Oral Surgery & Reconstructive Surgery

[aphistis]

I don't want to sound flippant, but pharmacists "receive" regulatory authority when we graduate and it also becomes our license on the line if something goes wrong. We are all professionals, thereby allowing us professional judgement. These two examples are poor examples of a pharmacist pushing his or her judgement. Sometimes dentists like to prescribe for meds out of their scope of practice and it is in those instances when pharmacists should refuse to fill (but of course calling the dentist first). It is by no means an "MD" / "non MD" issue....if a pathologist was writing Rxs for warfarin, you can bet any pharmacist would be calling that path doc right away.

And to answer your question about filling the dentist's script for psoriasis...Nope, there's no way I'd fill that.

The term "professional judgment" implies a high level of education & training. I don't want to sound flippant either, but if you're going to throw that term around, you need to be able to demonstrate that you meet that standard. Are we to assume, then, that pharmacists are educated in making scope-of-practice decisions as part of your training?

Again, let me emphasize that I'm not trying to pick on you personally. But if, as a profession, you folks are rejecting prescriptions in the name of policing fraud, I think it's pretty reasonable to have you able to produce some sort of documentation--of the *ability*, not just the authority.

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[28657]

The term "professional judgment" implies a high level of education & training. I don't want to sound flippant either, but if you're going to throw that term around, you need to be able to demonstrate that you meet that standard. Are we to assume, then, that pharmacists are educated in making scope-of-practice decisions as part of your training?

Again, let me emphasize that I'm not trying to pick on you personally. But if, as a profession, you folks are rejecting prescriptions in the name of policing fraud, I think it's pretty reasonable to have you able to produce some sort of documentation--of the *ability*, not just the authority.

It's really unfortunate that you aren't aware of the kind of training a PharmD. graduate acquires in pharmacy school. I am in professional school and I will be able to evoke my professional judgement when I see fit.
What does "professional" exactly mean to you?
Would you like to compare course schedules?

 

[aphistis]

It's really unfortunate that you aren't aware of the kind of training a PharmD. graduate acquires in pharmacy school. I am in professional school and I will be able to evoke my professional judgement when I see fit.
What does "professional" exactly mean to you?
Would you like to compare course schedules?

Calm down, lady. There's no fire here.

I figured it's pretty self-evident I'm not aware of the training a PharmD receives, or else I wouldn't be asking; and I'm not interested in the least in comparing schedules. *Is* there some sort of course where you're taught about scopes of practice, then? That's what I've been trying to find out for my last six posts in two different threads.

 

[kwakster928]

OK, I'll run with your hypothetical example. You call for verification, and the dentist is renewing a long-standing prescription for the patient's severe psoriasis because, say, the patient's dermatologist is on a three-month vacation (for the sake of realism ). Now, since in your own words, "i have no problem with filling any precription if i can verify that this medication is used for what is intended to use for," do you fill it?

(Note: I would never write a patient for a chemotherapeutic the way I glibly suggested here. It's a hypothetical, folks; call off the dogs.)

hmmm.. aphistis, i would fill assumming that,

1. pt's inabilty to get a contact with the dermatologist is verified.
2. i see that prescription in pt's profile for a long term use.
3. i can verify that with you that you are comfortable with writing this prescription. if something goes wrong this pt can sue you too.
4. i would not give full 30 day supply rather give pt enough to go by until he can get a hold of his/her dermatologist.

but if you happen to initiate this prescription, i may ask you what your intended use is in term of dental.

 

[aphistis]

hmmm.. aphistis, i would fill assumming that,

1. pt's inabilty to get a contact with the dermatologist is verified.
2. i see that prescription in pt's profile for a long term use.
3. i can verify that with you that you are comfortable with writing this prescription. if something goes wrong this pt can sue you too.
4. i would not give full 30 day supply rather give pt enough to go by until he can get a hold of his/her dermatologist.

but if you happen to initiate this prescription, i may ask you what your intended use is in term of dental.

Great--I was just checking to make sure your position stayed consistent under fire. Thanks for responding.

 

[kwakster928]

Calm down, lady. There's no fire here.

I figured it's pretty self-evident I'm not aware of the training a PharmD receives, or else I wouldn't be asking; and I'm not interested in the least in comparing schedules. *Is* there some sort of course where you're taught about scopes of practice, then? That's what I've been trying to find out for my last six posts in two different threads.

no there is no class teaches us scope of practice. but you know that dentist are specialist on teeth. cardiologist are speicialist in heart. from that we make professional judgement. sure a lot of drug can be used for off-lable indications. we try to make such judgements in best of ability however, sometimes may not satisfy all parties. i dont think there is a clear law stating that where the scope of one practice end and starts.

 

[kwakster928]

Great--I was just checking to make sure your position stayed consistent under fire. Thanks for responding.

see aphistis, you and i will get along just fine. just dont write viagra upon yourself, well actually i will give it to ya with a smile. if you promise me that you will not sell this stuff on the street.

 

[toofache32]

see aphistis, you and i will get along just fine. just dont write viagra upon yourself, well actually i will give it to ya with a smile. if you promise me that you will not sell this stuff on the street.

That reminds me...I'm due for a refill...

 

[toofache32]

Don't forget that pharmacists are at the front line in catching narcotics abusers who are taking advantage of us. The one Rx for Lortab you give a patient may be the 4th one that week from different dentists. And sometimes they're dumb enough to fill them at the same pharmacy.

We had a patient leave our clinic with a Lortab Rx and filled it in the hospital pharmacy. The pharmacy called to let us know that the patient brought back the pill bottle a few hours later and said they were given the wrong pills in the bottle, and wanted a new bottle of Lortab. It turns out they replaced the pills with a medication our hospital doesn't even stock. Dumba$$.

 

[KY2007]

I don't want to sound flippant, but pharmacists "receive" regulatory authority when we graduate and it also becomes our license on the line if something goes wrong. We are all professionals, thereby allowing us professional judgement. These two examples are poor examples of a pharmacist pushing his or her judgement. Sometimes dentists like to prescribe for meds out of their scope of practice and it is in those instances when pharmacists should refuse to fill (but of course calling the dentist first). It is by no means an "MD" / "non MD" issue....if a pathologist was writing Rxs for warfarin, you can bet any pharmacist would be calling that path doc right away.

And to answer your question about filling the dentist's script for psoriasis...Nope, there's no way I'd fill that.

If it is not an M.D./non-M.D. thing then why was the resident's prescription filled who had the M.D.. Remember, they are both oral and maxillofacial surgeons, they both receive the exact same training in oms but one went an extra 2 years to get an M.D. and the other did not.

This part is for Kwakster928. Oral and Maxillofacial surgeons are not just tooth specialists, in fact the only thing they do that directly involves teeth is to pull them. OMS does lots of other things like repair fractures of the maxillofacial region, tumor resection, cometic surgery (nose jobs, face lifts), orthognathic surgery just to name a few.

 

[kwakster928]

If it is not an M.D./non-M.D. thing then why was the resident's prescription filled who had the M.D.. Remember, they are both oral and maxillofacial surgeons, they both receive the exact same training in oms but one went an extra 2 years to get an M.D. and the other did not.

This part is for Kwakster928. Oral and Maxillofacial surgeons are not just tooth specialists, in fact the only thing they do that directly involves teeth is to pull them. OMS does lots of other things like repair fractures of the maxillofacial region, tumor resection, cometic surgery (nose jobs, face lifts), orthognathic surgery just to name a few.

i know OMS is a speciality of dentistry and some do hold DMD, and MD degrees together. i was making a point about general dentists. i guess situation can be also differ from prostho, endo, perio, and pedo.

 

[KY2007]

Here's another question that I have. If pharmacists do not know what each and every type of doctor does (I think this would be very difficult to know) then how can they regulate what is prescribed. Like this case with the eyedrops. This a very common procedure that oms does. Still the pharmacist did not know this.

 

[lunguv]

Here's another question that I have. If pharmacists do not know what each and every type of doctor does (I think this would be very difficult to know) then how can they regulate what is prescribed. Like this case with the eyedrops. This a very common procedure that oms does. Still the pharmacist did not know this.

They can figure it out by using Google! that is why in the next 10 years we will all have google hardwired in our brains . JK...but seriously .

 

[north2southOMFS]

When i was doing my ER rotation i wrote prescriptions from Ca channel blockers, to beta blockers, to cholcichine for gout, to diuretics, to beta agonists, to steroids, to SSRI's, to tricyclics, wellbutryn, zyprexa, seroquel, geodon and tons of others. Sure most were refills or a couple week supply of a new med until they could get a clinic appt.......but still.

All done with a DDS only.

But not one call from the pharm people.

I guess they grow the pharmacists dumber down here..........

........Or after school you just fill whatever the hell they come in with!!!(the more likely scenario)

 

[kwakster928]

Here's another question that I have. If pharmacists do not know what each and every type of doctor does (I think this would be very difficult to know) then how can they regulate what is prescribed. Like this case with the eyedrops. This a very common procedure that oms does. Still the pharmacist did not know this.

most of the prescription comes with the title of the prescriber and their area of practice for example.

Indiana Jones, MD
Board Certified Internal Medicine

or

Shelly Gold, MD
Springfield OBGYN

we can also can tell by license numbers, or DEA numbers or any record that we have in the system. i think we are over generalizing one extreme example. most of the time the prescription will be filled without a question. it is waste of time for both parties. pharmacist have general confidnece on every prescriber that that person knows what they are doing. only thing i would get little worried about will be over prescribing of narcotics (since we have to report this to DEA). again, situation above is an extreme example, and i still believe that the pharmacist went little too far.

 

[kwakster928]

When i was doing my ER rotation i wrote prescriptions from Ca channel blockers, to beta blockers, to cholcichine for gout, to diuretics, to beta agonists, to steroids, to SSRI's, to tricyclics, wellbutryn, zyprexa, seroquel, geodon and tons of others. Sure most were refills or a couple week supply of a new med until they could get a clinic appt.......but still.

All done with a DDS only.

But not one call from the pharm people.

I guess they grow the pharmacists dumber down here..........

........Or after school you just fill whatever the hell they come in with!!!(the more likely scenario)

hopefully neither of two cases.

 

[bananaface]

My pharmacy law class provides scope of practice training. If we believe a prescription is outside of a prescriber's scope of practice, we need to call the prescriber and ask them to explain how the prescription falls within their scope of practice. Just because you prescribed generalized meds during redisency rotations does not mean they are a part of your current scope of practice, at least in my state. The prescribed medication must be related to your current specialty.

 

[tx oms]

It's never been a problem for me. If I got called out by a pharmacist I'd be pissed, but I'd get over it.

Seems to me the thread is not much different from threads in which hygienists say they should be aloud to do pretty much anything and practice unsupervised. We all jump on those chicks pretty quick, tell 'em to go to dental school if that's what they want. When hygienists get on that soap box it's generally to cover up insecurities and jealousy.

I'm sure pharmacists and MD's look at it the same way--you want unquestioned prescribing authority, go to medical school. To argue otherwise may just be a sign of insecurity and jealousy. We've got to be content and realize we don't get all the privelages an MD has nor do we have the medical training they have. It's a two way street, though, and they should recognize our expertise. Or you can just go to medical school like me and really inflate your ego.

 

[bananaface]

MDs in no way have unquestioned prescribing authority. It's all about their individual scope of practice, as defined by their specialty. (At least in my state.)

 

[omfsres]

MDs in no way have unquestioned prescribing authority. It's all about their individual scope of practice, as defined by their specialty. (At least in my state.)

If you have an MD you are much less likely to raise eyebrows at the pharmacy or in the court room for writing various prescriptions.

 

[bananaface]

If you have an MD you are much less likely to raise eyebrows at the pharmacy or in the court room for writing various prescriptions.

I agree that those practicing dentistry are much more likely than MDs practicing medicine to be questioned for going outside of their scope of practice. We tend to question those in dentistry more, because we feel that the scope of practice is easier for us to define than many other medical specialties. And, honestly, many old school pharmacists are simply afraid to question someone practicing medicine but don't hold the reservations when it comes to dentistry. Anyway, I felt the need to speak up, because I hate to perpetuate the myth that being an MD entitles one to prescribe everything under the sun without question.

It's never been a problem for me. If I got called out by a pharmacist I'd be pissed, but I'd get over it.

As far as getting angry goes, you really shouldn't. When a pharmacist calls to inquire how a prescription relates to your scope of practice, they are only doing it to ensure your patient's safety. If they are unaware of your training, educate them. Don't take it personally.

I once turned down a prescription from a dental office. One of the secretary's friends had had a genital herpes outbreak and asked her friend to call in a refill on her Valtrex. The prescriber gave permission without even knowing what the drug was. He told his secretary that was fine to phone over whatever her friend, who was not a patient, needed as long it was not a narcotic.

 

[north2southOMFS]

I once turned down a prescription from a dental office. One of the secretary's friends had had a genital herpes outbreak and asked her friend to call in a refill on her Valtrex. The prescriber gave permission without even knowing what the drug was. He told his secretary that was fine to phone over whatever her friend, who was not a patient, needed as long it was not a narcotic.

So did you fill it?

Ouch, your letting genital herpes run amok!

 

[KY2007]

If dentists can prescribe medications for Herpes Labialis, which they can, they why not for herpes simplex 2?

 

[tx oms]

If dentists can prescribe medications for Herpes Labialis, which they can, they why not for herpes simplex 2?

B/c they should have been a physician if they wanted to treat STDs. Genital herpes is not in anyway a dental issue. Dentists are not trained to handle systemic conditions.

 

[kato999]

B/c they should have been a physician if they wanted to treat STDs. Genital herpes is not in anyway a dental issue. Dentists are not trained to handle systemic conditions.

You mean that I can't have them " turn their head and cough" after the TMJ check?

 

[bananaface]

So did you fill it?

Ouch, your letting genital herpes run amok!

No, I didn't fill it.

B/c they should have been a physician if they wanted to treat STDs. Genital herpes is not in anyway a dental issue. Dentists are not trained to handle systemic conditions.

Dentists do prescribe for select systemic conditions. I get pre-appointment antibiotics for those with heart valve damage all the time, diazepam (Valium) for those with procedure related anxiety, and anti-emetics for those who experience nausea when taking pain medications. But, those can all be related to the scope of practice of dentistry.

 

[OzDDS]

Dentists are not trained to handle systemic conditions.

Actually, that may depend on what dental school you attend. At some schools, the dental students complete 99% of the first 2 years of med school along with the med students. They are not doing 3rd year med rotations in ob/gyn.. but actually i would think most dental students would have a working knowledge of and be capable of perscribing for many systemic conditions.

 

[tx oms]

Actually, that may depend on what dental school you attend. At some schools, the dental students complete 99% of the first 2 years of med school along with the med students. They are not doing 3rd year med rotations in ob/gyn.. but actually i would think most dental students would have a working knowledge of and be capable of perscribing for many systemic conditions.

Medical school does not teach you how to manage/treat systemic diseases. Medical school teaches you how to do a good history and physical. Residency and real life are where you learn to be a doctor. It is a commonly held, though false, belief that medical students know how to treat disease.

Ignorance is bliss, though. Perhaps many dental students do feel they are capable of prescribing for many systemic conditions.

PS--There is a lot more to being a physician than two years of basic science and an ob/gyn rotation. If it were that easy residencies wouldn't exist.

 

[omfsres]

Medical school does not teach you how to manage/treat systemic diseases. Medical school teaches you how to do a good history and physical. Residency and real life are where you learn to be a doctor. It is a commonly held, though false, belief that medical students know how to treat disease.

Ignorance is bliss, though. Perhaps many dental students do feel they are capable of prescribing for many systemic conditions.

PS--There is a lot more to being a physician than two years of basic science and an ob/gyn rotation. If it were that easy residencies wouldn't exist.

I agree. Medical residents get advice from attendings all the time on how to appropriately manage a patient. This occurs throughout the residency. There all all sorts of guidelines and considerations to know before treating a systmic conditions. It's not as simple as, "oh, this person has high blood pressure, I think I'll prescribe a beta blocker until he can see his doctor." Good luck with that though.

 

[QCkid]

B/c they should have been a physician if they wanted to treat STDs. Genital herpes is not in anyway a dental issue. Dentists are not trained to handle systemic conditions.

Hmmm. Herpes not a dental issue. What about gingival stomatitis. I can't treat a patient with actively erupting lesions. Active manifestations in the oral mucosa need to be taken care of before I can treat. Why can't I prescribe Valtrex if herpes has already been diagnosed?

 

[egpndoc]

Hmmm. Herpes not a dental issue. What about gingival stomatitis. I can't treat a patient with actively erupting lesions. Active manifestations in the oral mucosa need to be taken care of before I can treat. Why can't I prescribe Valtrex if herpes has already been diagnosed?

Who has herpes?

 

[aphistis]

B/c they should have been a physician if they wanted to treat STDs. Genital herpes is not in anyway a dental issue. Dentists are not trained to handle systemic conditions.

Hmmm. Herpes not a dental issue. What about gingival stomatitis. I can't treat a patient with actively erupting lesions. Active manifestations in the oral mucosa need to be taken care of before I can treat. Why can't I prescribe Valtrex if herpes has already been diagnosed?

I've taken the liberty of highlighting an adjective you apparently missed your first time reading his comments.

 

[bananaface]

Why can't I prescribe Valtrex if herpes has already been diagnosed?

Because your prescribing rights are limited to your scope of practice.

 

[QCkid]

I've taken the liberty of highlighting an adjective you apparently missed your first time reading his comments.

Yes I noticed that, but my point related to prescribing the drug, not so much to the area of the body where the infection is present. Valtrex after all is used to treat HSV-2 infections and this can be transmitted to the oral mucosa via oral sex. In reality I would refer the patient to their physician but simply for arguments sake, why couldn't I write a perscription to treat this if it has already been diagnosed and this is simply an new flare up?

 

[28657]

Yes I noticed that, but my point related to prescribing the drug, not so much to the area of the body where the infection is present. Valtrex after all is used to treat HSV-2 infections and this can be transmitted to the oral mucosa via oral sex. In reality I would refer the patient to their physician but simply for arguments sake, why couldn't I write a perscription to treat this if it has already been diagnosed and this is simply an new flare up?

Well to reply for argument's sake -
While you may be a dentist who is confident and knowledgeable in Valtrex dosing (how much and for how long) and you trust your patient has genital herpes (without doing a physical exam)....not all dentists are comfortable with this. How is the pharmacist supposed to know that you know what you're talking about. Really, this is all for the health of the patient. And by refusing to fill this prescription, we are not letting herpes run amok, as this was earlier said. Herpes is possibly contagious whether in "flare up season" or not.

But this is all pointless anyway. Because I agree with you. Valtrex can be used to treat HSV I....which is in your scope of practice. So I'd fill it.

 

[KY2007]

Well to reply for argument's sake -
While you may be a dentist who is confident and knowledgeable in Valtrex dosing (how much and for how long) and you trust your patient has genital herpes (without doing a physical exam)....not all dentists are comfortable with this. How is the pharmacist supposed to know that you know what you're talking about. Really, this is all for the health of the patient. And by refusing to fill this prescription, we are not letting herpes run amok, as this was earlier said. Herpes is possibly contagious whether in "flare up season" or not.

But this is all pointless anyway. Because I agree with you. Valtrex can be used to treat HSV I....which is in your scope of practice. So I'd fill it.

No meaningful difference between HSV1 and HSV2. Just location. This was exactly my point. Not that I really care but I think the fact that you try to put all dentist in the same box and say "I really don't know what you do, but I think I am able to regulate what you prescribe is funny

 

[tx oms]

Hmmm. Herpes not a dental issue. What about gingival stomatitis. I can't treat a patient with actively erupting lesions. Active manifestations in the oral mucosa need to be taken care of before I can treat. Why can't I prescribe Valtrex if herpes has already been diagnosed?

Try hooked on phonics if reading is difficult for you. I said GENITAL herpes is not a dental issue. If that's not enough, let me further explain why a dentist cannot/should not treat GENITAL herpes: no one should treat a patient they did not examine. Are you going to do genital exams in your dental chair?

 

[toofache32]

...Are you going to do genital exams in your dental chair?

You mean I'm not supposed to be doing this?

 

[QCkid]

Try hooked on phonics if reading is difficult for you. I said GENITAL herpes is not a dental issue. If that's not enough, let me further explain why a dentist cannot/should not treat GENITAL herpes: no one should treat a patient they did not examine. Are you going to do genital exams in your dental chair?

Seriously, hooked on phonics? That was funny like 10 years ago. The only person that has trouble reading is you since I made it clear a few post earlier what I meant. As I said before, in reality I would refer the patient to their physician. What I was trying to get at was that a pharmacist really has no basis for making a decision on what we are qualified to treat (before the pharmacists lose it over this.... I do agree with your right to question the Dr. on how the treament corresponds to their area of expertise and to protect the patient). The herpes example was just to show how different diseases might relate to dentistry. By the way, we do conduct exams, not full physicals but we will check vitals, palpate the lymph nodes, check for asymmetry .... etc.

 

[QCkid]

Seriously, hooked on phonics? That was funny like 10 years ago. The only person that has trouble reading is you since I made it clear a few post earlier what I meant. As I said before, in reality I would refer the patient to their physician. What I was trying to get at was that a pharmacist really has no basis for making a decision on what we are qualified to treat (before the pharmacists lose it over this.... I do agree with your right to question the Dr. on how the treament corresponds to their area of expertise and to protect the patient). The herpes example was just to show how different diseases might relate to dentistry. By the way, we do conduct exams, not full physicals but we will check vitals, palpate the lymph nodes, check for asymmetry .... etc.

With that said. I've got better things to do so..... gotta go.

 

[lunguv]

With that said. I've got better things to do so..... gotta go.

Like what?

 

[bananaface]

No meaningful difference between HSV1 and HSV2. Just location. This was exactly my point. Not that I really care but I think the fact that you try to put all dentist in the same box and say "I really don't know what you do, but I think I am able to regulate what you prescribe is funny

It's not just funny, it's the law.

I have no obligation to fill any prescription. And, by law, I am the one who has the responsibility to ensure that all prescriptions I fill are appropriate. Prescriptions written outside of the scope of practice are not appropriate. So, if anyone goes outside of their scope of practice, I am left with the burden of telling them that I must decline on that basis. It's not as if it's fun for me either.

 

[brycethefatty]

Dear fellow SDN dentists/dental students,

I am about to begin dental school in the fall and had a question that I've not been able to find answers to online and from other dentists...

I am highly interested in pursuing oral surgery specialty following completion of my pre-doctoral education. My question is this: which states allow oral surgeons (who have also completed their MD requirements) allow them to perform all types of facial reconstructive surgery (therapeutic as well as elective)? I recently read that Gov Schwartzenager veto'ed the bill allowing CA oral surgeons to perform elective surgeries. I cannot seem to find any info on the AA of Plastic Surgeons and AA Oral Surgeons website regarding this.

Any and all help would be awesome! Thanks and good luck to you all...

Artin

If you want to do plastic surgery on people's faces you would probably be better off going to medical school and then doing a plastic surgery residency. It will be very difficult to build a referal base to do plastic surgery if you are a OMS, regardless whether you have an MD or not. I got all this from an OMS with an MD that tried to build a referral base and failed and is now doing orthognastic surgery and wisdom teeth.

 

[brycethefatty]

From what I have read, many plastic residencies right after med school are usually 5 years. So if nose jobs are what spark your interest you are better off saving yourself 2 years and just doing med school in stead of the 6+1 OMFS plastics fellowship after the DDS.

That being said one of our part time faculty did the 6 year OMFS and the plastics fellowship. He does the bread and butter wizzies, but also does boob jobs and rhinoplasties a few days a week.

When a patient calls to get implants he has to ask them where

Let's be honest, if your goal is to make a buttload of money then go to med school and finish a plastic surgery residency. The only problem is that when you've finished that route through hell, you've lost ten years of your life. Why not be a general dentist or even a specialist and make great money and be able to enjoy fresh air and boating while the OMFS and MD's live their lives indoors. Sure they can do a lot of great surgeries for the Ashlee Simpson's of the world (rhinoplasty, boob jobs, face lifts), but wouldn't you feel better about yourself if you had 7-10 years of your life to actually live? My final advice is if you want to do surgery, be a doctor. If you want to fix smiles, relieve pain, and work decent hours, be a dentist.

 

[north2southOMFS]

Let's be honest, if your goal is to make a buttload of money then go to med school and finish a plastic surgery residency. The only problem is that when you've finished that route through hell, you've lost ten years of your life. Why not be a general dentist or even a specialist and make great money and be able to enjoy fresh air and boating while the OMFS and MD's live their lives indoors. Sure they can do a lot of great surgeries for the Ashlee Simpson's of the world (rhinoplasty, boob jobs, face lifts), but wouldn't you feel better about yourself if you had 7-10 years of your life to actually live? My final advice is if you want to do surgery, be a doctor. If you want to fix smiles, relieve pain, and work decent hours, be a dentist.

Fatty, i don't think you know much about our profession.

 

[toofache32]

Fatty, i don't think you know much about our profession.

Obviously.

 

[toofache32]

Let's be honest, if your goal is to make a buttload of money then go to med school and finish a plastic surgery residency.

Or even better, do an OMS residency. A nosejob costs about 3-4G but takes about 2-4 hours. A set of 4 wisdom teeth averages about $1500 (depending on where you live) and you can do 2 or more patients in an hour. Simple math.

Of course, I'll never see the cash because I'm planning on going into academics.