Disadvantages of Dentistry?

[PSU SHC 414]

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Hey All,

A few months ago, I declined acceptance offer(s) to medical school after I had the chance to seriously consider how becoming a physician could possibly (negatively) impact my life over the long-term.

One of the biggest apprehensions I had about medicine is how the profession has changed to one that is now governed by managed care - I didn't want to devote that much time, money, and effort to medical school only to come out as another miserable M.D.

This leads to my first question:

How has the ADA been able to protect dentists from managed care, and do you anticipate that dentistry will eventually succumb to the same fate that (general practice) physicians have?

Also:

What, in your opinion(s), are the disadvantages of a career in dentistry?


Thanks for your time...

 

[Cold Front]

Personally, there are very few disadvantages in dentistry, as many people consider the profession as one of the best in America.

Some of down sides of the field are that it can become your whole life if you own your practice; i.e. working longer hours at the office or bringing charts home to work up treatment plans on patients who have not indicated the slightest interest in your ideas, plus it is a physically demanding profession. Efficiency is big deal in dentistry, and as result it can burn you out if you don't manage the way you practice from time to time.

In comparison to medicine, just look at the number of people applying to both professions. Dental school applications are higher than ever. For the first time, the GPAs of entering dental students exceed those of students applying to medical school. Dentists surpassed (general) physicians' income several years ago.

 

[brush]

Dentists are the most stressed professionals 😱

 

[armorshell]

Dentists are the most stressed professionals 😱

There's no way that the average dentist is more stressed than the average physician.

 

[Mackchops]

The biggest downside to dentistry that I can think of is that I am more likely to committ suicide as a dentist according to a Time article from the 80's that never really existed.

Really, the profession is great. There's some concerns over access -- the disparity is much greater than in medicine, but that has always been present. There are other problems as well, but it is a well-managed profession and for the forseeable future will remain self-governing in my opinion. But we do need to address access in order to avoid external pressures towards socialized or managed care...

 

[Rube]

The best part about dentistry is also the worst. You are autonomous from the day you pass your boards and so you can really can practice the way you want. Mostly, nobody is going to come behind you and double check your work. This is nice, and it is the way every profession should be, but if you don't keep up you can become lazy.

Also, some dentists look like ****** pushing beauty parlor treatment off the back of yellow pages rather than doctors. Advertising is good, but dentists need to do it with a certain amount of restraint. The ever increasing push to sell treatment plans or gain new patients is probably the most unseemly aspect of dentistry in 2007. If the profession was smart, they'd put some sensible restraints on advertising, before our image takes a big hit.

Overall though dentistry offers a lot to its doctors and patients. Given the advances in tx and products available, I think dentistry is in its golden age.

 

[Ericokle]

please delete this post

 

[BuckeyMcGee]

The only downside of dentistry I can see are the physical demands. I don't want a bent neck down the road (or back) and am constantly aware of proper ergonomic positioning.
And by the way, I don't believe there should be any restraint or limit upon a dentist in their ability to advertise/market their practice. We live in a capitalist society and if a dentist looks like a *****, let them continue to look like one...it only is ultimately to our benefit.

 

[SuperC]

it can become your whole life if you own your practice; i.e. working longer hours at the office or bringing charts home.

Uhh, what? If you don't think MD's are not doing this, you need to get off the pipe.

the GPAs of entering dental students exceed those of students applying to medical school.

Umm, no. Find me ONE reference. This is just plain not true.

Dentists are the most stressed professionals 😱

NO again! Granted there are many different areas if medicine, but the most stressed, just plain flat NO.

Some dentists look like ****** pushing beauty parlor treatment off the back of yellow pages rather than doctors. Advertising is good, but dentists need to do it with a certain amount of restraint. The ever increasing push to sell treatment plans or gain new patients is probably the most unseemly aspect of dentistry in 2007. If the profession was smart, they'd put some sensible restraints on advertising, before our image takes a big hit.

OH.... OK.... I see your point.... wait.... No I don't. Number 1: Gaining new patients will be your main goal when you are in practice. You need them to pay your bills. It helps YOU and it helps the PATIENTS. Number 2: There are "******" in every business. Number 3: Not every dentist on the planet is required to heal the world. There is NOTHING wrong with having a cosmetic based practice. If people did not want better looking teeth, there would not be a market for it. So until everyone is completely satisfied with their God given teeth, there will be a market for this. Again, BECAUSE THE PEOPLE WANT IT.

My points and my VERY own opinion: Dent is better than med, because of the individuality and craftsmanship of the field and the blending of science and art.
1: Individuality: Everyone has a different approach to the same problem. There are different techniques to EVERY SINGLE procedure you can think of.
2: Craftsmanship: If you really enjoy building, creating, problem solving, this stuff is great.
3: Science: More science classes than you can shake a stick at.
4: Art: Are you creative? Can you visualize what looks good, what the end product will be?

The great thing about dentistry is that you can make it WHAT YOU WANT. You can "*****" out and go cosmetic, you can "heal the world" and stop pain.

You have to be creative and independent. Many of the med people I speak with are "math type" people. They need rules. Dentistry is kinda like the rouge medical field, a few basic principles, and the rest is up to you.

XO,
-C

 

[makushin]

Uhh, what? If you don't think MD's are not doing this, you need to get off the pipe.
Umm, no. Find me ONE reference. This is just plain not true.

NO again! Granted there are many different areas if medicine, but the most stressed, just plain flat NO.

OH.... OK.... I see your point.... wait.... No I don't. Number 1: Gaining new patients will be your main goal when you are in practice. You need them to pay your bills. It helps YOU and it helps the PATIENTS. Number 2: There are "******" in every business. Number 3: Not every dentist on the planet is required to heal the world. There is NOTHING wrong with having a cosmetic based practice. If people did not want better looking teeth, there would not be a market for it. So until everyone is completely satisfied with their God given teeth, there will be a market for this. Again, BECAUSE THE PEOPLE WANT IT.

My points and my VERY own opinion: Dent is better than med, because of the individuality and craftsmanship of the field and the blending of science and art.
1: Individuality: Everyone has a different approach to the same problem. There are different techniques to EVERY SINGLE procedure you can think of.
2: Craftsmanship: If you really enjoy building, creating, problem solving, this stuff is great.
3: Science: More science classes than you can shake a stick at.
4: Art: Are you creative? Can you visualize what looks good, what the end product will be?

The great thing about dentistry is that you can make it WHAT YOU WANT. You can "*****" out and go cosmetic, you can "heal the world" and stop pain.

You have to be creative and independent. Many of the med people I speak with are "math type" people. They need rules. Dentistry is kinda like the rouge medical field, a few basic principles, and the rest is up to you.

XO,
-C

You make some good points about the autonomy of the profession.

To the OP: I think anyone considering dentistry has to ask themselves if they would become bitter if the job became less financially lucrative. If you wnat money thats fine, but the other desires have to be there too. Otherwise IF dentistry gets socialized in some regard, which I think is certainly a possibility in our lifetimes, you will probably become quite miserable. I'm coming to terms with this myself as I prepare to enter dental school next year. Anything is possible in this world we live in. And let's face it, people don't like to pay for health care. Health care does not fit well into the free-market system in the eyes of many americans. So let's prepare for the worst and hope for the best.

 

[Cold Front]

Umm, no. Find me ONE reference. This is just plain not true.

Well, the average non-science GPA of accepted medical student today is about 3.7. There are at least 6-7 dental schools who have the same average or even higher (Nebraska, Colorado, Harvard, UPenn, UTSA, Iowa, Stony Brook and possibly UCLA, Minnesota and OSU very soon).

The AAMC represents 126 accredited M.D.-granting U.S. medical schools, while the ADA represents only 56 dental schools (44% of total US med schools).

As of 2007, 42,315 applicants applied to those 126 MD programs, 17,759 matriculated (42% of those who applied). The total number of dental school applicants will probably set a new record this year, probably about 14,000 for this cycle, for around 4,688 seats (34% of those who applied).

The quality of med applicants might be slightly better overall when it comes to academic stats, but dental applicants are getting equally as good, and as seen in some dental programs even better!

You want sources?

• http://www.aamc.org/data/facts/2007/2007mcatgpa.htm
• http://www.adea.org/webdocs/AADSAS/DentistryUpdate.pdf
• http://forums.studentdoctor.net/showthread.php?t=388256

 

[PSU SHC 414]

I appreciate the everyone's feedback so far.

Anyone care to address what the role of managed care in dental medicine is today, and how this could change in the future (particularly if there is a significant administration change in Washington come '08 and going forward)?

 

[SuperC]

Well, the average non-science GPA of accepted medical student today is about 3.7. There are at least 6-7 dental schools who have the same average or even higher (Nebraska, Colorado, Harvard, UPenn, UTSA, Iowa, Stony Brook and possibly UCLA, Minnesota and OSU very soon).

The AAMC represents 126 accredited M.D.-granting U.S. medical schools, while the ADA represents only 56 dental schools (44% of total US med schools).

As of 2007, 42,315 applicants applied to those 126 MD programs, 17,759 matriculated (42% of those who applied). The total number of dental school applicants will probably set a new record this year, probably about 14,000 for this cycle, for around 4,688 seats (34% of those who applied).

The quality of med applicants might be slightly better overall when it comes to academic stats, but dental applicants are getting equally as good, and as seen in some dental programs even better!

You want sources?

• http://www.aamc.org/data/facts/2007/2007mcatgpa.htm
• http://www.adea.org/webdocs/AADSAS/DentistryUpdate.pdf
• http://forums.studentdoctor.net/showthread.php?t=388256

From http://www.adea.org/webdocs/AADSAS/DentistryUpdate.pdf
Dental school applicants.
Enrollee Mean Science GPA: 3.41
Enrollee Mean Total GPA 3.49
This data is from 2005. The only data reported in this document.

From http://www.aamc.org/data/facts/2007/2007mcatgpa.htm
Med school applicants
Enrollee Mean Science GPA: 2005: 3.56 2006: 3.57 2007: 3.59
Enrollee Mean Total GPA: 2005: 3.63 2006: 3.64 2007: 3.65

There is no comparable data in these documents about applicants because the AAMC uses a mean ONLY for applicants, while the ADEA uses a percentage of applicants with GPAs above, below a certain, point. Besides, if the overall applicant pool of dent is higher than med, wouldn't the enrollee figures reflect this?

I agree with you on the fact that the caliber of applicants to dental school is increasing, and someday may surpass that of med, but up until this point, according to the data, I still say, well.... um.... no.
-C

 

[ptrianon]

Dentistry is cheap compared to medicine (compare pt lifetime dental cost vs. cost to dialyze one pt for a few years) and perceived as more of a luxury than a right (BTW healthcare is not a “right” either…), therefore if a socialized healthcare system does come into play dentistry will likely be the last to be incorporated. Our current healthcare system is so massively complex that a universal healthcare system could not be implemented over a short period of time. Incremental changes toward a more socialized system are much more likely and would take a long time. Also, most people in the US expect esthetic dental care; notice how even non-dental types poke fun at european grills. This kind of treatment would never be covered and would continue to support free market out of pocket dentistry. Aside from the reasons above, ADA has large lobbying power because it has the support of the majority of practicing dentists in the US unlike the AMA.

Some disadvantages of dentistry:

Dentistry is physically demanding which is kinda hard to appreciate until you have spent a day actually working on a patient. Also, as was said above, the need to remain efficient, up to date, and manage/staff an office can be very stressful but I don't feel like this is much different from other medical professions.

 

[vasco]

The worst things in dentistry for me are 1 - ropy saliva, and 2- the smell of periodontal disease.

 

[SugarNaCl]

I have heard theories that if Hillary gets into office, and she gets her idea about universal dental care and medical care through Congress... dentistry may meet the same fate as medicine.

I agree there are pros and cons to dentistry as in everything. The pros are the challenge, the schedule, the patient interaction, the money. The cons are many dentists end up with chronic back pain and some hand/wrist problems.

Most of all though, I like that dentistry seems to be one of the more diamond in the rough professions. Best kept secret. Some people think dentists still just scrape teeth. Not only is our future occupation much more rewarding, but the "teeth scraping" theorists who obviously haven't been to the dentist since they were 16 will be counting on us when they are in danger of losing theirs at 50 years of age.

 

[OceanDMD]

The best part about dentistry is also the worst. You are autonomous from the day you pass your boards and so you can really can practice the way you want. Mostly, nobody is going to come behind you and double check your work. This is nice, and it is the way every profession should be, but if you don't keep up you can become lazy.

Also, some dentists look like ****** pushing beauty parlor treatment off the back of yellow pages rather than doctors. Advertising is good, but dentists need to do it with a certain amount of restraint. The ever increasing push to sell treatment plans or gain new patients is probably the most unseemly aspect of dentistry in 2007. If the profession was smart, they'd put some sensible restraints on advertising, before our image takes a big hit.

Overall though dentistry offers a lot to its doctors and patients. Given the advances in tx and products available, I think dentistry is in its golden age.

You are way off base here. The first priority as a dentist is to ethically take care of the patient and do no harm. However, it is a business that requires new patients. We are not still in the 70-80s here, and if you are not with the marketing program you are a step behind. Internal marketing will always be the best referral source, but since complete makeover with Dorfman things have changed. Do you think Complete Makeover was "like ****** pushing a beauty parlor"? Well let me fill you in, it has done one of the best services to our profession. Want dentistry is much more enjoyable to treat than need dentistry. This year there was over 15 billion dollars of cosmetic dentistry done. 50 billion dollars of plastic surgery. Neither of which have anything to do with managed care/hmos/insurance period. I guess its been a year of distasteful advertising huh?

 

[secants]

Let's say I et interested in Dentistry but am put off by the idea of having my own practice because of the hassle of managing it all. How common is it to get into a group practice or have an employer (ie. some hospital).

 

[BuckeyMcGee]

Very common. Lots of people choose to be an associate their entire career. They don't like the idea of having to manage a business on thei own. I suppose I can understand this.

 

[airwolfrocks999]

Disadvantages to dentistry:
- low starting salaries relative to dental school debt
- keen competition for associate positions in the late spring season
- lack of honest and fair dental employers
- sharps injuries and exposure to blood are very common, yet dental salaries are not high enough to justify working in a potentially dangerous environment
- poor quality of reimbursement from Medicaid, more so than physicians when factoring in the overhead of a dental office
- relatively poor quality of dental education as dental schools lack adequate facilities, patient pools, supplies, and competent professors
- dentistry is labor intensive and physical injury isn't something not foreseeable. And again, the current salaries of dentists don't seem to justify such a difficult working condition. Don't get started with how dentists are in the top 1% income bracket crap. That means practically nothing when you're in 300k of debt, earning 80k/yr under an unfair employer, and desperately searching for other positions
- most private dentists see far less patients than they want to see. No wonder dentists have time on their hands compared to physicians
- financial-wise, prepare to be disappointed as a general dentist. It's a forum myth that dentists are successful in society. Ortho and OS are exceptions but that would be <5% of all dentists
- as it stands, the ratio of dentists per pop is very favorable. But expect the supply to nearly meet demand as there are new dental schools opening and easing of restrictions to allow licensing for foreign dentists
- specialists consider it taboo for general dentists to learn and perform advanced specialty procedures like ortho, implants, bone grafting, and apicoectomies.

 

[dentista2012]

Disadvantages to dentistry:
- low starting salaries relative to dental school debt
- keen competition for associate positions in the late spring season
- lack of honest and fair dental employers
- sharps injuries and exposure to blood are very common, yet dental salaries are not high enough to justify working in a potentially dangerous environment
- poor quality of reimbursement from Medicaid, more so than physicians when factoring in the overhead of a dental office
- relatively poor quality of dental education as dental schools lack adequate facilities, patient pools, supplies, and competent professors
- dentistry is labor intensive and physical injury isn't something not foreseeable. And again, the current salaries of dentists don't seem to justify such a difficult working condition. Don't get started with how dentists are in the top 1% income bracket crap. That means practically nothing when you're in 300k of debt, earning 80k/yr under an unfair employer, and desperately searching for other positions
- most private dentists see far less patients than they want to see. No wonder dentists have time on their hands compared to physicians
- financial-wise, prepare to be disappointed as a general dentist. It's a forum myth that dentists are successful in society. Ortho and OS are exceptions but that would be <5% of all dentists
- as it stands, the ratio of dentists per pop is very favorable. But expect the supply to nearly meet demand as there are new dental schools opening and easing of restrictions to allow licensing for foreign dentists
- specialists consider it taboo for general dentists to learn and perform advanced specialty procedures like ortho, implants, bone grafting, and apicoectomies.

I dont mean to be disrespectful or mean but these sound like the rantings of a bitter person, not an objective one

 

[toofshucker]

Disadvantages to dentistry:
- low starting salaries relative to dental school debt
- keen competition for associate positions in the late spring season
- lack of honest and fair dental employers
- sharps injuries and exposure to blood are very common, yet dental salaries are not high enough to justify working in a potentially dangerous environment
- poor quality of reimbursement from Medicaid, more so than physicians when factoring in the overhead of a dental office
- relatively poor quality of dental education as dental schools lack adequate facilities, patient pools, supplies, and competent professors
- dentistry is labor intensive and physical injury isn't something not foreseeable. And again, the current salaries of dentists don't seem to justify such a difficult working condition. Don't get started with how dentists are in the top 1% income bracket crap. That means practically nothing when you're in 300k of debt, earning 80k/yr under an unfair employer, and desperately searching for other positions
- most private dentists see far less patients than they want to see. No wonder dentists have time on their hands compared to physicians
- financial-wise, prepare to be disappointed as a general dentist. It's a forum myth that dentists are successful in society. Ortho and OS are exceptions but that would be <5% of all dentists
- as it stands, the ratio of dentists per pop is very favorable. But expect the supply to nearly meet demand as there are new dental schools opening and easing of restrictions to allow licensing for foreign dentists
- specialists consider it taboo for general dentists to learn and perform advanced specialty procedures like ortho, implants, bone grafting, and apicoectomies.

Some of his points are valid, but a lot are coming from a person that HATES dentistry. Remember that as you read through what he has written, and realize this post is nothing more than the opposite of the posts you read saying you will make 300k a year first year out of school.

 

[PSU SHC 414]

airwolf,

i appreciate the candid response, but it has thrown a huge bend into what was seemingly a pretty straight road towards a desire to pursue dentistry.

does your (long) list of disadvantages come from legitimate experience as a practicing DMD or some other source(s)?

 

[red88m]

Disadvantages to dentistry:

- lack of honest and fair dental employers
- sharps injuries and exposure to blood are very common, yet dental salaries are not high enough to justify working in a potentially dangerous environment


- most private dentists see far less patients than they want to see. No wonder dentists have time on their hands compared to physicians
- financial-wise, prepare to be disappointed as a general dentist. It's a forum myth that dentists are successful in society. Ortho and OS are exceptions but that would be <5% of all dentists

I could agree with everything (to an extent) but these points listed above. The sharps injuries are your own fault for not following protocol.
There are many private dentists who stay booked up for months- just depends on if your patients like you or not.
A dentist I worked with had a plane and a huge antique car collection- the other guy had a boat and nice house- money's not a problem if you budget correctly.
I must admit, 3 out of 12 dentists I've worked with were borderline "honest and fair". There were situations where I questioned their ethics. But the other 9 are some of the best people you'll ever meet.

Every job has a downside. That's life.

 

[Rube]

OH.... OK.... I see your point.... wait.... No I don't. Number 1: Gaining new patients will be your main goal when you are in practice. You need them to pay your bills. It helps YOU and it helps the PATIENTS. Number 2: There are "******" in every business. Number 3: Not every dentist on the planet is required to heal the world. There is NOTHING wrong with having a cosmetic based practice. If people did not want better looking teeth, there would not be a market for it. So until everyone is completely satisfied with their God given teeth, there will be a market for this. Again, BECAUSE THE PEOPLE WANT IT.

XO,
-C

That's a great response to someone who disagrees with cosmetic dentistry. That's not me. I think cosmetic dentistry is legitimate.

But you should realize the point of this post was to take a critical look at dentistry and list its disadvantages... If you haven't realized it yet, you will, the biggest number of complaints to state boards are OVERTREATMENT claims. That's why my point about hard selling TXPs stands and its why dentists who claim to be experts in everything off the back of the Yellow pages look ridiculous. (perhaps my beauty parlor *****'s comment was a little harsh, but you can take the point can't you?)

Its not holier than thou to suggest this is a problem and should be reigned in, WITHIN the profession.

 

[Rube]

You are way off base here. The first priority as a dentist is to ethically take care of the patient and do no harm. However, it is a business that requires new patients. We are not still in the 70-80s here, and if you are not with the marketing program you are a step behind. Internal marketing will always be the best referral source, but since complete makeover with Dorfman things have changed. Do you think Complete Makeover was "like ****** pushing a beauty parlor"? Well let me fill you in, it has done one of the best services to our profession. Want dentistry is much more enjoyable to treat than need dentistry. This year there was over 15 billion dollars of cosmetic dentistry done. 50 billion dollars of plastic surgery. Neither of which have anything to do with managed care/hmos/insurance period. I guess its been a year of distasteful advertising huh?

Yeah some of the advertising is kind of distasteful. Have you not seen it? I believe I said "advertising is good but dentists should show some restraint." So that better not make me anti-advertising.

Its an excellent point you make that cosmetic dentistry has helped both patient and provider immensely and I never once argued against cosmetic dentistry (however, I can see where my comments about beauty parlor ******, was a bit over the top, so I'm sorry if I was misleading with my pointed comments). Nevertheless, just because advertising works, doesn't mean its good for for our image. I'm simply suggesting some restraint before we look like those idiot DO residents pushing hydroxycut weight loss supplements on TV. Look at what is happening to medicine. The image of physicians has gone downhill in the last 20 years, and nobody listens to physician advertising anymore. Finally if I ever support curbs on advertising it will be because the profession as voluntarily chosen to do so. Other than that let the free market work. I'm not especially a do-gooder and plan to be very wealthy selling and providing dentistry to my patients.

 

[straightwire]

I appreciate the everyone's feedback so far.

Anyone care to address what the role of managed care in dental medicine is today, and how this could change in the future (particularly if there is a significant administration change in Washington come '08 and going forward)?

Managed care is already in dentistry and probably affect general dentists more than specialists. However, I do think a practioner will always has the freedom to refuse participating managed care programs in dentistry simply because the cost of dentistry is a lot cheaper than medicine. Even in some worse case scenario of full mouth reconstruction with implants will certainly stay in low to mid five figure in cost. There is really no reason to push managed care dentistry. Also, dentistry today is very different from 20-30 years ago. Ever since the introduction of fluoridated water, the rate of cavities has decreased very significantly. But the dentists did not starve because less incidences of dental caries.....why? cosmetic dentistry is certainly one of the reason. More and more people are interested in costmetic dentistry and these are not covered by insurance. So I think teh future of dentistry is bright. However, there is a huge difference between dentistry and medicine...........unlike most of our medical colleagues (except surgeon maybe), dentists must use their hands to perform treatment....and this fact does not change no matter what you do in dentistry (maybe with the exception of ortho since a lot of work is delegated to assistants). So if you don't like to work with your hands....you may have a very miserable life in dentistry....I think this is a very important aspect of dentistry......

 

[toofshucker]

Managed care is already in dentistry and probably affect general dentists more than specialists. However, I do think a practioner will always has the freedom to refuse participating managed care programs in dentistry simply because the cost of dentistry is a lot cheaper than medicine. Even in some worse case scenario of full mouth reconstruction with implants will certainly stay in low to mid five figure in cost. There is really no reason to push managed care dentistry. Also, dentistry today is very different from 20-30 years ago. Ever since the introduction of fluoridated water, the rate of cavities has decreased very significantly. But the dentists did not starve because less incidences of dental caries.....why? cosmetic dentistry is certainly one of the reason. More and more people are interested in costmetic dentistry and these are not covered by insurance. So I think teh future of dentistry is bright. However, there is a huge difference between dentistry and medicine...........unlike most of our medical colleagues (except surgeon maybe), dentists must use their hands to perform treatment....and this fact does not change no matter what you do in dentistry (maybe with the exception of ortho since a lot of work is delegated to assistants). So if you don't like to work with your hands....you may have a very miserable life in dentistry....I think this is a very important aspect of dentistry......

The thing you have to remember about insurance is this. For every 3 dentists that retire, 2 graduate. Almost half of all graduating dentists are women, and most of them will be working part time after 7 years. So, in reality, for every 3 dentists retiring 1.5 dentists graduates. As the number of dentists goes down, the number of patients at each practice will go up. As the number of patients goes up, the dentists will look for ways to cut down/profit. So they cut insurance out of their practice. When that is done, they will raise their prices. The pertinent part is that insurance will be slowly cut out of most practices, making managed care a non-issue...unless national healthcare is proposed.

 

[PSU SHC 414]

Managed care is already in dentistry and probably affect general dentists more than specialists. However, I do think a practioner will always has the freedom to refuse participating managed care programs in dentistry simply because the cost of dentistry is a lot cheaper than medicine.

If a private practioner decides to refuse participating in managed care, doesn't he/she also risk significantly reducing the potential number of patients this he/she will have? Is this effect negligible since the majority of the profit the dentist will be pulling in is through cosmetic procedures that are not covered by insurance anyway?
Speaking from personal experience, the pharma company I work for now provides a dental DMO... when I searched for a dentist, I specifically limited my search based on offices that did accept my insurance.


Since I'm getting replies to my questions, here's another:

I've heard first-hand accounts from recent DMD grads that it is extremely difficult to start your own practice, especially in areas where there are already several established practices. Since I'm assuming the attrition rate of dentists is fairly low, how difficult is it to find openings as a "junior partner" in existing practices?

 

[PlaqueAttack]

I'll give you an example of how refusing managed care can work:
In mich, Blue Cross/Blue Shield has recently started offering this new type of dental insurance to employers, and its CHEAPER, so people sign on. However, the reason its cheaper is that they're not paying the dentists their full fees, say 70% if they agree to be a contracting dentist with BC/BS. What has happened, at least in Mich, is that no dentist will sign up/be contracted to BC/BS for these lower fees, even though they would get an increase in patients. So, the employees of the company that bought this insurance get PISSED because they can't find any dentist to take their insurance and eventually enough people/companies complain to BC/BS resulting in them raising the fee their willing to pay to the point where some dentists sign on.

I.E. its all based on SUPPLY and DEMAND, we should have all been thru this by now in some Econ class. But, as the # of dentists decreases, and the DEMAND increases, were going to see fewer and fewer dentists signing up for managed care and the price will rise.

And what you said about esthetic procedures is true, many are not covered and pt has to pay out of pocket. So you know, the VAST majority of private practice dentists operate Fee-for-Service practices and may only accept a few insurance companies that provide >80% of fees

And for the other question, it is hard to start a practice right from school since many of us carry such a large debt load, but there are AMPLE opportunities to find associatships that can lead to parnterships/buyouts. If you were to look at the back of any State dental journal i'm sure you will find a buttload of practices that are for sale or looking for associateship/partnership opportunities (there's at least 50 every month in Michigans journal, granted this isn't Cali)

hope it helps...