Is Double-Practice Possible and Acceptable?

[Philosophist]

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I am a long way away from having to make a decision, but I have been reading a lot lately about dental specialties. I am particularly interested in endodontics. However, it seems like a lot of GPs (especially those with an AEGD/GPR) are increasingly comfortable providing endodontic services, which seems to mean that the field will get smaller (or more specialized, or both) over time. So, my question: Could a dentist pursue on Endodontics residency and then open up a general practice, in which he also performed all of his patients' endodontic work himself?

I don't recall seeing anyone propose that, and I have seen a few people here opine that, "once you specialize, that's all you do." I don't really see why that should be the case. I mean, all specialists are also dentists in the general sense, all of them receive the same DMD/DDS, and any specialist COULD HAVE simply opened his own private, general practice straight out of dental school. Why should having additional training rule that out?

 

[Waldo2012]

I think the main reason is that you invest more time and money in more school to specialize. When you finish and start working you would much rather make more money paying that back. I think it would be difficult to continue to do general dentistry when I know I could make much more by doing only endodontics.

 

[Frank22]

You won't need to open up two types of offices to make a great deal of money in an endodontics specialty; there are plenty of general dentists willing to refer out sophisticated if not all endodontics work. Don't let the "naysayers" fool you; endodontics is and always will be a great specialty.

Remember also that opening two offices doubles your overhead but may not necessarily double your production:

Consider Dr. A, who has a practice in two locations, with each office producing $500,000 a year, or $1,000,000 collectively. The expenses for both his offices was $250,000, or 50%.

Now let's consider Dr. B, who produces the same as Dr. A, but has only one office. His practice produces $1,000,000 a year, but his expenses are only $250,000,

On 100% collections, Dr. A takes home $500,000 a year. On the other hand, Dr. B takes home $750,000 a year.

 

[Philosophist]

I was not (necessarily) talking about having two office locations. Admittedly, I am not familiar enough with endodontic practice to know what kind of setup they would need or how that differs from a typical GP setup. I am just assuming (someone can correct me if I'm wrong) that it is theoretical possible to house the two operations in the same building.

I guess what I'm hypothesizing is this: Take Dr. Steve, who went to dental school and has plenty of debt, and also went on to a good endodontic residency, and therefore has even more debt. (I don't know, something like $400,000?) He feels comfortable doing any endodontic diagnosis, procedure, etc. He's the man when it comes to endodontics. Still, a lot of the general dentists in his area are doing their own root canals. In fact, it seems like only unusually complex endodontic work is being sent his way. Mind you, he enjoys the clinical challenge of doing some of the toughest work in his field, but there's a problem, viz., that the toughest and most complex endodontic work is also the rarest. Therefore, he doesn't have as many patients as he would like, and is not making as much money as he believes he could, if general dentists were not, in a sense, cutting in on his endodontic turf. Would there be anything abnormal (or even wrong) with him including general dentistry in his practice, in order to get a chance at a great proportion of the area's routine root canals as well as filling the time between more complex procedures?

 

[gracey14]

General dentists may be weary to refer to an endodontist who also practices general dentistry out of fear that they may steal/take their patients.

 

[gryffindor]

You can do as you are suggesting, practice GP and Endo. But don't expect too many GPs to embrace your practice and send you referrals unless you could keep the two practices separate somehow (Mon-Wed-Fri GP and Tues-Thurs Endo?) and promise your referrals you would send the patients right back. I also don't think you can advertise as both but you'd want to check your state practice laws regarding specialty practice advertising.

 

[ziptree]

1) In Texas, you can't advertise as both.
2) GP overhead is more than Endo.
3) Training your assistants to be proficient in GP is a bear compared to Endo.
4) I would never refer to an Endo who owned a GP clinic. Ever.
5) Lots of dentists hate endo. You'll still get referrals.

 

[chill45]

I thought most states did not allow specialists to perform general practice procedures, primarily because it takes away work from GPs.

 

[DrJeff]

I thought most states did not allow specialists to perform general practice procedures, primarily because it takes away work from GPs.

It's not because of taking work away from a GP, it's because when one advertises themselves as a Specialist in a dental field, that designation as a specialist then per the ADA code of conduct limits their practice to the procedures associated with just that speciality. So you're not going to have a Specialist in Orthodontics doing root canals on the side. You're not going to have a Specialist in Oral Surgery fabricating dentures, You're not going to have a Periodontist doing ortho cases, etc.

A GP is more than welcome to do any procedure they want, as long as the level of work they do, should that case come to court, be up to the level of competence that the board certified specialist in that discipline that the plantiff's attorney WILL hire to give "expert witness" testimony

 

[bigstix808]

I am a long way away from having to make a decision, but I have been reading a lot lately about dental specialties. I am particularly interested in endodontics. However, it seems like a lot of GPs (especially those with an AEGD/GPR) are increasingly comfortable providing endodontic services, which seems to mean that the field will get smaller (or more specialized, or both) over time. So, my question: Could a dentist pursue on Endodontics residency and then open up a general practice, in which he also performed all of his patients' endodontic work himself?

I don't recall seeing anyone propose that, and I have seen a few people here opine that, "once you specialize, that's all you do." I don't really see why that should be the case. I mean, all specialists are also dentists in the general sense, all of them receive the same DMD/DDS, and any specialist COULD HAVE simply opened his own private, general practice straight out of dental school. Why should having additional training rule that out?

you're more than welcome to do specialty training and do general dentistry IF you dont advertise as a specialist. if you put Dr Jon Doe - Family Dentistry on your building you're fine. just dont put that you're an endodontist.

 

[lemoncurry]

General dentists may be wary to refer to an endodontist who also practices general dentistry out of fear that they may steal/take their patients.

this.

 

[uthscsaalum]

1) In Texas, you can't advertise as both.
2) GP overhead is more than Endo.
3) Training your assistants to be proficient in GP is a bear compared to Endo.
4) I would never refer to an Endo who owned a GP clinic. Ever.
5) Lots of dentists hate endo. You'll still get referrals.

I agree on every point, especially #4. I refer out out pretty much all molar endo and the guys I usually go with stay busy doing endo only and I would guess they make a ton of money as endodontists.