If you could do it all over , would you still be a dentist ?

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Zakaria12345

Zakaria12345

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If not , what career would you choose ?
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As a dentist in the final phase of my career...

Yes!!! Dentistry has been very good to me.
However, I encouraged my kids to do other things. Dentistry in the 21st century is not the same as it was for me.
 
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Yes, although I specialized. But I would have been ok with being a GP.
 
I wish I had specialized or gotten into ownership earlier. If i had to do something else entirely I would do medicine or business
 
No. Dentistry is not a straight forward career. Ownership takes a lot of debt and risk. Being an associate is not very rewarding professionally or financially. If I could do it all over again I would have done medicine. I think I would have found the work more rewarding, enjoyed the broader employment opportunities, and physicians have higher incomes on average. I think my biggest complaint of dentistry is that the dental workforce is not very professional. The culture of dentistry is lacking compared to medicine in my experience.
However, I find my work meaningful and everything considered dentistry has been good to me. I think, like other newer graduates, I'm still finding my place as I navigate this odd career path.
 
yappy said:
No. Dentistry is not a straight forward career. Ownership takes a lot of debt and risk. Being an associate is not very rewarding professionally or financially. If I could do it all over again I would have done medicine. I think I would have found the work more rewarding, enjoyed the broader employment opportunities, and physicians have higher incomes on average. I think my biggest complaint of dentistry is that the dental workforce is not very professional. The culture of dentistry is lacking compared to medicine in my experience.
However, I find my work meaningful and everything considered dentistry has been good to me. I think, like other newer graduates, I'm still finding my place as I navigate this odd career path.
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You can still apply to medical school!
 
TikiTorches said:
You can still apply to medical school!
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In a practical sense, he's better off applying for OMFS (4-6 yrs) rather than apply to med school, which will take atleast 1 yr to build up the resume, then 4 years of med school, then 3-8 years of residency + fellowship.... all to have a worse lifestyle and make less $

opportunity cost is a thing
 
ToothJockey said:
In a practical sense, he's better off applying for OMFS (4-6 yrs) rather than apply to med school, which will take atleast 1 yr to build up the resume, then 4 years of med school, then 3-8 years of residency + fellowship.... all to have a worse lifestyle and make less $

opportunity cost is a thing
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Yes I understand that. But only if he likes omfs
 
TikiTorches said:
Yes I understand that. But only if he likes omfs
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Yeah I get it, people should follow their passion.

But let's be realistic here, dental school + med school + accrued interest= > $1 million in student loans. Back when schools were cheap, following your heart was a great idea. But in 2020, when professional schools can put you in a buttload of debt, it's better to think financially instead of emotionally imo
 
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ToothJockey said:
Yeah I get it, people should follow their passion.

But let's be realistic here, dental school + med school + accrued interest= > $1 million in student loans. Back when schools were cheap, following your heart was a great idea. But in 2020, when professional schools can put you in a buttload of debt, it's better to think financially instead of emotionally imo
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I didnt say follow your passion. @yappy gave reasons he thought medicine was better for him.
 
Under the same circumstances, I'd do it all over again. If I had money and didn't need the money, I wouldn't do it again. Objectively, the best thing about dentistry is pure autonomy and money. As yappy has mentioned, our profession is dog eat dog (unfriendly professional culture/environment). If you're a beta dog, you're screwed. That's where the strength of autonomy comes in. I don't need to care what other dentists are doing nor care if they snub me or not. I'll be glad to win by taking their patients.

I respect what physicians do, but it just seems like a life of misery. So many controls, so many people to answer to, way too much school, the smell of hospitals, having to wake up early in the morning, dealing with medical insurance (dental insurance is cake compared to medical), etc...blech. Where else can you work 32 hours a week and still make comparable or potentially much more than a physician who went to school for so many more years. I have never seen a profession that requires so much extra bs, extracurriculars, and hoops that have to be jumped through to become a physician. That's why they deserve the respect that they think they deserve. Although when they start acting like gods, they also have to remember that they aren't the only doctor/specialist/subspecialist in the world.

Go to dentistry. It's an easier way to make money than medicine. Less time too.
 
TikiTorches said:
I didnt say follow your passion. @yappy gave reasons he thought medicine was better for him.
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You are correct in saying that if I really wanted medicine I could change careers and apply for medical school. However, at this point I don't have the energy to get back into the pre-med mindset to be successful. As I said, dentistry has treated me well. Overall, I enjoy what I do. By living well below my means I am debt free after a few years out from school. I think in order for me to get more enjoyment from my career I need to focus on buying a practice for autonomy.

As far as my passion goes, I think OMS would have been a good fit for me. However, I am doing most of the procedures I would have wanted to to do as an OMS already; site development, implants, and thirds. I think diving into a residency like OMS would be a huge financial and personal cost for me at this point. My goal is to master digital work flows so that I can perform all aspects of implant supported prosthesis. If I can find the right market and gear a practice towards this I think I could be very content without specializing or changing careers to medicine. Having said all that, if I could speak to my younger self, I think I would have gone into medicine and enjoyed that ride for the reasons I mentioned in my previous post.
 
yappy said:
You are correct in saying that if I really wanted medicine I could change careers and apply for medical school. However, at this point I don't have the energy to get back into the pre-med mindset to be successful. As I said, dentistry has treated me well. Overall, I enjoy what I do. By living well below my means I am debt free after a few years out from school. I think in order for me to get more enjoyment from my career I need to focus on buying a practice for autonomy.

As far as my passion goes, I think OMS would have been a good fit for me. However, I am doing most of the procedures I would have wanted to to do as an OMS already; site development, implants, and thirds. I think diving into a residency like OMS would be a huge financial and personal cost for me at this point. My goal is to master digital work flows so that I can perform all aspects of implant supported prosthesis. If I can find the right market and gear a practice towards this I think I could be very content without specializing or changing careers to medicine. Having said all that, if I could speak to my younger self, I think I would have gone into medicine and enjoyed that ride for the reasons I mentioned in my previous post.
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Why didn't you go into medicine at that time?
 
TikiTorches said:
Why didn't you go into medicine at that time?
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I was stuck between the two fields because I had an interest in both. I had family responsibilities that made the lengthy training in medicine the lesser option for me so I went with dentistry. Hindsight 20/20, I think I would have been okay doing a residency and delaying gratification.
 
Probably. However, there is no shame in starting a career at 22 in some other field. Financially could be smart.
 
Cold Front said:
To make more $$$?

Well, specializing would have gotten you into more debt and more income potential loss.


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Dude you seem to have serious issues with specialists. Is it a pride thing? Just give it a rest man.
 
TanMan said:
I don't think it has to do moreso with being a specialist but going into more debt to become a specialist.
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It definitely is the going into more debt factor. If it was paid residency training I think it would be a no brainer for certain specialties. But all in all if you can do simple cases for most of all of dentistry ( I know that is a lot in itself but you can do it ) then you really have the best of both worlds in terms of clinical stress level, referring out things you don't want to, and income potential. Fillings, CEREC crown, CEREC bridge, 3rd molar extraction (2), molar endo, started an Invisalign case and leave I mean this was an actual day of my fiancé. You basically become a multi-specialty practice by yourself but it is really about case selection and knowing what is good and predictable. Not pulling an ankylosed maxillary 3rd and worried about the sinus for 10809803 hours.
 
New_Vegas said:
Dude you seem to have serious issues with specialists. Is it a pride thing? Just give it a rest man.
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Most of my dentist friends are specialists, and I can do 40% of what they do every day - from Endo, Pedo, OS. The other 60% is what specialists are REALLY needed for.

If you love a specialty, do it. Take the extra big loans. If you don’t, and are doing it for the money, then you are wasting time/potential income for 2-3 more years of training at a very high price tag.


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I can't speak for general dentistry, but no regrets for being an orthodontist. I had the opportunity to practice ortho when things were really, really good. I was fortunate to have attended a cheap DS and a paid ortho residency. DS debt service wasn't even an issue when I graduated. I belonged to a very exclusive proud profession.
I can't really complain working in the Corp arena now. Work is easy. I'm paid relatively well. Lifestyle has remained the same.
At the end of the day ..... dentists (most specialists) have a superior lifestyle than most other professions (i.e medicine). No absurd working hours. No on call. No real emergencies. The ability to own your own practice. Autonomy.
I'm not saying dentistry is easy. It's not. Dentistry is an envious profession. But the DS debt is making it harder to choose dentistry as a profession.
Make the right financial decisions BEFORE choosing a DS and then make the RIGHT decision on where to practice. Life will be good.
 
2TH MVR said:
I can't speak for general dentistry, but no regrets for being an orthodontist. I had the opportunity to practice ortho when things were really, really good. I was fortunate to have attended a cheap DS and a paid ortho residency. DS debt service wasn't even an issue when I graduated. I belonged to a very exclusive proud profession.
I can't really complain working in the Corp arena now. Work is easy. I'm paid relatively well. Lifestyle has remained the same.
At the end of the day ..... dentists (most specialists) have a superior lifestyle than most other professions (i.e medicine). No absurd working hours. No on call. No real emergencies. The ability to own your own practice. Autonomy.
I'm not saying dentistry is easy. It's not. Dentistry is an envious profession. But the DS debt is making it harder to choose dentistry as a profession.
Make the right financial decisions BEFORE choosing a DS and then make the RIGHT decision on where to practice. Life will be good.
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What is the going rate for an orthodontist in a corp? I know it depends on location... I've seen about 1200 a day. Is there room to move up with more experience?
 
Cold Front said:
Most of my dentist friends are specialists, and I can do 40% of what they do every day - from Endo, Pedo, OS. The other 60% is what specialists are REALLY needed for.

If you love a specialty, do it. Take the extra big loans. If you don’t, and are doing it for the money, then you are wasting time/potential income for 2-3 more years of training at a very high price tag.


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Most people I know (myself included) specialize because they want to make more money. Education is a form of a financial investment.
 
charlestweed said:
Most people I know (myself included) specialize because they want to make more money. Education is a form of a financial investment.
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Absolutely. Time will tell how much of that investment is a good investment in the future - with many residency programs charging $200-350k today.


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Money wasn't my primary motivation for spec
charlestweed said:
Most people I know (myself included) specialize because they want to make more money. Education is a form of a financial investment.
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Money was not my primary reason for specializing. I was enamored with orthodontics. I had no interest in general dentistry.
 
Cold Front said:
Absolutely. Time will tell how much of that investment is a good investment in the future - with many residency programs charging $200-350k today.


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If things don't work out, you can go back to practicing general dentistry. Think of this as a bad investment. I know some general dentists who spent similar amount, $200-350k, to set up or buy an office. But things didn't work out well for them and they had to sell their practices at a loss.....and then they came to work at the same corp office with me. It's Ok to make mistakes when you are still young and healthy because you have more time to work to fix the mistakes. That's why I always tell my kids, nieces, nephews, and my teenaged patients who want to become an ortho like me to stay focused in school and try to graduate ontime.

Not every general dentist is good at running his/her own office. For GPs, they are stuck at $120-200k salary if they don't want to open their own offices. For specialists (pedo, endo, ortho, perio, OS), if they don't want to open their own offices, they can travel to work at multiple offices (corp or GP offices) and make a lot more than associate general dentists. I don't think I would have the same financial success as I have now if I were a general dentist. There are too many general dentists here in CA and they all accept medicaid. Can't make much with $50 per filling. At least medicaid pays the orthodontists $3000 a case... the doctor's time for the entire 2 -yr tx is under an hour because the assistants do 90% of the manual labors .
 
2TH MVR said:
Money wasn't my primary motivation for spec

Money was not my primary reason for specializing. I was enamored with orthodontics. I had no interest in general dentistry.
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Would you say many specialize today for the money more than for the passion? How does a pre-doc with no specialty exposure (which is the case for majority of applicants) truly know where their passion lies?


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2TH MVR said:
Money wasn't my primary motivation for spec

Money was not my primary reason for specializing. I was enamored with orthodontics. I had no interest in general dentistry.
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At the time that I applied, I didn't know if I liked ortho or not because I didn't know much about the specialty. I only took 5-6 ortho classes in dental school. I didn't treat any ortho patient in dental school. I had to think very hard to come up with the "fake" reasons for why I wanted to become an orthodontist because I knew this would be the first question that ortho directors would ask me at the interview. Just like many college grads who decide to go to through more schooling to get their MS and PhD degrees, I specialized after dental school becuase I hoped to make more money than working as a GP. There were already too many GP offices here in CA and it would be hard to compete with them.
 
Cold Front said:
Would you say many specialize today for the money more than for the passion? How does a pre-doc with no specialty exposure (which is the case for majority of applicants) truly know where their passion lies?


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Not sure if passion or money is the reason for specializing in the present.
As for knowing where your passion is. I don't know. I went to DS to become a good GP. After 1 yr .... I realized that I wanted to do something different. Orthodontics. Future salary was never part of the equation. Lifestyle and being somewhat exclusive were the main motivators.
 
2TH MVR said:
Not sure if passion or money is the reason for specializing in the present.
As for knowing where your passion is. I don't know. I went to DS to become a good GP. After 1 yr .... I realized that I wanted to do something different. Orthodontics. Future salary was never part of the equation. Lifestyle and being somewhat exclusive were the main motivators.
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How many residency applicants say “lifestyle and being somewhat exclusive” at their interviews as a reason to get into a post-doc program?

Most applicants (white) lie to programs to get into a specialty, and the programs don’t really care either way - because they just want people who will take orders and get through with the program, and get paid big money every year to put up with them.

Maybe that wasn’t the case when you applied and got into an Ortho program, but today - it’s more about “take my money and give me my diploma!” and less about “I truly care about teeth and dental specialties”. Ask any young dentist today, how often they calculate numbers; to keep up with their student loans and income. Dentistry has reached a full blown numbers game, from schools to the insurance industry. It’s now an intrinsic part of the fabric of the profession. For lack of better words, dentistry has become less of a service and more of a commodity today, IMO.

It’s a high stakes table, grab a seat and let’s hope you make it - financially.


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Cold Front said:
For lack of better words, dentistry has become less of a service and more of a commodity today, IMO.

It’s a high stakes table, grab a seat and let’s hope you make it - financially.


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I've been saying that for years. Dentistry is a commodity now. But there's plenty of blame to go around. The DS (mostly the private for profit) schools that charge insane tuition and have large class sizes are mostly to blame, but they are just taking advantage of a system that is available to them. The large dental Corps seized on the opportunity that most dentists didn't want to treat medicaid/low income patients. Now we're stuck with them and they are not going away. Large investor type companies such as Align Tech, SDC, Clear Choice, Amazon, Walgreens, CVS, Walmart, etc. etc. have also seen the potential to make money from dental/medical treatments. Medicine is no different. 1st there were the Urgent Care companies popping up. Now most of the large hospitals are positioning these smaller, local, more convenient health facilities on every corner. Kind of reminds me of the Dental Corps on every corner.

Back to the original topic. I agree. Getting into a post-doc residency is a numbers game now. Everyone has the information to find the easiest way to a specialty. With enough loan money .... I guess you can buy yourself into a residency.
 
Cold Front said:
How many residency applicants say “lifestyle and being somewhat exclusive” at their interviews as a reason to get into a post-doc program?

Most applicants (white) lie to programs to get into a specialty, and the programs don’t really care either way - because they just want people who will take orders and get through with the program, and get paid big money every year to put up with them.
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If you say you want to do ortho because you want to have a good lifestyle and that you hate doing general dentistry, your chance of getting accepted will be zero percent.

If I were a program director, I would also want to accept a candidate who respects the instructors and can get along with others. I wouldn't want to hire a candidate who is cocky and thinks he/she is smarter than the instructors. It's just like hiring an employee, I would want someone who is polite and is willing to listen to me.
 
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charlestweed said:
If you say you want to do ortho because you want to have a good lifestyle and that you hate doing general dentistry, your chance of getting accepted will be zero percent.
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So if @2TH MVR was honest at his ortho residency interview, he would be denied? So he had to say what the interviewer(s) wanted to hear instead.

The system is not about who is qualified the most, but who has the most connections to get in, best personality, good looks, and can pretend the most about why they want to specialize.


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Cold Front said:
So if @2TH MVR was honest at his ortho residency interview, he would be denied? So he had to say what the interviewer(s) wanted to hear instead.

The system is not about who is qualified the most, but who has the most connections to get in, best personality, good looks, and can pretend the most about why they want to specialize.


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I think he would be denied. I am pretty sure most ortho program directors know $$$ and lifestyle are the reasons why we want to become an orthodontist. They just want to hear how we answer the question.

Programs still have to accept candidates with good grades because these candidates have to take classes and pass the specialty board. OS residents have to take medical boards.

I wonder if you saw an old 1989 movie, "Gross Anatomy?" Here is the exact quote from the movie, when the main character, Joe, was at a med school interview:

“- Interviewer: Tell me. Joe or Joseph, why do you want to be a doctor?
- Joe Slovak: That's easy. I want to help people.
- Interviewer: Come one Joe, you can be honest with me. Why do you want to be a doctor?
- Joe Slovak: Well, uh, I want to make lots of money.”

This is so true in real life. Nobody is that crazy to spend so much time and effort in schools....take out enormous amount of student loans.....lose many of the youth years....so that he/she can become a doctor/dentist and help other people.
 
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Steins;Gate said:
Why do you wish you specialized or owned earlier?
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This response is a little off topic, but I will give some predents some numbers around my decision making process.

First dentistry is a top 10 career, but as my wife and I were doing our taxes I pulled out an old w2 from when i worked at a DSO
The following are real life numbers.

So I earned 187k the previous year which sounds like a lot of money, however 2 years ago I made 169k at my dso. I came to this figure by adding up my salary, 401k, bonus, healthinsurance, the portion business pay towards medicare and ss tax. So the grand difference between owning a practice vs working for someone is 18k a year. I believe in the future that gap will only shrink as more and more dentists go the DSO route+saturation. Even now, there is pressure on my hygiene department to break even! If I am paying someone 35 bucks an hour and delta dental is only paying me 90 dollars per hygiene check and each check on average is taking 45 minutes so that leaves very little room for profit. If I am running behind, or a patient is late or missing an appointment, or there is some issue we can likely be losing money.

Had i specialized i wouldn't have to deal with this much competition, marketing and all other parts of owning a business reliant on repeat customers, and had i established my practice earlier I would likely have lower rent, less money spent on marketing, a better trained staff with less turn over, and I could possibly negotiate higher rates with insurance companies.

If I was an endodontist I could literally work out of a shack or simply travel to offices and not deal with all the overhead I currently have.
 
theleatherwalle said:
This response is a little off topic, but I will give some predents some numbers around my decision making process.

First dentistry is a top 10 career, but as my wife and I were doing our taxes I pulled out an old w2 from when i worked at a DSO
The following are real life numbers.

So I earned 187k the previous year which sounds like a lot of money, however 2 years ago I made 169k at my dso. I came to this figure by adding up my salary, 401k, bonus, healthinsurance, the portion business pay towards medicare and ss tax. So the grand difference between owning a practice vs working for someone is 18k a year. I believe in the future that gap will only shrink as more and more dentists go the DSO route+saturation. Even now, there is pressure on my hygiene department to break even! If I am paying someone 35 bucks an hour and delta dental is only paying me 90 dollars per hygiene check and each check on average is taking 45 minutes so that leaves very little room for profit. If I am running behind, or a patient is late or missing an appointment, or there is some issue we can likely be losing money.

Had i specialized i wouldn't have to deal with this much competition, marketing and all other parts of owning a business reliant on repeat customers, and had i established my practice earlier I would likely have lower rent, less money spent on marketing, a better trained staff with less turn over, and I could possibly negotiate higher rates with insurance companies.

If I was an endodontist I could literally work out of a shack or simply travel to offices and not deal with all the overhead I currently have.
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Thank you for sharing. But you mean: "For me personally, the grand difference between owning a practice vs working for someone is 18k a year."

Again thank you for sharing and you make great points about specialties.
 
theleatherwalle said:
This response is a little off topic, but I will give some predents some numbers around my decision making process.

First dentistry is a top 10 career, but as my wife and I were doing our taxes I pulled out an old w2 from when i worked at a DSO
The following are real life numbers.

So I earned 187k the previous year which sounds like a lot of money, however 2 years ago I made 169k at my dso. I came to this figure by adding up my salary, 401k, bonus, healthinsurance, the portion business pay towards medicare and ss tax. So the grand difference between owning a practice vs working for someone is 18k a year. I believe in the future that gap will only shrink as more and more dentists go the DSO route+saturation. Even now, there is pressure on my hygiene department to break even! If I am paying someone 35 bucks an hour and delta dental is only paying me 90 dollars per hygiene check and each check on average is taking 45 minutes so that leaves very little room for profit. If I am running behind, or a patient is late or missing an appointment, or there is some issue we can likely be losing money.

Had i specialized i wouldn't have to deal with this much competition, marketing and all other parts of owning a business reliant on repeat customers, and had i established my practice earlier I would likely have lower rent, less money spent on marketing, a better trained staff with less turn over, and I could possibly negotiate higher rates with insurance companies.

If I was an endodontist I could literally work out of a shack or simply travel to offices and not deal with all the overhead I currently have.
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Thanks for sharing.
Is this an office you purchased or start up? Do you anticipate your 2020 income to be substantially higher than your first year in the office?
 
theleatherwalle said:
Had i specialized i wouldn't have to deal with this much competition, marketing and all other parts of owning a business reliant on repeat customers, and had i established my practice earlier I would likely have lower rent, less money spent on marketing, a better trained staff with less turn over, and I could possibly negotiate higher rates with insurance companies.

If I was an endodontist I could literally work out of a shack or simply travel to offices and not deal with all the overhead I currently have.
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Let me ask you this hypothetically... money aside, if you were an endodontist and made the same $187k/yr at your own office or $169k at a DSO, would you still consider specializing?

I had an associate who was making similar numbers as yours for 3 years at one of my offices, then decided to specialize in endo. He is in his first year of residency now, and staring at $250-300k in additional debt on top of his existing student loans. He is in his mid 30s now, and it will probably take him 2-3 years after residency to have the speed and the referral base to make the “good income” endodontists are advertised to make, by about age 40. He chose to specialize in Endo purely to make more money for his family, and not because he loves the Endo field. Just like yourself, he thinks the general dentistry income is not high enough and if he knew that as a pre-dent, he would steer away from dentistry all together.

I say this all the time on these boards, unless you are in an under saturated market, or have serious business skills and able to perform some specialty services as a general dentist - you will likely be walking on a quick sand as a new grad general dentist today, and very likely in the future. You have to stay above the “average” general dentist line to make more income than your peers. The same goes for the “average” specialist, otherwise you won’t be busy enough to payback the crushing debt (and debt is not just measured in monetary value, but in TIME as well). Specialists (ortho, Endo, perio, and pros) carry more student loans and pay more income taxes - you still have to run the numbers and include the potential income loss as a general dentist (typically $400-600k) while doing 2-3 years of residency.

Do something you love and are truly passionate about, and perfect it - the money will follow. More income has never made anyone happier if they had to sacrifice their passion.
 
I am very happy to have gone into my specialty of choice and did so mainly to get away from general dentistry. I really think I would have been miserable as a general dentist. My GP friends are having a tough time as associates. But you know there is no way I could have foreseen this as a pre-dent because dentists you shadow always tell you how happy they are. Now on the other side I fully believe you really have to love general dentistry a lot to be happy in this career especially if you have debt from dental school.
 
theleatherwalle said:
Had i specialized i wouldn't have to deal with this much competition, marketing and all other parts of owning a business reliant on repeat customers, and had i established my practice earlier I would likely have lower rent, less money spent on marketing, a better trained staff with less turn over, and I could possibly negotiate higher rates with insurance companies.

If I was an endodontist I could literally work out of a shack or simply travel to offices and not deal with all the overhead I currently have.
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There's good and bad being a specialist vs gp. Anymore .... there is just as much competition with the specialists in the saturated desirable cities. I've witnessed this 1st hand in Phx. Built many practices in great areas ... and then .... the competition finds you. As for being a specialist in a Corp setting. Yes. Probably better than being a gp. As an ortho in the Corp setting .... I just do not have as many of the patient and Corp hassles as the gps.

Another key point in specialist vs. GP is referrals. Yes ... as you said .... an Endo could work out of a shack. I believe Endo has the least amount of overhead. Definitely an advantage. When you mention traveling to other offices .... I assume you mean GP offices. So .... you're going to work for GPs. Use their staff and supplies? So ...you're going to 4 yrs of DS to become a gp. Then off for another 2-3 years to become an Endo or other ........ all so you can go work for a GP????

Endo probably more so than any other specialty requires GP referrals. GPs are very fickle with their referrals. This referral stuff is probably the least fun part of being a specialist. You're always kissing a** and being constantly judged by the GP. One bad move and you're out. Don't kid yourself. Losing one referral source can seriously impact your revenue. It is not easy to find more referral gps. With your so-called endo shack example. You think the referring gps are going to want to send their trusted patients to a shack? Perception is everything regardless how good you are.

Again. In the Corp setting you do not have to deal with this referral business. The Corp GPs to have to refer to you. It's their job.

There's good and bad. Nothing is perfect.
 
2TH MVR said:
Another key point in specialist vs. GP is referrals. Yes ... as you said .... an Endo could work out of a shack. I believe Endo has the least amount of overhead. Definitely an advantage. When you mention traveling to other offices .... I assume you mean GP offices. So .... you're going to work for GPs. Use their staff and supplies? So ...you're going to 4 yrs of DS to become a gp. Then off for another 2-3 years to become an Endo or other ........ all so you can go work for a GP????

Endo probably more so than any other specialty requires GP referrals. GPs are very fickle with their referrals. This referral stuff is probably the least fun part of being a specialist. You're always kissing a** and being constantly judged by the GP. One bad move and you're out. Don't kid yourself. Losing one referral source can seriously impact your revenue. It is not easy to find more referral gps. With your so-called endo shack example. You think the referring gps are going to want to send their trusted patients to a shack? Perception is everything regardless how good you are.

Again. In the Corp setting you do not have to deal with this referral business. The Corp GPs to have to refer to you. It's their job.

There's good and bad. Nothing is perfect.
Click to expand...

While I agree you may have to brown nose a few a GPs, it is easier to talk to GP than it is the general public.

I will admit coldfront is right about the cost of residency. IT is astronomical compared to what our medical/pharmacy/optical peers have to go through.
 
theleatherwalle said:
This response is a little off topic, but I will give some predents some numbers around my decision making process.

First dentistry is a top 10 career, but as my wife and I were doing our taxes I pulled out an old w2 from when i worked at a DSO
The following are real life numbers.

So I earned 187k the previous year which sounds like a lot of money, however 2 years ago I made 169k at my dso. I came to this figure by adding up my salary, 401k, bonus, healthinsurance, the portion business pay towards medicare and ss tax. So the grand difference between owning a practice vs working for someone is 18k a year. I believe in the future that gap will only shrink as more and more dentists go the DSO route+saturation. Even now, there is pressure on my hygiene department to break even! If I am paying someone 35 bucks an hour and delta dental is only paying me 90 dollars per hygiene check and each check on average is taking 45 minutes so that leaves very little room for profit. If I am running behind, or a patient is late or missing an appointment, or there is some issue we can likely be losing money.

Had i specialized i wouldn't have to deal with this much competition, marketing and all other parts of owning a business reliant on repeat customers, and had i established my practice earlier I would likely have lower rent, less money spent on marketing, a better trained staff with less turn over, and I could possibly negotiate higher rates with insurance companies.

If I was an endodontist I could literally work out of a shack or simply travel to offices and not deal with all the overhead I currently have.
Click to expand...
In order to make $169k at a corp, you would have to see higher patient volume per day and work much harder than you would at your own office because corp offices usually accept mostly low pay plans such as medicaid and HMO. Am I wrong?

How can you not make any profit when you get paid $90 per cleaning, which takes 45 minutes to perform, and you only have to pay your hygienist $35/hour? Should you net around $55 per cleaning ($90-$35=$55)? Does your hygienist have fully booked schedule? Or does your hygienist have some free time to sit around doing nothing? Do you have free time to do your own cleaning and get rid of the hygienist?
 
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theleatherwalle said:
While I agree you may have to brown nose a few a GPs, it is easier to talk to GP than it is the general public.

I will admit coldfront is right about the cost of residency. IT is astronomical compared to what our medical/pharmacy/optical peers have to go through.
Click to expand...
I'd rather brown nose the GPs and have a much easier working schedule as a specialist than working 8 hours a day, 5 days/wk as a GP. Placing 2-3 implants in less than an hour, or doing 2-3 molar endos in less than 4 hours, or supervising the assistants to work on 60-80 ortho patients/day is way better than having to work non-stop for 8 hours every day as a GP.

I'd rather work for a GP as an in-house specialist than working for a GP as an associate general dentist. GP owners need in-house specialists more than the specialists need them; therefore, they usually do everything to keep the in-house specialists happy. Not every general dentist has the right skills to run a successful practice like ColdFront and Tanman.
 
charlestweed said:
Should you net around $55 per cleaning ($90-$35=$55)?
Click to expand...

I'm not completely sure, but I think he could have been subtracting other overhead costs too. Maybe keeping his office open for 1 hour costs $55/hr (rent, supplies, electricity?), so it's $90 - $35 (hygeinist) - $55 (other overhead) = ~ $0 profit
 
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