OMFS is really just OS

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
What does the rest of your practice do? The Or every 1-2 weeks sounds like the ideal setup

If it is a group practice then the ideal situation is there are doctors in the office while you are at the OR in the hospital. That way there is someone at the office doing work and making money for the practice while you do surgery at the hospital
 
What does the rest of your practice do? The Or every 1-2 weeks sounds like the ideal setup
3 offices…3 surgeons…2 go to OR and the other surgeon is business as normal. It’s a nice break from the monotony of 3rds and the hoops ortho likes to put me through.

It’s not as lucrative as a double digit 3rds day…but we put it on our least busy weekday and triple-jaws and bilateral TMJ still reimburse ~$20k so it’s not like community service. Doing those big surgeries when others won’t also secures you referrals from ortho and GPs. But most importantly…it’s fun and i don’t have to feel like i wasted 6 years of my life.
 
3 offices…3 surgeons…2 go to OR and the other surgeon is business as normal. It’s a nice break from the monotony of 3rds and the hoops ortho likes to put me through.

It’s not as lucrative as a double digit 3rds day…but we put it on our least busy weekday and triple-jaws and bilateral TMJ still reimburse ~$20k so it’s not like community service. Doing those big surgeries when others won’t also secures you referrals from ortho and GPs. But most importantly…it’s fun and i don’t have to feel like i wasted 6 years of my life.
I may be wrong but if I remember correctly wasn’t it 9 years of your life after D school?
 
I had a OMFS/Perio guy tell me once he didn't think it was worth it to specialize in surgery with the ability to do so much as a GP in the US, but I would probably say for people who only want to do surgery it's the way to go.
 
3 offices…3 surgeons…2 go to OR and the other surgeon is business as normal. It’s a nice break from the monotony of 3rds and the hoops ortho likes to put me through.

It’s not as lucrative as a double digit 3rds day…but we put it on our least busy weekday and triple-jaws and bilateral TMJ still reimburse ~$20k so it’s not like community service. Doing those big surgeries when others won’t also secures you referrals from ortho and GPs. But most importantly…it’s fun and i don’t have to feel like i wasted 6 years of my life.
Agreed



Some different perspectives

 
I've had two surgeons tell me to really consider if OMFS is worth it for me since a lot of the private practice stuff is dentoalveolar. One surgeon told me he made more money from his general dentistry offices he owned than the surgery he did. It really makes you think
 
I've had two surgeons tell me to really consider if OMFS is worth it for me since a lot of the private practice stuff is mainly dentoalveolar. One surgeon told me he made more money from his general dentistry offices he owned than the surgery he did. It really makes you think
 
I've had two surgeons tell me to really consider if OMFS is worth it for me since a lot of the private practice stuff is dentoalveolar. One surgeon told me he made more money from his general dentistry offices he owned than the surgery he did. It really makes you think
Why even go into dentistry then? My friends dad makes a killing with his chain of 7/11’s.
 
I've had two surgeons tell me to really consider if OMFS is worth it for me since a lot of the private practice stuff is dentoalveolar. One surgeon told me he made more money from his general dentistry offices he owned than the surgery he did. It really makes you think
You should consider investment banking then. Or consulting. Or making viral videos.
All are way easier to do then OS
 
You should consider investment banking then. Or consulting. Or making viral videos.
All are way easier to do then OS
He said if I was really passionate about it to do it. The problem is, if I end up just extracting teeth and sedating, am I really doing what I set out to do when I signed up to be an Oral and MAXILLOFACIAL surgeon? I don't have answers to these questions
 
He said if I was really passionate about it to do it. The problem is, if I end up just extracting teeth and sedating, am I really doing what I set out to do when I signed up to be an Oral and MAXILLOFACIAL surgeon? I don't have answers to these questions
I mean nobody is forcing you to only extract teeth and sedate. Whether or not the OR stuff is worth the headache is another story, but there's nothing stopping you from doing the occasional mandible fracture or orthognathic case. It's not like hospital OMFS are homeless or something lol. Also GP dentoalveolar =/= OMFS dentoalveolar. GPs are not gonna do Caldwell-Lucs, full bony impactions, cyst enucleation, calvarial/hip grafts, and so on so forth.
 
I mean nobody is forcing you to only extract teeth and sedate. Whether or not the OR stuff is worth the headache is another story, but there's nothing stopping you from doing the occasional mandible fracture or orthognathic case. It's not like hospital OMFS are homeless or something lol. Also GP dentoalveolar =/= OMFS dentoalveolar. GPs are not gonna do Caldwell-Lucs, full bony impactions, cyst enucleation, calvarial/hip grafts, and so on so forth.
Plenty of GPs do full bony’s. Many of them have lots of additional training and CBCT’s. However they are limited by sedation level. But there plenty of excellent GP Exodontists. In fact, the military used to have a 1 year training track in just exodontia , so the OMFS actually do surgeries.

Plenty of GP’s are doing lateral lifts too. Enucleations are done too, depending on location and complexity. I will agree though that I have yet to meet a GP that does. Harvesting/Autologous grafts.

The benefit of being a GP is when doing a FMR is doing the extractions, grafting, implant placement, AND the restorative.
 
I decided not to do OMS because it wasn't for me. I did a lot of shadowing at my DS department, took the CBSE, and did externships. My impression was that the procedures that were most critical were the removal of teeth/pus, biopsy, implant placement in the edentulous, and trauma. However, I was disappointed that the bigger OR cases were often elective and had questionable therapeutic value. I couldn't see myself performing those big cases on patients because of the risk associated with surgery, and the healing that is necessary, VS the questionable therapeutic benefit.
To contrast, I can easily see how a cardiac surgeon justifies TAVR, but the issues that most OS treat are not age related and don't involve organs like the heart. The case volume for life saving/extending surgery just isn't there in OMS unless you go the path less traveled, and less available, like a cancer academic career. To me the 4-6 years of extra training didn't justify itself. I am happy with my career decision and do a lot of tooth removal and implant placement in my general practice. This is a bigger discussion, but I think there is a movement in healthcare towards doing what you're competent in rather than what "turf" your specialty claims. That's especially true in dentistry because we're in an outpatient environment.
Very curious as to what procedures are deemed too have little to no therapeutic value? And technically almost all cases are elective unless life threatening. Does that mean they do not have value?
 
Plenty of GPs do full bony’s. Many of them have lots of additional training and CBCT’s. However they are limited by sedation level. But there plenty of excellent GP Exodontists. In fact, the military used to have a 1 year training track in just exodontia , so the OMFS actually do surgeries.

Plenty of GP’s are doing lateral lifts too. Enucleations are done too, depending on location and complexity. I will agree though that I have yet to meet a GP that does. Harvesting/Autologous grafts.

The benefit of being a GP is when doing a FMR is doing the extractions, grafting, implant placement, AND the restorative.
Talking about mostly outliers here. No corp or group practice will allow its GPs to do cyst enucleations, full bony impacted wizzies sitting on the IAN, or full arch implant cases with or without zygomatic/pterygoid/transnasal implants. A GP simply cannot justify having a CBCT or even a pano in their office bc the volume simply isn't there. How many times will you use a CBCT when the bulk of your practice consists of hygiene checks, restorations, dentures, and etc? Sure, you can do whatever the hell you want as a GP in your own office, but thats the case with any physician/dentist that runs a private practice. Doesn't make it right though.

There are OMFS in the country who are trained to resect thyroid and parathyroid tumors, and do full body cosmetic surgery like breast augmentations and BBLs. And they do them regularly as well. Doesn't mean these procedures fall under the traditional/reasonable scope of practice of an OMFS.

But all aside, glad that you seem to be making a killing in your practice!
 
Talking about mostly outliers here. No corp or group practice will allow its GPs to do cyst enucleations, full bony impacted wizzies sitting on the IAN, or full arch implant cases with or without zygomatic/pterygoid/transnasal implants. A GP simply cannot justify having a CBCT or even a pano in their office bc the volume simply isn't there. How many times will you use a CBCT when the bulk of your practice consists of hygiene checks, restorations, dentures, and etc? Sure, you can do whatever the hell you want as a GP in your own office, but thats the case with any physician/dentist that runs a private practice. Doesn't make it right though.

There are OMFS in the country who are trained to resect thyroid and parathyroid tumors, and do full body cosmetic surgery like breast augmentations and BBLs. And they do them regularly as well. Doesn't mean these procedures fall under the traditional/reasonable scope of practice of an OMFS.

But all aside, glad that you seem to be making a killing in your practice!
My corp group actually has a traveling GP “exodontist” that travels from office to office doing IV sedation and he also does full bony 3rds. He comes to my office once a month to do my cases. My former co-worker also did full bony 3rds as a GP. I think it’s more common than you think.
 
My corp group actually has a traveling GP “exodontist” that travels from office to office doing IV sedation and he also does full bony 3rds. He comes to my office once a month to do my cases. My former co-worker also did full bony 3rds as a GP. I think it’s more common than you think.
A GP doing IV sedations in offices that aren't set-up for anesthesia? Seems like that dude is playing with fire. Most of my GP colleagues say that limiting their practice to dentoalveolar surgery is not the best idea for several reasons, including high malpractice insurance costs, lower reimbursement rates for non-specialists, trouble getting the referrals, liability, speed, not knowing how to manage the surgical complications, and etc. But hey if you can pull it off, nobody is stopping you from doing it. Your patients will certainly be happier
 
A GP doing IV sedations in offices that aren't set-up for anesthesia? Seems like that dude is playing with fire. Most of my GP colleagues say that limiting their practice to dentoalveolar surgery is not the best idea for several reasons, including high malpractice insurance costs, lower reimbursement rates for non-specialists, trouble getting the referrals, liability, speed, and etc.
He brings alot of his own equipment and instruments to our office. Pretty sure dental anesthesiologists operate in a similar fashion. I don’t think he has issues keeping a full schedule since our corp has so many offices. He’s always busy. If the the scheduled production for the office isn’t high enough he doesn’t even bother coming that day.

Looking at his production at my office alone it’s kinda crazy.
 
Talking about mostly outliers here. No corp or group practice will allow its GPs to do cyst enucleations, full bony impacted wizzies sitting on the IAN, or full arch implant cases with or without zygomatic/pterygoid/transnasal implants. A GP simply cannot justify having a CBCT or even a pano in their office bc the volume simply isn't there. How many times will you use a CBCT when the bulk of your practice consists of hygiene checks, restorations, dentures, and etc? Sure, you can do whatever the hell you want as a GP in your own office, but thats the case with any physician/dentist that runs a private practice. Doesn't make it right though.

There are OMFS in the country who are trained to resect thyroid and parathyroid tumors, and do full body cosmetic surgery like breast augmentations and BBLs. And they do them regularly as well. Doesn't mean these procedures fall under the traditional/reasonable scope of practice of an OMFS.

But all aside, glad that you seem to be making a killing in your practice!
Hey! Good to hear from you! Hope all is well.

I use CBCT very frequently. The bulk of my practice is crown/bridge/endo/ext. I’m not placing implants right now but I still take the diagnostic cone beams and do the restorative treatment planning for the Perio. I use it very frequently for endo. There are a lot of canals and bifurcations I would have missed otherwise. Obviously if it is a single canal second premolar I don’t bother. But for some molars, and especially lower centrals which can be deceptive on a PA, I like to do a small FOV scan.

I do extract thirds and I check to see their proximity to the nerve. If they are full bony horizontally impacted, or if they are way up in the sinus I send them to OS to avoid OAC. I would like to think I know my limits.

I do more than just fillings but I still refer plenty of cases to people who have far more training in procedures I am not prepared to address. Plenty of dentistry to go around.
 
Talking about mostly outliers here. No corp or group practice will allow its GPs to do cyst enucleations, full bony impacted wizzies sitting on the IAN, or full arch implant cases with or without zygomatic/pterygoid/transnasal implants. A GP simply cannot justify having a CBCT or even a pano in their office bc the volume simply isn't there. How many times will you use a CBCT when the bulk of your practice consists of hygiene checks, restorations, dentures, and etc? Sure, you can do whatever the hell you want as a GP in your own office, but thats the case with any physician/dentist that runs a private practice. Doesn't make it right though.

There are OMFS in the country who are trained to resect thyroid and parathyroid tumors, and do full body cosmetic surgery like breast augmentations and BBLs. And they do them regularly as well. Doesn't mean these procedures fall under the traditional/reasonable scope of practice of an OMFS.

But all aside, glad that you seem to be making a killing in your practice!
I would say the majority of GP offices have panos and many have CBCTs as well now for more complex endo, implants, and extractions
 
Top