orthognathic and OMS private practice

[koobpheej]

How much does orthognathic surgery play a role in OMS private practice? To me, that is one of the coolest parts of OMS, and I want to know it's role. Or does dentoalveolar stuff make up 90% and everything else kind of fills in the gaps. I know your practice is whatever you make it... I am more looking for averages, profitability, etc.

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[drben]

How much does orthognathic surgery play a role in OMS private practice? To me, that is one of the coolest parts of OMS, and I want to know it's role. Or does dentoalveolar stuff make up 90% and everything else kind of fills in the gaps. I know your practice is whatever you make it... I am more looking for averages, profitability, etc.

Little to none...99% of your practice is dentoalveolar, and implants

 

[rrc]

How much does orthognathic surgery play a role in OMS private practice? To me, that is one of the coolest parts of OMS, and I want to know it's role. Or does dentoalveolar stuff make up 90% and everything else kind of fills in the gaps. I know your practice is whatever you make it... I am more looking for averages, profitability, etc.

We average 1-2 orthognathic procedures per month. This is more than most places. Most of these are done as outpatient procedures in our office OR.

 

[toofache32]

Like all jobs, there are very cool things that bring into a field and keep you interested, but you eventually get over it. In the end it turns out to be "just a job." Orthognathics is a HUGE undertaking with regards to time....5-10 hours pre-op doing consultations, lab work & model surgery, meeting with the orthodontist, another 4-8 hours (or more) doing the actual surgery, and many more hours in post-op hospital care and follow-up visits. ALL this is included in the one-time surgical fee....which is about the same as 1 or 2 wisdom tooth patients (which takes less than an hour to make the same fee...with less headache, complications, and morbidity).

There are a few people who have been able to charge fee-for-service for orthognathics, but this is very rare and it just isn't worth it to many oral surgeons when the piggy-bank is sitting behind the 2nd molar.

 

[txdent2be2007]

There are a few people who have been able to charge fee-for-service for orthognathics, but this is very rare and it just isn't worth it to many oral surgeons when the piggy-bank is sitting behind the 2nd molar.[/QUOTE]


Arnatt in California comes to mind; nearly 150 cases a year, all fee-for-service, and mostly two-jaw operations. I think he's pretty much limited his practice to orthognathics.

Oh, and he's a single-degree OMS (in response to the USNews article).

 

[jpollei]

We average 1-2 orthognathic procedures per month. This is more than most places. Most of these are done as outpatient procedures in our office OR.

I know here they seem to do 3-4 cases each week. But I also know that's rare. Talking with some of the surgery faculty here I was surprised at how little orthognathics is done in private practice compared to here in the residency. The faculty always cited the same reason as toofache...$$$.
Spend a year hand-crafting a Ferrari, or mass-produce dozens of BMW's and Benz's in a single day...quantity wins out. Same goes for orthognathic cases vs. 3rd molars.

 

[rrc]

I know here they seem to do 3-4 cases each week. But I also know that's rare. Talking with some of the surgery faculty here I was surprised at how little orthognathics is done in private practice compared to here in the residency. The faculty always cited the same reason as toofache...$$$.
Spend a year hand-crafting a Ferrari, or mass-produce dozens of BMW's and Benz's in a single day...quantity wins out. Same goes for orthognathic cases vs. 3rd molars.

That actually has very little to do with it. If I had the same number of orthognathic cases referred to me as I did wisdom teeth, then I would do surgery on all of them.

You guys need to remember something in residency: the attendings in academic settings always make statements about how all private practitioners are financially motivated and out for the big buck. They also guilt residents who say they want to go into private practice. It is a real shame because those are such ignorant comments.

I didnt go into academics because of the politics, the hierarchy, the hours, the lack of comrodory,etc. In my practice I will take anything thrown at me minus head and neck cancer. The fact that orthognathics are not as financially beneficial as wisdom teeth is not the reason why there are more thirds done than orthognathics but rather the number of referrals.

 

[esclavo]

I know here they seem to do 3-4 cases each week. But I also know that's rare. Talking with some of the surgery faculty here I was surprised at how little orthognathics is done in private practice compared to here in the residency. The faculty always cited the same reason as toofache...$$$.
Spend a year hand-crafting a Ferrari, or mass-produce dozens of BMW's and Benz's in a single day...quantity wins out. Same goes for orthognathic cases vs. 3rd molars.

That Tucker guy in Carolina I hear does a bazillion orthognathic cases per year and he doesn't take any insurance. Some guys have started doing more orthognathics as Out Patient Surgery or in their office to help save on expenses. Then patients can pay cash and patients and surgeons can meet in the middle for treatment.

 

[gryffindor]

That Tucker guy in Carolina I hear does a bazillion orthognathic cases per year and he doesn't take any insurance. Some guys have started doing more orthognathics as Out Patient Surgery or in their office to help save on expenses. Then patients can pay cash and patients and surgeons can meet in the middle for treatment.

There's an OMS guy here in the city whose practice is also limited to orthognathics. Also a single degree guy, if I remember. Don't know if he was cash-only though.

 

[Gatorette]

I know i'll be doing both, in the OR one whole day with hospital privilege ensured doing orthognathics, reconstructions and in private practice other days seeing implants, thirds, path, post ops, consults. You can have the best of both worlds depends on your referrals and priorities. Of course that's 6 yrs from now...

How much does orthognathic surgery play a role in OMS private practice? To me, that is one of the coolest parts of OMS, and I want to know it's role. Or does dentoalveolar stuff make up 90% and everything else kind of fills in the gaps. I know your practice is whatever you make it... I am more looking for averages, profitability, etc.

 

[GatorDMD]

I know i'll be doing both, in the OR one whole day with hospital privilege ensured doing orthognathics, reconstructions and in private practice other days seeing implants, thirds, path, post ops, consults. You can have the best of both worlds depends on your referrals and priorities. Of course that's 6 yrs from now...

My ideal practice would be 5 days a week, 2 days dentoalveolar, 1 day cosmetics or Orthognathics in office surgicenter, 1 day orthognathics/H+N pathology/Cancer in Hospital setting, 1 day consults with add ons. There also may be an adjustment with 2 day DA, 1 day cosmetic/Ortho, 1-2 days part time academics doing H+N pathology/Ortho/Cosmetics/Etc. Hopefully I can have fun doing what I am trained in and make an easy 500k/year 😀 But of course I would do it for 80k/year 😉 But like Gatorette said... that is 6 years away and a lot of dreaming and planning!

 

[toofache32]

Do you guys realize that EVERYBODY says that before they start residency, then guess what 99% of them end up doing?

 

[Yah-E]

Do you guys realize that EVERYBODY says that before they start residency, then guess what 99% of them end up doing?

Class II amalgams?

 

[GatorDMD]

Do you guys realize that EVERYBODY says that before they start residency, then guess what 99% of them end up doing?

getting married without a pre-nup and then fooling around with the staff and getting caught?

 

[toofache32]

Sick bastards.

 

[jpollei]

That Tucker guy in Carolina I hear does a bazillion orthognathic cases per year and he doesn't take any insurance. Some guys have started doing more orthognathics as Out Patient Surgery or in their office to help save on expenses. Then patients can pay cash and patients and surgeons can meet in the middle for treatment.

And he does do well by all accounts... rrc I'll agree with you. good point.

 

[SC-Z]

getting married without a pre-nup and then fooling around with the staff and getting caught?

crap... I just spit my beer all over my keyboard... bastards!