Breaking the Match

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dr_lorin

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I am in need of advice and assistance. I matched at a GPR but was recently given the opportunity to specialize. My credentials are excellent (if that makes any difference). Anyhow, here are the details: I was sent an 9 page letter (doens't resemble anything of a contract), where it states my name, salary, and duties, and hospital policies, but does not state anything about me contracting to work there. I have already signed it and returned it in Feb. I realize that breaking the Match is dishonorable, etc. etc., and it is completely out of my character to do so, but I feel that this opportunity was placed there for a reason. My questions:
1. What are the consequences to breaking the Match (I don't really care if I can't use Match anymore)?
2. What advice can anyone give me on what I should tell the program director?
Thank you for your time.

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dr_lorin said:
I was sent an 9 page letter (doens't resemble anything of a contract), where it states my name, salary, and duties, and hospital policies, but does not state anything about me contracting to work there. I have already signed it and returned it in Feb.

Way to rationalize it. I can't answer any Match info because I haven't participated in it yet, but I can tell you that regardless of whether or not the "letter" said anything about contracting you to work there, it IS a contract.

Let's run down the gritty details: name, salary, duties, policies, and your signature. Yep, that's a contract.

Good luck (and hopefully the peeps here will have some solid answers for you).
 
ItsGavinC said:
Way to rationalize it. I can't answer any Match info because I haven't participated in it yet, but I can tell you that regardless of whether or not the "letter" said anything about contracting you to work there, it IS a contract.

Let's run down the gritty details: name, salary, duties, policies, and your signature. Yep, that's a contract.

Good luck (and hopefully the peeps here will have some solid answers for you).
One notable absence, Gavin, is the lack of a specified period of employment. Without that, and absent a lot of the usual CYA contract language, I think it's very possible that the document in question isn't binding.

To the OP: I can't answer #1 for you, but if doing the honorable thing is important to you, the only option for #2 is to level with the PD you're walking out on.
 
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aphistis said:
One notable absence, Gavin, is the lack of a specified period of employment. Without that, and absent a lot of the usual CYA contract language, I think it's very possible that the document in question isn't binding.


I agree that the document probably isn't binding in legal terms. My point was that it still seems like the OP wants us to help him rationalize why it's okay for him to back out.

I agree with you in that he must do whatever he feels comfortable with. Ultimately it's his situation, not ours, and he'll have to live with whatever decisions he makes.

An opportunity to specialize is a great thing, and I'm sure most people would drop the GPR and pursue the specialization.
 
Have a lawyer to review your contract to protect you from any hidden legal issues.
 
if its OEC for ortho:
STICK W/THE GPR!!!!
 
texas_dds said:
if its OEC for ortho:
STICK W/THE GPR!!!!

Easy to say when one is on the other side of the fence with admission into a non-OEC ortho program.

Until we see something concrete from the ADA/AAO that the OEC programs will NOT be receiving full accreditation, OEC is here to stay and may be the right answer for some dental students/dentists to pursue their ortho dreams (location, finances, not #1 in their class, etc.).

Like Gavin said, sitting in a GPR isn't going to make you an orthodontist.
 
So is OEC not recognized as being certified and just "additional training?" Can you advertise yourself as an orthodontist after graduating an OEC program?
 
unlvdmd said:
So is OEC not recognized as being certified and just "additional training?" Can you advertise yourself as an orthodontist after graduating an OEC program?

For sure you can. OEC programs have the same status of accreditation as do the UNLV and Arizona dental schools--initial accreditation.
 
Regarding the OEC programs...while an individual can certainly become an orthodontist via the opportunity provided by this organization, recent changes in certification guidelines by the ABO may make things a bit more difficult for OEC graduates. Basically, everyone graduating from an AAO accredited program will be board certified...board certification is likely to become the norm as it is in medical specialties. OEC program graduates cannot become board certified as they will never be accredited by the AAO. Public service announcements will likely surface encouraging the public to seek a board certified orthodontist for their care. Now don't get me wrong...if someone wants to become an orthodontist...an OEC program will give you the title. However, it may become difficult to do business if the public becomes aware of any disparity.
 
OEC programs have received initial accreditation by the ADA. They are not accredited by the American Association of Orthodontists nor are they recognized by the American Board of Orthodontists.
 
DocDrtySanchez said:
Public service announcements will likely surface encouraging the public to seek a board certified orthodontist for their care. Now don't get me wrong...if someone wants to become an orthodontist...an OEC program will give you the title. However, it may become difficult to do business if the public becomes aware of any disparity.

Oh yeah, this move would definitely stop the general public from going to OEC grads for their kid's ortho. This would be the same general public whose extent of dental knowledge is "root canal = painful" and "crooked teeth = braces."

If the ADA decides to not fully accredit the OEC programs and the ADA/AAO actually stop them from admitting new classes, then I will be convinced that the OEC programs are over and were nothing but a short lived fluke. Till then, all I hear is a lot of talk from orthodontists & non-OEC ortho residents about why they are better and why a prospective student shouldn't do OEC, but no real action on their part in trying to stop them.
 
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griffin04 said:
...all I hear is a lot of talk from orthodontists & non-OEC ortho residents about why they are better and why a prospective student shouldn't do OEC, but no real action on their part in trying to stop them.

The orthodontists along with the general community certainly stopped OEC from setting up a program at UMKC.

As long as the ADA grants full accreditation to OEC (which is not certain), then for better or worse OEC programs will always have enough residents and will continue to produce orthodontists. The responses to TX_dds and Sanchez's comments seem a bit defensive and sarcastic considering TX and Sanchez's advice was to simply do everything possible to enter a traditional ortho program before resorting to OEC. OEC has a lot of negatives that must be weighed heavily for the serious ortho applicant. OEC grads will be given the cold shoulder by other orthodontists. It's unlikely they will be granted board certification. More significantly they are indentured servants for 7 yrs (which includes a certain loss of freedom to set up a practice where you want, how you wish to run it, vacation time off, and possibly incurring a financial loss, etc). Lastly, there is a moral issue of whether or not it is right for a for profit company to possess that degree of control over one of the highest levels of education: Med/Dent residencies.

Now if you can't get accepted into a traditional ortho residency, then you may want to start weighing the compromises on one hand with becoming an orthodontist on the other. No doubt (with few exceptions) such students are the target applicants of OEC programs. I will be applying to ortho programs this fall and will not apply to JU, CU, or LV. As TX_dds suggested, I would rather enter a GPR, do research in an ortho lab, or do an ortho externship for a year or 2 and reapply rather than go OEC. I'm fundamentally against OEC for moral reasons and I don't wish to lose autonomy. But it's a personal choice and as griffin said, "Easy to say...." Maybe my perspective would change if I continued to reapply unsuccessfully, but I doubt it.
 
sorry i had to drag this thread down into the OEC quagmire - i dont even think the threadstarter said it was about ortho or not, i was just saying...
and thanks ddsslave for recognizing that i am just encouraging people interested in devoting the rest of their career to a specialty to be careful about how they go about it
also - i would encourage the thread starter to reread the match agreement that we all signed, im pretty sure the consequences are spelled out - if i recall, there is something in there about reporting to administrative boards, etc. If you are really intent on breaking your contract (and it IS a contract) please get a dental lawyer. in addition, i am curious about how a specialty position opened up at this point in time and would like to know more....


DDSSlave said:
The orthodontists along with the general community certainly stopped OEC from setting up a program at UMKC.

As long as the ADA grants full accreditation to OEC (which is not certain), then for better or worse OEC programs will always have enough residents and will continue to produce orthodontists. The responses to TX_dds and Sanchez's comments seem a bit defensive and sarcastic considering TX and Sanchez's advice was to simply do everything possible to enter a traditional ortho program before resorting to OEC. OEC has a lot of negatives that must be weighed heavily for the serious ortho applicant. OEC grads will be given the cold shoulder by other orthodontists. It's unlikely they will be granted board certification. More significantly they are indentured servants for 7 yrs (which includes a certain loss of freedom to set up a practice where you want, how you wish to run it, vacation time off, and possibly incurring a financial loss, etc). Lastly, there is a moral issue of whether or not it is right for a for profit company to possess that degree of control over one of the highest levels of education: Med/Dent residencies.

Now if you can't get accepted into a traditional ortho residency, then you may want to start weighing the compromises on one hand with becoming an orthodontist on the other. No doubt (with few exceptions) such students are the target applicants of OEC programs. I will be applying to ortho programs this fall and will not apply to JU, CU, or LV. As TX_dds suggested, I would rather enter a GPR, do research in an ortho lab, or do an ortho externship for a year or 2 and reapply rather than go OEC. I'm fundamentally against OEC for moral reasons and I don't wish to lose autonomy. But it's a personal choice and as griffin said, "Easy to say...." Maybe my perspective would change if I continued to reapply unsuccessfully, but I doubt it.
 
texas_dds said:
in addition, i am curious about how a specialty position opened up at this point in time and would like to know more....

It happens. A friend of mine got an ortho acceptance (a "traditional" program, not OEC) 3 months after match. My friend doesn't really know why the spot was open, but doesn't care b/c the spot now belongs to this person. But the OP didn't say it was ortho. There can be spots in perio/prostho/endo since those are not part of match that still might not be filled.
 
Another thing to keep in mind for those individuals seriously considering OEC programs...the ortho community is relatively small...in a particular area, practically all of the orthodontists know eachother. Furthermore, the referring network is generally tight. The OEC grad will likely be ostracized from orthodontists and general dentists alike once they complete their indentured servitude. As was stated earlier, one should be cognizant of all the consequences of signing on with OEC. As I wrote earlier, if you want to be an orthodontist and cannot get in the traditional way...go for it. Just keep in mind that you will be losing many of the quality of life advantages a specialist becomes privileged to.
 
One more point....Griffin, keep in mind that the majority of patients in an orthodontic practice are referrals from general dentists. Once it becomes publicly known that board certification is the norm in orthodontics...I'm sure a general dentist would not refer to a non-certified OEC grad simply to keep their patients happy and give the impression of only accepting the highest quality of care for their patients. It's an image issue...something the general public will certainly use to distinguish between orthodontists, especially since as you said their knowledge of orthodontics is limited to fixing crooked teeth. Of course there will always be patients looking for a bargain...these are the patients that will go to OEC offices. The chain mall practices have always existed and will continue to do so because there is demand for them by this segment of the population. Another things to keep in mind...orthodontists working in these mill practices generally see about 150 patients a day, the care provided can be likened to an assembly line, where efficiency is the rule and attention to detail/artistic influence (the fun part of orthodontics) goes out the window. The practice of orthodontics in these commercial practices is very different from that which attracts most to the profession.
 
DDSSlave said:
The orthodontists along with the general community certainly stopped OEC from setting up a program at UMKC.

Yes, they did do this and I will give the ortho community credit for this in an attempt to stop the OEC. But why did it end there? Why has the OEC been allowed to continue setting up shops? They are currently interviewing students for the new Las Vegas program; the first class will enter this fall.

How many general dentists ask their orthodontists where they did their training? They might, but they don't know a "good" ortho program from a "bad" one. I guarantee a lot of them don't know about the OEC at all b/c general dentists aren't necessarily keeping up with the trends in ortho education. I also know current orthodontists who only have a vague clue about the OEC and don't really know what it is either. In reference to what Doc Sanchez wrote, if there is to be a distinction then it has to be at the level of the referring dentist, not the general public. If the AAO feels there should be a distinction between OEC vs. traditional grads, the dental community has to be educated about it, not the patients.

I just think that before people go about OEC bashing, we have to wait and see what the graduates of the program end up doing with their careers. And with 14 grads per class and 3 schools currently, there will be lots of them. I don't think we can just assume that OEC grads will only be working at the ortho mills at the end of their "indentured servitude." If the programs do get ADA accreditation, then the grads will be free to set up shop right next to Doc Sanchez & texas DDS and treat who they want, not much unlike the current system.

Question - if the OEC gets ADA accreditation, can the graduates call themselves "orthodontists?" Or is there another level of accreditation by the AAO required for the title?

It's nice that the AAO is moving toward granting board certification to anyone who graduates from an AAO accredited program. But as stated in another thread, this expires in 5 years at which time it will be up to the dentist to renew the certification. The ortho profession has to bug its member to renew it, otherwise the levels will be right back to the dismal percentages they are right now where plenty of practitioners are just too lazy to get board certified.

Joining an OEC program is a decision the applicant has to make. IMO, it's too early to see what effect it's going to have on the ortho profession.
 
This OEC issue is not new in the world on labor economics. The members of the traditional blue collar construction unions experienced the same thing during the last couple of decades. Once they had moved into the middle and upper middle classes, they became exclusive and complacent. They thought they ruled the market and were immune from long term economic forces. It took time, but the once excluded nonunion construction folks began to move in and the eat the unions' lunches with a certainb sense of glee.

The same thing could happen to ortho if its membership becomes exlcusive and complacent. Those OEC folks may remember how they were shuned and could show no regrets in enabling the DHMO's to expand their use of ortho as a loss leader in its market statedgy to mop up dental patients.
 
groundhog said:
This OEC issue is not new in the world on labor economics. The members of the traditional blue collar construction unions experienced the same thing during the last couple of decades. Once they had moved into the middle and upper middle classes, they became exclusive and complacent. They thought they ruled the market and were immune from long term economic forces. It took time, but the once excluded nonunion construction folks began to move in and the eat the unions' lunches with a certainb sense of glee.

The same thing could happen to ortho if its membership becomes exlcusive and complacent. Those OEC folks may remember how they were shuned and could show no regrets in enabling the DHMO's to expand their use of ortho as a loss leader in its market statedgy to mop up dental patients.


Some people won't ever see the negative impact of OEC. As I recall, there were long threads on how Dentistry (report from Wall Street Journal - saying dentists on average are doing better than family physicians financially) is doing so well as a whole because as a profession, we have been relatively good at keeping control of our own destiny. One of the big reasons for this as mentioned in that report was there was less corporate/private/insurance influence allowing more freedom for dentists to work fee-for-service.

In all or most of the posts in that thread many were saying they were so thrilled and happy they were going into dentistry for this reason. Only people unhappy about that report were probably OEC defenders. Do you not understand that OEC is a threat to the autonomy that has allowed dentistry to prosper?? Those of you who are defending OEC -- good for you -- go for it -- be happy and get used to having someone control how, when, and where you work, and how much your financial compensation will be -- good for you-- go for it. And as I've said before in threads regarding OEC -- if any Joe blow can set up an ortho school, what would stop someone from doing it with any other specialty, or even a whole dental school. That would be real nice then wouldn't it -- we'll definitely know and feel what it means to loose career autonomy (as many physicians are feeling) and freedom to chart the direction of our own financial future --- dentist/orthodontists will now work like pharmacists and optometrists in every wal-mart, CVS, and walgreens around every corner. What a nice picture. It won't be a profession it will be a trade at that point. And your compensation will match. Believe me.

Heres the bottom line --- Why do you think OEC grads will be shunned in the first place. Because they are subpar students with academic profiles not good enough to compete for traditional ortho spots. That makes those of us who worked our behind off to get into a traditional ortho program resent and have animosity towards those that are taking the OEC route. Just as there is competition to get into dental school --- if you worked hard to obtain the necessary academic profile to obtain acceptance but then down the road there is a privately funded dental school that promised acceptance (even with subpar academic profile) as long as prospective students sign a 7-year work contract after they graduate--- now wouldn't that tick you off??

If you are so desperate (and can't figure out how to get into a real traditional ortho program) and you decide to sell out yourself, your professional and financial autonomy --- especially after having sacrificed 8-11 years of your life then by all means OEC is your ticket.

I know a lot of general dentists that did not get into ortho but have attended many ortho CE courses and learned ortho very well in this manner and have incorporated ortho into their privat practices and have done extremely well --- all the while keeping their professional and financial autonomy. I would take that option over selling yourself to make money for some private company (actually you will be making money for one guy -- Jasper Lazarra).

Good riddins griffin and groundhog.
 
I couldn't agree with you more dort-ort.
 
dort-ort said:
If you are so desperate (and can't figure out how to get into a real traditional ortho program) and you decide to sell out yourself, your professional and financial autonomy --- especially after having sacrificed 8-11 years of your life then by all means OEC is your ticket.

That may apply to most OEC applicants, but don't forget that there ARE spots at each and every OEC program for those who don't wish to participate in the "OEC scholarship" (read: slave labor).

Those grads will graduate without any ties to the OEC. What does their future hold?
 
dort-ort said:
Some people won't ever see the negative impact of OEC. As I recall, there were long threads on how Dentistry (report from Wall Street Journal - saying dentists on average are doing better than family physicians financially) is doing so well as a whole because as a profession, we have been relatively good at keeping control of our own destiny. One of the big reasons for this as mentioned in that report was there was less corporate/private/insurance influence allowing more freedom for dentists to work fee-for-service.

In all or most of the posts in that thread many were saying they were so thrilled and happy they were going into dentistry for this reason. Only people unhappy about that report were probably OEC defenders. Do you not understand that OEC is a threat to the autonomy that has allowed dentistry to prosper?? Those of you who are defending OEC -- good for you -- go for it -- be happy and get used to having someone control how, when, and where you work, and how much your financial compensation will be -- good for you-- go for it. And as I've said before in threads regarding OEC -- if any Joe blow can set up an ortho school, what would stop someone from doing it with any other specialty, or even a whole dental school. That would be real nice then wouldn't it -- we'll definitely know and feel what it means to loose career autonomy (as many physicians are feeling) and freedom to chart the direction of our own financial future --- dentist/orthodontists will now work like pharmacists and optometrists in every wal-mart, CVS, and walgreens around every corner. What a nice picture. It won't be a profession it will be a trade at that point. And your compensation will match. Believe me.

Heres the bottom line --- Why do you think OEC grads will be shunned in the first place. Because they are subpar students with academic profiles not good enough to compete for traditional ortho spots. That makes those of us who worked our behind off to get into a traditional ortho program resent and have animosity towards those that are taking the OEC route. Just as there is competition to get into dental school --- if you worked hard to obtain the necessary academic profile to obtain acceptance but then down the road there is a privately funded dental school that promised acceptance (even with subpar academic profile) as long as prospective students sign a 7-year work contract after they graduate--- now wouldn't that tick you off??

If you are so desperate (and can't figure out how to get into a real traditional ortho program) and you decide to sell out yourself, your professional and financial autonomy --- especially after having sacrificed 8-11 years of your life then by all means OEC is your ticket.

I know a lot of general dentists that did not get into ortho but have attended many ortho CE courses and learned ortho very well in this manner and have incorporated ortho into their privat practices and have done extremely well --- all the while keeping their professional and financial autonomy. I would take that option over selling yourself to make money for some private company (actually you will be making money for one guy -- Jasper Lazarra).

Good riddins griffin and groundhog.

Whoaa...I'm on your side. My statements were meant to be a warning as to what can happen to any trade/profession if its membership becomes, arrogant, exclusive, inbred, and complacent.. if it blindly supports the status quo because that is the path of least effort. The construction unionists forgot the core values and ethics of their founders. They began to live off the efforts of their founders without giving anything back themselves. It worked for a while and seemed like a free lunch....good wages for just showing up on the job without having to do any of the tough off the clock work in the political and social arenas of their communities.
 
ItsGavinC said:
That may apply to most OEC applicants, but don't forget that there ARE spots at each and every OEC program for those who don't wish to participate in the "OEC scholarship" (read: slave labor).

Those grads will graduate without any ties to the OEC. What does their future hold?


Who gives a fricken arse what happens to them. They're like specs of dust on the radar screen in terms of OEC and what OEC means to dentistry. Kinda like asking what happens to all the dental anesthesiology residents that graduate each year. Anyone know where they go?, Does anyone have a colleague that is a "dental anesthesiologist" ? Does anyone know what future hold for them?

Seriously though, in my opinion, the guys that graduate from an OEC program without the 7 yr binding servitude probably still won't be accepted equally in the orthodontic community. But they will probably have as good of a future as anyone else that graduated from a traditional ortho program -- because they can chart their own professional growth and direction and that is what matters.

To take this point further--I would have no problems with OEC (or have no legitimate right to have problems with) if they just did away with having to have prospective students sign the 7 yr contract binding them to work at an OEC office. You cannot have an objective acceptance process in a situation like that (and this is the heart of the issue and why the AAO does not favor full accreditation). If OEC did away with the 7 yr contract they would be just like any other ortho program opening up that has to go through accreditation (which I think the most recent one was at San Antonio (not sure though)). OEC can't and will never do that however --- because they are a for-profit company who have invested hundreds of millions of dollars into this venture and they need to secure a return on their investment -- thats what all these stupid OEC grad are --- just human labor used as a means by which they will secure a return on their investment --- why do you think its a 7 yr binding contract.

See how that works? You've invested all those years of schooling to then hand over the returns over to someone else --- Those wanting to do OEC should get a fricken backbone, grit your teeth, hold firm, be a man, and DO WHAT IT TAKES to get into a traditional program -- (if this means that you have to do a GPR for a year or an AEGD, or get private practice experience, or do research - get published, or an ortho externship, etc, etc, then reapply --- fine, do whatever it takes, eventually if you are persistent you will get into a traditional ortho program and it will be worthwhile.

otherwise OEC is for you --- go for it --- not the road for me.
 
groundhog said:
Whoaa...I'm on your side. My statements were meant to be a warning as to what can happen to any trade/profession if its membership becomes, arrogant, exclusive, inbred, and complacent.. if it blindly supports the status quo because that is the path of least effort. The construction unionists forgot the core values and ethics of their founders. They began to live off the efforts of their founders without giving anything back themselves. It worked for a while and seemed like a free lunch....good wages for just showing up on the job without having to do any of the after hours volunteer work in the political and social arenas of their communities.

yes I gotcha. I agree, orthodontists, by way of the AAO and the ADA should more adamantly voice their concerns and have a firmer stance against OEC.
 
dort-ort said:
In all or most of the posts in that thread many were saying they were so thrilled and happy they were going into dentistry for this reason. Only people unhappy about that report were probably OEC defenders. Do you not understand that OEC is a threat to the autonomy that has allowed dentistry to prosper?? Those of you who are defending OEC -- good for you -- go for it -- be happy and get used to having someone control how, when, and where you work, and how much your financial compensation will be -- good for you-- go for it. And as I've said before in threads regarding OEC -- if any Joe blow can set up an ortho school, what would stop someone from doing it with any other specialty, or even a whole dental school. That would be real nice then wouldn't it -- we'll definitely know and feel what it means to loose career autonomy (as many physicians are feeling) and freedom to chart the direction of our own financial future --- dentist/orthodontists will now work like pharmacists and optometrists in every wal-mart, CVS, and walgreens around every corner. What a nice picture. It won't be a profession it will be a trade at that point. And your compensation will match. Believe me.

If OEC is such a threat to our career autonomy, then I'll say it again. Why is the orthodontic profession not being more aggressive about stopping it? They've already been able to set up THREE schools in just TWO years and it sounds like they're not stopping there. I agree with all the points you made. I do not believe that OEC is a good thing for ortho at all.

However, I've talked to many ortho residents & orthodontists in the past year, and I have heard very few speak about being proactive and taking action to stop OEC. Most will just denounce it for a minute with a "oh yeah, it's not a good thing" and then go back to talking about expensive cars or wine tasting.

You can get out into private practice and shun the OEC grad all you want. But face it, at the rate OEC is going, there will be LOTS of OEC grads. 14 residents * 3 programs = 42 OEC grads per year starting in 2007. Nationwide, there are about 250 traditional ortho grads each year. In 2007, OEC will be responsible for almost 1/6 of the orthodontists graduating each year. THAT IS HUGE!!!! Where are they going to go? South Dakota? I heard there are only 17 orthodontists in that state. New York? Los Angeles? Next door to you?

Maybe you can help us here - do you know of any initiatives out there to stop OEC? There is an AAO meeting coming up - anything going to be discussed there?

FYI dort-ort: I do not agree with the OEC. I am one of those people who is really trying to DO WHAT IT TAKES to get into a traditional ortho program, including ALL of the other things you mentioned. However, it is hard to be on this side of the fence; when you see "orthodontic training opportunity," it's hard to not stop and read the flyer. But then I realize it's just an OEC ad disguised as an "opportunity." And I have to remind myself that although I may feel desperate at times, I am not ready to sell 9 years of my life to them.

At the same time, I am worried about what impact all the OEC grads will have in my future when I get out there and start practicing (hopefully ortho) someday.
 
I think this is the scariest part about the OEC "scholarship". I'm not familiar with any other residency/medical/dental educational program where a private company donates millions for the opportunity to establish a "scholarship". How big would the uproar in general dentistry be if Proctor and Gamble established the Colgate School of Dental Medicine in Cincinatti OH? What would the ADA's response be if a private company, say Sears Dental said, "we think there aren't enough general dentists and dentistry is too expensive, we're going to start schools across the country and plug them right in to our business after they graduate."

I think for a lot of us the problem is scary for two reasons, where does it stop, especially in ortho, and if were all honest about it, how does increasing the number of orthodontists every year influence the compensation for doing ortho treatment?

Hopefully this board certification has some impact, but I agree with other posts more needs to be done by orthodontists themselves to rally and squash this baloney.
 
griffin04 said:
If OEC is such a threat to our career autonomy, then I'll say it again. Why is the orthodontic profession not being more aggressive about stopping it? They've already been able to set up THREE schools in just TWO years and it sounds like they're not stopping there. I agree with all the points you made. I do not believe that OEC is a good thing for ortho at all.

However, I've talked to many ortho residents & orthodontists in the past year, and I have heard very few speak about being proactive and taking action to stop OEC. Most will just denounce it for a minute with a "oh yeah, it's not a good thing" and then go back to talking about expensive cars or wine tasting.

You can get out into private practice and shun the OEC grad all you want. But face it, at the rate OEC is going, there will be LOTS of OEC grads. 14 residents * 3 programs = 42 OEC grads per year starting in 2007. Nationwide, there are about 250 traditional ortho grads each year. In 2007, OEC will be responsible for almost 1/6 of the orthodontists graduating each year. THAT IS HUGE!!!! Where are they going to go? South Dakota? I heard there are only 17 orthodontists in that state. New York? Los Angeles? Next door to you?

Maybe you can help us here - do you know of any initiatives out there to stop OEC? There is an AAO meeting coming up - anything going to be discussed there?

FYI dort-ort: I do not agree with the OEC. I am one of those people who is really trying to DO WHAT IT TAKES to get into a traditional ortho program, including ALL of the other things you mentioned. However, it is hard to be on this side of the fence; when you see "orthodontic training opportunity," it's hard to not stop and read the flyer. But then I realize it's just an OEC ad disguised as an "opportunity." And I have to remind myself that although I may feel desperate at times, I am not ready to sell 9 years of my life to them.

At the same time, I am worried about what impact all the OEC grads will have in my future when I get out there and start practicing (hopefully ortho) someday.


griffin04:

I'll tell you why you don't see more urgency against OEC from the orthodontic or from the general dental community in regards to the swindlings of OEC.

Most of the practicing orthodontists are in their late 40's, 50's and 60's. These people (at least most of them) feel as though they don't have to worry about the negative out croppings that will come from OEC as they will be in the retirement stages of their careers. Besides most of them have busy practices making good money and are not feeling the effects of any OEC or rather the minions they graduate as it is still in progress. Most orthodontists are secure in their finances and close to their retirement and don't give a crap about what happens as they will be out of the system by the time the OEC minions set up shop near by. This is sad but its how many of the practicing orthodontist feel. In this regard OEC may have something going for them. As someone else said complacency is going to be the orthodontic communitie's achilles heel.

The general dental community doesn't care because most gp's are envious and have animosity towards the successful orthodontists. A lot of gp's feel ortho has always been a conspiracy by the orthodontic academics to prevent or hinder dissemination of orthodontic education (which is a bunch of crap) and so most gp's don't care about how a private venture like OEC can and will negatively influence the structure/business/academics of orthodontics.

Plain and simple thats why you don't see things happening with more fervor and urgency. So it is sad and frustrating for us in the late 20's or early 30's starting out cause we are the ones that will have to deal with it. And we are in the minority. Sad, sad, sad.

Endo is sounding better and better everyday.
 
dort-ort said:
Endo is sounding better and better everyday.

Seeing as I'm not starting ortho this year, guess I better make sure I get real good at general dentistry and running a business.

I agree with what you said - I can see why the "old timers" don't care (ie - anyone with a successful practice raking in cash).

Our MD colleagues were making serious $$$ in the 80s. Then insurance & HMOs happened and now look where they are. The general public thinks it's outrageous if you have to go to a doctor's appointment or the pharmacy and pay anything more than your co-pay. My MD's office staff freaked out the other day when I forgot my insurance card, even though I offered to pay full price for the exam. It's like they didn't know what to do if a patient was going to actually pay on the fee schedule for the doctor's services instead of using their insurance card.

It can't be good if ortho becomes "Your son's treatment will take a total of 2 years. He will come to one visit each month at which you have to pay your $5 copay. If his brackets fall off, there will be an emergency visit co-pay of $10."

Maybe it won't be so bleak.
 
griffin04 said:
Seeing as I'm not starting ortho this year, guess I better make sure I get real good at general dentistry and running a business.

I agree with what you said - I can see why the "old timers" don't care (ie - anyone with a successful practice raking in cash).

Our MD colleagues were making serious $$$ in the 80s. Then insurance & HMOs happened and now look where they are. The general public thinks it's outrageous if you have to go to a doctor's appointment or the pharmacy and pay anything more than your co-pay. My MD's office staff freaked out the other day when I forgot my insurance card, even though I offered to pay full price for the exam. It's like they didn't know what to do if a patient was going to actually pay on the fee schedule for the doctor's services instead of using their insurance card.

It can't be good if ortho becomes "Your son's treatment will take a total of 2 years. He will come to one visit each month at which you have to pay your $5 copay. If his brackets fall off, there will be an emergency visit co-pay of $10."

Maybe it won't be so bleak.


Exactly my point Griffin04, these fricken "old farts" don't give a crap. The frustrating thing about it is that they are by far the vast majority of orthodontists out there and they are the ones making decisions through the AAO and the ADA. As I said, they are going to be retired and have their retirement secured by the time the negative effects of OEC ripples into the ortho community (which I would say will take 5-7 yrs.). And this angers me to no end because us younger guys who are in the minority have less of a voice to express our concerns or do anything about it.

As far as insurance and HMO encroachment into the dental field -- dentistry has definitely been lucky and have reaped the benefits -- and thats why more and more are seeing dentistry as a better career choice compared to other health professions. We are still able to have private practices where we can choose whether we want to accept insurance - thus someone else's fee schedule - or work fee-for-service and charge what we feel we are worth and what the patient is willing to pay, in other words free-market. And you can't beat that. This is where OEC will have such a negative effect on the orthodontics profession financially/structually/academically and our reputation as a profession in the eyes of the public (do you want to be percieved on the same level as pharmacists, optometrists, or chiropractors in every walgreens or CVS or walmart?). As you mentioned, what is happening with the medical profession is a foreshadowing for what will befall dentistry if outfits like OEC come to fruition. OEC is worse than any insurance co. or HMO because they can make any fee schedule they deem appropriate and probably won't be bounded by any governmental regulations. Just think what will happen when OEC and the minions they graduate each yr obtain a big majority of the ortho market, they will then have leverage to force private practicing orthodontist to amend their fees to be more consistent with OEC. I do see this happening due to OEC's plan on graduating like 15-20 residents per year per program. Since there are 3 under way at this point that could be as much as 60 residents per yr. And as far as I know, bastard Lazarra, is always in dealings to open more programs. This is in contrast to most traditional ortho programs graduating 3-6 residents per yr. Can you see what is going to happen?

There are those dental students who say good -- that they would like to see OEC succeed. Many have this opinion because they may have envious animosity towards the orthodontic profession or that they are frustrated because they can't get accepted into a traditional ortho program (on that point -- not everyone can be astronauts or pro-atheletes either) and would like to see hardship befall the orthodontic professional. However, they don't understand that OEC can and will be a precedent that effects dentistry as a whole. So for those dental students that defend OEC (or who feel there is too much "OEC bashing"), I hope you keep defending them when someone comes around and starts not an orthodontic education company (OEC) but a dental education company (DEC) then we'll see how much favor you will have for such an enterprise. What will prevent big private dental companies (who have 100's to 1000's of offices) like Western dental, Castle dental, Monarch dental, or Sears dental from starting their own private dental school and favor acceptance for those (irrespective of whether they have proper academic profile or not) who are willing to sign a binding work contract for 7 yrs. and serve as their indentured servitude.

These are my opinions -- for better or for worse -- good riddins.

P.S. -- Griffin04 -- are you from upstate NY? I know that area well. What are you going to do while still trying to get into ortho? (the traditional way).
 
Very interesting discussion.
After reading this article: http://jacksonville.bizjournals.com/jacksonville/stories/2005/03/28/story7.html?page=1.

The chance of getting into a traditional ortho program is about 3.5 % (293 slots for 8200 applicants). Is there an explanation to why there are so little ortho programs in the country, when there is such a huge demand for it?

In this article it is mentioned that only 14 students from 125 applicants were accepted to the OEC program. This program works for students that do not want to own their own business, want to have the luxury of working as an orthodontist, and no debt. To my understanding this is a win-win situation for those students and OEC, since they do all the work and all you have to do is show up to work.

Can someone tell me why OEC students might be less knowledgeable than the traditional ortho students? I think OEC trains these students to the best they can, since these guys will work for them and generate tons of money for them. This is a profitable organization and it’s all about money.

Would I be interested in this program, at this point the answer is no, since I am not sure if I want to be an orthodontist. Also, would I attend this program, the answer is no, since I do not want to commit to this type of program for 7 years.

But, if the goal of this program is to make orthodontics more affordable for the public, I am not sure why anyone would want to close it down, except a very small group of people which are the traditional orthodontists.
 
Just some thoughts on your post..

balance said:
The chance of getting into a traditional ortho program is about 3.5 % (293 slots for 8200 applicants). Is there an explanation to why there are so little ortho programs in the country, when there is such a huge demand for it?

I believe that is 8200 applications not applicants. Each applicant applies to probably 15 schools on average. I'm sure actual stats exists somewhere. So, while strictly speaking, yes, the chance of getting into a given program may be 3.5%, that is not the whole story. And since when does having a huge demand (I assume you mean students given your previous reference) have anything to do with it? Look at derm, radiology, orthopedics, endo, OMFS. There will always be more applicants than spots for these popular specialties.

balance said:
This program works for students that do not want to own their own business, want to have the luxury of working as an orthodontist, and no debt. To my understanding this is a win-win situation for those students and OEC, since they do all the work and all you have to do is show up to work.

After 4 yrs of dental school and 2-3 yrs of residency, I can't imagine anyone wanting to give up their autonomy for the sake of avoiding management headaches. However, I'm sure you're right and there will always be a few. Nevertheless, keep in mind that OEC is there to make money. If they have their way, you will probably have less vacation or be working 5 full days a week or seeing more pt/day than an average orthodontist to increase profits. Possibly all 3. And OEC does not repay your dental school loans which is probably a lot greater than ortho school.

balance said:
only 14 students ... were accepted to the OEC program. ........

Can someone tell me why OEC students might be less knowledgeable than the traditional ortho students? I think OEC trains these students to the best they can, since these guys will work for them and generate tons of money for them. This is a profitable organization and it’s all about money.

You're answering your own question here. 14 students is a hell of a lot of students for ortho, and that's just the 1st yrs. There is a reason most programs take so few residents and it has nothing to do with keeping total ortho #s down. The technical difficulty of educating orthodontists requires a high faculty to student ratio. To give you an idea of OEC's notion of a good education, UMKC (which they tried to take over) had 4 residents (I believe) per class. OEC wanted to quadruple that number. Would the quality of education decrease? You bet. OEC is about making money, not about fine tuning alignment and occlusion. Admittedly, I have no first hand knowledge, but I would stick my neck out and bet compared to traditional programs, close is likely good enough for OEC. No doubt that is the case with OCA. To confirm or disconfirm this I would be interested to hear how often they consider orthagnathics or implant assisted orthodontics to give the pt a better final result. How often do they spend the extra time to fine tune Invisalign after the official Invisalign course of treatment?

balance said:
But, if the goal of this program is to make orthodontics more affordable for the public, I am not sure why anyone would want to close it down, except a very small group of people which are the traditional orthodontists.

And who says this will make ortho more affordable to the public. OEC is guaranteeing starting docs 150k. Plus they pay overhead. OEC wants a significant profit after this. OEC wants a return on the tens of millions invested over the long term. They're not going to dramatically cut prices of braces compared to a private orthodontist. Possibly a little, but nothing that is suddenly going to make braces an option for patients who couldn't otherwise afford it.
 
Those in favor of OEC should really sit in a lecture given by OEC about "how wonderful an opportunity" they're offering ortho. There was an OEC lunch and learn given at Tufts (which I stress is COMPLETELY against the OEC), and the students made the OEC (including Jasper Lazarra) look worse and worse.

Every response the OEC had for the students' questions made them seem more and more like they didn't give a damn about ortho. All that matters to the OEC is money. Plain and simple. It has nothing to do with a shortage of ortho, nor does it have anything to do with helping ortho applicants.

The real concern for OEC is money.
 
The chance of getting into a traditional ortho program is about 3.5 % (293 slots for 8200 applicants). Is there an explanation to why there are so little ortho programs in the country, when there is such a huge demand for it?

Thats major propaganda put out by OEC. As someone else said, its not 8200 applicants, its applications. OEC's goal is to push these exaggerated numbers to the unknowing public or the innocent and green dental students in their attempts make it sound like there is going to be an orthodontic labor crisis out there and to help push their insidious business structure. If there is ever a shortage in dentistry per se -- pediatric dentistry would be where the shortage is.

There is also a huge demand for plastic surgery --- do you see private plastic surgery schools opening up de novo out there???

Lazarra claims that his programs will be helping the underserved. This is total bull. When was the last time anyone heard that orthodontics was need based? Sure I will be the first to say everyone should have ortho tx if they need it. However, the more pressing need out there is the GENERAL DENTAL CARE that is needed by millions. Due to poor oral health / education / funding / attention - large groups of kids and adults in rural towns (where water is not flouridated), inner city, indian reservations, and poor / indigent communities are all lacking access to simple dental care. You see large numbers of decayed and missing teeth in these groups of people. That is where the NEED is. Who cares about straight teeth if their all carious.

If Lazarra was really noble and wanted to help -- he should require all his OEC grads to work as general dentists doing general dentistry in offices placed in underserved areas for 2 or more yrs taking care of the real need out there -- then they can do ortho after. And for that matter -- I bet you'll never see one of Lazarra's ortho offices open up in a poor or underseverd community ----- and lets agree that there is a need for ortho for the underserved -- do you think he will provide low cost orthodontic care for this group of people. That answer would be a big NO.


In this article it is mentioned that only 14 students from 125 applicants were accepted to the OEC program. This program works for students that do not want to own their own business, want to have the luxury of working as an orthodontist, and no debt. To my understanding this is a win-win situation for those students and OEC, since they do all the work and all you have to do is show up to work.

GIVE ME A FRICKEN BREAK. This shows exactly how shallow minded you are and how much time you've thought about your above statement. If you don't want to own your own business and only want to show up for work -- there are a myriad of other venues for you to do this --- ALL OF WHICH WILL STILL ALLOW YOU TO HAVE FULL CAREER AUTONOMY, PROFESSIONALLY AND FINANCIALLY. These are called associateships. As well, you can work for the big dental companies out there such as Castle dental, Monarch dental, Heartland dental, etc. etc. And in all these instances you are not bounded by a 7 yr. contract. Your contract for any of these other options is only limited by your negotiations in terms of length, compensation, raises, commission, etc etc. And since the terms in these contracts are much shorter (in the range of 1-2 yrs) as you get better and faster and more experience -- a compensation increase can be re-negotiated to match you experience level. Or after the 1-2 yr contract is over, if you don't like working where you are you can get up and go.

With OEC -- you are bounded for 7 yrs -- you are locked in, no say, no vote, no re-negotiation, no nothing -- good luck with that, why do you think people refer it as an indentured servitude. Sure you can break the contract with OEC but you better be ready to hand over the clothe on your back, your right arm, the kitchen sink and a boat load of cash.



Can someone tell me why OEC students might be less knowledgeable than the traditional ortho students? I think OEC trains these students to the best they can, since these guys will work for them and generate tons of money for them. This is a profitable organization and it’s all about money.

I can't claim that OEC's programs are poorer academically (although that may have been mentioned by others). No one can prove they are better or worse. But thats not where the issues of concerns are. The concerns involve regulations by the ADA stating that the interview process for applicants and their acceptance into specialty programs must be unbiased. Clearly, do you not see the conflict of interest when you have to sign a 7 yr binding contract stating that you HAVE to work for OEC. So if a better candidate comes along but does not want to sign the OEC contract -- do you seriously believe OEC is going give that person an acceptance. The answer is a big fat Lazarra arse NO.

So you are absolutely right on one thing -- that its all about money --- OEC's money -- Lazarra's money. Who cares about academic integrity.


Would I be interested in this program, at this point the answer is no, since I am not sure if I want to be an orthodontist. Also, would I attend this program, the answer is no, since I do not want to commit to this type of program for 7 years.

Dude you are not committing for 7 yrs. Its 9 yrs -- if you include the time you are in residency for OEC. For that matter, you've also just spent 2-4 yrs undergrad and 4 yrs dental school. So if you or anyone decides to par-take in the OEC venture -- by the time you have career autonomy that could mean (do the math) a total of 15-17 yrs of your life you've decided to given up.


But, if the goal of this program is to make orthodontics more affordable for the public, I am not sure why anyone would want to close it down, except a very small group of people which are the traditional orthodontists.

The vast majority of the public also are crying out that general dental procedures are too expensive. Orthodontics is clearly only a small percentage of the total dental spending in the US. Which is in the billions. So according to your logic. We should also open up private dental schools and graduate double or triple the number of graduating dentist as to make general dental treatment more affordable. Yes that is a super idea. And this would be great for dentistry as a whole -- right?

Or how about make dentistry more like medicine where managed care / insurance company / working close with the large corporations that employ thousands becomes pervasive and have control over which and how dental procedures are performed and charged out. Have all dental procedures be capped by fee schedules made by these dental insurance companies. Have them tell you an extraction would be compensated for but a root canal would not. Or a large 3-4 surface amalgam build up would be compensated for but not a crown. Or comprehensive ortho not needed here and we will only re-imburse you for partial anterior alignment only. etc, etc. Yes, that would be a great way to to make dentistry or orthodontics more affordable. This will also afford us to be looked upon by the public not as health care professionals but a tooth mechanic. Hey come to think of it, tooth mechanic has a nice ring to it.

Why don't you find and read the Wall street journal report on dentistry vs. medicine article that came out recently. It gives you a good perspective why dentistry is doing much better than medicine. Maybe you'll have a different perspective on the comments you've expressed.
 
balance said:
Very interesting discussion.
After reading this article: http://jacksonville.bizjournals.com/jacksonville/stories/2005/03/28/story7.html?page=1.

The chance of getting into a traditional ortho program is about 3.5 % (293 slots for 8200 applicants). Is there an explanation to why there are so little ortho programs in the country, when there is such a huge demand for it?

In this article it is mentioned that only 14 students from 125 applicants were accepted to the OEC program. This program works for students that do not want to own their own business, want to have the luxury of working as an orthodontist, and no debt. To my understanding this is a win-win situation for those students and OEC, since they do all the work and all you have to do is show up to work.

Can someone tell me why OEC students might be less knowledgeable than the traditional ortho students? I think OEC trains these students to the best they can, since these guys will work for them and generate tons of money for them. This is a profitable organization and it’s all about money.

Would I be interested in this program, at this point the answer is no, since I am not sure if I want to be an orthodontist. Also, would I attend this program, the answer is no, since I do not want to commit to this type of program for 7 years.

But, if the goal of this program is to make orthodontics more affordable for the public, I am not sure why anyone would want to close it down, except a very small group of people which are the traditional orthodontists.
If there are 8200 applicants for ortho each year, I'm curious to know where half of them are coming from, considering only 4000 new dentists graduate each year. Propaganda, anyone?
 
aphistis said:
If there are 8200 applicants for ortho each year, I'm curious to know where half of them are coming from, considering only 4000 new dentists graduate each year. Propaganda, anyone?


Maybe grads who re-apply or decide to go into ortho after doing GP
 
there are 8200 applications, not applicants
and everyone i know sent out around 15+
so... about 500 some applicants. and 250 spots.
much different math now
 
texas_dds said:
there are 8200 applications, not applicants
and everyone i know sent out around 15+
so... about 500 some applicants. and 250 spots.
much different math now

MUCH different math, but still extremely difficult to get matched, especially if you have your eye on a couple of programs.
 
balance said:
Also, would I attend this program, the answer is no, since I do not want to commit to this type of program for 7 years.

You wouldn't necessarily have to. Not all OEC-affiliated matriculants are actually on the "OEC scholarship".

So it's time we discuss this aspect.

Does having a couple of normal seats in each class somehow make the program more legit (or make it appear more legit)?
 
It seems that nearly all the negativity is directed towards Lazarra, and rightfully so perhaps, but what about the schools.

Is anybody downright ticked at Colorado or UNLV for ACCEPTING an OEC proposition? Let's hear about that for a change. It seems the schools are somehow dodging their fair share of responsibility.

[For the record, my school was contacted about a program and said "no".]
 
ItsGavinC said:
[For the record, my school was contacted about a program and said "no".]

That's good to know. In the back of my mind, I figured Arizona was next in the list of targeted schools. What's left then - SIU, Creighton, Mississippi, Meharry? Those are the dental schools I can think of off the top of my head as schools without ortho programs. Or maybe it'll just be more Jacksonville-type programs - no affiliated dental school, just a free-standing ortho school.

IMO, there should not be anymore OEC programs opened anyways. There are now 42 spots with the 3 schools, that's MORE than enough.

I know schools are all strapped for cash, but it's too bad the ortho communities in Colorado & Las Vegas didn't step up and halt the OEC like UMKC's community did. Then again, the dealings may have happened so fast that it was too late when the communities found out. Colorado just started an international dentist program as well; is the school so much in the red that it had to turn to OEC & a foreign dental training program (I'm guessing the foreign students probably have to pay a lot more tuition that the state resident) to raise $$$?

I feel like a lot of this OEC-anger is like the VitalCrap hostility from a few years ago. It's just more of someone else getting rich at the expense of powerless dental students.
 
I think your arguement about students from the OEC programs being less qualified, and poorly trained is wrong. I know a bunch of people who took OEC slots because of location, or because it's a two year program. The facilities, and faculty at these schools are second to none. Maybe you should meet some of the students or perhaps visit one of these schools before making these remarks. The accreditation committee was at JU on friday, sounds like it didn't go so well. Mainly because of the 7-yr contract. From what I understand the residents didn't have to many good things to say about OEC, and the contract. I did hear that the they were impressed with the school.
 
Firm said:
From what I understand the residents didn't have to many good things to say about OEC, and the contract. I did hear that the they were impressed with the school.

I'd be interested to here why the residents are disappointed with OEC. Afterall, they knew about the contract and their obligations to OEC before entering the program.

So, accreditation was impressed with the facilities, just not the OEC contract concept? Go figure. ADA Accreditation Standards for Advanced Specialty Education Programs in Orthodontics and Dentofacial Orthopedics, Standard 1-1 states: It is the responsibility of the sponsoring institution to ensure that financial support from entities outside of the institution do not compromise the integrity of the program or the professional options of the student and/or graduates.

The 7yr contract certainly compromises the graduates' professional options.
 
Firm said:
I think your arguement about students from the OEC programs being less qualified, and poorly trained is wrong. I know a bunch of people who took OEC slots because of location, or because it's a two year program. The facilities, and faculty at these schools are second to none.

The points you make above are important to consider with any ortho program. Two years in Las Vegas learning orthodontics sounds awesome to me. It's the 7 year contract with OEC that makes me cringe. The other issue I have is them arbitrarily opening programs to increase the number of ortho residents per year by a lot. If OEC was so generous and wanted to truly improve the quality of ortho training, they could easily do it in many other places in ortho - like setting up funded faculty positions at existing schools to help with the full time faculty shortage or helping to fund better research in orthodontics. Heck, if they just gave a scholarship without the contract, they'd be real popular real fast. If they really wanted to help the underserved, they could open clinics offering lower cost ortho to people who truly can't afford it and hire orthodontists (who would be paid fairly & wouldn't have to deal with the headaches of a business) to work for them. Instead they are roping in the existing residents in their programs by dangling the chance at receiving an ortho education, but with the provision that they remain at the mercy of the OEC for 7 years afterwards. Something in their equation just doesn't sound right to me.
 
Nothing is free, and OEC is just a down right ripoff.
 
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