Orthodontist for 40 years-Ask Me Anything

[JawJock47]

My son just recently showed me this site, what an awesome resource for student in today's era! I won't say when I was a pre-dent, but there certainly wasn't SDN 🙂

I owned a private orthodontic practice for 20+ yrs, have worked for a corporate dental company, and am also teach in a ortho residency program. My goal here is just to pay forward some of the help I received along the way. Ask my anything and everything!

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[Steins;Gate]

My son just recently showed me this site, what an awesome resource for student in today's era! I won't say when I was a pre-dent, but there certainly wasn't SDN 🙂

I owned a private orthodontic practice for 20+ yrs, have worked for a corporate dental company, and am also teach in a ortho residency program. My goal here is just to pay forward some of the help I received along the way. Ask my anything and everything!

Thank you very much for doing this. I had a few questions:
1) How did you decide to specialize in ortho?
2) Knowing what you know about the current landscape of ortho, would you still encourage students to specialize in ortho?
3) How many years would one budget to hit their stride as an owner with a solid patient base from a start up?
4) Do you think buying an existing practice is better or starting up?
5) Are you fulfilled professionally in ortho?

 

[O Gaúcho]

Over the last 40 years of being an Orthodontist how have you seen the field change? And do you see it heading a positive or negative way overall?

 

[CaliDDS1986]

How much more can you expect to earn as an ortho per year vs being a GP?

 

[multinucleated]

Thank you for being willing to share your wisdom with us. My question - Is there a way or more than one way or business model to have a profitable Orthodontics practice while significantly and consistently giving back to the local and possibly the global community?

 

[JawJock47]

Thank you very much for doing this. I had a few questions:
1) How did you decide to specialize in ortho?

Wow, well back in that day the decision came down to what it was I was looking for from my patient pool. I LOVED how the ortho patients came to the doctor with anticipation and excitement about a more beautiful aesthetic and healthy(id argue) smile.

2) Knowing what you know about the current landscape of ortho, would you still encourage students to specialize in ortho?

To be honest, I would explain that today and the future are going to be completely different than when I was coming up. Ortho specialization is way too often being outsourced (invisalign) and general dentist are now taking easier cases. Additional the number of orthognathic cases has decreased due to changes in insurance policies (I used to get about 1 a month now I see maybe 2 a year). The landscape of dentistry is changing, and the earners potentially will be in different areas...but that is perhaps a different discussion. Honestly the hay day for all orthodontists is on the decline, but there will always be room for the skilled.

3) How many years would one budget to hit their stride as an owner with a solid patient base from a start up?

I started with 1 office with 2 chairs and in 10 years I had 5 offices with 8 chairs each. That was 1969-1979. The increase is gradual obviously, but like I said above, building such a large practice with an increase in competition in2017 will be difficult.

4) Do you think buying an existing practice is better or starting up?

Depends on your age and motivation. If it were me, Id buy past the age of 37.

5) Are you fulfilled professionally in ortho?
Yes. I love my patients and there is nothing better in the world than looking back on the before and afters I've done through the years. I can honestly say it was easy for me to forget about money and focus on patient treatment which is a blessing.

 

[JawJock47]

How much more can you expect to earn as an ortho per year vs being a GP?

The corporate company pays entry level orthodontist 120k more per year base than a GP. Id say thats a decent measuring stick, but over time individual production comes into play.

 

[JawJock47]

Thank you for being willing to share your wisdom with us. My question - Is there a way or more than one way or business model to have a profitable Orthodontics practice while significantly and consistently giving back to the local and possibly the global community?

Two ways to grow and make more every year in my experience.

1. Large mega practices where you grow your patient pool. In this scenario, you will have to drive to different offices and pull from different markets around a city and suburbs. This would require you to be busy, but successful if you are aggressive in your marketing and if your product is above and beyond the competition.

2. Nice, Botique practices. Some orthodontist market to a specific patient pool most commonly seen with PEDO and ORtHO qualified individuals, but not always. These practitioners market to a specific patient pool and sometimes dont even take insurance. IF you go this route you will have more time and work less, while potentially being just as profitable. I know some orthodontists with 1 office who also teach and travel.

I would say I went with option 1 and still had ample time to raise a big family and went on at least 2 mission trips a year. If you are looking for a good work/life balance and you mostly just care about being successful and giving back to the international community, Ortho in general is an amazing choice.

 

[JawJock47]

What has been your favorite/most appreciated evolution in the way that Orthodontics is practiced today?

it is evolving in such a way that you can really model and manage a patients expectations with imaging. Technology and Invisalign, while they have taken some from the orthodontists money making ability, really have provided a much much larger portion of the population the ability to straighten their teeth.

Many years ago, going to the orthodontist was something a small percentage of the population was able to afford and have the patience for. In today's day and age, the American middle class can provide their children with straight teeth.

 

[JawJock47]

Over the last 40 years of being an Orthodontist how have you seen the field change? And do you see it heading a positive or negative way overall?

Hopefully the above responses will help you see that Orthodontics is becoming a more trivial treatment. More people want braces and want them for their children. Positive or Negative? I would just tell you the orthodontists who started 15 yrs ago are having trouble maintaining their growth, but straightening peoples teeth will always be rewarding.

 

[CaliDDS1986]

Would you take out an additional 300k in loans for orthodontic residency on top of dental school loans? Including lost opportunity income from being a GP it's potentially a one million dollar loss of income to attend residency.

 

[ortholurking]

1) Regarding Invisalign/Clear Correct tx - Are there any specific methods or courses you would recommend for learning the nuances of successful treatment? So much of obtaining a successful outcome depends on your initial case setup and modification of the ClinCheck, but it seems like most practitioners basically learn as they go including having to go through 1+ refinements, etc. Is there anything beyond simple trial and error on patients that you would recommend? My thoughts are just making sure to understand the basic biomechanics in play like any other appliance system, and using that to employ whatever various attachments you need to make the movements happen.

2) Regarding orthognathic cases (or lack of) - how do you manage to treat/camouflage those highly-in-need cases. For most of the patients I've seen getting surgery through my residency, there is pretty much no way to treat them otherwise (ie large skeletal discrepancies). Would you say you get a fair amount of patients you have to reject just by being impossible to treat? Or do you just give them all the informed consent discussion and pray for some kind of positive result.

Other orthos ofc feel free to chime in as well 🙂

 

[wengerout]

My son just recently showed me this site, what an awesome resource for student in today's era! I won't say when I was a pre-dent, but there certainly wasn't SDN 🙂

I owned a private orthodontic practice for 20+ yrs, have worked for a corporate dental company, and am also teach in a ortho residency program. My goal here is just to pay forward some of the help I received along the way. Ask my anything and everything!

As another poster has said, do you think it's still worth it to specialize to become an Ortho when considering the opportunity cost of lost salary + building interest + extra tuition for residency? You stated earlier that Ortho is financially on a decline as GP's take the easier cases. Would it make more sense to just be a GP and do some Ortho C.E.? Thanks!


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[free99]

Thanks for the post, looking forward to reading your responses!

 

[Steins;Gate]

As another poster has said, do you think it's still worth it to specialize to become an Ortho when considering the opportunity cost of lost salary + building interest + extra tuition for residency? You stated earlier that Ortho is financially on a decline as GP's take the easier cases. Would it make more sense to just be a GP and do some Ortho C.E.? Thanks!


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This is a great question. Thanks for asking it. By the way I am a Chelsea fan... I get the struggle with "wengerout".

 

[CaliDDS1986]

You mentioned that you do mission trips. Given that ortho takes 2 or more years to do the case, what kind of work do you do on the mission trips?

 

[Steins;Gate]

Two application related questions:

1) ADAT and GRE are important for orthodontic applications - are there particular ballpark percentiles for both exams that a prospective orthodontic applicant should exceed? For class rank, top 10% is important but what about for ADAT and GRE scores? Should we follow suit and aim for 90th percentile for both exams?
2) Often there is hearsay that "it is easiest to match at your home school". Obviously this is impossible to answer about other institutions but would this be the case at your own program? If so, is this related to the additional exposure/relationship faculty have with the DDS students and/or the fact that faculty understand the rigors of their own school the best and find their students well suited to their program?

Thank you for your time!

 

[Str82th]

1) Regarding Invisalign/Clear Correct tx - Are there any specific methods or courses you would recommend for learning the nuances of successful treatment? So much of obtaining a successful outcome depends on your initial case setup and modification of the ClinCheck, but it seems like most practitioners basically learn as they go including having to go through 1+ refinements, etc. Is there anything beyond simple trial and error on patients that you would recommend? My thoughts are just making sure to understand the basic biomechanics in play like any other appliance system, and using that to employ whatever various attachments you need to make the movements happen.

Other orthos ofc feel free to chime in as well 🙂.

I'm going to comment on ClinChecks. You need to use what you've learned in residency regarding possible tooth movements, reductions and timing when preparing your ClinCheck. You know far more than the lab tech that does the setup. Approach your adjustments from the macro to the micro.

A refinement is not a bad thing, in fact, the most effective practitioners plan a refinement. Invisalign is not precise enough to deliver high quality results with the first series of trays.

Your thoughts with biomechanics are correct. Use that logic in your approach. You will deliver amazingly superior results than those achievable by the average GP or "smile direct club."

As far as GPs taking the easier cases, yes, that happens. However, my observation had been that a GP will dabble in ortho for a couple years(long enough to finish a few cases) and then drop it. They seem to find it is not worth the extra time and overhead to continue, especially once they find a difficult case. Like missing the diagnosis of a CO/CR discrepancy in a class ii case.


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[JawJock47]

As another poster has said, do you think it's still worth it to specialize to become an Ortho when considering the opportunity cost of lost salary + building interest + extra tuition for residency? You stated earlier that Ortho is financially on a decline as GP's take the easier cases. Would it make more sense to just be a GP and do some Ortho C.E.? Thanks!


Sent from my iPhone using SDN mobile

I would say specializing is always worth it if you are in love with the field. As far as money goes, it will be difficult for orthodontists to earn in the same way they have been moving forward, but I think they will still always be fulfilled and making plenty of $. Thats all I will say. When I graduated dental school, I never considered the money making potential of my specialty, BUT dental school and residency these days is on average 6x as expensive.

There are tons of exciting areas growing in dentistry. Columbia is an EXCELLENT school. Stay engaged, ask questions, and learn as much as you can and I promise by the middle of 3rd year you will have clarity on what it is you for certain want to do, and the money will just be a side note (if it means loans, you will happily pay them off doing what you WANT to do).

IF you are talking about going over 600k in debt, I'd say find another way. The best orthodontists I know practiced General Dentistry for a few years to pay off some debt, then went into residency. I really have no issue with GPs doing ortho cases, it just doesn't bother me. I would do the same thing. With some education (2 yr AEGD) you can really be doing the kitchen sink when it comes to dentistry to include less difficult ortho cases. This, to me, is very cool.

When I entered Dental school I was dead set on perio. I loved the surgical aspect, patient interactions etc etc. I worked for a periodontist for 4 years in Louisville during undergrad. I changed my mind to ortho my 3rd year and never looked back.

 

[JawJock47]

Hey doc,

Is it reasonably possible to produce $2m two years out of residency in today's market (assuming ownership upon graduation)?

Are we talking NET or GROSS? Gross, sure, if you bought a booming practice and are competent enough to hang onto and continue to receive referrals at the same rate.

NET? in 2 years? Unless you have some skills Ive never seen before, it would be difficult.

 

[JawJock47]

Two application related questions:

1) ADAT and GRE are important for orthodontic applications - are there particular ballpark percentiles for both exams that a prospective orthodontic applicant should exceed? For class rank, top 10% is important but what about for ADAT and GRE scores? Should we follow suit and aim for 90th percentile for both exams?


2) Often there is hearsay that "it is easiest to match at your home school". Obviously this is impossible to answer about other institutions but would this be the case at your own program? If so, is this related to the additional exposure/relationship faculty have with the DDS students and/or the fact that faculty understand the rigors of their own school the best and find their students well suited to their program?

Thank you for your time!

1) Same song and dance as the DAT. IF you have great grades but terrible GRE, questions are going to be asked and vice versa. Id say top 10-15% in both is a solid applicant- or if you really want to be analytical 90 percentil average (85th w/ grades, 95th on GRE).

2) Some schools do claim to take care of their students, but in my experience, its the analogy of 2 identical applicants with the same grades experiences etc, the home school would win out. The other factor to come into play would be the state, connections to the state, etc in some cases. IF you are from the state school, plan on practicing there, that would give you an edge at some state schools.

 

[JawJock47]

You mentioned that you do mission trips. Given that ortho takes 2 or more years to do the case, what kind of work do you do on the mission trips?

No ortho on mission trips. I have almost always only do extractions in 3rd world countries on mission trips.

 

[JawJock47]

Would you take out an additional 300k in loans for orthodontic residency on top of dental school loans? Including lost opportunity income from being a GP it's potentially a one million dollar loss of income to attend residency.

See above. IF ortho is what you have to do to be fulfilled and there isnt another option, sure I would do it. I work at a corportate dental company now and some of these young folks are working 6 days a week and living in 1 bedroom apartments until the debt is paid off. I asked them if they are happy and they always without fail say they love it.

 

[Steins;Gate]

I would say specializing is always worth it if you are in love with the field. As far as money goes, it will be difficult for orthodontists to earn in the same way they have been moving forward, but I think they will still always be fulfilled and making plenty of $. Thats all I will say. When I graduated dental school, I never considered the money making potential of my specialty, BUT dental school and residency these days is on average 6x as expensive.

There are tons of exciting areas growing in dentistry. Columbia is an EXCELLENT school. Stay engaged, ask questions, and learn as much as you can and I promise by the middle of 3rd year you will have clarity on what it is you for certain want to do, and the money will just be a side note (if it means loans, you will happily pay them off doing what you WANT to do).

IF you are talking about going over 600k in debt, I'd say find another way. The best orthodontists I know practiced General Dentistry for a few years to pay off some debt, then went into residency. I really have no issue with GPs doing ortho cases, it just doesn't bother me. I would do the same thing. With some education (2 yr AEGD) you can really be doing the kitchen sink when it comes to dentistry to include less difficult ortho cases. This, to me, is very cool.

When I entered Dental school I was dead set on perio. I loved the surgical aspect, patient interactions etc etc. I worked for a periodontist for 4 years in Louisville during undergrad. I changed my mind to ortho my 3rd year and never looked back.

Thank you for the response. What made you change your mind from perio to ortho? These two appear to be very rewarding but quite different fields.

 

[JawJock47]

Thank you for the response. What made you change your mind from perio to ortho? These two appear to be very rewarding but quite different fields.

I noticed a difference in the nature of patients. People come to the periodontist with problems and pain in a lot of cases whereas people who come to the orthodontist have a much more posative outlook their future perfect occlusion. It was a small thing, but it made a big difference in my mind.

As far as the actual work goes, I got very interested in ortho my senior year and just fell in love. The above scenario was just the tie breaker quite honestly.

 

[Apramana]

@JawJock47 : Thank you so much for sharing your time and expertise.

Could you please consider getting verified as a professional? The details for the process, and the benefits, are here:
Doctor Verification

With a variety of information being shared on SDN, it can be difficult to determine how much weight to give the comments of a particular poster, especially when perspectives differ dramatically. Having SDN verification as a dentist would definitely help the SDN community, new and old, better evaluate the credibility of our sources and of the information you are kind enough to share.

Thank you for your consideration 🙂

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Edit:
There's also a faculty verification, since you mentioned you teach at an ortho program:
Faculty and Administration Verification

You can certainly get badged for both, and that would add a significant amount of credibility to your insight 🙂

 

[Str82th]

Yes, please verify, it is easy to do.


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[JawJock47]

@JawJock47 : Thank you so much for sharing your time and expertise.

Could you please consider getting verified as a professional? The details for the process, and the benefits, are here:
Doctor Verification

With a variety of information being shared on SDN, it can be difficult to determine how much weight to give the comments of a particular poster, especially when perspectives differ dramatically. Having SDN verification as a dentist would definitely help the SDN community, new and old, better evaluate the credibility of our sources and of the information you are kind enough to share.

Thank you for your consideration 🙂

---
Edit:
There's also a faculty verification, since you mentioned you teach at an ortho program:
Faculty and Administration Verification

You can certainly get badged for both, and that would add a significant amount of credibility to your insight 🙂

Ok, have you by chance gone through this verification? Im always a little bit reluctant to put that kind of info out there, my intent is to remain anonymous...a benefit to providing candid advice

EDIT: submitted anyways...

 

[Apramana]

Thanks, @JawJock47 . I've not gone through it, but I have never read any complaints about the process. SDN seems to work hard to maintain its high standards.

The verified badges certainly seem to go a long way in helping us evaluate the information we encounter here, especially for new readers who may have a tough time discerning the more reliable information.

Thus, thanks for electing to get verified, and thanks for your service to the community, both on and off SDN.

Have any of your family members opted to go the dental route based on your positive experiences in the field? It sounds like your son may be pursuing healthcare, which suggests you both may think its still a worthwhile pursuit 🙂

It seems like some pre-dental students choose dentistry after seeing their physician parents burnt out by the field, so it's nice to know that doesn't appear to be the case with your son and dentistry 🙂

Were you from a healthcare family originally, or did you opt to go the dental route without any encouragement or example to follow? Following in the family footsteps seems to be a common professional career pathway, so it would be interesting to know how you came about it.

Thanks, again, for all that you have been willing to share about your experience with the field, and for all that you may choose to share in the future.

 

[InformMe123]

My question is how realistic would it be for a general dentist to learn orthodontics through CE/courses/reading/etc. and open a practice limited to ortho without doing residency? Could the practice realistically become as successful as an ortho specialist practice? What would be problems/obstacles that may come up?

 

[JawJock47]

Thanks, @JawJock47 . I've not gone through it, but I have never read any complaints about the process. SDN seems to work hard to maintain its high standards.

The verified badges certainly seem to go a long way in helping us evaluate the information we encounter here, especially for new readers who may have a tough time discerning the more reliable information.

Thus, thanks for electing to get verified, and thanks for your service to the community, both on and off SDN.

Have any of your family members opted to go the dental route based on your positive experiences in the field? It sounds like your son may be pursuing healthcare, which suggests you both may think its still a worthwhile pursuit 🙂

It seems like some pre-dental students choose dentistry after seeing their physician parents burnt out by the field, so it's nice to know that doesn't appear to be the case with your son and dentistry 🙂

Were you from a healthcare family originally, or did you opt to go the dental route without any encouragement or example to follow? Following in the family footsteps seems to be a common professional career pathway, so it would be interesting to know how you came about it.

Thanks, again, for all that you have been willing to share about your experience with the field, and for all that you may choose to share in the future.

Well I had 7 children and only 1 chose the dental route, and even he is a nontraditional dental student now. In fact, he was so interested in medicine at first he went all the way through the MCAT and getting accepted to his "dream" medical school, only to turn around and take the DAT and now go to dental school. I think in his experience, he got sick of every MD telling him to do dentistry or something else. I have tried hard to not pressure any of my kids to do anything they didn't want to, just emphasized the importance of being a professional at something-but deep down im laughing at his experience and conclusions.

I didn't come from a health related family-both my parents were immigrants. I went to UL and majored in Biology and really just saw dentistry as a fascinating growing field and here I am still pluggin away into my 70s!

 

[Apramana]

Thanks, @JawJock47, I appreciate the perspective. I hope that your son ends up with a similarly fulfilling career in dentistry, based on what you have said about your own experiences with the profession. I'm sure that your example helped him in his decision-making process, and will continue to.

Thanks, again, for all that you do both on and off SDN. Please have an awesome day, and best wishes in all that you (and your loved ones) are up to.

 

[Steins;Gate]

I think in his experience, he got sick of every MD telling him to do dentistry or something else.

Did the physicians explain why your son should pursue dentistry or something else?

 

[JawJock47]

Did the physicians explain why your son should pursue dentistry or something else?

Im not specifically sure, however, he was very close with an orthopedic surgeon whom I know personally. Many of their gripes are specific to the growing burden of government and insurance/bureaucracy getting involved in their practice- a topic for another thread I suppose, and one that will eventually apply just as much to the dental field in my opinion. Either way, I would like to keep this about orthodontics moving forward.

 

[CaliDDS1986]

My question is how realistic would it be for a general dentist to learn orthodontics through CE/courses/reading/etc. and open a practice limited to ortho without doing residency? Could the practice realistically become as successful as an ortho specialist practice? What would be problems/obstacles that may come up?

Good question, id like to hear as well

 

[JawJock47]

Good question, id like to hear as well

How would you see this working out? What, you graduate dental school and take CE classes and courses then just try to start doing ortho? Look, moving peoples teeth around is very serious business. You the amount you learn during a grueling 3 year residency just cant be matched to any amount of CE and reading-you have to learn by doing it! Do you think people should be allowed to do fillings if they just never go to dental school but learn a bunch on youtube and through CE courses?

If you are a dentist, and you want to do SOME orthodontics, I think that is ok. Over time doing more and more cases and continuing education you may be in a position where 50% of what you do is orthodontics-and if you really are competent that is outstanding and very possible. But to be an orthodontist who isn't really an orthodontist (which does unfortunately occur) in my opinion is misleading.

There is so much out there on how to do ortho, that I think we are approaching the day where a lot of dentists will do a good amount of orthodontics, but the day of a dentist only doing ortho and being successful in the long run will never come. The variety of cases are just too vast.

 

[Biffster]

Nobody would refer to you as a general dentist doing ortho. Once you treat most of the ortho within your own practice then you will have the worlds smallest ortho practice. Not a good idea. Maybe if you practiced in a large group of GPs and they all referred ortho to you it could work. But other, unaffiliated GPs would likely refer to a specialist, not another GP--not only due to quality of care, but they also wouldn't want to lose a general dental patient to that office.

 

[Auntymarkovnikov]

Did you notice an increased demand for orthodontic/aesthetic treatment after the selfie camera revolution?

 

[8_man]

Hey @JawJock47, thanks for doing this Q&A.

In today's socioeconomic climate, can orthodontics still provide a very comfortable and "relaxed" lifestyle? To give some additional context to this question, let's say the new ortho grad has no debt.

 

[Xplorer11]

Thank you for doing this @JawJock47 !

Can you talk about the differences between your experiences in private and corporate practices. Why did you make the switch and what are the pros/cons you experienced in each? Your private practice sounded very successful so what was your exit strategy and what would it have taken for you to go from a large private practice to a corporate dental practice?

 

[JawJock47]

Hey @JawJock47, thanks for doing this Q&A.

In today's socioeconomic climate, can orthodontics still provide a very comfortable and "relaxed" lifestyle? To give some additional context to this question, let's say the new ortho grad has no debt.

Goodness gracious yes! I would say just about all successful dental healthcare providers can make enough money to live very comfortably and work 4 days a week. compare yourself to an egineer or primary care physician, then look at dollars per hour, and youll see dentistry is an outstanding profession.

Orthodontics is no different, and if you are debt free, the biggest advantage is going to be purchasing power when it comes to starting a practice. I always felt like I was working hard throughout my time as an orthodontist, but never the overworked miserable kind of hard work. The fulfilling kind, which is what we all are aiming for in a forum like this.

 

[JawJock47]

Thank you for doing this @JawJock47 !

Can you talk about the differences between your experiences in private and corporate practices. Why did you make the switch and what are the pros/cons you experienced in each? Your private practice sounded very successful so what was your exit strategy and what would it have taken for you to go from a large private practice to a corporate dental practice?

These are my opinions and observations- Everyone is up in arms about the corporate involvement in the dental profession, but it is not such a bad thing. Starting out you are a young shark and you think you'll enjoy being a businessman as well as an orthodontist-but over time all the business aspect becomes a huge hassle and you imagine a world where you can focus just on patient care and less on the property taxes of your office real estate. I loved competing and setting up new offices over my years, but at some point the buy out became too tempting an d lucrative. Now I just show up, treat my patients, and go home. If the guy next door leaves his lights on all night, not my problem...

Additionally, I own the actual buildings I work in so the company I work for pays the rent to me. It just made a ton of sense given my age to sell.

IF youre obsessed with being making money through business on the side, that opportunity will always be there. I know several counterparts who own strip malls and practice 5 days a week. You can also compete with a corporate dental practice, but in most settings I think youre going to have a tough time. They just have obtained too much capital. They can buy the latest and greatest equipment with the blink of an eye, where as the private guy will have to go to the bank and submit another justification for yet another large loan for the most up to date x-ray machine that will be outdated in 4 years... There are still ways of competing, but thats a different conversation.

I could run you through thousands of problems I ran into in private practice that would make you run to a corporate setting.

THAT SAID, there are plenty of negatives associated with not being your own boss. There is just something about not having to answer to anyone on a daily basis. The corporate guys will tell you that you run the office, but contradict themselves when they tell you what days you need to be open and how long.

 

[basketball_grey]

What is the max you would take out in loans to attend dental school? Is 250k too much? With interest that is likely to top 300k...

 

[2TH MVR]

These are my opinions and observations- Everyone is up in arms about the corporate involvement in the dental profession, but it is not such a bad thing. Starting out you are a young shark and you think you'll enjoy being a businessman as well as an orthodontist-but over time all the business aspect becomes a huge hassle and you imagine a world where you can focus just on patient care and less on the property taxes of your office real estate. I loved competing and setting up new offices over my years, but at some point the buy out became too tempting an d lucrative. Now I just show up, treat my patients, and go home. If the guy next door leaves his lights on all night, not my problem...



I could run you through thousands of problems I ran into in private practice that would make you run to a corporate setting.

THAT SAID, there are plenty of negatives associated with not being your own boss. There is just something about not having to answer to anyone on a daily basis. The corporate guys will tell you that you run the office, but contradict themselves when they tell you what days you need to be open and how long.

Funny. I am in the same situation. Practiced orthodontics for the last 26 years. Purchased my 1st practice during the so called hey day of ortho. Started from scratch 3 offices and enjoyed a great lifestyle. Everything changed after the 2008 recession. As JockJaw stated .... the business side of running multiple offices becomes tiring. I was literally spending 10-12 hours daily at my offices. Yes ... I only worked 4 days a week.

That said ....owning your own practice should be a goal and the rewards for hard work will pay off. As you get older "Me 🙁" ...... you just want to start slowing down. I'm also in the process of selling my two practices and have already been hired by a dental corporate office.

 

[JawJock47]

What is the max you would take out in loans to attend dental school? Is 250k too much? With interest that is likely to top 300k...

No, I dont think so. I have to admit, I refused to pay any of my children's tuition for anything-my sole reasoning is that if I did, they would have a less clear train of thought. I mean if dental school was just free, why not, heart in it or not?

My point is this, if you think dentistry is your vocation...go for it! One day you will look at the debt and say you wished you didn't lose your hair over it...literally. Do the math, figure how much you will have to pay and live off of. Most young guys I know that went to these large private dental schools with mountains of debt go to work somewhere with a salary, and pay it off year after year.

If you do the math and you see yourself still suffering and treading water into your 40s, then I would say the juice isn't worth the squeeze if I HAVE to say yes or no. Becoming a healthcare professional means you will have to suffer to get to your desired end state. Youll suffer in dental school, you'll suffer starting out, but I can only find a handful of guys who say it wasn't worth it.

Looking back, I think the early years were the best of my life. You just have to bring yourself to believe this is a long process, and most importantly you have to find a way to enjoy the process.

 

[cacajuate]

Nobody would refer to you as a general dentist doing ortho. Once you treat most of the ortho within your own practice then you will have the worlds smallest ortho practice. Not a good idea. Maybe if you practiced in a large group of GPs and they all referred ortho to you it could work. But other, unaffiliated GPs would likely refer to a specialist, not another GP--not only due to quality of care, but they also wouldn't want to lose a general dental patient to that office.

They are plenty of GPs that have referral based offices that are limited to ortho. Just as there is plenty of GPs that have referral based implant offices.

 

[Str82th]

They are plenty of GPs that have referral based offices that are limited to ortho. Just as there is plenty of GPs that have referral based implant offices.

Evidence?


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[2TH MVR]

They are plenty of GPs that have referral based offices that are limited to ortho. Just as there is plenty of GPs that have referral based implant offices.

Interesting concept.

 

[JawJock47]

They are plenty of GPs that have referral based offices that are limited to ortho. Just as there is plenty of GPs that have referral based implant offices.

Yes, the difference is that implant dentistry is not a recognized specialty.....YET! Orthodontics, on the other hands, is SIGNIFICANTLY, in a lot of cases, more difficult than just doing a cad cam exposure and sending to Invisalign.

I know for certain there are GP guys out there that name their practices "Orthodontics" or something similar. I cant tell you how many of them mess people up, get into legal nightmares, and then finally refer to an orthodontist to clean it all up. If this is the life you want as a "professional," then fine. I just dont think its a great choice. You could be a jack of all trades, master of none, general dentist and KILL it in todays age. Why in the world would you just limit yourself to ortho?

This is a fact that will never change- General Dentist that claim to be an orthodontist will be LESS referred to and less expansive than real orthodontists. They make it in a scenario where there isnt an orthodontist within the area, but as new private based residencies (in ortho) are opening, that day is long gone.

Saying youre are an implant professional, however, is really something I think is very very exciting. So far there isnt really a one stop shop for implants. Its usually a fight between perio, endo, and OS. If you could have a practice that can do the extraction, implant and prosthetic-you would be a hot commodity. But the best guys at this actually go to school for 2-3 years to learn the intricacies of such a practice, although it is not a recognized specialty except for in Texas to date.

 

[mooette]

Thanks for your time @JawJock47!

What do you consider the most important orthodontic-related skills or knowledge for GPs to have?
What are the biggest mistakes GPs make regarding orthodontic treatment or referral?