tends to not be able to hang onto the higher performing staff? One could say that there are good providers everywhere and there is most likely some truth to that; but, I have not been impressed with the ancillary staff or customer service at these places - in fact there has always been an angry person at the counter every time I went in.

Personally, I haven't had any experiences with Aspen, and there aren't any Aspen clinics in my area. I can guess only one thing - the price. Patients only care about the price. The more educated middle class, upper middle class are probably likely to pay more for better treatment. I know this 100% from experience. This IS one of the causes for lower quality of care.

My parents and I had my old GP do my ortho work because she had a better price. It turns out the GP had hundreds of miscalculations which resulted in a double impaction and wilckodontic treatment which lasted double the time I was supposed to be in braces. Now, the GP even said that, though she has taken classes, she has not been trained as an orthodontist. She is licensed to do so, but she isn't as qualified. Still, my parents(who aren't stupid or uneducated) took the cheaper route because we trusted the GP. Not to demonize the GP. It was our fault too.


Now, this is probably the brightest of scenarios. I can only imagine what shady business Aspen and clinical for profit chains are up to. I'm not sure how to stop them either.

Originally Posted by DMDWANNABEE

It is a new type of practitioner, but there are plans to open up training programs all over the country. A dental therapist may do procedures ranging from preventative care, to simple "irreversible" procedures such as fillings, extractions, and crowns. They may or may not be required to work under a dentist depending on the specific state's model.

The education they receive ranges from a masters level program, to a mere two years of post-high school training.

just look at what has happened with anesthesia and CRNAs. All I can say is -beware. Dentists are $$$$$$, don't take most insurances, and most people consider them prohibitive. So yes, midlevel practitioners have been introduced in dentistry as well, and will inevitably start off slowly "filling the gap" but will later become like CRNAs-they will demand equal rights.

Originally Posted by Medstudentquest

just look at what has happened with anesthesia and CRNAs. All I can say is -beware. Dentists are $$$$$$, don't take most insurances, and most people consider them prohibitive. So yes, midlevel practitioners have been introduced in dentistry as well, and will inevitably start off slowly "filling the gap" but will later become like CRNAs-they will demand equal rights.

This is my biggest concern with mid-lvl practitioners. How far will they go? The extent of these practitioners needs to be outlined and then surrounded by a laser fence. Otherwise the line between "doctor" and "mid-lvl practitioner" becomes very blurry in the general population.

This is what's happening in all of medicine. The interesting thing is that the mid-levels that were proposed for cost savings (CRNA, MsRN midwifes etc) are now demanding equal pay for equal work lol. So where are the cost savings? Your medical insurance is basically paying out the same if you see a board certified anesthesiologist or CRNA - in effect you're paying the same for a less educated & trained provider - now that's a bargin!

I'm convinced a lot of this mid-level stuff is political. If you want to see it continue vote democrat. They love to address access to care programs with mid-level training programs and love groups like the ANA and the financial backing of the nursing union. Liberals want to dumb down medicine and take all your money through taxation for their political security. Don't vote for them.

Originally Posted by SoulPower

This is my biggest concern with mid-lvl practitioners. How far will they go? The extent of these practitioners needs to be outlined and then surrounded by a laser fence. Otherwise the line between "doctor" and "mid-lvl practitioner" becomes very blurry in the general population.

Originally Posted by yappy

This is what's happening in all of medicine. The interesting thing is that the mid-levels that were proposed for cost savings (CRNA, MsRN midwifes etc) are now demanding equal pay for equal work lol. So where are the cost savings? Your medical insurance is basically paying out the same if you see a board certified anesthesiologist or CRNA - in effect you're paying the same for a less educated & trained provider - now that's a bargin!

I'm convinced a lot of this mid-level stuff is political. If you want to see it continue vote democrat. They love to address access to care programs with mid-level training programs and love groups like the ANA and the financial backing of the nursing union. Liberals want to dumb down medicine and take all your money through taxation for their political security. Don't vote for them.

i nominate this as worst post of the year. Medicine is controlled by the market. It is not political. There is a market for midlevel practitioners. Instead of insulting someones political affiliation, their work, or telling people how to vote concentrate on setting up a practice and getting into dental school.

Originally Posted by Parklife

Mid-level practitioners will serve those who can't afford dentists. They fill a much needed hole in dentistry. Pun intended. I don't really think it'll affect income, but who knows? ADA is fiercely protesting dental "therapist"


Does anyone know how much dental therapist make?

This niche doesn't exist. There are people who DON'T WANT TO PAY for a dentist. Unless the mid-level is hired by some agency who is going to pay for the supplies and salaries to treat those who don't want to pay, there is no way this model is going to work. Those same agencies could hire a dentist to do the same work.

And let's say there are communities where people truly can't afford dentists. Maybe a dentist's price for an extraction is $300. Say a patient can only afford $10. The overhead costs for that extraction alone is $10 - anesthesia, needles, gauze, instrument sterilization. Why would a mid-level be inclined to do this procedure for free? Again, unless there is some agency in the middle picking up the tab, the mid-level model doesn't solve the problem you suggest.

Medicine, like all industries, has market influences. However, the mid level proliferation has been a tightly held doctrine of liberal democrat politicians. It's the ultimate political solution. By relaxing practice licencing their goal of socialized medicine or at least expansion of state sponsored entitlements becomes more realistic. The symbiotic relationship between (D) politicians and unions like the ANA is no mystery either. Just look at the difference in practice rights between CRNA's and Anesthesia Assistants - the ANA union has lobbied for that difference.

Unions = collectivism thinking + money = bought/voted for democrat politicians. Why do you think mid-levels always bring up "access to care"? Because it's appealing to democratic leaders who want to expand entitlements. More people on entitlements means more votes for them. It's a positive feed back loop: as more mid-levels are created entitlements will expand which will get more democrats elected who will then push for more mid-levels and on and on.

Nov is coming. Please vote accordingly - on a side note - it looks like everyone will keep their current tax rate except those who make over 250k. Hmmm.. what bracket do many physicians & dentists fall in? What about mid-levels?

Originally Posted by theleatherwalle

i nominate this as worst post of the year. Medicine is controlled by the market. It is not political. There is a market for midlevel practitioners. Instead of insulting someones political affiliation, their work, or telling people how to vote concentrate on setting up a practice and getting into dental school.

Originally Posted by yappy

Medicine, like all industries, has market influences. However, the mid level proliferation has been a tightly held doctrine of liberal democrat politicians. It's the ultimate political solution. By relaxing practice licencing their goal of socialized medicine or at least expansion of state sponsored entitlements becomes more realistic. The symbiotic relationship between (D) politicians and unions like the ANA is no mystery either. Just look at the difference in practice rights between CRNA's and Anesthesia Assistants - the ANA union has lobbied for that difference.

Unions = collectivism thinking + money = bought/voted for democrat politicians. Why do you think mid-levels always bring up "access to care"? Because it's appealing to democratic leaders who want to expand entitlements. More people on entitlements means more votes for them. It's a positive feed back loop: as more mid-levels are created entitlements will expand which will get more democrats elected who will then push for more mid-levels and on and on.

Nov is coming. Please vote accordingly - on a side note - it looks like everyone will keep their current tax rate except those who make over 250k. Hmmm.. what bracket do many physicians & dentists fall in? What about mid-levels?

I don't mind paying extra taxes.I feel like we benefit more from society so we are obligated to contribute back to society more. "Noblesse oblige"
Regardless of tax rate, I will be working with knowledgeable tax lawyers and CPAs. The tax system is so complicated and thus has tons of loopholes.

I used to be a huge advocate for social safety programs and entitlement programs. But then seeing some people eating fries and frozen stuffs all the time and never work out makes me skeptical about the whole universal healthcare system when I try to eat healthy and exercise regularly. (but I think that we should still pick up the tab for people with innate diseases, disability, some other cases, etc)
I also watched a PBS TV 10 hr show about Navy aircraft carrier. There were hundreds of enlisted sailors working their butt off to earn money, go to college, and to get away from their drug-related/violent home and neighborhood. There are a plenty of opportunities out there in this country if one desires to achieve one's so-called American Dream. Although I made my lifelong commitment to give back, I don't believe we need to spoon-feed people anymore. (again, there are a few exceptions)

Yet I'm not still convinced that the ex-governor is a better package overall.

back to the main thread,
I think we should ask on medical forum. we need a case study.

You hit it on the head. I agree wholeheartedly about giving back. I've volunteered ever since I was professionally able to in my community. I think what we agree on is that some people need a "hand-up" and not a "hand-out". We disagree on taxes because I believe that politicians always offer the latter rather than the former in order to keep a voting base. They blow tax payers money on lost causes that will always suck up resources and make bad decisions until the well runs dry. In this way government handouts subsidize and proliferate poverty and subsidy living.

But It's true. There are real gems out there - people who face a challenging life and need a hand-up. I think we should be their for them but the money that would be used for helping out disadvantaged people get ahead is instead spent on life-long-generational-welfare and subsidizes poor life choices and lazy living. It's a shame and I will vote no more. We can do better more good with our money than the government ever will.

We live in a great country & some people take full advantage of it.

Originally Posted by TheClutch

I don't mind paying extra taxes.I feel like we benefit more from society so we are obligated to contribute back to society more. "Noblesse oblige"
Regardless of tax rate, I will be working with knowledgeable tax lawyers and CPAs. The tax system is so complicated and thus has tons of loopholes.

I used to be a huge advocate for social safety programs and entitlement programs. But then seeing some people eating fries and frozen stuffs all the time and never work out makes me skeptical about the whole universal healthcare system when I try to eat healthy and exercise regularly. (but I think that we should still pick up the tab for people with innate diseases, disability, some other cases, etc)
I also watched a PBS TV 10 hr show about Navy aircraft carrier. There were hundreds of enlisted sailors working their butt off to earn money, go to college, and to get away from their drug-related/violent home and neighborhood. There are a plenty of opportunities out there in this country if one desires to achieve one's so-called American Dream. Although I made my lifelong commitment to give back, I don't believe we need to spoon-feed people anymore. (again, there are a few exceptions)

Yet I'm not still convinced that the ex-governor is a better package overall.

back to the main thread,
I think we should ask on medical forum. we need a case study.