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Who makes more? Endo vs. OMFS?

Discussion in 'Dental Residents and Practicing Dentists' started by The Candidate, 09.20.07.


  1. Thanks to Crack the NBDE
  1. The Candidate

    The Candidate Senior Member

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    SDN Members don't see this ad. (About Ads)
    A friend of mine thinks Endodontists make more than Oral Surgeons. I disagreed - it's not even close.

    Just wanted to get people's opinion on this topic. :)
  2. brycethefatty

    brycethefatty thefatone

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    oooooooooooooooooooooooooooooooooooooooooooooh boy.
  3. 2thdoc4kidz

    2thdoc4kidz

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    Pedo!!!!!
  4. charlestweed

    charlestweed

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    They both make a lot of money. I think OMFS make more b/c it is a lot easier for OMFS to find jobs and stay busy 5-6 days a week. The daily take home incomes for OMFS and endo are similar…. approx. 3000-6000/ day. Some days with a lot of 3rd extractions, OMFS can bring home 10 grands.

    And yes, pedo makes a lot too.
  5. armorshell

    armorshell Moderator Emeritus

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    Someone come up with the answer so I can choose my profession based solely on dollar sign plox
  6. servitup

    servitup

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    The ADA has data on this. OMFS is the highest.
  7. Typo

    Typo

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    That's enough for me - I'm sold. Where do I sign up? What does OMFS stand for, anyways? Never mind, just sign me up.
  8. brycethefatty

    brycethefatty thefatone

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    By the way, I am never posting on SDN because I have reached a very special # of posts (69) and I do not want to disturb the reverence of that number for as long as I can. . .
  9. brycethefatty

    brycethefatty thefatone

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  10. KifsterDDS

    KifsterDDS Member

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    $3000 to $6000 a day? I think your numbers are a tad off. At $3000 a day, that's an income of $570,000. While that's attainable for an oral surgeon, it is not the norm. As a general dentist (2nd year in private practice) I make a bit over $200k, albeit working as an associate. Let us assume that when I start my own practice and it's reached maximum capacity, I'd make a bit over $300k. Specialists average $70k to $100k more than GPs do by most estimates, including the ADAs. Moreover, your numbers just don't add up. Let us say, hypothetically, that overhead is 50% (in reality, it's more). For an OMFS to bring home $6000, he'd have to do $12000 worth of work per day. The highest-dollar per hour work oral surgeons do is wisdom teeth, as far as I know. A healthy fee for a full-bony impacted third molar is, what, $350 to $450 per tooth? At $400 per tooth times 4 teeth, that's $1600 per case. Add to that $400 for sedation, and that's $2000 revenue per case--best case scenario. The surgeon would have to average six full-bony wisdom teeth cases a day to average $6000 per day. That's very unlikely. I worked for an oral surgery practice before starting dental school where they averaged two to three cases per doctor. Chair time per case was about an hour. The rest of the work oral surgeons perform is less lucrative. And we're only talking about a fee-for-service practice here! Insurance will take a very healthy bite out of practice revenue.

    You need to re-check your numbers.
  11. Cold Front

    Cold Front Supreme Member

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    I think Endo makes ~$1,000 per RCT, which might take about 45 minutes to 1 hour. If he/she sees six patients a day, which might not be too difficult with good referral base, the $6,000 theory is very real.

    As far as who makes the most... Endo > OMFS > Pedo > Ortho > Perio. General tops them all. :D
  12. charlestweed

    charlestweed

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  13. wizziefiend

    wizziefiend Guest

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  14. LSU-Cowboy

    LSU-Cowboy Resident

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    Ok...so it all depends on your scope and where you work. I know one who makes 1.7 mill...and his overhead is 45%. His scope is cosmetics and dentoalveolar. All his money is made on anesthesia, implants, and 3rds. He's in solo practice...and does a LOT of cosmetics (fellowship trained). It's not unheard of to make this amount. Most avg less than that but this guy has his SHi$ together.
  15. toofache32

    toofache32

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    Jeeeez, what did they do for a whole hour? Even as a resident, I can do most sets of full bonies under 30 minutes, my staff can do it in 15-20 tops. One of my staff does 12-15 sets between 1pm and 5pm (in 4 hours) every other Friday afternoon. Six cases per day is NOTHING.....that's barely a morning.
  16. ItsGavinC

    ItsGavinC Moderator Emeritus

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    Just gets your blood pumping enough to get you out of bed, eh?

    You guys do amaze me with your speed, but I suppose I could say that about all specialists. Endo with their molar endo is crazy. I hope our dental colleagues appreciate what we do as pediatric dentists. And perio, well, I'm amazed at how smooth those root surfaces get. :D
  17. dark_horse

    dark_horse the DaRk HOrsE

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    yes, but have you ever seen a perio take out a tooth? IT"S PAINSTAKING!!! I've seen first time dental students take out a tooth in record speed compaired to these atraumatic extraction freaks!!! (can you say oxymoron?)

    as for the money debate: The oral surgeon I know - brings in aprox 12-14,000 a day on average. Most of his cases are sedation. Pops full boney wizzies out in about 2 minutes if that, and just hops over to the next chair...you got to admit - he's making BANK!!
  18. backaction

    backaction Junior Member

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    People forget that surgeries aren't being done 100% of the time. There are complications, no shows, cancellations, consults/exams, post op visits, emergencies etc. that eat time away.

    For starting perio associates in the northwest:A realistic day:
    8 AM:1 flap/osseous sx half mouth=2 quads (2 hours) ($1,300/quad)
    10:30 AM: 1 root coverage procedure on one tooth(1 hour) ($900 per site; 2 sites=$1,800 and adds 1/2 hour)
    Lunch: 12-1
    1:15 PM: 1 Crown lengthenging one or two tooth(45 min) ($700 per tooth; mulitple teeth will probably bill as osseous sx=$1300)
    2:00 PM: a few post ops and 1 exam (2 hours) ($150)
    4-5:30 PM: write up charts, phone calls, meetings etc. $5000 without doing any implants and only 3 surgeries. Maybe 50% overhead when no implants involved. Using autogenous will keep overhead down in the practice. once membranes, implants come in the overhead goes way up, but so do patient fees.

    If you're getting 35-40% production as an associate for this work that's $1000/day on a bad day and maybe $1500-2000/day on an average or good day. Not bad if you can get enough flow of patients to work on.

    I know a travelling periodontal resident that gets 60% of production doing only osseous surgery and crown lenghenings for a GP. Resident fees are not as high as a periodontist. Does 1/2 mouth osseous flap sx and 1 crown lengthening in 3-4 hours and gets over a grand for a 1/2 days work. Doesn't have to look for patients. Just shows up with the instruments and does the surgeries and consults and leaves with a $1000 check in hand.
  19. KifsterDDS

    KifsterDDS Member

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    Pay attention to where your wisdom teeth sets are coming from, my friend. As part of a residency, especially if you're affiliated with a dental school, you'll have many, many doctors referring to you. Your program almost certainly takes Medicaid, and there are plenty of Medicaid patients who need thirds out. I did an OMFS internship at a program affiliated at a dental school, and we had the entire ortho, GP, and pedo departments referring thirds to us. We also got loads of Medicaid patients.

    As a GP who does not do full-bonies every day, it takes me an average of 45 minutes to do a set of full-bonies (actual surgery time, after anesthesia has been given). Of course, there are two factors that force me to work slower: 1. the patient isn't under IV sedation (I give them a milligram of Xanax an hour before and nitrous), so I can't brutalize them the way most oral surgeons do when the patient is under sedation. I have to stop and ask if they're ok, and if they feel pain, I have to give more lido. Under sedation, you can typically keep going because they'll forget all about it. 2. Because if I were to ever damage an IAN or lingual nerve, there are plenty of oral surgeons out there ready to testify that I was negligent and clinically incompetent. So I take extra precautions against severing a nerve with my handpiece, like not sectioning the tooth more than a millimeter or two lingual to the the pulp chamber and not extending my buccal trough lingually behind the tooth. Also, I make my incision from the DB line-angle of the 2nd molar well facial to the retromolar trigone. All of these things help to prevent nerve injuries, but they make the extraction more difficult.

    Moreover, I can tell you that most of the residents where I did my internship took longer than 30 minutes for their cases. So either you are very fast, or you're inacurrately estimating your procedure time.

    Besides, when you consider the time it takes to get the patient seated, hooked up to monitors, start the IV, get them sedated, perform the surgery, and get the patient recovered, you've burned an hour's-worth of chair time, minimum. When I assisted oral surgeons in private practice before dental school, 3rds cases were scheduled for an hour (but sometimes took longer).

    That's six hours right there. Which would leave just a measely two hours for the other procedures referring doctors (except for yours ruly) need for an oral surgeon to do: extractions of erupted teeth, expose/bonds, implants, etc.

    Sorry, but six wisdom teeth cases a day is a rarity, not the norm.
  20. KifsterDDS

    KifsterDDS Member

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    Personally, I think that any GP who doesn't know how to do osseous surgery or crown lengthenings should have his/her license to practice dentistry revoked. I can't think of any procedures performed by a periodontist that couldn't or shouldn't be handled by a GP or an OMFS.

    Your salary estimate seems plausible but a bit high for a perio average. At $2000 a day, that's $384k a year. Remember, of the various specialties, perio averages the least.
  21. charlestweed

    charlestweed

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    If the extraction socket of the tooth is the future implant site, you'd better take your time to extract that tooth (especially #8 and/or 9 with failed cast post). Nobody wants to have an ugly looking implant tooth with poor emergent profile and uneven gingival height. One could avoid doing "free" bone graft for his/her patient by spending an extra minute or two. This is why GPs routinely refer their patients to periodontist or OS for this type of extraction (for immediate or future implant placement).

    1000-2000/day is the daily average for perio....some days w/ 5-6 implant placements, they can bring home 3000-4000. Keep in mind that most periodontists don't work 5-6 days/week. The good thing about being a specialist is that you can squeeze a lot of patients into one busy working day and stay home w/ your kids on days that you don't have patients or work somewhere else. Specialists (I am not sure about pedo and prosth) don't rely too much on walk-ins. Sometimes, OMFS may have to see emergency patients (ie take out a root tip that was accidently pushed into the sinus by a GP:laugh:)
  22. KifsterDDS

    KifsterDDS Member

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    Yeah, and on a day where I have three root canals and three three-unit bridges, I can bring home $4000k. Obviously, those days are very rare, and not even worth mentioning.

    $1000 a day vs. $2000 a day is a huge difference. The former is $190k a year, the latter is $380k a year. To suggest that the average periodontist makes $380k a year just doesn't wash, especially since that's fairly close to what an orthodontist does.

    On another note, I've never pushed a tooth into the sinus. I do, however, know how to perform a Caldwell luc and get it. But since as a GP I'm swimming in specialist-infested waters, I'd refer it to an OMFS for retrieval.
  23. charlestweed

    charlestweed

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    I know a couple of my GP friends (my wife’s boss is one of them) bring home more than 4000 per day …5days/week.

    “1000 or 2000 a day” depends on how busy a periodontist wants to work. If he/she only wants to do 1 osseous surgery and 1 implant and a few cleanings, then he/she brings home 1000/day and only works 4hrs a day. But if he/she wants to double the amount of works, then he/she brings home 2000/day. As I mentioned earlier, specialists can control their the appointment more effectively than GPs. Most of them don’t work in their office 5 days a week… some have satellite offices… and some work for another practice as associates.

    You don’t have to believe me. I usually don’t want my referring dentists to know how successful my practice is…. so they continue to refer their patients to me.
  24. toofache32

    toofache32

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    I'm referring to 30 minutes of my time. The nurses/assistants can hook up the monitors and start the IV. I walk in, push drugs, and go to town and walk out. With 2 rooms going, the next one is already hooked up to monitors and has an IV. While I'm in the 2nd room, 30 minutes is plenty of time to move the patient in the 1st room to the recovery area and set up the next patient. It's a pretty simple system.

    I'm sorry, but I simply can't understand how an oral surgeon could routinely take an hour for a set of wisdom teeth. These are just my observations and experiences.
  25. Istr8nthem

    Istr8nthem

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    Yes, but you have to look at what you would want to schedule yourself in private practice. If it USUALLY takes you 30 minutes for a set of wisdom teeth, but more than occasionally takes closer to 45 minutes, you better schedule yourself 45 minutes to an hour per. In private practice, being timely with patients and being on an attainable schedule is more important, as it would be pretty easy to get an hour or so behind if you are scheduling 30 minute blocks routinely.
  26. wizziefiend

    wizziefiend Guest

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    No way. Some people take 45 mins, others are ready to punch holes through the walls if onset of sedation to gloves off takes more than 15 mins.

    Everyone runs their own show. In that 45 minutes maybe that doc likes to catch up on the latest little of puppies the family has or whatever....I had a boss that wrote rediculous notes after every case. It seemed excessive...

    I'm pretty sure after 4+ years of residency that most OMFS can extract all 4 in under 30 minutes.
  27. Yellowman

    Yellowman Member

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    as an oral surgery resident, I have mixed feelings about posts like this. On one hand, I think it's great that there is a good representation of OMFS as a specialty, as numerous residents from different programs around the country post their opinions. However, I do get a bit worried that we may come off as being a bit too cavalier. My point being, all the talk about oral surgeons making XX million dollars per year, who can extract 4 FBI in 20 minutes....things like this can potentially rub a lot of the practicing dentists and the dental students on this forum the wrong way. Guys, we have to remember that OMFS is a referral practice. Patients don't, on avg anyway, go on the phone book, look for oral & maxillofacial surgeon listings to get their wisdom teeth out. They normally go to their family dentists and do whatever they tell them to do. If the GP wants to take 1.5 hrs, and dig into the mandible under local anesthesia to get the wizzies out, most patients will comply. If the GP wants to refer the pt out to an oral surgeon becasue he/she likes us, trusts us and looks out for the best interest of the patient, then more power to us...That's just the fact. The last thing we want our referral colleagues to think that (1) we are arrogant bastards, (2) we are getting massively rich of their referrals, and (3) that we think that we are better than them. I think we'd all be much better off if our colleagues think that, although financially comfortable, we can always afford to see more patients because we are not millionaires. We should be focusing more on how we can form a stronger alliance with our dental colleagues rather than alienating them by discussing our surgical prowess, which I assure you they are probably not that interested in.

    Seriously, only those of us who are in the field know just how amazing this specialty is. No one, outside of the field, regardless of how many offices they worked or shadowed in, how many oral surgeons they've talked to etc will truly know what OMFS as a specialty is like. We shouldn't have to advertise how great OMFS is as a career. Let the ones who have the will to get thru residency find out for themselves. I think certain things should be 'trade secret' and I think income should be one of them. Besides, I'd much rather have GP's thinking that the periodontists are the ones who are getting truly rich off of their referrals, not us hard working oral surgeons. ;):D

    BTW, no one should take the ADA income figure too seriously. How many guys out there do you think ACTUALLY reports how much they make? You don't think after all the tax loop holes and etc, that teh income may be a lot higher than what they report? For example, some guys who have their practice as a LLC write themselves a paycheck, and consider this as a practice expense write off....
  28. backaction

    backaction Junior Member

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    A periodontist can make $2,000/day by doing: a good day
    -place 1 implant (1 hour) ($2,000)
    -2 quads of osseous surgery (2 hours) ($2,600)
    -root coverage two sites (1.5 hours) ($1,800)
    35% of production yields around $2,000/day

    OR

    $1,500/day with doing only 2 surgeries (an ok day)
    -4 quadrants of non surgical SRP (2 hours) ($1,500)
    -2 free gingival grafts (1 hour) ($1,600)
    -4 cleanings (2 hours) ($600)
    -1 vestibuloplasty (45 minutes) ($1,000)

    OR

    $1,000/day doing only 1 surgery (a very bad day)
    -1 apically positioned flap (1 hour) ($1,300)
    -8 quads of non surgical SRP (4 hours) ($3,000)

    About 25-35% of GPs do their own perio surgery. I think the study that i read a few weeks ago said that about 1/3 do their own crown lengthening and 1/4 do their own pocket reduction surgery. I know GPs that do lateral window sinus lifts and block grafts and doesn't do ortho because he doesn't like to do it. you are right, many GPs can do perio stuff if they have adequate training which for crown lenghtning may not be much training, or lots of training to do alloderm grafts with predictability. of course omfs can do ct grafts etc. but i don't think their training is geared to aesthetic soft tissue grafting. that's where the perio specialty comes in.
  29. clickytop

    clickytop Guest

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    Nobody collects on every procedure they do. Endodontists are a bit above average and oral surgeons are well below average, simply because of the types of patients they are seeing(higher percentage of low income/uninsured). An oral surgeon might do 10k worth of work in a day, but he's not taking that much home. On the other hand, the surgeons seem to enjoy working longer hours(as most are machines sent back from the future to shuck teeth),so its no surprise that the ADA has them listed as making more. They are working more.
  30. Doggie

    Doggie Professional Jackass

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    Nobody "enjoys" working long hours. That's the worst generalization I've heard on this thread so far. Go to a real private practice and see how the real guys are doing it in real life. Whether you are a GP, orthodontist, or even a pool cleaner, your typical hours do not add up to more than 40 hours a week. Heck, a lot of practices do much less than that!
  31. BeachBuff

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    "Location: Enjoying 16 hour work days"

    :thumbup: :laugh:
  32. VCUDDS

    VCUDDS

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    I guess it all boils down to your pt population, GP, orth, endo, perio, omfs, or pedo they all need pt's to earn thier income. There is also a huge learning curve in pvt practice in terms of managing the office and learning what insurances cover and how much you get paid per procedure. I like doing all my surgical procedures but i'm quickly finding the limitations of what i get paid back because some insurance companys would not pay a GP to do specialist's procedure!. There is also the experience factor and reputation, as is the case w/GP's, specialist w/ more experience will definitely be more known locally and should have more pt's to work on, the gpr program directore where i was doing my residency is a periodontist (army trained w/ tons of experience) he did not have his own practice but rather worked for 2-3 different practices, he was getting paid 50% off of collections working 3-4 days/week. I believe he used to say around 1000/ day was his daily average for the year (working in uPscale bethesda,MD).
  33. clickytop

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  34. KifsterDDS

    KifsterDDS Member

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    $1000 a day is quite a bit more reasonable (albeit a bit low) for a periodontist. 50% collections, however, is nice--almost too good to be true. As a GP working as an associate, I get paid 35% of collections and that's considered very good. At 50%, I'd top $1500 a day easily.

    I've never run into an insurance company refusing to pay me for "specialist" work that I do. In fact, it would make more sense that they'd prefer that I do it because I charge less for it.

    Seriously. Did you see some of the fees that these perio guys claim to charge for their work?

    $2000 for an implant? My practice charges $1600.
    $1300 for one quadrant of osseous surgery (a procedure you could train a chimpanzee to perform)?
    $375 per quadrant of scaling and root planing? We have our hygienists do that at $175 per quadrant!

    If those fees are accurate averages, then it is clear that periodontists are overcharging their patients. There is no excuse for the specialty to exist to begin with--GPs can and should be trained in dental school or at least in one year of mandatory residency to perform all the surgeries performed by periodontists. Deep down I think periodontists know this, but refuse to admit to it. Despite this, they not only have the gall to try and force us to refer to them (see the new AAP referral guidelines), but they have the audacity to charge patients horrendous fees for perio services. They are pushing for a monopoly on perio-disease so that they can price-gouge. As a doctor who cares about his patients' health and pocketbooks, I have a problem with this. The rare occasions in my practice where I refer a patient to a periodontist or an endodontist, my conscience tugs at me because I know that they're going to receive a financial mugging--especially with perio.

    And moreover, where does a specialist get the authority to dictate when a referral should be made? They are well within their right to dictate the standard of care to which all doctors who perform specialty procedures should adhere, but specifically stating conditions where patients should be referred to periodontists is inappropriate, unprofessional, and amounts to an unabashed attempt to forcibly bolster their patient pools.

    TOOFACHE32, you're missing an important point. Have you not heard the phrase "chair time" used before? Your time is meaningless (as is mine), because what dictates the pace of our practice is chair time and staff time, i.e. the amount of time a chair and staff is unavailable to another patient. It is impossible to properly set-up, treat, recover, and discharge a 3rds/sedation case in less than an hour. And that's not just an hour that a chair is used, it's also an hour that your staff is used--assuming you don't leave the patient unattended while you go do the 3rds case in the next room.

    I've taken out sets of full-bonies in as little as 15 minutes (albeit rarely)....without sedation--and even without sedation, the patient spends an hour in the chair. We doctors are rarely the limiting factor in terms of actual productivity. It's usually everything else around us.
  35. Yellowman

    Yellowman Member

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    Is 35% on collections is considered good? I get paid 40% on collections moonlighting (performing oral surgery procedures) in Ohio. I always thought 40% was the standard, with 45% being good. My buddies in Los Angeles are getting the same rate, if not higher. What state are you practicing in?


    I would have to disagree with you on this one. I'd agree that the actual chair time for extracing 4 impacted full bonies is more than a half hour, but not by much. I'd say 45min tops per pt turn around time for an experienced oral surgeon, and that would not be considered a break neck pace.


    5 minutes to set up room
    5 minutes to seat pt and have monitors hooked
    1 min for IV
    3 min for sedation to kick in and local anesthesia delievery
    10-25 min of actual sx time
    3-5 minutes for pt to be awake enuf to be moved to recovery area. While pt is waking up, room is being broken down and reset

    I think this is a VERY reasonable time breakdown and it works out to be about 45 minutes or less. Thus doing a set of thirds in less than 1 hr should not be impossible as you claim.

    Although I am sure you are very confident in your surgical extraction skills, the fact that you haven't had a root-in-sinus problem yet is likely becasue you haven't done enough extractins. I am a firm believer in the addage, "if u aren't having complications, you aren't doing enough procedures." Complications will always occur, even to the experienced, but they only occur if you do thousands of procedure. I must have extracted several thousands of teeth by now, and for the record, I've shoved 2 root tips in the sinus. It can happen to anyone....for me, I was rushing when I shouldn't have. But in retrospect, I would've never had these problems if I was a GP doing maybe 50-100 extractions per month (I am estimating here, don't flame me), as opposed to doing several hundred per month as OMFS.
  36. Yellowman

    Yellowman Member

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    It's possible to collect on every single procedure you do. U have the patient pay up front prior to starting the procedure. U simply do a consultation, let them know the fees and ask them to pay their share of the cost up front. if they don't like my fees, they go somewhere else. Simple and time saving for both me and the patient. Unless it's an emergent procedure, I will not perform the tx unless the payment is made in full. I've had too many bad expereinces having people pay after procedures. you wouldn't believe the stories they come up with. At first it was a bit tuff for people to comply, but it's been a year and now that I have my referrals and have been working in teh same office for a couple years, I've had nothing but good experiences. This saves a lot of chair time for me as I am not doing procedures that won't pay.

    Also, where are u getting the information that oral surgeons are below average in terms of collections whereas endodontists are above average? Could u please provide a link or refer to the article?
  37. toofache32

    toofache32

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    Unless my hands are in the patient's mouth, the patient should only be in the chair 10 minutes TOPS (5 minutes to seat them and hook up monitors, 5 minutes at the end to shove gauze in their mouth & drag them to the recovery area). Otherwise they are in the waiting room, another room, or the recovery area. Why do you let your patients occupy so much of your chair time when you're not in the room? And why are you trying to convince me that my observations of my own clinic are incorrect? I'm not being theoretical here.... I'm telling you how we do it every day! Jeeeeeez.
  38. VCUDDS

    VCUDDS

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    Ok .... when i mentioned the 1000/day this was what my director used to bring home as a daily average/ year. you will not have implants and good sx every day so as an average he would be making that much. he actually did note that many time he would do one or two procedures per/day and that's it!. others he would be running 2-3 rooms (all surgeries) at the same time.
    i dont know exactly what insurance was it (i think it was HMO) they denied my request for crown lengthening, the area where i'm practicing has a lot of managed care patients and you have to cater to thier need!.
    i dont think that it's too much for specialist to charge more, heck if they went through that much extra training than i think they deserve it!.
  39. Squished Rat

    Squished Rat

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    I think the difference is that you are doing oral surgery while he is doing general practice. With general practice, they have to factor in the overhead costs such as the lab bill for pros and that generally runs higher whereas the overhead for oral surgery is fixed (instruments and drugs) and lower overall.
  40. Yellowman

    Yellowman Member

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    general dentists get the same rate.
  41. VCUDDS

    VCUDDS

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    I think percentage of pay comes w/ experience of practicing dentist, most GP's coming out of school in my area (virginia) are getting 30-35% (collection) that will increase to 40% once experience kicks in!.
  42. Jaybe

    Jaybe Lazy Tongs

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    The funny thing is, that dude Kilfster lets Chair Time limit his productivity!!!! Come on Sherlock, put in another freakin' CHAIR!!! Hell put in 20 of them and let your patients sit there all day long! Doctor time is the most important determinant of dentist income. Period.
  43. Jaybe

    Jaybe Lazy Tongs

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    BTW; I doubt endodontists make more than OMFS. Especially now that rotary endo allows GPs to do most of the "home run" anterior endos. Endodontists in freakin' Arkansas charge like $750 for a central incisor. Takes 30 minutes. But those days are over cause GPs are hittin those hoes. Now the endos are really dependent on the hardass 2nd maxillary molars and retreats to make a living. On the other hand, OMFS are the only people really qualified to handle "bonies". GPs (or perios) doing those types of cases are living in a dreamworld. And their patients are hurtin.

    Okay, now I will disappear. . .
  44. backaction

    backaction Junior Member

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  45. clickytop

    clickytop Guest

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    Dude, its the internet. Most of what I'm saying, I make up on the spot. Just like everyone else here. But if a reference would make you happy, here you go: Felcher, et al. Western Manitoba Journal of Canine Endodontics. 2007 Jan. 31(2); 132-135.
  46. Yellowman

    Yellowman Member

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    way to build up your credibility bro :thumbdown:
  47. clickytop

    clickytop Guest

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    Almost everyone on this board who claims to know anything about running a practice is either lying or deluding themselves. All we know at this point is what other people have told us. And I don't need credibility...I have street credit. I was shot 9 times.
  48. KifsterDDS

    KifsterDDS Member

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  49. KifsterDDS

    KifsterDDS Member

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    Well, I did an OMFS internship, during which time I must have extracted thousands of teeth. In the past two years I've been in private practice, I've extracted thousands more teeth. I get referrals from co-workers for them.

    That aside, I have indeed had complications--generally sinus exposures and much less commonly neuropraxial IAN injuries. I've even had a couple of small OA fistulas develop, which I surgically treated myself successfully.

    As far as shoving a root into the sinus, allow me to modify my previous claim that it never happened to me. It did happen to me once, early on in my internship when I didn't realize how easily it could happen. I learned from it, and (knock on wood) haven't done it since.

    Anyway, you mentioned that the patient is sent to the recovery room after 3-5 minutes. I'm wondering, how long do they occupy the recovery room? Moving patients from room to room does not solve the issue of chair-time when you're doing back-to-back sets of 3rds. At some point, there is going to be a time when one of your operatories is going to be occupied by a recovering patient. Maybe you give them Rumazicon and Narcan to get them up and out?
  50. Yellowman

    Yellowman Member

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    It's all in how you administer anesthesia. By the time the last tooth is coming out, pt is starting to wake up. The 1-2 min it takes to put sutures (if needed at all), another 1-2 minutes disconnecting monitors, wiping pt's face etc, pt is already awake enough to be helped to the recovery room. By the pt is in the recovery room, he/she will be awake enough to be discharged within 5-10 minutes. No reversal agents needed, and no one ever stops moving. Now recovery room is freed up for the next pt, by which time, pt should be in the OR, unconscious and molars being extracted.

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