Orthodontist income? Why such a misconception?

[011110]

Why does there seem to be an overall misconception in the dental world about orthodontist income? Every predental and dental student thinks they are all making over 300k with the assistants doing a lot of the work. I know guys barely making 200k, and this is with Orthodontic residency debt piled on. It’s not like if you complete an OS residency you will be definitely making more. From what I’ve seen there are winners vs losers in ortho income with the winners being hardworking business guys that would have been successful as a GP anyway. There are probably a few outliers killing it in ortho, but I think the vast majority are pulling like 250k. What gives?


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[Big Time Hoosier]

What gives?

Probably the same reason why I have to keep telling predents to go to the cheapest school they get into. Everyone on SDN seems to think they are an outlier.

I mean, seriously, how many times do I need to point out that to pay off NYU, USC, and whatever other ridiculously expensive school you’ll need to earn near $70,000/year for TWO DECADES just to cover your student loans?!

Big Hoss

 

[321931]

Why does there seem to be an overall misconception in the dental world about orthodontist income? Every predental and dental student thinks they are all making over 300k with the assistants doing a lot of the work. I know guys barely making 200k, and this is with Orthodontic residency debt piled on. It’s not like if you complete an OS residency you will be definitely making more. From what I’ve seen there are winners vs losers in ortho income with the winners being hardworking business guys that would have been successful as a GP anyway. There are probably a few outliers killing it in ortho, but I think the vast majority are pulling like 250k. What gives?


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To many orthodontists, not enough retiring. Ortho is a great profession if you are in it and established...but at the same time double edged sword as they never retire. I still have a 70 year old + orthodontist that has no set date on retirement. Make some room for the new grads !

 

[011110]

It just seems with ortho there is a such a gross misconception, and for the past 10 years residency programs have fed on this as they open new programs that charge ridiculous amounts.




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[charlestweed]

Why does there seem to be an overall misconception in the dental world about orthodontist income? Every predental and dental student thinks they are all making over 300k with the assistants doing a lot of the work. I know guys barely making 200k, and this is with Orthodontic residency debt piled on. It’s not like if you complete an OS residency you will be definitely making more. From what I’ve seen there are winners vs losers in ortho income with the winners being hardworking business guys that would have been successful as a GP anyway. There are probably a few outliers killing it in ortho, but I think the vast majority are pulling like 250k. What gives?


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Those guys are probably too picky (don't want to travel, don't want to work for the greedy GPs, don't want to work for the evil corp, don't want to work on weekends etc) and only want to stay at one location. I make that much too, if I only work at 1 location.

Each ortho patient pays $120-150 per monthly visit....and this is a very low estimate. So if an ortho sees 20 active patients a day, he will produce $2400/day....or $48k/month (20 work days/month)....or $576k/year. If the overhead is 50%, his net will be $288k/year. If this ortho hires more assistants to help him see 60 patients/day, he only needs to work 6-7 days/month....and he can then use the other extra days in the month to travel to other offices to see more patients to double or triple that income. More patients = more $$$.

 

[charlestweed]

To many orthodontists, not enough retiring. Ortho is a great profession if you are in it and established...but at the same time double edged sword as they never retire. I still have a 70 year old + orthodontist that has no set date on retirement. Make some room for the new grads !

I don't plan to retire after 65. Why should I retire when I am still healthy to treat patients? I'd go crazy if I have to stay home 7 days/week doing nothing. I can't just travel 365 days/year for the next 10+ years. A lot of people feel depressed after retirement. For many, work brings a sense of usefulness and purpose. My aunt-in-law, who is a physician, is still seeing patients and she is in her early 70s. Making money is not the reason because she and her husband (my uncle) own several business and residential properties.

 

[2TH MVR]

It just seems with ortho there is a such a gross misconception, and for the past 10 years residency programs have fed on this as they open new programs that charge ridiculous amounts.




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There's some truth in this. Prior to Invisalign, saturation and Corp growth, managed care ..... Ortho was a cash cow.

 

[011110]

Those guys are probably too picky (don't want to travel, don't want to work for the greedy GPs, don't want to work for the evil corp, don't want to work on weekends etc) and only want to stay at one location. I make that much too, if I only work at 1 location.

Each ortho patient pays $120-150 per monthly visit....and this is a very low estimate. So if an ortho sees 20 active patients a day, he will produce $2400/day....or $48k/month (20 work days/month)....or $576k/year. If the overhead is 50%, his net will be $288k/year. If this ortho hires more assistants to help him see 60 patients/day, he only needs to work 6-7 days/month....and he can then use the other extra days in the month to travel to other offices to see more patients to double or triple that income. More patients = more $$$.

Yea but you’re assuming the ortho has 20 active patients per month per day for 20 days a month. That’s 400 active patients per month, which is probably difficult to have in this current environment. Also 50% overhead is a stretch for a newbie to get to that level of starts because now you have to market. Overhead is more like 70%


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[charlestweed]

Yea but you’re assuming the ortho has 20 active patients per month per day for 20 days a month. That’s 400 active patients per month, which is probably difficult to have in this current environment. Also 50% overhead is a stretch for a newbie to get to that level of starts because now you have to market. Overhead is more like 70%


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And that's why you need to expand the radius by traveling to more offices to get more patients. To get 800 active patients, I have to open 4 offices. And to get 1000+ patients, I have to add more work days at 2 corp offices. To get 400 active patients, you have to continue to get 16-17 new starts a month (or 1 new start a day).

You are right about the difficulty in maintaining a 50% overhead because today new grads are spoiled with all the expensive gadgets. They can't work at the corps because they can't work without these toys.

 

[011110]

And that's why you need to expand the radius by traveling to more offices to get more patients. To get 800 active patients, I have to open 4 offices. And to get 1000+ patients, I have to add more work days at 2 corp offices. To get 400 active patients, you have to continue to get 16-17 new starts a month (or 1 new start a day).

You are right about the difficulty in maintaining a 50% overhead because today new grads are spoiled with all the expensive gadgets. They can't work at the corps because they can't work without these toys.

It’s also very, very hard to attract and keep new patients if you don’t have a modern office. Facebook mom groups are not going to recommend the office that looks cheap. To compete with the big boys you have to have a nice looking office.


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[charlestweed]

It’s also very, very hard to attract and keep new patients if you don’t have a modern office. Facebook mom groups are not going to recommend the office that looks cheap. To compete with the big boys you have to have a nice looking office.


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This is a common belief among the new grad orthos because that’s what they are taught at many programs. Many ortho programs are now equipped with cone beam CT, intra oral scanner, a computer on every operatory etc. And they invite a bunch of sale reps to come in to convince the residents to buy their products. I wonder if there are still programs out there that teach their residents how to make their own ortho appliances and how to bend wires. Some new grads don’t even know how to bend a simple closing loop…or it takes them forever to bend one.

People choose your office because of what they heard from the referring GPs, from the existing patients, and from insurance companies….not how beautiful your office looks. The patients who care about the superficial things are usually not the good ones to have in your office anyway. The best way to attract new patients is to go door to door to meet the referring GPs. What most patients look for in an ortho office is the ortho’s honesty (no nonsense phase 1 tx, no expander on every kid etc), a good tract record of doing good work (which helps increase word-of-mouth referrals), reasonable fee, convenient office hours, and the type of insurances the office accepts etc.

 

[BluntForceTrauma]

. Some new grads don’t even know how to bend a simple closing loop…or it takes them forever to bend one.
.

Heck, I was an assistant and I could do this. I actually loved the wire-working part of Ortho. So cool. Didn't care for the bracket management or fitting bands.

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[2TH MVR]

It’s also very, very hard to attract and keep new patients if you don’t have a modern office. Facebook mom groups are not going to recommend the office that looks cheap. To compete with the big boys you have to have a nice looking office.


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Been there. Done that. Doesn't necessarily work in a saturated area. Patients in general want the least expensive price for the ortho tx. Word gets around about the average cost of the ortho tx. Most patients have PPO/HMO that dictates the low insurance fee. Yes ... there are some niche areas where an Ortho gets a FULL FFS fee, but not so in saturated, high insurance urban areas.

During the early 90's .... I practiced with the large, deluxe offices with large game rooms, fountains, hi-tech, etc. etc. Doesn't work now ..... in saturated, urban areas. Making money back then was stupid EASY. Had multiple offices and leased a new 911 turbo EVERY 3 years.

Now ... it's different. I practice in an urban,saturated area. If you choose to practice in these urban areas ..... follow @charlestweed practice model. It makes perfect sense. Low overhead, multiple locations, PT staff, PT Corp. It's a different way of practicing for sure, but I believe that is the only way to make good $$$$ in a saturated area.

Enough of this. I've got a tee time in 1 hour.

 

[charlestweed]

Now ... it's different. I practice in an urban,saturated area. If you choose to practice in these urban areas ..... follow @charlestweed practice model. It makes perfect sense. Low overhead, multiple locations, PT staff, PT Corp. It's a different way of practicing for sure, but I believe that is the only way to make good $$$$ in a saturated area.

I didn't come up with this practice model. I learned from my successful friends, who set up their practices before me. They also worked part time for the same corp and I met them at the meetings. With already so many student/business/home loan bills to pay back, I didn't really have any choice but to go cheap on the office construction and to pick a location with cheap rent. Once the construction was completed, I was surprised by how beautiful the office looked. It didn't cost much to make the office look modern. Paint and laminated wood floor are inexpensive. A year ago, I relocated my office to a better location (and cheaper rent as well) with more parking spaces for my patients. It only cost me $50k to convert an existing medical office to an ortho office. Here are some of the before and after pics.

 

[sb.tnh]

Sorry for reviving this thread, but I have a question. If I do a comprehensive ortho course (e.g. POS) and can do relatively easy cases, are patients okay with me doing ortho for them or will most of them prefer to be sent out to an orthodontist?

 

[Svart Aske]

Sorry for reviving this thread, but I have a question. If I do a comprehensive ortho course (e.g. POS) and can do relatively easy cases, are patients okay with me doing ortho for them or will most of them prefer to be sent out to an orthodontist?

If you offer treatment at $1-2K cheaper than the orthodontist, most patients will not care that you are not a specialist.

 

[HOPAone]

If you offer treatment at $1-2K cheaper than the orthodontist, most patients will not care that you are not a specialist.

Sorry for reviving this thread, but I have a question. If I do a comprehensive ortho course (e.g. POS) and can do relatively easy cases, are patients okay with me doing ortho for them or will most of them prefer to be sent out to an orthodontist?

Ask yourself this question: Would you want to bring your nice BMW to a BMW dealer for services or to a mechanics who does side jobs at home and may or may not be totally familiar with your car? You may say those are easy cases but how can you be for sure they are easy? Without proper training and experience you may not see hidden problems. I've been practicing ortho for 15+ years and after thousands of cases I'm still sometimes get fooled by the initial easy look. The sad thing is about half of my classmates from dental school do some ortho! My best friend, who is also a dentist, told me that he has to do ortho to keep patients from going away!

 

[Steins;Gate]

Ask yourself this question: Would you want to bring your nice BMW to a BMW dealer for services or to a mechanics who does side jobs at home and may or may not be totally familiar with your car? You may say those are easy cases but how can you be for sure they are easy? Without proper training and experience you may not see hidden problems. I've been practicing ortho for 15+ years and after thousands of cases I'm still sometimes get fooled by the initial easy look. The sad thing is about half of my classmates from dental school do some ortho! My best friend, who is also a dentist, told me that he has to do ortho to keep patients from going away!

Can I ask you some questions? Can you PM me as I am unable to PM you.

 

[Wingie]

The OP obviously has some weird obsession with Ortho. OP's post history seems discordant to say the least. In 2014, he claims that he matched. In 2018, he claims that he's a GP and ortho residency is bad investment. It's all very odd. I'd take everything he posts with a grain of salt.