I have compiled a list of cons with being a dentist… let me know if any of these are inaccurate or not common enough

[miketheooo]

Lets start with the general state of the profession:

1. The field is getting saturated and will require you to move to a more rural setting to find a job that pays more than $120K.
2. Insurance reimbursements are cut year-after-year, making you have to work harder to collect compensation over time.
3. The high amount of dental students graduating every year increases competition — this drives down compensation, and allows insurances to continue getting away with compensating less (Supply and Demand).
4. Decreased patient trust due to over treatment as a result of high student debt and unethical dilemmas sourced from students/practices wanting to earn more money.
5. Patients tell you they hate you quite often, and some just do not trust you or respect you.
6. Some patients are uncooperative or extremely anxious.
7. Some patients have unrealistic expectations for what you can do for them, and get mad when you deliver bad news.
8. Being a dentist is both physically and mentally laborious on the body.
9. Work follows you home in the form of notes or general stress for your patients or what you have to do the next day.

Now let’s look at issues with working for an office after graduation:

1. A large percentage of associateships fail within 1 year, whether it is private or corporate practices.
2. Large turnover rates not only for dentists but other staff as well.
3. Unrealistic expectations from bosses for time to complete a large load of procedure.
4. Owner doctors that “cherry-pick” the money generating cases.
5. Unethical dilemmas exist with over treatment of patients.
6. The dream of working 4 days week is hard to come by in many associateships. Often times you’re required to come to work 6 days two out of the four weeks in a month.
7. You lack clinical autonomy in some of these practice models.
8. You generally aren’t going to receive benefits even as an employee.
9. You will often have to pay for your own malpractice and disability insurance.
10. PTO is extremely rare to come by, and taking a 5 day vacation is not easy to do considering you are scheduled in months ahead of time for patients that rely on you.

Finally, let’s look what many dentists think is the best way to avoid all the issues listed — practice ownership:

1. Buying a practice is more expensive than ever with costs of purchase equalling about $500K-$1M. Overhead costs are also extremely high.
2. Not only is it expensive, it is also much harder to buy a practice today. Corporations are taking over existing private practices and outbidding new grads trying to purchase an office by hundreds of thousands in their offers.
3. Owning a practice isn’t all sunshine and rainbows. You may LOSE money the first few years or simply make less than an associate.
4. As an owner, you work harder, even if that means you’re not working in the dental chair as much.
5. You take a lot of your work and stress home in forms that are totally unrelated to healthcare or dentistry.
6. You have to worry about hiring staff, keeping them happy, paying them, and making sure they all are coming in on time to work.
7. You have to worry about bringing patients into your practice with new marketing strategies.
8. You have to worry about billing and insurances.
9. You have to worry about buying all your equipment and supplies and keeping everything up to date.
10. You have to worry about fixing anything that goes wrong.
11. You have to worry about competition, and the many dentists fighting for the same patients next door.

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[providence819]

Someone woke up and chose violence today

 

[Screwtape]

As a practicing dentist of about 5 years (~1 of which has been as an owner dentist)—I would say there is a fair amount of truth here. Although, some of it is exaggerated towards the negative. I think a lot of this list really depends on your geography, personality, risk appetite, and many other variables. Dentistry is definitely not all roses, I don’t know any “real” careers that are though. I do know if you’re in the right location, have the right personality, and make a few smart moves you can have a great life as a dentist. It’s definitely not a “gimme” career like a lot of medicine where you are guaranteed a good paycheck, but play your cards right and your life will be much better than the vast majority of physicians. And any other career in healthcare. Healthcare professions are definitely not what they used to be. But not much is… I’m quite happy with how dentistry has treated me so far. But no doubt it ain’t perfect. And I probably got lucky somewhere during this ride. Gotta work hard these days for the big bucks/great lifestyle, no matter the career you’re in.

 

[psiyung]

Staff alone makes up for the majority of the headache on that list.

 

[charlestweed]

Gotta work hard these days for the big bucks/great lifestyle, no matter the career you’re in.

Amen! It’s not that hard a concept to grasp. It’s incredibly troubling to see so many young kids who think that studying hard in school, attending a "famous" school, and making sacrifices (by giving up all the funs to spend eight years of schooling) are enough. And after graduation, they are entitled to an easy stress-free good paying job. I haven’t yet seen a successful person who is not a hard working person. Elon Musk used to work and sleep at his Tesla factory.

 

[Wahoowah]

Amen! It’s not that hard a concept to grasp. It’s incredibly troubling to see so many young kids who think that studying hard in school, attending a "famous" school, and making sacrifices (by giving up all the funs to spend eight years of schooling) are enough. And after graduation, they are entitled to an easy stress-free good paying job. I haven’t yet seen a successful person who is not a hard working person. Elon Musk used to work and sleep at his Tesla factory.

If you want easy, stress-free and well paying I think the only place left is tech.

 

[miketheooo]

If you want easy, stress-free and well paying I think the only place left is tech.

Many people in tech hate it. It’s incredibly stressful and mentally draining to be a software developer. You bring lots of your work home and you have deadlines to submit work. You also aren’t making that insane money everyone thinks developers make if you’re not working for FAANG companies.

 

[PerioDont]

Many people in tech hate it. It’s incredibly stressful and mentally draining to be a software developer. You bring lots of your work home and you have deadlines to submit work. You also aren’t making that insane money everyone thinks developers make if you’re not working for FAANG companies.

my tech friends seem to carry around pagers and be on 'call' much more frequently than any non-OMFS dentist I know

 

[Wahoowah]

my tech friends seem to carry around pagers and be on 'call' much more frequently than any non-OMFS dentist I know

Yikes - I guess I was referring more to the folks in product management or strategy.

To the OP, there are still people successful and happy in dentistry despite what you are listing here, even recent grads. At the end of the day you get to decide what challenges you find interesting and worthwhile to you. Fwiw when I did my MBA most people disliked their jobs and were trying to transition from one path to another (tech->banking, consulting->PE,, etc). While something might seem good or bad on paper, the intangible experiences are what make your calling attractive to some or unattractive to others.

 

[miketheooo]

Yikes - I guess I was referring more to the folks in product management or strategy.

To the OP, there are still people successful and happy in dentistry despite what you are listing here, even recent grads. At the end of the day you get to decide what challenges you find interesting and worthwhile to you. Fwiw when I did my MBA most people disliked their jobs and were trying to transition from one path to another (tech->banking, consulting->PE,, etc). While something might seem good or bad on paper, the intangible experiences are what make your calling attractive to some or unattractive to others.

Agreed. It’s tough figuring out where these issues are stemming from, how big these issues really are, or if negatives just stand out more over the known perceived positives (fulfilling work, work-life balance, pay, autonomy, etc.)

 

[GoDental101]

Agreed. It’s tough figuring out where these issues are stemming from, how big these issues really are, or if negatives just stand out more over the known perceived positives (fulfilling work, work-life balance, pay, autonomy, etc.)

Here's is a nice way to counter a lot of your worries.
1. Keep education debt below 250k. (do the military HPSP if necessary)
2. Practice in an area with need. (typically rural or for some other reason an undesirable place to live)
3. Own your means of production. (be the practice owner and no not some corporate office that you buy into)
4. Put the patient first and work hard.

The less you are willing to do the above, the more you will face those problems you listed originally. Sounds easy, but many aren't willing to do at least one if not all four of those things I listed.

 

[P7898]

Here's is a nice way to counter a lot of your worries.
1. Keep education debt below 250k. (do the military HPSP if necessary)
2. Practice in an area with need. (typically rural or for some other reason an undesirable place to live)
3. Own your means of production. (be the practice owner and no not some corporate office that you buy into)
4. Put the patient first and work hard.

The less you are willing to do the above, the more you will face those problems you listed originally. Sounds easy, but many aren't willing to do at least one if not all four of those things I listed.

The real truth right here. Like there are soo many first year jobs that new grads can get that are $200k+ potential. But like it says here #2.... practice and go where you are needed.

 

[oralcare123]

Oh, well - let's just close shops and all become Walmart greeters

 

[allDAT]

long term outlook is problematic because insurance controls fees and labor force has left our profession (the birth rate in the US is very low so replacement is hard without an influx of working-age females who traditionally seek employment in a dental office - immigration appears to be the only solution for the bulk of the country). The first one (insurance controlling fees) is bigger challenge though and it’s a beast.

New grads make more than 120k as full time associates just about everywhere.

The problem is that the hourly minimum hasn’t kept up with inflation. Although wages have gone up a bit in CA…a new grad in SoCal can expect $600-$650 a day in 2022 and the job market is terrible for dentists here. You should expect to make more the farther away you get from the most popular major metros.

Dentists are unwilling to move. The go rural thing isn’t a realistic solution for most people. You can also go rural and strike out. dentistry has a sweet spot - not too far from economic opportunities for your patients and not too close to city centers where overhead is high and cost of living makes your employees commute long distances because they can’t afford to live close.

 

[miketheooo]

long term outlook is problematic because insurance controls fees and labor force has left our profession (the birth rate in the US is very low so replacement is hard without an influx of working-age females who traditionally seek employment in a dental office - immigration appears to be the only solution for the bulk of the country). The first one (insurance controlling fees) is bigger challenge though and it’s a beast.

New grads make more than 120k as full time associates just about everywhere.

The problem is that the hourly minimum hasn’t kept up with inflation. Although wages have gone up a bit in CA…a new grad in SoCal can expect $600-$650 a day in 2022 and the job market is terrible for dentists here. You should expect to make more the farther away you get from the most popular major metros.

Dentists are unwilling to move. The go rural thing isn’t a realistic solution for most people. You can also go rural and strike out. dentistry has a sweet spot - not too far from economic opportunities for your patients and not too close to city centers where overhead is high and cost of living makes your employees commute long distances because they can’t afford to live close.

Would you say that sweet spot is about 30-45 minutes from a major city? A suburb of that city if you will

 

[allDAT]

Would you say that sweet spot is about 30-45 minutes from a major city? A suburb of that city if you will

Depends what city.
An hour out of San Diego or LA is not far enough. An hour out of Atlanta may be plenty.

 

[OMSDoc]

I love it when the young generation in Western culture, who have been raised to be socialists, are, in fact, capitalists.

Everyone is a capitalist when it comes to their own money.

Everyone.

 

[njdds2020]

While all these seem like a lot of cons, they're all kind of saying the same thing: if you don't enjoy the business-side of being a dentist, it will be hard to find happiness in this field. If you truly enjoy the competitive spirit of having a business (that means competing with other dentists in the area/dealing with saturation, ensuring patient "customer" satisfaction, staff and business logistics, etc.) you'll do great. However, if you want the safety of being an employee/associate, you'll have to deal with all the drawbacks of working under owners/bosses who have full control/no oversight and no pressure to look out for you.

This is why most people enter dentistry with the goal of being an owner, and despite all the cons of being an owner above, still find it to be a rewarding alternative to the other career options (including non-dental) out there.

 

[yappy]

While all these seem like a lot of cons, they're all kind of saying the same thing: if you don't enjoy the business-side of being a dentist, it will be hard to find happiness in this field. If you truly enjoy the competitive spirit of having a business (that means competing with other dentists in the area/dealing with saturation, ensuring patient "customer" satisfaction, staff and business logistics, etc.) you'll do great. However, if you want the safety of being an employee/associate, you'll have to deal with all the drawbacks of working under owners/bosses who have full control/no oversight and no pressure to look out for you.

This is why most people enter dentistry with the goal of being an owner, and despite all the cons of being an owner above, still find it to be a rewarding alternative to the other career options (including non-dental) out there.

Excellent analysis. You've put into words what I have felt, but could not articulate.

I don't have that... "competitive spirit" when it comes to business. I work as an associate and enjoy providing excellent patient care and being a healthcare provider. I am in a comfortable financial situation and debt is not a problem, but I am still young in my career. I really enjoy the art and science of dentistry. I don't enjoy working for the type of dentist-owners you describe. Where do you recommend I go from here?

 

[allDAT]

Excellent analysis. You've put into words what I have felt, but could not articulate.

I don't have that... "competitive spirit" when it comes to business. I work as an associate and enjoy providing excellent patient care and being a healthcare provider. I am in a comfortable financial situation and debt is not a problem, but I am still young in my career. I really enjoy the art and science of dentistry. I don't enjoy working for the type of dentist-owners you describe. Where do you recommend I go from here?

Academia part time. Part time associate or faculty practice the other half of the time.

 

[Mauricio45]

Those here who say dentists should simply move to rural areas or smallish towns to make big money or easy lifestyle. It's easier said than done. It's not easy to convince the spouse or kids to move to those locations. That is a big factor.

 

[Mauricio45]

I would add to cons: "dentists eat their own". You have to constantly worry about what other dentists say about your work even when they don't have the full story. Because dentists for the most part don't play well with each other and are quick to throw each other under the bus.

Alot of dentists love to point out other dentists' flaws but keep quiet about their own shortcomings and deficiencies. We really are our own worst enemies.

 

[Mauricio45]

Another thing for cons is worrying about bad online reviews as that can have an impact on your business and your reputation. Online reviews are a big thing these days. Maybe wasn't as important 10 years ago but social media is huge now.

So, if you piss off an unreasonable patient, you can't really fight back due to HIPAA laws. Another stress to an already difficult job.

 

[PerioDont]

Those here who say dentists should simply move to rural areas or smallish towns to make big money or easy lifestyle. It's easier said than done. It's not easy to convince the spouse or kids to move to those locations. That is a big factor.

Agreed. This is a major factor.

Being from a minority group I also want to have people from my religious community as well.

So there is basically a 0% chance of me going rural. Though I think it’s generally easier for specialists in big cities (more referrals)

 

[Molar Whisperer]

Agreed. This is a major factor.

Being from a minority group I also want to have people from my religious community as well.

So there is basically a 0% chance of me going rural. Though I think it’s generally easier for specialists in big cities (more referrals)

I see a lot of saturation in some specialties such as perio in my area. My sister practices in Texas and she has a periodontist come to her office once a week to place implants. That might be a realistic practice modality of going to where there is need. If you have a perio practice in a saturated area, you have to kiss up to GPs. Just like you, I'm a minority that cannot thrive (family-wise) in a rural area because I lived it.

 

[Molar Whisperer]

I'm fortunate to have practiced dentistry for 24 years. From my observations, the successful dentists (what defines success?) usually practice in less saturated areas in the Midwest and Southeast where the Cost of Living is lower. It is very difficult to compete with corporations because they are very aggressive with their big pool of investors' money. I work for a large corporation that does mostly Medicaid and I think I do better than many of my PP counterparts in my area (many of them work for corps part-time as well). I'm one of the few that does pediatric molar RCTs (endodontists refuse to work on them). I'm also one of the de-facto Oral Surgeons (they are in very short supply in my state). I do punt (refer) most implants since I don't do enough of them and I don't take on OS cases (Le Forts lol) that will get me in trouble. My job description was 100% not envisioned while I was in Dental School. I wanted to practice high-end dentistry and work on the governor's teeth. Dentistry continues to evolve and one must adapt.