Are graduating orthodontists living in La La Land?

[dort-ort]

to all the little orthos and ortho wanna be's out there. cry me a river. no one is entitled to anything, anywhere. you get paid what you get paid. it is a free market. I don't care how smart, how good, how pretty, how nice, how whatever you are --- its a free world out there. after graduation no one is entitled to give you anything. if you get a job for $5000/day or $50/day -- if you like it and it works out for you and you happen to find it fits for you then go for it -- if not -- look for something else. use your mojo to the best of your ability to make things happen the way you want. Dont' expect anything from anyone.

like i said before if you don't like the situation you're in then change it. Ortho is not what people think it is. ortho sucks. oral surgery is where things are at. at graduation an O.S. can demand what they want. if not put up a shingle and your good to go. thats because OS as a whole are smart and they as a group limit the number of graduates each year. unlike ortho where everyone, their sister, brother, mother and drinking buddy are an orthodontist and graduate each year. you don't see 20 residents in OS residency do you? what a bunch of crap ortho is becoming.

As far a charles tweed -- he's dead and no one follows his philosophy anymore, no one bends wires anymore so why don't you just drop the silly name dude. quit trying to pass along your 3rd world typical B.S. life story -- we understand that you've worked your way from a modest beginnings -- we were there too. if you are happy with your small skeleton offices with low overhead that attracts the poor hispanics or the medicaid crowd that pay you $50 per visit and $2500 per case you do that -- - but quit trying to tell others that is the only way to do things cuz its not!

those little orthos out there -- if you want to spend money and get a nice tricked out office -- do it -- you'll be attracting a different crowd -- its going to be tough at first but it can be done and build you reputation and you will have the kind of office you want but it takes time for that. if you want the 3rd world office like charlestweed you can do that too and work at 50 different offices and never really get anywhere. different types of practices,, you must choose.

at my office I did not spend 30 seconds at the chair, i took the time to spend with the patients and parents. to let them know whats going on with their kids treatment that they just spent $5000 on. I still saw 80-120 some patients per day. i too can use any bracket system -- cheez give me some wire and composite and i can straigten teeth. and if you think that the assistants do all the work your kidding yourself. I worked my butt off to make sure the case turned out ABO quality -- its not all retie and power chain which the assts do ... you have to get in there and make sure things are done right. so don't tell me 90% of work is done by assistants.

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[Aphid]

to all the little orthos and ortho wanna be's out there. cry me a river. no one is entitled to anything, anywhere. you get paid what you get paid. it is a free market. I don't care how smart, how good, how pretty, how nice, how whatever you are --- its a free world out there. after graduation no one is entitled to give you anything. if you get a job for $5000/day or $50/day -- if you like it and it works out for you and you happen to find it fits for you then go for it -- if not -- look for something else. use your mojo to the best of your ability to make things happen the way you want. Dont' expect anything from anyone.

like i said before if you don't like the situation you're in then change it. Ortho is not what people think it is. ortho sucks. oral surgery is where things are at. at graduation an O.S. can demand what they want. if not put up a shingle and your good to go. thats because OS as a whole are smart and they as a group limit the number of graduates each year. unlike ortho where everyone, their sister, brother, mother and drinking buddy are an orthodontist and graduate each year. you don't see 20 residents in OS residency do you? what a bunch of crap ortho is becoming.

As far a charles tweed -- he's dead and no one follows his philosophy anymore, no one bends wires anymore so why don't you just drop the silly name dude. quit trying to pass along your 3rd world typical B.S. life story -- we understand that you've worked your way from a modest beginnings -- we were there too. if you are happy with your small skeleton offices with low overhead that attracts the poor hispanics or the medicaid crowd that pay you $50 per visit and $2500 per case you do that -- - but quit trying to tell others that is the only way to do things cuz its not!

those little orthos out there -- if you want to spend money and get a nice tricked out office -- do it -- you'll be attracting a different crowd -- its going to be tough at first but it can be done and build you reputation and you will have the kind of office you want but it takes time for that. if you want the 3rd world office like charlestweed you can do that too and work at 50 different offices and never really get anywhere. different types of practices,, you must choose.

at my office I did not spend 30 seconds at the chair, i took the time to spend with the patients and parents. to let them know whats going on with their kids treatment that they just spent $5000 on. I still saw 80-120 some patients per day. i too can use any bracket system -- cheez give me some wire and composite and i can straigten teeth. and if you think that the assistants do all the work your kidding yourself. I worked my butt off to make sure the case turned out ABO quality -- its not all retie and power chain which the assts do ... you have to get in there and make sure things are done right. so don't tell me 90% of work is done by assistants.

You seem to be very disgruntled with the ortho. Seeing that you see 80-120 patients/day, you also seem to be very successful. Is there a reason why you don't enjoy the work? Just curious.

 

[dort-ort]

You seem to be very disgruntled with the ortho. Seeing that you see 80-120 patients/day, you also seem to be very successful. Is there a reason why you don't enjoy the work? Just curious.

Far from it skywalker ...... don't mistaken passion/disappointment for disgruntled. i am very passionate about orthodontics--it was my life. However, as with anyone's profession when you see it being watered down to something of a trade, which its become. its time to move on. if you want my advice. get into financial/investment business. millions are at the push of the button. of course like anything else its not as easy as it sounds and requires hard work for the big payoff......ortho used to be that its not anymore. to some it may still be but to me its not anymore in so many ways--its a whole other thread to get into the details of why. but we have touched on that just do a search.

 

[ItsGavinC]

I agree. Let me also clarify though for reading comprehension skills.

These applicants are probably thinking that this pedo office does have the volume to pay them 1300 a day. If Demeter doesn't have that volume then he should look at other applicants who will accept less, or make another offer he is willing to pay and the bartering can go from there. Obviously getting a doctorate and PhD in art history doesn't entitle you to making 6 figures right out of school. You are however entitled to demand more money than someone with less training than you, which was what I stated in my post. When done with residency I won't work for less than XXX,XXX guaranteed. I worked too long and too hard to be worth less, which is what I am entitled to think and demand.

<sigh>

Let me clarify for your poor reading comprehension skills.

1) Demeter is looking at hiring an ORTHODONTIST in a pedo office. He has ZERO orthodontic patients in his practice right now. He can have a HUGE volume of pedo patients and have a crappy ortho patient pool. If 75% of his patients are age 1-7, then ortho won't be very busy.

2) Your use of "entitled to demand" is ******ed. It makes no sense. Eliminate the "entitled to" crap and just state "demand." That's all you are referring to. And sure, you can demand whatever you like, but big whoop.

3) LOL at your "worked too long and too hard to be worth less..." Once again, you are worth whatever the market says you are worth, NOT how long and hard you've worked or how many student loans you have. How are you not going to work for less than $XXX,XXX if all the offers are below that when you graduate? I'm serious. I want to know how that plays out. Will you flash your 7 years of schooling that ALL orthodontic graduates also have?

Look at it from a logical perspective. Dental school tuitions are RISING and orthodontic class sizes (and therefore graduates) are also RISING and the economy is going DOWN. That means more graduates all wanting to treat an increasingly smaller patient population. You'll earn what you earn, literally.

 

[ObviousGuy]

Obvious Guy doesn't agree with me so I am going to call him ******ed. I also burned him back by saying he had bad reading comprehension.

I'm in OMFS, works different for me I guess.

I can still demand to be paid $$xxx.00. If you don't want to pay it, you don't have to.

If you don't like the market then go somewhere else. Dr. So and so charges 4K for 4 impacted teeth around here. His counterpart 3 blocks away charges 2500.

Market shmarcket. You demand and or charge what you think you are worth. Whatever the ortho grad is asking for is what he thinks he is worth. If the pedo practice with a bunch of 1-7 yr olds and can't pay it, no problem, don't hire him.

If that ortho grad doeesn't get any offers in 'city' then he has a few choices

a. demand less than what he thinks he is entitled to (his sweat equity value)
b. look at another city
c. open his own practice and charge what he wants

 

[charlestweed]

As far a charles tweed -- he's dead and no one follows his philosophy anymore, no one bends wires anymore so why don't you just drop the silly name dude. quit trying to pass along your 3rd world typical B.S. life story -- we understand that you've worked your way from a modest beginnings -- we were there too. if you are happy with your small skeleton offices with low overhead that attracts the poor hispanics or the medicaid crowd that pay you $50 per visit and $2500 per case you do that -- - but quit trying to tell others that is the only way to do things cuz its not!

those little orthos out there -- if you want to spend money and get a nice tricked out office -- do it -- you'll be attracting a different crowd -- its going to be tough at first but it can be done and build you reputation and you will have the kind of office you want but it takes time for that. if you want the 3rd world office like charlestweed you can do that too and work at 50 different offices and never really get anywhere. different types of practices,, you must choose.

No, I don’t bend wires nor I use the edgewise brackets. Like most orthos, I use straight wire technique, which make ortho treatments 100 times easier and faster. Because of the straight wires, I don’t have to do much. I just don’t feel right to charge the patient $5k a case when the work is so simple. I actually feel I am overpaid for the work that I am performing….yes, even at my low fees. However, I still follow Dr. Tweed’s treatment philosophy, that is to let the position of the lower 4 incisors dictates how I finish all my cases. I don’t just blow these lower incisors out to 120+ degrees and think that I meet the ABO standard. I don’t just blow them out to 120+ degrees and think that I am the greatest orthodontist because I just save the 4 bicuspids (or 2 upper bicuspids for class II cases) from being extracted.

at my office I did not spend 30 seconds at the chair, i took the time to spend with the patients and parents. to let them know whats going on with their kids treatment that they just spent $5000 on. I still saw 80-120 some patients per day. i too can use any bracket system -- cheez give me some wire and composite and i can straigten teeth. and if you think that the assistants do all the work your kidding yourself. I worked my butt off to make sure the case turned out ABO quality -- its not all retie and power chain which the assts do ... you have to get in there and make sure things are done right. so don't tell me 90% of work is done by assistants.

If the patients and parents just want their teeth tightened as quickly as possible so they can go back to school, why do you have to kiss their butts and bore them with some stupid nonsense ortho terminology? If you see 80-120 patients a day (which are 20-40 more patients than what I normally see) and say you are doing great work, then you are not telling the truth. I don’t see that many patients even when I work for a dental chain.

 

[ObviousGuy]

I don’t see that many patients even when I work for a dental chain.

Just because you can't see 80-120 pt's a day doesn't mean it can't be done and it doesn't mean it can't be done with a high quality result.

Some OMFS offices see 6 sedations a day. Some see 15 and have time for afternoon consults. The guy in a 6 sedation a day practice might think the guy in a 15 sedation a day practice is committing malpractice and nerve damage every day.

Not true. If the office is flowing like a well oiled machine then it can clean house with high quality and efficiency.

 

[DrReo]

I agree 100%. Are lawyers entitled to make more money since they have received more education? Same with those who have MS or PhD in a science field who then pursue patent law??? Business, people, business- it's basic and excludes your ego!

<sigh>

Let me clarify for your poor reading comprehension skills.

1) Demeter is looking at hiring an ORTHODONTIST in a pedo office. He has ZERO orthodontic patients in his practice right now. He can have a HUGE volume of pedo patients and have a crappy ortho patient pool. If 75% of his patients are age 1-7, then ortho won't be very busy.

2) Your use of "entitled to demand" is ******ed. It makes no sense. Eliminate the "entitled to" crap and just state "demand." That's all you are referring to. And sure, you can demand whatever you like, but big whoop.

3) LOL at your "worked too long and too hard to be worth less..." Once again, you are worth whatever the market says you are worth, NOT how long and hard you've worked or how many student loans you have. How are you not going to work for less than $XXX,XXX if all the offers are below that when you graduate? I'm serious. I want to know how that plays out. Will you flash your 7 years of schooling that ALL orthodontic graduates also have?

Look at it from a logical perspective. Dental school tuitions are RISING and orthodontic class sizes (and therefore graduates) are also RISING and the economy is going DOWN. That means more graduates all wanting to treat an increasingly smaller patient population. You'll earn what you earn, literally.

 

[DrReo]

I'm in OMFS, works different for me I guess.

I can still demand to be paid $$xxx.00. If you don't want to pay it, you don't have to.

If you don't like the market then go somewhere else. Dr. So and so charges 4K for 4 impacted teeth around here. His counterpart 3 blocks away charges 2500.

Market shmarcket. You demand and or charge what you think you are worth. Whatever the ortho grad is asking for is what he thinks he is worth. If the pedo practice with a bunch of 1-7 yr olds and can't pay it, no problem, don't hire him.

If that ortho grad doeesn't get any offers in 'city' then he has a few choices

a. demand less than what he thinks he is entitled to (his sweat equity value)
b. look at another city
c. open his own practice and charge what he wants

When will the general dentists start dictating the OMS around. There are a few folks on dentaltown that now have the surgeons come into their office so nothing has to be referred. Do you think this will be the norm at some point?

 

[drgoro]

^^ When they can get someone else to bail them out of a real **** situation. Its not the procedure, ..its the complication. You see, when it boils down to it, we're the last stop...for all the talking everyone else does, we say no and turn our backs then all we have left is a GD with a tooth stuck in the fossa/sinus sweating...pay now or pay later, deal with it

 

[charlestweed]

Just because you can't see 80-120 pt's a day doesn't mean it can't be done and it doesn't mean it can't be done with a high quality result.

It sure is possible to get good quality work when you see such high volume of patients. However, it is impossible when you have to see 80-120 patients/day, spend time talking to each patient, do more than 10% of the work yourself and let the assistants do less than 90% of the work…and still get good quality work. The math just doesn’t add up. Something’s gotta give.

 

[HALOdontist]

It sure is possible to get good quality work when you see such high volume of patients. However, it is impossible when you have to see 80-120 patients/day, spend time talking to each patient, do more than 10% of the work yourself and let the assistants do less than 90% of the work&#8230;and still get good quality work. The math just doesn't add up. Something's gotta give.

I second that, although I still think you can do good work, just not do all the criteria you listed. Anyone that thinks they can see 100-120 patients, talk to the patients, occasionally parents, and do alot of the clinical work hasn't done it or is out of there mind.

 

[scandalouslj]

Ortho is not what people think it is. ortho sucks. oral surgery is where things are at. at graduation an O.S. can demand what they want. if not put up a shingle and your good to go. thats because OS as a whole are smart and they as a group limit the number of graduates each year. unlike ortho where everyone, their sister, brother, mother and drinking buddy are an orthodontist and graduate each year. you don't see 20 residents in OS residency do you? what a bunch of crap ortho is becoming.

This is the biggest piece of B.S. I have read. Ortho doesnt limit the number of grads? Yeah right! Then there would no need for you to be in the top of your class to go into ortho. Yes there are a handful of classes that has 20 residents, but that is the exception and not the norm (not to mention the company that introduced this is now bankrupt). Ortho is more "protected" than any specialty out there in dental school. Undergrad dentist's take ortho lectures all 4 years, bend wires and trace in preclinical lab, and do the basic diagnosis in the clinic, why arent they taught to do the final piece which is actually treat the patient? Placing brackets isnt exactly rocket science, but they teach less ortho in undergrad dental school than endo or oral surgery. Has the quality of ortho gone down with invisalign? Sure, so why not teach it in the proper environment, something like minor crowding on in the anterior mandibular teeth could be fixed easily, and thousands of GPs are treatign that everyday, without really "compromising quality". Now I am not advocating treating kids and teenagers with traditional wires for Gp's or class 3's or crossbites, etc. But one could easily argue that endo and oral surgery has gone down also, so that is a crappy excuse. Does OS have it good? Yeah. But its not because they have limited the number of grads. Its because most students dont want to go to school, being on call 24/7, standing in an operating room for 3+ hours for the next 4-6 years. And every segment of dentistry is facing competition, GP's with the addition of 10 new schools in the next 5 years, and advanced practitioners (or whatever their formal name is) in states like Minnesota, Maine and several other states, and hygienists being able to practice independently. Oral surgeons with periodontists and even endodontists learning how to place implants. Endodontists with GP's doing more endo as better files come out and the list continues. So stop crying, ortho's have it better than anyone. Ortho's have one of the top salaries in dentistry, you dont have to worry about your back going out from bending over patients for hours or your eyes going bad so you cant use a handpiece. You dont have to worry about a patient (adult or child if you are doing pedo) crying over a 2 sec injection, or **tching about the cost of a $1000 crown that will last them 10 years, esp after they just put down $4K for their kids braces.

 

[S Files]

This is the biggest piece of B.S. I have read. Ortho doesnt limit the number of grads? Yeah right! Then there would no need for you to be in the top of your class to go into ortho. Yes there are a handful of classes that has 20 residents, but that is the exception and not the norm (not to mention the company that introduced this is now bankrupt). Ortho is more "protected" than any specialty out there in dental school. Undergrad dentist's take ortho lectures all 4 years, bend wires and trace in preclinical lab, and do the basic diagnosis in the clinic, why arent they taught to do the final piece which is actually treat the patient? Placing brackets isnt exactly rocket science, but they teach less ortho in undergrad dental school than endo or oral surgery. Has the quality of ortho gone down with invisalign? Sure, so why not teach it in the proper environment, something like minor crowding on in the anterior mandibular teeth could be fixed easily, and thousands of GPs are treatign that everyday, without really "compromising quality". Now I am not advocating treating kids and teenagers with traditional wires for Gp's or class 3's or crossbites, etc. But one could easily argue that endo and oral surgery has gone down also, so that is a crappy excuse. Does OS have it good? Yeah. But its not because they have limited the number of grads. Its because most students dont want to go to school, being on call 24/7, standing in an operating room for 3+ hours for the next 4-6 years. And every segment of dentistry is facing competition, GP's with the addition of 10 new schools in the next 5 years, and advanced practitioners (or whatever their formal name is) in states like Minnesota, Maine and several other states, and hygienists being able to practice independently. Oral surgeons with periodontists and even endodontists learning how to place implants. Endodontists with GP's doing more endo as better files come out and the list continues. So stop crying, ortho's have it better than anyone. Ortho's have one of the top salaries in dentistry, you dont have to worry about your back going out from bending over patients for hours or your eyes going bad so you cant use a handpiece. You dont have to worry about a patient (adult or child if you are doing pedo) crying over a 2 sec injection, or **tching about the cost of a $1000 crown that will last them 10 years, esp after they just put down $4K for their kids braces.

no, he's right. ortho is not what it used to be, trust me i'm a recent ortho grad. you're not understanding what he's saying. looking from a historical context, ortho academics lost control around the time of the OCA mess. the # of ortho grads/yr are at an all time high right now, with existing programs increasing spots, and new programs opening up. on top of that, orthodontists don't retire!!!
OMFS grads/yr hasn't changed much over time.

so yes, go for ortho if you truly enjoy it, but the money (more importantly, for new grads: the jobs) are in OMFS and pedo.

 

[S Files]

I placed an add looking for an orthodontist at my pedo office. I received 30 resumes, but everyone is expecting these ridiculous guarantees. One guy was expecting 1300$/ day. I have never even heard of somone receiving such a high per diem salary. Another guy told me he graduated 6 months ago and has been unable to find even a part time job. And yet, he would not work for less then a 1000$/ day.

Last year when I was an associate, I received 600$ guarantee and 30% of my production. I has happy to make 1000$ on most days. Some days the schedule would fall apart, and I only made a little over my guarantee. You have to take the good with the bad.

Is 1300$/day guarantee a realistic offer for new ortho grad?

perhaps you could give a base, and then a % as an incentive. it really depends on what part of the country this practice is in. but to answer your question, 1300 does seem high, even in NYC that's above average for a new grad.
but i have to tell you, when i was interviewing, i did visit a couple pedo offices, and be careful. like someone else on here wrote, you don't want to end up having a revolving door of associates.

 

[charlestweed]

This is the biggest piece of B.S. I have read. Ortho doesnt limit the number of grads? Yeah right! Then there would no need for you to be in the top of your class to go into ortho. Yes there are a handful of classes that has 20 residents, but that is the exception and not the norm (not to mention the company that introduced this is now bankrupt). Ortho is more "protected" than any specialty out there in dental school. Undergrad dentist's take ortho lectures all 4 years, bend wires and trace in preclinical lab, and do the basic diagnosis in the clinic, why arent they taught to do the final piece which is actually treat the patient? Placing brackets isnt exactly rocket science, but they teach less ortho in undergrad dental school than endo or oral surgery. Has the quality of ortho gone down with invisalign? Sure, so why not teach it in the proper environment, something like minor crowding on in the anterior mandibular teeth could be fixed easily, and thousands of GPs are treatign that everyday, without really "compromising quality". Now I am not advocating treating kids and teenagers with traditional wires for Gp's or class 3's or crossbites, etc. But one could easily argue that endo and oral surgery has gone down also, so that is a crappy excuse. Does OS have it good? Yeah. But its not because they have limited the number of grads. Its because most students dont want to go to school, being on call 24/7, standing in an operating room for 3+ hours for the next 4-6 years. And every segment of dentistry is facing competition, GP's with the addition of 10 new schools in the next 5 years, and advanced practitioners (or whatever their formal name is) in states like Minnesota, Maine and several other states, and hygienists being able to practice independently. Oral surgeons with periodontists and even endodontists learning how to place implants. Endodontists with GP's doing more endo as better files come out and the list continues. So stop crying, ortho's have it better than anyone. Ortho's have one of the top salaries in dentistry, you dont have to worry about your back going out from bending over patients for hours or your eyes going bad so you cant use a handpiece. You dont have to worry about a patient (adult or child if you are doing pedo) crying over a 2 sec injection, or **tching about the cost of a $1000 crown that will last them 10 years, esp after they just put down $4K for their kids braces.

Dort-ort and S-File are right about the significant increase in number of new grad orthos in recent years. Well, blaming the AAO for ruining the ortho profession (by allowing the new ortho programs to open) and blaming the cheap orthodontists (like myself) who degrade the ortho profession by lowering the ortho fees will not solve anything. Either quit ortho or learn to adapt to this change. I stopped paying the AAO membership fee when this Association adopted Invisalign 10 years ago.

I am not sure if ortho is still the highest paid specialty but it sure is the easiest and the most overpaid specialty. We, ortho, are compensated very well for the type of work we perform. Doing general dentistry procedures nonstop for 8 hours, 5 days a week is a back breaking job.

 

[BlueToothHunter]

I put an ad out for an ortho in Socal, one Chinese kid who just graduated asked for $2000/day!! That was a first!

 

[Firm]

I put an ad out for an ortho in Socal, one Chinese kid who just graduated asked for $2000/day!! That was a first!

And this thread is back from the dead. If he doesn't ask, then he won't be paid.

 

[gryffindor]

And this thread is back from the dead. If he doesn't ask, then he won't be paid.

I have dreams about quitting my associateships. But then I read a smack of reality from Charlestweed and employers thinking like Demeter and get back to work. Opening my Amex bill provides the same effect.

 

[Contach]

You fellows are making it incredible difficult for a dental student like myself to commit the rest of myself to orthodontics....

 

[prima]

I feel there are two problems:
1. Expectations of the Specialist
2. Offers by the GP

I am a Pediatric Dentist. I have been looking for jobs in the tri-state area.
Now, GP's want to have Pediatric Associates, who do sedations, see 35-40 patients and offer base of 500 or 35% collection a day .
I feel 750 is a reasonable base.
Its just a case of GP's wanting to make profit but no commitment from their end.
Sedations are high risk procedures and need to be compensated for well.

 

[Kobe08]

Would all of you consider orthodontics at present and in the near future to be one of the more risky dental specialities in terms of finance? Some orthodontic residencies cost much more than dental school and if you need to open an office (due to lack of available positions) then you are pretty much taking on even more debt. Not to mention mortgage, family, etc.

 

[thewingman]

I feel there are two problems:
1. Expectations of the Specialist
2. Offers by the GP

I am a Pediatric Dentist. I have been looking for jobs in the tri-state area.
Now, GP's want to have Pediatric Associates, who do sedations, see 35-40 patients and offer base of 500 or 35% collection a day .
I feel 750 is a reasonable base.
Its just a case of GP's wanting to make profit but no commitment from their end.
Sedations are high risk procedures and need to be compensated for well.

$750 is way on the low end. Check out dentaltown. There are a few pediatric dentist stating that $1,000/day is reasonable for an associate.

 

[Firm]

Would all of you consider orthodontics at present and in the near future to be one of the more risky dental specialities in terms of finance? Some orthodontic residencies cost much more than dental school and if you need to open an office (due to lack of available positions) then you are pretty much taking on even more debt. Not to mention mortgage, family, etc.

What makes ortho so difficult is that there is a lot of up front investment and to make any money you have to have a lot of patients paying you small amounts monthly. That takes time. There are few $1-2000 procedures that you can do and get paid in 2 weeks from. You need a constant fresh supply of new patients. There are fewer associateships, so for many the only option is to open your own office. This is what I had to do. There is no money for the houses, cars and vacations when you do this. If you can find a retiring orthodontist to buy from or a chain to associate with then it's worth it. Opening your own office is for the birds.

 

[Firm]

I feel there are two problems:
1. Expectations of the Specialist
2. Offers by the GP

I am a Pediatric Dentist. I have been looking for jobs in the tri-state area.
Now, GP's want to have Pediatric Associates, who do sedations, see 35-40 patients and offer base of 500 or 35% collection a day .
I feel 750 is a reasonable base.
Its just a case of GP's wanting to make profit but no commitment from their end.
Sedations are high risk procedures and need to be compensated for well.

No one wants to commit, everybody wants money now.

 

[Sublimazing]

$750 is way on the low end. Check out dentaltown. There are a few pediatric dentist stating that $1,000/day is reasonable for an associate.

Agreed. I have yet to meet a pediatric resident who didn't have a tremendous offer awaiting them upon grad.

 

[11234564]

Does anyone know if in $700 a day is reasonable in Wantagh, New York? I obviously am not ready to start my own business but is this too much to demand? I would be the second orthodontist working there.

 

[gryffindor]

Does anyone know if in $700 a day is reasonable in Wantagh, New York? I obviously am not ready to start my own business but is this too much to demand? I would be the second orthodontist working there.

And this thread is back again.

You haven't given us enough information. How many hours per day? How many patients? Do you have trained assistants doing the work or do you have to do EVERYTHING?

 

[ortho lurker]

Does anyone know if in $700 a day is reasonable in Wantagh, New York? I obviously am not ready to start my own business but is this too much to demand? I would be the second orthodontist working there.

I have worked as an orthodontic associate in both NYC and So Cal (the two most saturated markets in the world). The average salary in the Northeast is probably around $600-800/day because there are less chains and more private GP offices hiring orthos there, and the average in So Cal is $1,000-1,500/day where there are chains galore. So I would say the offer of $700/day fits with the area.

 

[OrthoK]

Does anyone know if in $700 a day is reasonable in Wantagh, New York? I obviously am not ready to start my own business but is this too much to demand? I would be the second orthodontist working there.

Wouldn't opening your own small practice be more beneficial in the long run? You'll learn business first hand and make mistakes, creating reference experiences that no associateship could teach.

"Entrepreneurship is living a few years of your life like most people won't so you can spend the rest of your life like most people cant."
- Warren G. Tracy's student

 

[twh019]

Orthodontists will have to become ultra-efficient with low overheads to compete. We have had to lower our fees and increase direct market advertising. We have trimmed costs and have increased our number of starts by 22% last year, but I think we were in the minority of practices around us.

Word. My cousin is an orthodontist in the very competitive New Orleans area and he has one employee... his wife (former DH). He rents a small block in a business complex and works M-Th. He is hardly 55 years old and is going to retire COMFORTABLY soon.

 

[gryffindor]

Word. My cousin is an orthodontist in the very competitive New Orleans area and he has one employee... his wife (former DH). He rents a small block in a business complex and works M-Th. He is hardly 55 years old and is going to retire COMFORTABLY soon.

Wrong. Orthodontists never retire. It is a known fact that they keel over while working with a Weingart in their hand.

Personally, if I can find a newbie to work for me for $700, I don't see why I would ever retire either.

 

[Silent Cool]

Wrong. Orthodontists never retire. It is a known fact that they keel over while working with a Weingart in their hand.

Personally, if I can find a newbie to work for me for $700, I don't see why I would ever retire either.

Exactly. It's not hard work, it's lucrative, and it's fun. Why on earth would you retire? It's the psychiatry of dentistry. Who cares if you have to make 300K instead of 350K? Or 250K instead of 300K? It's a fun, cool, interesting and low-stress job. You could teach at a uni; you could publish case reports; hell, it just gives you something to do! And as much as people idolize retirement, it ain't all that great--"the number one cause of death is retirement; it seems that, when people have some thing to do, they tend to live to do it." -'Bud' in Kill Bill

Sure, it ain't what it used to be, but it's still a helluva career. Ain't it, Tweedy?

cool out

 

[ortho lurker]

Exactly. It's not hard work, it's lucrative, and it's fun. Why on earth would you retire? It's the psychiatry of dentistry. Who cares if you have to make 300K instead of 350K? Or 250K instead of 300K?

Therein lies the problem for new grads. If older older orthodontists don't retire, it limits the opportunities for younger ones. If the only option left is to open your own in the middle of no where, pretty soon that option will get exhausted also with the increasing number of residents graduating every year and older orthos opening more satellite locations because their offices are slowing down as well.

 

[charlestweed]

Wouldn't opening your own small practice be more beneficial in the long run? You'll learn business first hand and make mistakes, creating reference experiences that no associateship could teach.

“Entrepreneurship is living a few years of your life like most people won’t so you can spend the rest of your life like most people cant.”
- Warren G. Tracy’s student

Associate job actually taught me a lot. I learned how to communicate with my patients more effectively. I learned from listening to the patients' complaints about me. My clinical skills improved greatly from treating a lot of difficult cases and from making a few mistakes here and there. I learned how to keep the overhead low. I learned that I don't need to have the high tech gadgets in order to achieve good clinical results. I learned that having an office in a highly visible location isn't important for ortho since most the of the new patients come from the GP referrals and word of mouth.

When I set up my first practice, I knew exactly what I needed to buy and things that I shouldn't waste my money on. Unlike my co-residents, I didn't go the AAO convention and listened to all the BS's that the sale reps tried to convince me to buy. The entire office set up (construction + equipments + instruments) only cost me $120k.

Having an associate job while trying to set up an office was a huge plus. Having a stable income from my associate made it less stressful for me to run my new practice.

 

[charlestweed]

Exactly. It's not hard work, it's lucrative, and it's fun. Why on earth would you retire? It's the psychiatry of dentistry. Who cares if you have to make 300K instead of 350K? Or 250K instead of 300K? It's a fun, cool, interesting and low-stress job. You could teach at a uni; you could publish case reports; hell, it just gives you something to do! And as much as people idolize retirement, it ain't all that great--"the number one cause of death is retirement; it seems that, when people have some thing to do, they tend to live to do it." -'Bud' in Kill Bill

Sure, it ain't what it used to be, but it's still a helluva career. Ain't it, Tweedy?

cool out

No, I still want to pay off all my debts and retire early. Nobody wants to work to pay bills forever. Yeah, ortho is a low stress job but keeping the patients and the referring GPs happy requires a lot of efforts. I'd rather stay home and spend time with my kids.

 

[gryffindor]

No, I still want to pay off all my debts and retire early. Nobody wants to work to pay bills forever. Yeah, ortho is a low stress job but keeping the patients and the referring GPs happy requires a lot of efforts. I'd rather stay home and spend time with my kids.

When you are 82 and still practicing ortho, you don't care if you keep the referring GPs happy because chances are your GP colleagues are no longer practicing or possibly no longer living. You get a steady stream of patients just from existing. If you don't feel like treating an impacted canine, you can just send them out the door because at this point you aren't do it to pay the bills anymore. You are just doing it to have some money to spoil your grandkids or eat at nice restaurants.

 

[Silent Cool]

When you are 82 and still practicing ortho, you don't care if you keep the referring GPs happy because chances are your GP colleagues are no longer practicing or possibly no longer living. You get a steady stream of patients just from existing. If you don't feel like treating an impacted canine, you can just send them out the door because at this point you aren't do it to pay the bills anymore. You are just doing it to have some money to spoil your grandkids or eat at nice restaurants.

Yup. Exactly.

Like I always say, retirement--especially early retirement--is overrated. I think what people are striving for is the ABILITY to retire. But, actually being retired gets boring. People do need to have goals in life to give them meaning. As great as it sounds, sitting around all day doing nothing gets boring. When you don't NEED to work anymore, work suddenly becomes a lot less stressful and a lot more fun. My family's dentist checked out at 67, and he said to me that for the last decade of his work, he just practiced for "something to do." He worked 2.5 days per week, or about 20 hours. If he had been an Ortho, he could have probably worked 10 more years.

 

[Shunwei]

Key take-home points of this thread for me:

1) Suppress overhead costs like a Navy SEAL team clears a bunker,
2) Big Academia (read: diploma mills such as Roseman, etc.) don't give a f*ck about saturation,
3) Love what you do because market conditions can and will change,
4) Disregard orthodontics, acquire OMS certificate.

Very smart man

 

[Solostr8]

No, I don’t bend wires nor I use the edgewise brackets. Like most orthos, I use straight wire technique, which make ortho treatments 100 times easier and faster. Because of the straight wires, I don’t have to do much. I just don’t feel right to charge the patient $5k a case when the work is so simple. I actually feel I am overpaid for the work that I am performing….yes, even at my low fees. However, I still follow Dr. Tweed’s treatment philosophy, that is to let the position of the lower 4 incisors dictates how I finish all my cases. I don’t just blow these lower incisors out to 120+ degrees and think that I meet the ABO standard. I don’t just blow them out to 120+ degrees and think that I am the greatest orthodontist because I just save the 4 bicuspids (or 2 upper bicuspids for class II cases) from being extracted.

If the patients and parents just want their teeth tightened as quickly as possible so they can go back to school, why do you have to kiss their butts and bore them with some stupid nonsense ortho terminology? If you see 80-120 patients a day (which are 20-40 more patients than what I normally see) and say you are doing great work, then you are not telling the truth. I don’t see that many patients even when I work for a dental chain.

Wow I can't believe what I am reading. Where the hell did you receive your orthodontic education? Edgewise is edgewise is edgewise... It's all edgewise.... Unless you're using removable appliances , crozats, pin and tube, ribbon arch, or Begg.
You don't bend wire Ha

<sigh>

Let me clarify for your poor reading comprehension skills.

1) Demeter is looking at hiring an ORTHODONTIST in a pedo office. He has ZERO orthodontic patients in his practice right now. He can have a HUGE volume of pedo patients and have a crappy ortho patient pool. If 75% of his patients are age 1-7, then ortho won't be very busy.

2) Your use of "entitled to demand" is ******ed. It makes no sense. Eliminate the "entitled to" crap and just state "demand." That's all you are referring to. And sure, you can demand whatever you like, but big whoop.

3) LOL at your "worked too long and too hard to be worth less..." Once again, you are worth whatever the market says you are worth, NOT how long and hard you've worked or how many student loans you have. How are you not going to work for less than $XXX,XXX if all the offers are below that when you graduate? I'm serious. I want to know how that plays out. Will you flash your 7 years of schooling that ALL orthodontic graduates also have?

Look at it from a logical perspective. Dental school tuitions are RISING and orthodontic class sizes (and therefore graduates) are also RISING and the economy is going DOWN. That means more graduates all wanting to treat an increasingly smaller patient population. You'll earn what you earn, literally.

 

[Silent Cool]

1300 isn't unreasonable. If your you're looking to hire an orthodontist then you should have enough starts lined up to keep them busy. Lets go with a low to moderate fee of 4500. If you have 1 start per day then what do you expect to be making off the orthodontist?

Lets say you're your overhead is 60 percent (not great), then you've made 500 bucks on that case, a good 11 percent. Seems like even thats lowballing the orthodontist.

I realize that it doesn't work this way right off the bat, because patients don't pay uprfront, medicaid, etc. But after a while it will work that way after the practice has many patients. In the meantime you might have to bite the bullet and be in the negative while the ortho side grows.

Why not just refer the patients to a local orthodontist. Save you the trouble. You do what you do best and they'll do what they do best. You're (hey, you got it right--third time IS a charm!) going to hire a young graduate who comes in and may want to leave after a year or so to make more money then (than--awww, wrong again) you are paying, then you'll hire one after another to work your patients, leaving little continuity of care and poor results for you patients. I believe it because I've seen it.

Better luck next time. How *did* you get into ortho?

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