Dentistry: Recession Proof

Started by ChrisM07
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Recessions are like bullets....remember nothing is ever "bullet proof" rather bullet resistant.



You never want to stand in front of a minigun for long to try and prove a point.
 
Most importantly... this recession has only begun... it's gonna get reaaal bad... then let me hear about dentist profit margins.
 
I don't know about all dental practices being recession proof. I think the recession proofness is dependent on several factors: location, dentist/population ratio, effort put into practice growth, and treatment planning.

I regularly shadow at two offices. Both dentists are in their 60s and have similar skill levels, but dentist 1 is making more money now than ever, while dentist 2 is struggling and has to rake charts for callbacks and recently let a hygienist go. Dentist 1 is in a low saturation area, actively works on bringing in new patients, and treatment plans aggressively (almost too agro for my taste). Dentist 2 is in a high saturation area, has let his practice ride (slide) over the years, and is conservative with his treatment planning.

It's been interesting to see the dichotomy between these two practices and be able to take notes for future reference.

I just hope this wicked recession (depression?) recovers by the time I graduate! :scared:
 
Interesting article to say the least. I wonder how ortho is doing these days.
 
ChrisM07 said:
Check out this article I found today:

http://www.time.com/time/business/article/0,8599,1879760,00.html?cnn=yes
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I believe this article does not paint an accurate picture of the dental industry for the whole country. This article has so many things wrong with it that I have to list down all of its flaws.

  • The article uses a dentist who lives in Indiana as an opening example of how dentists are recession proof. First of all, this is totally skewed. Some parts of the country such as the west coast and the northeast are doing much worse than the rest of the country because that is where the economic crisis has hit the hardest. Dentists in these areas are cutting back the number of hours because patients are not coming through the door like they use to. The rest of the country (i.e. Midwest, southeast, and northwest) I hear is a little bit better off but not for much longer. But once the car companies start crashing down like everyone suspects, the Midwest will be in a similar situation as the west coast and the northeast. So of course the author of this article is going to use a dentist in Indiana because that's where the picture is still rosy and nice. Why didn't he use a dentist in southern California or in New York City where there is a high saturation of dentists? He would have gotten a different story there.
  • This article was written using data from the fourth quarter of 2008 which is misleading because the economic downturn didn't hit full force until the tail end of the fourth quarter in December. That was when companies were starting massive layoffs. But prior to December, most people had their jobs and health insurance to be able to visit the dentist. In other words, this article is using data where the profits from the beginning of the fourth quarter are supporting the profit losses at the tail end of the quarter and so as a result, the data is painting a rosier picture than it actually is because the majority of the damaging data will be a part of the first quarter of 2009 which is not out yet.
  • Why is this author using data from the Academy of Dental CPAs which only has a small sample size? Why are they not using data from the American Dental Association which also keeps statistics on incomes of dentists and specialists? The ADA certainly has a larger and more accurate sample size than the Academy of Dental CPAs. You would think that if a person wanted to find statistics on dentists, they would go to the ADA which every dentist is a member of. Why go to a small dental organization with a small sample size, and therefore skewed statistics?
  • Furthermore, the author undermines the message of his own article. How can the author claim that dentistry is recession proof when he cites a source that says "Traditionally it takes six to 12 months for economic trends to affect dental practice"? In other words, how can the author pick a title of an article that claims dentistry is recession proof when every economic analyst and even President Obama has clearly stated that the recession has not yet hit rock bottom? This is bad reporting at best and jumping to conclusions at worse.
Although the economy has been bad for everyone, there is still work for dentists. A dentist may not be able to persuade patients to get their teeth bleached or buy a set of veneers, but they will still have their bread and butter procedures such as fillings, crowns, and root canals that will still pay the bills. These procedures are necessary and non-negotiable. If a patient doesn't choose to recieve these procedures, they will eventually loose that tooth...plain and simple. Tell that to a patient and he/ she will fight tooth (pun intended!) and nail to do whatever it takes to save that tooth. Also, if a dentist is willing to see pediatric patients, that will help a lot too. President Obama has already passed the bill for the State Children's Health Insurance Program for $35 billion which ensures that every child will have health insurance if their parents cannot afford to buy health insurance for them. That's one of the reasons why I am grateful to be going into pediatric dentistry because I don't have to worry about whether parents have health insurance for their children because the government has already ensured that. But you don't have to be a pediatric dentist to see kids…general dentists can see kids too. Anyhow, that's my thoughts on this article.
 
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I actually work at an ortho office full time right now and their numbers have definitely dropped since the recession began. Many people are thinking twice about starting their kids in braces right now due to their financial situations. This office is in an area where there are a lot of wealthy people too. Don't get me wrong, they definitely still have patients, but the office was booming a few years ago and things have definitely slowed down.
However, my father, who is a pediatric dentist in the same town isn't experiencing much of a decrease in patients. Obviously the services he offers are more "necessary" than orthodontics though and are mostly covered by dental insurance.
 
Black Teeth said:
Also, if a dentist is willing to see pediatric patients, that will help a lot too. President Obama has already passed the bill for the State Children’s Health Insurance Program for $35 billion which ensures that every child will have health insurance if their parents cannot afford to buy health insurance for them. That’s one of the reasons why I am grateful to be going into pediatric dentistry because I don’t have to worry about whether parents have health insurance for their children because the government has already ensured that.
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Do you think that you will get a decent reimbursement from government insurance? Look how well Medicaid is doing in dentistry today. You may have a constant supply of patients, but you will have to work for nothing if you rely mostly on patients with government insurance.
 
Dentistry is not recession proof. Every industry will be affected by it to some extent. Interesting enough, I've read and heard that the gaming industry has continued to do well; so that is probably the closest thing to being recession proof.
 
Epictetus21 said:
Do you think that you will get a decent reimbursement from government insurance? Look how well Medicaid is doing in dentistry today. You may have a constant supply of patients, but you will have to work for nothing if you rely mostly on patients with government insurance.
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Too late. That's already the case right now but despite that, pediatric dentists still manage to do quite well. As I have said in other posts, the income of a pediatric dentist can rival those of an orthodontists. There are dental practices in Texas right now that are hiring pediatric dentists for $800 per day...and that's working for someone else. Imagine how much the income of a pediatric dentist would be if he owned his own dental office? Specialists in general get a higher pay rate from insurances for the same work as a general dentists. Pediatric dentists, as specialists, have training that make them more efficient at dealing with the behavior of children than the average general dentist. Even though the procedures are simple, many general dentists have trouble calming kids down which ends up wasting a lot of chair time. For a general dentist, too much chair time means lost income. For example, one of my pediatric dental faculty at UCLA can calm a child down and perform 3-4 fillings in a 20 minute period whereas many general dentists only end up accomplishing 1 filling in that same 20 minute time period because they spend so much time trying to calm the child down. That's why many general dentists don't want to see kids because they feel that managing the behavior of the child is beyond their expertise.

But you bring up a good point about Medicaid. Medicaid is broken. Many general dentists didn't accept Medicaid because of the low reimbursement rates and that contributed to the death of Diamonte Driver in 2007 that was reported in the Washington Post. That article really embarrassed a lot of lawmakers in Washington and bought the problems of Medicaid to the attention of the nation. Since then, the lawmakers in Washington have acted with urgency. That is why the funding of the State Childrens Health Insurance Program has increased from $5 billion under President Bush to over $35 billion under President Obama. That's more than a 7 fold increase!!! There are banks that didn't get a bailout from the government as big as $35 billion! So to answer your question, I don't think re-imbursement rates from Medicaid for the healthcare of children will be too much of a problem in the future. Pediatric dentists and general dentists who treat kids will benefit that much more from this increase. THANK YOU PRESIDENT OBAMA!!! I always knew there was a good reason why I voted for him.
 
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I'm a practicing dentist, and what I see is that although emergency dentistry is more prevalent than ever, cosmetic and other optional dentistry is definitely on a low. People just don't want to pay for things they don't absolutely need. Also, fee for service dentists are the ones who are taking the biggest hit as opposed to those who accept multiple insurances. Still, I can honestly say, thankfully, overall as a profession we are doing much better than most others.
 
I think the main problem with the article is this:

They base the headline on anecdotal evidence this: "It has amazed me," says Ganz, who also reports having his best year ever. "

But then they also write: Willeford reports an overall fourth quarter slowdown among the Academy of Dental CPA's clients.

So which one is it? I know profitability in dentistry is always extremely varied, probably even more so during a recession, but the article takes a couple of examples of people who have had their best years ever to argue that dentistry is recession resistant, while ignoring the fact that the overall trend is towards a slowdown.
 
Dentistry and and recession, etc....

Dentistry is as essential as any profession to human life. Everyone has teeth. Everyone must eat to survive. If your teeth hurt and they hinder eating you call your dentist. I agree with one of the above posters that cosmetics will be down but emergency and more expensive treatments will be up while regular check ups will be down. Either way, you are a dentist and you may see a dip in the numbers that walk through the door but eventually they will have to see you. I think of it as working for a car garage, eventually they have to get the oil changed, more so because people cannot really practice self dentistry like trying to figure out how to replace a fuel pump or a belt in your engine. If anything with a recession looming, dentistry is a great field to be in especially if you own your own practice. You won't be let go, you won't be downsized, you won't be replaced by someone less qualified that gets paid less to do essentially the same job as you and you just get more vacation days 👍
 
i knew 4 years ago when i embarked upon this journey we were going to experience a national economic recession, thats why i chose dentistry 😉 haha

for real tho, bad times = less dental coverage = less patients

however, people will always need dentists. i have to book 3 mos in advance to get into my dentist..
 
I figure some of the cosmetic work will decline, but if your teeth hurt, you're gonna go to the dentist no matter what. So root canals and crowns will probably have steady demand, but regular checkups will probably take a hit. Ortho would probably take a hit too, no one wants to start expensive long term treatment when they're not sure if they're going to have a job in a couple months.

But the great thing about being self-employed is that you might make less money, but you'll never be fired. 🙂
 
drpsuedonym said:
But the great thing about being self-employed is that you might make less money, but you'll never be fired. 🙂
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But you still have to pay your staff, lease, mortgage, equipment....and make that car payment on your beemer..
 
I can say that there is a silver lining that can come from this recession. With people having lost thier health insurance along with thier jobs, I would not be surprised if the number of patients enrolling at dental schools explodes. Without dental insurance, people will be flocking to the cheapest source of dental care, which generally means dental schools. At a dental school, patients can get good dental care at a heavily reduced price. In return, the dental students wil get the clinical experience they need. Both parties benefit. Regardless of how you may feel about the quality of the dental work at a dental school, procedures are generally performed strictly "by the book" and monitored by actual dentists. Dental students are less likely to "cut corners" when they are being supervised by clinical instructors who have to approve the procedures before they can recieve credit, which is more than I can say for some unscrupulous dentists out in the real world. Besides, dental schools generally stand by the work of their students and will often correct any problems at no cost to the patient. I rarely see a dentist out in private practice admit to a mistake when one clearly was made and offer to fix at no charge. The only ones in the dental profession who could possibly take a hit are the private practice dentists who will be losing some of thier patients to the dental schools. I guess the silver lining in the recession can be good depending on what point of view you are looking at. Good for dental students and patients...possibly bad for private practice dentists.
 
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Black Teeth said:
I can say that there is a silver lining that can come from this recession. With people having lost thier health insurance along with thier jobs, I would not be surprised if the number of patients enrolling at dental schools explodes. Without dental insurance, people will be flocking to the cheapest source of dental care, which generally means dental schools. At a dental school, patients can get good dental care at a heavily reduced price. In return, the dental students wil get the clinical experience they need. Both parties benefit. Regardless of how you may feel about the quality of the dental work at a dental school, procedures are generally performed strictly "by the book" and monitored by actual dentists. Dental students are less likely to "cut corners" when they are being supervised by clinical instructors who have to approve the procedures before they can recieve credit, which is more than I can say for some unscrupulous dentists out in the real world. Besides, dental schools generally stand by the work of their students and will often correct any problems at no cost to the patient. I rarely see a dentist out in private practice admit to a mistake when one clearly was made and offer to fix at no charge. The only ones in the dental profession who could possibly take a hit are the private practice dentists who will be losing some of thier patients to the dental schools. I guess the silver lining in the recession can be good depending on what point of view you are looking at. Good for dental students and patients...possibly bad for private practice dentists.
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Nice way to put it. I think that was something many were thinking but could not put words to it. I think a nice word is, Dentistry = stability.
 
Black Teeth said:
I can say that there is a silver lining that can come from this recession. With people having lost thier health insurance along with thier jobs, I would not be surprised if the number of patients enrolling at dental schools explodes. Without dental insurance, people will be flocking to the cheapest source of dental care, which generally means dental schools. At a dental school, patients can get good dental care at a heavily reduced price. In return, the dental students wil get the clinical experience they need. Both parties benefit. Regardless of how you may feel about the quality of the dental work at a dental school, procedures are generally performed strictly "by the book" and monitored by actual dentists. Dental students are less likely to "cut corners" when they are being supervised by clinical instructors who have to approve the procedures before they can recieve credit, which is more than I can say for some unscrupulous dentists out in the real world. Besides, dental schools generally stand by the work of their students and will often correct any problems at no cost to the patient. I rarely see a dentist out in private practice admit to a mistake when one clearly was made and offer to fix at no charge. The only ones in the dental profession who could possibly take a hit are the private practice dentists who will be losing some of thier patients to the dental schools. I guess the silver lining in the recession can be good depending on what point of view you are looking at. Good for dental students and patients...possibly bad for private practice dentists.
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I overheard that some people are having trouble getting patients at our school due to the recession. Not a lot of people think logically like that... generally people don't know the quality they are getting when they get work done at a dental school. Plus it is more time intensive. And, well, time is money too.

What do you guys think about the part in the article that mentions that if people forgo dental visits during the recession, dentists will see an influx of more complex/expensive cases since a lot of people aren't keeping up with the upkeep now? Will this be enough to balance out the loss due to people holding off on procedures now?
 
wigglytooth said:
I overheard that some people are having trouble getting patients at our school due to the recession. Not a lot of people think logically like that... generally people don't know the quality they are getting when they get work done at a dental school. Plus it is more time intensive. And, well, time is money too.

What do you guys think about the part in the article that mentions that if people forgo dental visits during the recession, dentists will see an influx of more complex/expensive cases since a lot of people aren't keeping up with the upkeep now? Will this be enough to balance out the loss due to people holding off on procedures now?
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Usually when dental students complain that they are having a hard time finding patients, it really means that they are having a hard time finding patients who need the right type of dental procedures that they need to perform in order to graduate. I use to say that all the time when I was a dental student. Even though there were plenty of patients enrolling at the dental school, I sometimes had trouble finding patients that needed periodontal surgery and hence, I would always complain that I had problems finding patients. But in actuality, there were plenty of patients...just not patients with the type of dental procedures that I needed in order to graduate. It's possible that the students at your school were not specific about why they couldn't find patients? Was it because there actually weren't any patients or was it because they had a hard time finding a particular patient with the dental procedure that they needed to graduate?

Anyhow you might still be right in your assumption. Only time will tell. Patients don't show up at dental schools until they are in pain. Dental problems haven't had time to fester and get worse and the majority of uneployed people have only recently loss their jobs. Give it some time...when caries eventually result in a root canal and they cannot afford to pay a private practice dentist for it after trying thier hardest to find the money, it's probably then that they will go looking for a dental school. My suggestion that patient enrollment at dental schools will increase is only my prediction...but it's a prediction based on my past experience. Every single one of my patients in dental school became patients at UCLA simply because they could not afford to pay for the dental services by a private practice dentist. I'm sure that every one of them would have preferred a private practitioner but their finances left them little choice but to have it done at a dental school. I'm sure that theme is true of every dental school in the country. And even if they don't know the quality that they are getting with student dental work, what choice do they really have other than a GPR? Many areas are just not blessed with free dental clinics. In those areas, the dental schools and the hospital GPR programs are the next best thing.

I also noticed that you attend Stony Brook's dental school. New York City and Long Island may be the one exception to my prediction. Never have I seen a region that is more saturated with dental schools and hospital GPR programs than the New York City and Long Island areas. The area where you attend dental school is unique because unemployed patients have several alternatives to cheap dental care. That may also be the reason why the students at Stony Brook have not been getting the types of patients they need. The several GPR programs in your area may be consuming larger pieces of the patient pie...leaving Stony Brook with the few patients remaining. Anyhow, it's just my analysis.
 
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Black Teeth said:
Usually when dental students complain that they are having a hard time finding patients, it really means that they are having a hard time finding patients who need the right type of dental procedures that they need to perform in order to graduate. I use to say that all the time when I was a dental student. Even though there were plenty of patients enrolling at the dental school, I sometimes had trouble finding patients that needed periodontal surgery and hence, I would always complain that I had problems finding patients. But in actuality, there were plenty of patients...just not patients with the type of dental procedures that I needed in order to graduate. It's possible that the students at your school were not specific about why they couldn't find patients? Was it because there actually weren't any patients or was it because they had a hard time finding a particular patient with the dental procedure that they needed to graduate?

Anyhow you might still be right in your assumption. Only time will tell. Patients don't show up at dental schools until they are in pain. Dental problems haven't had time to fester and get worse and the majority of uneployed people have only recently loss their jobs. Give it some time...when caries eventually result in a root canal and they cannot afford to pay a private practice dentist for it after trying thier hardest to find the money, it's probably then that they will go looking for a dental school. My suggestion that patient enrollment at dental schools will increase is only my prediction...but it's a prediction based on my past experience. Every single one of my patients in dental school became patients at UCLA simply because they could not afford to pay for the dental services by a private practice dentist. I'm sure that every one of them would have preferred a private practitioner but their finances left them little choice but to have it done at a dental school. I'm sure that theme is true of every dental school in the country. And even if they don't know the quality that they are getting with student dental work, what choice do they really have? Many areas are just not blessed with free dental clinics. In those areas, the dental schools and the hospital GPR programs are the next best thing.

I also noticed that you attend Stony Brook's dental school. New York City and Long Island may be the one exception to my prediction. Never have I seen a region that is more saturated with dental schools and hospital GPR programs than the New York City and Long Island areas. The area that you attend dental school is unique because unemployed patients have several alternatives to cheap dental care. That may also be the reason why the students at Stony Brook have not been getting the types of patients they need. The several GPR programs in your area may be consuming larger pieces of the patient pie...leaving Stony Brook with the few patients remaining. Anyhow, it's just my prediction.
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The student I talked to did not say they were having problems with getting patients for particular procedures, but that the patient flow was low in general. I do not believe they were having the classic, "I need to do "x" to graduate problem." Your suggestion of saturation being the culprit is quite compelling, but I'm not sure if going to the dental school vs another dental clinic/GPR program would be have much difference in price since I've heard that we've always had a pretty good flow of patients (I really have no clue about this, just putting it out there!). It'll definitely be interesting to see what happens in the next few years in terms of where patients get their care, what types of procedures will be done, and what kind of change in number of dental visits occur.
 
I dont think any job is recession proof. Everyone suffers in some way especially with how bad this recession is. IMHO.
 
I find it ironic that one article says that dentistry is "recession proof" and the other one basically states that dentists are seeing less and less patients.
 
jay47 said:
I find it ironic that one article says that dentistry is "recession proof" and the other one basically states that dentists are seeing less and less patients.
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You can't compare these 2 articles. Like black teeth mentioned earlier, the article that mentions that "dentistry is recession proof" only gets the opinion of a single dentist from Indiana where dentistry is doing much better than in other areas like California and other states on the east coast.

Dentistry is not recession proof.
 
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