OMFS vs Ortho

[charlestweed]

Suffer? Seems a bit strong. If you can’t get steady work as an ortho, why can’t you just be a super GP with an ortho residency? You’ll never have a shortage of work.

Yup, there will always be work to keep you busy if you are not picky about the job offers (including getting a P/T GP job if you can’t get F/T ortho job). If you can't get enough days at the corp offices, there are plenty of GPs, who want to invite orthos to provide in-house services for them. Who wouldn’t want to earn extra passive income?

Having a steady income from a P/T ortho job actually helps make it easier to start a new ortho office from scratch. A general dentist cannot do that. He/she has to quit the F/T job in order to start his/her own office.

To create work for myself, I just keep the fee low to attract more patients. I’d rather work non-stop and get paid a little less than sitting around doing nothing and still have to pay for the fixed expenses such as rent and staff salaries. The assistants get paid 8 hours/day, regardless we have patients or not…so why not keep them constantly busy by starting new cases at lower fee? It’s actually more depressing to have half-filled appointment book. Also, the more new cases you start, the more people who will hear about your practice…free advertisement…less reliance on the GP referrals.

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[dante72]

You are welcome. We, orthos, actually have a lot of free time to post on this forum.... to relieve the boredom. The corp offices, where I am at, give me 1 hour for bonding, banding, re-bonding loose brackets, delivery appliances, final debond etc but these procedures only take us 15-30 minutes to complete. They give me 30 minutes for regular adjustment visits (wire changes, wire bendings, retainer checks etc) but these procedures only take us 5-10 minutes to complete. So I have plenty of free time here at the corp. I have to bring a laptop and books to kill time. That’s why I continue to hang on to this job for 15 + years. It’s hard to let go an easy job that pays well.

If you like to challenge yourself with difficult high risk surgical procedures, then OMFS is for you. I am lazy. I just want to do low risk procedures so I can come home worry-free. I had the experience in dealing with dry sockets and post-op bleedings on patients who were on Coumadin meds when I was a GPR resident. It wasn’t fun. Back then I was still single. It must be hard for those who have a family and kids and have to worry about all these post op complications.

that's why i love ortho 😛

 

[kingme23]

Yup, there will always be work to keep you busy if you are not picky about the job offers (including getting a P/T GP job if you can’t get F/T ortho job). If you can't get enough days at the corp offices, there are plenty of GPs, who want to invite orthos to provide in-house services for them. Who wouldn’t want to earn extra passive income?

Having a steady income from a P/T ortho job actually helps make it easier to start a new ortho office from scratch. A general dentist cannot do that. He/she has to quit the F/T job in order to start his/her own office.

To create work for myself, I just keep the fee low to attract more patients. I’d rather work non-stop and get paid a little less than sitting around doing nothing and still have to pay for the fixed expenses such as rent and staff salaries. The assistants get paid 8 hours/day, regardless we have patients or not…so why not keep them constantly busy by starting new cases at lower fee? It’s actually more depressing to have half-filled appointment book. Also, the more new cases you start, the more people who will hear about your practice…free advertisement…less reliance on the GP referrals.

Not to derail this topic too far but what do you think is a fair pay scheme for a GP bringing in an ortho to provide that service?

 

[Drifter_]

Really? What happened when you tried? I mean you would have to have in your business plan that you’ll get no referrals so you would just have to build up the ortho side of the practice from marketing and internal referrals. The plus is that you would have a steady stream of cash flow from the GP side of the practice.

I think the whole point of doing ortho is to not having to touch the drill ever again. If this is what you want, why not just take ortho CE and advertise the heck out of it.

 

[charlestweed]

Not to derail this topic too far but what do you think is a fair pay scheme for a GP bringing in an ortho to provide that service?

If the ortho provides everything (ortho assistants, supplies, xrays, insurance billings etc) for the GP, then the split can range from 75/25 to 80-/20 (ortho gets 75% and GP gets 25% of the collection).

If the GP provides assistant(s), supplies and handles all the insurance billings, then a reasonable pay should range from 50/50 to 60/40 (Gp gets 60, ortho gets 40).

If the GP office already has a well established number of active ortho patients and the current ortho quits his job, you can negotiate with the GP to pay you a flat daily rate…just like when you apply for a job at a corp office.

Another scenario would be the ortho just pay the GP a flat rental rate ($1700/month in my case) for using the facility.

 

[Medin2017]

Op good luck being an Ortho in the future it's not the same as charlestweed time. I don't believe any general dentists or specialists from 20 years ago because it was way easier then. Orthos do pretty badly based on averages and obvious trends- corporations Invisalign etc. Whereas a corporation still pays a lot to omfs.

And for Charlestweed saying the high risk cases, he's probably talking about his stellar omfs friend not the ones doing t and t (which oviously is easy for an omfs) making like 3k a day if they have 6+ extraction appointments. Do the math. One of the older students at my school said a corporation was paying 2750 a day in a really saturated area. the omfs is probably generating way more than 2750, but that income is more than literally all medical specialties in a 40 hour week. Good luck replicating that as a general dentist or Ortho in a saturated area LOL.

Search the threads of recent Ortho grads on this forum. Believe me life's not the same for them, no sir.

If I had a choice between general or any specialty other than omfs I would have gone to med school.

 

[2TH MVR]

Op good luck being an Ortho in the future it's not the same as charlestweed time. I don't believe any general dentists or specialists from 20 years ago because it was way easier then. Orthos do pretty badly based on averages and obvious trends- corporations Invisalign etc. Whereas a corporation still pays a lot to omfs.

And for Charlestweed saying the high risk cases, he's probably talking about his stellar omfs friend not the ones doing t and t (which oviously is easy for an omfs) making like 3k a day if they have 6+ extraction appointments. Do the math. One of the older students at my school said a corporation was paying 2750 a day in a really saturated area. the omfs is probably generating way more than 2750, but that income is more than literally all medical specialties in a 40 hour week. Good luck replicating that as a general dentist or Ortho in a saturated area LOL.

Search the threads of recent Ortho grads on this forum. Believe me life's not the same for them, no sir.

If I had a choice between general or any specialty other than omfs I would have gone to med school.

I wonder if the OMFS receiving $2750 a day is being paid as an employee or as an IC? If employee ... that's great. Employees have all of their malpractice liability insurance paid by the Corp. Health benefits. 401K. PTO. Etc. Etc. If independent contractor? Working in Corp as an OMFS? I would hate to see their malpractice premiums. Working in a bunch of different Corp offices doing surgery on patients and being responsible for their post-op care. Sounds tenuous.

But I do agree. Ortho is not the same as it once was. The question is how much longer will OMFS be immune to the current market conditions with fewer FFS and more insurance patients and Corporations proliferating. The OMFS with a private office has to be feeling the same economic pressures as every other specialist that relies on referrals. Corps and GPs with specialists in-house means internal referrals only.

 

[Medin2017]

Stay away from orthodontics

Orthodontics and debt
The Facts

• There are more orthodontic graduates per year than jobs available.
• The mean debt of graduates is very high and rising.
• Compared to the traditional 10-year loan payback, new graduates are looking at loan repayment over 20 years or longer.
• Tuition at public and private universities has increased at a greater rate than the consumer price index.
• There are approximately 65 accredited orthodontic residency programs in the United States, with more 3-year programs than 2-year programs.
• The number of residency positions has significantly increased in the past decade.
• There are two tiers of orthodontic residency programs. First-tier programs pay residents a stipend or charge a lower tuition, while second-tier programs charge up to $80,000 per year for tuition.
• Individuals are not the only buyers of orthodontic residency positions. Some schools have initiated programs with foreign governments to reserve positions for international dentists at a “premium” tuition.
• Some fiscally mismanaged dental schools and universities are dependent on orthodontic tuition revenue to keep their doors open.

"first-year income expectations are as follows:

• 8% expect less than $100,000;
• 37% expect $100,000 to $150,000;
• 41% expect $150,000 to $200,000; and
• 14% expect more than $200,000."

Jeez... on top of that paying for tuition unless you're the top of the top? No thanks

 

[Medin2017]

I wonder if the OMFS receiving $2750 a day is being paid as an employee or as an IC? If employee ... that's great. Employees have all of their malpractice liability insurance paid by the Corp. Health benefits. 401K. PTO. Etc. Etc. If independent contractor? Working in Corp as an OMFS? I would hate to see their malpractice premiums. Working in a bunch of different Corp offices doing surgery on patients and being responsible for their post-op care. Sounds tenuous.

But I do agree. Ortho is not the same as it once was. The question is how much longer will OMFS be immune to the current market conditions with fewer FFS and more insurance patients and Corporations proliferating. The OMFS with a private office has to be feeling the same economic pressures as every other specialist that relies on referrals. Corps and GPs with specialists in-house means internal referrals only.

The thing is you don't have to be private office to be successful in omfs unlike literally every other dental specialty (except maybe endo). Corporation proliferation I don't see as a bad thing if the reimbursement is still so extremely high. It's not like ortho or general from what I've read and heard.

 

[schmoob]

Op good luck being an Ortho in the future it's not the same as charlestweed time. I don't believe any general dentists or specialists from 20 years ago because it was way easier then. Orthos do pretty badly based on averages and obvious trends- corporations Invisalign etc. Whereas a corporation still pays a lot to omfs.

And for Charlestweed saying the high risk cases, he's probably talking about his stellar omfs friend not the ones doing t and t (which oviously is easy for an omfs) making like 3k a day if they have 6+ extraction appointments. Do the math. One of the older students at my school said a corporation was paying 2750 a day in a really saturated area. the omfs is probably generating way more than 2750, but that income is more than literally all medical specialties in a 40 hour week. Good luck replicating that as a general dentist or Ortho in a saturated area LOL.

Search the threads of recent Ortho grads on this forum. Believe me life's not the same for them, no sir.

If I had a choice between general or any specialty other than omfs I would have gone to med school.

Stay away from orthodontics

Orthodontics and debt
The Facts

• There are more orthodontic graduates per year than jobs available.
• The mean debt of graduates is very high and rising.
• Compared to the traditional 10-year loan payback, new graduates are looking at loan repayment over 20 years or longer.
• Tuition at public and private universities has increased at a greater rate than the consumer price index.
• There are approximately 65 accredited orthodontic residency programs in the United States, with more 3-year programs than 2-year programs.
• The number of residency positions has significantly increased in the past decade.
• There are two tiers of orthodontic residency programs. First-tier programs pay residents a stipend or charge a lower tuition, while second-tier programs charge up to $80,000 per year for tuition.
• Individuals are not the only buyers of orthodontic residency positions. Some schools have initiated programs with foreign governments to reserve positions for international dentists at a “premium” tuition.
• Some fiscally mismanaged dental schools and universities are dependent on orthodontic tuition revenue to keep their doors open.

"first-year income expectations are as follows:

• 8% expect less than $100,000;
• 37% expect $100,000 to $150,000;
• 41% expect $150,000 to $200,000; and
• 14% expect more than $200,000."

Jeez... on top of that paying for tuition unless you're the top of the top? No thanks

The thing is you don't have to be private office to be successful in omfs unlike literally every other dental specialty (except maybe endo). Corporation proliferation I don't see as a bad thing if the reimbursement is still so extremely high. It's not like ortho or general from what I've read and heard.

Dude, you’re not in a position to be providing expert opinions of any sort when you’re not an expert. This is a forum for people your age and your stage of training as a D1 to listen quietly and learn, or to ask questions - not to provide guidance to those who have far more knowledge and first-hand experience.

 

[Str82th]

Firm,

I don’t spend much time on these forums. What is the axis of evil your avatar refers to?

He needs to add one more location to that map... those are the three original ortho mills- large class sizes and supersized tuition. The latest addition is in Atlanta, GA.

 

[Medin2017]

Dude, you’re not in a position to be providing expert opinions of any sort when you’re not an expert. This is a forum for people your age and your stage of training as a D1 to listen quietly and learn, or to ask questions - not to provide guidance to those who have far more knowledge and first-hand experience.

Eh linking posts from people with firsthand experience or extrapolating from surveys and other reputable sources seems pretty reasonable to me. And anyone can see someone who started 20+ years ago saying how good a field is wouldn't be the most relevant information, right? Like if a dentist opened shop 30 years ago back when no one practiced and then said to open in LA and just try harder, his experience is pretty irrelevant right? Am I the only one who thinks this? With the internet and information readily available, age or experience of a person means far less since it's a single data point- really just an anecdote. I'll trust an ADA survey or like 20+ employee ads or Marc Bernard Ackerman, DMD, MBA, FACD who wrote the article I linked over a random person who succeeded in a field that was booming 30 years ago. Catch my drift? Feel free to ban me or delete my posts, but it would be nice to see someone refute the point I just made.

It's no longer an age where if you're a predent and saying something, you're just pulling stuff out of your who knows where. People who are somewhat educated can gather information from surveys, people payed to analyze data, trends, etc.

 

[Str82th]

Dude, you’re not in a position to be providing expert opinions of any sort when you’re not an expert. This is a forum for people your age and your stage of training as a D1 to listen quietly and learn, or to ask questions - not to provide guidance to those who have far more knowledge and first-hand experience.

I agree. I wish the best to Medin in his path to OMFS. The fields are almost completely different, ortho is far more laid back and OMFS makes more money. There may be more graduating residents than job openings, there is pressure from labs marketing directly to consumers, there are GPs doing more ortho. But, I would argue the quality of life of an orthodontist is rivaled by no other specialty. We have happy patients, our work is visible and appreciated, our bodies are punished less.

The main takeaway here, as it should be with every specialty or GP, is to minimize debt. You cannot comprehend how crippling debt is until you’re trying live your life and service debt at the same time. If you don’t have huge debt, it doesn’t matter what you do, you’ll have plenty of money.

 

[Str82th]

Marc Bernard Ackerman, DMD, MBA, FACD

You don’t know this but in my opinion Ackerman is a hack, on the same level as Burris. Doing whatever they can to push Orthodontics to the bottom of the barrel. Burris is a participating provider for smile direct club. Not the best example of happy or reliable sources, those two.

 

[schmoob]

Eh linking posts from people with firsthand experience or extrapolating from surveys and other reputable sources seems pretty reasonable to me. And anyone can see someone who started 20+ years ago saying how good a field is wouldn't be the most relevant information, right? Like if a dentist opened shop 30 years ago back when no one practiced and then said to open in LA and just try harder, his experience is pretty irrelevant right? Am I the only one who thinks this? With the internet and information readily available, age or experience of a person means far less since it's a single data point- really just an anecdote. I'll trust an ADA survey or like 20+ employee ads or Marc Bernard Ackerman, DMD, MBA, FACD who wrote the article I linked over a random person who succeeded in a field that was booming 30 years ago. Catch my drift? Feel free to ban me or delete my posts, but it would be nice to see someone refute the point I just made.

It's no longer an age where if you're a predent and saying something, you're just pulling stuff out of your who knows where. People who are somewhat educated can gather information from surveys, people payed to analyze data, trends, etc.

It IS still that age. You have absolutely zero experience. You’ve never made a referral, gone through residency, given a single block, or cut a single prep. You selectively pick data and make points that you can not support. ADA surveys? Give me a break. I would NEVER trust an ADA survey. Vujicic’s name is on everything coming from the ADA and holds no weight.

Why would I ban or delete your posts? I’m a moderator, but I’m still a member of this community who’s allowed to participate in discussions.

And if your argument is to use firsthand experience, that’s what you’re getting here in the forums. Don’t argue with those who actually have it by using biased data or name dropping authors who support your argument, especially when their credibility is questionable.

 

[Steins;Gate]

OMFS may make more per year than ortho but orthos may practice a lot longer than OMFS.

 

[Medin2017]

It IS still that age. You have absolutely zero experience. You’ve never made a referral, gone through residency, given a single block, or cut a single prep. You selectively pick data and make points that you can not support. ADA surveys? Give me a break. I would NEVER trust an ADA survey. Vujicic’s name is on everything coming from the ADA and holds no weight.

Why would I ban or delete your posts? I’m a moderator, but I’m still a member of this community who’s allowed to participate in discussions.

And if your argument is to use firsthand experience, that’s what you’re getting here in the forums. Don’t argue with those who actually have it by using biased data or name dropping authors who support your argument, especially when their credibility is questionable.

Alright I'll be sure to let everyone know about the dentist I shadowed in an urban area that's now saturated completely that you should open in saturated areas. Worked for him. Why is no one calling into question that charlestweed's experience is from a whole different environment? Just odd to me. On the medical forums, when someone says primary care is good because their dad's a family practictioner clearing 400k, people call them out. When a pathologist says the job market is good, people would say it's different now. Weird that in the dental forums, it seems to be the opposite. When a general practice dentist is a hardcore outlier making 300k 3 years out of school, everyone instantly is happy and believes the future is bright. When an orthodontist who opened a practice 20-30 years ago in California says how awesome orthodontics is, people get excited. Maybe it's a difference in debt between medical schools and dental schools, or the fact that the lowest paid doc is still making like 180k, or even maybe that medical students are less naive. It sometimes feels like people in this forum cling to blind hope instead of looking more rationally like they do in the medical forums.

 

[Medin2017]

OMFS may make more per year than ortho but orthos may practice a lot longer than OMFS.

I don't want to be practicing when I'm 65+ so I guess I'm good on that

 

[Medin2017]

Been thinking about this post for a bit (bored on a break) and I think I'll dip out. I understand I would probably be pissed if a highschooler was talking like he/she knew what dental school was like without experiencing it at all. Even if they had multiple siblings or anecdotes, it's not the same. Whether the posters are painting a rosy colored or pessimistic view, their input is still valued.

 

[CaliDDS1986]

@Medin2017

Used to be a D1 like you. Then I graduated and found how grueling being a GP is, and how much I love ortho. I make 300k as a GP, but I’m tired and exhausted everyday from the patients. The best parts of my day are my ortho patients, and learning more about ortho since it’s so vast. If I had the choice between being a GP for 300k or an ortho for 200k I’d pick being an ortho every time. It’s a passion, and life is worth more than just money. If I do get into a residency, and I find I can’t get a job as an ortho guess what? I’m still a GP that can always find a job. Just limit your debt as much as possible.

 

[Firm]

Alright I'll be sure to let everyone know about the dentist I shadowed in an urban area that's now saturated completely that you should open in saturated areas. Worked for him. Why is no one calling into question that charlestweed's experience is from a whole different environment? Just odd to me. On the medical forums, when someone says primary care is good because their dad's a family practictioner clearing 400k, people call them out. When a pathologist says the job market is good, people would say it's different now. Weird that in the dental forums, it seems to be the opposite. When a general practice dentist is a hardcore outlier making 300k 3 years out of school, everyone instantly is happy and believes the future is bright. When an orthodontist who opened a practice 20-30 years ago in California says how awesome orthodontics is, people get excited. Maybe it's a difference in debt between medical schools and dental schools, or the fact that the lowest paid doc is still making like 180k, or even maybe that medical students are less naive. It sometimes feels like people in this forum cling to blind hope instead of looking more rationally like they do in the medical forums.

Charles Tweed has a different (niche) model than anybody that I know. He has 3 basic offices (1 is his sisters?) and still works at a corporate gig. He employed his staff part-time and doesn't use a lab (teaches his staff to make appliances). His focus is on lower income immigrants and he is very efficient in his work/equipment in order to keep costs down.

 

[Firm]

Eh linking posts from people with firsthand experience or extrapolating from surveys and other reputable sources seems pretty reasonable to me. And anyone can see someone who started 20+ years ago saying how good a field is wouldn't be the most relevant information, right? Like if a dentist opened shop 30 years ago back when no one practiced and then said to open in LA and just try harder, his experience is pretty irrelevant right? Am I the only one who thinks this? With the internet and information readily available, age or experience of a person means far less since it's a single data point- really just an anecdote. I'll trust an ADA survey or like 20+ employee ads or Marc Bernard Ackerman, DMD, MBA, FACD who wrote the article I linked over a random person who succeeded in a field that was booming 30 years ago. Catch my drift? Feel free to ban me or delete my posts, but it would be nice to see someone refute the point I just made.

It's no longer an age where if you're a predent and saying something, you're just pulling stuff out of your who knows where. People who are somewhat educated can gather information from surveys, people payed to analyze data, trends, etc.

People lie in the ADA survey and I don't think Ackerman has ever been in private practice. You still don't know a lot yet.

 

[321931]

@Medin2017

Used to be a D1 like you. Then I graduated and found how grueling being a GP is, and how much I love ortho. I make 300k as a GP, but I’m tired and exhausted everyday from the patients. The best parts of my day are my ortho patients, and learning more about ortho since it’s so vast. If I had the choice between being a GP for 300k or an ortho for 200k I’d pick being an ortho every time. It’s a passion, and life is worth more than just money. If I do get into a residency, and I find I can’t get a job as an ortho guess what? I’m still a GP that can always find a job. Just limit your debt as much as possible.

See what I mean? I tell everyone that $$$ shouldn't be the bottom line of WHY you choose a specialty or just be a GP. In either realm, GP, Ortho, Perio, Endo, OMFS...you will be fine. It's more about doing things that you LIKE. You will be in the field for 20-30 years.

I always get counterpoints by pre-dents about but 180k is peanut income, or whatever. I get it. It is peanut income compared to 500k. And I get it, that there's more stability in other jobs per-say. But for me, I personally couldn't go 4-6 more years of 60 hour residencies and then go out into the real world and do heavy corporate driving back and forth to make that sweet sweet $$$. And I couldn't do the partnership thing either and wait for my partner to die before I make money. I don't mind doing my own solo gig and sitting on DT/SDN in between patients and taking home 200-300k.

Everyone's wants are different, but I think the universal thing that can be said is in either gig in dentistry, you will be fine if you plan it out. So do what you like. We have a GP here that says they would rather do ortho for 100k less. That's cool. I guess he is making peanut money compared to me so what a loser? No. Dude I have mad respect for you. Do what you like to do, don't do it cuz of $$$. It gets old and trust me my life isn't happier because I make 300k now over 150k.

 

[CaliDDS1986]

See what I mean? I tell everyone that $$$ shouldn't be the bottom line of WHY you choose a specialty or just be a GP. In either realm, GP, Ortho, Perio, Endo, OMFS...you will be fine. It's more about doing things that you LIKE. You will be in the field for 20-30 years.

I always get counterpoints by pre-dents about but 180k is peanut income, or whatever. I get it. It is peanut income compared to 500k. And I get it, that there's more stability in other jobs per-say. But for me, I personally couldn't go 4-6 more years of 60 hour residencies and then go out into the real world and do heavy corporate driving back and forth to make that sweet sweet $$$. And I couldn't do the partnership thing either and wait for my partner to die before I make money. I don't mind doing my own solo gig and sitting on DT/SDN in between patients and taking home 200-300k.

Everyone's wants are different, but I think the universal thing that can be said is in either gig in dentistry, you will be fine if you plan it out. So do what you like. We have a GP here that says they would rather do ortho for 100k less. That's cool. I guess he is making peanut money compared to me so what a loser? No. Dude I have mad respect for you. Do what you like to do, don't do it cuz of $$$. It gets old and trust me my life isn't happier because I make 300k now over 150k.

Yea I’m telling you guys. Do what makes you happy, but limit your debt. Making 300k as a GP is nice, but I’d rather enjoy the day to day more. Most importantly, limit your loans loans loans. None of us are going to be billionaires from dentistry so you might as well be happy in your day to day work. Just don’t be stupid by taking out a lot of loans.

 

[321931]

Yea I’m telling you guys. Do what makes you happy, but limit your debt. Making 300k as a GP is nice, but I’d rather enjoy the day to day more. Most importantly, limit your loans loans loans. None of us are going to be billionaires from dentistry so you might as well be happy in your day to day work. Just don’t be stupid by taking out a lot of loans.

I agree with this. If you have a ton of loans...then maybe OMFS is the ONLY way to go because you need LARGE cash flow to make your DEBT disappear. So I see that point of view to. Doesn't make sense to go high in debt to make 150k.

Medin has a point though at least with OMFS the corporate/private sector is available. I personally think with the loans now-a-days that as a GP, you have to go ownership in order to make it work. So he has a point, but I guess it rubs people off the wrong way when the focus is always on 500k income income income.

 

[CaliDDS1986]

@Firm

Do you wish you had been a GP instead? Do you not make what you thought you were going to as an ortho? What kinda loans did you have after residency?

 

[Firm]

@Firm

Do you wish you had been a GP instead? Do you not make what you thought you were going to as an ortho? What kinda loans did you have after residency?

I’m glad that I’m ortho. It just takes a long time before you see rewards. I was 28 when I got out of school and 36 before my practice was established and doing well. I would have LOVED to have been making the big bucks in my late 20’s.

 

[DrTooth19]

I always get counterpoints by pre-dents about but 180k is peanut income, or whatever. I get it. It is peanut income compared to 500k.

I think it is so interesting that people see 180k as peanut money. When I came into dental school, I knew I would be making around 150k and I was happy with that. That is how much my family makes right now, and we are all living a good life. And 150k is only how much I would make, my future spouse would double that income.

If 150k is what orthodontists have the potential to make now, I am ok with that! When everyone was saying that orthos make less, I was thinking it would be 80-90k, which made me a little nervous. My biggest thing right now is that I want to pay off loans soon.

Questions for you guys - My dental school debt will be around 340k. Let's say I do go to an ortho program that costs money. What should my tuition limit be so that I do actually pay off my debt and live a reasonable life?

Also the idea of working as a part time GP and part time ortho is so interesting! I may do that. But do you lose the hand skills when you are in ortho residency for 3 years? And how do I go about doing this?

 

[schmoob]

Always go to the cheapest school. It’s simple Hoss-onomics!

 

[kingme23]

I think it is so interesting that people see 180k as peanut money. When I came into dental school, I knew I would be making around 150k and I was happy with that. That is how much my family makes right now, and we are all living a good life. And 150k is only how much I would make, my future spouse would double that income.

If 150k is what orthodontists have the potential to make now, I am ok with that! When everyone was saying that orthos make less, I was thinking it would be 80-90k, which made me a little nervous. My biggest thing right now is that I want to pay off loans soon.

Questions for you guys - My dental school debt will be around 340k. Let's say I do go to an ortho program that costs money. What should my tuition limit be so that I do actually pay off my debt and live a reasonable life?

Also the idea of working as a part time GP and part time ortho is so interesting! I may do that. But do you lose the hand skills when you are in ortho residency for 3 years? And how do I go about doing this?

180K is not peanut money until the loans come into the equation. Also when it gets stated here that GPs make 180 and specialist make up to 500k just for doing an extra 2-4 years of training (not saying it’s true), working the same or LESS hours, that’s when it becomes peanut money.

 

[Medin2017]

I think it is so interesting that people see 180k as peanut money. When I came into dental school, I knew I would be making around 150k and I was happy with that. That is how much my family makes right now, and we are all living a good life. And 150k is only how much I would make, my future spouse would double that income.

If 150k is what orthodontists have the potential to make now, I am ok with that! When everyone was saying that orthos make less, I was thinking it would be 80-90k, which made me a little nervous. My biggest thing right now is that I want to pay off loans soon.

Questions for you guys - My dental school debt will be around 340k. Let's say I do go to an ortho program that costs money. What should my tuition limit be so that I do actually pay off my debt and live a reasonable life?

Also the idea of working as a part time GP and part time ortho is so interesting! I may do that. But do you lose the hand skills when you are in ortho residency for 3 years? And how do I go about doing this?

It's peanut money for people who came to dental school that easily could have gone to medical school for a cheaper price and easily match a middle of the road specialty that clears 300+ with a decent lifestyle (EM, anesthesiology, etc) and potentially something more. Doesn't apply to every dental student. If I wanted to make 150 I would go to PA school for 2 years and a cheaper cost or become a CRNA. Or I would become an engineer.

Also LOCATION. A medical doc can work anywhere. Dentistry is saturated to the point if you want to live in an urban city, you're out of luck if it's saturated.

 

[321931]

It's peanut money for people who came to dental school that easily could have gone to medical school for a cheaper price and easily match a middle of the road specialty that clears 300+ with a decent lifestyle (EM, anesthesiology, etc) and potentially something more. Doesn't apply to every dental student. If I wanted to make 150 I would go to PA school for 2 years and a cheaper cost or become a CRNA. Or I would become an engineer.

Also LOCATION. A medical doc can work anywhere. Dentistry is saturated to the point if you want to live in an urban city, you're out of luck if it's saturated.

I agree with this. People also underestimate the amount of physical and mental WORK that a dentist does. It's physically and mentally draining. Oh but you don't think so? Huh. 1-2 fillings in your 3 hour block in clinic is legit? Uhh...if you aren't producing at least 2000 a day in private practice you gonna go belly up and bankrupt. 1-2 fills is maybe 200 production. Let's condense your schedule a bit...60 minutes for 2 mod, 3 mod, 4 mod while doing 2 hygiene checks, and seeing emergency exams in the next room. Now get moving. Bend over and get drilling otherwise you gonna be broke.

 

[Medin2017]

I agree with this. People also underestimate the amount of physical and mental WORK that a dentist does. It's physically and mentally draining. Oh but you don't think so? Huh. 1-2 fillings in your 3 hour block in clinic is legit? Uhh...if you aren't producing at least 2000 a day in private practice you gonna go belly up and bankrupt. 1-2 fills is maybe 200 production. Let's condense your schedule a bit...60 minutes for 2 mod, 3 mod, 4 mod while doing 2 hygiene checks, and seeing emergency exams in the next room. Now get moving. Bend over and get drilling otherwise you gonna be broke.

Yep dental school showed me that in full. You aren't just checking in and checking out. It's another reason that made me want to specialize. I would rather have fewer large cases then be going room to room constantly. Vs ortho, I would rather have 6-10 patients than have to talk to like 40+ people a day which would be draining as well. Dental school actually solidified my desire to specialize.

I also realized I don't want to work in the midwest. I've gone to "small" cities (not suburbs), and there is just no diversity in food, things to do, etc unless you're extremely out doorsy.

 

[charlestweed]

I think it is so interesting that people see 180k as peanut money. When I came into dental school, I knew I would be making around 150k and I was happy with that. That is how much my family makes right now, and we are all living a good life. And 150k is only how much I would make, my future spouse would double that income.

If 150k is what orthodontists have the potential to make now, I am ok with that! When everyone was saying that orthos make less, I was thinking it would be 80-90k, which made me a little nervous. My biggest thing right now is that I want to pay off loans soon.

Do your parents have a large student loan debt like you? Do their employers offer health insurance and 401k etc? I don't think a dentist's/orthodontist's income of $150k/year is a lot if you owe $340k in student loan. If you work as an independent contractor like most dentists, you have to buy own health insurance, which is around 1200/month for a family of 4. It definitely helps if your spouse has a good paying job with health benefit. And hopefully, you two stay happily married.

Questions for you guys - My dental school debt will be around 340k. Let's say I do go to an ortho program that costs money. What should my tuition limit be so that I do actually pay off my debt and live a reasonable life?

Try to stay below $450k. In order have a comfortable lifestyle with such loan amount, your and your spouse's combined income needs to be at least $300-350k. My wife and I owed $450k in student loans. Our starting salaries weren't as high as they are today and we were still able to pay off our loans in 5 years. My first job paid me $800/day. Now most corp offices pay $1200-1500/day. That is working for someone else. If you have your own office and know how to control your overhead, you can easily double or tripple that daily rate.

Also the idea of working as a part time GP and part time ortho is so interesting! I may do that. But do you lose the hand skills when you are in ortho residency for 3 years? And how do I go about doing this?

Yes, having a part time job as a GP is better than staying home doing nothing, especially when you are young, healthy and haven't had a kid yet. This, however, should be your last resort. You should try to start in-house ortho service at a GP office first. Just don't be picky. There are a lot of places that want to hire you or let you rent their office spaces. Learn to get along with the GPs and treat their staff well and you will be fine.

 

[charlestweed]

I agree with you, the stress of being a GP is insane, I did not even realize it until I came to dental school. I am so stressed right now, and I am not even practicing with my license on the line. That is definitely another thing about ortho that is nice. But I do not want too much free time. I want to stay busy during the day, see lots of patients, build patient connections, do complicated cases that will involve really changing someone's life. I hope my patient base will be large enough to be able to do this!

Ortho is a very relaxing laid back job. I often bring my son to work to let him see how cool my job is. When I am done, I take him to a movie, a football game, to eat etc. That's the beauty of ortho.... I don't feel exhausted or stressed at the end of the work day. Hopefully, he'll follow my footstep.

 

[charlestweed]

It's peanut money for people who came to dental school that easily could have gone to medical school for a cheaper price and easily match a middle of the road specialty that clears 300+ with a decent lifestyle (EM, anesthesiology, etc) and potentially something more. Doesn't apply to every dental student. If I wanted to make 150 I would go to PA school for 2 years and a cheaper cost or become a CRNA. Or I would become an engineer.

Also LOCATION. A medical doc can work anywhere. Dentistry is saturated to the point if you want to live in an urban city, you're out of luck if it's saturated.

My cousin is an MD anesthesiologist here in CA . He works for a group that has a contract with the hospital. He always fears of losing his job because the hospital can cancel the contract with his group and sign a new one with another group. He wishes he can be a dentist like me.

I can't set up my ortho practice in rural areas because there is a higher demand for braces in big cities.

 

[charlestweed]

Yep dental school showed me that in full. You aren't just checking in and checking out. It's another reason that made me want to specialize. I would rather have fewer large cases then be going room to room constantly. Vs ortho, I would rather have 6-10 patients than have to talk to like 40+ people a day which would be draining as well. Dental school actually solidified my desire to specialize.

I also realized I don't want to work in the midwest. I've gone to "small" cities (not suburbs), and there is just no diversity in food, things to do, etc unless you're extremely out doorsy.

40 patients a day is way under my capacity...and it's boring to sit around doing nothing. Ever since graduation (in the early 2000s), I've got used to seeing 60+ patients a day at the corp offices. I do the same at my own offices. If don't have at least 50 patients, I cancel the day....and use the extra free days that I have to work for the corp offices.

For me, staying home doing nothing (especially at this age...46) makes me feel useless. I need to have at least 20 days/month. It's a waste not to work at the maximum capacity when I am in a good health shape to do so. Making lots of money is of course the main motivator. Who knows what will happen to my health and to ortho specialty in the next 5-10 years? I have kids to support. The more money I make and use it to invest (because practicing dentistry won't make me rich) at earlier age, the sooner I can reach the goal of being financially independent. And when I reach this goal, I will probably continue to work part time because I will be bored to death if I stay home every day. Ortho is a very enjoyable job. It's hard to let it go completely.

 

[Medin2017]

40 patients a day is way under my capacity...and it's boring to sit around doing nothing. Ever since graduation (in the early 2000s), I've got used to seeing 60+ patients a day at the corp offices. I do the same at my own offices. If don't have at least 50 patients, I cancel the day....and use the extra free days that I have to work for the corp offices.

For me, staying home doing nothing (especially at this age...46) makes me feel useless. It's a waste not to work at the maximum capacity when I am in a good health shape to do so. Making lots of money is of course the main motivator. Who knows what will happen to my health and to ortho specialty in the next 5-10 years? I have kids to support. The more money I make and use it to invest (because practicing dentistry won't make me rich) at earlier age, the sooner I can reach the goal of being financially independent. And when I reach this goal, I will probably continue to work part time because I will be bored to death if I stay home every day. Ortho is a very enjoyable job. It's hard to let it go completely.

different strokes I guess. 60 sounds even worse for my personality type. It's why some competitive med students actually don't do derm despite having the stats (right now there's a thread on the MD page of derm vs rads).

I would say staying home doing nothing would make me feel useless for sure but if I'm on the job I don't mind working at a normal pace. If I feel overwhelmed though, I'd rather have fewer hours than downtime at work (likewise I'd rather stay home for 4 hours then go to class for 4 hours than go to class for 8 hours with random breaks for no reason).

Awesome that you were so successful. Multiple pathways to success for sure.

 

[The Anhedonia]

40 patients a day is way under my capacity...and it's boring to sit around doing nothing. Ever since graduation (in the early 2000s), I've got used to seeing 60+ patients a day at the corp offices. I do the same at my own offices. If don't have at least 50 patients, I cancel the day....and use the extra free days that I have to work for the corp offices..

how do you document your visits (i.e. how the hell do you write any notes)? do you have a scribe or something or write notes at home because that many notes in the OMFS world would give me diarrhea.

 

[321931]

Ortho is a different beast. You have to see many patients but assistants are delegated to do a ton of work. There's no way as a GP that 40-60+ will fly. After 40 patient's I'm done for the day mentally and physically. If I were to do 20 actual treatments out of the 40 patients (rest are hygiene check), I guarantee you that your back will give out by the time you are 40.

 

[charlestweed]

different strokes I guess. 60 sounds even worse for my personality type. It's why some competitive med students actually don't do derm despite having the stats (right now there's a thread on the MD page of derm vs rads).

I would say staying home doing nothing would make me feel useless for sure but if I'm on the job I don't mind working at a normal pace. If I feel overwhelmed though, I'd rather have fewer hours than downtime at work (likewise I'd rather stay home for 4 hours then go to class for 4 hours than go to class for 8 hours with random breaks for no reason).

Awesome that you were so successful. Multiple pathways to success for sure.

Yup, it sucks having a lot random breaks in between. The problem with working at a corp office is I have to work 8 hours and it’s really slow in the morning, when most kids are at school. I know shouldn’t complain because I get paid for sitting around. At my own offices, I book all my patients from 2pm-6pm weekday and 8am-12noon on weekends so I can have a non-stop work schedule.

60 patients is actually on the low side. With 6 assistants and 7 chairs, I can see up to 100 patients.

 

[charlestweed]

how do you document your visits (i.e. how the hell do you write any notes)? do you have a scribe or something or write notes at home because that many notes in the OMFS world would give me diarrhea.

It takes me less than 30 seconds to write something like this “Powerchain upper 6-6. Class II elastics. Upper 16x22ss” and sign my note. My assistant comes in, reads my note and performs the tasks that I wrote on the chart. Life is beautiful.

 

[Medin2017]

Yup, it sucks having a lot random breaks in between. The problem with working at a corp office is I have to work 8 hours and it’s really slow in the morning, when most kids are at school. I know shouldn’t complain because I get paid for sitting around. At my own offices, I book all my patients from 2pm-6pm weekday and 8am-12noon on weekends so I can have a non-stop work schedule.

60 patients is actually on the low side. With 6 assistants and 7 chairs, I can see up to 100 patients.

That's sick. That is a hell of a lot of patients. Was it easy when you first graduated or did it take a while to get used to the interpersonal skill stuff on the fly

 

[charlestweed]

That's sick. That is a hell of a lot of patients. Was it easy when you first graduated or did it take a while to get used to the interpersonal skill stuff on the fly

On my very first job, I often fell behind because it took time for me to study the transferred cases....and a lot of patients in the lobby complained about the long waits. As I treated more and more cases and saw similar ortho problems and complications, things became easier for me.

I usually let my assistants do all the talkings such as OH, elastic wear, retainer wear, RPE activation instructions etc so I can put more of my time on what I do best...diagnosis and tx planning. I rarely talk to the parents. And when I do, we usually talk about schools (because all want their kids to be like me) or about immigrants' lives (because many are immigrants like me) etc. I don't need to spend time to sell cases since my tx fee is already very low. It's like getting low cost ortho treatments at an ortho residency program...the patients are presented the fee and they just need to pay the initial down payment, if they want to start tx.

A lot of people wonder how I can provide high quality care with such high patient volume. Ortho is different from general dentistry in that the ortho tx outcomes depend more on the orthodontist's ability to diagnose and tx plan and not so much on the time spent to treat each patient. For example, if you tx plan NOT to extract teeth on a bimax patient with moderate to severe crowding, the result will be horrible...no matter how much time you spend to treat or talk to that patient.

 

[charlestweed]

You're right, my parents didn't have that much debt. But, they only started making 6 figures a few years ago. We were living under 50k for the entire family while I was growing up, so I'm equating my lifestyle growing up to my life in the future. That isn't saying I don't want to work hard to do better. Of course I do, that's one of the reasons I'm here. But for me, money isn't the big driving factor. As long as I can pay off my loans, I'll be happy. Maybe I'll change my mind in the future as I start to work though. I just want to enjoy my life and be relaxed - def a perk from ortho.

My family definitely does not have experience paying off hundreds of thousands of dollars of debt. I wont know what life will be like with that so it's nice to hear from experienced dentists who can give me advice on this.

With such huge loan amount, I don't think you can really afford to have a relaxed lifestyle and take things easy....ie working for someone else.....at a slow pace office 4-5 days/week....and not thinking about starting your own office. Money should be the big driving factor. You can't really enjoy life when you let the banks control your life. You are far from being done when you pay off your student loans. What about savings for your retirement ? What about college savings for your kids (if you plan to have a few)? Remember with your great income, your kids won't qualify for grants and other government assisted programs when they enter college.

 

[Medin2017]

With such huge loan amount, I don't think you can really afford to have a relaxed lifestyle and take things easy....ie working for someone else.....at a slow pace office 4-5 days/week....and not thinking about starting your own office. Money should be the big driving factor. You can't really enjoy life when you let the banks control your life. You are far from being done when you pay off your student loans. What about savings for your retirement ? What about college savings for your kids (if you plan to have a few)? Remember with your great income, your kids won't qualify for grants and other government assisted programs when they enter college.

yea 300+ debt and 150k income is not a good ratio at all... not to mention 4 year opportunity cost.

 

[Munks]

There are a lot of places that want to hire you or let you rent their office spaces. Learn to get along with the GPs and treat their staff well and you will be fine.

Sidenote of this thread, but I've long wondered- how does renting an office space from a GP work? If I remember correctly, you use your sister's and wife's spaces so I would imagine that makes it much easier, but in general, how does it work using someone else's office? With their name on the door, their name in the google searches for the address, their posters and information on the walls. I feel parents may be confused like, "am I in the right building?". Just always been curious, as in theory it does sound like a good way to reduce overhead by splitting the rent.

If don't have at least 50 patients, I cancel the day....and use the extra free days that I have to work for the corp offices.

How do you do this when your adjustments are scheduled ~4 weeks out? I wouldn't think it's as simple as "today is Friday and next week's Friday there isn't as much so let's cancel and reschedule 30 patients". I would imagine you would have to cancel weeks to a month ahead of time in your own practice. And same goes for picking up the day at the corp instead; aren't those appointments already made a month before?

 

[charlestweed]

Sidenote of this thread, but I've long wondered- how does renting an office space from a GP work? If I remember correctly, you use your sister's and wife's spaces so I would imagine that makes it much easier, but in general, how does it work using someone else's office? With their name on the door, their name in the google searches for the address, their posters and information on the walls. I feel parents may be confused like, "am I in the right building?". Just always been curious, as in theory it does sound like a good way to reduce overhead by splitting the rent.

Yes, one GP office belongs to my sister and the other GP office belongs to a dental classmate. I pay my classmate a monthly rent. He agrees to pay all the utility bills. All agreements are verbal....no contract, no lawyer. Luckily, everything works out great. I've been at my classmate's office for about 4 years now. He provides 2 chairs because he only needs 2. I brought in 5 chairs + a $10k refurbished pan/ceph machine. At the end of a busy messy day, I make sure my staff clean all the mess and get the office ready for the owner to see his patients the following day.

Yes, the patients may be confused at first because the large office sign has the owner's name. My name is on a small glass panel. When the patients like you and your fee (through word of mouth and GP referrals), they will make an effort to find you no matter how hard it is to find your office. It's no different than having an office inside a professional building. In fact, one of my offices is inside a professional building.

How do you do this when your adjustments are scheduled ~4 weeks out? I wouldn't think it's as simple as "today is Friday and next week's Friday there isn't as much so let's cancel and reschedule 30 patients". I would imagine you would have to cancel weeks to a month ahead of time in your own practice. And same goes for picking up the day at the corp instead; aren't those appointments already made a month before?

I don't cancel the day that I already have patients but I will cancel that day next month when I feel I don't need it. The good thing about hiring P/T staff is I can cut their hours when I don't need them. The corporate that I current work for has begged me to give them more days so I should have no problem getting more days there. For the busy months of June through August, I usually give the corp offices 1-2 more days a month....and I just cut 1-2 days at my own offices. To compensate for fewer work days at my offices, I just work 1 additional hour each day and pay the P/T staff a little bit more.

 

[2TH MVR]

In the early 90s and 2000s I had large staffs (8-10) and we were seeing 80-100 patients routinely. It is quite easy IF you have a well trained staff. At this point in my life ... I am quite happy seeing 30-50 patients a day. I am much more hands-on than most orthodontists. Although now I work for a Corp ... so I won't be in control of that patient number.

CharlesTweed's is an interesting business strategy and it obviously works in today's climate. I'm not sure that is the strategy that most young graduating orthos will want to pursue. But given the current climate .... they may want to reconsider. When I 1st graduated ... I met a young GP in a small town about 3 hours from Phoenix. My mother actually winters in that particular town. There are two local GPs and that is it. They had to send their ortho referrals to either Sierra Vista or Tucson. We got to talking and since I was coming to town every month .... he suggested that I work in his office once a month to see his ortho referrals. Cost to me? nothing. He was just happy to have an orthodontist in town. I actually enjoyed the small town atmosphere. It was great. I actually kind of miss it. Gave it up since my main practice in Phx was doing well and I was getting tired of driving there every month. I still see my mom though. 🙂.

CharlesTweed's strategy seems pretty busy and is important now, but in time when he's my age (55) .... he may consider slowing down a bit and enjoying time off with the family and oneself.

 

[deleted678432]

how do you document your visits (i.e. how the hell do you write any notes)? do you have a scribe or something or write notes at home because that many notes in the OMFS world would give me diarrhea.

Diarrhea from the mouth*


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