Dental Doomsday.

[valkairon]

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"You get out and think you're gonna be a rich dentist. You're half right, you'll be a dentist"

"We have lost our profession and I don't like it. I don't like it and it's not gonna stop."

These are the things I kept hearing from dentists at the midwinter meeting these past few days. It's not very reassuring to a first year dental student going to one of the most expensive schools out there... Anyone here disagree? Anyone want to validate my career choice? Or were they right to disabuse me of the idea that I'll have a bright future?

 

[Cello]

Well, I'm not a practicing dentist, in fact I haven't even applied to dental school yet, but here are my two cents.

When you graduate, you won't be a rich dentist. You'll be a dentist with a large debt burden, and you may even struggle to find a rewarding job. But, that's true of most professions, and that doesn't mean it will be like this forever. Eventually you'll pay off your student loans, you'll make a good living, and you'll have increasing autonomy. No one knows for certain what things will be like 20 years from now, but that's true of any career path.

I don't think you can expect to be wealthy straight out of school in ANY profession. Not medicine, dentistry, finance, engineering, aviation, politics, or anything else. Anything that's worthwhile takes time, and the rewards may not be apparent at first, but you'll get there someday.

As far as "losing our profession" goes, I can only speculate, but was this speaker perhaps referring to corporate dentistry? The way I see corporate dentistry is like this. There are lots of corporate restaurants out there, and yet there are still some amazing single-owner restaurants thriving out there. Their secret to success is usually a combination of good service, good food, reasonable prices, etc. It's possible to compete with corporations, there are plenty of businesses which do so every day. Just be glad Walmart hasn't gotten into the dentistry business... yet.

 

[UCSFx2017]

I don't know but reading DentalTown didn't help.

I was checking out DT a few hours ago and the posts there kind of made me want to pursue Medicine and become a salaried physician/surgeon.

There are some really grumpy dentists out there. There was a lot of gripe about running a business, dealing with employees as a boss, and suffering through some really nit-picky, hard-to-please, "hate-going-to-the-dentist"-type, patients. Not only do you have to be a good dentist but you have to be a really good manager, employer, and entrepreneur. I wish I could just focus on doing my "job" right. As a predent having just finished this application cycle, I got all worked up about the dentistry aspect and totally forgot about the incredibly significant role as a business owner.

 

[DentinBond]

running a business -- being in command of my own destiny
dealing with employees as a boss -- having the scarce honor of leading people
suffering through some really nit-picky, hard-to-please patients -- making a difference for someone who deep down inside is just scared out of their wits

And so on. It's all how you look at it, chaps. And what's in the mirror has more influence than anything else.

(Oh, and yes of course, some hard-to-please patients are just plain mean. Those? I fire them.)

 

[UCSFx2017]

running a business -- being in command of my own destiny
dealing with employees as a boss -- having the scarce honor of leading people
suffering through some really nit-picky, hard-to-please patients -- making a difference for someone who deep down inside is just scared out of their wits

And so on. It's all how you look at it, chaps. And what's in the mirror has more influence than anything else.

(Oh, and yes of course, some hard-to-please patients are just plain mean. Those? I fire them.)

👍👍 Awesome.

 

[jmh018]

I want some clarification on what the people who are complaining about dentists not being "rich" mean exactly. It may very well be true but I just want to get an idea.

What is rich to you? $200,000 a year? $350,000 a year? Living extravagantly like a doctor with a well paid specialty like radiologist or something else?

Or do people mean that dentistry can no longer be a comfortable lifestyle that supports a family as a single income and allows for a nice retirement fund in the Midwest where things are less expensive?

I know a dentist, who is in his own practice with no other dentists or associates, who does very very little advertising has a great house and several kids in college which he pays for. He is also the only source of income. What I'm getting at is he by no means is one of those intense businessmen you hear about that make bank with investing and running a super busy office but he is still very well off.

Is the problem that people overestimate what "rich" is?

 

[Shunwei]

Like I said before in one of my posts, people who hate dentistry tend to be those who have minimal or no real life experiences and don't know how hard most other professions can be. Dentists still do very well depending on your location (of course, unless you absolutely must practice in CA like so many posters here) and the profession as a whole is not going under the regulations of socialized medicine. Dentists can still have the pride of ownership, not being on call like medical doctors, and engage in a healthcare field mostly devoid of high liability stuff (unless you are in OS). The main concern in the field on where I stand is the supply-demand situation with the increasing schools and the midlevel providers/international dentist recognition, but fortunately the latter two are restricted to a few states. My advice: go to a cheap school, practice in an unsaturated location, and you should still come out pretty well.

 

[jwdent]

Great, another Dental Doomsday thread. As if no other profession besides dentistry faces problems or obstacles in the future. Shunwei brings up a great point about not knowing how hard other professions can be. I often hear other people in other professions talk about how dentistry is a great career, and some say they wished they had chosen the profession. Also, minimized your debt. The fact that so many people are willing to pay $350000+ for a dental education says something. I personally do not think the degree is worth amassing that much debt, I do not think any degree is.

 

[jmh018]

The OP goes to an expensive private school so that means he/she will have >$400,000 in debt once he/she graduates. That also means >$6,000 in monthly loan repayment under a 10-year plan. Since >$6,000 a month is equivalent to >$72,000 a year, the OP will likely opt for a 30-year repayment plan unless he/she increases his/her efficiency and opens his/her own practice. If he/she chooses to continue on the 30-year plan, which no one should do, the OP will have paid >$900,000 in loan repayment. (Look at my thread on calculating loan repayment).

For your first few years out of dental school, an awesome salary is going to be >$90,000. Let's say it were $120,000 (unlikely). Depending on your state, your total taxes (Federal and State) would be $33,545.50 for Virginia. Under a 10-year repayment plan, you would be paying >$75,000 a year. Add these up and you get a loss of $109,495.50 per year. With a $120,000 salary, you're left with $10,505.50 to live off on. It's unlikely that someone would live off of such a low take home amount so you can assume that they'd opt for a 30-year plan until they increase their salary and then refinance to a 10-year plan. You would make less than a lot of highly-educated people if you went to a private dental school and if you tried to pay it off on a 10-year schedule.

I think there's a lot of options for these newly graduates from private dental schools. There's income-based repayment (it could be an awesome deal), National Health Service Corps., and unfortunately dental chains that pay reasonably high (I'm shaking my head at how expensive dental schools have caused newly grads. to seek employment at some of these unscrupulous chains).

How to make a nightmare come true:
1. Make more private dental schools
2. Increase class sizes
3. Increase number of highly indebted graduates subjected to loans
4. Have newly graduated dentists face a poor job market
5. Create pressure for newly grads. wanting a high paying job in order to pay off loans
6. Open more dental chains
7. Chains employ desperate newly grads.
8. Chains gain profit and open more offices
9. Chains replace traditional dental offices

Luckily, I was accepted to my state school and am married so my wife will be able to work to cover living costs and much more until we have children. After all that, I am looking at around 180,000-200,000 in debt depending on how things go. Not all that bad of a prospect considering what others have to go through with dental school debt.

Wouldn't it be a good idea to plan repayments for over 20 years with the intention of making higher payments once you are more established and successful so you can survive the first few years but still pay everything off in less than 20 years?

 

[UCSFx2017]

Luckily, I was accepted to my state school and am married so my wife will be able to work to cover living costs and much more until we have children. After all that, I am looking at around 180,000-200,000 in debt depending on how things go. Not all that bad of a prospect considering what others have to go through with dental school debt.

Wouldn't it be a good idea to plan repayments for over 20 years with the intention of making higher payments once you are more established and successful so you can survive the first few years but still pay everything off in less than 20 years?

Yes. I think I mentioned refinancing from 30-years down to 10-years once your output increases. You probably know more than me. I did not know you could finance at 20 years.

 

[jmh018]

I actually don't know anything about loan repayment. I just said 20 years for a "longer than 10 years" kind of thing Thanks for your help. Very informative.

 

[suarez 7]

Yes. I think I mentioned refinancing from 30-years down to 10-years once your output increases. You probably know more than me. I did not know you could finance at 20 years.

You can finance whatever term-period you want. If you setup a 20, or 30 year program doesn't mean you're tied into it. If you are at your 10th year on a 20 year program, you can technically finish your loan payments at year 12 if you wanted to... just deposit a larger payment on your loan balance.
The thing with government student loans is that you can pretty much finance and pay what ever you'd like, thanks to Obama's new IBR and Pay-As-You-Earn strategies. I call it sweeping garbage under a rug, since it doesn't really solve the issues of education costs.

 

[UCSFx2017]

You can finance whatever term-period you want. If you setup a 20, or 30 year program doesn't mean you're tied into it. If you are at your 10th year on a 20 year program, you can technically finish your loan payments at year 12 if you wanted to... just deposit a larger payment on your loan balance.
The thing with government student loans is that you can pretty much finance and pay what ever you'd like, thanks to Obama's new IBR and Pay-As-You-Earn strategies. I call it sweeping garbage under a rug, since it doesn't really solve the issues of education costs.

Awesome! I guess lax financial repayment schedules are what you get for paying the high Federal interest loan rates over private.

IBR seems like a great loophole...smh

 

[Sublimazing]

Awesome! I guess lax financial repayment schedules are what you get for paying the high Federal interest loan rates over private.

IBR seems like a great loophole...smh

Can you explain how you see it as a loophole? It takes 25 years of ibr to be forgiven... In 6-8 years youll be making too much to qualify...if i understand it correctly

Thanks

 

[UCSFx2017]

Can you explain how you see it as a loophole? It takes 25 years of ibr to be forgiven... In 6-8 years youll be making too much to qualify...if i understand it correctly

Thanks

http://newamerica.net/publications/policy/safety_net_or_windfall

http://www.nasfaa.org/research/News...enefits_High-Income,_High-Debt_Borrowers.aspx

http://www.fastweb.com/nfs/fastweb/static/PDFs/Med_school_loan_forgiveness_loophole.pdf

Play around with this calculator to see if you qualify. I was playing around with my situation and the maximum gross salary that was acceptable for IBR was ~$380,000 with a repayment at $4,541/month which sucks for an OMFS such as yourself.

http://studentaid.ed.gov/repay-loans/understand/plans/income-based/calculator

Now if you were a GP grossing $120,000 and you went to UPenn and took out $400,000 in loans, you would pay $1,291/month which after 20 years is $309,840. The U.S. Government covers the remaining $190,160. If you took out only $328,000 in loans, you would still pay $1,291 which after 20 years is again $308,840 but you only save $19,160 more than taking out $400,000. But still you are much better off than not doing IBR. If you tried to pay off $328,000 in ten years w/o IBR, you would pay $600,000. You're saving >$300,000 by doing IBR! That's a big loophole.

The problem gets worse now that Obama decreased the rate from 15% to 10% and the repayment duration from 25 to 20 years.

Here's how you qualify for partial financial hardship.

http://www.equaljusticeworks.org/sites/default/files/ibr_worksheet_09.pdf

http://www.equaljusticeworks.org/ed-debt/students/income-based-repayment/who-is-eligible

 

[mmmsteakdinners]

http://newamerica.net/publications/policy/safety_net_or_windfall

http://www.nasfaa.org/research/News...enefits_High-Income,_High-Debt_Borrowers.aspx

http://www.fastweb.com/nfs/fastweb/static/PDFs/Med_school_loan_forgiveness_loophole.pdf

Play around with this calculator to see if you qualify. I was playing around with my situation and the maximum gross salary that was acceptable for IBR was ~$380,000 with a repayment at $4,541/month which sucks for an OMFS such as yourself.

http://studentaid.ed.gov/repay-loans/understand/plans/income-based/calculator

Now if you were a GP grossing $120,000 and you went to UPenn and took out $400,000 in loans, you would pay $1,291/month which after 20 years is $309,840. The U.S. Government covers the remaining $190,160. If you took out only $328,000 in loans, you would still pay $1,291 which after 20 years is again $308,840 but you only save $19,160 more than taking out $400,000. But still you are much better off than not doing IBR. If you tried to pay off $328,000 in ten years w/o IBR, you would pay $600,000. You're saving >$300,000 by doing IBR! That's a big loophole.

The problem gets worse now that Obama decreased the rate from 15% to 10% and the repayment duration from 25 to 20 years.

Here's how you qualify for partial financial hardship.

http://www.equaljusticeworks.org/sites/default/files/ibr_worksheet_09.pdf

http://www.equaljusticeworks.org/ed-debt/students/income-based-repayment/who-is-eligible

I wouldn't get too excited yet. You will not be making only 120K after 20 years in the field. Does this also affect your ability to go out and take on more debt for a practice?

 

[tingting]

http://newamerica.net/publications/policy/safety_net_or_windfall

http://www.nasfaa.org/research/News...enefits_High-Income,_High-Debt_Borrowers.aspx

http://www.fastweb.com/nfs/fastweb/static/PDFs/Med_school_loan_forgiveness_loophole.pdf

Play around with this calculator to see if you qualify. I was playing around with my situation and the maximum gross salary that was acceptable for IBR was ~$380,000 with a repayment at $4,541/month which sucks for an OMFS such as yourself.

http://studentaid.ed.gov/repay-loans/understand/plans/income-based/calculator

Now if you were a GP grossing $120,000 and you went to UPenn and took out $400,000 in loans, you would pay $1,291/month which after 20 years is $309,840. The U.S. Government covers the remaining $190,160. If you took out only $328,000 in loans, you would still pay $1,291 which after 20 years is again $308,840 but you only save $19,160 more than taking out $400,000. But still you are much better off than not doing IBR. If you tried to pay off $328,000 in ten years w/o IBR, you would pay $600,000. You're saving >$300,000 by doing IBR! That's a big loophole.

The problem gets worse now that Obama decreased the rate from 15% to 10% and the repayment duration from 25 to 20 years.

Here's how you qualify for partial financial hardship.

http://www.equaljusticeworks.org/sites/default/files/ibr_worksheet_09.pdf

http://www.equaljusticeworks.org/ed-debt/students/income-based-repayment/who-is-eligible

One thing you need to realize is that the portion forgiven after 20 years is treated as taxable income. Since it is lopped on top of your regular income for that year, you will be paying tax on it at a very high marginal tax rate. I would expect taxes to be even higher in 20 years than they are now with our fiscal situation. Better be prepared to pay back 40+% of the "forgiven" sum to the IRS. Might need more loans for that.

 

[UCSFx2017]

One thing you need to realize is that the portion forgiven after 20 years is treated as taxable income. Since it is lopped on top of your regular income for that year, you will be paying tax on it at a very high marginal tax rate. I would expect taxes to be even higher in 20 years than they are now with our fiscal situation. Better be prepared to pay back 40+% of the "forgiven" sum to the IRS. Might need more loans for that.

This is a headache. Well I guess I'll be okay since I'm choosing my state school...

This still sounds better than paying this off the normal route on the 20-year plan with a total payment of over $600,000 within 10-years or $918,000 within 30-years.

 

[ryansgs]

"You get out and think you're gonna be a rich dentist. You're half right, you'll be a dentist"

"We have lost our profession and I don't like it. I don't like it and it's not gonna stop."

These are the things I kept hearing from dentists at the midwinter meeting these past few days. It's not very reassuring to a first year dental student going to one of the most expensive schools out there... Anyone here disagree? Anyone want to validate my career choice? Or were they right to disabuse me of the idea that I'll have a bright future?

Since when are dentists considered rich? Rich is upper class. General dentist (associate or owner of 1 office w/ no side projects) is at best upper middle class. Well-off but hardly rich.

I'm not going into dental to be rich. I'm going into it because of the good hours and the good pay. Leaving me plenty of time to be with my future family. Also working with your hands is far better than shuffling paper all day.

If you want to be a rich dentist you'll have to do one or more of these things. Specialize into the right field. Run one above-average sized office efficiently. Run multiple offices. Or have other side projects such as real estate, stocks or other something else.

Being a dentist alone wont make you rich. Investing the money you earn from being a dentist into side projects is what will make you rich. That is of course if you're business savvy, that you know what you're doing.

The future is bright, if you can adapt to the changing environment.

running a business -- being in command of my own destiny
dealing with employees as a boss -- having the scarce honor of leading people
suffering through some really nit-picky, hard-to-please patients -- making a difference for someone who deep down inside is just scared out of their wits

And so on. It's all how you look at it, chaps. And what's in the mirror has more influence than anything else.

(Oh, and yes of course, some hard-to-please patients are just plain mean. Those? I fire them.)

Right on. 👍

 

[DentinBond]

The future is bright, if you can adapt to the changing environment.:

👍👍