Current Dentists: Is this career still worth pursuing for the money?

[Cold Front]

I notice that a lot of people get married before or during dental school, which to me is crazy early. I personally can't even imagine myself being married till I'm atleast 40.

To quote the fictional Marvel character King T’Chaka from the movie Black Panther - “The World is Changing”.

There are many many many things society expects from people under the age 40 today. Go to school, go to grad school, get married, have kids, own a home, if you are a dentist - own your own practice, save early, travel while you are young, and don’t get sick or fall behind. Like you said, everyone’s situation is different. I didn’t graduate from dental school until I was 32. Some students in my class graduated at age 23. I was ready for the real world as a dentist than those in their early 20’s. My point is - looking at the big picture, being married at 25, 30, or even 40 gets easier with older age from personal development standpoint. People married in their early 20’s just few decades ago, now it’s their early 30’s. I honestly believe the future of marriage age will be closer to 40’s - because delays are happening due to economic and personal terms reasons.

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[DaviBR]

I'm a Dental Student in Brazil. Here, we have an gorvenament program called ProUni, that offers 100% scholarships for people who can't afford going to college. I'm on my 2nd year of Dental School here. The only cost are the real expasive instrumentals that we have to buy. And even that I'll have 0 loan debts after graduating, I'm still not convincing of Dentristy. It's an satuared area in Brazil and everything is so expansive. The only way that I see to get a future is to move to an rural area, like you guys has been saying or get another scholarship for an OMFS residency, so I cant specialize. I always had that doubt about scholarships on US, how hard is to get one? I've never read about anyone on Dentristy field that will not have to pay loan debts, which seems to be the main problem.

 

[FutureDent020]

I've never read about anyone on Dentristy field that will not have to pay loan debts, which seems to be the main problem.

I went to a private school that was $60K/ year tuition. 100 people in my class. 10 people including myself received the HPSP (military scholarship that pays for school and a $2,000/ month stipend). I personally know 3 people who were fortunate enough to have their parents pay their tuition. There may have been more although I wouldn’t assume it. So right there, you have over 10% of my class with no dental school student debt. It exists, but as the percentages show, it’s not common.

 

[deleted634258]

A lot of talk about the salary of hygienists and assistants. Why not bring those down or let assistants actually do a little more? In many countries they have a 'prevention-assistant' who actually does a lot of cleanings, given the pockets aren't too deep (more than 6mm where I live). Then you also wouldn't need as many hygienists. This could be a double-edged sword because maybe reimbursements would go down.

I don't really want to get too political, but I do have a few questions for you guys.

1. Do you guys think that this talk about medicare for all could also benefit dentistry in a way?
2. Would you guys support a type of numerus fixus for dental students, just like there are for medical students due to their required residencies?
3. Numerous presidential candidates have plans to relieve students of their debt to a certain degree. Do you think that you would look differently at the profession if this were to be enacted?
4. The dentist to patient ratio on a national level is actually a healthy one. Isn't the problem really maldistribution and not necessarily saturation on a national level?

 

[deleted634258]

I actually think we are mostly in agreement. Dental School tuition is exceeding inflation, I think it increases 5% per year. Whereas dental income is falling behind, I think it is actually decreasing based on ADA stats.

But from my perspective as a student, most people won't do dentistry in the future. At some point dental school will cost $1 million+, and trying to pay that off on $150k a year (or less since dental income is decreasing) means that you will have less than 30k to live off of. By 2050, 30k might as well be the new poverty line. Imagine that, a dentist living off of food stamps. Prospective students need to run the calculations taking into account purchasing power of money relative to the time period they will be practicing.

I figure at that point people will stop going to dental school, more people will apply to med school. Med school has lower debt and higher income, and the income trends are up for most specialties and primary care. Dentists might have to stop accepting insurance just to make enough profit on procedures to clear overhead, if it's really as bad as you describe it. Due to inflation rent will go up, cost of supplies will go up, staff salaries will go up and if reimbursements go down then the practice can't run.

But I guess my point was that there is usually always a solution to these types of problems. I'm sure dentistry will be fine in the long run, but from where I'm looking as a student, right now medicine definitely seems like a more secure route. I haven't jumped ship yet but it's crossed my mind.
For all you 4.0 studs out there, run the numbers and keep an open mind.

I think income for medical specialists and primary care physicians is somewhat on par with what many dentists or dental specialists make. It also really depends on the specialty. Also, I don't see more people going into medical school, simply because there are residency requirements and there aren't endless residency spots. That's why I was suggesting that maybe if dental residencies become mandatory (and compensated), we would be producing less dentists. Maybe this is stupid or ignorant of me to say, but I just don't think that our profession is taken that seriously. Maybe the ADA needs better lobbyists.

 

[BoolaHI]

Hmmmn, just as point of context relative to medicine, my daughter does locums work as a critical care doc, so a little above in this string, there was mention of an orthodontist, getting a flat rate of $1400 a day, —my daughter does a three day gig, twice a month, and is paid about 7,000 for each three day period or about 2300 a day, plus they cover travel and lodging costs. 1400 is nothing to sneeze at, but it does really reflect the disparity in compensation between the two related professions.

 

[Anondds87]

Hmmmn, just as point of context relative to medicine, my daughter does locums work as a critical care doc, so a little above in this string, there was mention of an orthodontist, getting a flat rate of $1400 a day, —my daughter does a three day gig, twice a month, and is paid about 7,000 for each three day period or about 2300 a day, plus they cover travel and lodging costs. 1400 is nothing to sneeze at, but it does really reflect the disparity in compensation between the two related professions.

How many hours is she having to work during that 3 day period though?

 

[BoolaHI]

It’s night coverage, so it’s basically 8pm to 8am. From what she says, 75% of the time, she is up the entire time, and the other 25%, she gets 2-3 hours sleep.

 

[Anondds87]

It’s night coverage, so it’s basically 8pm to 8am. From what she says, 75% of the time, she is up the entire time, and the other 25%, she gets 2-3 hours sleep.

Sounds like a pretty good deal. Does this sort of thing exist in dentistry at all? I mean where you can do night shifts for higher pay?

 

[BoolaHI]

I’m not sure....I think the nature of dentistry and medicine are different in that way, as medicine always has some form of overnight coverage. I’m sure some of the folks here on this board are much more versed and knowledgeable—I just know the medicine part because of my wife and daughter (tho the other daughter is applying this year to dental school).

 

[Anondds87]

I’m not sure....I think the nature of dentistry and medicine are different in that way, as medicine always has some form of overnight coverage. I’m sure some of the folks here on this board are much more versed and knowledgeable—I just know the medicine part because of my wife and daughter (tho the other daughter is applying this year to dental school).

Do you still encourage your daughter to pursue dentistry with the current debt levels associated with tuition?

 

[BoolaHI]

Yeah, but I would not want to speak for others, as our family is in a different situation. The costs are profoundly large, but she made a prudent choice when she entered college and took a full scholarship from UCLA and forgo attending an Ivy—because of that, we were able to save her 529 account (CA college savings account) and put more into it and apply it to dental school. It’s not going to cover everything, but likely about half her costs. That said, I would think long and hard if someone had to swallow the entire costs of a dental school, which could easily be 400k-plus. It really limits your options, and well, the next 20 years of your life. In her case, she might end up owing a little north of 100k, so she has some flex...

 

[ToothJockey]

I think income for medical specialists and primary care physicians is somewhat on par with what many dentists or dental specialists make. It also really depends on the specialty. Also, I don't see more people going into medical school, simply because there are residency requirements and there aren't endless residency spots. That's why I was suggesting that maybe if dental residencies become mandatory (and compensated), we would be producing less dentists. Maybe this is stupid or ignorant of me to say, but I just don't think that our profession is taken that seriously. Maybe the ADA needs better lobbyists.

If you go by MGMA rather than Medscape, and most docs say that MGMA is more accurate, then the average Medical Specialist makes about 420K and the average Primary Care doc makes around 250k. Compare that to Dentistry I think going by ADA the average specialist makes around 320k and the average GP (owner and associate combined) makes around 180k.

I'm not sure how accurate ADA surveys are, maybe more dentists can chime in. But based on ADA vs MGMA on average medical docs do make more than dentists. However the average medical doc also works 50+ hours/week compared to dentists who work on average 36 hrs/week so if you adjust for hours worked the income disparity isn't as great. A dentist/specialist working medicine hours would probably make a similar income. A neurosurgeon making 700k is cool until you realize they work 70 hrs a week, on a 40 hr work week they would be making 400k which honestly isn't that high for someone who went through a 7 year surgical residency.

I agree that dentistry isn't taken seriously enough. I read a paper by ADA that dental expenditures are not increasing as much anymore because dentistry is viewed as a commodity and people are putting off dental work.

 

[BoolaHI]

Just from my family—and our close circle of friends that are physicians— almost all now work for a hospital and have a fairly typical work week of more or less 40 hours as it is primarily shift work. My wife works 5-6 nights in a row, 12 hour shifts, where she receives a night differential of 3 hours a night, and that stretch equals roughly 2 weeks of work. She then has 11-12 days off — so she works in total each month about 12-13 nights. Her salary is north of 400k.

 

[ToothJockey]

Just from my family—and our close circle of friends that are physicians— almost all now work for a hospital and have a fairly typical work week of more or less 40 hours as it is primarily shift work. My wife works 5-6 nights in a row, 12 hour shifts, where she receives a night differential of 3 hours a night, and that stretch equals roughly 2 weeks of work. She then has 11-12 days off — so she works in total each month about 12-13 nights. Her salary is north of 400k.

That's fair, but I was just giving averages. I'm guessing your wife is a hospitalist or EM since you said shift work? Either case she is above average according to MGMA, 75th percentile for EM and above 90th percentile for hospitalist. A 90th percentile dentist will probably have similar income.

Also EM and hospitalists are definitely on the low end of hrs/week, along with specialties like dermatology/psychiatry. 40 hrs/week is normal for those specialties. On the other side you have Ortho/Neurosurgeons or Cardiologists working 60-70 hrs a week.

According to this study, the average physician worked 2500 hrs in a year. The figure shows variation among specialties.

Annual Work Hours Across Physician Specialties

Debate surrounds the relative pay of physicians in various specialties. Several studies have addressed income differences.1 Few, by comparison, have addressed work hours, and we are not aware of any that consider annual work hours. Yet, work hours—independent of income—figure prominently in...

jamanetwork.com

According to ADA dentists work around 1700-1800 hrs a year.

So Physicians work about 1.5 times more than dentists per year and make about 1.5 times as much as dentists on average. I think it's fair game either way you look at it. Physicians don't have to pay for residency, and school is cheaper, but dentists don't have to spend as long in school/residency.

I'm just looking at things objectively here. Don't shoot the messenger.

 

[BoolaHI]

She is a critical care doctor or what is also called an intensivist. And don’t get me wrong, I’m not arguing or even debating, merely given information from my particular situation. Now that might be certainly anecdotal, but from what I know, as she is a partner in her group, the mentioned salary is only slightly above average for that type of practice group.

 

[ToothJockey]

She is a critical care doctor or what is also called an intensivist. And don’t get me wrong, I’m not arguing or even debating, merely given information from my particular situation. Now that might be certainly anecdotal, but from what I know, as she is a partner in her group, the mentioned salary is only slightly above average for that type of practice group.

Oh gotcha, from MGMA apparently average for a critical care doc is just below 400k, so you're right they're paid well compared to EM/Hospitalists. I'm guessing a critical care/intensivist fellowship is pretty competitive, because on the surface it is one of the better gigs in medicine along with dermatology with a 400k income and 40 hr/week. Good for your wife!

 

[BoolaHI]

My wife said about 14 years ago when she completed her sub-fellowship she would put it around 6.5 (out of 10) or mildly competitive. But my daughter who just recent finished the same felllowship about a year ago or so, said it’s now more like a solid 8.