Is it Ortho worth 750K Debt?

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Batmansvoice

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I have friends who have undegraduate debt of around 120-200K, dental school debt of around 300-400K who go into ortho residencies that charge around 80-100K per year for 2-3 years. Is this worth it?
 
Batmansvoice said:
I have friends who have undegraduate debt of around 120-200K, dental school debt of around 300-400K who go into ortho residencies that charge around 80-100K per year for 2-3 years. Is this worth it?
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Batman,

I am SO GLAD that you asked this question. I have been running the numbers on dental specialties for some time, and that is right around the figure I came up with. 400-500K for dental school followed by specialty training comes out to 3/4 of a million bucks. 750K. You are right on the money. None of the Orthos out practicing now paid anywhere NEAR that amount of money to be an ortho. This is absolutely nuts. Re: the thread about 500K to be an ortho, I have a friend who has that much debt from dent school ALONE, nevermind specialty training. Honestly, I don't think people are running the numbers; looking at these loan burdens makes me think that there is absolutely a bubble in higher education. Paying that much just for education is patently absurd, and it is driven by universities' easy access to government money. Is it worth it? Honestly, I don't know.
 
My wife borrowed more than $300k (could have been a lot more if she didn't moonlight) for a perio certificate. To me, that was a much bigger risk than paying $750k for an ortho certificate. I'd rather be an ortho with $750k in debt than being a general dentist with $400k in debt and than being a perio with 300k in debt.

I bought my first house only a few months after I got my ortho certificate for $382k. So I had just as much debt as today new grad ortho who owes $750k in student loans and doesn't own a house. Live with your parents (if you are single) after graduation. Work at any place even if you get paid worse than a GP. Save money to set up a small low overhead office. And you will be fine.
 
charlestweed said:
My wife borrowed more than $300k (could have been a lot more if she didn't moonlight) for a perio certificate. To me, that was a much bigger risk than paying $750k for an ortho certificate. I'd rather be an ortho with $750k in debt than being a general dentist with $400k in debt and than being a perio with 300k in debt.

I bought my first house only a few months after I got my ortho certificate for $382k. So I had just as much debt as today new grad ortho who owes $750k in student loans and doesn't own a house. Live with your parents (if you are single) after graduation. Work at any place even if you get paid worse than a GP. Save money to set up a small low overhead office. And you will be fine.
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What's wrong with a traveling periodontist? 50% overhead traveling from GP office to GP office placing implants, and no annoying transfer patients in case you decide to leave.
 
charlestweed said:
My wife borrowed more than $300k (could have been a lot more if she didn't moonlight) for a perio certificate. To me, that was a much bigger risk than paying $750k for an ortho certificate. I'd rather be an ortho with $750k in debt than being a general dentist with $400k in debt and than being a perio with 300k in debt.

I bought my first house only a few months after I got my ortho certificate for $382k. So I had just as much debt as today new grad ortho who owes $750k in student loans and doesn't own a house. Live with your parents (if you are single) after graduation. Work at any place even if you get paid worse than a GP. Save money to set up a small low overhead office. And you will be fine.
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Tweedy what is the breaking point for you, man? You're always saying that you would rather have more debt and be an ortho than less debt as a general dentist. Would you pay a million? Also your house debt doesn't count--that is debt that you can sell. You can't sell student loans. The value of your house went up. It's very different. Going into 3/4 of a million dollars of debt to be an orthodontist is absolutely bat-$hit crazy. You will be paying 60K per year in loans for 30 years. Even if you make the ortho average of 300K, you will be left with around 100K take home before servicing practice debt and a home mortgage. That's ridiculous. At that level you are much better off in a variety of other careers in health care. It's foolish to put oneself in that much debt. If you are looking at THAT much debt, join the military. I can't believe that people would actually contemplate spending that much on education. I mean, seriously? C'mon, guys--the average dental incomes have dropped over the past 5 years. With more schools coming online and dental therapists, don't put yourself under that kind of weight.
 
charlestweed said:
My wife borrowed more than $300k (could have been a lot more if she didn't moonlight) for a perio certificate. To me, that was a much bigger risk than paying $750k for an ortho certificate. I'd rather be an ortho with $750k in debt than being a general dentist with $400k in debt and than being a perio with 300k in debt.

I bought my first house only a few months after I got my ortho certificate for $382k. So I had just as much debt as today new grad ortho who owes $750k in student loans and doesn't own a house. Live with your parents (if you are single) after graduation. Work at any place even if you get paid worse than a GP. Save money to set up a small low overhead office. And you will be fine.
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Didn't you say on another thread that having 400K student loans and 400K practice loans frightened you? And that was the reason that a lot of practitioners didn't want to take out loans of that size?
 
Batmansvoice said:
I have friends who have undegraduate debt of around 120-200K, dental school debt of around 300-400K who go into ortho residencies that charge around 80-100K per year for 2-3 years. Is this worth it?
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Your friends are nuts. Have fun paying off 750k becoming an orthodontist. That is so crazy, it makes me want to throw up just thinking about it.
 
ortho lurker said:
What's wrong with a traveling periodontist? 50% overhead traveling from GP office to GP office placing implants, and no annoying transfer patients in case you decide to leave.
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My wife has done well as a traveling perio because she knows a lot of GPs. If I had her job, I don't think I'd survive because of my timid personality. In ortho, I can still get patients without the GP referrals.
Silent Cool said:
Tweedy what is the breaking point for you, man? You're always saying that you would rather have more debt and be an ortho than less debt as a general dentist. Would you pay a million? Also your house debt doesn't count--that is debt that you can sell. You can't sell student loans. The value of your house went up. It's very different. Going into 3/4 of a million dollars of debt to be an orthodontist is absolutely bat-$hit crazy. You will be paying 60K per year in loans for 30 years. Even if you make the ortho average of 300K, you will be left with around 100K take home before servicing practice debt and a home mortgage. That's ridiculous. At that level you are much better off in a variety of other careers in health care. It's foolish to put oneself in that much debt. If you are looking at THAT much debt, join the military. I can't believe that people would actually contemplate spending that much on education. I mean, seriously? C'mon, guys--the average dental incomes have dropped over the past 5 years. With more schools coming online and dental therapists, don't put yourself under that kind of weight.
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You haven't worked as a general dentist yet so you don't really know how hard (both physically and mentally) the job is. And all the insurance BS's that the GPs have to deal with. If you live in So Cal, it's will be 100x time harder working as a GP. To me, earning an ortho certificate is like winning a lottery ticket. No money can buy it.....only good grades and hard work can.

How can you say the house debt doesn't count? As long as you stay in your house, you have to write the monthly check to the bank just like any other loans. Sure, you can sell the house but you can only do that if the house is worth more than what you owed. And if you sell your house, where are you and your kids going to sleep? My current house has depreciated more than $500k in the last 6 years. Three years ago, I owed more than what my house was worth but this didn't bother me because of my stable orthodontic income. Sure, I can file bankruptcy to erase my house debt but it's not in my DNA. I don't care what the law says or what it tries to do to help protect the consumers. If I owe someone money, I am obligated to pay it back in full + the interest.
Silent Cool said:
Didn't you say on another thread that having 400K student loans and 400K practice loans frightened you? And that was the reason that a lot of practitioners didn't want to take out loans of that size?
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It wasn't me who said this. I think someone else did and I absolutely agree with that person. If I owed more than 400k in student loan, I would never take out another 400k to set up a practice. As you already know, I've always been a strong advocate of small low overhead office. It took me 4 years after graduation to finally have the courage to start my first office.
 
charlestweed said:
If you live in So Cal, it's will be 100x time harder working as a GP.
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What specifically makes working in So Cal a 100x harder? Because it is so saturated and you will have to do a ton of marketing? Can you please elaborate on this. I am a 1st year D student and am interested in practicing in California. Thanks.
 
cariesRbad said:
What specifically makes working in So Cal a 100x harder? Because it is so saturated and you will have to do a ton of marketing? Can you please elaborate on this. I am a 1st year D student and am interested in practicing in California. Thanks.
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You are not the only one. There are probably 100x more students like you than the number of dental students who want to practice in the midwest (I am exaggerating of course).
 
cariesRbad said:
What specifically makes working in So Cal a 100x harder? Because it is so saturated and you will have to do a ton of marketing? Can you please elaborate on this. I am a 1st year D student and am interested in practicing in California. Thanks.
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It is harder here in CA because of the oversaturation of dentists. Most employers (both dental chains and private practice owners) no longer pay their associate dentists the guaranteed per diem rate because they all realize that many new grads are in desperate need of associate jobs. Most employers pay the associates the percentage of collection. If you are not able to produce or if your boss is not able to collect (from insurance companies), you won't get paid.

A friend of mine, who owns 2 GP practices, posted a job ad on Craiglist and he received nearly 100 phone calls from dentists who wanted to work for him.

Many new grads have to work for the dental chains. The chain, where I current work at, pays the associate dentists 23% of the collection. Most of the patients you see at the dental chains have HMO plans, which pay the dentist zero for cleaning, zero for fillings, $90 for a molar endo etc. When you first start, the chain manager gives you a stack of insurance applications to sign. And it usually takes a few months for the insurance companies to accept you as their provider. During this waiting period, you are not allowed to treat the patients….you can only see the cash patients. So you basically sit there all day long doing nothing and not get paid.


Just last week, the managing dentist, who works at the same chain with me, did 6 amalgam fillings on this one kid so I could start the ortho treatment on him. Normally, these 6 fillings are done at several appointments because this patient has HMO, which pays zero for amalgam fillings. But the company wanted to make $$$ from ortho tx; therefore, this managing GP had to do all 6 fillings in one appointment and she did not get paid for doing these fillings.

At least in ortho, we get paid for doing the work even when the patient has the HMO plan.

Sorry, I didn't mean to scare you. That's just the reality. If you still want to live and practice in CA, try to borrow for dental school as little as possible. Work for nobody but yourself. Many of my GP friends who graduated from USC and LLU 10-15 years ago with 200-250k debt are doing extremely well here. The GP, whom I mentioned on the 2nd paragraph, graduated from LLU one year before me. He paid off his $600k house before his 40th birthday. Until last year, he still drove the same Tacoma truck. He finally got rid of the truck and guess what he bought? A 2-year old Subaru sport wagon so he can mount his snow board on the roof. He is very simple guy....that's how he managed to pay off all his debts.
 
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ortho lurker said:
You are not the only one. There are probably 100x more students like you than the number of dental students who want to practice in the midwest (I am exaggerating of course).
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whats the midwest???? sounds cold and windy as that third world country, canada??? Cali dreaming for sure!!!!
 
Normally what tweed says jives with me. But $750k is unbelievable.

I'll have to think about it to see if I agree.
 
What charlestweed said was all good. But he's from the pre-housing bubble era when there was easy consumer credit and economy seemed to be running on par with the housing bubble. What worked for him and his generation of dentists probably will not work for the new millennial generation of new dentists. Just remember that past performance does not guarantee future performance!
 
I started a thread about a year and a half ago for 500k and thought that was dumb. Now were at 750k? Haha
 
BlueToothHunter said:
What charlestweed said was all good. But he's from the pre-housing bubble era when there was easy consumer credit and economy seemed to be running on par with the housing bubble. What worked for him and his generation of dentists probably will not work for the new millennial generation of new dentists. Just remember that past performance does not guarantee future performance!
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I agree. I had much easier time when I started my career in the early 2000s (just a little over 10 years ago). The associate jobs were more abundant. There were also fewer orthodontists because of the stricter CA state board exam that prevented orthodontists from other states to move in. That's how I could afford all the luxury things like nice German cars, nice houses, Ethan Allen furnitures etc. Now, if all the new grad orthos are willing to live without these luxury items, they will be just fine. At one point in your life you will have to take out a loan that is bigger than this $750k….either for a house or for an investment apartment or office building. As I said earlier, I lost more than $500k on a house due to the recent housing bubble. I just think of this loss as if I went to an expensive private dental school. If I weren’t an orthodontist, I would have been in big financial trouble.

It’s not all that bad during this housing bubble time. I’ve just refinanced my house at 3.75% interest rate. I haven’t seen a low rate like this in my life. It’s sure harder for new grads to get the approval for a business loan for setting up an office. This may be a good thing since it will force them to set up a smaller (under $100k) office. There are a few abandoned GP offices here in CA that you can buy for very cheap….and convert it to an ortho office.

Bluetooth Hunter, we met each other in person before. I am sure you could tell that I look nothing like an outgoing type of person who knows how to run a successful business. I am just a shy orthodontist who runs 3 very low budget orthodontic practices. To keep the overhead low, I still bend wires and make the quad helix and RPE myself. If I can make it in this competitive market in So Cal, so can other new ortho grads.

I didn't start my first own office until 2006....just a year or 2 before the housing bubble started.
 
Word, Silent.. I respect tweed for his 'positive' outlook but at some point reality and optimism has to intercept to provide an accurate forecast for people who are not in the know. Lets be realistic here: loans accumulate interest and orthodontics doesnt that much anymore due to the rapidly skewing supply/demand of the specialty, and CA certainly isn't as rosy as he paints it.
 
Shunwei said:
Word, Silent.. I respect tweed for his 'positive' outlook but at some point reality and optimism has to intercept to provide an accurate forecast for people who are not in the know. Lets be realistic here: loans accumulate interest and orthodontics doesnt that much anymore due to the rapidly skewing supply/demand of the specialty, and CA certainly isn't as rosy as he paints it.
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Yup. Anyone out there actually have this much debt for ortho? I read a thread over on dentaltown in which one of the posters mentioned that a colleague had about 750K of debt for ortho.
 
Just wanted to thread bump this to see if anyone else has some more thoughts.
 
Silent Cool said:
Just wanted to thread bump this to see if anyone else has some more thoughts.
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Several of my ortho friends here in TX are having a really hard time trying to find a job of any kind--there is simply nothing here especially since the Medicaid bubble burst. I can only surmise that in other areas such as CA or NYC it'd many magnitudes worse. Add to that the saturation already present (and increasing) in the field, I am of the firm opinion that ortho is rapidly declining in its desirability. It used to be that new grads can expect 300k off the bat, nowadays it is hard to find even part-time jobs paying 1k/day. And definitely not worth a whopping 750k. Can't imagine being saddled down with 5-6k/month for 30 years.
 
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I wonder if pedo would have as much problem as ortho by the time I graduate. Takes a brave soul to take on 750k just to do ortho in THIS economy.
 
KittySquared said:
I wonder if pedo would have as much problem as ortho by the time I graduate. Takes a brave soul to take on 750k just to do ortho in THIS economy.
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Ortho is elective so parents can wait until (if) the economy gets better. Parents would rather take care of their children's tooth ache over their own if they had to ration out resources. One option that orthos can do to survive in this environment is to reduce their case fees and buy cheaper products directly from China on the internet (and bypass the sales reps) and hire cheaper staff. It will be the big ortho supply companies who will hurt the most when (if) the economy recovers.
 
I have great faith in Ortho. Nothing in this world is better than this one.
 
dinodent said:
I have great faith in Ortho. Nothing in this world is better than this one.
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Dino,

Does that mean you think that ortho is worth 750K of debt? Seriously. That just seems like an unfathomable number.
 
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