NEWSFLASH for Ortho residents

[Texas Ortho]

Over the past couple of years we've started receiving letters from residents all over the country saying something similar to, "I'm graduating in _____ and will be moving to Texas. Do you know of any opportunities?"

I've talked to the reps down here and they've noticed the same thing - everyone seems to think there are orthodontic patients coming out the nose in Texas.

Guess what...the metro areas in Texas are actually over-saturated with orthodontists.

You just need to know this coming in. If you're really interested in moving here because you love the area, etc. and just can't live anywhere else by all means come on down. You'll be accepted with open arms. But, if you just assume there are a ton of opportunities down here (at least in the metro areas) please do some research before moving your families across the country.

For the current residents...is this the perception out there? Do people really think Texas is plump full of patients without enough orthodontists to treat them?

I'd be interested to hear your thoughts.

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[furcation]

Over the past couple of years we've started receiving letters from residents all over the country saying something similar to, "I'm graduating in _____ and will be moving to Texas. Do you know of any opportunities?"

I've talked to the reps down here and they've noticed the same thing - everyone seems to think there are orthodontic patients coming out the nose in Texas.

Guess what...the metro areas in Texas are actually over-saturated with orthodontists.

You just need to know this coming in. If you're really interested in moving here because you love the area, etc. and just can't live anywhere else by all means come on down. You'll be accepted with open arms. But, if you just assume there are a ton of opportunities down here (at least in the metro areas) please do some research before moving your families across the country.

For the current residents...is this the perception out there? Do people really think Texas is plump full of patients without enough orthodontists to treat them?

I'd be interested to hear your thoughts.

I think this is true in just about any major city you go to. I have noticed some extra attention to texas though, by ALL dental fields.... I know its true for Colorado and Nevada as well and Im sure many other states. California, everyone says it sucks for just about any dental area.

I think there are two things sucking for ortho right now. 1.) the economy sucks right now. ortho, im sure isnt first on a lot of families lists. 2. there have been several new ortho programs opening up over the past several years. some of them very large for an ortho program. Same thing is happening with Pedo. There are so many new pedo programs out there that a few years down the road, they-re going to be experiencing the same thing. I'm sure that there are shortages of specialists in some areas, but the shortage that the US should be worried about is general dentists and general dentists willing to see low income patients and venture to rural areas. Im with you on this and I hope you and others can voice their concern. If the ADA hears us, maybe they will put more focus into getting general dentists out there instead of accrediting specialty programs left and right. It's my 2 cents, but I hope a lot of dentists out there read this and think about this, it ties in with that Obamacare post in endo vs. OMFS, if we dont adress the issues the gov. will...

 

[og2]

Over the past couple of years we've started receiving letters from residents all over the country saying something similar to, "I'm graduating in _____ and will be moving to Texas. Do you know of any opportunities?"

I've talked to the reps down here and they've noticed the same thing - everyone seems to think there are orthodontic patients coming out the nose in Texas.

Guess what...the metro areas in Texas are actually over-saturated with orthodontists.

You just need to know this coming in. If you're really interested in moving here because you love the area, etc. and just can't live anywhere else by all means come on down. You'll be accepted with open arms. But, if you just assume there are a ton of opportunities down here (at least in the metro areas) please do some research before moving your families across the country.

For the current residents...is this the perception out there? Do people really think Texas is plump full of patients without enough orthodontists to treat them?

I'd be interested to hear your thoughts.

just curious -- who are you that people are sending you letters about possible job opportunities in texas?

 

[Demeter]

Over the past couple of years we've started receiving letters from residents all over the country saying something similar to, "I'm graduating in _____ and will be moving to Texas. Do you know of any opportunities?"

I've talked to the reps down here and they've noticed the same thing - everyone seems to think there are orthodontic patients coming out the nose in Texas.

Guess what...the metro areas in Texas are actually over-saturated with orthodontists.

You just need to know this coming in. If you're really interested in moving here because you love the area, etc. and just can't live anywhere else by all means come on down. You'll be accepted with open arms. But, if you just assume there are a ton of opportunities down here (at least in the metro areas) please do some research before moving your families across the country.

For the current residents...is this the perception out there? Do people really think Texas is plump full of patients without enough orthodontists to treat them?

I'd be interested to hear your thoughts.

Awesome!
I am looking for an orthodontist to work part -time in my pediatric practice.
Tell them to go to SDN and send me a pm. Medicaid Ortho in Texas is a gold mine.

 

[Demeter]

The main problem for new ortho graduates is finding a decent place to associate. Most go and work for big chains such as Castle Dental and Monarch until they are able to open their own practice. I thought Ortho would be like other fields such as Pedo where you can work with an experienced Mentor, learn the ropes of private practice and then move on. My ortho friend told me these opportunities are rare, because Orthodontists can handle a ton of cases alone and simply hire inexpensive dental assistants on an hourly wage to bracket and deband cases, while they tx plan.

BTW: Would 50% collections sound like a fair offer to a new ortho graduate?

 

[1992Corolla]

Over the past couple of years we've started receiving letters from residents all over the country saying something similar to, "I'm graduating in _____ and will be moving to Texas. Do you know of any opportunities?"

I've talked to the reps down here and they've noticed the same thing - everyone seems to think there are orthodontic patients coming out the nose in Texas.

Guess what...the metro areas in Texas are actually over-saturated with orthodontists.

You just need to know this coming in. If you're really interested in moving here because you love the area, etc. and just can't live anywhere else by all means come on down. You'll be accepted with open arms. But, if you just assume there are a ton of opportunities down here (at least in the metro areas) please do some research before moving your families across the country.

For the current residents...is this the perception out there? Do people really think Texas is plump full of patients without enough orthodontists to treat them?

I'd be interested to hear your thoughts.

Uh-oh! Sounds like someone is trying to save their turf!

 

[Simiam]

Who wouldn't want to move to Texas?

 

[gryffindor]

I have heard of a number of fellow recent grads (at least 4 or 5) who were not from Texas but had "full time offers" in Texas. Whatever operation Texas has going on giving out full time offers is fueling the rumors.

 

[nug]

BTW: Would 50% collections sound like a fair offer to a new ortho graduate?

overhead alone is 55-60%. I don't think there is an ortho practice in america where you could get anywhere near 50%

 

[charlestweed]

overhead alone is 55-60%. I don't think there is an ortho practice in america where you could get anywhere near 50%

The overhead can be 40% or less if you do the following:

-Set up a small 900-1300 sf office. You can easily put 4-6 chairs in there. Your monthly rent will be lower. The construction cost will be significantly less because the contractor charges you by square footage.

-Use regular film based pan/ceph machine. You can diagnose and tx plan all ortho cases using the film based radiographs. So why waste $50-80k on a digital machine?

-Cross train your staff. Instead of hiring 5-6 different employees, you can have 2-3 employees who can perform multiple tasks. My office manager can help me sell ortho cases, do billing, check ortho benefits, and handle all emergency calls. My RDA can assist ortho, sterilize instruments and make ortho appliances. My other RDA works as an ortho/perio assistant (my wife is a periodontist), xray tech, and receptionist.

- Don't use the self-ligating brackets that cost 10x more than the nonself-ligating brackets.

I also hear that ortho in TX are doing really well. The company I currently work for also owns Monarch Dental in Texas. According to the production report that comes out every month, the Monarch ortho offices in Texas always beat our ortho offices in Southern California. And we are doing really well here in Southern California…3-4 starts per day.

 

[kato999]

I have heard of a number of fellow recent grads (at least 4 or 5) who were not from Texas but had "full time offers" in Texas. Whatever operation Texas has going on giving out full time offers is fueling the rumors.

I've heard the same rumors. Actually the market was bad enough here in the Twin Cities for a few residents to jump ship and move down to Texas.

I think Minnesota's state income tax (7-9 percent) along with the Minnesota Care tax of (2 percent of gross) was also a factor when comparing incomes to Texas' no state tax. Gotta love red states.

 

[Demeter]

overhead alone is 55-60%. I don't think there is an ortho practice in america where you could get anywhere near 50%

The overhead equation changes when you are adding an associate.
I have to pay for the bank loan, rent, cam, utilitize regardless. I am referring ortho out. So if I had these cases done inhouse on the fridays when I am not seeing patients, my only overhead increase would be the additional hours for the staff.

 

[QCkid]

We have had about 4 residents go to Texas over the last couple of years. The reason? It absolutely sucks everwhere else in the west right now. Texas is the farthest west you can go and start a practice or get a job and not have to work for Western Dental. In the past Arizona and Nevada were the states where everyone was going. Its just Texas turn to be overrun. In all seriousness though. We are graduating to many orthos. Their arent enough opportunities and thus we have the mass migration like lemming to whatever state their happens to be a few spots available. Texas will be oversaturated soon if it isnt already and then the next state will be Kansas or Nebraska. % years from now, all the states will be saturated and new grads will have to do dentistry instead.
Good thing I like general dentistry.

 

[S Files]

Over the past couple of years we've started receiving letters from residents all over the country saying something similar to, "I'm graduating in _____ and will be moving to Texas. Do you know of any opportunities?"

I've talked to the reps down here and they've noticed the same thing - everyone seems to think there are orthodontic patients coming out the nose in Texas.

Guess what...the metro areas in Texas are actually over-saturated with orthodontists.

You just need to know this coming in. If you're really interested in moving here because you love the area, etc. and just can't live anywhere else by all means come on down. You'll be accepted with open arms. But, if you just assume there are a ton of opportunities down here (at least in the metro areas) please do some research before moving your families across the country.

For the current residents...is this the perception out there? Do people really think Texas is plump full of patients without enough orthodontists to treat them?

I'd be interested to hear your thoughts.

THIS is the NEWSFLASH????.....ugh...
i think it's safe to say all over the country it's tough, EXCEPT for semi-rural and rural areas. Don't worry my friend, no one from my program is moving to TX.

 

[furcation]

We have had about 4 residents go to Texas over the last couple of years. The reason? It absolutely sucks everwhere else in the west right now. Texas is the farthest west you can go and start a practice or get a job and not have to work for Western Dental. In the past Arizona and Nevada were the states where everyone was going. Its just Texas turn to be overrun. In all seriousness though. We are graduating to many orthos. Their arent enough opportunities and thus we have the mass migration like lemming to whatever state their happens to be a few spots available. Texas will be oversaturated soon if it isnt already and then the next state will be Kansas or Nebraska. % years from now, all the states will be saturated and new grads will have to do dentistry instead.
Good thing I like general dentistry.

Hear hear... If the ADA and AAO approve one more ortho residency Im gonna cry...

 

[BlueToothHunter]

This is what I heard from many seasoned orthodontists on the reason why the ADA and AAO would continue to approve opening more orthodontic residencies: It is because the old retiring orthodontists need new orthodontic graduates to eventually buy them out.

Shortage of orthodontists? No. Access to orthodontists hampered? No.
Shortage of young orthodontists who needs to buy their old over-valued practices? Plenty.
In other words, the young orthodontists will eventually become THE retirement plan for some of the older orthodontists...

 

[furcation]

This is what I heard from many seasoned orthodontists on the reason why the ADA and AAO would continue to approve opening more orthodontic residencies: It is because the old retiring orthodontists need new orthodontic graduates to eventually buy them out.

Shortage of orthodontists? No. Access to orthodontists hampered? No.
Shortage of young orthodontists who needs to buy their old over-valued practices? Plenty.
In other words, the young orthodontists will eventually become THE retirement plan for some of the older orthodontists...

Where are these retiring dentists?? if you look at the ADA website, more orthodontists are coming out than retiring..

 

[QCkid]

This is what I heard from many seasoned orthodontists on the reason why the ADA and AAO would continue to approve opening more orthodontic residencies: It is because the old retiring orthodontists need new orthodontic graduates to eventually buy them out.

Shortage of orthodontists? No. Access to orthodontists hampered? No.
Shortage of young orthodontists who needs to buy their old over-valued practices? Plenty.
In other words, the young orthodontists will eventually become THE retirement plan for some of the older orthodontists...

I was at a seminar a few weeks ago and some consultant quoted an AAO statistic that said their were 1200 orthodontists looking for a job or a practice and only 177 positions or practices. The number of graduating residents greatly exceeds the number of retiring orthos.

 

[DrReo]

I was at a seminar a few weeks ago and some consultant quoted an AAO statistic that said their were 1200 orthodontists looking for a job or a practice and only 177 positions or practices. The number of graduating residents greatly exceeds the number of retiring orthos.

And do you think this alarming statistic will impact anyone applying for an ortho residency in the near future?

 

[furcation]

And do you think this alarming statistic will impact anyone applying for an ortho residency in the near future?

Its not like the programs are going to disappear, so I hope there is no negative impact.

 

[QCkid]

And do you think this alarming statistic will impact anyone applying for an ortho residency in the near future?

Dont patronize me. We all know it wont have any affect, but we need to get a hold on our profession. For that reason im hoping that in the future I can have an influence on the direction that we are going. Hopefully before its too late.

 

[280040]

My vote is that ortho will always be awesome for those who actually like it.

Some years it might just be kinda awesome that you get to charge money for something that is low risk to you, high reward for the patient and family, and has outstandingly positive impact for the majority of the patient's life.

And during the good years, you make a killing and get even more of the above.

1200 applicants with few openings....why on earth would an orthodontist hire another orthodontist?!?! The true applications of this employment model seem few and far between.

1200 seems awfully exaggerated though....the BLS shows 7700 orthos in US. 15% unemployed....

With new starts down as much as suggested, that has got to suck. No one likes to take a hit on their lifestyle.

Hang a shingle, get to work.

 

[QCkid]

My vote is that ortho will always be awesome for those who actually like it.

Some years it might just be kinda awesome that you get to charge money for something that is low risk to you, high reward for the patient and family, and has outstandingly positive impact for the majority of the patient's life.

And during the good years, you make a killing and get even more of the above.

1200 applicants with few openings....why on earth would an orthodontist hire another orthodontist?!?! The true applications of this employment model seem few and far between.

1200 seems awfully exaggerated though....the BLS shows 7700 orthos in US. 15% unemployed....

With new starts down as much as suggested, that has got to suck. No one likes to take a hit on their lifestyle.

Hang a shingle, get to work.

My post actually mentions jobs and practices not one or the other. Yes I know several orthodontists that do not have work right now. I also know several who are underemployed. I know that this statement is anecdotal but since you dont like my statistics what else is their.

Ortho is awesome. I dont know an orthodontist that doesnt love what he does and that includes me. At the same time, I want to be able to support my family. Dont think for a second that bad things cant happen to this profession, they are already happening. As distastefull as it is to compare ortho to law or chiropractic care, both of these professions used to be more lucrative with more solid prospects for work and making a good living. Both have been damaged significantly due to increases in the supply of professionals. This supply increased for the same reason that the supply of orthodontists is increasing. Their was a high demand for the education, and their were those with a desire to supply it. As a member of the profession, I think we have a vested interest in managing its future.

The hang the shingle and get to work days are long gone for ortho. If it were only that simple.

 

[280040]

My post actually mentions jobs and practices not one or the other. Yes I know several orthodontists that do not have work right now. I also know several who are underemployed. I know that this statement is anecdotal but since you dont like my statistics what else is their.

Ortho is awesome. I dont know an orthodontist that doesnt love what he does and that includes me. At the same time, I want to be able to support my family. Dont think for a second that bad things cant happen to this profession, they are already happening. As distastefull as it is to compare ortho to law or chiropractic care, both of these professions used to be more lucrative with more solid prospects for work and making a good living. Both have been damaged significantly due to increases in the supply of professionals. This supply increased for the same reason that the supply of orthodontists is increasing. Their was a high demand for the education, and their were those with a desire to supply it. As a member of the profession, I think we have a vested interest in managing its future.

The hang the shingle and get to work days are long gone for ortho. If it were only that simple.

Haha. Don't you dare compare yourself to chiro. Youre a dds/dmd so that already puts you ahead of them. and on top of that you are likely hard working and intelligent due to the simple requirements needed for admission into ortho.

But how can you NOT just hang a shingle with an assistant a front desk and build from there? Ortho fees are just too high for an office to go bankrupt. Perhaps the personal life and lifestyle can cause it. It only takes a few starts to pay your non-discretionary bills. I just don't buy it. Is there a sense of entitlement after college, dschool, ortho at play here? The sense of finally arriving only to find out the hardest work of all has just begun?

I still feel for ya. I'm about to graduate and entering residency and I bet I'd feel the same.

Ortho is still great. I am heading into oms but hang around ortho enough via surgical cases and the patients are just soooo happy with the outcomes. That is just too cool. And they pay you for that.

The argument that ortho did it to themselves is worthless also. If the new wires, bonding techniques, assistant executed adjustments/changes, invisalign, new techniques, new brackets didn't happen, I bet you wouldn't be as interested. If ortho was still at the level of treatment evolution of banding every tooth old school I bet it wouldn't be as interesting to most applicants. If you actually had to do what most ortho assistants do, there would be less interest. If the new modalities with anchorage didn't exist, less interest. The profession is growing with so many neat things and I have only been exposed to the tip of what is available.

The increadible profit oriented ortho programs I believe will be the source of downfall, if there ever is one. The number of grads they produce isn't that significant is it? It's more worse that they are sometimes unaffiliated with dental schools or major universities. Where is the treatment collaboration or research opportunities or the simple commeradery I have come to enjoy with my dental friends? Go fight em!! After all, I hear you and 1200 smart professionals have time on their hands.

America just has less discretionary $$$ right now. Ortho is under that. And if it wasn't elective, you'd be less interested in it also because you'd get $500 for all your hard work!!

 

[Guy Smiley]

Haha. Don't you dare compare yourself to chiro. Youre a dds/dmd so that already puts you ahead of them. and on top of that you are likely hard working and intelligent due to the simple requirements needed for admission into ortho.

But how can you NOT just hang a shingle with an assistant a front desk and build from there? Ortho fees are just too high for an office to go bankrupt. Perhaps the personal life and lifestyle can cause it. It only takes a few starts to pay your non-discretionary bills. I just don't buy it. Is there a sense of entitlement after college, dschool, ortho at play here? The sense of finally arriving only to find out the hardest work of all has just begun?

I still feel for ya. I'm about to graduate and entering residency and I bet I'd feel the same.

Ortho is still great. I am heading into oms but hang around ortho enough via surgical cases and the patients are just soooo happy with the outcomes. That is just too cool. And they pay you for that.

The argument that ortho did it to themselves is worthless also. If the new wires, bonding techniques, assistant executed adjustments/changes, invisalign, new techniques, new brackets didn't happen, I bet you wouldn't be as interested. If ortho was still at the level of treatment evolution of banding every tooth old school I bet it wouldn't be as interesting to most applicants. If you actually had to do what most ortho assistants do, there would be less interest. If the new modalities with anchorage didn't exist, less interest. The profession is growing with so many neat things and I have only been exposed to the tip of what is available.

The increadible profit oriented ortho programs I believe will be the source of downfall, if there ever is one. The number of grads they produce isn't that significant is it? It's more worse that they are sometimes unaffiliated with dental schools or major universities. Where is the treatment collaboration or research opportunities or the simple commeradery I have come to enjoy with my dental friends? Go fight em!! After all, I hear you and 1200 smart professionals have time on their hands.

America just has less discretionary $$$ right now. Ortho is under that. And if it wasn't elective, you'd be less interested in it also because you'd get $500 for all your hard work!!

I would argue that adding 50+ new residents each year is a significant increase. If there were suddenly 3 new OMFS programs that churned out 16 new surgeons per year each once they got going, wouldn't you consider that significant?

 

[OG1]

The argument that ortho did it to themselves is worthless also. If the new wires, bonding techniques, assistant executed adjustments/changes, invisalign, new techniques, new brackets didn't happen, I bet you wouldn't be as interested. If ortho was still at the level of treatment evolution of banding every tooth old school I bet it wouldn't be as interesting to most applicants. If you actually had to do what most ortho assistants do, there would be less interest. If the new modalities with anchorage didn't exist, less interest. The profession is growing with so many neat things and I have only been exposed to the tip of what is available.

Worthless? That's a little harsh, don't you think? Sure, some of the techniques make ortho more appealing, mostly direct bonding and NiTi wires. It's still a two-edged sword. You don't need as many orthodontists to do as much work as was done before. This is compounded by the huge increase in orthodontists that Guy Smiley mentioned. In the end it's a bunch of issues combining to make things tough for graduating residents, with the economy and increase in residents being the two biggest issues.

There are a lot of current residents legitimately worried because dental and ortho school tuition has increased astronomically, student loans are larger than ever before, associateships and transitions aren't available, and it's a very tough market to be opening a start-up in. I'm not a rich orthodontist taking a hit to my lifestyle; I'm a guy concerned about paying for my loans, supporting my family, and especially concerned about the current trends in orthodontics deteriorating the profession.

 

[280040]

Worthless? That's a little harsh, don't you think?

Yes. My apologies.

Orthos are top of their class, they'll figure this out.

 

[Texas Ortho]

http://www.aftco.net/Dental-Transitions-Resources/Dentistics.aspx

 

[KlingonDentist]

http://www.aftco.net/Dental-Transitions-Resources/Dentistics.aspx

Seems like everywhere you look there are more orthodontists than any other single specialty.

 

[QCkid]

Haha. Don't you dare compare yourself to chiro. Youre a dds/dmd so that already puts you ahead of them. and on top of that you are likely hard working and intelligent due to the simple requirements needed for admission into ortho.

But how can you NOT just hang a shingle with an assistant a front desk and build from there? Ortho fees are just too high for an office to go bankrupt. Perhaps the personal life and lifestyle can cause it. It only takes a few starts to pay your non-discretionary bills. I just don't buy it. Is there a sense of entitlement after college, dschool, ortho at play here? The sense of finally arriving only to find out the hardest work of all has just begun?

I still feel for ya. I'm about to graduate and entering residency and I bet I'd feel the same.

Ortho is still great. I am heading into oms but hang around ortho enough via surgical cases and the patients are just soooo happy with the outcomes. That is just too cool. And they pay you for that.

The argument that ortho did it to themselves is worthless also. If the new wires, bonding techniques, assistant executed adjustments/changes, invisalign, new techniques, new brackets didn't happen, I bet you wouldn't be as interested. If ortho was still at the level of treatment evolution of banding every tooth old school I bet it wouldn't be as interesting to most applicants. If you actually had to do what most ortho assistants do, there would be less interest. If the new modalities with anchorage didn't exist, less interest. The profession is growing with so many neat things and I have only been exposed to the tip of what is available.

The increadible profit oriented ortho programs I believe will be the source of downfall, if there ever is one. The number of grads they produce isn't that significant is it? It's more worse that they are sometimes unaffiliated with dental schools or major universities. Where is the treatment collaboration or research opportunities or the simple commeradery I have come to enjoy with my dental friends? Go fight em!! After all, I hear you and 1200 smart professionals have time on their hands.

America just has less discretionary $$$ right now. Ortho is under that. And if it wasn't elective, you'd be less interested in it also because you'd get $500 for all your hard work!!

You assume too much about me. Since you dont know me, I wont take it personally. However, your lack of knowledge concerning ortho and its prospects is lacking........and thats ok. You have other things to worry about. We as orthodontist are obviously concerned. That concern also extends to orthodontists that are already established. Many have voiced concerns about the same things that we have been talking about here. Part of the problem though is that they are too busy (and sometimes lack awareness) and happy doing what they are doing right now to get involved and have a say in the future of the profession. That is why we need to get involved. Im not talking about a fulltime job as an ortho politician. Simply showing up at state and local meetings, voicing concerns, and helping to awaken some of these older guys to the problems will go a long way. The older guys quite frankly often live in a little world of their own making and dont pay as much attention as they should. They are also lees concerned because they rightly assume that the impacts on themselves wont be as great as they are on us.

 

[BlueToothHunter]

Any recent orthodontic grads found a quality practice for full time associateship? Out in California especially, it's pretty gloomy. Overall, all of the existing practices are down 30 to 40%. More GPs are doing in-house ortho and there is a glut of orthodontists with golden parachute trying to squeeze in between corporate and their "1 day a week" private practice. The practice loan and the practice expenses don't suddenly melt away, and there are cases of dentists/orthodontists literally giving away their newly built offices in Orange County because it's just too much to sustain an office. Bad business decisions definitely played a major part, but seriously, I think it's time to leave! What do y'all think?

 

[omaralt]

unless you cannot leave southern cali or NYC, i would get the hell out of there and have a much better income/quality of life elsewhere. just my honest opinion