Is the Dental Industry going retail?

[Slueman33]

Hello,

This may seem like something dumb to worry about but it is on my mind a lot. I switched from pharmacy to dentistry because I hate how the whole industry is so damn corporate. It’s a meaningful career but just not for me.

I wonder these days that is dental industry at risk of losing its private practice appeal, and will end up going retail as with the optometry and pharmacy industry? One can even infer with the CVS x Aetna deal that retailers are gearing up to turning general physicians into a retail setting. I see this occurring with an increase of health clinics inside retail department stores. You can just walk in and get a quick check up at Walgreens.

In the next 5-6 years will a consumer have the option to get their dental work done at their nearest CVS? I’m not sure but it’s entirely possibly.

My main appeal from Dentistry vs other health fields is the autonomy and idea of owning a small business, as I am very business savvy.

Sorry for the grammar mistakes, I am on the toilet while typing this.


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[artist2022]

Moved to Dental to get input from students and dentists, rather than pre-dental students.

 

[princeafrica]

Aspen Dental Opens its First Office in a Walgreens | Group Dentistry Now

 

[Cold Front]

Yes. Dentistry is evolving, and unfortunately the evolution is based on what consumers (in our world we call them patients) want. The public, specially the young generation, want more of the same convenience and experiences where they shop, eat and get treated. MD’s communicate with their patients through portals without the patient getting out of bed. Dentistry has been testing similar portal with tele-dentistry, and I think that will eventually come online for patients who need follow up for extractions and root canals, or even some emergencies. Dentistry will become more retail - Invisalign booths and stores are popping up in big malls, and more dental offices will be moving away from the traditional offices where patients find the dentist, to retail centers where dentists find the patients. I can see dentistry being consolidated with other health services, like the Walgreens-Aspen Dental deal. It will be common to see more direct-to-consumer services in the future, like the Smiles Direct Club, cosmetic whitening products and so on. Corporations will be pushing these boundaries, as they have more business brains and resources than the average dentist.


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[738177]

If you attend a 400k-500k dental school, you'll most likely not be owning a private practice anyway. That's something to keep in mind. I would not enter dental school if I'm not comfortable being an associate for a long time.

 

[AEZDent]

If you attend a 400k-500k dental school, you'll most likely not be owning a private practice anyway. That's something to keep in mind. I would not enter dental school if I'm not comfortable being an associate for a long time.

Why would you say that?

 

[doktorinprogres]

If you attend a 400k-500k dental school, you'll most likely not be owning a private practice anyway. That's something to keep in mind. I would not enter dental school if I'm not comfortable being an associate for a long time.

This is untrue and it could be argued that it is paramount for someone in this position to seek to own as quickly as possible. Banks are generally amenable to student loan debt. It does help your case if you have capital on hand.

 

[Kodybanks]

I disagree with this completely. It isn't so difficult to open a practice that a 500k loan would keep you forever from doing so. If you're smart with handling your money, its very do-able. I think I read that over 90% of dentists open their own practice

 

[luisfigo]

no one is forcing anyone to go into retail. If you are business savvy then don't go retail. It's that simple

 

[2TH MVR]

no one is forcing anyone to go into retail. If you are business savvy then don't go retail. It's that simple

I believe the post is about DENTISTRY as an industry eventually heading into retail. Not individual dentists. There are obvious signs that the market is experimenting with this concept. Look at all the dental offices opening up in large malls.

All the market research people are looking at how to capitalize on the aging boomer generation. I'm in that group ....just barely lol. But I'm, along with a bunch of old, wrinkly people are always at CVS or Walgreens picking up prescriptions, etc. so why not place a medical clinic or dental clinic in the store? All about convenience. Think about it? Is an old person, mother in a hurry, father in a hurry, millennial checking the SDN forum, etc. etc. going to visit a dental practice on the 12th floor office building in a very busy, urban area with no parking (not talking about NYC) or a retail dental practice conveniently located near the school, work, Starbucks, CVS, Walgreens, etc. etc.

I personally prefer the private traditional dental practices. Retail options will be available going forward, but the vast majority of patients will still want to be seen at a nice, private dental practice.

 

[Cthuluhoop]

I disagree with this completely. It isn't so difficult to open a practice that a 500k loan would keep you forever from doing so. If you're smart with handling your money, its very do-able. I think I read that over 90% of dentists open their own practice

Everyone makes it seem so simple, you just buy a practice and you just start rolling in the money. From dentists I have spoke with, you make almost no money for a decent amount of years following the purchase. Between learning the ropes, paying for your business loan, losing patients from the previous owner and all the other struggles of operating a practice. Your student loan repayments however, keep coming.
I don't know how realistic it is out side of very rural areas that can support a new dentist, to come right out of school and be ready to jump into PP without any experience in the field or any idea of how to run a practice. Especially when it's absolute sink or swim with those serious student loan repayments.

You have to get your handspeed up somehow, and unfortunately new dentists don't have the luxury of not worrying about money with $300k+ in student loans. Desperation for jobs is where the corporate offices come in for new grads and has become a pretty crucial stepping stone in dentistry for most new grads

 

[Cold Front]

Everyone makes it seem so simple, you just buy a practice and you just start rolling in the money. From dentists I have spoke with, you make almost no money for a decent amount of years following the purchase. Between learning the ropes, paying for your business loan, losing patients from the previous owner and all the other struggles of operating a practice. Your student loan repayments however, keep coming.
I don't know how realistic it is out side of very rural areas that can support a new dentist, to come right out of school and be ready to jump into PP without any experience in the field or any idea of how to run a practice. Especially when it's absolute sink or swim with those serious student loan repayments.

You have to get your handspeed up somehow, and unfortunately new dentists don't have the luxury of not worrying about money with $300k+ in student loans. Desperation for jobs is where the corporate offices come in for new grads and has become a pretty crucial stepping stone in dentistry for most new grads

Retail is driven mostly by corporate dentistry, which is growing at a faster pace than private practice, but at a cost.

Look at these brands and their number of offices:

Heartland Dental: 900
Aspen Dental: 800
Pacific Dental: 600

Heartland is valued close to $3 billion and have debt of 8 times their earnings. They are considered a junk rated company, thanks to their high leverage approach to obtain more credit to grow and open more offices. The same applies for Aspen and Pacific. Their investors are so hungry that they accepted lenient terms to provide more credit to the leveraged loans. So high debt is the silver lining to corporate dentistry growth, something private practice dental offices don’t have, and will eventually push back on the retail direction dentistry is heading in the future. In the meantime, the insane corporate debt puts more strain on corporate offices; from unnecessary procedures to pushing more corporate growth goals. There could be a slowdown in the economy or change in the regulatory environment, or who knows what could happen... That could make corporate dentistry more difficult to meet their debt requirements. That’s something most dentists in private offices can feel good about.

 

[Dental2347]

Nowadays dentist are going for partnership practices for more time for them-self.

 

[luisfigo]

My post was concerning the OP, why should he/she care that the INDUSTRY is going retail? So what if it does? OP can still open a private practice. Pharmacy outside of hospitals is pretty much an obligation to work retail. Dentistry is not so, and will probably be a good mix.

 

[Medin2017]

I believe the post is about DENTISTRY as an industry eventually heading into retail. Not individual dentists. There are obvious signs that the market is experimenting with this concept. Look at all the dental offices opening up in large malls.

All the market research people are looking at how to capitalize on the aging boomer generation. I'm in that group ....just barely lol. But I'm, along with a bunch of old, wrinkly people are always at CVS or Walgreens picking up prescriptions, etc. so why not place a medical clinic or dental clinic in the store? All about convenience. Think about it? Is an old person, mother in a hurry, father in a hurry, millennial checking the SDN forum, etc. etc. going to visit a dental practice on the 12th floor office building in a very busy, urban area with no parking (not talking about NYC) or a retail dental practice conveniently located near the school, work, Starbucks, CVS, Walgreens, etc. etc.

I personally prefer the private traditional dental practices. Retail options will be available going forward, but the vast majority of patients will still want to be seen at a nice, private dental practice.

How would someone adapt to this trend other than go rural? I don't mind doing that but I would like to hear more alternatives

 

[2TH MVR]

How would someone adapt to this trend other than go rural? I don't mind doing that but I would like to hear more alternatives

Alternatives is extreme service and exceptional treatment. Not everybody wants to visit a dentist at a CVS just because it is convenient. There is a large population of patients who want a traditional experience and a dentist they can trust instead of a no-name dentist in a Corp setting. I'm the no-name ortho in a large, busy Corp office lol. They don't come to see me. They come to the Corp office much like visiting any retail business. Treat your patients with respect instead of "selling" dentistry. Many good families would like to see you, but maybe your hours are not conducive to their busy work and kid schedule. Open some late night and sat appts. Be more flexible with payment plans. These are the obvious things.

But location trumps everything.

Not all is doom and gloom. Plenty of dentists have private practices in saturated areas. It just isn't as easy as it once was.

 

[deleted659902]

Alternatives is extreme service and exceptional treatment. Not everybody wants to visit a dentist at a CVS just because it is convenient. There is a large population of patients who want a traditional experience and a dentist they can trust instead of a no-name dentist in a Corp setting. I'm the no-name ortho in a large, busy Corp office lol. They don't come to see me. They come to the Corp office much like visiting any retail business. Treat your patients with respect instead of "selling" dentistry. Many good families would like to see you, but maybe your hours are not conducive to their busy work and kid schedule. Open some late night and sat appts. Be more flexible with payment plans. These are the obvious things.

But location trumps everything.

Not all is doom and gloom. Plenty of dentists have private practices in saturated areas. It just isn't as easy as it once was.

What's your thought on combined DDS/DMD with MBA programs? Given the increasing number of corporate offices opening up and a sustained interest in dentistry from the private equity, do you think the combined programs are worth it for those seeking to climb the corporate ladder right out of school, essentially becoming a business person with extensive dental background?

 

[Cthuluhoop]

What's your thought on combined DDS/DMD with MBA programs? Given the increasing number of corporate offices opening up and a sustained interest in dentistry from the private equity, do you think the combined programs are worth it for those seeking to climb the corporate ladder right out of school, essentially becoming a business person with extensive dental background?

It's a sad outlook on this profession if the goal of some dental students is to enter the business side of corporate dentistry rather than actually practicing dentistry.

I doubt you would even need a DDS/DMD to enter the corporate ladder

 

[2TH MVR]

What's your thought on combined DDS/DMD with MBA programs? Given the increasing number of corporate offices opening up and a sustained interest in dentistry from the private equity, do you think the combined programs are worth it for those seeking to climb the corporate ladder right out of school, essentially becoming a business person with extensive dental background?

I have no idea. The levels of middle and upper management is almost ridiculous. I have a local boss. That person has a regional boss. That person has a corporate midlevel boss. That person has a corporate high level boss. Above that person is the CEO. I've probably missed another few bosses lol. Out of all these bosses that I KNOW OF .... only TWO are dentists. Not sure what their compensation levels are. Personally ... I wouldn't want their jobs, but who knows.

 

[321931]

Dentistry is and still will be a good field. The reality is that dentistry is changing yes. But it's not that bad. A few things you will have to note:

1) You have to go into the field with minimal debt
2) You have to own your own practice to make the most of it
3) Dentistry hasn't kept up with the market. Wages go up, rent goes up, but your costs to charge the patient remains the same. Coupled with corporate encroachment, and more dentists being pumped out...you will see less and less revenue. But you have to understand that dentistry is still profitable. A restaurant operates on 5-10% margins, a dental business 30-50%. So in a decade or so, it might shift to 25-40%...but still profitable compared to most businesses.
4) The bottom line is that finding a good practice will setup yourself for so much success in the future. It truely is a great career if you end up in the right practice...and that amounts to luck, hard work, and sacrifice. I work 36 hours a week and have 5 weeks off and I'm happy as a bumble-bee. But if you end up in a crappy practice or have no aspirations for ownership, and or you THOUGHT you bought the right practice/startup and things aren't good...then there are way way way better fields that you should go into.

A good dental practice >>>>>>>>>>>>>>>>>any other health career.
A good dental practice with heavy loans >>>>>>>> any other health career. (you can pay back the loans in no time with a good practice)
An average dental practice = or < any other 8-5 health career
An average dental practice with heavy amount of loans < any other 8-5 health career
A bad dental practice/poor associateships <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< any other health career
A bad dental practice/associateships with heavy amount of loans <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< Becoming a plumber, tradesmen, or working at wal mart would of been a better choice.

Alot of this cannot be determined by just undergrad and graduate school. Alot of it depends on luck. So good luck!

 

[charlestweed]

Dentistry is and still will be a good field. The reality is that dentistry is changing yes. But it's not that bad. A few things you will have to note:

1) You have to go into the field with minimal debt
2) You have to own your own practice to make the most of it
3) Dentistry hasn't kept up with the market. Wages go up, rent goes up, but your costs to charge the patient remains the same. Coupled with corporate encroachment, and more dentists being pumped out...you will see less and less revenue. But you have to understand that dentistry is still profitable. A restaurant operates on 5-10% margins, a dental business 30-50%. So in a decade or so, it might shift to 25-40%...but still profitable compared to most businesses.
4) The bottom line is that finding a good practice will setup yourself for so much success in the future. It truely is a great career if you end up in the right practice...and that amounts to luck, hard work, and sacrifice. I work 36 hours a week and have 5 weeks off and I'm happy as a bumble-bee. But if you end up in a crappy practice or have no aspirations for ownership, and or you THOUGHT you bought the right practice/startup and things aren't good...then there are way way way better fields that you should go into.

A good dental practice >>>>>>>>>>>>>>>>>any other health career.
A good dental practice with heavy loans >>>>>>>> any other health career. (you can pay back the loans in no time with a good practice)
An average dental practice = or < any other 8-5 health career
An average dental practice with heavy amount of loans < any other 8-5 health career
A bad dental practice/poor associateships <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< any other health career
A bad dental practice/associateships with heavy amount of loans <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< Becoming a plumber, tradesmen, or working at wal mart would of been a better choice.

Alot of this cannot be determined by just undergrad and graduate school. Alot of it depends on luck. So good luck!

Rainee, you finally admit that dentistry is still a great field. Working only 36 hours a week…not bad at all. All the MD’s (my brother…a GI doc, my brother in law….internal medicine, my 3 cousins…anesthesiogist, nephrologist, and rheumatologist) I know work a lot more hours per week and also on the weekends. Despite the hard work, they are all very happy with their jobs, except for the anesthesiologist. They probably make more than us, dentists, but if you take their gross income amount and divide it by the number of hours they have to work, I think we, dentists, make more per hour.

Edit: on my past posts, I kept repeating that I had to work 5-6 days/week and people on here praised me for my hard work. Currently, I work 22 days/month.... 11 days at the corp x 8 hours/day + 11 days at my own offices x 4 hours/day = 132 hours/month...or just 33 hours/week. After doing this calculation, I see why I've never felt I work hard. No wonder why I keep saying ortho is an easy job. No wonder why I have so much free time to write posts on this forum.

 

[321931]

Rainee, you finally admit that dentistry is still a great field. Working only 36 hours a week…not bad at all. All the MD’s (my brother…a GI doc, my brother in law….internal medicine, my 3 cousins…anesthesiogist, nephrologist, and rheumatologist) I know work a lot more hours per week and also on the weekends. Despite the hard work, they are all very happy with their jobs, except for the anesthesiologist. They probably make more than us, dentists, but if you take their gross income amount and divide it by the number of hours they have to work, I think we, dentists, make more per hour.

Edit: on my past posts, I kept repeating that I had to work 5-6 days/week and people on here praised me for my hard work. Currently, I work 22 days/month.... 11 days at the corp x 8 hours/day + 11 days at my own offices x 4 hours/day = 132 hours/month...or just 33 hours/week. After doing this calculation, I see why I never feel I work that hard. No wonder why I keep saying ortho is an easy job. No wonder why I have so much free time to write posts on this forum.

Well, I had a re-evaluation or refocused on my life. Last year, a few things happened. 1) I almost drowned. 2) I had one of the best years in dentistry.

1) Drowning makes you sorta realize that life is sorta fickle. One minute you are here, the next minute you aren't. What does that mean? It means ENJOY your life. Dentistry is so awesome because as my own boss, I can take vacations, or breaks whenever I want. I decided to take off 5 weeks this year. Vacations to Taiwan, Italy, Alaska, Vancouver. Why does this pertain to dentistry? Because where else in healthcare can you just say I'm going to take X amount of days off on these times because I want to. That's the beauty of being your own boss.

2) Best years in dentistry. Raised collections 10% and cut writeoffs by 22%. Then I realized, what am I complaining about? I see 18 hygiene checks, I do 2 crowns a day which technically is 10 minutes of drilling while my assistant does the temp/cord.... Why am I complaining about this??? This is freaking awesome. Usually during a crown prep, I numb up 8:00, then turn on my CNBC markets or Netflix, wait 5 minutes, go back in drill 10 minutes, then impression, then two hygiene checks. Next patient up is in 1-2 hours. So in the span of 1 hour of "work" -30 minutes is chilling in my office reading a book or watching a movie.

Seriously dentistry is amazing if you have a good gig. It's good job. I'm lucky to have it, but I still do think that dentistry requires luck, owning your business, and working hard. But once you get settled and have a good thing going, you can't beat this job. Pharmacy? you work counting pills from 8-5 on your feet. Medicine- while can be lucrative and relaxing if you have a specialty- takes forever. I'm in my 5th year of dentistry and doing well in my practice. Medicine? I would be still in school and maybe would be getting out in 2-3 more years...and after that who knows where you end up? 60 hour rotations in the hospital? Yuck. The worst thing that happens in dentistry is a broken tooth and a phone call to fix it. Medicine? Surgery paging you at 2 am sounds great. Not.

Bottom line, dentistry is good. But you have to own your practice. That's what makes it really worth it. Yes things are changing, but if you look at the margins of a good practice, you can't go wrong with ownership. 50% margins? That's crazy- no wonder corporate wants a piece of the pie. But there will always be room for private practice. Patients want to see the same provider and hygienists. The mouth is a very scary place and they want someone they trust to take care of them. They don't care who sees them for the general checkups with blood pressure and what not. But when the dentist is drilling and filling and doing "invasive" things, they want trust. That's why some patients follow their dentists for years and decades. It's a great thing.

 

[2TH MVR]

Who is this imposter filling in for @Rainee?

😀

 

[321931]

Who is this imposter filling in for @Rainee?

😀

Lol. I have no room to complain man. My sister in law who works for amazon came over for winter break. I had two weeks off. She was on her computer everyday sometimes at 10 PM writing emails to her coworkers/team about projects. Eating lunch, she was checking emails. Phone glued to her face doing work. Blah blah blah. Techies have a good job- yes- but they work hard for it. I just sat around in my pajamas and watched Game of Throne marathon and played Smash Brothers with the nephews. Didn't even think about dentistry.

Then I opened up shop for a day and had my hygienist come in and clean all their teeth and made them nightguards with whitening while I watched TV in the office.

Job is good gig. Be grateful for what you have. =D

 

[soxinabox90]

Lol. I have no room to complain man. My sister in law who works for amazon came over for winter break. I had two weeks off. She was on her computer everyday sometimes at 10 PM writing emails to her coworkers/team about projects. Eating lunch, she was checking emails. Phone glued to her face doing work. Blah blah blah. Techies have a good job- yes- but they work hard for it. I just sat around in my pajamas and watched Game of Throne marathon and played Smash Brothers with the nephews. Didn't even think about dentistry.

Then I opened up shop for a day and had my hygienist come in and clean all their teeth and made them nightguards with whitening while I watched TV in the office.

Job is good gig. Be grateful for what you have. =D

As a current dental student with a huge student loan burden this makes me wonder how you ended up in such a position? If you dont mind, what school did you go to, and what state/area are you practicing in now?

 

[knewstance]

I know I need to be a practice owner to be profitable, but at the same time I am not very fond of the business side of dentistry. I think my best route is to get into a partnership. How does one find a partner to open a business with, and what are the cons of partnerships?

You can be profitable in as a corporate position, but perhaps not as profitable as you could be as an owner. The possibility of being more profitable as a practice owner is due to the carried risk, you also have the possibility of not doing well and ending up with crushing debt and needing to file BK. Where that is 100% not even an option in a corporate office - worst case scenario, you lose your job and have to find another place to work.

The way that I see most people getting into a partnership is by working as an associate and then buying into the practice (purchasing a percentage from the owner(s)). You will get an idea while working as an associate if you work well with that owner or not and if you want to partner with them or not.

 

[2TH MVR]

I know I need to be a practice owner to be profitable, but at the same time I am not very fond of the business side of dentistry. I think my best route is to get into a partnership. How does one find a partner to open a business with, and what are the cons of partnerships?

Have you owned your own practice? If no .... Then you should be EXCITED at the idea of owning. There is pride in ownership. Your building something. If start up .... Do lots of research . Get a dentist specific acct. Learn how to repair things when they break. Learn about computer networking so you can manage your network. Use QuickBooks for accounting. Do your own payroll. Its easy with the help from your acct. Most important is hiring the right staff. An experienced front office person who is versed with filing insurance .

Partnerships. Not common in my saturated, urban area. Your office needs to be BUSY enough to support 2 dentists.

 

[321931]

As a current dental student with a huge student loan burden this makes me wonder how you ended up in such a position? If you dont mind, what school did you go to, and what state/area are you practicing in now?

Luck and hard work. Pacific NW. Big factor is life and luck. If you asked me 5 years ago when I graduated that I would be up in the Pacific NW, I would never think of it. Bottom line is focus on getting your clinical skills down within a year or two, then focus on buying a business.

I know I need to be a practice owner to be profitable, but at the same time I am not very fond of the business side of dentistry. I think my best route is to get into a partnership. How does one find a partner to open a business with, and what are the cons of partnerships?

Why aren't you fond of the business side? Let me put it this way. Dentistry is the second best business for a bank to lend to. I think the best venture is Vets. Why is it the best business to venture? Because the margins are so high that virtually no dentist that gets lended to goes bankrupt. You have to be truly "bad" and "try" to ruin your practice to fail. Partnerships are hard to find. It's virtually like marrying someone. There's alot of divorces over issues. For example, Doctor A wants to expand and buy a 100,000 laser. Doctor B wants to split the profit of 100k instead of adding more debt. That or Doctor A takes more patients, then Doc B. Or Maybe one of them throws each other under the bus. It happens.

You can be profitable in as a corporate position, but perhaps not as profitable as you could be as an owner. The possibility of being more profitable as a practice owner is due to the carried risk, you also have the possibility of not doing well and ending up with crushing debt and needing to file BK. Where that is 100% not even an option in a corporate office - worst case scenario, you lose your job and have to find another place to work.

The way that I see most people getting into a partnership is by working as an associate and then buying into the practice (purchasing a percentage from the owner(s)). You will get an idea while working as an associate if you work well with that owner or not and if you want to partner with them or not.

As stated, yes there is carried risk, but the risk of bankruptcy is minimal. Would you rather open a restaurant which hundreds of thousands of people do every year on a 5% profit margin, or own a dental business with 50% margins and has a BARRIER to entry via having a dental license? Any other joe blow can open a restaurant. But Dental? You need a license in most states.

Dentistry is a safe, great field. Work hard, learn learn learn, and go the business route.

 

[charlestweed]

Well, I had a re-evaluation or refocused on my life. Last year, a few things happened. 1) I almost drowned. 2) I had one of the best years in dentistry.

1) Drowning makes you sorta realize that life is sorta fickle. One minute you are here, the next minute you aren't. What does that mean? It means ENJOY your life. Dentistry is so awesome because as my own boss, I can take vacations, or breaks whenever I want. I decided to take off 5 weeks this year. Vacations to Taiwan, Italy, Alaska, Vancouver. Why does this pertain to dentistry? Because where else in healthcare can you just say I'm going to take X amount of days off on these times because I want to. That's the beauty of being your own boss.

2) Best years in dentistry. Raised collections 10% and cut writeoffs by 22%. Then I realized, what am I complaining about? I see 18 hygiene checks, I do 2 crowns a day which technically is 10 minutes of drilling while my assistant does the temp/cord.... Why am I complaining about this??? This is freaking awesome. Usually during a crown prep, I numb up 8:00, then turn on my CNBC markets or Netflix, wait 5 minutes, go back in drill 10 minutes, then impression, then two hygiene checks. Next patient up is in 1-2 hours. So in the span of 1 hour of "work" -30 minutes is chilling in my office reading a book or watching a movie.

Seriously dentistry is amazing if you have a good gig. It's good job. I'm lucky to have it, but I still do think that dentistry requires luck, owning your business, and working hard. But once you get settled and have a good thing going, you can't beat this job. Pharmacy? you work counting pills from 8-5 on your feet. Medicine- while can be lucrative and relaxing if you have a specialty- takes forever. I'm in my 5th year of dentistry and doing well in my practice. Medicine? I would be still in school and maybe would be getting out in 2-3 more years...and after that who knows where you end up? 60 hour rotations in the hospital? Yuck. The worst thing that happens in dentistry is a broken tooth and a phone call to fix it. Medicine? Surgery paging you at 2 am sounds great. Not.

Bottom line, dentistry is good. But you have to own your practice. That's what makes it really worth it. Yes things are changing, but if you look at the margins of a good practice, you can't go wrong with ownership. 50% margins? That's crazy- no wonder corporate wants a piece of the pie. But there will always be room for private practice. Patients want to see the same provider and hygienists. The mouth is a very scary place and they want someone they trust to take care of them. They don't care who sees them for the general checkups with blood pressure and what not. But when the dentist is drilling and filling and doing "invasive" things, they want trust. That's why some patients follow their dentists for years and decades. It's a great thing.

I am glad to hear you are doing well. It's only been 5 years and you are only in your early 30s. You are in a much better financial shape than when I was at your age. I graduated when I was 29. When I was at your age, I owed more than $1 million ($450k student loan, $382k home loan, $125k practice loan, and 2 leased cars etc). Things will definitely will get better as you gradually pay down your debts. Once all the debts are paid off, things like office rent increases, staff salary increases, pay cuts from insurance companies, slow days (due to economic recessions and oversaturations of dentists) etc won't bother you as much....your net take home income will still be a lot higher than right now when you won't have to repay your debts. The stress level will be much less than it is right now.👍

 

[charlestweed]

Having your own office doesn't necessarily guarantee that you will make more than working for someone else. A few dentists and specialists, whom I've met at the corp, admitted to me that they make more working here than at their own offices. And that's why they sold their failing practices and went back to work for the corp.

I bought a failing ortho practice in 2009. During the first couple of months, I only net around $1k a month because the overhead was like 90+%. Once I was more familiar with the office, I let go all the overpaid existing F/T staff and replaced them with the P/T ones. The seller is originally from Russia and most of her patients were White. None of the previous staff spoke Spanish so I had to bring in Spanish speaking assistants and lower the tx fee to attract the Hispanic and Asian patients. I'd rather have a busy working schedule, treat patients at lower fee, and have a steady flow of cash than sitting around earning nothing. This is my 2nd office. The reason I made the decision to purchase this failing office was I already had the experience in running my first office that I set up from scratch in 2006. If I didn't had such ownership experience, I wouldn't have bought it. My previous jobs at the corps also taught me a lot.

 

[Slueman33]

I’d like to comment to express my gratitude for all practicing dentists putting their input here. Your information is greatly appreciated to a hungry pre dental student like me.

@2TH MVR you are amazing, thank you!

Sent from my iPhone using SDN mobile

 

[2TH MVR]

I’d like to comment to express my gratitude for all practicing dentists putting their input here. Your information is greatly appreciated to a hungry pre dental student like me.

@2TH MVR you are amazing, thank you!

Sent from my iPhone using SDN mobile

Your welcome. Great topic btw. Just stay the course. None of us can predict the future. Patients are not commodities. Patients still want personable service from private practice dentists who have a vested interest in their patients care.

 

[Cthuluhoop]

Having your own office doesn't necessarily guarantee that you will make more than working for someone else. A few dentists and specialists, whom I've met at the corp, admitted to me that they make more working here than at their own offices. And that's why they sold their failing practices and went back to work for the corp.

That was going to be a question I had for you experienced doctors. Is the gap in earnings between owning and being an associate really that large? That seems to be the general consensus from those I've spoken to and from what I've read online. Everyone seems to say that you won't earn real money in dentistry until you own your own practice, but the ADA paints a different picture

https://www.ada.org/en/publications/ada-news/2018-archive/july/hpi-gap-in-earnings

 

[theleatherwalle]

The dental industry is most definitely heading to a more consumer related approach. This means likely more chains and more retail like offices.

That doesn't mean all hope is lost. Honestly, you can make alot of money running your practice like a dental chain. Be open 8-8 and open some saturdays and there will be plenty of money rolling in.

I don't trust a damn thing the ADA writes. The ADA has been bought off by corporations and dental insurance companies and has not looked out after dentists.

I suspect dental insurance getting in bed with chain dental groups will lead to a death of many private practices in the next couple of years.

We are going down the same path of optometry and pharmacy, but certain dentists who will be open late, fast producers, or willing to go where others do not wish to live will still make a fair bit of money.

 

[321931]

The dental industry is most definitely heading to a more consumer related approach. This means likely more chains and more retail like offices.

That doesn't mean all hope is lost. Honestly, you can make alot of money running your practice like a dental chain. Be open 8-8 and open some saturdays and there will be plenty of money rolling in.

I don't trust a damn thing the ADA writes. The ADA has been bought off by corporations and dental insurance companies and has not looked out after dentists.

I suspect dental insurance getting in bed with chain dental groups will lead to a death of many private practices in the next couple of years.

We are going down the same path of optometry and pharmacy, but certain dentists who will be open late, fast producers, or willing to go where others do not wish to live will still make a fair bit of money.

The biggest problem I see with Dentistry is if there is a 2020 or future candidate that really tries to turn dentistry into universal healthcare system and gets rid of PPO/insurance, you will see a total collapse of dentistry. If crown costs become 400$ subsidized by the gov and taxpayers pay into the system, dentistry will be unsustainable. With how politics is becoming more divisive... and people asking for free healthcare and free college, who know what happens 2020.
If we do have a universal healthcare system- you will WISH and PRAY that private dental insurance comes back

So no. I'm not worried about the rise of corporations, more competition, or private dental insurance. I'm worried about gov mandated healthcare. When fillings become 50$ a filling and or crowns become more expensive then the cost to make them plus overhead, you will see bankruptcies in dental practices and students unable to pay back their loans. It will be a complete disaster.

 

[allantois]

The biggest problem I see with Dentistry is if there is a 2020 or future candidate that really tries to turn dentistry into universal healthcare system and gets rid of PPO/insurance, you will see a total collapse of dentistry. If crown costs become 400$ subsidized by the gov and taxpayers pay into the system, dentistry will be unsustainable. With how politics is becoming more divisive... and people asking for free healthcare and free college, who know what happens 2020.
If we do have a universal healthcare system- you will WISH and PRAY that private dental insurance comes back

So no. I'm not worried about the rise of corporations, more competition, or private dental insurance. I'm worried about gov mandated healthcare. When fillings become 50$ a filling and or crowns become more expensive then the cost to make them plus overhead, you will see bankruptcies in dental practices and students unable to pay back their loans. It will be a complete disaster.

Even in countries with socialized medicine, dentistry is rarely a covered benefit. And where it is covered, dentists can opt out of the system. There are a lot more realistic issues facing dentistry than extremely unlikely government takeover of dental benefits. We need to solve the huge medical crisis, before anyone will even start paying attention to dentistry

 

[charlestweed]

That was going to be a question I had for you experienced doctors. Is the gap in earnings between owning and being an associate really that large? That seems to be the general consensus from those I've spoken to and from what I've read online. Everyone seems to say that you won't earn real money in dentistry until you own your own practice, but the ADA paints a different picture

HPI: Gap in earnings between owner-dentists and nonowners declining

In order to produce, you have to have patients and the problem is we don't have unlimited supply of patients due to oversaturation of dentists, expansions of corp offices, patients losing their jobs and dental insurances, patients leaving towns etc. So your success as a practice owner depends on 2 things:

1. How good you are at attracting new patients and retaining the existing patients. Having good communication skills and good clinical skills, that allows to see high volume of patients with very few redos and complaints, are very important. Being good clinically, you can do more procedures yourself and refer fewer cases to specialists.

2. How good you are at controlling your overhead. If you have good clinical skills and can multitask, you don't need to hire a lot of assistants nor have to waste a lot of money on high tech gadgets. Most of the successful GPs that I know who practice here in CA, have small low overhead 2-3 op offices. My sister is one of them.

If I decided to work F/T at my first office, which only has 300 active patients, I would make 50-100k/year less than what I get paid for working F/T at the corp. In order for me to have the current 800 active patients, I had to widen the radius by adding 3 more office locations. And to save in overhead, I make the staff travel (and carry the instruments) with me, instead of hiring different staff for each office. To make myself available to work at 6 different locations (4 are my own and 2 are corp offices), I have to book as many patients (50-100 patients) in one day as possible...so I only need to come to work a few days/month at each office location. A lot of GPs and specialists, whom I have met at the corp, also do the same thing...they travel to different offices to gain more patients and to keep themselves busy. So my point is more patients you treat = higher income.

You shouldn't assume that if you accept medicaid and open your office 8am-8pm and on the weekends, your office will be flooded with patients. That's because other offices around you also do the same things, especially in saturated areas. You are not the only one who has student loan and is desperate for new patients. Your colleagues, who set up their practices near yours, also have student loan are desperate as well.

 

[321931]

Even in countries with socialized medicine, dentistry is rarely a covered benefit. And where it is covered, dentists can opt out of the system. There are a lot more realistic issues facing dentistry than extremely unlikely government takeover of dental benefits. We need to solve the huge medical crisis, before anyone will even start paying attention to dentistry

I agree with this, but once that is solved don’t be surprised if dentistry is next. We are lucky in a sense that dentistry is disconnected from medicine. If it was connected, the entire premise of private practice would be in a dumpster. Remember solo physicians back in the old days? They don’t exist anymore.

A few more thoughts on it: Britain as a National healthcare type of dentistry:
Waiting for NHS dentistry to collapse? Dentists highlight crisis to the pay review body

NHS dentistry across UK running on fumes, in face of 35% collapse in real incomes

I don’t worry about competition. I worry about gov intervention. But yes you are right, there are more pressing issues.

 

[allantois]

If I decided to work F/T at my first office, which only has 300 active patients, I would make 50-100k/year less than what I get paid for working F/T at the corp. In order for me to have the current 800 active patients, I had to widen the radius by adding 3 more office locations. And to save in overhead, I make the staff travel (and carry the instruments) with me, instead of hiring different staff for each office. To make myself available to work at 6 different locations (4 are my own and 2 are corp offices), I have to book as many patients (50-100 patients) in one day as possible...so I only need to come to work a few days/month at each office location. A lot of GPs and specialists, whom I have met at the corp, also do the same thing...they travel to different offices to gain more patients and to keep themselves busy. So my point is more patients you treat = higher income.

You shouldn't assume that if you accept medicaid and open your office 8am-8pm and on the weekends, your office will be flooded with patients. That's because other offices around you also do the same things, especially in saturated areas. You are not the only one who has student loan and are desperate for new patients. Your colleagues, who set up their practices near yours, also have student loan are desperate as well.

I've noticed that there are two types of practice owners: those who try to squeeze every single drop of profit by cutting down on their overhead and those who care about their staff well-being. Certainly those who pay their staff a pittance are making more money off of it. I am not criticizing anyone for maximizing their income, but as I worked at one of those offices in my gap year, there was constant staff turnover as everyone would immediately jump ship whenever they found a higher paying job.

 

[321931]

I've noticed that there are two types of practice owners: those who try to squeeze every single drop of profit by cutting down on their overhead and those who care about their staff well-being. Certainly those who pay their staff a pittance are making more money off of it. I am not criticizing anyone for maximizing their income, but as I worked at one of those offices in my gap year, there was constant staff turnover as everyone would immediately jump ship whenever they found a higher paying job.

Yeah I never understood that. The staff benchmark for practices is 25% on overhead. Mine is 30% To some consultants my overhead is to high and I could save 6% that could be pocketed towards gross profit... But I find turnover and unreliable employees to be a headache nuisance and costing more money in the end. When profit margins are 30-50% then everything will be fine in the end. That’s why I overpay my employees and I realize that they really make my business run well. Without them I would be dead in the water. There’s other areas where you can save on for example marketing and supplies. Couponing bulk buys and Costco helps. Never skimp our on your employees.

 

[charlestweed]

I've noticed that there are two types of practice owners: those who try to squeeze every single drop of profit by cutting down on their overhead and those who care about their staff well-being. Certainly those who pay their staff a pittance are making more money off of it. I am not criticizing anyone for maximizing their income, but as I worked at one of those offices in my gap year, there was constant staff turnover as everyone would immediately jump ship whenever they found a higher paying job.

It’s a 2-way street. The staff also have to care about success of their boss’ practice. The problem is most of them don’t. Nobody cares about your practice like you do. The staff only try do minimum work that are assigned to them. They only care about getting paid on the 15th and 30th of each month. You would think that they always try to work hard for you so you can have a successful practice and their jobs will be more secured, right? Wrong, they actually prefer to have a slow day everyday so they don’t have to work as hard. When you are not around watching them, they either are on their cell phones or take a break.

It also has to do with supply and demand. When you work in oversaturated areas, you also have oversupply of assistants as well. I currently have a pool of 9 P/T ortho assistants, who are eager to work for me want me to give them more hours….but I only have 6-7 chairs at each of my offices and I only work 6 weekend days (3 Saturdays and 3 Sundays). None of my staff gets the health and paid holiday benefits. Only my right handed person, who is my trusted office manager, gets paid holidays. Everyone else is replaceable. I give all 3 of my F/T staff 3-day sick pays because my state requires me to do so.

 

[2TH MVR]

Ah .... One of the advantages to working Corp. I don't have to deal with staff issues. All I care is that they show up and do their jobs well. Luckily all is good since a bad apple working with me has been fired.

 

[charlestweed]

Yesterday, my wife and I attended the Lunar New Year banquet hosted by the Vietnamese Physician Association of Southern Cal. And this year, to attract a larger crowd, they invited dentists and pharmacists to join them. I ran into several of my dentist friends from USC and UCLA, whom I haven't met since graduation. I also ran into a couple of undergrad friends, who are now physicians. I found it funny that when we talked about what we want our kids to be when they grow up (it's a common topic of discussion among us, asian parents), all the physicians said don't do medicine and dentistry (especially orthodontics) is a better field. And we, dentists, said medicine is a better field for our kids because of oversaturation and high student loan problems that new grad dentists are facing. It was a fun night....there were so many nice cars there.

 

[2TH MVR]

Yesterday, my wife and I attended the Lunar New Year banquet hosted by the Vietnamese Physician Association of Southern Cal. And this year, to attract a larger crowd, they invited dentists and pharmacists to join them. I ran into several of my dentist friends from USC and UCLA, whom I haven't met since graduation. I also ran into a couple of undergrad friends, who are now physicians. I found it funny that when we talked about what we want our kids to be when they grow up (it's a common topic of discussion among us, asian parents), all the physicians said don't do medicine and dentistry (especially orthodontics) is a better field. And we, dentists, said medicine is a better field for our kids because of oversaturation and high student loan problems that new grad dentists are facing. It was a fun night....there were so many nice cars there.

It obvious you like nice cars. Any favorites?

 

[charlestweed]

It obvious you like nice cars. Any favorites?

Those Ferraris, Lamborghinis, and Bentleys that I saw yesterday were fun to look at but they are not for me for a couple of reasons: too expensive (I'd rather invest the same amout of money in a rental property), very high maintenance cost, not for every day driving, limited number of seats etc. I have very poor taste in cars. The car that I buy has to be large enough for 5 people because I want to drive with the wife and kids in it. It has to have self driving feature so I can let the car drive by itself in a traffic jamp. So no 2-seater roadster for me.....maybe, I change my mind when the kids are in college. For a sedan or a coupe, I like Tesla model S (model X looks like a Prius from a distance), Merdedes S class, BMW 7 series, Audi A8 etc. For SUVs, I like a large one such as Lexus LX570, Mercedes GLS 550, Cadillac Escalade....and all these cars have semi-autonomous self-driving features. I couldn't control myself....and got myself another fully loaded model S last month.

 

[2TH MVR]

I agree that autonomous, electric cars are the future .... but I'm going to enjoy the sweet smell and noise of internal combustion engines burning the remains of dinosaurs for as long as it will last. 🙂

 

[321931]

I agree that autonomous, electric cars are the future .... but I'm going to enjoy the sweet smell and noise of internal combustion engines burning the remains of dinosaurs for as long as it will last. 🙂

Tesla has effectively killed any "drive" - no pun intended- for me to buy a gas car. I always wanted to buy an M3..but there is no point in doing so. Electric can effectively be as fast as a supercar ferrari... and go for 500 miles without a charge...etc etc. So whats the point of gas cars?

 

[Cthuluhoop]

Tesla has effectively killed any "drive" - no pun intended- for me to buy a gas car. I always wanted to buy an M3..but there is no point in doing so. Electric can effectively be as fast as a supercar ferrari... and go for 500 miles without a charge...etc etc. So whats the point of gas cars?

As much as I like the Model S, just wait for the Germans to actually begin caring about electric cars, and Tesla is going to be in massive trouble. Luckily they have their massive charging infrastructure they can hold over the Germans, but if the Taycan is any indication of what the Germans can do when they put their minds to it, Tesla's going to need to hit the drawing board.

 

[321931]

As much as I like the Model S, just wait for the Germans to actually begin caring about electric cars, and Tesla is going to be in massive trouble. Luckily they have their massive charging infrastructure they can hold over the Germans, but if the Taycan is any indication of what the Germans can do when they put their minds to it, Tesla's going to need to hit the drawing board.

I agree with the assessment. I have been really trying to wrap my head around the valuation of $TSLA stock. It's either going to go to the moon prices or crater... I do think EV vehicles are the future, but I just can't justify investing in $TSLA. I'm rooting for an American Car Company to be the next big thing, but those balance sheets look scary.

 

[2TH MVR]

Tesla has effectively killed any "drive" - no pun intended- for me to buy a gas car. I always wanted to buy an M3..but there is no point in doing so. Electric can effectively be as fast as a supercar ferrari... and go for 500 miles without a charge...etc etc. So whats the point of gas cars?

Oh my friend. You do not sound like a car enthusiast. It's not about all out speed in a straight line. It's about how the car feels. Sounds. Smells. I've had plenty of really fast cars, but my little Alfa 4C trumps all of them. 2500 pounds with a hand laid carbon fiber monocoque tub. Midengine. Un-assisted, manual steering, Acrapovic titanium center exhaust, no sound deadening, etc. etc. A back to basics car. Analog instead of digital.

I could see myself in an electric car for commuting, but for fun ...... NO.