Seriously, how am I supposed to pay off 400k in debt when people already in the dental field are talking about how the profession is dying a slow death and not viable for people exiting the pricier schools. Is it more manageable than I think? Or are the doomers right
Is it just me or is dentistry just for rich kids these days?
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The doomers, are all (or mostly) crazy. You pay off 400k in debt by working smart and working hard.
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$400k is a lot but doable (depending on your goals/location). If you pay that off in 10 years then it’s about $4k a month in loan payments, let’s just call it $50k a year. You should play around with the numbers in your area, but $180k income (highly variable) turns into about $120k in most states after taxes. So if you’re making $180k as a dentist, after taxes and loans you are at $70k to live off of. Very doable, but you are far from wealthy. Obviously the higher the income the better lifestyle you will be able to afford. Income in dentistry is most related to geography IMO. All of this depends on your priorities as well, but if high income is most important to you then ownership in an area of need is the way to go. If you prefer a saturated city over all else, then that’s ok too, but you won’t be living like a rich dentist anytime soon. Or ever. Ownership comes with a loan and loan payback as well, but buying the right practice is definitely the best thing one can do in regards to obtaining a higher income generally speaking. But let’s take worst case scenario: working in LA making $120k—> $80k after taxes, leaving you with $30k to live on. Yikes. This obviously doesn’t take into consideration all of the programs like IBR etc which make more sense when income is lower.
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The "real" rich kids are not going into dentistry! Dentistry takes too much of a commitment. (Dentistry also takes a little bit of talent.)
The "real" rich kids are going into corporate finance, corporate banking, hedge fund management, venture capital management, private equity fund management, etc. In the world of high finance, daddy's money can make up for a of lack of talent and diligence.
The "real" rich kids are going into corporate finance, corporate banking, hedge fund management, venture capital management, private equity fund management, etc. In the world of high finance, daddy's money can make up for a of lack of talent and diligence.
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It's always the same. Work harder or spend less
Get better GPA etc and go to cheaper school. Get military scholarship
Stop blaming parents wise enough to take care of their kids
High income is everything to me rn. What about geography makes income rise? Lack of competition, high number of patients in need of dentistry, low COL?
No way in hell will I be living in a saturated place like LA if I can go somewhere else and make more. The one upside would be saving on rent while I live with my parents but that isn't really what I had in mind when I set out on this path
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All of those reasons. Lower amount of competition is probably the most influential. You can choose to not participate with insurance (which means much higher reimbursements) or only a few of the better paying ones. Insurance reimbursements are generally lowest in areas of high competition. You also don’t have to market at all, don’t need all the bells and whistles to get people in/keep people, don’t have to pay hygienists $100k a year, the list goes on. Basically higher revenue with lower costs = higher income.
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It has to be a lot more because it’s not cheap to pay for your own place + food + utility bills + other things that are necessary for living on your own…..easily $2-3k a month even in a rural area. It’s actually not a bad idea to live with your parents if they are ok to let you stay with them. Despite getting paid less here in CA, you may end up saving more money and paying off debt faster by living with your parents. If the pay in another state is only $30-40k more a year than the pay in CA, then I’d rather work in here CA and stay with the parents. It’s more fun to live in CA.
Once you cut the debt in half (hopefully in 2 or less years if you continue to live like a student in your parents’ house) and gain enough clinical experience, you can move to a different state, where the competition is not as bad, to set up a practice there. With the remaining half of the student loan debt ($200k), you should breathe easier. I believe you can practice in 10-15 different states (including CA) if you pass the WREB exam.
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The real question should be... why would anyone get into something without a plan to get out of it on the other side? If you deem $400k debt is insane and ridiculous to become a dentist, you don’t have to take that level of debt to become a dentist. It’s really that simple. You shouldn’t be talked into - “just work hard and you will make a lot of money and pay off that debt eventually”, which is a total BS advise to assume that people are “all” capable of enduring additional mental stress and possibly physical pain post dental school to pay off their high student debt. Since when did that become a prescription to become a dentist for pre-dents? Is every pre-dent cut out for this path?
I do agree dentistry is increasingly becoming a risky proposition for many pre-dents. And to be fair to most of them, they do not know enough about the realities of dentistry through the lens of a practicing dentist, they do not ask the right questions when they talk or shadow a dentist, and/or their commitment to enter the profession is completely shortsighted and focused on getting in dental school at all cost regardless of how things may turn out. It’s the classic “everything will take care of themselves by default”.
I would strongly advise any pre-dent to do their homework on the profession, specially if it comes with a big price tags at the front end with dental school tuition and fees. Know thyself; your limits, your character, your strengths and weaknesses beyond GPA and DAT scores - which only get you as far getting into a dental school and are far less relevant behind the veil of real world dentistry. The profession is undisputedly trending towards more corporate based dental offices, stagnant insurance reimbursements, and with more barriers than this post can get into.
Do your due diligence. Don’t fall for the school’s marketing, or some successful dentist who graduated a decade plus ago’s view from the summit. Plan carefully, your future self will thank you for it.
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I don’t think this is a BS advice at all. If you don’t work hard, you will fail miserably in life PERIOD. I haven’t yet met a successful person who is lazy and lacking in motivation. If you happen to know a self-made millionaire, who is lazy, please give me a name of that person….just one name. Dental school simply gives you a piece of paper that allows to work as a dentist. You still have go out there to find yourself a job and earn the money…..nobody owes you anything. We, dentists, are spoiled. Compare to other health fields (medicine, pharmacy, optometry, PA, RN etc), we, dentists beat them all in term of life style, salary (hourly wage), and work hours. Those guys and gals in other fields have to work long and odd hours every day. And we, dentists, on this forum are complaining about having to work on Saturdays, C’mon.
I think the predents should watch more Dave Ramsey’s video. He does not only give people advice on how to pay off debts….he also preaches hard work, discipline, and personal responsibilty.
Dentistry is not the only field that is risky. Taking out a loan to get a college education is risky. Graduating from Harvard doesn’t necessarily guarantee you a good stable job that will stay with you until you retire. Education is a type of investment and just like any other types of investments, it is risky. According to this website, only 27% of the college grads have jobs that are related to their college major. Only 27 percent of college grads have a job related to their major - The Washington Post. No matter how much homework (and shadowing) the HS and college kids do before they apply, they will never fully understand the reality of the careers that they want to pursue. The only way for them to understand is to face the reality themselves after they graduate. It’s kind of like what speaker Pelosi said about the healthcare bill “pass the bill so you can find out what’s in it”. And hopefully, facing difficulties helps them become successful. Nobody can predict the future. What they learn now may become obsolete after they graduate. Technology continues to have impact on the workforce. At least dentistry hasn’t changed much with time....dentists are still required to be present at the office to diagnose, tx plan, and execute the tx plan….doctor-patient relationship, which is largely lacking in most DSO offices, continues to play an important role. I still treat my patients the same way that I was taught 20 years ago. Sure, there are a few changes like insurance reimbursements, growth of DSO's, increasing in number of new grads (it happens in other fields as well), Invisalign, Smile Direct Club etc...the successful dentists will learn to adapt to the changes.
If not dentistry, then what’s a better alternative option (beside medicine) for the pre-dents? since they can't do much with a BS degree that they currently have.
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I’m not arguing that hard work increases the odds of being successful at something. I’m merely pointing out that many pre-dents view dentists as a really “chilled” gig with a great income. Part of me did too when I applied to dental school. Maybe that was the case in the 90’s and early 2000’s. But today it’s a very much different profession in terms of effort. Working hard in school and getting through dental school is still the same over the past few decades, very little has changed. In fact, some might argue it got easier to get through dental school with the advent of better technology and lax graduation requirements. However, working hard and becoming successful in the profession in the real world became more elusive and far more challenging.
Pre-dents do not understand fully what happens to them when they enter the arena with a much higher student debt and more constrained reimbursement fees than their predecessors. There are some economics you simply can’t fix with hard work.
Hard work is one of many tools to get through a very challenging path, but it’s far from being the only tool a pre-dent would need to enjoy dentistry. Let’s be careful with the “work hard” guidance, it’s a very relative term - specially under different settings and situations. Dentists do not work for a single employer or all do the same exact job. Just because we’ve been trained under the same curriculum and took the same boards doesn’t mean we are all going to have the same outcome in the profession - even if all of us work very hard post-dental school.
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I tend to agree with these statements.
@charlestweed is to be commended for his "work hard" sentiment. I and most on this forum admire him in that regard. In order to get to where he is economically .... he had NO CHOICE but to work hard. He has developed an ortho practice scenario that relies on working very hard and working on those sat/suns. It works for him. I've noted in many of my posts that I did not go into ortho to work his kind of schedule. I'm not a fan of low fee economics or working on sundays. That's just myself.
To say that "working harder" will overcome any debt obstacle is not beneficial to the pre-dents. There are situations where the dynamics of where you practice. How you practice. You could be an extremely hard worker, but have no business sense. How much DS debt you graduated with. Spouse with good job. Kids. Family. Alot of times ..... LUCK comes into play on your success.
What @Cold Front et al are saying is ......... hard work may not necessarily dig you out of your financial hole. It is not wise to tell every prospective dental student to go ahead and be a dentist at all cost .... and with alot of hard work ..... you can dig yourself out of your hole.
What I see is alot of students taking on higher than average DS debt .... and then hoping to reverse engineer their terrible financial situation.
Not everybody can be a dentist. Well. Except for those RICH kids lol. Professional, doctorate level schools want the best students to represent their profession. The less expensive schools have to choose the best students. The more expensive private schools cater to everybody else.
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You get it!
Some of the best indicators on how things became more challenging for new dentists are; the number of new dentists choosing IBR for their student loan repayments over traditional repayments, the number of new grads joining DSO’s, the declining number of practice ownership, the falling salary/income first few years out of school relative to inflation (starting salary has been $500-600 a day for most new dentists for the past 15 years), etc. Did “working harder” make any difference to these trends? Not to say dentists are not working harder, but it just shows that there are bigger forces at play that can’t
make most young and future dentists scape from the realities of the profession.
In the eyes of pre-dents, to assume most of them can be Aladdin and enter the Cave of Wonders and come out with a pot of gold ignores “everything” that comes with dentistry.
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I agree that hard work alone may not be enough to overcome the debt burden but lack of motivation to work hard (ie choosing an IBR option to lower the monthly repayment so one doesn’t have to work too hard) would be a big disaster. Many today predents are not as naïve as you think. The OP is one of those predents, who are very concerned about the debt burden and the future of the dental profession. That’s why he started this thread. Have you noticed that there are much fewer SDN threads about this school vs that school now than there were 10+ years ago? Now, most predents want to attend a cheapest dental school because they start to realize that with an enormous amount of debt, the job will not be as “chilled” as when the debt amount is lower.
Another way, if one doesn’t want to work too hard, to deal with debt is to follow Oralcare123's advice (post #5)...and that is to spend less…..aka living like a student for another 2-3 years post graduation. That’s what all med students do when they do residency trainings after med schools. If all doctors can do this, why can’t we, dentists, do this? It’s called delayed gratification. You and I didn’t have to delay and were both able to buy ourselves a house and nice cars right after graduation. That’s because we didn’t have as much student loans as today grads have….and we both worked very hard. You told us that you made plan to start a practice and took several CE classes even before you graduated from dental school….if this is not hard work, then I don’t know what is. 2-3 years of delay for new grads, who have a large amount of student loan debt, shouldn’t be too bad if they are young enough to do dentistry for at least 20 years.
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Thanks for the kind words. You are right! I had no choice because I am in a very saturated area. I chose to work on Saturdays right after graduation (and continue to do this until now) because I couldn’t resist the nice newly redesigned 7-series that was released that year….it felt good when people at the gas stations asked me to show them what were under the hood and inside the car😛. I lower the tx fee because I don’t want to have an empty office….it’s more depressing to sit around doing nothing (and still have to pay office rent/bills) than having some patients to work on. Making less money is better than not making any.
Yeah, we older dentists had the luxury of saying no to working on the weekends because we didn't have an astronomical amount of student loans like what the current dental students have to borrow now. Today predents need to realize that they don't have such luxury if they want to pursue dentistry.
It’s not beneficial to tell the pre-dents to forget about dental school either. They have already wasted 3-4 years of their youth to go to college to prepare for dental school. And now you tell them to forget about dental school? If they have some undergrad loans, how will they pay back the loans with a useless BS degree in Bio? At least with a DDS degree, hard work, and frugal living, they can conquer debt. IMO, it's a much better option than switching to a different college major (and there's no guarantee that it'll be better than dentistry) and borrowing more loans. I only believe in hard work because it's something I can control and is within my reach. I don’t believe in LUCK because it is beyond my control.
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I agree Charles. We are both preaching to the choir I guess.
Another interesting trend is female dental student enrollment is going up, and the majority of them want to work part time due to starting a family obligations... so their “hard work” will be in fewer hours of the week than their male counter parts. This trend will continue for the foreseeable future.
Percentage of female dental students in the US programs over the last decade:
2010: 45%
2011: 46%
2012: 47%
2013: 47%
2014: 48%
2015: 49%
2016: 49%
2017: 50% (the majority)
2018: 51%
2019: 53%
2020: 54%
2021: 55%+ (expected)
This will have a big impact on the profession’s dentist hours to patients seen ratio.
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I personally know a few female dentists who are much more capable than their male counterparts.
Dentist #1: USC graduate. A mother of 2. A cancer survivor. She’s is her mid 50s years and is still working 4-5 days/week. Her husband, who is an ex-engineer, was laid off 5-6 years ago and is currently working at her dental office as a lab tech/dental assistant. Her 28yo daughter hasn't been very serious about school and future career. According to this dentist, her daughter will apply for dental schools this cycle. Hopefully, she'll get in so she can help her mother.
Dentist #2: A managing dentist who is currently working 4 days/wk at the same corp with me. She has 3 kids. She owns 2 offices and both of them are managed by her husband, who is also a dentist. Her husband saves all the difficult cases for her to perform on the weekends because she is a much better clinician than her husband.
Dentist #3: She is my referring GP. Her husband is also a dentist but he can no longer work due to eye problem. They both graduated from the same dental school that you went to….you may know them…..class of 2013, I think. They have 2 kids. The wife works full time at her own office and drives kids to schools because her husband can no longer drive.
Dentists #4 and 5: my wife and my sister. You’ve already heard enough about them from my other posts.
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That’s horrible! Sorry to hear their situation. I was class of 2010. So when I was 4th yr at school, they were in their 1st year - highly unlikely that we ran into each other.
There are definitely extremely hard working female dentists out there, but I would think overtime, maybe the span of 20-30 years, their average weekly hours are much less than the average male dentist hours.
Here are some examples of female dentists I know:
Female dentist #1: Former classmate. Her husband was a priest. She had 5-6 kids after dental school and became a stay home mom for good.
Female dentist #2: A good friend. She has been associating for 10 years, then decided to open a practice with 4 chairs in 2015. She started a family, got divorced and raising her son now and says it’s a lot of work to balance life and work schedules as a single mother with a practice to run. She plans to retire early and sell the practice within the next 5 years - which is about when her son starts going to college. She also says the profession is too stressful and not heading in the right direction long term.
Female dentist #3: Former classmate. She specialized in Endo. Married an international dentist in the same residency program. They moved overseas to start a family. Not common, but few people in my school did that.
Female dentist #4: Older dentist in her 50’s, know her through a network of other dentists. Divorced with 3 kids. One of the kids is autistic and she had to close her practice to focus on the kids. The kids are grown up now and she wants to start over with a new practice and be busy again while she still can.
Female dentist #5: Former classmate. Moved to a rural town that she doesn’t know anyone and started a practice. 2 years into it, she got super bored as a single woman in a very small town. Put the practice on the market, moved to a big city and recently got married in her late 30’s. She is associating as a contractor for hire and wants to start a family ASAP. She’s sure she will work less hours once kids come into the picture.
Anyways... not to sound clueless or sexist, but generally speaking, female dentists have different priorities than male dentists. Not just in dentistry, but life in general.
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lol it's been only 11 years since you graduate and you already amass this much? this is very impressive. I read your post 5 years ago before I went to dental school (graduated now) and you were doing super well back then.
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Military, investing early, scholarships, studying harder for better grade to get into state school are all viable options for much less expensive dental education. So in reality it is the Smarter who have the better outcome and it works beautifully since that's the kinda person that should graduate as a medical professional and run a business.
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Time flies. I joined SDN about 16 years ago. I learnt a lot from different dentists on these threads as a pre-dent, dental student and dentist. I will significantly slow down Q4 this year (I have 1 more project under my sleeve), then work 2 days a week at my office (will taper the practice down to more hygiene + restorative dentistry, refer everything else out). I had a very good run at those 11 years, I was very lucky and fortunate, even during the covid pandemic. I need to figure out something to spend my days off on; probably oversee my other business ventures (real estate and logistics).
I took some very important advise from older dentists on this website; Daurang (open a dental office after you finish school asap - by far the guy who I learnt the most from), CharlesTweed (work very hard), 2TH MVR (live within your means), and many other great members on these boards. A lot of SDNers are not fully utilizing the depth of guidance seasoned dentists on these forums offer.
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ColdFront, instead of slowing down and referring cases out to the specialists, why not continue to work hard to maintain the success of your dental practice? And then get out of the dentistry business completely by selling the office at good price because it is at its peak production. You give dentistry a very low mark and you don’t think it has a very good future (due to openings of new dental schools and increase in number of new grad dentist)…s.why continue to practice dentistry…even at 2 days/wk?
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Just curious... I’ve heard old dentists tend to sell their offices to corporate these days since they tend to pay more... what are your thoughts?
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As I guess what would be considered an "old" dentist by many on this board (hitting the big 5-0 later this year, been in my practice for 20 years, etc), with a partner who is 62 and been in the practice for just over 30 years and is thinking about retiring in the next 2-3 years (he has been saying that for about 5 years and I think the main thing preventing him from doing so is that he just hasn't found a hobby that he has enough interest in to convince him to retire 😉 ) so there certainly is some thought in our office about what the next step will be.....
Frankly there is some appeal about selling to a chain, if they want to buy, as the lure of having someone else handle the managerial side of things, especially during a potential transitional time in ownership, as the business side of the profession is something we have to do, but not always something that we want to do/enjoy doing. #2 with a practice in a rural area, you do run the challenge of finding someone who may want to come in and join the practice, often because they don't know that living in a rural area isn't the barren wasteland of society that some have the false impression that it is, and may not understand that from a saturation standpoint it's often not an issue when compared to many urban and suburban areas.
So in particular with point #2, an "older" dentist selling to a corporate chain may very well have something to do with the folks running the corporate chain seeing the economic potential in the "older" dentists office that a new grad may not realize is there, especially if the office isn't in the new grad desired location and/or full of the latest and greatest modern equipment.
Which way my practice will go in the coming years? Who knows.... Time will tell
I will say that advice that I would give a recent grad, or a dental student, is not to assume that your "dream" practice will have the combo of both the perfect location zip code wise and the perfect office space equipment wise, if so, you are likely over looking a plethora of opportunities that are out there
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I’m just a lowly endo associate in my mid 30s... I’m hoping to join a practice that is not in the middle of no where and the owner is willing to let me buy in... most 50 yo owners just want associates that are willing to stay associates long term to make them richer... the owners that are old enough to retire then want to sell to chain to maximize profits... I guess I have to start my own office then
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I don’t want to work harder. I want to work more comfortably. Hard work comes with stress. High stress comes with aging and other health risks. My mind and body tolerated hard work better in my 20s and 30s. Now I reached a cruising altitude, and want to enjoy life more. Come home early every day, drive my 911 more on weekends, spend time with family and friends with the limited time I have left in life.
I doubt most people can work hard from day 1 to retirement anyways. Maybe you. But even you will be physically slowing down at some point, and if you don’t, it’s probably for a different reason than you worked hard for in the previous decades.
Either way, we will both be ok in the end.
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That’s what I’ve heard as well. But that’s not what I’ve seen here in CA. Most older solo practice owners sell their offices to younger dentists and not to the corps. The reason for selling is they are unable to earn the same profit was when they were younger…..in other words, their offices are failing. As they get older and no longer have any debt to pay back, they devote less of their time to run their practices. Most of the solo practice owners here in CA have smaller offices with 3-5 chairs. I don’t think big corps are interested in buying these smaller failing offices. They are only interested in buying larger offices in good locations (ie busy shopping center and near the freeway exit) so they can hire in-house specialists to work along side with the general dentists.
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Isn't dentistry a wonderful profession? Being an owner, you can do anything you want with your work schedule. You don't want to deal with stress, just work less. So I guess you still enjoy practicing dentistry and don't want to let it go completely. I thought you hate it.
Are you concerned that the office will decline rapidly when you no longer devote all your time into it? And it will be worth nothing by the time you list it for sale.
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I think if I waited another few years to become a dentist, I would have huge regret. I graduated in middle of the last 2008-2010 recession. My first landlord gave me almost $100k in tenant allowance to build my first practice. Everything was cheaper back then. My assistants got paid $10-12 an hour. I was almost a classic case of the right time and at the right place. I don’t think i could repeat any of that today if I graduated from dental school, maybe in super rural area towns.
I have a good hygiene program at my offices. I’m ok with my production declining, but in exchange of having a better life. I also own my roof/the building, so no landlord or rent to worry about. My overhead is low... so I don’t mind the set up, specially when it’s very favorable to me. Even if my practice is worth $0, I can lease the space to a younger dentist in the future and collect 6 figures a year as a landlord. My space is about 3,500 sft and the today’s market rent is $30 psft. So assuming nothing crazy happens in the economy on the future, the worst case scenario, I can sell any valuable dental equipment with the future space lease.
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Cold Front, did you take DHMO/ medicaid when u first started. im hoping to start my endo practice and the thought of not having patients scare the crap out of me...
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Yes. I took all insurances, including medicaid and DHMO. As a new grad and a practice owner, there were many learning curves that came with taking all kind of insurances to keep myself busy and boost my chair side communication with patients, manage staff, increase my clinical speed, and run a new practice from scratch. It was worth it. I was extremely ambitious. I opened 2 more practices couple of years later, then bought the buildings the practices were in. I worked super hard on my long term goals.
I took CE courses on Endo, and I did ton of Endo. Most of my Medicaid patients needed Endo due to high caries risk. Medicaid here pays $600 for molar Endo and a build up. I was probably doing as much Endo cases as new grad endodontist.
You should associate part time and work part time at your new practice in the beginning. You will be busy that way until your new practice patient volume picks up.
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I am sure you could easily repeat all these if you graduated from dental school today. You are a hard working person. You are a good clinician and you are fast. You are willing to charge less (willing to accept medicaid) and treat high patient volume to make up for the low fees. Not a lot of dentists are willing to accept medicaid because unlike us, California dentists, they are not that desperate yet and because they are still able to get a lot of patients come to their offices through other methods such as advertisement, walk-ins, word of mouth referrals etc.
A lot of landlords want to have good tenants to rent their spaces so they don’t mind offering us, dentists, big $$$ for tenant improvement….they’ll easily get back the money because we usually stay there long term. And when we retire, the landlords don’t lose the tenants because we sell our practices to other dentists.
Not much have changed in dentistry in the last 10-15 years, except for the ridiculous amount of tuitions that dental schools charge their students. There were already a lot of dental offices and corp offices when I graduated 19-20 years ago. My starting associate salary was only 2/3 as much as what today grad orthos get. My 2 F/T staff (an office manager and an assistant) only get $3 more per hours than what they earned 15 years ago. My P/T assistants haven’t gotten any raise.
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You know what the really smart advanced healthcare degree students are doing which puts em in the same league? Going right to consulting, biotech banking/equity research/VC/HF/PE. You don’t have to be a clinician once you’re done if you want to make money. Not everyone needs daddy’s money lol. I speak for myself and most of my MD/PharmD/PhD friends. The world of life science finance/business is vast… no one wants to practice clinical anymore.
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I can confirm that my younger brother, a PharmD with MBA, works as a consultant for a big pharma company. He makes more than the average dentist, takes more vacations than the average dentist, gets a generous 401k match, has a pension waiting for him when he retires, etc. I agree, the world has changed.... specially in dentistry’s finances from dental school cost to insurance reimbursements. The sooner one realizes that, the sooner they will be on the good side of the bell curve.
The problem is many of us want to be able to sleep at night. We cannot all have fake jobs exploiting others.
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