Is Corporate Dentistry Less of a Threat to the Specialties?

[Biggytooth]

Hey all,

I am in the midst of determining what dental school I will be able to attend this coming fall. I have an offer of admission from an expensive private school and am still praying to get into my state school. The entire situation has me thinking about my future quite a bit, as well as the future of dentistry-- particularly the corporate influence on the profession. So here's my question:

Is corporate dentistry as big a threat to private practice among the dental specialties as it is among general dentists? Do specialists still primarily operate private offices, and is that becoming less common? Does is vary among specialties-- i.e. more corporate orthodontic offices than, say, endodontist offices?

I'd appreciate any input; thank you!

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[2TH MVR]

Yes to all above. I'm not happy about it, but it is reality.
Corporate is a deep pocket business entity that has grown considerably over the last decade. Any business that generates good profit is going to be corporatized. Right or wrong.
As for specialists. It's mostly a double hit for private practice specialists. GP who used to refer to your specialty practice sells to Corp. Corp has their own specialists. See the point? This was a constant theme during my last 10 years of private practice. As a result, and that I'm getting older .... I sold both my ortho practices and now work for Corp. The pay is surprisingly good considering I just show up and clock in/clock out.
I see more ortho being advertised in the Corp offices than any other specialty. Positive note is that means there are plenty of Corp ortho jobs available.
I forsee what all large Corp entities do over time. Consolidate and grow. Largest Corps will eat smaller Corps. I see it already with the Corp I work for. They are constantly looking to expand and grow.
Private practice dentistry is still viable .... just pick the right, non-urban (saturated) area to practice. Plenty of patients still want personalized care.

 

[charlestweed]

I think oversaturation of orthodontists (due to openings of new ortho programs and increase in class size at some programs) is a much bigger threat than expansion of corp offices. Corp offices actually helped orthodontists like me, who are afraid to take risk to start their own office right after graduation. Ortho is not the only specialty that faces this oversaturation problem. The openings of new dental school and pedo programs in the last 10 years create oversaturations of general and pediatric dentists as well. OS and perio are competing against each other to gain the referrals from the same group of GPs in the area. Due to oversaturation of GPs, more GPs are trying to do their own endos and refer less to the endodontists.

These are what I've seen and experienced over the last 20 years:

- In the late 90s when I was still a dental student, the corp paid their associate orthodontists $500/day, which was around $200 more per day than what an associate GP made.

- Five years later when I completed my ortho residency in the early 2000s, my first job at a corp paid me $800/day....and another corp office paid me $950/day. At that time, there was a shortage of orthodontists because it was very hard to pass the CA board exam and ortho programs didn't pump out as many new grads as they do right now. It took the corps 3 months to find me. I easily got 3 job offers a month before I graduated. Because of the shortage, we, orthodontists, were able to demand the corps to pay us $1200-1500/day by the mid 2000s.

- Then the CA Dental board started to make things easier for orthodontists and dentists from other states to enter CA....by taking the easier Western Regional Board exam, or by reciprocity, or by doing a year of GPR/AEGD. We now have huge surpluses of dentists and specialists. Finding good paying orthodontic jobs at the corps is no longer easy. Before, the corps begged the new grad orthos to come work for them....no experience necessary. Now, the corps only select the orthos, who are fast, complain less, and have a few years of experience. The good thing is they haven't cut the base salaries...still around $1200-1500/day. And of course, the 2008 reccession/housing bubble added more salt to the injury. Many real estate brokers, who used to make 6-figure incomes, now have to work at Target. People have lost their jobs and can no long afford to pay $5-6k ortho tx for their kids. With huge drops in new patients, a couple of big name orthodontists in my area had to sell their pratices or merge into another ortho practice. Oversaturation does not just hurt the private practices. The corp offices I work for have been getting fewer new patient consultations as well.

Yes, most specialists I know have their own offices. However, most of them don't have enough patients to keep them busy full time at one location....either because they are too good and too fast that they can treat a lot of patients in a day and don't need to work too many days....OR....because the general dentists don't refer enough patients to their practices. So to make more and to keep themselves busy, most of them travel to multiple offices: their satelite offices, GP offices, or corp offices etc. For specialists, I think it's better to spend the same amount of money to open 2-3 small low overhead offices (to reach out to more referring GPs) than to open 1 big expensive state-of-the-art office.

 

[Biggytooth]

Yes to all above. I'm not happy about it, but it is reality.
Corporate is a deep pocket business entity that has grown considerably over the last decade. Any business that generates good profit is going to be corporatized. Right or wrong.
As for specialists. It's mostly a double hit for private practice specialists. GP who used to refer to your specialty practice sells to Corp. Corp has their own specialists. See the point? This was a constant theme during my last 10 years of private practice. As a result, and that I'm getting older .... I sold both my ortho practices and now work for Corp. The pay is surprisingly good considering I just show up and clock in/clock out.
I see more ortho being advertised in the Corp offices than any other specialty. Positive note is that means there are plenty of Corp ortho jobs available.
I forsee what all large Corp entities do over time. Consolidate and grow. Largest Corps will eat smaller Corps. I see it already with the Corp I work for. They are constantly looking to expand and grow.
Private practice dentistry is still viable .... just pick the right, non-urban (saturated) area to practice. Plenty of patients still want personalized care.

I think oversaturation of orthodontists (due to openings of new ortho programs and increase in class size at some programs) is a much bigger threat than expansion of corp offices. Corp offices actually helped orthodontists like me, who are afraid to take risk to start their own office right after graduation. Ortho is not the only specialty that faces this oversaturation problem. The openings of new dental school and pedo programs in the last 10 years create oversaturations of general and pediatric dentists as well. OS and perio are competing against each other to gain the referrals from the same group of GPs in the area. Due to oversaturation of GPs, more GPs are trying to do their own endos and refer less to the endodontists.

These are what I've seen and experienced over the last 20 years:

- In the late 90s when I was still a dental student, the corp paid their associate orthodontists $500/day, which was around $200 more per day than what an associate GP made.

- Five years later when I completed my ortho residency in the early 2000s, my first job at a corp paid me $800/day....and another corp office paid me $950/day. At that time, there was a shortage of orthodontists because it was very hard to pass the CA board exam and ortho programs didn't pump out as many new grads as they do right now. It took the corps 3 months to find me. I easily got 3 job offers a month before I graduated. Because of the shortage, we, orthodontists, were able to demand the corps to pay us $1200-1500/day by the mid 2000s.

- Then the CA Dental board started to make things easier for orthodontists and dentists from other states to enter CA....by taking the easier Western Regional Board exam, or by reciprocity, or by doing a year of GPR/AEGD. We now have huge surpluses of dentists and specialists. Finding good paying orthodontic jobs at the corps is no longer easy. Before, the corps begged the new grad orthos to come work for them....no experience necessary. Now, the corps only select the orthos, who are fast, complain less, and have a few years of experience. The good thing is they haven't cut the base salaries...still around $1200-1500/day. And of course, the 2008 reccession/housing bubble added more salt to the injury. Many real estate brokers, who used to make 6-figure incomes, now have to work at Target. People have lost their jobs and can no long afford to pay $5-6k ortho tx for their kids. With huge drops in new patients, a couple of big name orthodontists in my area had to sell their pratices or merge into another ortho practice. Oversaturation does not just hurt the private practices. The corp offices I work for have been getting fewer new patient consultations as well.

Yes, most specialists I know have their own offices. However, most of them don't have enough patients to keep them busy full time at one location....either because they are too good and too fast that they can treat a lot of patients in a day and don't need to work too many days....OR....because the general dentists don't refer enough patients to their practices. So to make more and to keep themselves busy, most of them travel to multiple offices: their satelite offices, GP offices, or corp offices etc. For specialists, I think it's better to spend the same amount of money to open 2-3 small low overhead offices (to reach out to more referring GPs) than to open 1 big expensive state-of-the-art office.

Thank you both for your input. I appreciate that you took the time to write all this out.

 

[RootRadar]

Endodontist here. I am not sure about the other specialties. But as for as corporate dentistry incorporating endodontists, it is much harder due to device limitations, such as microscopes and CBCTs. This is especially troublesome when one corporate dental office is never busy enough to hire an endodontist fulltime at that one office. These corporate dental companies hire one endodontist to cover multiple dental offices. This makes those device limitations even worse. As a result, it is hard for corporate dental companies to hire new graduate endodontists as we are trained on modern devices. This is a problem as new graduates are the ones more willing to work in corporate.

 

[2TH MVR]

Endodontist here. I am not sure about the other specialties. But as for as corporate dentistry incorporating endodontists, it is much harder due to device limitations, such as microscopes and CBCTs. This is especially troublesome when one corporate dental office is never busy enough to hire an endodontist fulltime at that one office. These corporate dental companies hire one endodontist to cover multiple dental offices. This makes those device limitations even worse. As a result, it is hard for corporate dental companies to hire new graduate endodontists as we are trained on modern devices. This is a problem as new graduates are the ones more willing to work in corporate.

The large Corp I work for have Orthodontists, OMFS, Perio. The GPs do all the pedo and endo.

 

[321931]

Corporate is a threat for everyone because they make life easier for the consumer by doing it all under one roof. One of the biggest problems GP face is that they have to refer to OMFS/ENDO/PERIO/ORTHO all over the place. Patients like to go to a one stop shop and do everything. Corporate has traveling dentists that rotate to clinics and take care of all the specialities. Patient's like that.

Now is that a thread for specialists? I would say that Ortho has taken the biggest hit. Everything else is sorta ok/treading along just fine.

 

[2TH MVR]

Corp offices actually helped orthodontists like me, who are afraid to take risk to start their own office right after graduation.

But IMO this is not a good thing. When an ortho graduated in the early 90s .... There were very few Corp practices. As a new Ortho you were compelled to associate with most starting or buying their private practice. Now .... Corp practices has made practice ownership harder and not by default as before.

But of course ..... Corp also has its advantages . But overall ..... Dentistry would have been better without it.

 

[charlestweed]

Endodontist here. I am not sure about the other specialties. But as for as corporate dentistry incorporating endodontists, it is much harder due to device limitations, such as microscopes and CBCTs. This is especially troublesome when one corporate dental office is never busy enough to hire an endodontist fulltime at that one office. These corporate dental companies hire one endodontist to cover multiple dental offices. This makes those device limitations even worse. As a result, it is hard for corporate dental companies to hire new graduate endodontists as we are trained on modern devices. This is a problem as new graduates are the ones more willing to work in corporate.

The endodontist who works at the same corp with me doesn't use the microscope. The GP, whom my wife works for, also hires an in-house endodontist. And the reason this endodontist got a job at my wife's boss' office was he didn't ask for the microscope either. The less you rely on the modern devices, the more jobs you can find. As an employee, don't you want your boss to spend as little as possible so he can afford to pay you a higher salary?

 

[HOPAone]

Yes to all above. I'm not happy about it, but it is reality.
Corporate is a deep pocket business entity that has grown considerably over the last decade. Any business that generates good profit is going to be corporatized. Right or wrong.
As for specialists. It's mostly a double hit for private practice specialists. GP who used to refer to your specialty practice sells to Corp. Corp has their own specialists. See the point? This was a constant theme during my last 10 years of private practice. As a result, and that I'm getting older .... I sold both my ortho practices and now work for Corp. The pay is surprisingly good considering I just show up and clock in/clock out.
I see more ortho being advertised in the Corp offices than any other specialty. Positive note is that means there are plenty of Corp ortho jobs available.
I forsee what all large Corp entities do over time. Consolidate and grow. Largest Corps will eat smaller Corps. I see it already with the Corp I work for. They are constantly looking to expand and grow.
Private practice dentistry is still viable .... just pick the right, non-urban (saturated) area to practice. Plenty of patients still want personalized care.

Hi there, you keep saying that working for corp is good and the pay is good too. Is this something that I should consider? If so where do I look if I decide to sell my 16 year-old ortho practice? Thanks for the advice.

 

[charlestweed]

But IMO this is not a good thing. When an ortho graduated in the early 90s .... There were very few Corp practices. As a new Ortho you were compelled to associate with most starting or buying their private practice. Now .... Corp practices has made practice ownership harder and not by default as before.

But of course ..... Corp also has its advantages . But overall ..... Dentistry would have been better without it.

I only spoke from my own personal experience. There may not have been a lot of corp offices where you live. But where I grew up (in So Cal), there were already a lot of corp offices in the 80s and 90s. When I was still a dental student in the 90s, all I wanted to do after graduation was to work full time for these corps because I didn't think I was good enough (I have no people skills and I speak English with an accent) to start my own office. Right before the completion of my ortho residency, I sold many of my ortho instruments to my co-residents because I already got F/T job offers at 3 different corp offices...and had zero intention to open my own office. I've learned a lot from working at the corps. The experience I gained from working at the corp helped me succeed in running my own offices. Knowing the corp's weaknesses helped me compete against the corps.

 

[2TH MVR]

Hi there, you keep saying that working for corp is good and the pay is good too. Is this something that I should consider? If so where do I look if I decide to sell my 16 year-old ortho practice? Thanks for the advice.

PM me and I can offer some advice.

 

[Afterhoursdentist]

Hey all,

I am in the midst of determining what dental school I will be able to attend this coming fall. I have an offer of admission from an expensive private school and am still praying to get into my state school. The entire situation has me thinking about my future quite a bit, as well as the future of dentistry-- particularly the corporate influence on the profession. So here's my question:

Is corporate dentistry as big a threat to private practice among the dental specialties as it is among general dentists? Do specialists still primarily operate private offices, and is that becoming less common? Does is vary among specialties-- i.e. more corporate orthodontic offices than, say, endodontist offices?

I'd appreciate any input; thank you!

I’m a GP and work for my dad in Tampa (one of the highest dentist per capita markets in the country). Before my dad, there was his aunt. It’s a family business that has been passed down for 60+ years. One location with the best technology around that has been incorporated over time. My situation is different than most but it has given a unique perspective on the industry as a whole. Corporate dentistry is not threat to private practice GP or specialist. I’ve worked corporate for a short period and then went back to my dads practice. Corporate chains do not make money after paying the dentist and other employees on top of the other fixed costs of running a practice. They squeeze pennies out of anything they can. If corporate dental companies make so much profit why don’t they have cerac systems (or something similar) in all of their offices? Patients (who according to you love convience and one stop shops) would flock to these offices. That technology costs a lot of money that they don’t have. I love the argument “digital crowns are subpar and we use traditional labs because they allow us to deiever better quality products”. I agree that traditional lab work produces a better product as long as it is done by a certified lab technician. Corpoarate dental companies use labs that outsource their work to China for $17 a crown. So they degrade cad/cam technology in order to validate the quality of the work “their lab partners” which are sweat shops in China using substandard materials? If I made a lot of money and wanted to expand my business of dental care this would definitely be my number one option (lol)). Corporate dental companies make so much money they find it necessary to over prescribe treatment that ultimately destroys trusts of patients with the goal of making money? Corporate dentistry has the highest employee turnover in the country and they cut costs every where they can because they have to in order to survive. My uncle owns 28 McDonald’s stores and only 7 make a profit. Corporate dental chains are trying to be McDonald’s but haven’t realized they aren’t fast food chains and their doctors aren’t car salesman, which is how they are paid. 7 extremely profitable McDonald’s can support the other stores because everyone gets paid minimum wage and no one makes a percentage of production. A business is considered succesful if it takes home 30% or more of its revenue. Corporate dental companies pay 30% of revenue to the dentist before all other expenses. It is not a sustainable business model and will bleed dry sooner than later

 

[Biggytooth]

I’m a GP and work for my dad in Tampa (one of the highest dentist per capita markets in the country). Before my dad, there was his aunt. It’s a family business that has been passed down for 60+ years. One location with the best technology around that has been incorporated over time. My situation is different than most but it has given a unique perspective on the industry as a whole. Corporate dentistry is not threat to private practice GP or specialist. I’ve worked corporate for a short period and then went back to my dads practice. Corporate chains do not make money after paying the dentist and other employees on top of the other fixed costs of running a practice. They squeeze pennies out of anything they can. If corporate dental companies make so much profit why don’t they have cerac systems (or something similar) in all of their offices? Patients (who according to you love convience and one stop shops) would flock to these offices. That technology costs a lot of money that they don’t have. I love the argument “digital crowns are subpar and we use traditional labs because they allow us to deiever better quality products”. I agree that traditional lab work produces a better product as long as it is done by a certified lab technician. Corpoarate dental companies use labs that outsource their work to China for $17 a crown. So they degrade cad/cam technology in order to validate the quality of the work “their lab partners” which are sweat shops in China using substandard materials? If I made a lot of money and wanted to expand my business of dental care this would definitely be my number one option (lol)). Corporate dental companies make so much money they find it necessary to over prescribe treatment that ultimately destroys trusts of patients with the goal of making money? Corporate dentistry has the highest employee turnover in the country and they cut costs every where they can because they have to in order to survive. My uncle owns 28 McDonald’s stores and only 7 make a profit. Corporate dental chains are trying to be McDonald’s but haven’t realized they aren’t fast food chains and their doctors aren’t car salesman, which is how they are paid. 7 extremely profitable McDonald’s can support the other stores because everyone gets paid minimum wage and no one makes a percentage of production. A business is considered succesful if it takes home 30% or more of its revenue. Corporate dental companies pay 30% of revenue to the dentist before all other expenses. It is not a sustainable business model and will bleed dry sooner than later

Interesting. Thanks for your input!

 

[RootRadar]

The endodontist who works at the same corp with me doesn't use the microscope. The GP, whom my wife works for, also hires an in-house endodontist. And the reason this endodontist got a job at my wife's boss' office was he didn't ask for the microscope either. The less you rely on the modern devices, the more jobs you can find. As an employee, don't you want your boss to spend as little as possible so he can afford to pay you a higher salary?

I would agree with you that if one focuses on simpler cases for their endodontic treatment it is possible to do endos without a microscope. If one focuses on primary treatment with larger canals and no disassembly retreatments or apicos, I would say that is probably a good idea to just join an office without a microscope. Heck, loupes may not be necessary for those cases either.

However, there are several reasons for an endodontist to request modern devices, such as microscopes and CBCTs (whether a scan is done in-house or external service), before joining a GP office as an in-house endodontist:

1. New endo graduates are trained exclusively on microscopes and CBCTs. So graduates would certainly want a microscope and CBCT, unless the new graduate practiced in GP for many years prior.
2. Apicos require microscopes and CBCTs, for sure.
3. Retreatments could be done with loupes. But in cases with post, core, and crown, microscopes are very important in removing posts without aggressively toughing on tooth structure and super important in finding any missed canals.
4. In older teeth where the canals are calcified, microscopes and CBCTs are important in identifying where the orifices are within the tooth to prevent perforations.

Overall, microscopes and CBCTs are not mandatory to practice as an endodontist. But it certainly is important in many cases. They are both important components of improving the clinical diagnosis and skills of root canal treatment, just like electronic health records. EHRs are not a must. But they certainly are very valuable in many modern dental clinics.

 

[2TH MVR]

It is not a sustainable business model and will bleed dry sooner than later

And yet ... they are continually expanding. Like I said previously .... I'm not a big fan of Corp dentistry. Technically ... I'm not a fan of Corp anything. I work Corp now because it is easy for an Ortho at my stage.

But I do not agree with your last statement. Corp is here to stay. If anything ... it will evolve into something even bigger. The large Corp I work for is already acquiring smaller Corps in different states. Heck ... there's Corp business models opening up in malls and retail areas offering Invisalign and DSC. Aspen dental in Walgreens .... or was it CVS?

Aspen Dentals, Pacific Dental Services, Western Dental, Heartland Dental, Gentle Dental ..... they're everywhere and they all have a different approach. Aspen, Western, PDS are more retail on the street corners. Heartland Dental buys private GP offices and pretends to be private, but is Corp. Gentle Dental just buys anything .... anywhere.

Then you have 2nd tier Corp models.

I am not an advocate of Corp dentistry. But to pretend that Corp Dentistry is just going to disappear is highly unlikely. If anything .... they will be bought out by one or two Corps.

 

[Afterhoursdentist]

And yet ... they are continually expanding. Like I said previously .... I'm not a big fan of Corp dentistry. Technically ... I'm not a fan of Corp anything. I work Corp now because it is easy for an Ortho at my stage.

But I do not agree with your last statement. Corp is here to stay. If anything ... it will evolve into something even bigger. The large Corp I work for is already acquiring smaller Corps in different states. Heck ... there's Corp business models opening up in malls and retail areas offering Invisalign and DSC. Aspen dental in Walgreens .... or was it CVS?

Aspen Dentals, Pacific Dental Services, Western Dental, Heartland Dental, Gentle Dental ..... they're everywhere and they all have a different approach. Aspen, Western, PDS are more retail on the street corners. Heartland Dental buys private GP offices and pretends to be private, but is Corp. Gentle Dental just buys anything .... anywhere.

Then you have 2nd tier Corp models.

I am not an advocate of Corp dentistry. But to pretend that Corp Dentistry is just going to disappear is highly unlikely. If anything .... they will be bought out by one or two Corps.

Start a practice and get a duns and Bradstreet number for your business which gives you a credit score for your business. Build that up and seek hard money or direct capital lending. You will have own your own corporate dental chain in the next 5-10 years

 

[2TH MVR]

Start a practice and get a duns and Bradstreet number for your business which gives you a credit score for your business. Build that up and seek hard money or direct capital lending. You will have own your own corporate dental chain in the next 5-10 years

Again ... lots of smaller chains hoping to be bought by the larger Corps. As you said .... they (smaller chains) are working on small to negative margins and their hope is to be bought out by the larger chains. There is this smaller Corp (4-5 offices) whose main business plan (AFAIK) was too build right next to the large Corp I work for. They are super busy and have taken patients from my Corp. Reason why they're busy? They have super low fees. Braces for less than $2500. Dentistry really cheap. With the overhead ... low fees ..... low margins .... I do not see how they can survive long term. It occurred to me their plan is hoping my Corp will buy them. I know this since the Corp I work with is actually thinking about doing this. Corp mantra ..... buy out the competition. That small Corp is hoping they get bought out.

 

[charlestweed]

I would agree with you that if one focuses on simpler cases for their endodontic treatment it is possible to do endos without a microscope. If one focuses on primary treatment with larger canals and no disassembly retreatments or apicos, I would say that is probably a good idea to just join an office without a microscope. Heck, loupes may not be necessary for those cases either.

However, there are several reasons for an endodontist to request modern devices, such as microscopes and CBCTs (whether a scan is done in-house or external service), before joining a GP office as an in-house endodontist:

1. New endo graduates are trained exclusively on microscopes and CBCTs. So graduates would certainly want a microscope and CBCT, unless the new graduate practiced in GP for many years prior.
2. Apicos require microscopes and CBCTs, for sure.
3. Retreatments could be done with loupes. But in cases with post, core, and crown, microscopes are very important in removing posts without aggressively toughing on tooth structure and super important in finding any missed canals.
4. In older teeth where the canals are calcified, microscopes and CBCTs are important in identifying where the orifices are within the tooth to prevent perforations.

Overall, microscopes and CBCTs are not mandatory to practice as an endodontist. But it certainly is important in many cases. They are both important components of improving the clinical diagnosis and skills of root canal treatment, just like electronic health records. EHRs are not a must. But they certainly are very valuable in many modern dental clinics.

I am not an endodontist so I don’t really know what are important to have in an endo office. My wife and I are a both specialists and I can you that the referring GPs don’t really care what you use. They are not going to come to inspect your office to see whether you have a microscope and a CBCT or not. As long as you have good communication with them, take good care of their patients, and get the jobs done right, you will continue to get more referrals from them. In addition to providing high quality care, having convenient office hours, accepting most insurances, charging reasonable fees etc. also help increase the referrals.

I went to a very low budget low tech ortho program. To save cost, the director made us do everything such as making our own ortho appliances, cleaning the lab, calling the patients to schedule the appointments etc. The only luxury things we used were the expensive prepasted 3M ortho brackets, cooper Niti and TMA wires, which were donated to us by the sale reps….because they wanted us to buy their products after graduation. My ortho director told us that these were luxury items. He said when we get out and work for someone else, we have to work with much lower quality products. And he was right. On my first day at a corp office, I had to see 70-80 patients….low quality brackets, dull wire cutters, no TMA, no cooper Niti wires. I am glad I went to a very good program that had a great director.

 

[HOPAone]

I am not an endodontist so I don’t really know what are important to have in an endo office. My wife and I are a both specialists and I can you that the referring GPs don’t really care what you use. They are not going to come to inspect your office to see whether you have a microscope and a CBCT or not. As long as you have good communication with them, take good care of their patients, and get the jobs done right, you will continue to get more referrals from them. In addition to providing high quality care, having convenient office hours, accepting most insurances, charging reasonable fees etc. also help increase the referrals.

I went to a very low budget low tech ortho program. To save cost, the director made us do everything such as making our own ortho appliances, cleaning the lab, calling the patients to schedule the appointments etc. The only luxury things we used were the expensive prepasted 3M ortho brackets, cooper Niti and TMA wires, which were donated to us by the sale reps….because they wanted us to buy their products after graduation. My ortho director told us that these were luxury items. He said when we get out and work for someone else, we have to work with much lower quality products. And he was right. On my first day at a corp office, I had to see 70-80 patients….low quality brackets, dull wire cutters, no TMA, no cooper Niti wires. I am glad I went to a very good program that had a great director.

Totally agreed with you. I went to a great program but the rule about doing everything yourself was not truly reinforced. I did pretty much everything myself but some of my classmates didn’t. And now I’m glad that I did. I’m more flexible and could pretty much adapt to work in any working environment. Most of the new technological toys for ortho, imo, are just gimmick to impress patients. They don’t add anything valuable to how I treat my patients.