doing peds after ortho

[ortho20255]

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I'm an orthodontist working in a saturated market. I am thinking of possibly studying peds to give myself a whole extra scope of procedures. Peds is in demand in my area. I am 36 years old, have 1m invested, no debt (except housing mortgage) and no family. The peds courses I am looking at are 2 years (I couldn't handle doing 3 years) but I also only want to live in certain cities. I have done my time living in areas I don't want to. The problem is, the programs in the cities I am looking at pay small stipends and have tuition of 150k. I hate the idea of low income for 2 years and a huge cost of the program, but I also think about practicing over the next 20 or so years and it would be worth it eventually. What do you guys think?

 

[2TH MVR]

Are you saying that you don't see increasing your income doing ortho in the saturated area? If you become a Pediatric dentist .... how do you incorporate doing orthodontics? If you offer both services under the same roof .... you will receive no ortho referrals outside of your office.

Are you going to be happy doing alot of Pedo procedures? When you get into your 40's, 50's? Maybe you are comfortable with managing kids. I personally could not do it. I currently only treat young teenagers and adult patients. Very little Phase 1 or Interceptive tx. Just not worth the headaches.

I guess the question for you is? Are you considering this for future income reasons ..... or you just want more variety by doing pedo procedures?

The good news is at age 36. You have time on your side. A 2 yr residency is nothing.

 

[ortho20255]

Are you saying that you don't see increasing your income doing ortho in the saturated area? If you become a Pediatric dentist .... how do you incorporate doing orthodontics? If you offer both services under the same roof .... you will receive no ortho referrals outside of your office.

Are you going to be happy doing alot of Pedo procedures? When you get into your 40's, 50's? Maybe you are comfortable with managing kids. I personally could not do it. I currently only treat young teenagers and adult patients. Very little Phase 1 or Interceptive tx. Just not worth the headaches.

I guess the question for you is? Are you considering this for future income reasons ..... or you just want more variety by doing pedo procedures?

The good news is at age 36. You have time on your side. A 2 yr residency is nothing.

I have 2 thoughts on this.

1: I think the future is going direct marketing to patients. With any specialty, general dentists are trying to keep everything in house. There's not much else I could learn in the field of ortho that will inc increase income dramatically. The majority of learning I can do in ortho, TADs etc, aren't really going to increase my scope much. I think that 2 years of peds would increase my scope massively and open a whole new market.

2: I am apart of a practice with 3 other orthos in the network. I think doing peds for the ability to do canine surgical exposures, and other minor surgical procedures, would increase my scope a lot so that I could do all of those procedures for all the ortho's in our practice. This is a procedure that could be done without taking work away from general dentists as these referrals would go to peds or omfs anyway. I wouldn't necessarily be doing it for peds procedures - although I do think it would be fun to do canine exposures.

So I think it would mostly be to learn how to do canine exposures for the initial increase in work short term. But also long term, if we find in 10 or 15 years that direct to patient marketing is the main source of work then it gives me a whole extra scope of procedures

 

[OncePreDent]

I have 2 thoughts on this.

1: I think the future is going direct marketing to patients. With any specialty, general dentists are trying to keep everything in house. There's not much else I could learn in the field of ortho that will inc increase income dramatically. The majority of learning I can do in ortho, TADs etc, aren't really going to increase my scope much. I think that 2 years of peds would increase my scope massively and open a whole new market.

2: I am apart of a practice with 3 other orthos in the network. I think doing peds for the ability to do canine surgical exposures, and other minor surgical procedures, would increase my scope a lot so that I could do all of those procedures for all the ortho's in our practice. This is a procedure that could be done without taking work away from general dentists as these referrals would go to peds or omfs anyway. I wouldn't necessarily be doing it for peds procedures - although I do think it would be fun to do canine exposures.

So I think it would mostly be to learn how to do canine exposures for the initial increase in work short term. But also long term, if we find in 10 or 15 years that direct to patient marketing is the main source of work then it gives me a whole extra scope of procedures

I don't think it is a bad idea saying as to what your goal is and if you know that there would be demand for a pedatric dentist in your area. Also think it's a great idea for you to only apply to 2 year programs because of your set up and age as well. If you are close to a city or anything, you might be able to fly back to your ortho practice 1 day a week to see patients (depending on your set up). At my dental school some of the faculty teach 4 days a week and than fly out to there practice to see patients 1-2 days a week.

For you it may be worth going for

 

[Stethescope]

Practicing pedo with ortho wife here.
90%+ of the exposure cases are sent to perio and omfs (more to our local perio).
Exposure cases (i.e. Thought #2) cannot be a significant motivation for this move.
Thought #1 is valid as it allows you to establish yourself as a pediatric dentist to create your patient pool and in 2-3 years, you can slowly start transitioning yourself to a more ortho/interdisciplinary provider.

 

[juniordentist]

Practicing pedo with ortho wife here.
90%+ of the exposure cases are sent to perio and omfs (more to our local perio).
Exposure cases (i.e. Thought #2) cannot be a significant motivation for this move.
Thought #1 is valid as it allows you to establish yourself as a pediatric dentist to create your patient pool and in 2-3 years, you can slowly start transitioning yourself to a more ortho/interdisciplinary provider.

I've never heard of someone sending exposures to peds before this thread. Do you guys trained in it at residency? What makes you only want to do 10% of them? Is it not a very profitable procedures?

 

[Stethescope]

I don't know any orthodontists that would send them to peds either, I only get them from the wife.
The ones we keep in house are ones that are rather straight forward and teens.
It is not often done in residency but neither are frenectomies (at least at my program, it was almost frowned upon) nor mesio dens extractions (especially inverted ones) - you will find pedos doing these as we learn about them after graduating.
It is definitely not as profitable as say, 2-4 quadrant treatment with oral sedation.

 

[Big Time Hoosier]

I've never heard of someone sending exposures to peds before this thread. Do you guys trained in it at residency? What makes you only want to do 10% of them? Is it not a very profitable procedures?

Peds here. Never did them in residency and I’ll never do them in practice. In fact, I don’t even know of any peds that do. I was talking to an OMFS friend and he said expose and bond is his absolute least favorite procedure because they are such a pain to do.

Big Hoss

 

[ortho20255]

Peds here. Never did them in residency and I’ll never do them in practice. In fact, I don’t even know of any peds that do. I was talking to an OMFS friend and he said expose and bond is his absolute least favorite procedure because they are such a pain to do.

Big Hoss

would you think its worth doing peds after ortho for other reasons?

 

[Big Time Hoosier]

would you think its worth doing peds after ortho for other reasons?

Could be. It’s probably a lot easier to start your own office as a peds.

Big Hoss

 

[gryffindor]

When I think of profitable pedo procedures, I don't think of expose and bonds. I think of quadrant dentistry while running a prophy palace. With parents that hover and question everything you do worse than we have in ortho. The peds in my saturated areas all try to hire an ortho to keep it in house, tell every patient they need a lingual frenectomy, or both. Almost like there aren't enough fillings for them to do or something.

 

[yappy]

When I think of profitable pedo procedures, I don't think of expose and bonds. I think of quadrant dentistry while running a prophy palace. With parents that hover and question everything you do worse than we have in ortho. The peds in my saturated areas all try to hire an ortho to keep it in house, tell every patient they need a lingual frenectomy, or both. Almost like there aren't enough fillings for them to do or something.

That sounds so awful

 

[juniordentist]

When I think of profitable pedo procedures, I don't think of expose and bonds. I think of quadrant dentistry while running a prophy palace. With parents that hover and question everything you do worse than we have in ortho. The peds in my saturated areas all try to hire an ortho to keep it in house, tell every patient they need a lingual frenectomy, or both. Almost like there aren't enough fillings for them to do or something.

But if the goal was to build a busy practice, it sounds like a lot of these headaches could be solved by hiring a peds dentist. I could see logic in doing ortho and peds and using it to build a practice and then when you are busy enough hire a peds or a dentist to do a lot of those procedures. Do the GA and ortho yourself. But I agree, haven't heard of expose and bonds with peds

 

[D1Bound]

Why not increases your income through other means that aren’t dental related?

 

[2TH MVR]

Why not increases your income through other means that aren’t dental related?

Sounds good on paper. But I think you have to have some good business skills and knowledge in that particular non-dental area. I was always told to invest in things that I knew about. Dentistry (ortho). Therefore I expanded my ortho footprint (bought some real estate and started a 2nd ortho branch location). Worked great for awhile. Until it didn't work. Market conditions (Corps, aligners, GPs doing ortho, etc. etc.) that I could not control.

During my "Golden" years .... I thought I could invest and buy some Florida vacation condos. Bought one. Then another. I did ok on the 1st condo, but then the BLM oil spill in the Gulf of "America" happened. Lost my ass with the 2nd condo. I really did not understand Real Estate investing.

You need good business and marketing skills. LOL most dentists have no training in the basic business skills needed to run a dental office.