big name ortho schools worth 300k+ in cost of attendance?

[deleted659902]

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Is specializing in ortho worth 300k+ in cost of attendance (like Michigan, Harvard, UNC, and UConn) and 150-200k of forgone associate GP income for three years? Let's assume the motive is for easier work, higher income potential, more pleasant patient-base, and early financial independence. While the technology is allowing most of the easier cases to be treated by seasoned GPs, I still believe orthodontists achieve better clinical results overall. So, is it worth it? Or is it better to use the three years to establish my own office, take CE ortho courses, and retire early?

I feel like the GP route to financial independence can happen quicker but also more unlikely/riskier due to competition and higher emotional and physical stress. On the other hand, if I specialize in ortho, it will take longer to achieve financial independence but the process will be less stressful. I'm also hearing that making 1k/day fresh out of ortho school is a thing of the past especially in urban settings.

 

[2TH MVR]

If you really want to be an orthodontist .... then do it. If you would rather be a jack of all trades ... then be a super GP. It really depends on what YOU want at the end of the day. As an orthodontist .... the simple cases are BORING to me. I'm glad the GPs are doing them. I want all the tough cases. Much more interesting. Everyone knows that practicing orthodontics is easier on your body. Procedures are less stressful. Less liability. I mean you would really have to screw up to be sued as an ortho.

Financially. Orthodontists are still paid well, but it is a different climate as you know. In saturated areas .... you are going to have to get creative. In rural areas .... I believe you could run a traditional ortho practice built more on reputation, repeat patients and dental referrals.

As for GPs doing aligners. Well .... lots of anger going down regarding Direct Smile Club. Class action suits. ADA and AAO are fighting this as they should. Nothing wrong with aligner treatment. It's HOW they are administered and monitored. Lets be real. These patients choosing the easier route are finishing with lousy posterior occlusion. Their complaints are after aligner tx .... most of them cannot bite down properly. Posterior open bites.

As you may recall ... I sold my practices a year ago. Downsizing my life. Work for corporate now. I make substantially more than $1000 per day and many of my checks have been exceptional due to bonuses. If you go Corp .... pick one that is super busy. Plenty of jobs if you are okay with traveling.

Super GP. I went to a CE course over the weekend concerning SLEEP DENTISTRY. I believe this is the area that GPs and Orthos should consider. A huge untapped area of need. This qualified GP is combining aligners with sleep appliances. He uses a 3rd party company to diagnose sleep apnea and to bill the medical insurance. The dentist than provides the appliances and is reimbursed medically. Every appt is also reimbursed. Records are reimbursed. Not just simple sleep appliances, but an ideal way to straighten and whiten the teeth using aligners, widen the arches to allow for additional tongue room, allow mandible to come forward and at the same time the pt's wear the repositioning sleep appliances directly attached to the aligners. I find it fascinating. It's a TREATMENT ....not an appliance.

Is it worth the extra time to be an ortho? Only you can answer that.

 

[deleted659902]

If you really want to be an orthodontist .... then do it. If you would rather be a jack of all trades ... then be a super GP. It really depends on what YOU want at the end of the day. As an orthodontist .... the simple cases are BORING to me. I'm glad the GPs are doing them. I want all the tough cases. Much more interesting. Everyone knows that practicing orthodontics is easier on your body. Procedures are less stressful. Less liability. I mean you would really have to screw up to be sued as an ortho.

Financially. Orthodontists are still paid well, but it is a different climate as you know. In saturated areas .... you are going to have to get creative. In rural areas .... I believe you could run a traditional ortho practice built more on reputation, repeat patients and dental referrals.

As for GPs doing aligners. Well .... lots of anger going down regarding Direct Smile Club. Class action suits. ADA and AAO are fighting this as they should. Nothing wrong with aligner treatment. It's HOW they are administered and monitored. Lets be real. These patients choosing the easier route are finishing with lousy posterior occlusion. Their complaints are after aligner tx .... most of them cannot bite down properly. Posterior open bites.

As you may recall ... I sold my practices a year ago. Downsizing my life. Work for corporate now. I make substantially more than $1000 per day and many of my checks have been exceptional due to bonuses. If you go Corp .... pick one that is super busy. Plenty of jobs if you are okay with traveling.

Super GP. I went to a CE course over the weekend concerning SLEEP DENTISTRY. I believe this is the area that GPs and Orthos should consider. A huge untapped area of need. This qualified GP is combining aligners with sleep appliances. He uses a 3rd party company to diagnose sleep apnea and to bill the medical insurance. The dentist than provides the appliances and is reimbursed medically. Every appt is also reimbursed. Records are reimbursed. Not just simple sleep appliances, but an ideal way to straighten and whiten the teeth using aligners, widen the arches to allow for additional tongue room, allow mandible to come forward and at the same time the pt's wear the repositioning sleep appliances directly attached to the aligners. I find it fascinating. It's a TREATMENT ....not an appliance.

Is it worth the extra time to be an ortho? Only you can answer that.

May I ask why you decided to sell your own practices? Is it because you would have made roughly the same amount of money working for DSOs but without the administrative duties? Could you give some rough estimate of how much you make as a salaried ortho and work schedule? My hunch is that 300-400k is the ceiling for a salaried ortho working for a corp, with most fresh hires making 250-300k (assuming 5d/wk schedule at multiple locations). True? You're still in metro AZ area right? Do you think you could make similar amount of money say in LA or NYC?

 

[2TH MVR]

May I ask why you decided to sell your own practices? Is it because you would have made roughly the same amount of money working for DSOs but without the administrative duties? Could you give some rough estimate of how much you make as a salaried ortho and work schedule? My hunch is that 300-400k is the ceiling for a salaried ortho working for a corp, with most fresh hires making 250-300k (assuming 5d/wk schedule at multiple locations). True? You're still in metro AZ area right? Do you think you could make similar amount of money say in LA or NYC?

It was time to sell. I wanted to sell them while they were still valuable. Of course I did not get what I wanted, but did alright. My wife and I are downsizing our lives. I will be 56 soon. One kid still at the house. She will be leaving for college next year. Time to enjoy life while we're relatively still young. Sold the practice. Our N. Scottsdale home is too big for 2 people. It is currently on the market. We will be looking for a nice luxury 3 bedroom townhouse with little to no maintenance. I also own an office condo that the new ortho is leasing from me. That will be put up for sale in 12-18 months. The other reason I sold is because I stubbornly did not want to change how I practiced over the years. As a result ... revenue was trending downward.... as is the case with most aging practices.

I currently work 4 days per week. I get a base rate of $1100 per day. I am bonused for each new pt start. I average about 2-3 starts per day. That's another $400-500 per day. So on a typical day ... I make $1500-1600. On exceptional days (4,5,6 starts) .... I'm over $2000 a day. I contribute 20% to the employer 401K. Just renewed my family medical plan thorugh the company for LESS than $400 per month for a family of 4. My health plan in private practice was $1600 for a family of four and going up every year.

Work schedule. You can work as much or as little as you want. I used to work 3 days per week .... then I got bored and was offered another office. So I work 2 offices at 4 days per week. Wed-sat. I don't mind working weekends. I have sun-mon-tues off. Golf is cheaper on mons.

As for the salary ceiling. The ortho I replaced worked 6 days a week. You can do the math.

Yes ..I am in Arizona. Not sure what the ortho market is like in LA or NYC. Go to Glassdoor.com. Register and it will tell you where the orthodontic jobs are. Seems like there are plenty of opportunities in Corp. I'm registered and would eventually like to consider working for a Corp near a nice beach in Florida.

Can't remember if you're a dental student, pre dent or dentist. If you want to be an orthodontist. Just keep your debt low and follow @charlestweed's path or practice in a nice rural area.

Good luck and btw. ..... no hard feelings about our past posts.

 

[Svart Aske]

There are programs that don't cost $300K to attend, and a few that even pay you. Why not consider those?

 

[2TH MVR]

There are programs that don't cost $300K to attend, and a few that even pay you. Why not consider those?

I attended a stipend paying ortho residency. Everyone would love to go to these, which makes it more difficult to get into.

 

[DreamingOfOrthodontics]

There are programs that don't cost $300K to attend, and a few that even pay you. Why not consider those?

I noticed on interviews that the paid programs didn't offer the education school based tuition programs did. They had two bracket systems, saw maybe one Invisalign case per resident in the full 3 years, shared chairs, rarely did any complicated cases, saw mainly one patient population meaning mostly one case type, had very few faculty members to learn from, and everything was learning by yourself through reading the textbook on nights and weekends. However, I do have to say that I think this works for some people! There were advatanges such as working really fast and getting paid. And I think that's why they loved people who had actual dental experience (not just dental school). I think it's to each their own!
For me, I feel like to stay in the ortho job market, we have to treat a lot of complicated cases compared to GD's who will take the simple cases. So I wanted to get as much exposure as possible to complicated cases so that in the long run, I am more advantageous off. (Even though financially I am at a disadvantage right now).

That said though, I think there are a ton of programs cheaper than $300k tuition, most are around $100k to $200k, and some are even almost cheaper than that. They also do school based and get lots of exposure. Do your research, and you'll find cheap good programs out there

Also, take what I say with a grain of salt because I haven't worked in the real world. And 2TH MVR does do mostly complicated cases himself and he went to a paid program, and he's doing amazingly!! I think you have to find your own fit and also explore all of the hospital programs. Oh, and I agree with him, those are very competitive programs so you may not have the chance to interview at one :/ for me personally, I felt I would get a better education at a school and so I moved the hospital programs to almost the bottom of my rank list

 

[DreamingOfOrthodontics]

It was time to sell. I wanted to sell them while they were still valuable. Of course I did not get what I wanted, but did alright. My wife and I are downsizing our lives. I will be 56 soon. One kid still at the house. She will be leaving for college next year. Time to enjoy life while we're relatively still young. Sold the practice. Our N. Scottsdale home is too big for 2 people. It is currently on the market. We will be looking for a nice luxury 3 bedroom townhouse with little to no maintenance. I also own an office condo that the new ortho is leasing from me. That will be put up for sale in 12-18 months. The other reason I sold is because I stubbornly did not want to change how I practiced over the years. As a result ... revenue was trending downward.... as is the case with most aging practices.

I currently work 4 days per week. I get a base rate of $1100 per day. I am bonused for each new pt start. I average about 2-3 starts per day. That's another $400-500 per day. So on a typical day ... I make $1500-1600. On exceptional days (4,5,6 starts) .... I'm over $2000 a day. I contribute 20% to the employer 401K. Just renewed my family medical plan thorugh the company for LESS than $400 per month for a family of 4. My health plan in private practice was $1600 for a family of four and going up every year.

Work schedule. You can work as much or as little as you want. I used to work 3 days per week .... then I got bored and was offered another office. So I work 2 offices at 4 days per week. Wed-sat. I don't mind working weekends. I have sun-mon-tues off. Golf is cheaper on mons.

As for the salary ceiling. The ortho I replaced worked 6 days a week. You can do the math.

Yes ..I am in Arizona. Not sure what the ortho market is like in LA or NYC. Go to Glassdoor.com. Register and it will tell you where the orthodontic jobs are. Seems like there are plenty of opportunities in Corp. I'm registered and would eventually like to consider working for a Corp near a nice beach in Florida.

Can't remember if you're a dental student, pre dent or dentist. If you want to be an orthodontist. Just keep your debt low and follow @charlestweed's path or practice in a nice rural area.

Good luck and btw. ..... no hard feelings about our past posts.

Is your pay typical for an orthodontist around the area? Do you think it is a lot less in bigger cities

 

[Big Time Hoosier]

@2TH MVR, any thoughts on how the next recession is going to affect the ortho market?

Nearly half of US CFOs fear a 2019 recession - CNN

Big Hoss

 

[charlestweed]

I noticed on interviews that the paid programs didn't offer the education school based tuition programs did. They had two bracket systems, saw maybe one Invisalign case per resident in the full 3 years, shared chairs, rarely did any complicated cases, saw mainly one patient population meaning mostly one case type, had very few faculty members to learn from, and everything was learning by yourself through reading the textbook on nights and weekends. However, I do have to say that I think this works for some people! There were advatanges such as working really fast and getting paid. And I think that's why they loved people who had actual dental experience (not just dental school). I think it's to each their own!
For me, I feel like to stay in the ortho job market, we have to treat a lot of complicated cases compared to GD's who will take the simple cases. So I wanted to get as much exposure as possible to complicated cases so that in the long run, I am more advantageous off. (Even though financially I am at a disadvantage right now).

That said though, I think there are a ton of programs cheaper than $300k tuition, most are around $100k to $200k, and some are even almost cheaper than that. They also do school based and get lots of exposure. Do your research, and you'll find cheap good programs out there

Also, take what I say with a grain of salt because I haven't worked in the real world. And 2TH MVR does do mostly complicated cases himself and he went to a paid program, and he's doing amazingly!! I think you have to find your own fit and also explore all of the hospital programs. Oh, and I agree with him, those are very competitive programs so you may not have the chance to interview at one :/ for me personally, I felt I would get a better education at a school and so I moved the hospital programs to almost the bottom of my rank list

Ortho residency simply gives you a piece of paper "an ortho certificate" so you can call yourself an orthodontist. And yes, this piece of paper is totally worth $2-300k and 2-3 extra years in my opinion. You will need this piece of paper to get a good paying job at a corp office or to advertise your practice "limited to ortho" so other GPs will refer patients to you (they won't refer patients to another GP who does ortho). Like dental schools, ortho programs only teach you basic orthodontics. You can't become a competent dentist from doing 10-12 crowns, 20-30 fillings, 3-4 RCTs etc in dental school. Same for ortho, you won't learn much from starting only 50-60 new cases and accepting another 50-60 transferred cases from your upperclassman. You learn to become a good ortho from your job from treating many complicated cases every single day. To me corp offices are the ideal place to gain your expierence because they have a lot more patients than most private offices. So if you are not picky about the job offer and get as many jobs and see as many patients as you can, you will learn a lot more than your picky colleagues, who only want to work at a slow pace private ortho practice. I only saw 1 impacted canine case during my ortho residency training. When I got out, I saw 3 impacted cases on my first day at a corp.

IMO, it's best to attend the cheapest and shortest program.

 

[DreamingOfOrthodontics]

Like dental schools, ortho programs only teach you basic orthodontics. You can't become a competent dentist from doing 10-12 crowns, 20-30 fillings, 3-4 RCTs etc in dental school. Same for ortho, you won't learn much from starting only 50-60 new cases and accepting another 50-60 transferred cases from your upperclassman. You learn to become a good ortho from your job from treating many complicated cases every single day.

Agree with this; learning is forever

 

[2TH MVR]

I noticed on interviews that the paid programs didn't offer the education school based tuition programs did. They had two bracket systems, saw maybe one Invisalign case per resident in the full 3 years, shared chairs, rarely did any complicated cases, saw mainly one patient population meaning mostly one case type, had very few faculty members to learn from, and everything was learning by yourself through reading the textbook on nights and weekends. However, I do have to say that I think this works for some people! There were advatanges such as working really fast and getting paid.

That said though, I think there are a ton of programs cheaper than $300k tuition, most are around $100k to $200k, and some are even almost cheaper than that. They also do school based and get lots of exposure. Do your research, and you'll find cheap good programs out there

Also, take what I say with a grain of salt because I haven't worked in the real world. And 2TH MVR does do mostly complicated cases himself and he went to a paid program, and he's doing amazingly!! I think you have to find your own fit and also explore all of the hospital programs. Oh, and I agree with him, those are very competitive programs so you may not have the chance to interview at one :/ for me personally, I felt I would get a better education at a school and so I moved the hospital programs to almost the bottom of my rank list

Yeah ... hospital based residencies are unique vs. the traditional DS. Pros and cons. Pros. Wow ... did I see alot of craniofacial patients. Great if you plan on working with a craniofacial team, but not great if you plan to have regular private practice. In private practice it is ethical and correct to refer all these cranifacial patients to the local craniofacial team. We also treated with permanent extractions on almost everyone. No early treatment or nonextraction protocols. Maybe it was the medicaid patients we saw. When I moved west to Arizona ... I essentially had to learn to treat more Phase 1 and nonextraction. But hey ... I was paid to go to school.

Here's an interesting tidbit. I was essentially 3rd on call at the hospital regarding any emergency involving teeth or facial/boney lacerations. !st call went to the OMFS residents. If they did not answer .... next was the GPR residents. And lastly ..... the ortho residents. Luckily I never had to answer the call.

Is your pay typical for an orthodontist around the area? Do you think it is a lot less in bigger cities

I have no idea. When I went Corp .... money wasn't really a motivating factor.

@2TH MVR, any thoughts on how the next recession is going to affect the ortho market?

Nearly half of US CFOs fear a 2019 recession - CNN

Big Hoss

During the last recession in my private practice .... I had many patients that could not pay their monthly bills. As a courtesy ... I debonded all of them. Placed them into retainers and relieved them of their financial obligations. Of course .... this was a major drain on my practice.

Bottom line: paying your mortgage and buying food is more important than braces.
Just an opinion, but the next recession will not be like the last. Maybe 2-3 years. Just a correction. IMHO.

 

[deleted659902]

There are programs that don't cost $300K to attend, and a few that even pay you. Why not consider those?

Regarding programs that pay (ie hospital-based ones), they seem to prefer those with GPR experience, which I do not have. I also got the impression that ones that pay don't really "hold residents’ hands" so to speak.