ItsGavinC said:
Well, since you are a practicing dentist, I suppose I should take advantage of the opportunity and ask you how attending Arizona will inhibit me from paying off my student loans quickly?
This is a fascinating topic. Please elaborate to your fullest how the school will have control over my income, practice focus, practice location, patient base, and amount I dedicate each month to student loans. Thanks.
Wow! Didn't know I was going to set off such a firestorm. Seems to me like you are bit thin-skinned. Please believe me, I don't want any ASDOH students to fail. I would hope your school produces individuals who reflect favorably on the profession I practice with great passion.
I readily admit there are many things about ASDOH's internal workings I don't fully understand, but likewise, there is much about the dynamics and economics of dental practice in Arizona you don't understand either. I sincerely doubt an on-site visit will change my mind or bring about an epiphany.
I have read many of your posts on this web-site for nearly a year and believe there is a lot a great insight you bring to the table, but there are times I simply have to smirk and roll my eyes in disbelief at some of your thoughts.
Gavin, have you worked in a dental office before? And if you did -- were you responsible for making the payroll and paying the taxes? What about maintaining high clinical and ethical standards--all the while keeping patients who often hate your guts happy and satisfied?
I think you and your perhaps some of your "progressive" classmates are in for some rude awakenings when you hit the real world. I don't say this in a mean-spirited way, but I believe that is just the way it is.
I would like to point out that nearly all of the principal full-time faculty at your school have backgrounds in Public Health in some capacity or other. Several of them I have met and talked to at some point. Their mantra seems to be this: "Oral health care and dentistry ought to be a basic human right."
I'll ardently defend their right to this opinion, but I respectfully disagree. When someone comes to my office seeking treatment but isn't willing to pay-- in my eyes is is essentially the same as someone visiting my home and trying to walk out the front door with a piece of property -- WITHOUT fairly compensating me. If I agree to give something away I'll call it charity, but without a pre-arranged agreement its basically the same as theft.
As I view ASDOH's web site I note that Dr.'s Cottom, Blue Spruce and Dillenberg all have public health backgrounds, as does Kneka Smith, R.D.H.
Dr Simonsen (who seems to be the most self rightous one) is from England originally (home of Western Europe's most envied NHS dental delivery system!) with stints in Norway, Tennessee and Minnesota. Dr. Miles is originally from Canada. My point is this--their personal backgrounds are from areas where--Tennessee excepted-- socialistic health care systems dominate.
Can you name one other dental school whose full time faculty is so dominated by public health personnel? And for that matter, [since you state only 2 of your 54 (52?-I thought you lost 2 students from your class) fellow students are interested in public health] what the heck is the matter with doing public health if that is your passion?
As I view ASDOH's web-site I note your school has its "Hometown" program which seems designed to funnel ASDOH graduates into Community Health Care centers. Without passing judgement about the "morality" of this form of health care delivery -- are these not publicly funded by the taxpaying public??? To me, this is a form of socialized dentistry, is it not? ASDOH faculty can use whatever "progressive" spin they want -- but as for me I'll call a spade a spade.
To answer a few of your questions specifically, here are a few of my thoughts:
Your school WILL have some bearing on your potential future dental income might be--IF they groom you to only provide certain types of services. I have heard Dr. Dillenberg very specifically criticize dentists who perform cosmetic procedures--and spoken with other individuals who tell me he "hates" veneers. This is a very gray area in my opinion as it pertains to dental ethics. For me one of the most rewarding and satisfying things I do is to provide restorations that look like the "real thing". I don't want collegues out there aren't really able to deliver esthetic restorations if that is what they are promising a patient. It makes us all look bad!
Coincidentally, a few weeks ago I saw a new patient who had previously seen one of your pros professors and whom had a 2 unit cantilever anterior bridge ( #11 to #10 as a cantilever) and a single PFM crown on #3 delivered by this particular individual. The marginal fit of these restorations was acceptable, but nothing to brag about. The ceramic detail and artistry was simple terrible--I think my eight year old son could have produced something comparable!
Obviously, after graduation and passing the boards you are free to focus your practice on whatever you like, practice where you like, and see whomever you please. Somewhat sarcastically, I must say I don't think it is quite as easy as you seem to think. I've been there, done that--and continue to do so (hopefully for at least another 20 or so years).
After 8 and 1/2 years I'm still waiting to get to that 6 figure income. Please don't tell me that I'm a mediocre dentist. I'd love to show that statement to the many dentists (some whom I believe you may have met) who come to me as patients. As for my business acumen -- I'll readily admit it could be better -- but for me quality and integrity come first. I literally can think of couple of dozen of ways to cut corners if I wanted to. Finally, perhaps I have chosen the wrong practice location--but I have to be willing to live in a community where my spouse is also willing to locate.
What do you think an average practice's hourly overhead is? $250 to $350 PER HOUR for a decent quality practice in AZ is very normal. Do Dr.'s Dillenberg or Simonsen know this figure? I sincerely doubt they have a clue.
Gavin, hopefully you'll have excess funds to divert towards paying off your 150K to 200K student loan debt upon graduation. More power to you if you do.
What complicates matters that if you go into private practice you'll also have to pay 300 to 600 or 700K for decent quality dental practice as well. A scratch start-up is another option--but it also has it downside (including no patients to start). It's easy to find yourself half a million dollars in debt a year or 2 post graduation. I also note that you are married with 2 children (like myself) -- where is your spouse willing to live and what type of lifestyle and housing is she expecting?
In closing, I simply say I wish you the best both professionally and personally, but I remain cynical and unconvinced regarding ASDOH. I'll bide my time continuing to focus on becoming the best dentist I am capable of.
