Dentist posting. Are you guys sure about this???

[askadds]

I am practicing dentist for the last 8 years. I wanted to share some realities with you guys. My biggest concern with the predental students is the amount of debt you guys are picking up to go to these dental schools. Some are 700k at the top range and the state schools are around 400k. How are you guys planning on manage this debt? You guys should understand that dental salaries have stayed about the same for the last two decades. Dentists are not making any more than they were 20 years ago. We are having major issues with dental insurance companies, some have not raised their fees for the last two decades. There is a lot of talk about this amongst practicing dentists. Be aware of the financial obligation you are about to accept and choose wisely.

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[2TH MVR]

I am practicing dentist for the last 8 years. I wanted to share some realities with you guys. My biggest concern with the predental students is the amount of debt you guys are picking up to go to these dental schools. Some are 700k at the top range and the state schools are around 400k. How are you guys planning on manage this debt? You guys should understand that dental salaries have stayed about the same for the last two decades. Dentists are not making any more than they were 20 years ago. We are having major issues with dental insurance companies, some have not raised their fees for the last two decades. There is a lot of talk about this amongst practicing dentists. Be aware of the financial obligation you are about to accept and choose wisely.

Can you share some information about yourself to provide some perspective. Owner/Associate. Private practice/DSO. Rural/Semi-rural/Saturated urban city. General dentist/specialist. How much debt did you graduate with?

 

[askadds]

graduated with 320k including undergrad. the vast majority of the loans you get in dental school is having interest accumulated at the federal rate (around 6.5%) from the moment it is dispersed so you're accumulating interest on it compounding during the entire time. then you come out as an associate making $400-500 a day which is simply not enough. then you start a practice to pay down your debt and go under another 500k of debt. paying back 800-1 million worth of money with the interest accumulating which is not tax deductible is an uphill battle that may not be worth it. these are the reasons practicing dentists are scratching their heads and worried about prospective dental students.

 

[Carmencitas]

Not to derail or minimize the issue but aren't there enough threads on this

 

[allDAT]

Not to derail or minimize the issue but aren't there enough threads on this

No.

There needs to be a lot more threads like this. I might even post one. The reality is that very few people should be interested in becoming a dentist at these debt levels. I used to say that 400k was the cutoff. Post 2020, I’d say it’s about 300k as major insurance networks have actually decrease their contracted fees. Receiving a letter saying that your fees are going down 20% or 30% across the board for a network at this point in time is unbelievable and it’s now my opinion that this profession is heading towards a dead end.

The key has always been practice ownership to increase earning potential and now there are banks who are amortizing student loan payments over 10 years when calculating projected cashflow instead of taking into account IBR payments. This effectively makes it almost impossible to acquire a practice for some of these high debt students unless they find a practice with monster net profits and a below average valuation which is much easier said than done.

 

[askadds]

year allDAT is right on point, its heading towards a dead end. Delta Dental which is the biggest insurance company has not raised their fees in two decades. How does that sound?

 

[2thDoc11]

Can someone practicing speak to working at two offices? I’ve seen quite a few dentists post about working at a private practice and public health, or a couple private practices and so on. How does this effect earning potential? Is it 3 at one and 2 at the other, or do you work on weekends? Just curious, especially when it comes to the ”rural” Midwest.

 

[allDAT]

Can someone practicing speak to working at two offices? I’ve seen quite a few dentists post about working at a private practice and public health, or a couple private practices and so on. How does this effect earning potential? Is it 3 at one and 2 at the other, or do you work on weekends? Just curious, especially when it comes to the ”rural” Midwest.

Most people who would split time at 2 offices would be doing so either because 1) there’s a capacity problem at the private office or 2) there’s not enough work to be done at the private office until the associate has a larger patient pool.

PT work at a community health center may qualify for NHSC LRP and provide the associate access to benefits like health insurance or a 401k that they otherwise wouldn’t have access to in a private office.

In general, the highest earning dentists would be working in 1 office. The less time you spend at an office, the more difficult it is to complete fixed prosth cases which is where you make the majority of your income.

 

[allDAT]

year allDAT is right on point, its heading towards a dead end. Delta Dental which is the biggest insurance company has not raised their fees in two decades. How does that sound?

It sounds terrible, it is terrible, and there are no signs that it’s going to change.

In fact, I recently put an offer in on an office that has delta premier which I will not get, so that will decrease the collections for patients with delta PPO plans by 30-40%. My exam fees may actually be cut in half from what the selling dentist has access to. We’re in negotiations now and we may be too far apart on valuation to make it happen. The math just doesn’t work when you factor in the loss of collections solely due to a change in provider status with Delta.

Dental students and prospective dental students don’t have a clue.

 

[2thDoc11]

Most people who would split time at 2 offices would be doing so either because 1) there’s a capacity problem at the private office or 2) there’s not enough work to be done at the private office until the associate has a larger patient pool.

PT work at a community health center may qualify for NHSC LRP and provide the associate access to benefits like health insurance or a 401k that they otherwise wouldn’t have access to in a private office.

In general, the highest earning dentists would be working in 1 office. The less time you spend at an office, the more difficult it is to complete fixed prosth cases which is where you make the majority of your income.

Gotcha! Would you guess that there’s a correlation with working at 2 offices vs 1 and income? I know most offices aren’t open more than 4 days a week so working at another office that’s open Friday and Saturday would surely increase that earning potential?

 

[allDAT]

Gotcha! Would you guess that there’s a correlation with working at 2 offices vs 1 and income? I know most offices aren’t open more than 4 days a week so working at another office that’s open Friday and Saturday would surely increase that earning potential?

Well just logically you should make more money if you work more hours.

However, that’s not always the case in our profession because we’re usually paid a percent of collections. So if the office doesn’t collect much, or you’re in network with every PPO, you may find that you could make more working 32 hours at a great office vs 40 at a bad one.

Sorry to say it’s just not cut and try because we’re usually not paid hourly or salaried.

 

[TanMan]

The old way of doing things no longer applies as market conditions and reimbursement changes. If you're going to setup a practice like your dad's dentist 50 years ago, you'll definitely go broke. Lower reimbursement requires faster procedural times. No one is forcing you to take those fees, but at the same time, no one is forcing you to do procedures that you would lose out on either.

I don't know where people get this crazy idea that you need to spend 500k on a new practice or borrow money to start a new office or buy an office. That's problem one - thinking that there's this "universal/expensive" way of starting an office. Problem two - taking too long for procedures at specific reimbursement levels. If you're getting paid 70 dollars on a fill, you need to know how much time you HAVE to spend on that procedure. If you cannot execute that procedure within that allocated time without sustaining a loss, don't do the procedure. Either find an alternate way or do it faster. Delta has horrible fees, BUT delta also doesn't clawback any money (at least now in the time I've been practicing). Some insurances have much better fee schedules, but they do try and clawback sometimes or downgrade. Administratively, it becomes annoying and the allocated labor required to dispute these clawbacks.

For those that complain about exam fees, as I've mentioned before, we're poorly compensated for examinations and therefore, exams need to be short and succinct. Your team needs to close the deal because your time is worth way more than theirs. You cannot spend 30 minutes on an exam, lest you go broke.

 

[DMD12345]

The old way of doing things no longer applies as market conditions and reimbursement changes. If you're going to setup a practice like your dad's dentist 50 years ago, you'll definitely go broke. Lower reimbursement requires faster procedural times. No one is forcing you to take those fees, but at the same time, no one is forcing you to do procedures that you would lose out on either.

I don't know where people get this crazy idea that you need to spend 500k on a new practice or borrow money to start a new office or buy an office. That's problem one - thinking that there's this "universal/expensive" way of starting an office. Problem two - taking too long for procedures at specific reimbursement levels. If you're getting paid 70 dollars on a fill, you need to know how much time you HAVE to spend on that procedure. If you cannot execute that procedure within that allocated time without sustaining a loss, don't do the procedure. Either find an alternate way or do it faster. Delta has horrible fees, BUT delta also doesn't clawback any money (at least now in the time I've been practicing). Some insurances have much better fee schedules, but they do try and clawback sometimes or downgrade. Administratively, it becomes annoying and the allocated labor required to dispute these clawbacks.

For those that complain about exam fees, as I've mentioned before, we're poorly compensated for examinations and therefore, exams need to be short and succinct. Your team needs to close the deal because your time is worth way more than theirs. You cannot spend 30 minutes on an exam, lest you go broke.

What option do you think is better?

 

[allDAT]

The old way of doing things no longer applies as market conditions and reimbursement changes. If you're going to setup a practice like your dad's dentist 50 years ago, you'll definitely go broke. Lower reimbursement requires faster procedural times. No one is forcing you to take those fees, but at the same time, no one is forcing you to do procedures that you would lose out on either.

I don't know where people get this crazy idea that you need to spend 500k on a new practice or borrow money to start a new office or buy an office. That's problem one - thinking that there's this "universal/expensive" way of starting an office. Problem two - taking too long for procedures at specific reimbursement levels. If you're getting paid 70 dollars on a fill, you need to know how much time you HAVE to spend on that procedure. If you cannot execute that procedure within that allocated time without sustaining a loss, don't do the procedure. Either find an alternate way or do it faster. Delta has horrible fees, BUT delta also doesn't clawback any money (at least now in the time I've been practicing). Some insurances have much better fee schedules, but they do try and clawback sometimes or downgrade. Administratively, it becomes annoying and the allocated labor required to dispute these clawbacks.

For those that complain about exam fees, as I've mentioned before, we're poorly compensated for examinations and therefore, exams need to be short and succinct. Your team needs to close the deal because your time is worth way more than theirs. You cannot spend 30 minutes on an exam, lest you go broke.

There's a lot of truth in your posts.

My complaints about exam fees is really that we're under-compensated for our education. When evaluating a practice a further reduction in our fees for exams (when switching from premier to PPO) is frustrating to say the least.

 

[allDAT]

What option do you think is better?

There are alternative ways to do a startup that don't involve the big box suppliers who often try and sell all the bells and whistles to drive up the price. Spending 500k for a startup is not a good idea and can be avoided.

 

[TanMan]

What option do you think is better?

There's a lot of truth in your posts.

My complaints about exam fees is really that we're under-compensated for our education. When evaluating a practice a further reduction in our fees for exams (when switching from premier to PPO) is frustrating to say the least.

Starting out for cheap, that's for sure. You can get away with about 100k for a startup. I value a dentist time to be 40 to 50 dollars a minute, so procedural time should fall in line around there on average. The example of a 70 dollar fill should take 2 mins or so.

I understand your frustration with exams. We make our money through procedures. We're caught between a rock and a hard place. Exams are important since that's where we find our procedures, but if we don't execute the proposed treatment, then the exam was a waste of time. I prefer to have my assistants do the selling since their time is less expensive than my time. People need to adapt to the new realities of dentistry and those that do not will probably end up broke. Pure ffs practices operate a bit differently, so your ymmv.

 

[charlestweed]

Can someone practicing speak to working at two offices? I’ve seen quite a few dentists post about working at a private practice and public health, or a couple private practices and so on. How does this effect earning potential? Is it 3 at one and 2 at the other, or do you work on weekends? Just curious, especially when it comes to the ”rural” Midwest.

To be successful, you need to work smart as well as hard. Working smart means you need to find ways to increase the productivity and get more things done in less time. If your office doesn’t have enough patients (either because it was set up from scratch or because previous owner, whom you bought an office from, was slow and didn’t have a lot of patients), there’s no reason for you to sit around doing nothing 8 hours a day, 5-6 days/wk. You should book as many patients in one day as possible and use the other free days in the week to work at another office as an associate increase your income. Never assume that when you buy an existing practice, you will be busy on day one and you can just quit your associate job. Most of the practices that are listed for sale are bad ones (high overhead, overpaid lazy staff, high rent, old equipment/instruments, low tech etc). Being near the retirement age, the sellers no longer have the same motivation to work hard like when they were younger….no more advertisement, no more late and weekend hours...their practices are losing a lot of patients….and that’s why they have to sell them. Most are not worth $500k to acquire. I’d rather spend $100-120k to build one from scratch and hire the right staff to work for me than buying an existing office that has so many things that I can’t control.

IMO, a good place to learn to improve your speed and to manage the chair time more efficiently (like what Taman described on the previous post) is a busy corp office. You will be way ahead of your classmates who choose to work at slow private and public health offices.

 

[2TH MVR]

Dentistry is obviously a commodity. We are definitely under paid for the amount of education required. As for the new patient consultations. I started practice (1993) when orthodontists used to charge for a comprehensive, records included, new patient exam. Not anymore. Consultations (if you can still call them this) are 5-10 minutes. If patients don't pay for something. They don't attach any value to that procedure. Try to see a medical specialist and not pay something.

The smart dentists have figured this out and have adapted their strategies to succeed in this environment. Low overhead. Time management. Staff delegation. Well .... these strategies mean less staff pay, fewer staff benefits, PT staff, no long term staff members, etc.. Less personal service for the patients. I see this all the time in Corporate. With the number of patients I see .... it is impossible to offer personal service to these patients.

Low fees is a race to the bottom. No one wins except for the insurance companies. The low fees further reduces the UCR fees for your area. Patients don't win because they are being marginalized. Staff doesn't win because they are getting fewer benefits. Only the insurance companies win since they control the reimbursements. Does anyone really think the ins. cos are going to increase reimbersements?

So. What does this mean for those interested in entering the dental field? Still a very viable career as long as you don't OVERPAY for your education. The days of making dentist money cannot overcome the ridiculous price of entry at some of these expensive dental schools.

It just amazes me when I see new posts on which school offers the best clinical experience with no mention of how expensive some of these schools are.

You want to be a dentist? Find the cheapest route to get there. Period.

 

[charlestweed]

It just amazes me when I see new posts on which school offers the best clinical experience with no mention of how expensive some of these schools are.

You want to be a dentist? Find the cheapest route to get there. Period.

It amazes me as well. I guess most of the people, who started these posts, have rich parents and they don’t care about cost. There are a lot of people who still think it matters where they attend school. My 18 yo niece and her mom (my younger sister….a general dentist) are among these people. I’ve repeatedly told both my sister and my niece that if none of the combined BS/MD programs offer the acceptance, they should consider going to cheap school like UCI or UCLA but they didn’t listen. My niece has a very good SAT score… took and got a bunch of 5s on the AP exams….won the debate competition….and was recently nominated senior of the year (an equivalence of valedictorian). Therefore, she feels she deserves to be in a well known Ivy school and my sister also encourages this. High tuition is not an issue. Sadly, none of the Ivy schools nor the BS/MD programs accepted her. She is on the waitlist at one BS/MD program but I think there’s little hope of getting an acceptance there. If nothing changes, she will attend UCLA this coming Fall. She is not very excited about UCLA. She plans to reapply to the Ivy schools next year. And my sister fully supports her daughter’s decision.

 

[9ss]

graduated with 320k including undergrad. the vast majority of the loans you get in dental school is having interest accumulated at the federal rate (around 6.5%) from the moment it is dispersed so you're accumulating interest on it compounding during the entire time. then you come out as an associate making $400-500 a day which is simply not enough. then you start a practice to pay down your debt and go under another 500k of debt. paying back 800-1 million worth of money with the interest accumulating which is not tax deductible is an uphill battle that may not be worth it. these are the reasons practicing dentists are scratching their heads and worried about prospective dental students.

It's funny you say it's an uphill battle, the start of this profession is a steep incline now, so what's another mountain to climb? This is not an issue; dentistry is a profession that will continuously challenge you, which is interesting. It's for those that seek challenges in their life. Just don't do this **** for money, do it because you like it.

 

[TanMan]

Dentistry is obviously a commodity. We are definitely under paid for the amount of education required. As for the new patient consultations. I started practice (1993) when orthodontists used to charge for a comprehensive, records included, new patient exam. Not anymore. Consultations (if you can still call them this) are 5-10 minutes. If patients don't pay for something. They don't attach any value to that procedure. Try to see a medical specialist and not pay something.

The smart dentists have figured this out and have adapted their strategies to succeed in this environment. Low overhead. Time management. Staff delegation. Well .... these strategies mean less staff pay, fewer staff benefits, PT staff, no long term staff members, etc.. Less personal service for the patients. I see this all the time in Corporate. With the number of patients I see .... it is impossible to offer personal service to these patients.

Low fees is a race to the bottom. No one wins except for the insurance companies. The low fees further reduces the UCR fees for your area. Patients don't win because they are being marginalized. Staff doesn't win because they are getting fewer benefits. Only the insurance companies win since they control the reimbursements. Does anyone really think the ins. cos are going to increase reimbersements?

So. What does this mean for those interested in entering the dental field? Still a very viable career as long as you don't OVERPAY for your education. The days of making dentist money cannot overcome the ridiculous price of entry at some of these expensive dental schools.

It just amazes me when I see new posts on which school offers the best clinical experience with no mention of how expensive some of these schools are.

You want to be a dentist? Find the cheapest route to get there. Period.

Definitely, a DDS/DMD is a DDS/DMD. Get there through the easiest and cheapest possible way, since the degree is just an entrance fee to join the club of being a dentist. Paying more for the same entrance fee makes absolutely no sense, since it's just another barrier that needs to be overcome. However, I do think there's some value to be extracted out of being a dentist, as long as you're willing to work smart and work hard. Doing that alone puts anyone above most dentists (who tend to be lazy or can't think for themselves). If people are planning to just become your average dentist, with average dental income, then paying 500k+ makes no sense. I don't think candidates necessarily plan to be mediocre, but there's this mindset that having a dental degree alone will give you a boatload of cash. Unfortunately, with any business, you have to go where the money's and work hard to make lots of money.

Personal service is out the door when it comes to PPO offices. The volume of patients is what subsidizes the lower out of pocket expense for PPO patients. Essentially, every PPO patient is subsidizing other PPO patient's treatment by waiting longer and less doctor time. There's no way around it unless you want to be broke.

To be successful, you need to work smart as well as hard. Working smart means you need to find ways to increase the productivity and get more things done in less time. If your office doesn’t have enough patients (either because it was set up from scratch or because previous owner, whom you bought an office from, was slow and didn’t have a lot of patients), there’s no reason for you to sit around doing nothing 8 hours a day, 5-6 days/wk. You should book as many patients in one day as possible and use the other free days in the week to work at another office as an associate increase your income. Never assume that when you buy an existing practice, you will be busy on day one and you can just quit your associate job. Most of the practices that are listed for sale are bad ones (high overhead, overpaid lazy staff, high rent, old equipment/instruments, low tech etc). Being near the retirement age, the sellers no longer have the same motivation to work hard like when they were younger….no more advertisement, no more late and weekend hours...their practices are losing a lot of patients….and that’s why they have to sell them. Most are not worth $500k to acquire. I’d rather spend $100-120k to build one from scratch and hire the right staff to work for me than buying an existing office that has so many things that I can’t control.

IMO, a good place to learn to improve your speed and to manage the chair time more efficiently (like what Taman described on the previous post) is a busy corp office. You will be way ahead of your classmates who choose to work at slow private and public health offices.

It's all about efficiency. I was thinking about it as I had an 18OB/19OB. 10 seconds for an IA block, numb other patients, start procedure a few minutes later, prep + fill in 1.5 minutes. Say goodbyes, round it out to about 2 minutes doctor time for 2 fills. Jump to next patient for treatment. As I tell other prospective students and dentists - every minute counts. A loss of 1 minute results in a significant loss of productivity. An example is if the reimbursement for each fill was 100 USD, that's 200USD for 2 minutes, averaging 100USD/minute or 6k/hour. If you ended up taking 3 minutes, it goes down to 67USD/minute or 4k/hour. Now, unfortunately, there are overhead times such as chit-chatting, having to spend an extra minute or two due to some difficult access/pt, running to the next room, but it's part of the business. As dentists, we do have a lot of unbillable hours. We cannot pull a dental school moment and spend an hour on a fill.

 

[Davidfromcali]

Really interesting post; not a dental student myself but have a close friend in a private dental school where the tuition alone is 100k+ per year. I know they could do very well in dentistry but it seems like a lot of risk to take with this much debt. By definition, most dentists are going to be average and make an average income. Really seems like the ROI just isn’t there unless you’re one the few dentists with a very productive and efficient practice, which everyone just won’t have.

 

[charlestweed]

It's all about efficiency. I was thinking about it as I had an 18OB/19OB. 10 seconds for an IA block, numb other patients, start procedure a few minutes later, prep + fill in 1.5 minutes. Say goodbyes, round it out to about 2 minutes doctor time for 2 fills. Jump to next patient for treatment. As I tell other prospective students and dentists - every minute counts. A loss of 1 minute results in a significant loss of productivity. An example is if the reimbursement for each fill was 100 USD, that's 200USD for 2 minutes, averaging 100USD/minute or 6k/hour. If you ended up taking 3 minutes, it goes down to 67USD/minute or 4k/hour. Now, unfortunately, there are overhead times such as chit-chatting, having to spend an extra minute or two due to some difficult access/pt, running to the next room, but it's part of the business. As dentists, we do have a lot of unbillable hours. We cannot pull a dental school moment and spend an hour on a fill.

Unlike many of my colleagues, I don’t have a separate 30-minute or 1-hour slot for a new patient consultation. I wonder why they need so much time for consultation. What kind of conversation they have with the new patients? What if these new patients don’t show up? What if the patients decline tx recommendation and get tx somewhere else? That would be a big waste of doctor’s and staff’s time. Working for a corp office helped train me how to do consultation in less than 5 minutes. A short 30 second video clip like this one () can easily help me explain to a new patient why I need to take out 4 premolars and how I close the extraction spaces. With experience, I don't need to waste time taking a bunch of x rays (except for some impacted canine cases) in order to know what to do. And for a patient who likes to ask a lot of questions, I don’t just stay in one room to chit chat with him/her and make other patients wait. I go to other chairs to examine all other active patients first…..I write down the instructions (that’s why I love paper charts) for my assistants to perform necessary procedures…..and then I go back to talk to the patient who still has a lot of questions for me.

Any new patient, who calls my office for consultation, should get the appointment right away....because there is no specific time slot for this....all walk-ins are welcome. A lot of times, the parents, who bring in their kids for a routine ortho visit, ask me if I can do quick consultations for themselves or for their younger kids. I always say yes without any hesitation.

 

[charlestweed]

Really interesting post; not a dental student myself but have a close friend in a private dental school where the tuition alone is 100k+ per year. I know they could do very well in dentistry but it seems like a lot of risk to take with this much debt. By definition, most dentists are going to be average and make an average income. Really seems like the ROI just isn’t there unless you’re one the few dentists with a very productive and efficient practice, which everyone just won’t have.

It really depends on how hard one works and how one spends his/her hard earned money. A dentist with $500k student loan + $100k practice loan has the same amount of debt as a dentist who has $100k student loan + $500k practice loan. A dentist who has $500k student loan and lives with his/her parents has the same debt amount as a dentist, who has zero student loan but took out a $500k loan to buy a house. Not all dentists who graduated from expensive private dental schools will be in financial trouble. If he/she works smart as well as hard, paying back a huge debt shouldn't be a problem. Cold Front graduated from a very expensive school not too long ago. He graduated at least 9-10 years after me and he has been a lot more successful than I am.

After graduation, my sister and her husband moved in to live with our parents to save money. Our parents helped babysitting her 2 kids so she could work 7 days/wk (3 days/wk at her own office and 4 days/wk for a Corp office). While living with our parents, she bought a multi-million dollar medical/surgical office building with our uncle, who’s a MD, and several of his MD friends. At that time, she could only afford to put in $100k. A couple of years later, this medical building was sold to a Hong Kong investor for 5 times its original price. She then used the profit to buy more properties. She now owns more properties than me despite making less money than me. I am a dental specialist and she is a general dentist.

 

[2TH MVR]

Unlike many of my colleagues, I don’t have a separate 30-minute or 1-hour slot for a new patient consultation. I wonder why they need so much time for consultation. What kind of conversation they have with the new patients? What if these new patients don’t show up? What if the patients decline tx recommendation and get tx somewhere else? That would be a big waste of doctor’s and staff’s time. Working for a corp office helped train me how to do consultation in less than 5 minutes.

Any new patient, who calls my office for consultation, should get the appointment right away....because there is no specific time slot for this....all walk-ins are welcome. A lot of times, the parents, who bring in their kids for a routine ortho visit, ask me if I can do quick consultations for themselves or for their younger kids. I always say yes without any hesitation.

Obviously I work Corp now and I've mastered the 5 minute consultation. You and I also have tons of experience which makes diagnosis and tx planning easier. These 5 min ortho consultations are probably more difficult for the new ortho grads. They have no real life experience. Regardless ..... anything that is FREE lessens the value of that consultation. Patients attach no value to the consultation. I get it. This is the world we live in. "Convenience" rules. The "E" world. Medicine charges for that Dr's time. Even if it is a pt copay along with some insurance payment. These patients are paying for knowledge through years of education. Experience. You cant just walk into a medical office and demand a free consultation. Nope. Free ortho consultations. Free dental exams with 4 BWs. Free lifetime bleaching with exam. $1000 off Invisalign today. Groupon. Internet ads. Facebook ads. Dentists advertising prices for crowns, braces, extractions, etc. etc.

Again. I understand why dentists are doing what they have to do to "compete" with their fellow colleagues. But all of this moves us closer and closer to being "tooth mechanics" as opposed to highly educated, respected Doctors of Dental Surgery (DDS) or Doctors of Medical Dentistry (DMD).

Now the positive. I still love what I do. Enjoy helping patients and the interaction. It helps that my total education debt (11 yrs) was less than 100K.

 

[babagandu2424]

It really depends on how hard one works and how one spends his/her hard earned money. A dentist with $500k student loan + $100k practice loan has the same amount of debt as a dentist who has $100k student loan + $500k practice loan. A dentist who has $500k student loan and lives with his/her parents has the same debt amount as a dentist, who has zero student loan but took out a $500k loan to buy a house. Not all dentists who graduated from expensive private dental schools will be in financial trouble. If he/she works smart as well as hard, paying back a huge debt shouldn't be a problem. Cold Front graduated from a very expensive school not too long ago. He graduated at least 9-10 years after me and he has been a lot more successful than I am.

After graduation, my sister and her husband moved in to live with our parents to save money. Our parents helped babysitting her 2 kids so she could work 7 days/wk (3 days/wk at her own office and 4 days/wk for a Corp office). While living with our parents, she bought a multi-million dollar medical/surgical office building with our uncle, who’s a MD, and several of his MD friends. At that time, she could only afford to put in $100k. A couple of years later, this medical building was sold to a Hong Kong investor for 5 times its original price. She then used the profit to buy more properties. She now owns more properties than me despite making less money than me. I am a dental specialist and she is a general dentist.

This concept of saving and investing applies to every income earner. I think the point of the post was that the ROI for dent isn’t worth it nowadays with the tuition costs. Generally, I agree; however, their will always be individuals who are more business savvy that make their income work for them and come out on top. Unfortunately, this is a small subset of really all healthcare professionals.

 

[charlestweed]

Obviously I work Corp now and I've mastered the 5 minute consultation. You and I also have tons of experience which makes diagnosis and tx planning easier. These 5 min ortho consultations are probably more difficult for the new ortho grads. They have no real life experience. Regardless ..... anything that is FREE lessens the value of that consultation. Patients attach no value to the consultation. I get it. This is the world we live in. "Convenience" rules. The "E" world. Medicine charges for that Dr's time. Even if it is a pt copay along with some insurance payment. These patients are paying for knowledge through years of education. Experience. You cant just walk into a medical office and demand a free consultation. Nope. Free ortho consultations. Free dental exams with 4 BWs. Free lifetime bleaching with exam. $1000 off Invisalign today. Groupon. Internet ads. Facebook ads. Dentists advertising prices for crowns, braces, extractions, etc. etc.

Again. I understand why dentists are doing what they have to do to "compete" with their fellow colleagues. But all of this moves us closer and closer to being "tooth mechanics" as opposed to highly educated, respected Doctors of Dental Surgery (DDS) or Doctors of Medical Dentistry (DMD).

Now the positive. I still love what I do. Enjoy helping patients and the interaction. It helps that my total education debt (11 yrs) was less than 100K.

Yes, with my PPO plan, I have to pay $40 copay every time (usually once or twice a year) I see my family physician. But doing exams all day long is pretty much the doctor's main source of income, which isn’t much. In order to make more money, the doctors have to perform procedures. To get paid more in medicine, one has to specialize. Gastroenterologgists have to perform colonoscopy. Cardiologists have to perform angioplasty. Orthopedic surgeons have to perform knee surgeries. Opthalmologists have to do cataract surgeries etc. The reason we, dentists, make more money than the primary care physicians is we actually have to sit down to perform procedures.

For us, orthodontists, we can do easy 5-minute consultations while we treat our other active patients. It doesn’t take much of our time. Therefore, it’s not a big deal that we don’t to charge the patients for the consultation visit. We still get paid a lot for what we do.

 

[charlestweed]

This concept of saving and investing applies to every income earner. I think the point of the post was that the ROI for dent isn’t worth it nowadays with the tuition costs. Generally, I agree; however, their will always be individuals who are more business savvy that make their income work for them and come out on top. Unfortunately, this is a small subset of really all healthcare professionals.

Any dentist with common sense should have no problem paying back the debt. People with common sense make decisions based on what will provide the best and most positive outcome. You don’t work 4 days (or less days) a week when you owe $500k loan. You don’t spend $500k to build or purchase an office when you owe $500k in student loan. You don’t buy a house when you have $500k student loan. You don’t go out and buy a $50-60k car when you have that much student loan debt. How about continuing to live like a student for another 2-3 years (live with the parents or share an apartment with roommates) after graduation to cut the debt in half using Dave Ramsey’s debt snowball method? Most physicians live like this after they graduate since their resident’s salary is only $50-60k a year. If physicians can do this, why can’t we, dentists, do the same?

 

[PerioDont]

Unlike many of my colleagues, I don’t have a separate 30-minute or 1-hour slot for a new patient consultation. I wonder why they need so much time for consultation. What kind of conversation they have with the new patients? What if these new patients don’t show up? What if the patients decline tx recommendation and get tx somewhere else? That would be a big waste of doctor’s and staff’s time. Working for a corp office helped train me how to do consultation in less than 5 minutes. A short 30 second video clip like this one () can easily help me explain to a new patient why I need to take out 4 premolars and how I close the extraction spaces. With experience, I don't need to waste time taking a bunch of x rays (except for some impacted canine cases) in order to know what to do. And for a patient who likes to ask a lot of questions, I don’t just stay in one room to chit chat with him/her and make other patients wait. I go to other chairs to examine all other active patients first…..I write down the instructions (that’s why I love paper charts) for my assistants to perform necessary procedures…..and then I go back to talk to the patient who still has a lot of questions for me.

Any new patient, who calls my office for consultation, should get the appointment right away....because there is no specific time slot for this....all walk-ins are welcome. A lot of times, the parents, who bring in their kids for a routine ortho visit, ask me if I can do quick consultations for themselves or for their younger kids. I always say yes without any hesitation.

What does your wife do charles as far as consults?

Perio charting etc can take a bit longer than what I imagine ortho consults would take. Does she have consult appointments and how much does she charge for them?

 

[charlestweed]

What does your wife do charles as far as consults?

Perio charting etc can take a bit longer than what I imagine ortho consults would take. Does she have consult appointments and how much does she charge for them?

Yes, she charges $50 for consultation. If the patient accepts the tx plan, she will waive that fee.

 

[charlestweed]

This is a success story of a dentist who achieves the financial freedom at a very young age. He graduated from dental school less than 10 years ago and he recently quit his job because he already saved enough for retirement. He doesn't own a practice. He worked as an associate dentist in a rural area in Canada, where he was the only dentist there. He chose to skip lunch so he could see many patients in one day possible.....so he only needed to work 4 days/wk. He wanted to have time to travel to back and forth to see his fiance. His fiance is also a general dentist. She will go back to school to specialize in endo.

 

[tarheelsg]

This is a success story of a dentist who achieves the financial freedom at a very young age. He graduated from dental school less than 10 years ago and he recently quit his job because he already saved enough for retirement. He doesn't own a practice. He worked as an associate dentist in a rural area in Canada, where he was the only dentist there. He chose to skip lunch so he could see many patients in one day possible.....so he only needed to work 4 days/wk. He wanted to have time to travel to back and forth to see his fiance. His fiance is also a general dentist. She will go back to school to specialize in endo.

Keep in mind he has an active role at bootcamp.com, sold DAT genius to them a while back, and owns roadmapprep so not exactly an average dentist.

 

[charlestweed]

Keep in mind he has an active role at bootcamp.com, sold DAT genius to them a while back, and owns roadmapprep so not exactly an average dentist.

Yes, he’s a smart person. But to get to where he is right now, he had to make a lot of sacrifices (moving to a boring rural town, having a long distance relationship with his fiance, giving up his lunch hour etc) that many dentists at his age are not willing to make.

He also works smart. Earlier in his career, he worked 5 days a week. Now with the experience and the right office, he works 7 hours straight (no lunch), 4 days a week and makes a lot more than when he worked 5 days a week. I am sure to get to where he’s right now, he also has to spend and save his hard earned money wisely…..unlike many of the young dentists I know.

He’s definitely an above average dentist but he may not be way above average like you think. After 6 years, he’s still not able to open his own dental office. He’s successful because he works smart as well as hard.

 

[askadds]

Funny! we all just got a letter from Cigna dental lowering our fees by 25% across the board. Going to Dental School is making more and more sense financially. This is not sustainable. You guys can talk about working hard all day, wait till you have to, then we talk.

 

[alexteethdocman]

To answer the initial prompt as a predental student applying this cycle, there is more to the profession that interests me than just the potential for earnings. To be completely honest, I don't see jobs as more than that- a job, not something I'm trying to devote my time to 7 days/week or something that will make me completely happy. Still, I think there's something to be said for going into a profession that could contribute (at least in part) to being happy.

I'm just a predental student, but I already have tens of thousands of dollars worth of loans for my undergrad. I would be a 1st gen dentist and my family's income is definitely below average. Still, if dentistry is something that you're actually interested in, I think you shouldn't eliminate it as a potential option just because of the cost. I cannot afford to take out more loans, nor do I want to dig myself into that enormous hole of debt. I found out about the HPSP scholarship and that is the route that I'm planning on taking. I know this isn't necessarily feasible for everyone, but there are options besides just accepting the burden of the debt. Ultimately, the amount of debt you're willing to take on to reach your goals is more of a personal question. How much is becoming a dentist worth to you?

Again, I'm not saying everyone should go for it, but I do think that if you weigh the benefits and costs of it, there is more than just what's on a balance sheet. What about the ability to adjust your own schedule? What about the fact that you get to interact with tons of people everyday and create relationships with your patients? What about the satisfaction that you get from knowing you are having a positive impact on people's lives? For me, these benefits outweigh the costs and having even the possibility to attend school debt free makes me excited for my future.

Finally, if you're interested in dentistry to become rich, you sir/mam have some serious thinking to do. There are certainly easier ways to make a six figure income- ways that wouldn't require more/much more schooling than an undergrad degree. I'm totally fine with wanting to make a lot of money (as a dentist or otherwise), it sure seems as though that would ease a lot of stress. BUT, that should not be your primary goal as a dentist.

These are just my opinions, obviously I'm lacking in all of the actual experiences of dental school and practicing. Still, we are not all clueless predents expecting to make 7 figures and work 3 days/week- and I'm ok w/that.

- Alex

 

[2TH MVR]

Funny! we all just got a letter from Cigna dental lowering our fees by 25% across the board. Going to Dental School is making more and more sense financially. This is not sustainable. You guys can talk about working hard all day, wait till you have to, then we talk.

Yeah. Not fun. I can remember when I was in private practice and for many years ... Cigna NEVER raised their ortho reimbursement fees. But at the same time you are getting that 25% drop in reimbursements. You get a letter from your landlord that your rent will be raised per your lease. Employees are looking at you for their annual raises. The health care medical insurance premiums for your small group are going UP. They always do. Software management fees, IT fees, phone, internet, accounting and tax fees, area expenses, marketing, insurance for the facility, malpractice, etc. ect. EVERYTHING always goes up. How about when an AC conditioner dies? $5000-7000 replacement. You think the landlord is responsible for the AC units? Nope. You are if you are in a retail building.

I juggled this for years. Two practices. Thank goodness I owned the real estate for one practice .... therefore I CONTROLLED the monthly mortgage amount. Make no mistake. Running a dental practice is tough and takes some business knowledge.

These are just the expenses you have some control of. What about the other variables? Corps and other dentists opening next to you further dividing the patient pie. This happened to me. You want to practice in a desirable area? Guess what? So does EVERY other dentist and Corp.

The point of all of this is to go into dentistry with your eyes open. I and others who are older did fine because we graduated with less debt and were able to build equity in our lives. I graduated in total with less than 100K of school debt. I am in shock when I read about new grads with over 500K in debt looking to practice in saturated areas such as LA, Phx, NY, etc. etc.

 

[askadds]

To answer the initial prompt as a predental student applying this cycle, there is more to the profession that interests me than just the potential for earnings. To be completely honest, I don't see jobs as more than that- a job, not something I'm trying to devote my time to 7 days/week or something that will make me completely happy. Still, I think there's something to be said for going into a profession that could contribute (at least in part) to being happy.

I'm just a predental student, but I already have tens of thousands of dollars worth of loans for my undergrad. I would be a 1st gen dentist and my family's income is definitely below average. Still, if dentistry is something that you're actually interested in, I think you shouldn't eliminate it as a potential option just because of the cost. I cannot afford to take out more loans, nor do I want to dig myself into that enormous hole of debt. I found out about the HPSP scholarship and that is the route that I'm planning on taking. I know this isn't necessarily feasible for everyone, but there are options besides just accepting the burden of the debt. Ultimately, the amount of debt you're willing to take on to reach your goals is more of a personal question. How much is becoming a dentist worth to you?

Again, I'm not saying everyone should go for it, but I do think that if you weigh the benefits and costs of it, there is more than just what's on a balance sheet. What about the ability to adjust your own schedule? What about the fact that you get to interact with tons of people everyday and create relationships with your patients? What about the satisfaction that you get from knowing you are having a positive impact on people's lives? For me, these benefits outweigh the costs and having even the possibility to attend school debt free makes me excited for my future.

Finally, if you're interested in dentistry to become rich, you sir/mam have some serious thinking to do. There are certainly easier ways to make a six figure income- ways that wouldn't require more/much more schooling than an undergrad degree. I'm totally fine with wanting to make a lot of money (as a dentist or otherwise), it sure seems as though that would ease a lot of stress. BUT, that should not be your primary goal as a dentist.

These are just my opinions, obviously I'm lacking in all of the actual experiences of dental school and practicing. Still, we are not all clueless predents expecting to make 7 figures and work 3 days/week- and I'm ok w/that.

- Alex

You realize that when you come out and under close to 3/4 million dollars in loans, your passion will quickly fade because the loans are holding you back and then it becomes a JOB. Good luck to you if you're doing for passionate reasons.

As the previous person said, us dentist that are coming on this board to say this stuff is purely to open your eyes. Not to discourage you but to let you know about the realities that so many dentists are concerned with. That's all.

 

[alexteethdocman]

You realize that when you come out and under close to 3/4 million dollars in loans, your passion will quickly fade because the loans are holding you back and then it becomes a JOB. Good luck to you if you're doing for passionate reasons.

As the previous person said, us dentist that are coming on this board to say this stuff is purely to open your eyes. Not to discourage you but to let you know about the realities that so many dentists are concerned with. That's all.

Understandable, and I appreciate the real insight from the people who know more than I do. This is the reason, however, that I'm only applying to and considering schools that are on the lower end of the tuition range. I'm also trying to get a scholarship to have 100% of my tuition paid by the military.

I don't doubt that the debt kills the passion, but there's no reason to assume that every one of us in the process of applying has no financial plan. I also think its kinda dumb to try and dissuade kids from what they're interested in because you don't see it as financially favorable. Not everything in life makes financial sense- if it did, no one would get married, have kids or even spend money on hobbies.

 

[askadds]

Understandable, and I appreciate the real insight from the people who know more than I do. This is the reason, however, that I'm only applying to and considering schools that are on the lower end of the tuition range. I'm also trying to get a scholarship to have 100% of my tuition paid by the military.

I don't doubt that the debt kills the passion, but there's no reason to assume that every one of us in the process of applying has no financial plan. I also think its kinda dumb to try and dissuade kids from what they're interested in because you don't see it as financially favorable. Not everything in life makes financial sense- if it did, no one would get married, have kids or even spend money on hobbies.

READ my previous response. "Not to discourage you but to let you know about the realities that so many dentists are concerned with. That's all."

 

[allDAT]

Understandable, and I appreciate the real insight from the people who know more than I do. This is the reason, however, that I'm only applying to and considering schools that are on the lower end of the tuition range. I'm also trying to get a scholarship to have 100% of my tuition paid by the military.

I don't doubt that the debt kills the passion, but there's no reason to assume that every one of us in the process of applying has no financial plan. I also think its kinda dumb to try and dissuade kids from what they're interested in because you don't see it as financially favorable. Not everything in life makes financial sense- if it did, no one would get married, have kids or even spend money on hobbies.

How do you know that you’re interested in practicing dentistry? Besides some shadowing of mostly older dentists who practice under different conditions than what’s available to younger dentists, what has prepared you to be certain that being a dentist will be a satisfying and rewarding career choice?

One of the biggest challenges for pre dental students evaluating the profession is the impossibility of kicking the tires and looking under the hood of day to day dentistry before they handcuff themselves (and their families) to massive student loan liabilities.

You must speak to dentists who have graduated after 2012.

 

[alexteethdocman]

How do you know that you’re interested in practicing dentistry? Besides some shadowing of mostly older dentists who practice under different conditions than what’s available to younger dentists, what has prepared you to be certain that being a dentist will be a satisfying and rewarding career choice?

One of the biggest challenges for pre dental students evaluating the profession is the impossibility of kicking the tires and looking under the hood of day to day dentistry before they handcuff themselves (and their families) to massive student loan liabilities.

You must speak to dentists who have graduated after 2012.

Spoke to and shadowed a dentist who graduated from the University of MN SOD in 2016. He's an associate at a pediatric office in a rural area in WI and didn't warn me against the career or possibility of digging myself into a student debt shaped hole at all. He seemed happy.

For me, the HPSP route is basically the only way I'm going to dental school. I'm not too attached to realize that going to grad school and getting a job in research or otherwise w/a bio degree would be a much better option than being in debt for 20+ years. Still, this thread is filled with unsolicited advice from dentists who seem upset that they're profits are dwindling under modern healthcare practices. Yes- insurance companies are robbing you, yes- the debt to earning ratios simply don't make sense, and yes- we do understand how crippling that kind of debt can be. At the end of the day, I'm still interested in dentistry because there's a chance it may be worth while (w/a scholarship). If I'm not so lucky, I have no doubt in my mind that I will find another, more financially sensible career.

You're never too old to change your plans (unless of course you're already 1.3 mil in debt )

- Alex

 

[allDAT]

Spoke to and shadowed a dentist who graduated from the University of MN SOD in 2016. He's an associate at a pediatric office in a rural area in WI and didn't warn me against the career or possibility of digging myself into a student debt shaped hole at all. He seemed happy.

For me, the HPSP route is basically the only way I'm going to dental school. I'm not too attached to realize that going to grad school and getting a job in research or otherwise w/a bio degree would be a much better option than being in debt for 20+ years. Still, this thread is filled with unsolicited advice from dentists who seem upset that they're profits are dwindling under modern healthcare practices. Yes- insurance companies are robbing you, yes- the debt to earning ratios simply don't make sense, and yes- we do understand how crippling that kind of debt can be. At the end of the day, I'm still interested in dentistry because there's a chance it may be worth while (w/a scholarship). If I'm not so lucky, I have no doubt in my mind that I will find another, more financially sensible career.

You're never too old to change your plans (unless of course you're already 1.3 mil in debt )

- Alex

HPSP is the way to go if that door is open.