Dental service demand during the outbreak

[TanMan]

Is there a point to doing all this testing while shutting down the economy? Many people are avoiding testing due to the life consequences of testing positive. The big question is how many people are symptomatic, and even more important, how many people are severely symptomatic? If less than 1% of the people are having severe symptoms, 80% are asymptomatic, and the rest have mild symptoms, why not just open everything up and deal with the people with severe symptoms as we go? I think that's where our society may be butting heads, is that 1% (or less) severely symptomatic worth shutting down the economy? It might be for the rich and those that have something to benefit from it.

I wish I had the know-how or invested on making testing kits. I'd probably be saying the same thing that everyone needs to be tested everyday and sell tests to everyone.

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[charlestweed]

A sample size of 20-30 people is not big enough to suggest if the virus is contagious or not. 80% of people are asymptomatic, so all of you could have been infected and asymptomatic.

My wife and I took the seasonal flu shots last fall, and got really sick with a severe flu like symptoms early February (when the pandemic reached the US). My whole staff at both offices got sick as well. Some local schools were closed for few days due to kids and teachers getting sick too. Luckily, we all made it through (from what I know). There was no way to test what virus hit our community. They still don’t know if this virus has multiple strains in different parts of the country - because no community is doing any mass testings.


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That's right, we don't really know much about this new virus...how contagious or how deadly it is. Even the WHO director criticized the president for issuing the China travel ban in late January. Mayor De Blasio and Speaker Pelosi said it's safe to celebrate the Lunar New Year in their towns. Therefore, this should not be the time for finger pointing at who did wrong.....the virus is new and unkown. It's hard to stop the disease when the country, where the virus originated from, didn't give us any warning and still let its people travel to other countries. Since the virus is new and unknown, it will take time for companies to develop and produce the new test kits and vaccine. And even when the new vaccine comes out, the problem will not be solved because like you said, the virus might have multiple strains. People still get the flu every year even when they got the flu shots. I don't think shutting the whole country down is the right solution. In order for our body to naturally produce the antibodies to fight the virus, we have to let ourselves exposed to the virus...instead of trying to stay away from it.

 

[TanMan]

Texas regained their sanity, looks like we're on track for May 1st!

 

[Cold Front]

Texas regained their sanity, looks like we're on track for May 1st!

No surprise there. Red states were always downplaying the virus. Covid19 has now killed more Americans than the Vietnam war - in a matter of 2-3 months, and we are still in the first wave.


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[TanMan]

No surprise there. Red states were always downplaying the virus. Covid19 has now killed more Americans than the Vietnam war - in a matter of 2-3 months, and we are still in the first wave.


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Blue states make it seem like it's the end of the world. If this is seasonal, it'll keep coming wave after wave after wave.

 

[allantois]

There’s a herd, but no immunity

 

[Cold Front]

Blue states make it seem like it's the end of the world. If this is seasonal, it'll keep coming wave after wave after wave.

The south arrived really late for the battle against Covid.

Were you against the lockdown in the first place? If you were, you don’t think a stay-home order made any difference in your community and state? If you were not, what’s the rationale to re-open a state in a hurry after a brief period, which defeats the purpose of closing in the first place?

You acknowledge the crisis, but against the best medical protocols.


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[TanMan]

The south arrived really late for the battle against Covid.

Were you against the lockdown in the first place? If you were, you don’t think a stay-home order made any difference in your community and state? If you were not, what’s the rationale to re-open a state in a hurry after a brief period, which defeats the purpose of closing in the first place?

You acknowledge the crisis, but against the best medical protocols.


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I was against the lockdown and I don't think the stay-at-home order made any difference because no one in my area listened to the stay at home order. In my area, this is just theatrics and opening up is going to get our local economy up and running again. It's a crisis by name. The bigger crisis is the economic crisis on the horizon. I acknowledge the COVID-19 crisis by gearing up against it because the regulatory agencies make me recognize it. If they told me I don't have to wear this ridiculous amount of PPE, I wouldn't.

 

[Cold Front]

I was against the lockdown and I don't think the stay-at-home order made any difference because no one in my area listened to the stay at home order. In my area, this is just theatrics and opening up is going to get our local economy up and running again. It's a crisis by name. The bigger crisis is the economic crisis on the horizon. I acknowledge the COVID-19 crisis by gearing up against it because the regulatory agencies make me recognize it. If they told me I don't have to wear this ridiculous amount of PPE, I wouldn't.

On one hand, you are speaking your mind and standing up/voicing your concerns against the lockdown because you disagree with it. On the other, you are totally conceding to the protocols and “recognizing” the guidelines that come with the lockdown. You seem conflicted about the whole thing; even going both ways on the new PPE guidelines (if yes, then yes! If no, then no!) - that’s a “pure frustration” and careless approach, no offense. Like the people who protest in front of their State House with guns and no face masks - demanding their governor to open their state. They are frustrated too, because of “economy, economy, economy!”. It turns out some of them got infected and even died after they got infected at those protests.

I supported the lockdown and most protocols at about 100%. Both my feet were on one side of this covid street, and I’m not bothered by any of the guidelines and stay home orders. More PPE’s? Yes to more precautions! I grew up broke and all I ever had was my “health” growing up, the real “wealth”. Money comes and goes, but a single “life” can never be replenished.

These viewpoints are first world problems, and even more unique to the US.


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[TanMan]

On one hand, you are speaking your mind and standing up/voicing your concerns against the lockdown because you disagree with it. On the other, you are totally conceding to the protocols and “recognizing” the guidelines that come with the lockdown. You seem conflicted about the whole thing; even going both ways on the new PPE guidelines (if yes, then yes! If no, then no!) - that’s a “pure frustration” and careless approach, no offense. Like the people who protest in front of their State House with guns and no face masks - demanding their governor to open their state. They are frustrated too, because of “economy, economy, economy!”. It turns out some of them got infected and even died after they got infected at those protests.

I supported the lockdown and most protocols at about 100%. Both my feet were on one side of this covid street, and I’m not bothered by any of the guidelines and stay home orders. More PPE’s? Yes to more precautions! I grew up broke and all I ever had was my “health” growing up, the real “wealth”. Money comes and goes, but a single “life” can never be replenished.

These viewpoints are first world problems, and even more unique to the US.


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I have to do what I'm told because it is the state/government that grants me the power to practice dentistry. That doesn't mean I agree with what I'm told to do, but I'll do it anyway. It's not careless, it's forced. Just like I'm not obligated to pay anymore tax than I'm legally obligated to, my stance is that I will comply, but if you reduce the requirements for compliance, I will reduce them within the letter of the law while looking at my risk management.

As much as we want to celebrate the importance of one life, the cost of one life shouldn't affect millions of people. We are lucky that our businesses survive through this event, but there are real people out there, particularly small business owners, that will lose their livelihood because of these restrictions. As much as we can profit off these suffering individuals and as such, is the cycle of business life, it's not something I purposefully wish upon others. I can stick to my ivory tower and say, hey, everyone stay at home, let your businesses go to ****, the government has your back and will support you, etc... but I still think this is an overreaction. I may come to eat my words someday, but as of now, I think that the economic sacrifices made are too great.

 

[Cold Front]

I have to do what I'm told because it is the state/government that grants me the power to practice dentistry. That doesn't mean I agree with what I'm told to do, but I'll do it anyway. It's not careless, it's forced. Just like I'm not obligated to pay anymore tax than I'm legally obligated to, my stance is that I will comply, but if you reduce the requirements for compliance, I will reduce them within the letter of the law while looking at my risk management.

As much as we want to celebrate the importance of one life, the cost of one life shouldn't affect millions of people. We are lucky that our businesses survive through this event, but there are real people out there, particularly small business owners, that will lose their livelihood because of these restrictions. As much as we can profit off these suffering individuals and as such, is the cycle of business life, it's not something I purposefully wish upon others. I can stick to my ivory tower and say, hey, everyone stay at home, let your businesses go to ****, the government has your back and will support you, etc... but I still think this is an overreaction. I may come to eat my words someday, but as of now, I think that the economic sacrifices made are too great.

I totally agree that there will be economic consequences, but that is already a forgone conclusion. I never ignored the economic red flags you mentioned; all these money being printed by government, digging ourselves into more debt, businesses closing for good, and so on.

The scale of deaths from covid is also underreported. The scale of this crisis will be understood in retrospect, both in lives and in economic impact.

We are just at the tip of the iceberg, with a lot of associated fallout remains unknown and hidden from view at this point.


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[TanMan]

Today was the first day of partial freedom... and I gotta say, I'm optimistic about the future. From seeing hygiene patients to going to Costco, rush hour is back! Even Lowes and the mall were packed! Seeing people happy to go out for the longest time to not being scared to death of being closer than 6 feet from one another... and people even happy/appreciative to get their prophies.

 

[Cold Front]

Today was the first day of partial freedom... and I gotta say, I'm optimistic about the future. From seeing hygiene patients to going to Costco, rush hour is back! Even Lowes and the mall were packed! Seeing people happy to go out for the longest time to not being scared to death of being closer than 6 feet from one another... and people even happy/appreciative to get their prophies.

I will do the “wait and see” approach until June 1st.

I got the PPP loan for each office and will spend the entire month of May on how to get it forgiven (free 6-figure money at the end). Weather is finally nice up north, time to go for outdoor runs and do more staycation. Will definitely have some popcorn around if coronavirus strikes back against the states that re-opened.


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[setdoc7]

May I ask where you get this diversified income stream? Is it through investing in the stock market, investing in rental properties or investing in commercial buildings?

All of the above. And gold is up 33%. I also own a business in the film/tv field.

 

[2TH MVR]

I've been furloughed for a month now. Earliest for me to start work again would be the 20th of May, but even that date is tenuous. Applied for unemployment. If I read the information correctly ... I'll be getting $240 per week less fed and state taxes. Yippee. Never applied for unemployment benefits. Never been furloughed. Never had this much time off. According to my wife ... if this goes on much further ... she's moving out since I'm driving her crazy.

Thank goodness Arizona considered GOLF an essential business. Social distancing when you pay for the golf round. No food. One person per cart. No ball washers. No H2O dispensers. Can't take the flag out. They placed plastic inserts into the holes to prevent the ball going down to prevent excess hand contact to get your ball out. I bring wipes and sanitizer and fully wipe the cart down in those areas that maybe touched. Gotta go. Tee time in 1 hour with some friends. Not making light of this situation. I do feel bad for those families that have been impacted both health wise and financially. But I'm not going to just sit around and do nothing. I'm trying to enjoy this time off.

Could be worse. I could live in CA and wouldn't be allowed to go to the beach.

 

[AONLINE]

Applied for unemployment. If I read the information correctly ... I'll be getting $240 per week less fed and state taxes. Yippee.

You should get $600/wk on top of that until the last week of July, so actually $840/wk.

 

[TanMan]

For dentists watching the Texas reopening, I've got good news for you... demand is strong and looks to be strong for at least the next two months. I'm surprised in the massive surge in demand for general dentistry services and we've even had to get a 4th hygienist to keep up. We are seriously looking into expanding our office now, if the trends keep up. All you need to do is make sure you can secure enough of the appropriate PPE required by your state.

Anyway, good luck and see you on the other side of the government lockdown!

 

[mmc12]

For dentists watching the Texas reopening, I've got good news for you... demand is strong and looks to be strong for at least the next two months. I'm surprised in the massive surge in demand for general dentistry services and we've even had to get a 4th hygienist to keep up. We are seriously looking into expanding our office now, if the trends keep up. All you need to do is make sure you can secure enough of the appropriate PPE required by your state.

Anyway, good luck and see you on the other side of the government lockdown!

Does the fact that so many people no longer have jobs and thus dental insurance affect anything?

If demand is so high, shouldn’t it be easy for graduating dental s

 

[TanMan]

Does the fact that so many people no longer have jobs and thus dental insurance affect anything?

If demand is so high, shouldn’t it be easy for graduating dental s

A lot of people still have jobs and we're getting a huge uptick of cash patients too. I think that it might be easier for graduating dental students as long as they aren't picky/fussy about where they work or the working conditions like some hygienists. New grads may also find themselves replacing hygienists, as the drama ensues. It may not be the title that you want, but it's still a job. Also, a lot of older dentists are looking into cutting back or retiring altogether for fear of their mortality, so that's an added bonus for new grads. Worst case scenario for older dentists is that they die from the virus and frees up another slot for an aspiring new grad. Either way, it should be a boon for new grads or those looking to buy an office.

 

[deleted972255]

A lot of people still have jobs and we're getting a huge uptick of cash patients too. I think that it might be easier for graduating dental students as long as they aren't picky/fussy about where they work or the working conditions like some hygienists. New grads may also find themselves replacing hygienists, as the drama ensues. It may not be the title that you want, but it's still a job. Also, a lot of older dentists are looking into cutting back or retiring altogether for fear of their mortality, so that's an added bonus for new grads. Worst case scenario for older dentists is that they die from the virus and frees up another slot for an aspiring new grad. Either way, it should be a boon for new grads or those looking to buy an office.

Things are not getting better with regard to the pandemic. See below:

Models Project Sharp Rise in Deaths as States Reopen (Published 2020)

An internal Trump administration report expects about 200,000 daily cases by June. The White House bars coronavirus task force officials from testifying to Congress without approval.

www.nytimes.com

Former FDA commissioner warns of new fall epidemic amid 'persistent spread'

If "you have this slow burn of infection, it can ignite at any time," Former FDA Commissioner Scott Gottlieb warned.

www.politico.com

Additionally, the way you talk about other people dying as if it is nothing is alarming. "Worst case scenario for older dentists is that they die from the virus and frees up another slot for an aspiring new grad." I bet you wouldn't be saying that if that older person were your father or mother. Very inconsiderate.

 

[TanMan]

Things are not getting better with regard to the pandemic. See below:

Models Project Sharp Rise in Deaths as States Reopen (Published 2020)

An internal Trump administration report expects about 200,000 daily cases by June. The White House bars coronavirus task force officials from testifying to Congress without approval.

www.nytimes.com

Former FDA commissioner warns of new fall epidemic amid 'persistent spread'

If "you have this slow burn of infection, it can ignite at any time," Former FDA Commissioner Scott Gottlieb warned.

www.politico.com

Additionally, the way you talk about other people dying as if it is nothing is alarming. "Worst case scenario for older dentists is that they die from the virus and frees up another slot for an aspiring new grad." I bet you wouldn't be saying that if that older person were your father or mother. Very inconsiderate.

The truth is not pleasant to hear, but it's an objective way of looking at things. I'd rather be direct about it than dance around the subject. The faster we can accept certain truths, the faster we can move on with our lives.

 

[Cold Front]

Things are not getting better with regard to the pandemic. See below:

Models Project Sharp Rise in Deaths as States Reopen (Published 2020)

An internal Trump administration report expects about 200,000 daily cases by June. The White House bars coronavirus task force officials from testifying to Congress without approval.

www.nytimes.com

Former FDA commissioner warns of new fall epidemic amid 'persistent spread'

If "you have this slow burn of infection, it can ignite at any time," Former FDA Commissioner Scott Gottlieb warned.

www.politico.com

Additionally, the way you talk about other people dying as if it is nothing is alarming. "Worst case scenario for older dentists is that they die from the virus and frees up another slot for an aspiring new grad." I bet you wouldn't be saying that if that older person were your father or mother. Very inconsiderate.

I agree. Lives > economy. Not everyone values lives like we do. Makes you wonder how does one even become a doctor with a mindset like that.

Also, I was watching 60 minutes on CBS last night. 1 in 5 Texans are uninsured and majority live in rural areas. The state ranked bottom in testing. It was really sad watching how Texas many hospitals are closing and going under, with the lack of shortage of doctors and funding. They are highly vulnerable and short of resources there. There are few people who don’t understand that the entire healthcare system in this country is under a threat under covid. There are no financial backstops for issues that we ignored for years. We can print money and try to fix issues, but even that won’t be enough.

Let’s see what happens in Texas in the coming weeks with all their “Let’s all go back to work” and “but we don’t have enough hospitals and testings” at the same time.


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[Molar Whisperer]

I agree. Lives > economy. Not everyone values lives like we do. Makes you wonder how does one even become a doctor with a mindset like that.

Also, I was watching 60 minutes on CBS last night. 1 in 5 Texans are uninsured and majority live in rural areas. The state ranked bottom in testing. It was really sad watching how Texas many hospitals are closing and going under, with the lack of shortage of doctors and funding. They are highly vulnerable and short of resources there. There are few people who don’t understand that the entire healthcare system in this country is under a threat under covid. There are no financial backstops for issues that we ignored for years. We can print money and try to fix issues, but even that won’t be enough.

Let’s see what happens in Texas in the coming weeks with all their “Let’s all go back to work” and “but we don’t have enough hospitals and testings” at the same time.


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My sister practices in Texas. The state is very economically driven and has very low taxes except for property. With no state income tax and fairly low sales taxes, the rich are very rich and the poor are very poor with little state funding. Their high and prohibitive property taxes keeps the poor out of the desirable rich areas. Many rich areas are like the new Beverly Hills with people showing off their wealth.

 

[charlestweed]

A lot of people still have jobs and we're getting a huge uptick of cash patients too. I think that it might be easier for graduating dental students as long as they aren't picky/fussy about where they work or the working conditions like some hygienists. New grads may also find themselves replacing hygienists, as the drama ensues. It may not be the title that you want, but it's still a job. Also, a lot of older dentists are looking into cutting back or retiring altogether for fear of their mortality, so that's an added bonus for new grads. Worst case scenario for older dentists is that they die from the virus and frees up another slot for an aspiring new grad. Either way, it should be a boon for new grads or those looking to buy an office.

My GP friend, whom I rent an office space from, also wants to stay home longer because he is afraid of getting the virus. Another GP friend of mine also has the same fear and wants to stay home longer. Both are not that old.....around my age (late 40s, early 50s). They are currently receiving the unemployment benefit.

Earlier this morning, I drove my wife to work at a GP office....only half a day from 8am-11am. This is her first day back since the shutdown. She did 3 crown lengthenings in less than 3 hours. According to her GP boss, who also works there this morning, his in-house endodontist has treated emergency endo patients every day since the shutdown. Before the shutdown, this endodontist only worked there 1 day/week. The in-house OS has also come in a few days (but not as many days as before) to perform the "essential" procedures. My wife will come back to work at this office again on May 18th and it will be a fully booked 8-hour day.

I plan to reopen my ortho offices next week to treat patients who have loose bands/brackets that cause gingival inflammation and other ortho emergencies. I have to create work for my P/T employees since they keep asking me when they will be able to come back to work. Our governor hasn't said anything......he ordered to close all public beaches last weekend...so it'll probably be awhile.

 

[Cold Front]

My sister practices in Texas. The state is very economically driven and has very low taxes except for property. With no state income tax and fairly low sales taxes, the rich are very rich and the poor are very poor with little state funding. Their high and prohibitive property taxes keeps the poor out of the desirable rich areas. Many rich areas are like the new Beverly Hills with people showing off their wealth.

Yes. A lot of my classmates from the northeast moved to Texas after D school. They are doing well for themselves and paying less taxes. Here in Ohio, there is no state income tax for the first $250k. 40% of our state budget goes toward Medicaid. Most Ohioans are mostly from or have German ancestors - and care about the society’s socioeconomic as a whole, not the rich vs the poor BS. People here are well balanced; old, young, poor, students, political, non political, religious, non religious, etc. We really pay attention to the safety nets and have good social programs.

Ohio was one of the first states to lockdown it’s economy 2 months ago, and we are still in lockdown for the most part. We have a Republican Governor, but is well supported by everyone (for the most part) for how he handled the pandemic. We had some knucklehead protestors who brought guns and their kids (instead of face masks) to the state house - with “open Ohio!” signs, and the governor responded with “I give 0 F’s about those people”. I doubt most governors can be pushed around like that to take public health risks.


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[Molar Whisperer]

Yes. A lot of my classmates from the northeast moved to Texas after D school. They are doing well for themselves and paying less taxes. Here in Ohio, there is no state income tax for the first $250k. 40% of our state budget goes toward Medicaid. Most Ohioans are mostly from or have German ancestors - and care about the society’s socioeconomic as a whole, not the rich vs the poor BS. People here are well balanced; old, young, poor, students, political, non political, religious, non religious, etc. We really pay attention to the safety nets and have good social programs.

Ohio was one of the first states to lockdown it’s economy 2 months ago, and we are still in lockdown for the most part. We have a Republican Governor, but is well supported by everyone (for the most part) for how he handled the pandemic. We had some knucklehead protestors who brought guns and their kids (instead of face masks) to the state house - with “open Ohio!” signs, and the governor responded with “I give 0 F’s about those people”. I doubt most governors can be pushed around like that to take public health risks.


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It seems like professionals in Texas including my sister are income hungry. Money this, money that. I live in one of the highest taxed states so we have no incentive to bend over backwards working our tails off. My sister keeps asking me to move down and work with her but I can't stand their heat. I like 75 degrees in the summer not 105.

 

[TanMan]

It seems like professionals in Texas including my sister are income hungry. Money this, money that. I live in one of the highest taxed states so we have no incentive to bend over backwards working our tails off. My sister keeps asking me to move down and work with her but I can't stand their heat. I like 75 degrees in the summer not 105.

What's wrong with making money? You make it seem like if the government oppresses you enough that you will not care to make as much money anymore. I'm excited for airlines and destinations to open up again (don't care much about US3 airlines even though they are our main options domestically) and travel to places that won't screen or quarantine me.

 

[Molar Whisperer]

What's wrong with making money? You make it seem like if the government oppresses you enough that you will not care to make as much money anymore. I'm excited for airlines and destinations to open up again (don't care much about US3 airlines even though they are our main options domestically) and travel to places that won't screen or quarantine me.

There's absolutely nothing wrong with making money. My income is sacred to me but I feel there is a lowering plateau of income from dentistry. It takes smart and ambitious people like you, Cold Front, charlestweed, my sister, and many others to surpass that plateau although I still make more than my sister. I also feel that success in dentistry varies by location. It's very difficult to succeed in private practice at my location but it's my fault that I don't want to move. I guess in TX, you have to constantly think about making money to keep up with the Jones.

 

[Cold Front]

It seems like professionals in Texas including my sister are income hungry. Money this, money that. I live in one of the highest taxed states so we have no incentive to bend over backwards working our tails off. My sister keeps asking me to move down and work with her but I can't stand their heat. I like 75 degrees in the summer not 105.

Money tests people on their principles and values. Those who refuse to support better healthcare access, or better social programs, or more affordable education, or anything that’s for the greater good of collective society financially, are those who would probably not be satisfied if they had the whole world to themselves.

Nothing wrong with being income hungry, but everything is wrong with using that drive to downplay larger societal issues that’s holding us back from coming together as a nation.


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[TanMan]

There's absolutely nothing wrong with making money. My income is sacred to me but I feel there is a lowering plateau of income from dentistry. It takes smart and ambitious people like you, Cold Front, charlestweed, my sister, and many others to surpass that plateau although I still make more than my sister. I also feel that success in dentistry varies by location. It's very difficult to succeed in private practice at my location but it's my fault that I don't want to move. I guess in TX, you have to constantly think about making money to keep up with the Jones.

I don't think it's about keeping up with the Jones'. I think it has more to do that it's pretty easy to make and keep your money , so you have more incentive to work rather than having most of your hard earned money go to the government. Also, you have to try pretty hard in Texas NOT to make money. When put in that position, the only way is up.

Money tests people on their principles and values. Those who refuse to support better healthcare access, or better social programs, or more affordable education, or anything that’s for the greater good of collective society financially, are those who would probably not be satisfied if they had the whole world to themselves.

Nothing wrong with being income hungry, but everything is wrong with using that drive to downplay larger societal issues that’s holding us back from coming together as a nation.


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It all depends on what/where the responsibility of each citizen starts and ends. I believe that personal responsibility should exist to a certain extent and that people should be responsible for their own well being with the government being an emergency safety net, rather than the go-to for the majority of the population.

In your blanket statement of coming together as a nation, this sounds like a cover to demonize all those that oppose government intervention for "better healthcare access/social programs/affordable education" and force people to implicitly participate via taxation. These principles/goals all sound like a dream in the making, but in practice, I don't believe the government can execute your lofty goals as intended. This is another reason I support state sovereignty to an extent. I can live in state that aligns with my value systems more.

 

[Molar Whisperer]

I don't think it's about keeping up with the Jones'. I think it has more to do that it's pretty easy to make and keep your money , so you have more incentive to work rather than having most of your hard earned money go to the government. Also, you have to try pretty hard in Texas NOT to make money. When put in that position, the only way is up.

TanMan, you seem very ambitious. Have you considered or probably doing this on the side, going into more lucrative arenas like high finance and or real estate development? I figure you can be involved with multi-million dollar deals as opposed to being subjected to discounted PPOs like the rest of us dentists. You seem to have the smarts for it.

 

[charlestweed]

It all depends on what/where the responsibility of each citizen starts and ends. I believe that personal responsibility should exist to a certain extent and that people should be responsible for their own well being with the government being an emergency safety net, rather than the go-to for the majority of the population.

In your blanket statement of coming together as a nation, this sounds like a cover to demonize all those that oppose government intervention for "better healthcare access/social programs/affordable education" and force people to implicitly participate via taxation. These principles/goals all sound like a dream in the making, but in practice, I don't believe the government can execute your lofty goals as intended. This is another reason I support state sovereignty to an extent. I can live in state that aligns with my value systems more.

The problem is only a small percentage of the taxpayers’ money actually serves the purposes it intends to serve…..the rest are fraud, waste, abuse, and mismanagement of the funds. The government think they can manage our money better than what each of us can. The government is never good at running anything.

 

[TanMan]

TanMan, you seem very ambitious. Have you considered or probably doing this on the side, going into more lucrative arenas like high finance and or real estate development? I figure you can be involved with multi-million dollar deals as opposed to being subjected to discounted PPOs like the rest of us dentists. You seem to have the smarts for it.

I have ongoing investment projects but this is still relatively easy cash flow to buffer my position(s). In a time like this, I'd be incredibly stupid not to work right now. Where else can you make 1500-2000/hour with relative ease? Also, because of all these restrictions, it's not like I can travel anywhere fun. So... I'm stuck here, might as well make money. If I can strengthen my cash holdings and position, I will be in a better position to acquire assets at a deep discount.

Although, I keep telling myself not to, I feel the want to expand more, lol. I might take the leap and add +7 chairs to my office if things end great this month.

 

[Cold Front]

I have ongoing investment projects but this is still relatively easy cash flow to buffer my position(s). In a time like this, I'd be incredibly stupid not to work right now. Where else can you make 1500-2000/hour with relative ease? Also, because of all these restrictions, it's not like I can travel anywhere fun. So... I'm stuck here, might as well make money. If I can strengthen my cash holdings and position, I will be in a better position to acquire assets at a deep discount.

Although, I keep telling myself not to, I feel the want to expand more, lol. I might take the leap and add +7 chairs to my office if things end great this month.

Good to hear. At what income or point is enough?


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[TanMan]

Good to hear. At what income or point is enough?


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Is it ever really enough? I think if you're looking at it from a need perspective, enough income means that you make enough to cover all your living expenses/debt obligations. If you're past that, the pursuit of money is excessive when it starts to consume your daily life (stress, nothing but working, meaningless work, etc...). I have enough where I can drop everything now and not have to worry about any bills, but I guess I've grown attached to my office in that it's like a neverending home improvement project where I make money but it doesn't really matter anymore. The challenge is more appealing now. I want to see if I can do 20 chairs at a time and/or break 400k.

 

[Cold Front]

Is it ever really enough? I think if you're looking at it from a need perspective, enough income means that you make enough to cover all your living expenses/debt obligations. If you're past that, the pursuit of money is excessive when it starts to consume your daily life (stress, nothing but working, meaningless work, etc...). I have enough where I can drop everything now and not have to worry about any bills, but I guess I've grown attached to my office in that it's like a neverending home improvement project where I make money but it doesn't really matter anymore. The challenge is more appealing now. I want to see if I can do 20 chairs at a time and/or break 400k.

Yes, there is “enough” point for many including me. Then again, I can see the purpose for you to keep going and do multiple laps on your “enough” point.

This reminds me of Jeremy Renner’s character in the movie Hurt Locker. [spoiler alert]. He got bored out of civilian life after serving in multiple dangerous tours in a war zone area of Middle East, and he wouldn’t walk away from a job that would kill him into pieces.

My point is, most dentists I know or met are running away from dentistry, while you are running towards it. I’m more in the middle, and slowly tilting to the running-away side. Because dentistry as a profession has seen a real downturn over the years.

Can I make a lot of money like you from this gig? Probably. Am I getting more respect as a dentist and clinician the longer I go after money? Probably not. Unlike in medicine, dentists are completely fragmented and are taken advantage of as the sole “Guardians” of the field by different interest groups; from corporations to local reps who can’t give you the same benefits group practices get, to the insurances who discriminate your crown fees because you are practicing in certain zip code or not doing enough crowns (quality of crown and fee are not correlated).

There is a general lack of respect towards the profession by patients and insurances, and the only thing that gets me out of bed every morning is that I’m fortunate to have a high income job, so it’s really more about ceasing the opportunity and going after the money than working in an environment that doesn’t give me the full respect of what I do as a dentist in the eyes of other stakeholders in our profession. You meet with a local dental supplier? It’s all about money! You call the local lab? It’s really more about money too! Patient shopping for a new dentist? That’s money decision too! Employee loyalty? Open your wallet! Frankly speaking, dentistry has slowly morphed to the overall greed disease this country suffers from (covid19 public health v economy example), and I was part of it in every way - because that’s how most people are programmed. But I’m starting to let this mindset go slowly.

In dentistry, hit high production goals to pay your bills or go bust. Most clinically proficient dentists are probably broke or make the least money in general. A never ending conveyor belt that starts with dental schools that take advantage of students, and someday those students will take advantage of patients (to hit production goals at all cost), and patients who will feed that negative loop back somewhere else by choosing and fueling insurances that screws the dentist’s reimbursement. Kind of ironic. Anyways! All power to you for going deep in this to look for more gold!


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[TanMan]

Yes, there is “enough” point for many including me. Then again, I can see the purpose for you to keep going and do multiple laps on your “enough” point.

This reminds me of Jeremy Renner’s character in the movie Hurt Locker. [spoiler alert]. He got bored out of civilian life after serving in multiple dangerous tours in a war zone area of Middle East, and he wouldn’t walk away from a job that would kill him into pieces.

My point is, most dentists I know or met are running away from dentistry, while you are running towards it. I’m more in the middle, and slowly tilting to the running-away side. Because dentistry as a profession has seen a real downturn over the years.

Can I make a lot of money like you from this gig? Probably. Am I getting more respect as a dentist and clinician the longer I go after money? Probably not. Unlike in medicine, dentists are completely fragmented and are taken advantage of as the sole “Guardians” of the field by different interest groups; from corporations to local reps who can’t give you the same benefits group practices get, to the insurances who discriminate your crown fees because you are practicing in certain zip code or not doing enough crowns (quality of crown and fee are not correlated).

There is a general lack of respect towards the profession by patients and insurances, and the only thing that gets me out of bed every morning is that I’m fortunate to have a high income job, so it’s really more about ceasing the opportunity and going after the money than working in an environment that doesn’t give me the full respect of what I do as a dentist in the eyes of other stakeholders in our profession. You meet with a local dental supplier? It’s all about money! You call the local lab? It’s really more about money too! Patient shopping for a new dentist? That’s money decision too! Employee loyalty? Open your wallet! Frankly speaking, dentistry has slowly morphed to the overall greed disease this country suffers from (covid19 public health v economy example), and I was part of it in every way - because that’s how most people are programmed. But I’m starting to let this mindset go slowly.

In dentistry, hit high production goals to pay your bills or go bust. Most clinically proficient dentists are probably broke or make the least money in general. A never ending conveyor belt that starts with dental schools that take advantage of students, and someday those students will take advantage of patients (to hit production goals at all cost), and patients who will feed that negative loop back somewhere else by choosing and fueling insurances that screws the dentist’s reimbursement. Kind of ironic. Anyways! All power to you for going deep in this to look for more gold!


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I guess I still feel young and want to test my vitality and the limits of my vigor/health. There is always opportunity when everything is crashing down. This is an unfortunate reality of economic downturns. The winners will be the ones that benefitted from the losses of the losers. Looking at this situation like a burning building, people are running away while I'm running towards it to gather assets left behind by the people running away. Those assets can be anything, real estate, practices, businesses, patients, etc...

You're right though, the world revolves around the money. On your examples, you make it seem like they are the only ones who benefit, but an astute individual will know the right questions to ask. How can I make more money from x product/service? What do I have to benefit from x product or service. That's the same thing with customers... you need to know what they want or inclined to want and convince them to give x money for x services.

 

[Cold Front]

I guess I still feel young and want to test my vitality and the limits of my vigor/health. There is always opportunity when everything is crashing down. This is an unfortunate reality of economic downturns. The winners will be the ones that benefitted from the losses of the losers. Looking at this situation like a burning building, people are running away while I'm running towards it to gather assets left behind by the people running away. Those assets can be anything, real estate, practices, businesses, patients, etc...

You're right though, the world revolves around the money. On your examples, you make it seem like they are the only ones who benefit, but an astute individual will know the right questions to ask. How can I make more money from x product/service? What do I have to benefit from x product or service. That's the same thing with customers... you need to know what they want or inclined to want and convince them to give x money for x services.

I get it. Everyone sees a situation from their own vantage point.

A friend of mine never went to college and started a mulch company after high school. He is an older guy - in his 50s, and his business grosses close to $100M a year. He has that market on a choke hold. Mulch is a seasonal product up here, so he only work 4-5 months of the year. The rest he re-invests his money and buys more properties.

I could leave dentistry today and be ok and focus on my other side businesses. But with all the opportunities that could be on market in dentistry today after new covid dental economic climate, I would rather swing my money away from dentistry. The more I look closer at everything wrong with dentistry, the more I just want to step back sooner.


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[yappy]

There is a general lack of respect towards the profession by patients and insurances, and the only thing that gets me out of bed every morning is that I’m fortunate to have a high income job, so it’s really more about ceasing the opportunity and going after the money than working in an environment that doesn’t give me the full respect of what I do as a dentist in the eyes of other stakeholders in our profession. You meet with a local dental supplier? It’s all about money! You call the local lab? It’s really more about money too! Patient shopping for a new dentist? That’s money decision too! Employee loyalty? Open your wallet! Frankly speaking, dentistry has slowly morphed to the overall greed disease this country suffers from (covid19 public health v economy example), and I was part of it in every way - because that’s how most people are programmed. But I’m starting to let this mindset go slowly.

In dentistry, hit high production goals to pay your bills or go bust. Most clinically proficient dentists are probably broke or make the least money in general. A never ending conveyor belt that starts with dental schools that take advantage of students, and someday those students will take advantage of patients (to hit production goals at all cost), and patients who will feed that negative loop back somewhere else by choosing and fueling insurances that screws the dentist’s reimbursement. Kind of ironic. Anyways! All power to you for going deep in this to look for more gold!


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I cannot agree with this more. How did this happen and has dentistry always been like this?

For example, I've often questioned why office managers or dentists discuss financial goals with the whole office (do assistants really need to know last months revenue?) during morning meetings. I've never seen this practice in any other form of healthcare. Why am I told the financial opportunities of a product or service during a CE before I learn about its efficacy? The field doesn't have to be like this but for some reason the culture is so financially driven. I don't believe this is all due to student loan debt, however.

 

[charlestweed]

I cannot agree with this more. How did this happen and has dentistry always been like this?

For example, I've often questioned why office managers or dentists discuss financial goals with the whole office (do assistants really need to know last months revenue?) during morning meetings. I've never seen this practice in any other form of healthcare. Why am I told the financial opportunities of a product or service during a CE before I learn about its efficacy? The field doesn't have to be like this but for some reason the culture is so financially driven. I don't believe this is all due to student loan debt, however.

I think you will understand why when you own an office and have to pay rent, staff salaries, worker comp/business insurances, and other fixed expenses. The manager and other staff members need to know the production goal so when they under-produce, they won’t be surprised why their requests for salary increase get denied or why their hours get cut. Dentistry is not a non-profit charity. It’s a business. Medicine is also a business. If hospitals cannot pay their doctors and nurses, they too have to close their businesses.

 

[yappy]

I think you will understand why when you own an office and have to pay rent, staff salaries, worker comp/business insurances, and other fixed expenses. The manager and other staff members need to know the production goal so when they under-produce, they won’t be surprised why their requests for salary increase get denied or why their hours get cut. Dentistry is not a non-profit charity. It’s a business. Medicine is also a business. If hospitals cannot pay their doctors and nurses, they too have to close their businesses.

I'm not naive about the costs of doing business. The staff don't need to know their production goals because their "goal" is formalized in a template for them by the office manager or owner. The evaluation of assistants and hygienists are dictated by task performance. They do not prescribe. So it's ridiculous and in poor taste to discuss the daily, weekly, monthly, etc. financial goals IMO.

The financial goal of an office has no bearing on the disease present in someones mouth, their likelihood to pay, or ability to pay. Therefore, setting an arbitrary financial goal is wasted breath. So is arbitrarily increasing it once said goal is met.

Strategic insurance participation, services offered, internal/external advertising, systems, financing, and patient education are what increase revenue. Lowering net overhead is what increases profit. None of those things have to do with setting arbitrary financial goals that are then disseminated throughout the office during morning meetings. I've worked in medicine and there is not nearly as much bone-headed corporate BS, such as daily production goal announcements, as found in corporate dentistry. I believe it's better to make strategic decisions based on sound data and then deliver those policies to your staff to increase productivity.

 

[allantois]

I think you will understand why when you own an office and have to pay rent, staff salaries, worker comp/business insurances, and other fixed expenses. The manager and other staff members need to know the production goal so when they under-produce, they won’t be surprised why their requests for salary increase get denied or why their hours get cut. Dentistry is not a non-profit charity. It’s a business. Medicine is also a business. If hospitals cannot pay their doctors and nurses, they too have to close their businesses.

I appreciate what you bring to these forums but reading about exploiting staff and paying them a pittance is cringeworthy. It is this culture of big fish eat small that is destroying so many industries in America. There will always be a bigger fish, however. Look at how wealthy people live in countries where the population is largely poor. They are living behind fences with bodyguard in constant fear of being attacked. You cannot ensure prosperity for your kids in a country if a majority of its population plunges into poverty.

 

[2TH MVR]

I appreciate what you bring to these forums but reading about exploiting staff and paying them a pittance is cringeworthy. It is this culture of big fish eat small that is destroying so many industries in America. There will always be a bigger fish, however. Look at how wealthy people live in countries where the population is largely poor. They are living behind fences with bodyguard in constant fear of being attacked. You cannot ensure prosperity for your kids in a country if a majority of its population plunges into poverty.

Welcome to low fee economics. He doesn't have a choice based on where he practices.

 

[charlestweed]

I'm not naive about the costs of doing business. The staff don't need to know their production goals because their "goal" is formalized in a template for them by the office manager or owner. The evaluation of assistants and hygienists are dictated by task performance. They do not prescribe. So it's ridiculous and in poor taste to discuss the daily, weekly, monthly, etc. financial goals IMO.

The financial goal of an office has no bearing on the disease present in someones mouth, their likelihood to pay, or ability to pay. Therefore, setting an arbitrary financial goal is wasted breath. So is arbitrarily increasing it once said goal is met.

Strategic insurance participation, services offered, internal/external advertising, systems, financing, and patient education are what increase revenue. Lowering net overhead is what increases profit. None of those things have to do with setting arbitrary financial goals that are then disseminated throughout the office during morning meetings. I've worked in medicine and there is not nearly as much bone-headed corporate BS, such as daily production goal announcements, as found in corporate dentistry. I believe it's better to make strategic decisions based on sound data and then deliver those policies to your staff to increase productivity.

The whole point of hiring staff (especially the office manager) is you want them to help you produce..... to help you succeed. The job of the manager is to "manage" the office and not to sit around and collect your paycheck. They need to know the production goal and should do what they are paid to do to meet this goal. How do you feel when your manager or your receptionist intentionally put fewer patients on the appointment book so they don't have to work too hard? How do you feel when your associate dentist refuses to do an easy endo case and refer patient to endodontist just because he/she doesn't want to be late for a concert?

I think you will understand why when you have your own office. You will realize that employees only care for themselves no matter how well you pay them and how nice you treat them. Nobody cares about your office, except you. When things break down, you are the one who will come in first and the one who has to call the plumbers, handymen, or repair tech etc. They can take a day off anytime (for their kids' performance, graduation etc) without an advance notice.....while you are super busy treating your patients.

 

[yappy]

The whole point of hiring staff (especially the office manager) is you want them to help you produce..... to help you succeed. The job of the manager is to "manage" the office and not to sit around and collect your paycheck. They need to know the production goal and should do what they are paid to do to meet this goal. How do you feel when your manager or your receptionist intentionally put fewer patients on the appointment book so they don't have to work too hard? How do you feel when your associate dentist refuses to do an easy endo case and refer patient to endodontist just because he/she doesn't want to be late for a concert?

I think you will understand why when you have your own office. You will realize that employees only care for themselves no matter how well you pay them and how nice you treat them. Nobody cares about your office, except you. When things break down, you are the one who will come in first and the one who has to call the plumbers, handymen, or repair tech etc. They can take a day off anytime (for their kids' performance, graduation etc) without an advance notice.....while you are super busy treating your patients.

I agree with everything that you've said.

 

[charlestweed]

I appreciate what you bring to these forums but reading about exploiting staff and paying them a pittance is cringeworthy. It is this culture of big fish eat small that is destroying so many industries in America. There will always be a bigger fish, however. Look at how wealthy people live in countries where the population is largely poor. They are living behind fences with bodyguard in constant fear of being attacked. You cannot ensure prosperity for your kids in a country if a majority of its population plunges into poverty.

This class warfare needs to stop. It really divides the American people. It discourages people like you and me, who have tried to work hard to move up the socioeconomic ladder. People become rich because of their hard work and the sacrifices (ie going to schools, taking out student loans, taking risks to start a business etc) that they had made earlier in their lives.

If my any member of my staff feels he/she is exploited, he/she can always leave. It's supply and demand. Nobody forces them to stay with me. I hire fewer staff (to keep the overhead low, of course) not because I want them to work harder for me but because I can multitask. I can work as an extra assistant. I can take xrays/ortho records. I can make retainers. I can sterilize instruments. I try to set a good example for my staff by mopping/sweeping the floor with them. I keep the overhead low so I can pass on the low cost treatments to my patients.

I guess you can never make people happy. When you charge low fees, your colleagues accuse you of cheapen the ortho profession. When my colleagues charge high treatment fees, people accuse them of being greedy. When you accept medicaid, your colleagues say you are stupid. When my colleagues don't accept medicaid, people say they are heartless. When you are fast and can treat a lot of patients in a day, people accuse you of doing sub-standard dentistry. When you try to take time to treat your patients, people criticize you for being too slow and inexperienced. I don't care what others think. I just do my best to take care of my business, my patients (so they keep referring their friends to me) and my family.

 

[endodonia]

I guess you can never make people happy. When you charge low fees, your colleagues accuse you of cheapen the ortho profession. When my colleagues charge high treatment fees, people accuse them of being greedy. When you accept medicaid, your colleagues say you are stupid. When my colleagues don't accept medicaid, people say they are heartless. When you are fast and can treat a lot of patients in a day, people accuse you of doing sub-standard dentistry. When you try to take time to treat your patients, people criticize you for being too slow and inexperienced. I don't care what others think. I just do my best to take care of my business, my patients (so they keep referring their friends to me) and my family.

just wanted to make sure people get to read that part twice.

 

[Alpha Centauri]

I have ongoing investment projects but this is still relatively easy cash flow to buffer my position(s). In a time like this, I'd be incredibly stupid not to work right now. Where else can you make 1500-2000/hour with relative ease? Also, because of all these restrictions, it's not like I can travel anywhere fun. So... I'm stuck here, might as well make money. If I can strengthen my cash holdings and position, I will be in a better position to acquire assets at a deep discount.

Although, I keep telling myself not to, I feel the want to expand more, lol. I might take the leap and add +7 chairs to my office if things end great this month.

My question for you is that do you have patients who are willing to come to the office and allow you to make that 1500-2000/hour consistently?

 

[OSOSOS]

I'm not naive about the costs of doing business. The staff don't need to know their production goals because their "goal" is formalized in a template for them by the office manager or owner. The evaluation of assistants and hygienists are dictated by task performance. They do not prescribe. So it's ridiculous and in poor taste to discuss the daily, weekly, monthly, etc. financial goals IMO.

The financial goal of an office has no bearing on the disease present in someones mouth, their likelihood to pay, or ability to pay. Therefore, setting an arbitrary financial goal is wasted breath. So is arbitrarily increasing it once said goal is met.

Strategic insurance participation, services offered, internal/external advertising, systems, financing, and patient education are what increase revenue. Lowering net overhead is what increases profit. None of those things have to do with setting arbitrary financial goals that are then disseminated throughout the office during morning meetings. I've worked in medicine and there is not nearly as much bone-headed corporate BS, such as daily production goal announcements, as found in corporate dentistry. I believe it's better to make strategic decisions based on sound data and then deliver those policies to your staff to increase productivity.

everything you’re not happy about is already “solved” in most corporate medical offices And hospitals. Most doctors you see are run by large companies. The staffing of RNs, assistants, patients per hour, clocking in and out, supplies etc is all decided for you. The compensation for doctors is either hourly, RVU based or blended. But the math is already figured out to make it work. The business people are having these discussions, they just don’t include the doctor unless you aren’t falling in line.

Much as you suggested should be done on the sly and magically it will work in the dental Office but it’s just not realistic. Yes it can be taken to an extreme but everyone needs to understand the general costs of business and what it takes to keep the practice alive and thriving.

 

[TanMan]

My question for you is that do you have patients who are willing to come to the office and allow you to make that 1500-2000/hour consistently?

Yes.