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whosnisarg

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Hey, guys!

It's a bit early for me but I'm very curious... How is the job market right NOW for a full-time OMFS? Where are most of these jobs (location and private-practice/universities)? What is the estimated job growth in ten years for OMFS? I've been hearing/reading that the job market for orthopedics is pretty stale lately...

I was just wondering if from a strictly financial standpoint it is worth it (not to say it isn't a super interesting specialty to me already from my shadowing of a local OMFS), especially after racking up a higher-than-average debt from the extra two years of MD education (I know it isn't necessary) and long, low-pay residency.

Again, not ripping on anyone pursuing this route as I myself would love to someday do this, strictly curious!

I'd love to hear all of your input on this!
 

yappy

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I have not researched it too much but this is my take on the situation. There are increasing inroads are being made into lucrative areas of OMS (extractions and implants) by perio, prosth, and general dentistry. I think on average they will continue to earn high wages but it may not be as easy in the future as it was in the past.
For this reason I would only pursue OMS if you really want to be a surgeon. You must be okay with doing procedures on patients that generalists dont want to do or cannot do. If you choose to do full scope then also be ready to perform high risk surgeries for relatively low compensation.
 

whosnisarg

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Sep 21, 2017
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I have not researched it too much but this is my take on the situation. There are increasing inroads are being made into lucrative areas of OMS (extractions and implants) by perio, prosth, and general dentistry. I think on average they will continue to earn high wages but it may not be as easy in the future as it was in the past.
For this reason I would only pursue OMS if you really want to be a surgeon. You must be okay with doing procedures on patients that generalists dont want to do or cannot do. If you choose to do full scope then also be ready to perform high risk surgeries for relatively low compensation.
Hmm... lot to consider, thank you for your reply! While the surgery aspect is super interesting to me, this might just be something that I'd have to wait and see about.

Is it possible to get a job in a hospital as an OMFS or only in private/group practices?
 
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Medin2017

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Hmm... lot to consider, thank you for your reply! While the surgery aspect is super interesting to me, this might just be something that I'd have to wait and see about.

Is it possible to get a job in a hospital as an OMFS or only in private/group practices?
Dont think others really do impacted thirds. And if choosing based on the future, dental income has gone down in the past like 5-10 years while saturation is going up. Not to mention omfs avg income rose during this time (despite what people say about enroachment from other specialties). And if you look around online, job offers are in the 3-500k ranges from the getgo not including partnerships. Until I see a bunch of omfs come on here crying about the future like orthos and general dentists do, I'd stick with going for it. From the posts I've read by them in like 2013-2015 when there were more active ones, they all seemed to think the future was fine. I've yet to see an omfs say it's going bad-just general dentists and maybe like 1 ortho
 

whosnisarg

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Sep 21, 2017
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Dont think others really do impacted thirds. And if choosing based on the future, dental income has gone down in the past like 5-10 years while saturation is going up. Not to mention omfs avg income rose during this time (despite what people say about enroachment from other specialties). And if you look around online, job offers are in the 3-500k ranges from the getgo not including partnerships. Until I see a bunch of omfs come on here crying about the future like orthos and general dentists do, I'd stick with going for it. From the posts I've read by them in like 2013-2015 when there were more active ones, they all seemed to think the future was fine. I've yet to see an omfs say it's going bad-just general dentists and maybe like 1 ortho
Wow, thank you for the vote of confidence Medin2017... Really calmed my nerves!
 

Medin2017

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Wow, thank you for the vote of confidence Medin2017... Really calmed my nerves!
I'm obviously biased but if the sky is falling for omfs then general dentistry will be even worse. I only look at trends for the most part. Also seeing general dentists say they wish they studied harder on school bc they realized they liked a specialty or saw an omfs killing it is motivation too.
 

Medin2017

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Wow, thank you for the vote of confidence Medin2017... Really calmed my nerves!
forums.studentdoctor.net/threads/why-is-oral-surgery-so-competitive-i-dont-understand.1184872/
A 2016 post about omfs with a buttload of omfs and residents chiming in. Many saying it's pretty sweet. Only an Ortho is saying it might not be (idk what it is about orthos saying omfs is tough but their field is having it 5* worse than peds or omfs or even general dentistry based on trends).
 
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kingme23

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Dec 21, 2011
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Dont think others really do impacted thirds. And if choosing based on the future, dental income has gone down in the past like 5-10 years while saturation is going up. Not to mention omfs avg income rose during this time (despite what people say about enroachment from other specialties). And if you look around online, job offers are in the 3-500k ranges from the getgo not including partnerships. Until I see a bunch of omfs come on here crying about the future like orthos and general dentists do, I'd stick with going for it. From the posts I've read by them in like 2013-2015 when there were more active ones, they all seemed to think the future was fine. I've yet to see an omfs say it's going bad-just general dentists and maybe like 1 ortho
The Future of Private Practice OMFS in My Opinion

OMFS

OMS is great for sure, if you really like the work they do on a daily basis. However don’t fool yourself into thinking that you’ll have it easy Peezy as an OMS. I’d argue it’s probably harder to establish yourself as an OMS than a GP. Just because you finished your residency and got certified as an OMS doesn’t mean people are going to refer to you when there are other surgeons in their area that they have probably known much longer and trust more than you. You won’t find as many OMS complaining about their field because it’s a numbers game..there are probably less than 5 active posters on this forum that are surgeons while the vast majority are GPs (same on DT). Of course you’re going to hear more people complaining about general dentistry.
 

kingme23

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Dec 21, 2011
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Are most OMFS jobs private practice? Do hospitals hire OMFS?
Are you in dental school, or near one? I would ask to shadow and speak with the OMFS faculty at your nearest dental school, they would probably be happy to meet and answer any of your questions.

Yes in terms of sheer numbers, most of them are in private practice. The residency is done in a hospital, so yes they can work in hospitals as well. Some are full time in the hospital (in an academic setting), some work on an as-needed basis in their local hospitals in addition to working in private practice or working with dental students.
 

whosnisarg

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I would ask to shadow and speak with the OMFS faculty at your nearest dental school, they would probably be happy to meet and answer any of your questions.
Thank you for the reply, kingme23! I am shadowing a local OMFS this summer, I'm just too eager to learn about all of this! :)
And yes, just as a job outlook, I was curious to know whether they work in a hospital setting. Hospital OMFS don't deal with the dental aspect as much, right? Mostly facial trauma and all?
 

kingme23

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Dec 21, 2011
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Thank you for the reply, kingme23! I am shadowing a local OMFS this summer, I'm just too eager to learn about all of this! :)
And yes, just as a job outlook, I was curious to know whether they work in a hospital setting. Hospital OMFS don't deal with the dental aspect as much, right? Mostly facial trauma and all?
From everything I've seen they don't do as much teeth...but still a good amount. Whether it's taking out teeth during a surgery or placing implants into a reconstructed jaw. A lot of the ones I know also supplement their work at the hospital with a faculty practice which is basically a private practice where they see dental patients.
 

Medin2017

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The Future of Private Practice OMFS in My Opinion

OMFS

OMS is great for sure, if you really like the work they do on a daily basis. However don’t fool yourself into thinking that you’ll have it easy Peezy as an OMS. I’d argue it’s probably harder to establish yourself as an OMS than a GP. Just because you finished your residency and got certified as an OMS doesn’t mean people are going to refer to you when there are other surgeons in their area that they have probably known much longer and trust more than you. You won’t find as many OMS complaining about their field because it’s a numbers game..there are probably less than 5 active posters on this forum that are surgeons while the vast majority are GPs (same on DT). Of course you’re going to hear more people complaining about general dentistry.
Only your first link is relevant. The second post is something that seems pretty cool to me (and I believe reimburses exceptionally well from what I've read).
 
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Munks

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OMFS will be fine. While they are pressed by perios and young GPs (as are all specialties nowadays), ultimately once life gets cushy for the others, many will cut out the higher risk procedures such as sedation and third molar extractions, or instead hire you to work in their office. Also with all the corporate offices now, I would say starting a job is not terribly difficult for an OS, though your ethical limits will be tested and the competition may lead to difficulty starting your own practice later on. AAOMS or the specialty in general has done a great job so far in limiting the amount of specialists in the field (compared to the huge increase in residency spots in pedo & ortho in the past ~5-10yrs), so there is not a huge saturation in OS like in ortho or peds. Now is it worth the extra effort of schooling and pain in the ass residency is up to you - but I would say it is worth it.
 
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786783

OMFS will be fine. While they are pressed by perios and young GPs (as are all specialties nowadays), ultimately once life gets cushy for the others, many will cut out the higher risk procedures such as sedation and third molar extractions, or instead hire you to work in their office. Also with all the corporate offices now, I would say starting a job is not terribly difficult for an OS, though your ethical limits will be tested and the competition may lead to difficulty starting your own practice later on. AAOMS or the specialty in general has done a great job so far in limiting the amount of specialists in the field (compared to the huge increase in residency spots in pedo & ortho in the past ~5-10yrs), so there is not a huge influx of supply on the side of OS. Now is it worth the extra effort of schooling and pain in the ass residency is up to you - but I would say it is worth it.
Are you close friends with Oral Surgeons? Is this a common sentiment amongst your OS colleagues or just an educated guess? I’ve talked to a few and all they do is complain.
 
7

786783

Care to share their complaints (if you know any specifically)?
Laughably low reimbursement rates (and it’s only going to get worse,) other clinicians doing oral surgery horribly and then referring the mess to the surgeons, corporate dentistry keeps on growing ultimately increasing treatment risks due to a system that encentivizes questionable ethics (as Munks points out.) Last point is true for all specialties, but risks for complications are higher for surgeons by a large margin.
 

PhansterZ

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The market is getting saturated, but not to the level of other specialties in dentistry.
It's very hard to set up practice in a metro area these days due to the huge amount of loans residents are graduating with, the footprint (referrals) already established by existing oral surgeon(s), and internal referrals from the corporates.

If you go the private practice route, you either go into a group practice, associate a couple of years, and then partner or you can work for the chains. The corporate chains are always looking for oral surgeons, and they will keep you busy and well paid (think 1 million+). You'll just be driving to different offices every day and doing a ton of dentoalveolars (wizzies and implants). Many older surgeons frown upon this because there is no continual care for these patients since it's very hard to pinpoint exactly where you are when things go wrong (and things go wrong a lot more than in general dentistry).

Depending on the OMFS program you enter to, you will be taught to perform complex facial trauma, orthognatic surgery, benign pathology, dentoalveolar, etc. But the reimbursements for everything but dentoalveolar is extremely low, with way higher risk. If you work in a group practice, they may share call trauma call with you, so you don't lose the skills you learned during residency. Doing trauma is pretty much charity, staying up all night fixing a face, and will be dead tired the next day to work. But, this your chance to back up your "I want to help people" statement during your dental school interview. With corporate, it would be very rare for them to give you time do anything else but dentoalveolar.

If you want to do all the cool cases you did during residency, then working as faculty is the perfect job for you. The residents do all the work up, so you just come for the surgery. The pay is pretty decent too, with jobs starting at 250-300k. It's just a very slow climb in terms of compensation. In private practice, you may start at 250k out of school, but it climbs exponentially once you partner. Or like I said earlier, sell your soul so you can pay back your insane loans and work for the chains for 1 million+.
 
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Munks

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Are you close friends with Oral Surgeons? Is this a common sentiment amongst your OS colleagues or just an educated guess? I’ve talked to a few and all they do is complain.
I mean, everyone complains, that's just the nature of people :p. I am close friends with oral surgeons through dental school and practice, both in corporate and private settings, and now in my ortho residency have OS colleagues a door away as well. Even in my state of CA, OS appears to be the least worst off compared to all the specialties.

GPs botching surgery? That's what GPs do; that's why specialists exist. A patient's nerve gets f'd up, someone gets sued whether they deserve it or not, and they stop taking out thirds. Now it's definitely not an argument for this forum if an OS could have done better (and even any OS will say you do enough and you will get paresthesia or other complications), but for an OS doing this day in and day out, even if it does happen, it's one of the risks well explained ahead of time. And it's a risk that often GPs are not willing to take after it happens the first time.

It is my opinion that more 'super-GPs' are becoming more prevalent with today's student debt, but this is seen for every field. For ortho, it's Invisalign, which was a HUGE killer. For endo, talk to RoseEndo and she'll tell ya how she sees retreats all day now compared to the old days of ez single anteriors or the like. BUT, with surgery, the complications are generally on the higher end and is far more of a risk-reward scenario than with the other specialties. Pedo is similar to this - sure GPs can see good kids, but hell no are they doing sedations or seeing hospital cases.. it's just not worth the time. And corporate, like I said, is a double edged sword.. more associate job availability and speed of income, but questionable ethics (no continuity of care like PhansterZ said, no post-op followups, triple booking sedations, etc) in a field with high risks is just playing with fire.
 
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321931

+1 to the lucrative drive to every practice specialist thing. But for every 1 mil earner there was 10 others that just made the average 250...350k.

It’s good to look at the averages of things rather then the outliers.

I do think omfs is a more protected field but it’s not for everyone. The amount invested is equivalent to medical school.... and frankly most people that went into dentistry went into it for “less schooling, and better lifestyle” then their md counterparts. I would argue that omfs is same amount of schooling and same lifestyle as a specialized MD ... which sorta defeats the whole “I want to go the less schooling and less liability dental route.”

The oral surgeons I know are definately different people and know they want this. Very intelligent but are definately “surgeons” in their demeanor.
 
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kingme23

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+1 to the lucrative drive to every practice specialist thing. But for every 1 mil earner there was 10 others that just made the average 250...350k.

It’s good to look at the averages of things rather then the outliers.

I do think omfs is a more protected field but it’s not for everyone. The amount invested is equivalent to medical school.... and frankly most people that went into dentistry went into it for “less schooling, and better lifestyle” then their md counterparts. I would argue that omfs is same amount of schooling and same lifestyle as a specialized MD ... which sorta defeats the whole “I want to go the less schooling and less liability dental route.”

The oral surgeons I know are definately different people and know they want this. Very intelligent but are definately “surgeons” in their demeanor.
After hearing all the stories from the surgeons on this forum, I'm not so sure they're outliers. All of them have said those huge numbers are within reach, if they're willing to put up with the constant driving and push ethics to the side a bit. Especially with Aspen, I haven't heard about the situation with other corporations.

I agree OMFS is for all intents and purposes a medical residency...sad to see how most of the skills becomes irrelevant once they start working in private practice.
 
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Medin2017

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After hearing all the stories from the surgeons on this forum, I'm not so sure they're outliers. All of them have said those huge numbers are within reach, if they're willing to put up with the constant driving and push ethics to the side a bit. Especially with Aspen, I haven't heard about the situation with other corporations.

I agree OMFS is for all intents and purposes a medical residency...sad to see how most of the skills becomes irrelevant once they start working in private practice.
Yea and it's ironic he's saying that considering he often uses himself as an example of not choosing a specialty based on income when most of his classmates are making a pathetic <180 a few years out of school.

And if he wants us to look at averages, Ada is at 460 for omfs which is as about as high as orthopaedic surgeon but with better hours. I'll take it! Beats derm, plastics, cardiologists, what's not to like?
 
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IHO

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+1 to the lucrative drive to every practice specialist thing. But for every 1 mil earner there was 10 others that just made the average 250...350k.

It’s good to look at the averages of things rather then the outliers.

I do think omfs is a more protected field but it’s not for everyone. The amount invested is equivalent to medical school.... and frankly most people that went into dentistry went into it for “less schooling, and better lifestyle” then their md counterparts. I would argue that omfs is same amount of schooling and same lifestyle as a specialized MD ... which sorta defeats the whole “I want to go the less schooling and less liability dental route.”

The oral surgeons I know are definately different people and know they want this. Very intelligent but are definately “surgeons” in their demeanor.
same amount of schooling, yes. Same lifelstyle as specialized MD...hell no. Not even close....about half the hours and 2x-4x the vacation.

Iggy
 
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321931

Wow 400k. I actually didn’t know that. That’s pretty legit and I just looked it up on ada. I guess I was misinformed. Thanks for teaching me something new today :)
 
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Medin2017

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Wow 400k. I actually didn’t know that. That’s pretty legit and I just looked it up on ada. I guess I was misinformed. Thanks for teaching me something new today :)
Yea it seems awesome if I make it. Honestly I would be definitely happy going into general too but the prospects just don't seem nearly as good at the moment. And with my academics, I have a much higher chance of succeeding by putting the effort in now and trying to go into OMFS over the much higher risk (from a statistics standpoint) and on average lower reward of general dentistry.

I've got friends with parents as dentists or people they know who would hire them for 150+ 4 days a week, and that must be pretty sick too.
 

Medin2017

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same amount of schooling, yes. Same lifelstyle as specialized MD...hell no. Not even close....about half the hours and 2x-4x the vacation.

Iggy
mhm. I don't know any OMFS in my city that works more than 40 hours a week. Derm which is THE lifestyle specialty and only like the best of the best medical student can make is about the same (or more hours) than omfs and honestly lower pay too.
 

kingme23

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Yea and it's ironic he's saying that considering he often uses himself as an example of not choosing a specialty based on income when most of his classmates are making a pathetic <180 a few years out of school.

And if he wants us to look at averages, Ada is at 460 for omfs which is as about as high as orthopaedic surgeon but with better hours. I'll take it! Beats derm, plastics, cardiologists, what's not to like?
I still think it's a dangerous game to play when you talk about comparing income averages. Take a look at the survey they did on dental town titled "How much are GPs really making?"
The average for practice owners was 411K. Meaning, half made more than that and half less. Those ADA surveys are all crap.. not a reliable source to base your future career off of. Since most dentists aren't employees, you can't get accurate salary surveys like in other fields. The average is still higher for OS I'm sure, but probably not by a staggering amount if we're talking practice owners. Yes there are surgeons that work for corporate that probably kill that average...but that opens another can of worms. How cool are you with doing less-than-ethical things, driving several hours each day, not being your own boss, plus the toll it takes on your body doing that all day. But it sounds like you have your mind made up that OS is the only way to reach your $$ goals.
 
3

321931

There are guys here who have to travel to offices up to 100 miles away :sick:
Yup. Knew a few guys that would go to one area for 1-2 days stay in a hotel then go home.

Rinse repeat every other week. On the bright side they were doing 10000 production days.
 

2TH MVR

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One thing you guys are missing is the other aspect of being a surgeon. GPs, pedos, orthos on a smaller level, do not need to rely 100% on patient referrals from GPs, etc. OMS better have great interpersonal skills and a** kissing skills to keep the referrals coming in from the GPs. I never liked relying on others for my success. Of course nowadays ..... patients just look up provider names based on their insurance.

So, if some of you like OMS potentials want their lifestyle and better job opportunities .... just remember where your patients are coming from.

One thing I like about medicine is that they don't have to go out and "market" themselves for patients.

Upsides and downsides to everything.
 

Medin2017

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One thing you guys are missing is the other aspect of being a surgeon. GPs, pedos, orthos on a smaller level, do not need to rely 100% on patient referrals from GPs, etc. OMS better have great interpersonal skills and a** kissing skills to keep the referrals coming in from the GPs. I never liked relying on others for my success. Of course nowadays ..... patients just look up provider names based on their insurance.

So, if some of you like OMS potentials want their lifestyle and better job opportunities .... just remember where your patients are coming from.

One thing I like about medicine is that they don't have to go out and "market" themselves for patients.

Upsides and downsides to everything.
Corporation and partnership is more likely than opening a private from scratch and needing to do that from the get go. And oms does pretty well on those fronts
 
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PhansterZ

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Corporation and partnership is more likely than opening a private from scratch and needing to do that from the get go. And oms does pretty well on those fronts
In any form of private practice you get into, you will spend most of your time networking with general dentists for referrals. You won’t make it out in private practice if general dentists don’t like you.
 
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vellnueve

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And you're a veteran of the field with practice experience in a multitude of settings?
that's inaccurate AF.
ITT we get lectured on private practice options by a predent. Lol
 
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321931

One thing you guys are missing is the other aspect of being a surgeon. GPs, pedos, orthos on a smaller level, do not need to rely 100% on patient referrals from GPs, etc. OMS better have great interpersonal skills and a** kissing skills to keep the referrals coming in from the GPs. I never liked relying on others for my success. Of course nowadays ..... patients just look up provider names based on their insurance.

So, if some of you like OMS potentials want their lifestyle and better job opportunities .... just remember where your patients are coming from.

One thing I like about medicine is that they don't have to go out and "market" themselves for patients.

Upsides and downsides to everything.
+1. I dropped my local OS who is ONE block away from me after they messed up a few times. I refer now 10 minutes away to another OS office. I'm sure I don't effect their bottom line to much, but meh whatever.
 

Localnative

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Can you give an accurate description of what it's like?
"corporate" - mixed bag depending where you are. be wary if production reports show 15-20 g daily. sure thats alot of implant and extractions... consider pts health (they have no problems sticking a pt with H and N rads 2 weeks prior on your schedule for same day surgery), risks of procedure, distance you are from office in case stuff goes south afterhours.

"partnership" - one and only time I was an associate, promised partnership in "1-2 yrs". took all the senior guys call, was paid for maybe 10% of the trauma I did (lots of excuses from the SOB, plus he took his fair share). didn't pay me for 3 months because he wanted to renegotiate the terms of my contract and I expressed a strong desire to peace out at the end of the yr. etc etc etc.

"hired gun" - learned to keep the itinerant thing to 25-30 miles from my home base. depending on office, have alot of autonomy. recently did an alveolar cleft repair under GA in one particularly well equipped multi specialty practice. i don't have an answering service, pts call me direct. Patient flow depends on relationship with other docs in office. keep it professional but casual, you can do pretty well.

"hospital based" - not so much anymore. reimbursements absolutely suck. need to take off either a 1/2 or whole day from office, in which case you are behind the eight ball at that point. pay an arm and leg for malpractice premiums where I live. im not the traumahawk i used to be . cowboy days are numbered.

"my own place" - tried it. within 2 years about a dozen corporate offices opened up within a 10m radius around me. theres goes the insurance pts, at that point GPs are bringing specialist in house, there goes my ability to competitively negotiate with insurance companies, can't compete with their budget for marketing, social media.

there you have it in a nutshell.
 

OlenCF

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Just want to give my two cents.

OMS has the potential to make really big earning, and so is a GP; but that pretty much depends on what kinda person you are, your speaking skill and whatnot. Whereas in the case of OMS, so long as you have can a consistent flow of patients, you are set. But sure, how much is enough, that's the question you gotta answer for yourself.

Now let me give you two examples that I know, one is a friend of mine and one is an instructor from my school (didn't know him that well back then).

OMS 1 finished his training and was back to his hometown where there is a huge monopoly in the field of OMS by the group he joined. (He actually GOT the offer PRIOR to leaving for his OMS training. And it was known through the grapevine that his "package" when he matched was $750K/year + bonus). So he finished his OMS training, received further fellowship training, and bam went back to his hometown to the group. He is doing some private practice work a few days a week and definitely racking AT LEAST 750K, and since his group has such a monopoly in the town, he got hospital privilege right away and is onto doing the things he got advanced training for. So, 750K + whatever money he racked up from hospital (he told me a hospital based full mouth clearance isn't too too bad either rated at abtou $3k per case), and from whatever surgeries he did (not as lucrative, but hey, we are not all in for the money). I think a healthy guess is he's approaching $900K.

OMS 2 I remember from way back in dental school drove a nice little MB GLK as a commuter, and that was 6+ yrs back. Last thing I heard was his commuter/beater is a Tesla S P100D L, and he just bought a MB G65 AMG for his wife a couple years ago. So I thought, wow, he must have done pretty well.
So, I asked further, and his model is this. He has a clinic that's about an hr away from the metro area, but he's only there probably 4 days a month. And no, that's not a type, FOUR DAYS A MONTH. However, guy is efficient (note, being efficient doesn't necessarily mean he's unethical, I think we need to get that notion straight), he see anywhere from 14 - 17 cases of ALL-4-Thirds in the AM (0730 - 1130 HR), and do just consults in the PM. Other time he teaches, and he has other businesses which I did not inquire further. But I know he's billing 2 million / yr, and it's very realistic because you can't expect yourself to have ALL the patients referred to you such that you are working on a daily basis. But he must have done some ground works, so averaging 15-ish patients per week is still pretty awesome, but not unattainable. So, let's do some math, annual billing of $ 2 million probably means 50% take home since overhead of OMS office isn't as crazy as GP office (however IV meds are expensive), he collected chump change from his teaching, and that's negligible, plus some business that probably rack him some more moolah. We are looking at approximately $1 million / year. Not too shabby, no?

So, pick your poison, both cases are real surgeons that I know. The life styles are pretty different, but no one is to say that you can't be devising your own way.
 
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vellnueve

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Dec 4, 2006
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to clarify, been practicing for awhile (stints in corporate, with senior OS, my own place, itinerant, etc.)
predent was eons ago , broham.
I was referring to the guy you quoted, I can see how that got confused lol. I guess SDN doesn’t quote previous quotes.
 

kingme23

7+ Year Member
Dec 21, 2011
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"corporate" - mixed bag depending where you are. be wary if production reports show 15-20 g daily. sure thats alot of implant and extractions... consider pts health (they have no problems sticking a pt with H and N rads 2 weeks prior on your schedule for same day surgery), risks of procedure, distance you are from office in case stuff goes south afterhours.

"partnership" - one and only time I was an associate, promised partnership in "1-2 yrs". took all the senior guys call, was paid for maybe 10% of the trauma I did (lots of excuses from the SOB, plus he took his fair share). didn't pay me for 3 months because he wanted to renegotiate the terms of my contract and I expressed a strong desire to peace out at the end of the yr. etc etc etc.

"hired gun" - learned to keep the itinerant thing to 25-30 miles from my home base. depending on office, have alot of autonomy. recently did an alveolar cleft repair under GA in one particularly well equipped multi specialty practice. i don't have an answering service, pts call me direct. Patient flow depends on relationship with other docs in office. keep it professional but casual, you can do pretty well.

"hospital based" - not so much anymore. reimbursements absolutely suck. need to take off either a 1/2 or whole day from office, in which case you are behind the eight ball at that point. pay an arm and leg for malpractice premiums where I live. im not the traumahawk i used to be . cowboy days are numbered.

"my own place" - tried it. within 2 years about a dozen corporate offices opened up within a 10m radius around me. theres goes the insurance pts, at that point GPs are bringing specialist in house, there goes my ability to competitively negotiate with insurance companies, can't compete with their budget for marketing, social media.

there you have it in a nutshell.
Thanks for the insight. Do you think most of those issues are universal or just have a lot to do with your location? It sounds like a pretty heavily saturated market. Do you think financially you are in a much better position than GPs around you?
 

Localnative

7+ Year Member
Jan 4, 2011
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Thanks for the insight. Do you think most of those issues are universal or just have a lot to do with your location? It sounds like a pretty heavily saturated market. Do you think financially you are in a much better position than GPs around you?
location is an important variable. south of the Mason/Dixon it can be a tough ride in the major cities and surrounding areas. Charleston, Miami, Atlanta - tough markets.
some GPs around me are doing as well as a specialist. they are the superGPs that call me on a friday at 459p because they displaced a root tip into the floor of the mouth.
 
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Jul 3, 2017
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Just want to give my two cents.

OMS has the potential to make really big earning, and so is a GP; but that pretty much depends on what kinda person you are, your speaking skill and whatnot. Whereas in the case of OMS, so long as you have can a consistent flow of patients, you are set. But sure, how much is enough, that's the question you gotta answer for yourself.

Now let me give you two examples that I know, one is a friend of mine and one is an instructor from my school (didn't know him that well back then).

OMS 1 finished his training and was back to his hometown where there is a huge monopoly in the field of OMS by the group he joined. (He actually GOT the offer PRIOR to leaving for his OMS training. And it was known through the grapevine that his "package" when he matched was $750K/year + bonus). So he finished his OMS training, received further fellowship training, and bam went back to his hometown to the group. He is doing some private practice work a few days a week and definitely racking AT LEAST 750K, and since his group has such a monopoly in the town, he got hospital privilege right away and is onto doing the things he got advanced training for. So, 750K + whatever money he racked up from hospital (he told me a hospital based full mouth clearance isn't too too bad either rated at abtou $3k per case), and from whatever surgeries he did (not as lucrative, but hey, we are not all in for the money). I think a healthy guess is he's approaching $900K.

OMS 2 I remember from way back in dental school drove a nice little MB GLK as a commuter, and that was 6+ yrs back. Last thing I heard was his commuter/beater is a Tesla S P100D L, and he just bought a MB G65 AMG for his wife a couple years ago. So I thought, wow, he must have done pretty well.
So, I asked further, and his model is this. He has a clinic that's about an hr away from the metro area, but he's only there probably 4 days a month. And no, that's not a type, FOUR DAYS A MONTH. However, guy is efficient (note, being efficient doesn't necessarily mean he's unethical, I think we need to get that notion straight), he see anywhere from 14 - 17 cases of ALL-4-Thirds in the AM (0730 - 1130 HR), and do just consults in the PM. Other time he teaches, and he has other businesses which I did not inquire further. But I know he's billing 2 million / yr, and it's very realistic because you can't expect yourself to have ALL the patients referred to you such that you are working on a daily basis. But he must have done some ground works, so averaging 15-ish patients per week is still pretty awesome, but not unattainable. So, let's do some math, annual billing of $ 2 million probably means 50% take home since overhead of OMS office isn't as crazy as GP office (however IV meds are expensive), he collected chump change from his teaching, and that's negligible, plus some business that probably rack him some more moolah. We are looking at approximately $1 million / year. Not too shabby, no?

So, pick your poison, both cases are real surgeons that I know. The life styles are pretty different, but no one is to say that you can't be devising your own way.
Wow I didn't know OMFS is this good. I think it's the best specialty to pursue at this moment. If you're willing to go where you're needed, you will do very well.
 

DDS9994

2+ Year Member
Jan 25, 2017
136
111
Status
Dentist
Just want to give my two cents.

OMS has the potential to make really big earning, and so is a GP; but that pretty much depends on what kinda person you are, your speaking skill and whatnot. Whereas in the case of OMS, so long as you have can a consistent flow of patients, you are set. But sure, how much is enough, that's the question you gotta answer for yourself.

Now let me give you two examples that I know, one is a friend of mine and one is an instructor from my school (didn't know him that well back then).

OMS 1 finished his training and was back to his hometown where there is a huge monopoly in the field of OMS by the group he joined. (He actually GOT the offer PRIOR to leaving for his OMS training. And it was known through the grapevine that his "package" when he matched was $750K/year + bonus). So he finished his OMS training, received further fellowship training, and bam went back to his hometown to the group. He is doing some private practice work a few days a week and definitely racking AT LEAST 750K, and since his group has such a monopoly in the town, he got hospital privilege right away and is onto doing the things he got advanced training for. So, 750K + whatever money he racked up from hospital (he told me a hospital based full mouth clearance isn't too too bad either rated at abtou $3k per case), and from whatever surgeries he did (not as lucrative, but hey, we are not all in for the money). I think a healthy guess is he's approaching $900K.

OMS 2 I remember from way back in dental school drove a nice little MB GLK as a commuter, and that was 6+ yrs back. Last thing I heard was his commuter/beater is a Tesla S P100D L, and he just bought a MB G65 AMG for his wife a couple years ago. So I thought, wow, he must have done pretty well.


Are these positions located in Canada at all? If in the states what part of the country?
So, I asked further, and his model is this. He has a clinic that's about an hr away from the metro area, but he's only there probably 4 days a month. And no, that's not a type, FOUR DAYS A MONTH. However, guy is efficient (note, being efficient doesn't necessarily mean he's unethical, I think we need to get that notion straight), he see anywhere from 14 - 17 cases of ALL-4-Thirds in the AM (0730 - 1130 HR), and do just consults in the PM. Other time he teaches, and he has other businesses which I did not inquire further. But I know he's billing 2 million / yr, and it's very realistic because you can't expect yourself to have ALL the patients referred to you such that you are working on a daily basis. But he must have done some ground works, so averaging 15-ish patients per week is still pretty awesome, but not unattainable. So, let's do some math, annual billing of $ 2 million probably means 50% take home since overhead of OMS office isn't as crazy as GP office (however IV meds are expensive), he collected chump change from his teaching, and that's negligible, plus some business that probably rack him some more moolah. We are looking at approximately $1 million / year. Not too shabby, no?

So, pick your poison, both cases are real surgeons that I know. The life styles are pretty different, but no one is to say that you can't be devising your own way.
 

DDS9994

2+ Year Member
Jan 25, 2017
136
111
Status
Dentist
Are these positions in Canada? If in the US what part of the country?
 

OlenCF

2+ Year Member
Aug 5, 2016
59
19
Status
Dentist
Are these positions in Canada? If in the US what part of the country?
They are in West Coast, and I can't speak no more for obvious reason. :p

That said, money wise the figures are certainly awesome... but you risk getting stuck at becoming a private practice ONLY kinda OMFS. IF money is your thing, then sure, Monsieur Trudeau welcomes you (actually, not sure if he does, with the new corporate tax reform, he's gonna make it harder.. but we will see).

Surgeon 2 in my post seems to be completely happy with his private practice, and I have not inquired to see if he's got privilege in the OR... chances are, most likely he doesn't because the city hospital is occupied by some long standing surgeons.... And this is true for any decent sized city/metro areas.

Now the health system and the hospital framework is quite different up North here and getting hospital privilege means you need to be able to go far far away from city centre OR if you are willing to "work your way up". From what I heard, not so down in the States as the hospital is more run like a business, and your surgical skill is viewed as an asset, so getting privilege doesn't seem to be a problem. Correct me if I am wrong, by all means.

Surgeon 1 is lucky because the group he joins is BIG in town, so he got privilege by default. That said, calling him lucky would be an insult, because he is a hardworking surgeon who has been networking since he was 18 with the mind of becoming a fellowship-trained OMFS and join the group when he finishes... and he did exactly that. He has always had that goal in his peripheral, and he's just making it a reality one bit at a time.
 
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OlenCF

2+ Year Member
Aug 5, 2016
59
19
Status
Dentist
Wow I didn't know OMFS is this good. I think it's the best specialty to pursue at this moment. If you're willing to go where you're needed, you will do very well.
That's right, so long as you are efficient, and don't mind the drive. You can find 3 or 4 clinics that you visit every month, and do your 15 cases everytime you are there. Split the billing with your GP friends, you will still make your 3 -4 days a month.
 
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Wow I didn't know OMFS is this good. I think it's the best specialty to pursue at this moment. If you're willing to go where you're needed, you will do very well.
It's a great specialty but hard as hell to get in and the journey is long. Top 5 and you might not even place. If you do get in, it might be in middle of nowhere school...but def. a good specialty, but they def put in their "time" to reap the rewards.
 
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