Is it worth it to pursue dentistry nowadays?

[gunnyworms]

In your honest opinion, is it worth it to pursue dentistry even if the tuition is around 400-500k? I was wondering if recent grads and current dentists could give their inputs, as the debt in this day and age does seem daunting and I’d like to be informed. I assume that after your repayment term, things become less difficult? Thank you!

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[free99]

At 400-500k principle, no.

 

[Saddleshoes]

At 400-500k principle, no.

Ditto!
There are better and cheaper ways for a bright young person to make a living in today's world.

 

[surfline]

In your honest opinion, is it worth it to pursue dentistry even if the tuition is around 400-500k? I was wondering if recent grads and current dentists could give their inputs, as the debt in this day and age does seem daunting and I’d like to be informed. I assume that after your repayment term, things become less difficult? Thank you!

Hell no.

If I didn’t get into a program under 300k I would have just gone to medical school.

 

[Big Time Hoosier]

HPSP. You don't have to make the military your career. Just grind out those 3-4 payback years and move on. Oh, and then you'll have the GI Bill to help pay for any specialty residency you go on to do.

I assume that after your repayment term, things become less difficult?

How long do you think your repayment term would be with $500,000 in student loans? Answer: A really, really long time.

Big Hoss

 

[Medin2017]

Hell no.

If I didn’t get into a program under 300k I would have just gone to medical school.

Yea medical schools can get that pricy, but at least there are more debt repayment options and flexible ways to pay it off. Like Em's can take more night shifts for example but in dentistry, there doesn't seem to be that option. Or at least I'm unaware of that. And doctors seem to be guaranteed 180+ out of residency even for the lowest paid specialties, so it seems to be a safe route if you want to pay off debt.

 

[321931]

In your honest opinion, is it worth it to pursue dentistry even if the tuition is around 400-500k? I was wondering if recent grads and current dentists could give their inputs, as the debt in this day and age does seem daunting and I’d like to be informed. I assume that after your repayment term, things become less difficult? Thank you!

Most new grads are on the 30 year repayment plan with the tax bomb. I don't know of ANYONE that has paid off that much yet. We are in uncharted territory. I know of grads that have paid off 200-300...but 400-500??? That's UNCHARTED territory. So take what you hear with LITTLE weight because noone knows how its like because no-one has done it yet. It doesn't matter if the words come from me who is 5 years out...or some old foggie that has 30 years of experience out in the dental field because this has never been experienced before.

So good luck.

 

[gunnyworms]

Most new grads are on the 30 year repayment plan with the tax bomb. I don't know of ANYONE that has paid off that much yet. We are in uncharted territory. I know of grads that have paid off 200-300...but 400-500??? That's UNCHARTED territory. So take what you hear with LITTLE weight because noone knows how its like because no-one has done it yet. It doesn't matter if the words come from me who is 5 years out...or some old foggie that has 30 years of experience out in the dental field because this has never been experienced before.

So good luck.

Would you suggest that I reapply to a cheaper school next year? Everything’s looking at least like 350+ nowadays, though, which includes living expenses...

 

[Awarara]

i guess i'll go against the general feeling on these forums. i'd say i have a good understanding about salary and loan repayment options. based on my experience, i would not hesitate to do dental school with 400-500k in loans. it may not be like what it was back then, but it's still a great job. grass is always greener...

 

[Likkriue]

Definitely not.

 

[GypsyHummus]

I would think it depends on the type of practice that you intend to run vs being an associate after a principle of 300K in debt. If you plan on being an associate grossing 120-170K for your entire life, I could see swinging 300-350K in student loan debts. I wouldnt personally do higher than this.

If you plan on running your own practice and gross 300-400K/year, Id go as far as 600K in student loan debt. There is a TON of money to be made in dentistry if you are smart, good at business and do great dental work. Look up some of the figures on Salary.com or dental forums. On SDN, you have dentists breaking the 200K mark easy, even before 5 years of practice. My personal dentist works 3 days/week and pulls in about 300K. He also runs his practice very effiecntly and is always busy.

If you specialize into Ortho or Oral Surg, it most certainly is worth it. Oral surgeons make about 250K/year, and ortho can make anywhere from 150-500K+.

 

[TheSuccessfulDentist]

Gypsy, I agree it depends on your future situation—owner, non-owner, type of specialty, location etc. However, for most people these things can’t be known to a high degree of certainty. Because of that, you have to do all you can to keep debt low. You want to keep your options as open as possible.

 

[321931]

Gypsy, I agree it depends on your future situation—owner, non-owner, type of specialty, location etc. However, for most people these things can’t be known to a high degree of certainty. Because of that, you have to do all you can to keep debt low. You want to keep your options as open as possible.

+1 Don't go into dentistry expecting a 300-500k income. Go with the fact that half of your graduating class will be making less then the ADA reported average and the other half will be making More then the ADA reported average. There will be a few that will be making <100 doing part time, and there will be a few doing 500k+ with a few practices.

But do not expect that. That is an outlier. Go in expecting the average.

 

[desertrat12]

There is no way of adequately explaining what it feels like to be that much in debt, be in dental school, watch your friends (who may or may not be less capable humans than you and chose not to enter a professional school) out in the real world getting great jobs, watch the rise of DSOs and the questionable future of private practice, listen do your dean tell you everything is just fine, and oh yea you are in dental school and you've got a practical tomorrow that is graded based on an old retired dentists opinion of how things should be done (which may be different than how you were taught)...its a special type of, should I say torture?

All that said, I am still happy I am here. BUT I will come out with less than half the debt you quoted. I personally know of 3 recent grades (within 5 years out) that all make over 400k. But they have done extreme things that the normal dental student wouldn't consider. The vast majority of new grads I know are making around 120k.

Going 500k in debt in order to make 120k after school is a guaranteed way to voluntarily submit yourself to indentured servitude. It is a completely irresponsible decision. "But I love dentistry" if this is what you are thinking I just have a hard time believing it. Doing dentistry is awesome, I enjoy it, but do I love it? Not for a 4x debt to income ratio. No way. If someone handed me a check for 500k and said I could spend it on dental school or keep it I would definitely keep it, not pay for dental school, and use that cash as a huge head start to a solid financial future. There are quite a few new grads out there doing very well. There are also quite a few new grads struggling who will figure it out and eventually do well. But there are even more than wont.

If you have what it takes to be a great business owner AND an incredible clinician then you have more than enough capability to do well, even very well, in another profession. Look into computer science, finance, etc...there are good salaries to be had for those that work hard and are capable.

Sorry this turned in to a pretty long rant, I'm approaching finals so I may be temporarily jaded. Don't get me wrong, I am very happy to be in dental school. There is nothing wrong with the job of a dentist, but the circumstances around becoming a dentists can be VERY bad. Too many bright eyed students go into it completely unaware of the future they are setting up for themselves....at 500k debt the military is an absolute steal. If you must do dentistry, do military.

 

[UpperBite]

I feel it is entirely worth it. If you sacrifice for 1-2 years after graduation, living within your means, you can get yourself into a comfortable position with your loans and refinance. I love what I do. I think that is important as well. If I became a dentist 10+ years ago when school wasn't as expensive as it is now, I might balk at the idea of paying 4-500K. But it is all I know, so I do not feel the tuition should deter you.

 

[Ding2daDong]

Just graduated in 2017. I love what I do and couldn't imagine doing anything else. I don't plan on retiring so the debt doesn't scare me at all. I get excited to go to work each day and constantly hear friends and family complaining about going to work. I am grateful I found dentistry and I'll take the 400k debt again in a heartbeat. Just my perspective.

 

[2TH MVR]

Just graduated in 2017. I love what I do and couldn't imagine doing anything else. I don't plan on retiring so the debt doesn't scare me at all. I get excited to go to work each day and constantly hear friends and family complaining about going to work. I am grateful I found dentistry and I'll take the 400k debt again in a heartbeat. Just my perspective.

I commend you for your attitude and quite frankly .... your viewpoint is so typical of the young and enthusiastic as it should be. It will be interesting when you reach your 50's to see if your "I don't plan on retiring" statement still rings true. The financial decisions you make today will have a huge influence on "retirement" in the future.

 

[Van Der Woude]

Just graduated in 2017. I love what I do and couldn't imagine doing anything else. I don't plan on retiring so the debt doesn't scare me at all. I get excited to go to work each day and constantly hear friends and family complaining about going to work. I am grateful I found dentistry and I'll take the 400k debt again in a heartbeat. Just my perspective.

Be careful, your body might not work the same in 20 years and force you into retirement and you will become one of those bitter dental school professors who just didn't plan appropriately. Its important that you set some money aside and buy a disability/life insurance plan with that level of debt.

 

[321931]

Just graduated in 2017. I love what I do and couldn't imagine doing anything else. I don't plan on retiring so the debt doesn't scare me at all. I get excited to go to work each day and constantly hear friends and family complaining about going to work. I am grateful I found dentistry and I'll take the 400k debt again in a heartbeat. Just my perspective.

So much scary nformation in this post it’s almost comical.

 

[Yachi]

I graduated recently and I wish I had gone to medical school instead. I love the patient interaction and the hands-on aspect of what I do, but dentistry is not what it used to be (when I was in undergrad and decided on dentistry).

Physician salary has gone up and average GP salary stayed the same. To be on the same salary as newly minted EM/IM/hospitalist, you have to specialize or be owner. It’s the same number of years of training for the same $200-$300k starting salary (4 years med + 3 year residency OR 4 years dent + 2-3 specialist).

The lifestyle can be very different, too. EM/IM 7on/7off allow a lot of personal time and sometimes 8 weeks paid vacation on top of that. There is stress being a owner and married to your practice; associate specialist doesn’t get paid if you don’t produce.

Medical school is not as expensive as dental school. Medical residencies are PAID; most dental specialties you have to PAY them. I love dentistry and what I do, but if I could go back in time, I’d have gone into medicine instead.

 

[2TH MVR]

Nothing is easy. There is no such thing as "having it easy" like the older dentists did. Trust me. The older dentists had to work their butts off as much, or more so than most of you think. Maybe the older generation didn't expect as much (luxuries) as the younger dentists and that is the difference. I'm not sure.

As for all the advice (some negative) from members here. The seasoned, in the trench dentists, have been there ...done that. I can assure you that I made my share of financial mistakes through out my career. I've got time to make more financial mistakes lol. No one is perfect.

One last comment. We're in a bull or correction market right now. The economy has been good. No signs of inflation. Many are complaining about the future of dentistry while we are currently in a positive market. Can you imagine what the attitude here will be when the markets go into another recession?

 

[Awarara]

I graduated recently and I wish I had gone to medical school instead. I love the patient interaction and the hands-on aspect of what I do, but dentistry is not what it used to be (when I was in undergrad and decided on dentistry).

Physician salary has gone up and average GP salary stayed the same. To be on the same salary as newly minted EM/IM/hospitalist, you have to specialize or be owner. It’s the same number of years of training for the same $200-$300k starting salary (4 years med + 3 year residency OR 4 years dent + 2-3 specialist).

The lifestyle can be very different, too. EM/IM 7on/7off allow a lot of personal time and sometimes 8 weeks paid vacation on top of that. There is stress being a owner and married to your practice; associate specialist doesn’t get paid if you don’t produce.

Medical school is not as expensive as dental school. Medical residencies are PAID; most dental specialties you have to PAY them. I love dentistry and what I do, but if I could go back in time, I’d have gone into medicine instead.

i'm not saying i know a lot about the specialty, but i do have some experience. there's a reason they have a nice salary. it is a stressful and demanding job. burnout is high and you can just see it among the residents. not only that, you see the worst patients in the ed that can be physically and emotionally draining. they are disrespectful and ungrateful of what you do. i know there a problem patients in dentistry, but i think a majority of patients are very grateful when you fix their smile or remove their tooth pain and the emotional satisfaction is pretty important. shift work can be nice, but it is also be a huge pain in the ass in the future if you have children. also working as an employee for a hospital, there's a lot of politics and bureaucracy that weigh you down. now these are the bad things about em, but there are a ton of great things as well. i just wanted to show that the grass is always greener on the other side.

i see a lot of dentists/dental students say they would rather have done medical school and vice versa. both are truly great fields. after experiencing both, i am extremely glad i did dental school and would do the same if i were to do it all over again.

this is for all the people who view this and have doubt after seeing all the dissatisfaction among dental students/dentists. too much negativity in these forums imo. dentistry is a great field and i am grateful that i am able to be a part of it.

 

[schmoob]

The lifestyle can be very different, too. EM/IM 7on/7off allow a lot of personal time and sometimes 8 weeks paid vacation on top of that.

Hospitalist jobs are very very stressful. I was visiting someone in the hospital recently and stayed rather late. As I was waiting for the elevator two nurses wheeled over a patient in their bed, and they had their sheet draped over them. Is this something you would like to deal with daily?
Oh and as far as EM, it's a great gig. But do not underestimate how much butt stuff they do. Not trying to put down the profession in any way. Besides, mouths are pretty gross too. But at least it's not the other end.

 

[Van Der Woude]

Hospitalist jobs are very very stressful. I was visiting someone in the hospital recently and stayed rather late. As I was waiting for the elevator two nurses wheeled over a patient in their bed, and they had their sheet draped over them. Is this something you would like to deal with daily?
Oh and as far as EM, it's a great gig. But do not underestimate how much butt stuff they do. Not trying to put down the profession in any way. Besides, mouths are pretty gross too. But at least it's not the other end.

I know an OMFS resident who played quarterback during EM rotation neonate deliveryy b/c the woman wanted to give birth in the ED and "couldn't hold it in." So butts...and other things.

 

[321931]

Hospitalist jobs are very very stressful. I was visiting someone in the hospital recently and stayed rather late. As I was waiting for the elevator two nurses wheeled over a patient in their bed, and they had their sheet draped over them. Is this something you would like to deal with daily?
Oh and as far as EM, it's a great gig. But do not underestimate how much butt stuff they do. Not trying to put down the profession in any way. Besides, mouths are pretty gross too. But at least it's not the other end.

I think the poster was giving an example of what you can do. With the medical profession there are various venues to pursue. Yes there is 7 on 7 off...and yes there is whatever he posted regarding benefits and what not.

The point of his post is that as a MD, there are tons of venues to pursue and those venues off generous income, generous time off, and a variety of different gigs, in patient, out patient, clinical, non clinical, whatever.

The point with dentistry at the current point is that you either sink as an associate or go as all in as an owner... As far as I know...there aren't many dental associates (aside specialists) that get time off, get benefits, get 7 on 7 off. It's only two real venues and one makes you sink (associating), and the other...while can be profitable is a not a guarantee as noone can ever be prepared to be an "owner." I think the poster you quoted is probably an associate and isn't that happy. Now he probably thinks that if was just an MD associate at a big hospital...life would be easier. True. But that's why dentistry really shines in the other venue- owning- as it allows much of the luxuries that "MD's" envy.

 

[desertrat12]

Not sure if OP is still reading this, but I’ll add one more thing...

Yachi mentioned that to reach your medical colleagues income level you would need to be an owner. While this is true, you need to consider your situation and not just think “oh there is the answer, I’ll just be an over. 500k debt problem solved.”

To be an owner you need to BUY a practice. For a good practice you are probably looking at at least 500k buy in, maybe more. This will put you at 1 million + debt. Are you ready for that? Can you emotionally handle that? Being an owner is an excellent option, but you’ve got to be honest with yourself. Are you cut out for it? Or are you wanting a no hassle employee lifestyle?

People have made comparisons to medicine, and medicine is an attractive option as well. Much different lifestyle/work place, but good financially for many specialties. BUT I say it again, you’d be wise NOT to limit yourself to just Dental or medicine. There are other great fields out there that you should at least consider. At the very least you’d reconfirm your interest in a health profession. Or, you might find another avenue that you like/is tolerable and wind up spending a lot less on tuition. In the end, I’ve found very bitter people in all professions. No job will make you happy, that is our own personal responsibility. But not being shackeled with 500k debt for an income of 120k as an employee is a great way to help jump start your job happiness.

 

[GypsyHummus]

You could also look at Podiatry, which is like a foot dentist.

If you score high enough on the MCAT, you can get scholarship at many schools. The cheapest school I know is DMU, which is around 35K/year in tuition. add in cost of living at 20K/year to make 55K/year. You could get out of school at 220K in debt, and pods can make anywhere from 120K to 150K when they first start out up in private practice pod groups to 250k if you work in Ortho or MSG (these are the top 20% of pod jobs though).

Good lifestyle if you dont wanna take call, and get to work with your hands. Little death (unless someone has emergency gangrene).

 

[321931]

In your honest opinion, is it worth it to pursue dentistry even if the tuition is around 400-500k? I was wondering if recent grads and current dentists could give their inputs, as the debt in this day and age does seem daunting and I’d like to be informed. I assume that after your repayment term, things become less difficult? Thank you!

As to back to the topic, gunnyworms. I would definatley NOT lean on the advice of a new graduate that is 100% happy with his choice. If you want to wander over to Dentaltown there are many threads on this subject. Sdn is a good venue for opinions but doesn't have alot of old timers posting here.

i'm not saying i know a lot about the specialty, but i do have some experience. there's a reason they have a nice salary. it is a stressful and demanding job. burnout is high and you can just see it among the residents. not only that, you see the worst patients in the ed that can be physically and emotionally draining. they are disrespectful and ungrateful of what you do. i know there a problem patients in dentistry, but i think a majority of patients are very grateful when you fix their smile or remove their tooth pain and the emotional satisfaction is pretty important. shift work can be nice, but it is also be a huge pain in the ass in the future if you have children. also working as an employee for a hospital, there's a lot of politics and bureaucracy that weigh you down. now these are the bad things about em, but there are a ton of great things as well. i just wanted to show that the grass is always greener on the other side.

i see a lot of dentists/dental students say they would rather have done medical school and vice versa. both are truly great fields. after experiencing both, i am extremely glad i did dental school and would do the same if i were to do it all over again.

this is for all the people who view this and have doubt after seeing all the dissatisfaction among dental students/dentists. too much negativity in these forums imo. dentistry is a great field and i am grateful that i am able to be a part of it.

I personally would of done MD school if I could of done it again if I was an associate. Everyone's different. I think the sour point of many "new" dentists is that associating flat out sucks. While you are working in some HMO clinic seeing 40 patients a day on some 500$ contract, your peers in medicine have some great gig that allows 7 on 7 off, or 3-4 weeks PTO, or benefits whatever...

Many people at this point just say "man I wish I was an MD." and they either stick with this sour note, or they jump into owning which is a whole nother beast of a topic. Owning isn't for everyone, but when it's "good," the 4 days week, go golfing, 3 weeks off, making 200-300k, not on call, not dealing with emergencies, not dealing with life and death...thats when MD's say "man I wish I went to Dental School." However, not everyone ends up owning, not everyone ends up being successful..

 

[2TH MVR]

The other issue is that MD employment is more recession resistant than associate or private practice dentistry.

 

[321931]

The other issue is that MD employment is more recession resistant than associate or private practice dentistry.

You know what’s sad is that for many employee owners... the associate is more replaceable then the hygienist/assistant/front. In my opinion, it’s harder to replace a key front then it is an associate. Associates are a dime a dozen, I can hire one cheap for 400-500 but they will leave after 6-12 months and so another round of interviews begin. So yeah md employment for associating is much more recession proof. Associates are literally disposable. I

 

[desertrat12]

The other issue is that MD employment is more recession resistant than associate or private practice dentistry.

2TH MVR, do you think there is a specialty in dentistry that is more recession proof? Perhaps OMFS that could transition to more hospital work if necessary? Or maybe pedo as parents are often quite motivated to help their kids? The logic of GPs keeping more referrals in house during a recession seems sound, but ada salary reporting (however accurate/inaccurate) seems to show omfs and other specialties doing well in terms of salary increases compared to GP.

 

[321931]

2TH MVR, do you think there is a specialty in dentistry that is more recession proof? Perhaps OMFS that could transition to more hospital work if necessary? Or maybe pedo as parents are often quite motivated to help their kids? The logic of GPs keeping more referrals in house during a recession seems sound, but ada salary reporting (however accurate/inaccurate) seems to show omfs and other specialties doing well in terms of salary increases compared to GP.

During a recession everyone suffers. GPS that are ffs and do cosmetic will hurt but it won’t bankrupt them. The majority of everyone will be fine as a GP you have 30/40% wiggle room for profit. Same with endo they have even more wiggle room for profit. Dentistry is a good business gig to have that much wiggle room. If business goes down 20% you still turning a profit.

 

[2TH MVR]

Ortho gets hurt pretty bad during a recession. Braces is just not a necessity during a recession. If your tooth hurts ... you will find a way to see a GP. If your kid's tooth hurts .... you will find a way to the Pedo. During the last recession ... I had many current patients that could not pay their monthly payments. They were begging me to remove their braces and release them from their financial obligation. I, of course, did so. It was during the last recession that I envied my MD neighbors.

On the flip side .... when the economy was rocking (pre-2006) .... my neighbors envied me.

 

[charlestweed]

If you don’t like the headache of owning a dental practice and plan to work for someone else for the rest of your life, then it’s probably not worth it. Without any benefit (health, 401k, paid vacations etc), an associate income of $120-150k is not that much if you have kid(s) and are the main income earner in the family. Your associate income will eventually hit the ceiling….and you will be no different than the pharmacists who work at Walmart or the optometrists who work at Costco. At least being a dentist, you can own a practice and you can even compete against the powerful corp offices by offering higher quality care and less wait time for your patients. I think it’s worth the extra stress, extra work, and lot of sleepless nights to run a practice and be your own boss than working for someone else. I know it's not easy to run a successful practice. If it is easy and not too risky, I wouldn't have waited for 4 years before I finally had the courage to start my own office. No pain no gain.

Some posters here said they should have picked medicine instead of dentistry. The problem is a lot of people don’t have the choice because getting accepted to med school is not easy. Med schools only pick the best and the brightest. MCAT is a lot harder than DAT. If one has the good grades and the test score to get accepted to med school, one should have no problem getting accepted to dental school….and not the other way around.

 

[TheSuccessfulDentist]

Practice ownership is what it’s all about when it comes to dentistry. Income is better, autonomy is awesome, not to mention the little perks like racking up points on th credit card you use to purchase stuff for the office and traveling around the world essentially for free. It’s hard to describe how gratifying it is to build something with your own hands and see it become successful.

 

[desertrat12]

Some posters here said they should have picked medicine instead of dentistry. The problem is a lot of people don’t have the choice because getting accepted to med school is not easy. Med schools only pick the best and the brightest. MCAT is a lot harder than DAT. If one has the good grades and the test score to get accepted to med school, one should have no problem getting accepted to dental school….and not the other way around.

Very true that the MCAT is more challenging than the DAT. Having taken both the new MCAT and the DAT, the MCAT is on another level. But one thing Medicine has that dentistry doesn’t is the D.O. I would say that getting accepted to a DO school is on equally difficult grounds as Dental school, or perhaps a bit easier. For someone considering Med or Dental but drawn towards Dental because of their perceived lack of competitiveness they should definitely consider D.O.

 

[schmoob]

Very true that the MCAT is more challenging than the DAT. Having taken both the new MCAT and the DAT, the MCAT is on another level. But one thing Medicine has that dentistry doesn’t is the D.O. I would say that getting accepted to a DO school is on equally difficult grounds as Dental school, or perhaps a bit easier. For someone considering Med or Dental but drawn towards Dental because of their perceived lack of competitiveness they should definitely consider D.O.

The differences in applicant stats between the two programs are narrowing. Now that AACOMAS no longer considers grade replacement, and MD & DO postgraduate programs have merged, it has become more difficult to gain acceptance to osteopathic programs. Either way, medicine and dentistry are both difficult to get into.

 

[MaxAnn]

Dentistry makes sense long term in certain cases. It makes more sense to be an owner after a few years rather than a long term associate. At the very least, a partner or an associate with a written contract to buy in after a certain period of time. Personally, I found being an associate annoying and not worth the headaches because some owners will throw all the excess bs stress on you they don't want to deal with and try to dictate treatment they don't want to do. Being an associate is for suckers.

 

[DocJL]

I have been following tuition costs for the last few years, as one of my kids is interested in becoming a dentist.

The skyrocketing, and truly unreasonable cost of dental school tuition, is very troublesome.


It is very hard for most people in their younger years to fully fathom the truly crippling effect that large debt, and the INTEREST on that debt, will have on ones career and lifestyle, for MANY years.


One of the biggest problems is the hurdle to becoming a practice owner, due to inability to finance a practice. When one has student loans totaling $300-500k, it will be exceptionally difficult to get financing for a practice. Having huge debt, and a work history of maybe a few years as an associate where ones salary may be in the $120-180k range, doesn't look that great when put on a loan application.

Particularly for buying an existing practice (which IMO, is generally better than a startup, unless in an underserved area), which can cost anywhere from $500k-1 million. Even if financing is obtained, it will probably be at a higher interest rate; business loans are already much more expensive than the typical mortgage loan or student loans.

As a general dentist, one can truly only reach the higher levels of earning potential as a practice owner. The maximum earning potential of even a skilled and experienced associate will always be considerably less than the someone with the same skill set as an owner, IMO.

So the extra hurdle to practice ownership makes it that much more difficult to pay back those huge student loans.

 

[TheSuccessfulDentist]

I have been following tuition costs for the last few years, as one of my kids is interested in becoming a dentist.

The skyrocketing, and truly unreasonable cost of dental school tuition, is very troublesome.


It is very hard for most people in their younger years to fully fathom the truly crippling effect that large debt, and the INTEREST on that debt, will have on ones career and lifestyle, for MANY years.


One of the biggest problems is the hurdle to becoming a practice owner, due to inability to finance a practice. When one has student loans totaling $300-500k, it will be exceptionally difficult to get financing for a practice. Having huge debt, and a work history of maybe a few years as an associate where ones salary may be in the $120-180k range, doesn't look that great when put on a loan application.

Particularly for buying an existing practice (which IMO, is generally better than a startup, unless in an underserved area), which can cost anywhere from $500k-1 million. Even if financing is obtained, it will probably be at a higher interest rate; business loans are already much more expensive than the typical mortgage loan or student loans.

As a general dentist, one can truly only reach the higher levels of earning potential as a practice owner. The maximum earning potential of even a skilled and experienced associate will always be considerably less than the someone with the same skill set as an owner, IMO.

So the extra hurdle to practice ownership makes it that much more difficult to pay back those huge student loans.

Totally agree. I think buying into a practice as a partner through earned equity (shifting income to seller) over a period of time can work well for both parties. This can minimize or eliminate the need to go to a bank for financing.

If it’s a buyout over a short time frame then you will normally need to get outside financing.

 

[DrReo]

I would never pursue dentistry at the cost of 500k. You need to realize the estimated costs usually do not include the 7% increase in tuition and do not factor for all the interest earned in school.

How will you pay 5000k a month over 10 years or 3000+ over 30 years? It's not worth it. You'd be living on 1500$ a month.

Either reapply to your state school or move onward.

 

[TanMan]

Even at 500k tuition, I still think dentistry is worth pursuing if you're willing to work hard and plan on owning an office. That's the problem these days, a lot of my colleagues are lazy. 500k principal + interest will go by pretty quickly if you can ramp up your office profitability. As an associate, you're on a sinking ship with that kind of debt load. You'll pretty much live in poverty as an associate and stuck in debt.

Reminds me of this infomercial:


... if you don't take the initiative to work hard and get out of the debt trap. This infomercial is also relevant since you'll meet a lot of sheisty people who will sell you into all sorts of different systems, products, and seminars.

The formula I've given people pretty much depends on your financial situation: If you have money, go start a cheap office immediately, if you don't have the money, go associate for a year or two, save your money (pay debt down as slowly as possible during this stage), start a practice as soon as you can and work while ramping up. I am a big skeptic of buying a practice since I don't believe most practices are worth purchasing; although it's convenient that there's existing cash flow, the 10 year note takes a good chunk off your bottom line. I feel like it's like a bond/annuity that I have to work for 10 yrs. You can do a startup cheaper and with aggressive marketing + taking on a heavy workload, you can potentially overtake established practices for sale in your area.

If you can start your office with 100k+ and within a few months, start producing 100k/month, doesn't that make that initial investment worth more than buying these practices with 500-1M+ pricetags? Anyway, I digress, original question was, is it worth it? Yes, if you start your own office.

 

[TheSuccessfulDentist]

Even at 500k tuition, I still think dentistry is worth pursuing if you're willing to work hard and plan on owning an office. That's the problem these days, a lot of my colleagues are lazy. 500k principal + interest will go by pretty quickly if you can ramp up your office profitability. As an associate, you're on a sinking ship with that kind of debt load. You'll pretty much live in poverty as an associate and stuck in debt.

Reminds me of this infomercial:


... if you don't take the initiative to work hard and get out of the debt trap. This infomercial is also relevant since you'll meet a lot of sheisty people who will sell you into all sorts of different systems, products, and seminars.

The formula I've given people pretty much depends on your financial situation: If you have money, go start a cheap office immediately, if you don't have the money, go associate for a year or two, save your money (pay debt down as slowly as possible during this stage), start a practice as soon as you can and work while ramping up. I am a big skeptic of buying a practice since I don't believe most practices are worth purchasing; although it's convenient that there's existing cash flow, the 10 year note takes a good chunk off your bottom line. I feel like it's like a bond/annuity that I have to work for 10 yrs. You can do a startup cheaper and with aggressive marketing + taking on a heavy workload, you can potentially overtake established practices for sale in your area.

If you can start your office with 100k+ and within a few months, start producing 100k/month, doesn't that make that initial investment worth more than buying these practices with 500-1M+ pricetags? Anyway, I digress, original question was, is it worth it? Yes, if you start your own office.

I would be interested to hear more details of how someone might start a practice with 100k and then within months be producing 100k/month.

I think starting from scratch can be a fantastic option, but in most circumstances you will do better financially by purchasing or buying into an existing practice.

 

[TanMan]

I would be interested to hear more details of how someone might start a practice with 100k and then within months be producing 100k/month.

I think starting from scratch can be a fantastic option, but in most circumstances you will do better financially by purchasing or buying into an existing practice.

I'm going to give some specific examples on how and where you can save money... (If these links are in violation of TOS, please let me know, I'll take them down. These are not referral links to make money)
Air Compressor w/ air filter
Ingersoll Rand Reciprocating 60 Gal. 5 HP Electric 230-Volt with Single Phase Air Compressor-SS5L5 - The Home Depot
Dryaire Desiccant System by Sharpe
Cheap Countertops
Hampton Bay Valencia 10 ft. Laminate Countertop in Typhoon Ice-495252V10 - The Home Depot
Vacuum: Used vacuums work well to start cheap.
Flooring: VCT or laminate
Computers: Refurbished dell computers from Newegg or other places
Radiographs: Get a refurb pano from renewdigital, go buy used sensors (you don't need top of the line, you just need them diagnostic enough to diagnose and bill out). Sensors that come to mind are the Gendex eHD's. Old generation, but less than 1k each.
Xray: Go buy a Nomad. A used nomad can be had for around 2500-3500. Makes every room an xray room.
Piezoscaler: Woodpeckers are cheap for scalers and light curing units.

- You don't need a "dental plumber", any plumber will do. Edit: Avoid most professions with the word dental preceding their profession, such as dental lawyer, dental cpa, dental IT, etc...
- Plumb overhead, avoid breaking ground. Save money, easy repairs.
- No sinks/drain in your rooms
- No overhead lights, cuspidors, rear delivery everything. All you really need in a room is a countertop, rear delivery, chair, computer/monitor, TV, handpiece and piezo connection. Cabinetry is optional, depending on your budget. Usually, residential cabinet makers are cheaper, and you can slap on a countertop afterwards.
- When looking for a new spot, look for a business that closed that has a bathroom already that does not need to be moved. Moving a bathroom can be costly, having an existing bathroom saves lots on plumbing. Even better if the closed business has vent ducts w/ AC unit.
- Lighting: go with cheap commercial lighting for now, you can add recessed lighting later on, costs add up.
- Furniture: Go look for stores that sell slightly defective, returned, or repossessed furniture. Save lots of money on couches, chairs, tables, etc...
- Printer: Have a color and b&w ink printer. Color when you have to send photos for claims (there are still some insurances that want us to mail photos!), b&w for everything else. The killer here is not the printer, but the ink. I have an epson r4640 and multiple canon lbp6670dn. Why? Ink is supercheap, cost per page is very low.
- Cables: Monoprice... any cable, every cable. When setting up your network, you can throw the cables down yourself leading to the server and intended room while they are still framing and doing electrical. Ask your contractor to make a conduit before they sheetrock the walls.
- Need a logo? Crowdsource your logo! One that comes to mind is zilliondesigns.com, I can't remember the other one. You don't have to pay an arm and a leg for your "brand identity". Another BS moneymaking scheme that fleeces dentists.

Anyway, I'm going on a massive tangent, I'm just listing whatever comes to mind, but when I look at the amounts people splurge on "dental" or "commercial/professional" products, it's ridiculous how much the markup can be.

So... after cutting costs everywhere, I was able to get it a little above 100k. Now, the disclaimer is that you'll need to spend more to upgrade because durability is not as high as alternatives. However, at this stage of practice startups, it's more important to be able to start producing than the appearance and color scheme of your office.

Now, how to get 100k production. You need to have the capacity to handle 100k+ production levels and bring patients in. Average family size is 3-4 members. You need at least 3-4 chairs that are hygiene compatible so that you can see them in an hour slot. For ops, anything less than 3 chairs is a bottleneck. Imagine if you are trying to juggle 2-3 ops at the same time and you get an emergency patient come in. Overflow rooms are important to make sure that patient is seen, services rendered, and get the patient out of pain. The lesson here is that you should have at least 6 rooms ready, bare minimum of 2 ops, 4 hygiene, but I would prefer to have 3 ops that can be converted to hygiene and 3 hygiene exclusive room to start off.
You might ask, how do I get the patients in? Offer them something that everyone else isn't offering (mine is convenience, lots do price) and advertise the hell out of it. Most effective ad mediums are TV, radio, local celeb endorsements, adwords. Print media is horrendously ineffective from my experience. Social media is a double edged sword. If you build your practice on social media, you can grow cheap, but you can also be taken down rather easily.

 

[2TH MVR]

@TanMan ...... great info. Can you offer any information regarding location for a new graduate on a budget? You also mention convenience. I assume you mean expanded hours. Seems like everyone is doing that also. Corps, privates. Sats. Open till 6pm or 7pm. Is there something else that you do to offer "convenience"?.

Also ... what do you think about all the free exams, free bleaching, etc advertising. Good? Bad?
Thanks for the great post.

 

[TheSuccessfulDentist]

Great post, TM. How many square feet is the office?

I agree if you can make the office presentable and you can get people in the door then you can let your own hard work and dental skills take it from there to build a successful practice.

I’m also interested in the location question. Depending on where you are located a low budget start up might struggle to compete with the “high end” offices. Does your advertising strategy overcome this kind of issue? Maybe where you’re at there is a variety of demographics to accommodate different types of practices.

I was involved in a project for a 3,000 sqft office that we were going to remodel and equip as cheaply as we could and if I remember correctly the cost was around 225k. We didn’t go super low end on materials like flooring or lighting etc. Getting a cheaper x ray unit to start out and replace down the road once the cash is flowing is a great idea and it’s worked well for me. I also agree that it’s easy to get ripped off if you think you need “dental specific” everything.

The last thing I will add to this discussion is that as soon as feasible, owning your own building can be a great investment. It’s worked really well for me.

 

[fancymylotus]

In your honest opinion, is it worth it to pursue dentistry even if the tuition is around 400-500k? I was wondering if recent grads and current dentists could give their inputs, as the debt in this day and age does seem daunting and I’d like to be informed. I assume that after your repayment term, things become less difficult? Thank you!

Yes.

 

[charlestweed]

I recently converted an existing, 20+ year old, 1741 sf medical office to a 7-chair ortho office for only $50k. For an ortho office of this size, many of my colleagues had to spend $2-300k. I didn’t need to hire an architech nor an interior designer. To avoid the high cost of cutting the concrete slab, I asked the guy to run the air and vacuum lines above ground. I kept the existing receptionist counter and just changed the old countertop with new granite material. New paint and flooring are all you need to make any old office look good again. The less picky you are about the office design, the more money you'll save.

Here are some before and after pics.

 

[TanMan]

@TanMan ...... great info. Can you offer any information regarding location for a new graduate on a budget? You also mention convenience. I assume you mean expanded hours. Seems like everyone is doing that also. Corps, privates. Sats. Open till 6pm or 7pm. Is there something else that you do to offer "convenience"?.

Also ... what do you think about all the free exams, free bleaching, etc advertising. Good? Bad?
Thanks for the great post.

Convenience is open evenings (7-8pm), sat, and sunday, doing the treatment the same day, insurance verification before they come and just getting the message out there via mass media.

Free exams gets you a lot of low quality patients. It will clog up your patient rolls with non-productive patients. The only way I could see free exams work in a lower income neighborhood is if the lower income population has good credit for you to utilize and your staff can convert those patients into carecredit/financing type of patients... or on the flip side, you could get budget conscious people who are lured in by the free ______ and can be difficult to convert into any kind of treatment. Free anything is bad, it attracts the wrong type of patients and already sets certain types of expectations coming in through the door.

For location, I would map out all the dentists and major neighborhoods in the area. Look for deficiencies in dentist distribution relative to the neighborhoods. When looking for a space, I do my own negotiation. I don't want TI, I prefer much lower rent. For commercial retail space, it's best to look for a space that's been vacant for awhile but with at least 60-70% of the spaces occupied so that you don't look like you are in a dilapidated strip mall.

Great post, TM. How many square feet is the office?

I agree if you can make the office presentable and you can get people in the door then you can let your own hard work and dental skills take it from there to build a successful practice.

I’m also interested in the location question. Depending on where you are located a low budget start up might struggle to compete with the “high end” offices. Does your advertising strategy overcome this kind of issue? Maybe where you’re at there is a variety of demographics to accommodate different types of practices.

I was involved in a project for a 3,000 sqft office that we were going to remodel and equip as cheaply as we could and if I remember correctly the cost was around 225k. We didn’t go super low end on materials like flooring or lighting etc. Getting a cheaper x ray unit to start out and replace down the road once the cash is flowing is a great idea and it’s worked well for me. I also agree that it’s easy to get ripped off if you think you need “dental specific” everything.

The last thing I will add to this discussion is that as soon as feasible, owning your own building can be a great investment. It’s worked really well for me.

Started with 3k, upgraded to 4500 sqft later on. Location is more important, if you have nothing else to differentiate your office from Office X/Y/Z. How does a low budget start up attack and address high end offices? Flip it around, imply that these high end offices will probably charge you up the ___ for their services and make them look pretentious. Market yourself as a no-nonsense dentist who's not there for their wallet, but there for their health. In these high end offices, there's always a feeling of coldness to them, even though they try to warm the atmosphere with warm lighting and semi-friendly staff.

I'll try and go into more detail in a little bit.

 

[whatisit350]

Hospitalist jobs are very very stressful. I was visiting someone in the hospital recently and stayed rather late. As I was waiting for the elevator two nurses wheeled over a patient in their bed, and they had their sheet draped over them. Is this something you would like to deal with daily?
Oh and as far as EM, it's a great gig. But do not underestimate how much butt stuff they do. Not trying to put down the profession in any way. Besides, mouths are pretty gross too. But at least it's not the other end.

Stress level is a huge, and possibly over looked factor, when considering a career. It's easy for us to look at a high paying job and think it's awesome, but will we have to pull our hair out everyday to earn that income? Coming from a nurse (ICU & psych) I can vouch that being in that high stress environment day in and day out, is not worth it in my opinion. Not only do you have to wheel that dead body around, but now you have to break the news to the family members who are already stressed out. Not fun at all. I'm not saying that dentistry is not stressful, but when compared to the ICU/ER I think it's definitely calmer.

And, it's kind of funny that you mention the "butt stuff". When I was applying to dental school, I had to get some of my nursing school professors to write me LORs. They actually asked me "Why would you want to have your hands in somebody's mouth all day??" I responded with "Lady, do you know how many butts I wiped today?! I will gladly take the other end." lol