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Discussion in 'Dental Residents and Practicing Dentists' started by gunnyworms, Apr 11, 2018.
There has to be a better way of saying that last sentence.
You are a smart dude. But you can't help but wonder what the next generation of DDS will endure when the house of cards all comes crumbling down. To bad student loans not forgiven. I bet you will make money though. Can probably hire them dentists for 20% collections soon as associates. Supply demand you know the drill. No pun intended lol
A lot of students are graduating with little to no student loans(me included ). I think we’ll be just fine
Hey awesome! No debt and dentistry/pharmacy/medicine is a sweet gig. Grats in the scholarships, dentistry will be a really good gig.
I'm sure there is, but if you want to sugar coat it, you can say that one person's trash is another man's treasure. That's the unfortunate truth during a bear market, buyer's market, natural disasters, etc... People are more likely to sell at a loss if they are not able to meet their financial obligations or if they are near death. Acquiring undervalued assets is one of the keys in a bear/buyer's market. Being liquid or having access to capital during the harder times is the more difficult part. I was looking at my watch, and it serves as a reminder that there's always opportunities out there (someone pawned the watch to me and wasn't able to pay me back).
Even if we hit a bear market, patients will still require dental work. The more elective dentistry will definitely take a hit, but emergency dentistry will not take as much of a hit. Existing dentists and incoming dentists will definitely have to adapt, if a bear market/economic recession occurs. The attrition isn't as pretty, but I can already think of a few ways new grads might be able to take advantage (such as lower practice acquisition costs of failing practices or lower construction costs due to decreased demand for commercial construction). For existing dentists, as you have pointed out, may be able to hire dentists and personnel for cheaper, lower costs of expansion if you can get a better deal with a contractor or start your own contractor company, etc...
Nice watch doc but too many people have them
Get Audemars piguet or Patek Phillipe. Now we are talking
I prefer Breitling.
A lot of people do have them, but I think it's a nice, classic look. If the objective was prestige, Audemars/Patek would be better if your target audience knows about watches. I like the submariner a lot because I can bang it around without much worry. If it breaks, not a problem. I hit a stone pillar with my wrist and broke the bezel once already. I don't know how I would feel if I broke a 100k+ watch.
Kinda like how I tell my gf how LV bags look like sh!t (the brown LV, other designs are not as bad). I'm afraid they are becoming the next coach.
LV is aight. Gotta get dem Hermès for bags your gf will wanna become your wife
But I agree with the watch thing
But why, when a couple of doubled up grocery bags is just as functional?
LOL I hope I can meet you some day in the service Big Hoss..
If you’re really looking for something to carry all of your accessories, might I interest you in a male romper?
This thread had some real staying power.
Worth it if you like teeth a lot. It's a thing. In college I met a guy who collected them. From animals of every type. Gross, but to each his own.
Financially it's a gamble. You will be at the mercy of the government with 400k in student loans at 6+%. Maybe they won't cap forgiveness and you can just hike your tax rate by 10% for 20 years, watch that principle grow and just give it the middle finger as it does. Maybe not. Nobody knows.
Living below your means for a few years won't do it though. 400k is a lot. Dentist salaries have been falling sharply for years - during growth years for the country as a whole.
So is it worth it. Idk. Do you stare at people's teeth affectionately right now? Do chipped teeth make you cry? Is it your dream to be a tooth mechanic?
You could mitigate your debt and go for the NHSC scholarship or go work for IHS or a rural clinic after school and get the loan repayment. Plus, IHS dentists make some pretty good dough for the amount of work they put in. Have you ever looked at Federal Benefits? They're the bomb. Plus, you still get a pension through the guvment.
By the way, most federal salaries are public information. Anyone can look them up. Look at "Department of Health and Human Services" for IHS.
Search Federal Employee Salaries
Would you like to share your native language...if you don’t mind? I actually thought it was Italian at first...
My native country was colonized by Italy, so my parents and their generation spoke Italian. My generation grew up speaking the native language and Arabic (as part of the faith). English was the 4th language for me, and I didn’t speak English until I was the age of 10. I picked up some Spanish and Nepali (my 5th and 6th) languages as a dentist, due to local communities and businesses near my offices.
Thanks for sharing! When you first mentioned that Latin reference I thought you were Italian (as me) that’s why I asked. You really have an impressing background and chapeau to all you’ve accomplished.
New grad here.
I graduated with 494k from UoP in June '18, currently at 511k. I plan to use stay on REPAYE and switch to PAYE eventually for the 20 year forgiveness tax bomb. There is almost no way to justify refinancing right now to a 5-10 year plan unless I buy a practice in 1-2 years or I get a huge windfall and reduce my debt burden to <300k. Financially it makes more sense to stay on the IDR and save up monthly for the tax bomb unless I don't plan on purchasing a house, get married, pay for kids, etc until I'm 35-40... Even going out of state to a rural part of the US won't make it possible at this debt load unless we buy a practice out there but there are friends, family, quality of life, and future goals to consider.
Some some numbers for previously discussed purposes of my friends and myself (0-2 years out).
Oklahoma: Baseline 162k (some previous new grads made 200k first year out) with 4.5-5 days a week. One fresh grad 2 years out in the company is working 6 days a week who made 300+ this year.
Wisconsin: 180-210k first year out (sample size = 4) in Madison/Kenosha. Two making 300k second year after moving to Green Bay (ridiculous fee schedules). Working 5-5.5 days a week
New Hampshire: 210k first year out in rural southern NH working 4 days a week
Boston: 120k working in family private practice working 4-5 days a week
California (bay area): One friend who commutes 1 hr to work making 625/day 4.5 days a week
San Francisco: 550-625/day multiple part time locations
Cali (LA Area): Multiple friends who can't go back yet because they require 2-5 years of experience and still only makes 500-600/day.
Your mileage may vary greatly depending on location, drive, and office/company.
Worth it? Definitely not looking at the numbers right now.. Maybe things will change when if and when we're practice owners and bring in 300k+ on a 3-4 days/week but I don't foresee that anytime soon. Even then, we're still so much behind our engineer/programmer friends who started making six figures the day we entered dental school with zero or close to zero debt and now have a net worth the other direction of zero to what my fellow dentists have.
As a practice owner you can bring in more than 300k+.
I say 300k because we all live in the Bay Area or LA area and so even 300k is hard sometimes without putting in a lot of effort or having a niche due to the insane saturation of dentists. I know the ceiling is much higher, but 300k seems like a safer number to speculate around.
Who knows, maybe we'll bite the bullet and move out of state to open a practice but again it's all speculation at this point. Life can take many wild turns.
Ah okay, now it’s clearer.
My brother-in-law was an engineer for Boeing. He was laid off when he was only in his mid 50s. He is now 62-63 years old and has to go door to door selling solar panels to support his son, who is in college. Fortunately, he and his wife already paid off their $600k house, which is now worth $1.8 million. This is the only thing they own. They have to rent out one of the rooms to another person and use this income to pay property tax.
I also know another engineer guy who was also laid off at around the same time as my brother-in-law got laid off. Fortunately for him, his wife is a general dentist, who owns a very successful practice. He now works as lab tech at this wife’s practice.
Long-term job stability is a problem for many engineers. Many dentists can work until they are 60+ years old. If they have back and hand problems (from many years of practicing dentistry), they can work part time (ie 2-3 hours a day 2-3 days/week) and still earn a very good income.
Do those dentists with the back and hand problems have disability coverage that covers for being unable to work full time?
Dental school did not cost 400-500k 35 years ago when his wife went to school though. I'm not saying the glass is necessarily greener on the other side, but looking at the current situation of new grads with 350-500k in debt graduating at 25-30 and comparing to our engineer friends who are positive a couple hundred thousand in net worth making 120k+ (California considered. 120k considered low for bay area even) at the same age is a little depressing. But hey if you buy right out of school and you're on track to make 300-500k/year I'd say it's more than worth it. The problem is that isn't most people.
Sure relocating permanently out of state is an option, but it isn't always that easy with family here.
pretty sure you can't claim disability payments and work PT as a dentist. You can teach. Assuming you have a personal disability policy.
Yes as long as you develop your own treatment philosophy, don't allow yourself to be corrupted by the insane practice of over treatment planning for profit, and avoid DSO's and being controlled by bean counters with MBAs and Taco Bell (Clinic and Regional Managers).
Your prejudice is high re: Corps. Like I said previously .... I personally would love a world without Corps anything, but that is not the present reality. Corp is just a job. Don't like it. Don't work there. No one is forcing anyone to work at a Corp. Pretty sure the Corps have endless resumes of recent DS grads with HUGE debt that NEED a place to work. Corp is a good place for older orthos like myself to continue practicing without the day to day issues involved in running a dental practice. It's an option that was not available years ago.
As for over treatment. I see NONE of that in MY area of orthodontics. Can't speak for the general dentistry area. Over diagnosing or what ever that means is just as prevalent in private (for profit) practices. Don't be naive. All the "Smile Design" treatment plans. 6 month braces. Fastbraces. Lets crown and veneer all the front teeth without correcting the debilitating deep OB, etc. etc.
As many others have stated the grass can certainly be greener. I am in my last year of obtaining an MD but my primary experience with dentistry comes from only my cousin who graduated in 2014. At 30 years old (4 years into practice) he recently became partner at his practice. He busted his ass for the past few years as an associate, going the extra mile to become both an excellent dentist and businessman, and now he is on track to make ~$400k this year working only 3.5 days a week. No nights. No weekends. I understand this is not the norm but consider that he put in above average effort into his craft, took risks, and was willing to learn the business aspects of things. The opportunity for an excellent career is there for those bold enough to take it.
Contrast this to my experience with medicine. We both had roughly the same levels of debt (though his was marginally higher). I'm going into a traditionally higher-paying "lifestyle" field (Radiology). For 6 years of residency I will work 70-80 hours/week with high stress levels and get paid $50-60k for my time, but will also be making debt payments. At 33 I can get my first attending job for a solid salary improving moderately a few years later as a partner (if private practice radiology even exists then). BUT this still requires working an average of 55 hours/wk, generally five 10 hour shifts scattered with evening and weekend shifts where you actually do work the entire day. The prospect of working 3.5 days a week is frankly unreasonable for most docs without a massive paycut. My W2 earnings would probably be slightly higher than my cousins, assuming he doesn't improve further.
The work dentists do is meaningful and can greatly improve a patient's quality of life. You get to work with your hands and are an expert in your field. You actually get paid for the work you do (i.e. bs insurance stuff is much less prevalent). Dentists largely don't work nights/weekends and a 4 day work week seems feasible. And most importantly the ability to own your own practice and have the autonomy and pay therein still exists. This is not the case for many medical specialties as medicine becomes more incorporated. Many many medical students cite the same qualities when choosing their field but either out of ignorance, ego or "ew factor" never consider dentistry. Knowing what I know now, I wish I had done dentistry.
Sorry to hijack this thread with a block of text, but I though it was important. Many MDs wish they could have dentistry, and the grass on our side isn't as green as it may look. Overall many of us genuinely think you guys have an awesome set-up and honestly many of us should have gone this route. I admittedly don't know what the average dentist should expect or "if it is worth it to pursue dentistry nowadays", but I will certainly encourage my children to consider it. It is very hard to place a value on free time. From my perspective I believe it certainly can be a great field for those with the right ambition and aptitude.
Good post. As with all things in life .... if you put in the effort regardless what you do .... you can be successful. I enjoyed dentistry (ortho)for the majority of my working career. Dentistry has been good for myself and my family. But the economics of owning your own practice and competing with the Corps is more complicated now. Especially in the saturated, urban areas. Throw in the insane amounts of DS debt some these future dentists will have and if these same individuals do not have those business or marketing skills or work ethic as your cousin. Well .... it won't add up.
Again .... speaking from practicing in a SATURATED area .... the practice of dentistry has changed. Call me old fashioned, but there was a time when treating patients with respect and as if they were your family members meant something. Build a good reputation and the snow ball of new patients will follow. This was the norm in the early 90's. This does not seem to be the case anymore and this brings me to the biggest disappointment about practicing dentistry or orthodontics.
Dentistry is all about marketing. Dentistry is a commodity now. Patients judge you by the number of positive and negative reviews you have. Your facebook ads. Google ads. Youtube stuff. Your online presence. Everyone wants a good, cheap price for their dentistry. So many dentists offering $15 and less new patient exams with cleaning. FREE bleaching with new patient exam. Seems like the world revolves around anything and everything including dental and health services that are available ONLINE. Look at Direct Smile Club. We all know that it is terrible treatment with less than ideal results .... but patients do not know and all they care about is the low price and convenient packaging of the product. Look at Invisalign. Just about every sandwich board outside of another new dentist practice says they offer Invisalign. Anything to attract a new patient.
I did not go into dentistry to SELL dentistry. Maybe the younger dentists are more equipped for this. I am not.
Medicine is also being commoditized, but not to the extent of dentistry.
As some know .... I sold my ortho practice a few years ago. Work for Corps now. In my mid 50's and love working 4 days per week with no worries. I love sitting in those Corp meetings where the non-dentist business person is going over numbers and new ways to bring patients in and requesting that we all work on getting positive online reviews. I just sit there and smile.
What is the point of my post? GO TO A LESS SATURATED RURAL MARKET. Open up a nice practice and be a part of the community. Do exceptional dentistry and build a reputation on how well you treat your patients. Practice dentistry without all the gimmicks.
I was accepted to both medical and dental school. Ended up going the dental route. So many premeds would say that it would be disgusting to spend all day in someone’s mouth. Really? Any idea what physicians have to deal with?
That Smelly Smell that Smells Smelly
I am happy you wrote this, this is the reality of most dentist these days wether you like or not, the day of the introvert dentist wont fly anymore, as you stated its all about marketing and selling. Insurance is ever present and getting bigger and bolder by the day the flip side of the limits of insurance is now pts think twice about treatment as it come out of their pocket book, and they will go to different office to price match, as a radiologist you will never see such a thing. I will tell you your cousin who is 30 making 400k on 3.5 days is not the norm period. Dentist go out of there way to provide FREE second opinions, bring in your treatment plan we will match it, billboards offereing get 5 venners and the last the 6 is free. Go to SOCAL and you will see. And each one of us who works with our hands are one bad accident away from not practicing, I know ….disability insurance..... trust me to get the coverage you actually need its a huge ripoff with no guarantee they will even pay..
This is why it’s important to keep the overhead low so you can pass on the low cost treatments to your patients. A low overhead 2-3 op office that has solidly booked schedule every day can net a lot more than what a high end, high overhead 5-6 op office can.
I don’t know why some people only work 3.5 days/week. I’d go crazy if I stay home doing nothing the other 3.5 days in a week. Why waste the youth years when you are only in your 30s, have full of energy and, and are in good health? If I were his cousin, I wouldn’t settle for $400k. I’d go find another job (by either opening up another office or working for a corp) to keep myself busy 5-6 days/week…and make $600-700k. The more I make, the sooner I can get out of this stressful dental profession, and sooner I can retire and won’t have to worry about recession, oversaturation of dentist, openings of new corp offices, and the decline of the dental profession etc. Nobody can forbid me from taking several long vacations even when I work 5-6 days/week. “Laziness may appear attractive but work gives satisfaction.” Anne Frank.
Charles Tweed I think you take for granted that you are in Ortho, working 5 to 6 days as Ortho is a different beast than 5 to 6 days a week as a GP. I work 5 days a week and it has its moments. Honestly if a person is able to successfully build a business model working 3.5 days a week for 400K I would not call that lazy. This person may be quite content making 400K and he meets all his responsibilities and only in dental world do we think someone making 400K as lazy . LOL
I currently work with 2 general dentists at 2 corp offices:
One is managing doc. She has 3 young kids. She works 4 days/week for the corp and she usually gets the award every year for being the top producing dentist. On the weekends, she works at her own office, which is managed by her husband, who is also a GP. Her husband is not as skillful as her so he saves all the difficult cases (implants, molar endo, wisdom teeth etc) for her to perform.
The second dentist is a NYU grad….he looks about 10 years younger than I am. I don’t know how much he makes but he drives a top of the line Maserati that has a NYU license frame. He owns a very successful private practice that employs associate GPs and specialists. He works with me every Friday at a corp office.
That's great but I imagine that is out of necessity in a saturated area, I hear Maserati are nice cars, but I typically dont look at peoples cars as to how well they are doing.
Agree to disagree.
Why rush through a career life just to retire? I'd much rather use my "youthful years, full of energy" to work 3.5 days/week and use those other days off to hike, ski, travel, and have fun. Just because someone works 3.5 days/week doesn't mean they are wasting away at home on the other days. I'd go crazy if I worked 5+ days/week and all I had going for me was the hope of one day retiring to do fun things. Add in the physical strain of being a dentist possibly limiting future fun activities.
There's way more to life than dentistry. Enjoy what you do each day at work, but also learn to have fun and a life outside of the office. It's all about balance.
C'mon Charlestweed. You know this. Leasing or financing an expensive car vs. owning that car outright are two different things. I live in N. Scottsdale. I see tons of Maseratis, BMWs, Mercs, Audis, Porsches, Teslas, etc. etc that are leased or financed for some ridiculous term. People trying look affluent. I NEVER judge a person by the car they drive. Means nothing. Not discounting your story, but the type of car a person drives is not a good measure of that person's success. You just never know. Lots of pretenders. Especially those posters who have a white sportscar as their avatar.
And yes .... I understand that a lot of dentists lease their cars since it is a right off. I did this too.
As for working your butt off. Yes .... you work very hard. It is very admirable. You have found a niche that works for YOU. I could not do what you do. Working 6 or 7 days a week .... or was it 6 1/2 days? I get it. Work hard now to have rewards later. I believe you are in your 40's. Soon ... you will realize that $$$$$ is not everything. Time is. My personal time is worth more to me than working more days to make more $$$$$. I would choose the laid back rural family practice over working in an ultra saturated city working 6-7 days a week bouncing around practice to practice. Your practice schedule seems really stressful. 100 patients a day?
I'm pacing myself. I really enjoy practicing orthodontics. I love the interaction with patients. I could do this for another 10-15 years. I have no set time table for retiring.
But again .... I admire your work ethic and it's obvious that you are successful in how you practice. Much respect.
Now you see why some dentists like Tanman and I still think highly of our profession despite all the negative things like the openings of new dental/ortho schools, opening of new corp offices, rising tuitions, insurance companies’ pay cuts etc. We both have done things that many of our colleagues are not willing to do. Now you see why both of us don’t think $500, 600k, or even a $1M loan a huge hurdle to overcome. Most physicians, pharmacists, optometrists, and other health professionals work 5-6 days/week….many have to work on Saturdays, Sundays, at very odd hours, 8+ hours a day, so why can’t we, dentists, do the same?
Most people who work 5-6 days/week are still able to find time to do most of the fun activities that you listed above….just need to plan everything ahead of time. You can only ski when there are snowfalls in a few winter months. If you have kids, you can only take vacation when the kids are not in school (Spring breaks, Xmas breaks, summer breaks etc). For us, we won’t be able to take any vacation this coming summer because my son will take the SAT prep classes and he needs to spend time studying for the test. We try not to expose the kids to expensive vacations too often…they need to learn the value of money and hard work. My wife and I will definitely start taking care of ourselves more when the youngest one starts college 4 years from now.
Thank You, 2THMVR.
That's great you are willing to work 5 to 6 days in 7 different offices if I remember correctly including Sundays, but I think it is rather irresponsible advice to say to a 22 year old that 500K, 600k, or 1 million dollars is not a huge hurdle. That is a daunting task for the majority of students and not to be taken lightly. While many physicians work odd hours and weekends many do not depending on specialty, I dont know too many optometrist open on Sundays., perhaps that's a regional thing.
I said such loan amount is not a huge hurdle for me because I can work hard to pay it back. It is, of course, a huge hurdle, especially for dentists who don’t own an office and plan to work for someone else for the rest of their life. This is why I always advise many young HS students (many of them are my patients who want to have a job like mine) to work hard in school so they can get accepted to cheap local public universities and dental schools. And with their good grades in dental school, they’ll have higher chance of getting accepted to paid specialty programs. This is why I always suggest young dentists to spend as little as possible to set up their new offices. Patients judge the dentist by his work and his honesty and not by how beautiful and modern the office looks. According to some of these ads (The Dental Trader=), one can walk into a fully equipped office and is ready to start his business (no need to wait for building permit and city approval) for under $50k.
I agree with you about going to cheapest schools as possible, but outside of OS and some PEDO paid specialty programs tend to be rare if not based in a hospital.
I attended a hospital ortho residency that paid a stipend. These residencies are obviously super competitive.
Is it worth it to be a dentist?
Well, that depends.
Did you go to a school that would lead you to have crushing debt?
Do you work in an saturated Metro or place that is 1 hour within a dental school?
If the answers to both of these questions is yes, then the answer is NO. It is not worth it to be a dentist.
If you have crushing debt and can go rural then you can pay it back. If you're debt isn't that bad and you accept 25% of production in a cool city then you'll be okay.
Dentist's seem to be stuck in the yester year of early 2000s. I would tell most new dentists to expect to work weekends and work at a corporation. I remember before I found a corporate entity I could tolerate; I strung along 2 days a week at various practices. I likely only worked 32 hours a week and still cleared 100k. Very few jobs offer that ability to work 30 hours and make a six figure income. Dentistry is an amazing profession, but it is on the down swing just like every other job in the country right now. I have had multiple dental colleagues from India and Brazil tell me how difficult it was for them to even find work in their country of origin. I think many dentist are just stuck up. "I don't work fridays, corporate hours are inconvenient, I don't want to drive that far/move there for work" . Dentistry is a great job. Work hard at corporate save some money open a practice and expect to hustle. I washed the windows outside my practice on Saturday morning. It wasn't demeaning, It was cleaning something I had worked 30 years of my life towards, and I loved it.
Yep these are gold, my friend his endo residency at VA in Cali, all paid for and HE got paid 50K a year, sadly the program closed. My other buddy paid 50K a year at Temple.
I'd probably have to disagree, IF you can retire early. If there's no chance in finishing early to enjoy the rest of your life, then why rush it. You'll be old when you're done anyway, might as well make the journey fun and balanced.
True that, lots of posers. Usually, the biggest posers have a 3-series bimmer(not to say all of them are, but the really low lease rates are what brings them in). This coming from the guy who has a bimmer, lol. Man, ortho sounds like a dream job. Is it still the same profession (work dynamic and profitability) as it was back then? I wish I had the energy to work 6-6.5 days / week like CTweed.
I think this is where the message is lost in translation... If you're willing to work hard, flexible to the demands of the consumer, and willing to move where there's demand and opportunity, you will make a lot of money. 500k+ is not much in the grand scheme of your professional life, unless you're willing to be a mediocre 120k/year dentist in a highly saturated area with little to no room for professional/financial advancement.
If 500k+ in debt isn't enough to light a fire up someone's a$$ to work, I don't know what is. Unfortunately, I still believe that the main barrier to people's success is themselves.
You've read the threads here on SDN regarding ortho. Ortho back in the 90's was amazing .... even in the urban areas. I believe my name back then was TanMan Jr. lol. Ortho after 2008, after Invisalign, after Corps proliferation was difficult in the urban areas if you didn't adjust to the market conditions. I didn't nor did I want to. CTweed prospers in this environment with his common sense and worth ethic. If I were just starting out .... I would look to the small markets. That's me. Although my wife would miss Scottsdale and the finer things that a large city offers. LOL. Come to think of it .... I would miss the big city also. Love Golf and Hiking in the Sonoran Desert.
Work dynamic: love what I do. That's never changed. I like to look at a patient's mouth as moldable clay. At every appt .... I get to do my magic and watch as the clay transforms into a beautiful smile. Damn .... that's corny. But it's fun. There's a certain satisfaction in bending and molding wires to achieve perfection that aligners will never provide.
It is a dream job. This is my work schedule for December (all the work days are highlighted in blue)….20 days/month. I normally work 21 days/month but I had to block 1 day because of the Xmas holiday. I will be off on the 24th and 25th but I will work from 8-4 on the 31st at the corp office. It’s cool because there will be some exciting bowl games to watch and hopefully, there will be some new interesting posts on this SDN forum to read to make the day go by faster.
These are encouraging. Maybe I should just move out west for a few years and build up some capital.
Dentists Among Highest Student Loan Monthly Debt-to-Income Ratio
DTI by degree by Ryan Kaldani - Infogram