I currently practice in the Orange County region of Southern California, and do believe we will see a significant market shift from the current status. over a decade span. This change will take place gradually, and dentists need to recognize timing plays a huge factor when choosing whether to remain here or leave the state. If you can spot the future changes in trend you can time your career so that you may survive and hopefully thrive, in one of the most competitive markets in the country.
I base this opinion on these factors:
- California is unique, in that it has a glut of foreign trained baby-boomer-gen dentists who were able to obtain licensure via bench exam in the 80's. This increased supply sharply when the demand was there. Post-2008 supply has not decreased, yet demand has dropped. The bench-exam-path was closed off eventually, with the advent of the AISPID program, thus offering more control to the supply influx. This segment of foreign-trained dentists found a very lucrative niche in that they cater specifically to a certain ethnic enclave. If you live in the Southern California region you know that it's pretty much one big sprawl broken up into somewhat segregated communities based of ethnicity. Its not only a tough market due to saturation, but the patient demands and expectations are unique to the region. You can't just be really good. Because here you're literally practicing next door to internationally recognized clinicians. You have to understand the patient population extremely well and tailor your practice, in addition to having a mind for business and management. And even that may not be enough. For example, different ethnic backgrounds prefer to finance their treatment differently. If you're able to understand these subtle dynamics you will be able to take advantage of the vacuum being left behind from the original babyboomer gen dentists here. I see that vacuum starting to form beginning 2018.
- Speaking of SoCal demographics. It's clear that this is an aging state. It's a state where the increasing rate of retirees will outpace the rate of new skilled labor into the marketplace. Just look at the number of young families being started here. It not good. And young families means there's usually a working professional. Seems like because the cost of living here is so high, those talented young professionals are leaving the state to find the American dream elsewhere. What does that mean? The survivors who stay may reap the rewards of fortuitous timing. Factor the fact that the impending baby boomer exodus includes dentists of that generation on top of the exiting young skilled professionals. You're looking at potentially a huge demand for physically-able dentists with the technical proficiency to service an increasing geriatric patient pool. That means you need Young Guns who are qualified to do things like Full Mouth Reconstruction. This is California. Retirees here want their entire mouth restored with implants for cheap. That's why corporate clinics have a harder time breaking into this market. The fee schedules here are ridiculous. As far as the other end of the patient spectrum (ie children), I feel that's pretty self explanatory. Pedo is Pedo. There will always be kids to treat, and there will always be federal funds allocated for that. Pedo is a predictable outcome. I feel the growing trend is all pedo or all geriatric; all rich or all poor. You're seeing less middle of the road patients here. Eerily similar to how the middle class is disappearing here. Nonetheless, the avg volume of patients per CA dentist will increase, but the reimbursement rates will go down. In effect, you'll be working harder for the same pay. But hey - atleast you'll be busy.
- Finally I do have faith in California's economy as a whole. Granted its not a business friendly state due to it overblown bureaucracy, but it has a long standing culture for innovation, commerce, and trade. It is a highly desirable place to live, due to its geographic location and diversity. Its a place where there's new influxes all the time. (new immigrants, new startups, new dental techniques from Asia, etc....) That makes it an interesting place to do business if you're adaptible, motivated, and resilient.
On a side note, I've worked both Socal and the Texaplex. Two very different markets. It'll be interesting to see how things trend over the next 10 years. While currently, the growth rate in TX is amazing, and CA is in stagnation... I'm still long on CA. Simply put - I feel TX will eventually turn into CA. And by the time that happens. CA will have already reinvented itself.
