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[mgh7860993]

I'm gonna be a D1 this fall and I am concerned about the phenomenon that dentistry is over saturated. I've heard from peers and multiple resources that in most desirable places to live, There's several dental offices within a mile radius (which I see in most places) and this results in a lot of competition in the field which makes it hard to find well paying jobs and open a new practice. I'm wondering if this is a serious cause for concern/ negative aspect regarding dentistry? I was always interested in the health care field and medicine and dentistry both interested me and I am interested in having a career that is secure and stable, where I can find a job at any part of the country I choose to live? However, I am wondering if dentistry is nearing the point where we would be forced to relocate to different parts of the country just to find decent well-paying job opportunities? Or is the saturation of the field not a serious concern that could cause this, and it's likely that the profession will remain secure an stable so that we should not have problems finding well paying jobs wherever in the country we choose to live?

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[CanaDMD]

I'm gonna be a D1 this fall and I am concerned about the phenomenon that dentistry is over saturated. I've heard from peers and multiple resources that in most desirable places to live, There's several dental offices within a mile radius (which I see in most places) and this results in a lot of competition in the field which makes it hard to find well paying jobs and open a new practice. I'm wondering if this is a serious cause for concern/ negative aspect regarding dentistry? I was always interested in the health care field and medicine and dentistry both interested me and I am interested in having a career that is secure and stable, where I can find a job at any part of the country I choose to live? However, I am wondering if dentistry is nearing the point where we would be forced to relocate to different parts of the country just to find decent well-paying job opportunities? Or is the saturation of the field not a serious concern that could cause this, and it's likely that the profession will remain secure an stable so that we should not have problems finding well paying jobs wherever in the country we choose to live?

depends on your definition of well paying...

you'll still make six figures in big cities... just low six figures and harder work

 

[mgh7860993]

depends on your definition of well paying...

you'll still make six figures in big cities... just low six figures and harder work

In general dentistry regardless of whether you work in a big city or surrounding suburbs as your career progresses and you're experienced and been practicing for 5-10 + years is it common to hit an annual income of 200k+ if you don't have your own practice? Or is it common that your income will not be that high even with several years of experience? I'm just wondering if income significantly increases as a dentist becomes experienced for several years or if it tends to stay somewhat stagnant throughout one's career?

 

[Steins;Gate]

In general dentistry regardless of whether you work in a big city or surrounding suburbs as your career progresses and you're experienced and been practicing for 5-10 + years is it common to hit an annual income of 200k+ if you don't have your own practice? Or is it common that your income will not be that high even with several years of experience? I'm just wondering if income significantly increases as a dentist becomes experienced for several years or if it tends to stay somewhat stagnant throughout one's career?

The key to the higher incomes is to be an owner. There are associates that can do 200K+ (I'm assuming you mean for general dentistry) but you will work hard for the money (and at that point you may not necessarily want to work that hard). Owner = passive hygiene income, higher cut of production or collections, if you hire in-house specialists you can earn some of that production, writing off business expenses, corporation (though you can do this as an associate).

 

[CanaDMD]

In general dentistry regardless of whether you work in a big city or surrounding suburbs as your career progresses and you're experienced and been practicing for 5-10 + years is it common to hit an annual income of 200k+ if you don't have your own practice? Or is it common that your income will not be that high even with several years of experience? I'm just wondering if income significantly increases as a dentist becomes experienced for several years or if it tends to stay somewhat stagnant throughout one's career?

I just don't think you fully understand what you're asking, but that's fine we were all noobs at one point

This isn't family med. Not all dentists do all the same procedures. You eat what you kill.

If you learn implants within your first few years as a dentist and place tons, and within 5-10 years you're placing them on a weekly, yes you're obviously going to be making a bigger income. If you decide not to expand your skill set and stick with restorative and simple C&B, you might make just as much money depending on your patient base.

You get the idea, I hpe

 

[CanaDMD]

The key to the higher incomes is to be an owner. There are associates that can do 200K+ (I'm assuming you mean for general dentistry) but you will work hard for the money (and at that point you may not necessarily want to work that hard). Owner = passive hygiene income, higher cut of production or collections, if you hire in-house specialists you can earn some of that production, writing off business expenses, corporation (though you can do this as an associate).

Yes, being an owner helps you make more, but you can make just as much as an associate

The variation is endless

 

[Steins;Gate]

Yes, being an owner helps you make more, but you can make just as much as an associate

The variation is endless

You can but you may have to work harder as an associate. All about chairtime efficiency.

 

[Kareful]

Okay question: any difference between SnF2, NaF, or Na2PO3F in toothpaste? Also, if you don't mind, see a related question in a thread of mine: Different fluoride formulations

 

[CanaDMD]

You can but you may have to work harder as an associate. All about chairtime efficiency.

Not necessarily, once again it depends on the treatments you offer and your patient base

but yes, if ALL things are equal, you will take more home as an owner

 

[Steins;Gate]

Not necessarily, once again it depends on the treatments you offer and your patient base

but yes, if ALL things are equal, you will take more home as an owner

Yeah I agree, hence the use of the word may!

 

[Axiomatician]

Ok.. I have had lots of serious questions/concerns in the back of my mind for 1+ year.
Just some background: I am a Rising-Senior biochemistry major. I've had an interest in dentistry since the tail end of high school, and made up my mind to be a dentist sometime around 2 years ago.

As a high-achieving college student(I realize this is relative) that has yet to even apply to Dental school(application cycle opens June 1st, applying then), should I even be thinking about specializing now? Should I be worrying about the future outlook of dentistry?

Should I just do my best in dental school and keep an open mind, not thinking about specialties until Year 3/4?


General dentistry has obviously moved from mainly procedure-based work(60s, 70s) to prevention-based work(current). Where do you see dentistry in 5/10/20 years?

Do you think some parts of dentistry will be slowly corporatized?(Potentially simple ortho-maybe invisible liners; Aspen Dental-opinions on them?)

Do you see some specialties becoming more commonplace; do you perhaps see others phasing out?

Do you think there are too many new dental graduates? Not enough?(What happens when all the baby boomers-lots of our parents-pass away?)

 

[P7898]

1) Population of area = 2,475 (one other part time dentist in town), most of my patients come from surrounding county (outside city limits). I am forty miles from the biggest city in the state, lots of people are starting to move in my direction to get out of the city. The population of the county is around 48,000.

2) The previous owner that retired worked M-Thu from 8:00am-5:30pm and produced $1,022,000 (2016) and had a very low overhead of around 57%. He did well. We are on pace to do $1,450,000 for 2017.I obviously have a practice loan and lease that he didn't have to pay for. But I'm blessed to be still doing well. The way you pay yourself when you get out (so it's to your advantage with student loans, tax write-offs, etc.) is to setup an S-Corporation that owns your practice. Mine is named "Doctor's name, DDS, PA." You can pay yourself as much or as little as you like. To answer your question, my overhead is probably around 62% due to my practice loan, lease payment, etc. I plan to purchase the building soon through my LLC that I formed, so it'll go down with that. My lease is 3k per month, mortgage will be $1,500.

3) To be quite honest, this practice is busting at the seams to grow. There isn't hardly any time to do much besides basic stuff. I only do basic restorative (fillings), extractions (no 3rds--another source of growth possibly), crowns/bridges, dentures, implant (I restore them for now) crowns. I'm planning to go to an implant continuum soon called Engel Institute, supposed to be VERY good. No endo, but I plan to do anterior and premolar endo in the near future. His office wasn't setup for it, so I'm getting set in before I buy more equipment. Molar endo IMO is very difficult and less predictable, and way less profitable...so I refer those out to the endodontist. I plan to start keeping anteriors/premolars in house by this summer.

4) I picked the practice I did because everything lined up for me, I got lucky. I learned to network with the supply reps (Patterson Dental) at my associateship position. As soon as they heard of this doctor retiring, they immediately let me know and the rest is history. Took me around 8 months do all my research, get approval from the banks, setup everything, etc. It's A LOT of work. The things that were very important to me in searching for a practice were:

A) Potential growth-this practice is obviously waiting to explode growth wise
B) Little to no insurance involvement (not in network with lots of insurances)
C) Little competition-which forces you to go rural---BUT as I said, I live 20 minutes from downtown Charlotte, NC and my practice is only 40 miles out of Charlotte.
D) Location-we wanted as close to a big city as possible (airports, wife wants to go back to get her PhD and become a principal), yet in an area where I feel like I have a big impact on the community.

5) I paid around 700k for the practice. That's about 68.5% of gross production of the previous year. They have lots of calculations they do to figure out what's fair...his CPA vs. my CPA. TBH, I didn't get involved that much with negotiations, my CPA did most of the work. We started negotiations at 680k and they started at 775k, if that means anything to you. I played hardball and acted as if I were backing out for a couple weeks, the seller contacted me saying "I'm ready to make a deal." Typically, practices in rural areas sell for around 60 to 70% of the gross production for the past year (the easiest calculation I've come up with). Since this one was so insurance/cash base friendly, it valued out to be a little on the higher end. I've seen some practices in super competitive areas sell for up to 110% of gross, which is absolutely stupid and insane to me (Charleston, SC for example). EVERYONE wants to practice there for some reason... if you move there, you'll be forced to be in network with every insurance known to mankind. My crown fee is $993 and I get every dollar of that. Those dentists in those areas get (if lucky) around $650 for crowns. After a $200 lab fee and impression materials/supplies...there's a lot less room for profit.

I hope this helps a little.

Hey! Thanks for the post! In order to get the bank loan for the practice what was the minimum amount of production you had to be producing at your associate gig? - (incoming D1 in NC)

 

[doktorinprogres]

Hey! Thanks for the post! In order to get the bank loan for the practice what was the minimum amount of production you had to be producing at your associate gig? - (incoming D1 in NC)

I have no experience but from what I've heard they'll look at what the doctor production is in the practice you wish to buy and match that up to how much you're able to produce as an associate. Generally, banks like you to have 10% of the total loan amount on hand as working capital. If you have this and are able to produce appropriately, there are banks that will loan you 100% + additional working capital for a given practice.

 

[P7898]

I have no experience but from what I've heard they'll look at what the doctor production is in the practice you wish to buy and match that up to how much you're able to produce as an associate. Generally, banks like you to have 10% of the total loan amount on hand as working capital. If you have this and are able to produce appropriately, there are banks that will loan you 100% + additional working capital for a given practice.

So I guess my next question is can you buy let’s say a $700k proscribing practice if you’re only producing $500k but you know you can handle more but your limited because you’re an associate?

 

[P7898]

Producing**

 

[BasicG]

How do you make a rural practice grow? OP lives in a town of 2500 people and county of 48k. Billboards and radio?

 

[doktorinprogres]

So I guess my next question is can you buy let’s say a $700k proscribing practice if you’re only producing $500k but you know you can handle more but your limited because you’re an associate?

Well if you have a strong hygiene department then it's possible that they're doing 1/3 of the practice production and so you would be fine with your 500k production. If not, let's say that they were able to provide only 100k production, then you would have to include in your business plan how you will make up the difference. So perhaps you are comfortable doing extractions but the doc you are buying from referred out all extractions. Or maybe you've taken lots of endo CE and are ready to add that in the practice. Alternatively you can show your schedule as an associate. If you were producing 500k on 4 days or had plenty of free appointment blocks and you're ready to work 5 that would likely be acceptable.

 

[P7898]

Well if you have a strong hygiene department then it's possible that they're doing 1/3 of the practice production and so you would be fine with your 500k production. If not, let's say that they were able to provide only 100k production, then you would have to include in your business plan how you will make up the difference. So perhaps you are comfortable doing extractions but the doc you are buying from referred out all extractions. Or maybe you've taken lots of endo CE and are ready to add that in the practice. Alternatively you can show your schedule as an associate. If you were producing 500k on 4 days or had plenty of free appointment blocks and you're ready to work 5 that would likely be acceptable.

All makes plenty sense. Greatly appreciate the input!

 

[dkamin99]

What advice do you have to make your application stand out?