15 years ago, when implants werent as popular as they are today, endodontics was a one of the most desired specialties in our class. 3 of my 4 roommates (they were also my classmates) are endodontists and my wife is a periodontist. They all told me that they were glad that they specialized and that they dont have practice as GPs.
Endo:
The hours are not as flexible as other specialties. You have to be at your office all day (even when you dont have any patient or only 1-2 patients on the schedule) to receive emergency phone calls from the referring GPs. If you are not available to do the emergency RCT, the GPs will send their patients to another local endodontist who has better office hours than yours.
To get more patients, many endodontists have to accept HMO plans. Since the GP dont get paid much for doing RCT on the HMO patients (ie $80-100 a case), they find excuses not to do the RCT and refer these HMO patients to the endodontists. HMOs pay the endodontists a lot more but it is still very low compared to the UCR fee.
Perio:
Flexible hours. You only have to be at your office when you have patients. On the days you dont have patients, you can supplement your income by working as an in-house periodontist at different GP offices. When my wife is not at her private office, she goes to 7 different GP offices. On certain days, my wife works at 1 GP office in the morning and at another GP office in the afternoon. On some slow days, my wife brought our 2 kids to work, placed 1-2 implants in an hour, and took the kids to Disneyland afterward🙂.
The problem with perio is many GPs ignore perio diseases and dont refer patients to the periodontists. By the time the cases reach my wifes office, the teeth are pretty much hopeless
.they need extractions and implant placements. You cant survive if you just sit there and expect the GPs send patients to you. To do well, you have to be good at both implant placements and restorations. For many GPs who dont have strong clinical skills, you have to help diagnose and tx plan implant cases for them. You have to come to their offices and show them how to make provisional restorations after implant placements, restore implants, and adjust the final restoration etc. Once the GPs know how to restore implants, they will continue to refer patients to you.
Good luck with your decision.
