Endodontist pay

[MdBrndPhrmcst]

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Hi guys,

Im a pharmacist but I went to an endontist today for a root canal :-( (actually wasn't that horrible I was impressed!) My insurance covered 90% of the bill but when I saw the cost of the procdure it got me thinking..

$1000 for about an hour of work

my questions are..

1) How much (%) of this you think goes into overhead? ex: paying staff, leasing office, insurance supplies etc

2)The guy that did the procedure owned the practice so he got to keep a good chunk of the money.. what if he was working for someone else who owned the practice? How much would he have taken home then?

I was just curious..

Thanks in advance!!

 

[Cold Front]

Hi guys,
$1000 for about an hour of work

my questions are..

1) How much (%) of this you think goes into overhead? ex: paying staff, leasing office, insurance supplies etc

2)The guy that did the procedure owned the practice so he got to keep a good chunk of the money.. what if he was working for someone else who owned the practice? How much would he have taken home then?

I was just curious..

Thanks in advance!!

1) A recent CE course I took talked about this, the national average overhead for endo is 40-45%. Which means, if the procedure was in fact completed within 1 hour, $550-600 goes straight to the endodontist's pocket (assuming that he/she is the owner, with overhead of 40-45%).

2) If the root canal was done by an associate endodontist, then they would take about 35%-45% of the production (or collection, depending on their contract).

Not every endodontist charges $1,000.

 

[Daurang]

Not every case is as easy as yours. A $1500 case can often take 3 hrs and never heal completely which you then need to come back for another 3 hrs.

Usually the easy case aren't sent to the endodontist. Would you rather go to a specialist, with 3 extra years of postgrad education, to do it in an hour or be happier with me doing it in 3 hours to make your money and pain worth it?

 

[Daurang]

"Share the Wealth" Cold Front?

I'll see if you feel the same in three years after having your own office paying 50% of your income in taxes on top of your student loan.

 

[monreal]

Not every case is as easy as yours. A $1500 case can often take 3 hrs and never heal completely which you then need to come back for another 3 hrs.

Usually the easy case aren't sent to the endodontist. Would you rather go to a specialist, with 3 extra years of postgrad education, to do it in an hour or be happier with me doing it in 3 hours to make your money and pain worth it?

I don't think treatment time is a difference between RCT done by a GP and another done by a specialist. On the contrary, I believe a GP would take less time in average, simply because he/she is more likely to miss 1-2 canals.🙂

 

[nydds25]

I had oral surgery work (3rd extractions) done on me billed about a grand and it took less than 10 minutes.

 

[Daurang]

I had oral surgery work (3rd extractions) done on me billed about a grand and it took less than 10 minutes.

I'll make sure he takes more time for the next one. Would you prefer it done in 30 or 45 minutes instead?

 

[Cold Front]

"Share the Wealth" Cold Front?

I'll see if you feel the same in three years after having your own office paying 50% of your income in taxes on top of your student loan.

😀

Remember Obama's share the wealth statement to a plumber from Ohio during last year's general election? I liked the slick line so much, I used it as argument point against Obama critics, even though it's a bad strategy to fix the economy.

By all means, I will not apply the concept into my business.

 

[OceanDMD]

😀

Remember Obama's share the wealth statement to a plumber from Ohio during last year's general election? I liked the slick line so much, I used it as argument point against Obama critics, even though it's a bad strategy to fix the economy.

By all means, I will not apply the concept into my business.

When you graduate, you won't have a choice. Payroll taxes will be a nice way to pay back the 780 billion this administration is going to spend today. And your income tax. Oh wait, TARP and TARP part II. Better stay in school and specialize, you'll need to make 500/hour to pay your debt.

 

[dheav005]

I don't think treatment time is a difference between RCT done by a GP and another done by a specialist. On the contrary, I believe a GP would take less time in average, simply because he/she is more likely to miss 1-2 canals.🙂

you are wrong, sir. there is a GIANT treatment time difference between your average GP and and endodontist. endo guys do the same thing day in and day out, they develop a rhythm and efficiency that would be hard for a GP to match. on the other hand, i wouldnt one of them to prep a crown on me...

and if its your average to miss 1-2 canals, might i suggest developing a solid referral list? cause thats just ridiculous!

 

[monreal]

you are wrong, sir. there is a GIANT treatment time difference between your average GP and and endodontist. endo guys do the same thing day in and day out, they develop a rhythm and efficiency that would be hard for a GP to match. on the other hand, i wouldnt one of them to prep a crown on me...

and if its your average to miss 1-2 canals, might i suggest developing a solid referral list? cause thats just ridiculous!

With this answer sir, I am not surprised you missed my point. I quoted the sarcastic post of Daurang (and I know he is not talking about himself here), and I meant when an endodontist does in 1 hour what a GP does in 3 hours (with pain), it doesnt lead to a fact that a specialist is faster than a GP. It means that this GP should not attempt to do anymore RCT's. 3 hours? this is a joke, right?

If you think you don't miss canals, this is typical of someone who doesn't know what he doesn't know.
A referal list is a not a so bad idea, for many of us.
Yea, rediculous it is.

 

[aphistis]

Knock it off, people. Yeesh.

 

[Simiam]

n m

 

[dheav005]

With this answer sir, I am not surprised you missed my point. I quoted the sarcastic post of Daurang (and I know he is not talking about himself here), and I meant when an endodontist does in 1 hour what a GP does in 3 hours (with pain), it doesnt lead to a fact that a specialist is faster than a GP. It means that this GP should not attempt to do anymore RCT's. 3 hours? this is a joke, right?

If you think you don't miss canals, this is typical of someone who doesn't know what he doesn't know.
A referal list is a not a so bad idea, for many of us.
Yea, rediculous it is.

i dont think Daurang was being sarcastic. the fact remains that specialists ARE faster than GPs if all things are equal. regardless, 3 hours for difficult molar endo isnt unheard of for a GP. is it in the best interest of the patient? probably not; it does demonstrate that the GP ought to improve his case selection skills.

i didnt say that i dont miss canals, but i make darn sure i know all the averages about numbers of canals for each tooth, centering files in canals radiographically, and checking for hidden roots on my off-angled shots.

referrals are a great tool, but there arent near enough endo guys out there to do all the endo that needs to be done. GPs still do something like 70-80% of all the endo.

 

[jmick101]

To answer the OP:

I had this same conversation in Endo clinic on a slow day.

He charges 1250 for posterior endo (works in Napa California). Most of what he sees is posteriors b/c most general dentists won't refer easy anterior jobs. He does 5-6 cases a day, takes about an hour and 15 minutes each, 4 days a week. Overhead is in the 20-30% range. He has been doing endo since 91 though, so he doesnt have too many bills.

If you run the numbers it is kinda ridiculous.
20 endos a week x 45 weeks a year x $1250 x .7 for overhead = 787k. After taxes (35%) that comes out to a little over 500k. Of course this is for an established endodontist with good overhead control, but you can see why endo is one of the hardest residencies to get these days.

 

[ptrianon]

To answer the OP:

I had this same conversation in Endo clinic on a slow day.

He charges 1250 for posterior endo (works in Napa California). Most of what he sees is posteriors b/c most general dentists won't refer easy anterior jobs. He does 5-6 cases a day, takes about an hour and 15 minutes each, 4 days a week. Overhead is in the 20-30% range. He has been doing endo since 91 though, so he doesnt have too many bills.

If you run the numbers it is kinda ridiculous.
20 endos a week x 45 weeks a year x $1250 x .7 for overhead = 787k. After taxes (35%) that comes out to a little over 500k. Of course this is for an established endodontist with good overhead control, but you can see why endo is one of the hardest residencies to get these days.

These numbers are consistent with what I have heard also (established practice with take home of 470k). Does any one else feel that with the falling price of implants that endodontists may be pricing themselves out of the market?

 

[jmick101]

These numbers are consistent with what I have heard also (established practice with take home of 470k). Does any one else feel that with the falling price of implants that endodontists may be pricing themselves out of the market?

Eh... I dunno. Maybe. Having a tooth extracted, an implant placed, waiting for it to integrate and heal, and then putting on a crown, total time 4-7 months at roughly the same cost? I think RCT is going to be a viable option for a long time to come.

 

[achilles2]

Eh... I dunno. Maybe. Having a tooth extracted, an implant placed, waiting for it to integrate and heal, and then putting on a crown, total time 4-7 months at roughly the same cost? I think RCT is going to be a viable option for a long time to come.

I also heard that endos are placing implants now as well.

 

[Mackchops]

Everyone wants a piece of the implant pie... but endo??? That doesn't make any sense.

My question, does it make a noticable difference for the patient to have an RCT vs implant with regards to oseointegration? With an implant, it's like an ankylosed tooth -- no occlusive sensation, right? Isn't it better to keep a natural tooth in place as long as it has a viable PDL so the patient can actually feel it? Or does it not really make any difference...?

 

[Guy Smiley]

Everyone wants a piece of the implant pie... but endo??? That doesn't make any sense.

My question, does it make a noticable difference for the patient to have an RCT vs implant with regards to oseointegration? With an implant, it's like an ankylosed tooth -- no occlusive sensation, right? Isn't it better to keep a natural tooth in place as long as it has a viable PDL so the patient can actually feel it? Or does it not really make any difference...?

I think so. I guess the best measure is if you had a choice to have a RCT or an implant on yourself, what would you choose? I know what I'd do.

 

[Endo2011]

Couple of my opinions, take em or leave em

I know many GPs who charge $1k for molar endo

Implants are a great restorative option when the tooth is hopeless but are not a substitute for a good RC

GPs-you may be very well qualified to do molar endo but does it make sense ($)- for example
3hrs for molar endo=$1000
refer 3 molars to the endodontist-get back 3 crowns to prep in 3 hrs=$3000

just my .02 not words to live by

 

[aphistis]

Couple of my opinions, take em or leave em

I know many GPs who charge $1k for molar endo

Implants are a great restorative option when the tooth is hopeless but are not a substitute for a good RC

GPs-you may be very well qualified to do molar endo but does it make sense ($)- for example
3hrs for molar endo=$1000
refer 3 molars to the endodontist-get back 3 crowns to prep in 3 hrs=$3000

just my .02 not words to live by

If it routinely takes three hours to do a molar endo, you're not "very well qualified." I say that from a position of authority, being someone who still often needs about three hours to do a good molar endo. As for the rest, doing a wide variety of procedures offers a lot of intangible benefits; firmly on that list is "keeping your career interesting."

 

[Dukie]

Couple of my opinions, take em or leave em

I know many GPs who charge $1k for molar endo

Implants are a great restorative option when the tooth is hopeless but are not a substitute for a good RC

GPs-you may be very well qualified to do molar endo but does it make sense ($)- for example
3hrs for molar endo=$1000
refer 3 molars to the endodontist-get back 3 crowns to prep in 3 hrs=$3000

just my .02 not words to live by

Well said. Just because you can do something does not mean you should. Granted, I speak as a fourth year student, not a practicing dentist, but it would seem to me that if one is trying to maximize income, he or she should focus on those procedures that can be done quickly and efficiently. Some GP's do all of their own endo. That is always an option, but your time may be much better served completing other procedures.

On another note, the numbers mentioned above seem to be relatively accurate. I have heard of molar prices costing as much as $1800 in some major cities, but the price is typically closer to $1000-1200 when done by an endodontist. I know that many disagree with me, but I still feel that specialists can and should charge more than GPs for the same procedure. There is a reason one spends three or more years refining skills.

 

[charlestweed]

GPs-you may be very well qualified to do molar endo but does it make sense ($)- for example
3hrs for molar endo=$1000
refer 3 molars to the endodontist-get back 3 crowns to prep in 3 hrs=$3000

No, it doesn't make sense when the GP is super busy. But when the GP doesn't have a lot of patients (either b/c of the poor economy or b/c he/she's just started a practice), it is not a bad idea to spend 3 hours to do RCT and make $1000….it's still better than working for Western Dental (or other dental chains) for 8 hours and only make $450

 

[Simiam]

Everyone wants a piece of the implant pie... but endo??? That doesn't make any sense.

My question, does it make a noticable difference for the patient to have an RCT vs implant with regards to oseointegration? With an implant, it's like an ankylosed tooth -- no occlusive sensation, right? Isn't it better to keep a natural tooth in place as long as it has a viable PDL so the patient can actually feel it? Or does it not really make any difference...?

The endo I am associated with explained to me that Endodontists have begun to do implants because it is convenient. If they are refered a patient who would not benefit from RCT, then they would be able to extract and implant right there as opposed to refering it out to a oral surgeon. At least, this is how it was explained to me.

 

[monreal]

The endo I am associated with explained to me that Endodontists have begun to do implants because it is convenient. If they are refered a patient who would not benefit from RCT, then they would be able to extract and implant right there as opposed to refering it out to a oral surgeon. At least, this is how it was explained to me.

Yes. It's very convenient and easy way to lose his referral base. Imagine the face on the GP (who does implants himself) when he sees a screw instead of the tooth he sent.

 

[Guy Smiley]

I think you also have to think about your patient. I personally wouldn't feel super about subjecting a patient to a 3 hour procedure when another provider (the specialist) could do it in an hour or less at the same price. If I was saving the patient some money or perhaps a long drive, then I would feel better about it.

 

[achilles2]

Yes. It's very convenient and easy way to lose his referral base. Imagine the face on the GP (who does implants himself) when he sees a screw instead of the tooth he sent.

this is what will keep the system in check

referrals


BUT when the economy starts eating dirt and lifestyle quality gets effected don't be surprised to find people stepping on toes.

One Perio I know of starting being a hero by placing implants THEN doing the restorations. He got cut off from referrals rather quickly.