Pay over $350k for ortho residency?

[JacquesVallee]

I think we can all agree the state of the dental profession is in serious decline…

Big Hoss

100%. When predents have shadowed at my office I've always tried to steer all of them away from dentistry. Sadly, none of them listen. There is still this crazy misconception that all dentists are super wealthy which couldn't be further from the truth, especially for new grads.

Also, even though I went to a "cheap" state school, most of my classmates aren't even paying off their loans. Rather, they're relying on government loan forgiveness programs. The current state of dentistry is even attending some of the cheapest dental schools will still require you to go on IBR or PAYE. This isn't sustainable for an entire profession.

---

Members don't see this ad.

 

[yappy]

Except omfs.

Doesn’t it have the same issues? Massive debt? Wouldn't you rather be an oms that graduated 20 years ago vs today? All the ones I know work for DSOs or their specialty’s variant.

 

[charlestweed]

I graduated during the “golden age” era (in 2001) when the average daily pay for associate orthodontists was around $800-1000/day. I worked for 3 different Corp offices. I had to see around 80-100 patients a day with only 3 ortho RDAs. I had to work as an extra RDA (doing wire changing and sterilizing instruments myself) in order to keep up with the busy schedule. I also opened my own office. When I finished work the corp offices at 6pm, I drove straight to my office to see my patients until 9pm…..my wife worked at front desk…..and my 2 yo daughter slept inside one of the consultation rooms. With a positive cash flow (from my associate jobs), running a practice, which I set up from scratch, wasn’t too stressful.

Now that the golden age is over, the number of new start cases per day has declined a lot. I only see around 50-60 patients a day at this same corp office, where I’ve worked for for 20+ years (since graduation). 50-60 patients/day is a very easy day for a veteran orthodontist like me. And the company pays me more than 2X as much now than when I was first hired. They underpaid/overworked me in the past and I didn’t realize it. As a young grad with debt, I was desperate.

With years of experience and having zero debt, the job is so easy now.

 

[Big Time Hoosier]

Now that the golden age is over

Big Hoss

 

[White_Sponge_Nevus]

Every job in dentistry, regardless of specialty, isn't as good as it was a generation ago. If you're already in dental school, do what you'd be happiest doing so long that it's feasible with the debt:income situation you'll find yourself in.

If you're not in dental school yet, try to be wary of comparing your future career to that of anyone in dentist who is over the age of 40. It is a different career for them. They faced separate challenges but not the financial ones today. Dentistry is a terrible gig compared to dentistry of the previous generation but a much better gig than most available to us now. Gotta compare it to the right things.

 

[2TH MVR]

I think we can all agree the state of the dental profession is in serious decline…

Big Hoss

I would say the business side of dentistry has changed for the worse. Mostly due to Corporates turning dentistry into a profit only business.

Most of us were attracted to dentistry (I was anyway) for the chance to start a small business, treat patients ethically, and earn a good living for all the years we toiled in school.

Fortunately .... I love the practice of orthodontics. But I get it. Easier for someone in my position (close to retirement) as compared to those young dentists, specialists justing graduating, or just a few years in the profession.

 

[Greyangel6]

I use handpieces multiple times per day. Some days it feels like all I do is go from chair to chair using handpiece. Broken brackets, removing aligner attachments, removing bands/banded appliances, removing composite after braces coming off, repairing fixed retainers, etc etc. I will often also do enameloplasty to flatten out chipped incisors, or sometimes even add small amounts of composite to teeth to make a nicer looking incisal edge. All of these things require use of a handpiece. There's some misconception out there about ortho being easy on the body. My counter is this- have you ever seen an orthodontist in their late 60s or even 70s that's still practicing? Same hunched over back that all dentists get. I knew an older orthodontist who had multiple fused discs, and couldn't move his neck anymore. He had to move his whole torso.

Owning a practice is like two jobs. One job where you show up and do your work (not easy), then another job where you have to run the clinic and figure out how to get new patients in the door. This true for anyone who runs a practice. The lifestyle is great, you get to choose which 80 hours of the week you get to work!

I'm sure they mean it figuratively because I think I would rather do what you do now with the handpiece than working on tooth #2-DB on a patient with large cheek and constantly wanting to suction.

 

[702]

Every job in dentistry, regardless of specialty, isn't as good as it was a generation ago. If you're already in dental school, do what you'd be happiest doing so long that it's feasible with the debt:income situation you'll find yourself in.

If you're not in dental school yet, try to be wary of comparing your future career to that of anyone in dentist who is over the age of 40. It is a different career for them. They faced separate challenges but not the financial ones today. Dentistry is a terrible gig compared to dentistry of the previous generation but a much better gig than most available to us now. Gotta compare it to the right things.

maybe I’m blind, but I actually think omfs is not worse than it was decades ago. Maybe even better.

More full scope surgeries in office instead of in the OR, safer anesthesia practices, better implant dentistry in general, etc. The key is to have control of supply and demand of doctors id say, which omfs has done better than probably anyone else in all dentistry

 

[White_Sponge_Nevus]

maybe I’m blind, but I actually think omfs is not worse than it was decades ago. Maybe even better.

More full scope surgeries in office instead of in the OR, safer anesthesia practices, better implant dentistry in general, etc. The key is to have control of supply and demand of doctors id say, which omfs has done better than probably anyone else in all dentistry

You may be right... I was thinking more in the terms of purchasing power in every day life as well as an OMFS practice with current cost of living: income, as well as increased debt. But I do keep hearing of incredible jobs out there in areas that aren't overrun with current OMFS, and know a lot of retirements are on the horizon that will keep opportunities good for the people coming out over the next 10 years

 

[JacquesVallee]

What I love about OMFS is they don't drastically increase the number of residency spots and make pay to play programs like virtually every other dental specialty has done. They do a good job at keeping the barrier to entry very high, especially with keeping the CBSE. Ortho used to be the dream, but now programs like the Georgia school of Orthodontics take forty residents per class. I know OMFS around me who clear 7 figures while many of the younger Orthos around me have trouble staying busy or even finding full time work.

 

[New_Vegas]

What I love about OMFS is they don't drastically increase the number of residency spots and make pay to play programs like virtually every other dental specialty has done. They do a good job at keeping the barrier to entry very high, especially with keeping the CBSE. Ortho used to be the dream, but now programs like the Georgia school of Orthodontics take forty residents per class. I know OMFS around me who clear 7 figures while many of the younger Orthos around me have trouble staying busy or even finding full time work.

This is very true. If I could do it again I would not go into ortho.

 

[JacquesVallee]

This is very true. If I could do it again I would not go into ortho.

What would you do if you could go back?

 

[New_Vegas]

What would you do if you could go back?

Pediatric dentistry or oral surgery. Probably oral surgery. I had the grades to do it but chose chose ortho instead and I kick myself every day for it. Problem is, I had already chosen ortho before dental school and I didn't know then what I know now. I didn't even know I would like doing extractions until third year of dental school.

 

[OncePreDent]

Pediatric dentistry or oral surgery. Probably oral surgery. I had the grades to do it but chose chose ortho instead and I kick myself every day for it. Problem is, I had already chosen ortho before dental school and I didn't know then what I know now. I didn't even know I would like doing extractions until third year of dental school.

have you ever thought about going back for OMFS?

 

[charlestweed]

Pediatric dentistry or oral surgery. Probably oral surgery. I had the grades to do it but chose chose ortho instead and I kick myself every day for it. Problem is, I had already chosen ortho before dental school and I didn't know then what I know now. I didn't even know I would like doing extractions until third year of dental school.

How about quitting ortho and going back to practicing general dentistry? I know a general dentist who works at the same Corp with me who travels to multiple offices.....and he only does pedo.

 

[JacquesVallee]

Pediatric dentistry or oral surgery. Probably oral surgery. I had the grades to do it but chose chose ortho instead and I kick myself every day for it. Problem is, I had already chosen ortho before dental school and I didn't know then what I know now. I didn't even know I would like doing extractions until third year of dental school.

Yeah I understand where you're coming from. Hopefully, you don't have too much in loans and can just try to make the most out of Ortho.
I'd also recommend endo as a specialty to any dental student reading this as well.

 

[2TH MVR]

Yeah. The current cost of entry. Multiple ortho programs. Corps and everyone else doing ortho. Aligners. All of this has made a once enviable, proud specialty ... less so nowadays.

However. Saw our OMFS working on a crazy patient at the Corp office I work at. OMFS warned me that her patient was going to be "loud". And she was. Crying, screaming, emotional. My cortisol levels were climbing just hearing this patient. OMFS was doing a good job, but the patient was just being difficult. She was scheduled for sedation, but the patient ate breakfast prior to the procedure ... which meant no sedation according to the OMFS.

Anyway. Happy as hell doing ortho. Financially may not be close to OMFS, but I don't care. Life is more than money. Day to day experiences, memories are important in the long run.

 

[charlestweed]

Anyway. Happy as hell doing ortho. Financially may not be close to OMFS, but I don't care. Life is more than money. Day to day experiences, memories are important in the long run.

The income depends on how hard one works (traveling to more offices = more work days = more money) and the number of patients that one treats in a day. An orthodontist can see 70-80 patients a day, which is 10X more than the number of patients that an OS can typically see. Therefore, a no show or cancellation doesn’t hurt the orthodontist’s daily production that much. If a patient in an OS office doesn’t show up or has to reschedule (due to medical problems like having high blood pressure or forgetting to discontinue the blood thinner med), it will be a bigger drop in the production.

Most people (as high as 85% according to the Gallup poll) are unhappy with their jobs. They hate their jobs because they have to deal with the same cons every day....cons that people from other professions don't have to deal with. Dentistry/Ortho/OS/ENDO is just a job and working is not supposed to be fun. It’s part of human nature to wonder if there is something better out there…..AKA “the grass is greener” syndrome.

 

[Big Time Hoosier]

Dentistry/Ortho/OS/ENDO is just a job and working is not supposed to be fun.

Unless you’re a predent. Then it’s your “passion.”

Big Hoss

 

[charlestweed]

Unless you’re a predent. Then it’s your “passion.”

Big Hoss

It took me 3 days (4 hours per day) to clear the massively overgrown weeds at one of my rental properties. The tenants have just moved out. Since I had all the necessary equipment, I thought it would be a simple task. Man, it’s tough. I couldn’t do it for more than 4 hours per day because of the extreme heat from being exposed continuously to the hot Sun (and we’re still in the cool Spring Season). I got blisters on my hands despite wearing thick gloves. I am glad that I am a dentist. I feel bad for the people, especially the ones who are in their 50s, who have to do this backbreaking job every single day. When you guys have kids, never tell them to pursue a trade job even if it pays $100k+/yr. Save money and help pay for their college education.

 

[JacquesVallee]

never tell them to pursue a trade job even if it pays $100k+/yr.

It's terrible on your body. Being a GD in rural America, so many of my patients are in the trades and their knees and back are destroyed. One of my patients left the trades in his mid 30s for this reason.

 

[New_Vegas]

Are you guys going to sit here and pretend like dentistry isn't hard on the body? I've got family member who is a multimillionaire as an electrician, he's in great physical shape in his 60s. He looks better than most dentists in their 60s. No hunched over back, and neck. He's probably made more money and had less physical ailments than the vast majority of dentists.
At the end of the day it really depends on who you are as an entrepreneur, a good entrepreneur can succeed in any business.
But to dissuade your kids from going into the trades? Why? You also don't have to go into extreme levels of debt if you go into the trades.
Why do dentists have high levels of suicide rate? The fact that there are dentists out there making like 80k or less as a business owner despite putting in 60 hours per week, plus all the education, debt, and stress it takes to run business... then it starts to make sense.

 

[charlestweed]

It's terrible on your body. Being a GD in rural America, so many of my patients are in the trades and their knees and back are destroyed. One of my patients left the trades in his mid 30s for this reason.

Yup, many of these trade jobs require you to bend down, pick/lift up a heavy object, and get then get up using your knees. It’s like doing squat non-stop all day, but unlike a squatting exercise, you do it in poor body form, which will lead to hronic knee and back pain. In many cases, you have to lift bigger heavier item in order to get the job done faster and to avoid getting behind in the project. Sure, you can hire people to do the lifting for you but this will cut into your overhead....and have to deal with the labor law headache, worker comp, customers’ complaints etc.

 

[charlestweed]

Are you guys going to sit here and pretend like dentistry isn't hard on the body? I've got family member who is a multimillionaire as an electrician, he's in great physical shape in his 60s. He looks better than most dentists in their 60s. No hunched over back, and neck. He's probably made more money and had less physical ailments than the vast majority of dentists.
At the end of the day it really depends on who you are as an entrepreneur, a good entrepreneur can succeed in any business.
But to dissuade your kids from going into the trades? Why? You also don't have to go into extreme levels of debt if you go into the trades.
Why do dentists have high levels of suicide rate? The fact that there are dentists out there making like 80k or less as a business owner despite putting in 60 hours per week, plus all the education, debt, and stress it takes to run business... then it starts to make sense.

Dentistry is indeed very hard on your body as well. My wife gets a sore right thumb (from elevating/extracting teeth) that doesn’t go away. But it’s not as physically demanding as many of the trade jobs. It’s why you see most men, and very few women, are doing these tough trade jobs. I didn’t get a knee problem until I started doing my yard work (because I’m bored) 2 years ago….maybe, it’s just old age.

This is why I don't recommend older non-traditional students to pursue dentistry.

Debt is also a problem. Therefore, as soon as your kid is born, you should start the 529 college saving plan for him/her right away. IMO, getting a college education is important.

 

[New_Vegas]

Dentistry is indeed very hard on your body as well. My wife gets a sore right thumb (from elevating/extracting teeth) that doesn’t go away. But it’s not as physically demanding as many of the trade jobs. It’s why you see most men, and very few women, are doing these tough trade jobs. I didn’t get a knee problem until I started doing my yard work (because I’m bored) 2 years ago….maybe, it’s just old age.

This is why I don't recommend older non-traditional students to pursue dentistry.

Debt is also a problem. Therefore, as soon as your kid is born, you should start the 529 college saving plan for him/her right away. IMO, getting a college education is important.

I don't know man, dentistry is pretty physically demanding. I think you are downplaying how hard dentistry is on the body, and exaggerating how hard the trades are on the body.

Let's be honest here. Dentistry is very different now than when you started your career. I don't think you will ever understand the hopelessness and soul crushing of having 1 million in student loans like some specialists are now starting their careers with (including some people going into ortho). The job simply does not pay enough to justify that debt. I'm not speaking from experience, because I'm not even close to that amount of student debt - but I could see how I would be in a completely hopeless financial situation right now if that were the case.

So you entered the field with much, much less debt and had a much more favorable market than current grads. I've noticed how it's almost impossible for your generation to empathize with us because the situation was so much different than when you entered the field.

Not every kid is born with a silver spoon in their mouth, and not every dentist is going to be able to afford to fully fund a 529 for their kids. So to say college education is important... Yeah kinda. If the kid doesn't study underwater basketweaving it might be. Otherwise they may just be wasting their time and your money. Or robbing their own future with student loans to line the wallets of those who benefit from the corruption in academia.

 

[charlestweed]

I don't know man, dentistry is pretty physically demanding. I think you are downplaying how hard dentistry is on the body, and exaggerating how hard the trades are on the body.

Let's be honest here. Dentistry is very different now than when you started your career. I don't think you will ever understand the hopelessness and soul crushing of having 1 million in student loans like some specialists are now starting their careers with (including some people going into ortho). The job simply does not pay enough to justify that debt. I'm not speaking from experience, because I'm not even close to that amount of student debt - but I could see how I would be in a completely hopeless financial situation right now if that were the case.

So you entered the field with much, much less debt and had a much more favorable market than current grads. I've noticed how it's almost impossible for your generation to empathize with us because the situation was so much different than when you entered the field.

Not every kid is born with a silver spoon in their mouth, and not every dentist is going to be able to afford to fully fund a 529 for their kids. So to say college education is important... Yeah kinda. If the kid doesn't study underwater basketweaving it might be. Otherwise they may just be wasting their time and your money. Or robbing their own future with student loans to line the wallets of those who benefit from the corruption in academia.

I don’t disagree with you that dentistry is a physically demanding profession, unless you’re doing ortho or dental anesthesiology. Before you encourage your kid to get a trade job, instead of going to college, you should ask him to do work around the house like mowing grass, cleaning the backyard etc, and then ask him if is ok to do this every day as a full time job for the next 40+ years of his life. Plumbing is not just about connecting the pipes together. Electrical work is not just about connecting wires together. These jobs often require digging, crawling into tight crawl/attic space, breaking the thick concrete slabs, climbing, and cleaning up after the project as well. And like dentistry, you have to do many of the heavy lifting by yourself in the beginning and to establish good relationship with your clients before you can expand your business and become a successful multi-millionaire electrician like your uncle. Reputation can’t be built overnight....it requires a lot of hard work, time, and sacrfice.

You are right. We, older generation, had it much easier than the current generation. Even when I got paid half as much as a new grad as I make today, I was still able to buy a lot of things. I bought my first house for $380k. Now, this same house costs $1.5M. This is why I work hard to save for my son’s education so he will be at the same starting point as mine when I first started. You are also right that not every kid has wealthy parents to help out. IMO, dentistry is still worth it if one can keep the debt amount to around $300k or below (with some helps from their parents)

I had put in $400/month to the 529 plan for my son for about 3 years and the amount was enough to cover his college tuition + dorm + food for 1.5 years (5 quarters at UCLA) . The reason I stopped contributing after 3 years was I didn’t see the money grew fast enough and I thought I could get more by investing it real estate. My cousin has contributed a similar monthly amount to the 529 plan for his daughter since she was born and it’s more than enough to cover her entire 4 undergrad years at UCLA + maybe 1-2 yrs of professional school. His daughter is will apply for dental schools next year.

 

[yappy]

Are you guys going to sit here and pretend like dentistry isn't hard on the body? I've got family member who is a multimillionaire as an electrician, he's in great physical shape in his 60s. He looks better than most dentists in their 60s. No hunched over back, and neck. He's probably made more money and had less physical ailments than the vast majority of dentists.
At the end of the day it really depends on who you are as an entrepreneur, a good entrepreneur can succeed in any business.
But to dissuade your kids from going into the trades? Why? You also don't have to go into extreme levels of debt if you go into the trades.
Why do dentists have high levels of suicide rate? The fact that there are dentists out there making like 80k or less as a business owner despite putting in 60 hours per week, plus all the education, debt, and stress it takes to run business... then it starts to make sense.

It’s not nothing special if you look at analogous professions. I think the issue is the type of people who would go into a field like dentistry.

 

[2TH MVR]

You are right. We, older generation, had it much easier than the current generation. Even when I got paid half as much as a new grad as I make today, I was still able to buy a lot of things. I bought my first house for $380k. Now, this same house costs $1.5M.

And your grandparents probably paid a fraction for their house compared to the $380K you paid. And were wages back then the same as today? No. Curious if your grandparents felt they had it easier than your generation? Probably not.

Something has changed in the world of dental economics compared to the earlier years. Capitalistic greed on all fronts.

 

[Big Time Hoosier]

The real issue with housing is that the longterm historical average of median home price vs median income was around 3x, but it has since ballooned to nearly 6x. Homebuyers today absolutely have it worse off.

Big Hoss

 

[JacquesVallee]

The real issue with housing is that the longterm historical average of median home price vs median income was around 3x, but it has since ballooned to nearly 6x. Homebuyers today absolutely have it worse off.

Big Hoss

Unquestionably true. My dad bought his first home at 20. I can't even fathom that today. A new study just showed about half of parents now financially support their adult children. The America where you could hand your resume to a random CEO, give him a firm handshake, and get a job that pays enough to support a family is gone. 50% of parents financially support adult children, report finds. Here's how much it costs them.

 

[charlestweed]

And your grandparents probably paid a fraction for their house compared to the $380K you paid. And were wages back then the same as today? No. Curious if your grandparents felt they had it easier than your generation? Probably not.

Something has changed in the world of dental economics compared to the earlier years. Capitalistic greed on all fronts.

It’s true about the capitalistic greed. We just have to learn to adapt and try to survive. There’s nothing we, small people, can do to change this. I keep working hard to save for my kids’ future because this is the only thing that I can control.

 

[charlestweed]

The real issue with housing is that the longterm historical average of median home price vs median income was around 3x, but it has since ballooned to nearly 6x. Homebuyers today absolutely have it worse off.

Big Hoss

True, the rapid rate of increase in home prices has significantly outpaced the increase in income making homeownership less affordable for most young people. And for those who can’t buy a house, they have to deal with the very high rent payments as well. This problem affects everyone, and not just new grad dentists. This affects older dentists like us as well but at least we already paid off our debt. We will just have to work a little longer than what we originally planned in order to make up for the unexpectedly high inflation rate and to save more for our children. Giving my children a debt-free education is the very least I could do for them. It’s not their fault that they were born late....and have to face this financial mess, where the government keeps printing more money.

 

[Molar Whisperer]

The real issue with housing is that the longterm historical average of median home price vs median income was around 3x, but it has since ballooned to nearly 6x. Homebuyers today absolutely have it worse off.

Big Hoss

I was observing numerous new homes being built near my other property. I saw how much work it took to build a home. Of course many builders take shortcuts and built crap homes for big profits. I was wondering how new homes can be affordable for young people. I was considering how much the electricians, cabinet makers, dry wall, plumbers, flooring guys, etc, all needed to get paid to support their families in this economic environment. In my area, the county codes and permits for buildings are very strict and restrictive increasing costs.

On the flip side, not all housing in this country are unaffordable. Many "affordable" homes are mostly in rural farming communities where nobody wants to live. When my dad passed away in 2021, we sold his rural 3000+ sq ft house for $190k (When I bought by first home in 2003, my dad was upset that I bought a home costing 3 times more than his. Now it's worth 4.5 times). In the future, maybe the younger generation can come together and build a desirable community in lower COL areas.

 

[charlestweed]

I was wondering how new homes can be affordable for young people. I was considering how much the electricians, cabinet makers, dry wall, plumbers, flooring guys, etc, all needed to get paid to support their families in this economic environment. In my area, the county codes and permits for buildings are very strict and restrictive increasing costs.

Many of these men bring their kids to my office for ortho tx. I've spoken to many of them. As you know, I am an immigrant. I target mainly low income Hispanic and Asian populations because I feel I can connect with them better. I don’t have to be a good communicator in order to be successful. The reason these low income blue collar immigrants are able to afford to live in very high cost of living areas in So Cal is they have as many people (friends, extended family members etc) living in the same house as possible. Due to the high rent demand and housing shortage, many cities in SoCal make it easier for homeowners to apply for permit for adding an ADU (Accessory Dwelling Unit) on their backyard.

I’ve run my own practice for nearly 20 years and these are what I’ve noticed:

1. Before the Covid, most of my patients paid cash and wrote personal checks to me…..only about 1/3 of them used their credit cards.

2. When the government allowed the owners to reopen their business from Covid shutdown and infused large amount of cash (Covid-relief funds, PPP loans etc, EIDL, pause on student loan repayments etc) into the economy (with money printing), my practice got so busy with a lot of new case starts. One day, I got as many as 13 new cases. I had to hire 2 additional assistants to help me. But the practice boom didn’t last very long….only about 1 year. It's also when the home prices started to shoot up.

3. Now, at the current time, very few of my patients write checks or pay cash. I’d say about 80-85% of my patients pay me by credit cards. Sometimes, the card got denied for reaching the limit and they have to use another card. It seems like more and more people are living on borrowed money. The high rents and other increases like auto insurance premium, egg price etc. really hurt them.

 

[Molar Whisperer]

Many of these men bring their kids to my office for ortho tx. I've spoken to many of them. As you know, I am an immigrant. I target mainly low income Hispanic and Asian populations because I feel I can connect with them better. I don’t have to be a good communicator in order to be successful. The reason these low income blue collar immigrants are able to afford to live in very high cost of living areas in So Cal is they have as many people (friends, extended family members etc) living in the same house as possible. Due to the high rent demand and housing shortage, many cities in SoCal make it easier for homeowners to apply for permit for adding an ADU (Accessory Dwelling Unit) on their backyard.

I’ve run my own practice for nearly 20 years and these are what I’ve noticed:

1. Before the Covid, most of my patients paid cash and wrote personal checks to me…..only about 1/3 of them used their credit cards.

2. When the government allowed the owners to reopen their business from Covid shutdown and infused large amount of cash (Covid-relief funds, PPP loans etc, EIDL, pause on student loan repayments etc) into the economy (with money printing), my practice got so busy with a lot of new case starts. One day, I got as many as 13 new cases. I had to hire 2 additional assistants to help me. But the practice boom didn’t last very long….only about 1 year. It's also when the home prices started to shoot up.

3. Now, at the current time, very few of my patients write checks or pay cash. I’d say about 80-85% of my patients pay me by credit cards. Sometimes, the card got denied for reaching the limit and they have to use another card. It seems like more and more people are living on borrowed money. The high rents and other increases like auto insurance premium, egg price etc. really hurt them.

In my area, these guys make good money. My bathroom/handyman remodeling guy is from Romania. His plumber also from Romania connected my bathtub to the plumbing for $1000 taking about 45 min (my top of the line bathtub was about $600 wholesale). These Romanian guys build their own multi-million dollar homes making my home look shabby. They will tell me how snobby their wives get when they're looking at other people's bathrooms & kitchens knowing how much the materials and labor costs. Fortunately, my guys charge me wholesale for all the materials because they have a construction cartel and I kiss up to them.

 

[charlestweed]

In my area, these guys make good money. My bathroom/handyman remodeling guy is from Romania. His plumber also from Romania connected my bathtub to the plumbing for $1000 taking about 45 min (my top of the line bathtub was about $600 wholesale). These Romanian guys build their own multi-million dollar homes making my home look shabby. They will tell me how snobby their wives get when they're looking at other people's bathrooms & kitchens knowing how much the materials and labor costs. Fortunately, my guys charge me wholesale for all the materials because they have a construction cartel and I kiss up to them.

My friend owns a tile shop and he is doing very well. He went to the same community college with my wife. He opened a tile business and my wife went to D- school. We are currently renovating our rental property (the one I posted above). We are replacing the existing carpet with vinyl flooring and my friend only charges us 99 cents per sf for the material + $2 per sf for the labor, which aren't much. I don't know how much my friend will pay his floor installers (there are 3 of them).....probably not much.

The painter charges us $3k to paint the entire interior including doors and closet doors. He pays for the paint. It will take his crew 3 days to complete. He is Korean. IMO, getting paid $1K a day for the amount of labor that will be performed isn’t much.

 

[8_man]

This is very true. If I could do it again I would not go into ortho.

I'm curious as to why you feel this way. Is it related to debt, corporatization, competition with GPs, and/or lower-than-expected compensation?

Edit: sorry I did not read the whole thread until now. Just saw your earlier posts explaining why.

 

[2TH MVR]

I'm curious as to why you feel this way. Is it related to debt, corporatization, competition with GPs, and/or lower-than-expected compensation?

Thought I would chime in. New-Vegas may have other reasons also.

My perspective is from someone who has been in practice for the last 32 years. The 1st 25 years I had two ortho practices and practiced privately. The last 9 or so years .... I've been an employee of a Corp.

Everything you mentioned above is correct. I would add that "Aligner" tech has made it possible for everyone including DYI to "straighten" teeth. I am not a fan of aligner tx due to it's limitations, but understand that it is a desirable option for adults.

Prior to Corps, aligners ..... orthodontists had the monopoly on straightening teeth. We could build numerous offices, hire alot of staff and see ALOT of patients. Easy money. This was the 1st half of my career. Boy. Do I miss it.

Now? No so easy. Too many providers: Corps, non-orthodontists doing ortho, at home DYIers, etc. etc. Look around town. Almost every Dental office has a sign: Gentle Dentistry AND Orthodontics. We're saturated with providers. Even the Corp I work for is having issues with all the other Corps that offer Ortho tx.

As mentioned: the cost of entry is high for the new orthos. I graduated with less than 100K for everything. There are some crazy new orthos with debts in the 800K and higher. With that kind of debt .... even if you wanted to open or buy an ortho practice ..... you would have to take on even more debt.

But. For myself. I have no regrets. Working Corp is easy. Money is sufficient for my needs. No hassles. No stress. At 62 yrs of age .... I continue to love practicing orthodontics. I hope to continue for as long as possible. On my terms.

 

[8_man]

Thought I would chime in. New-Vegas may have other reasons also.

My perspective is from someone who has been in practice for the last 32 years. The 1st 25 years I had two ortho practices and practiced privately. The last 9 or so years .... I've been an employee of a Corp.

Everything you mentioned above is correct. I would add that "Aligner" tech has made it possible for everyone including DYI to "straighten" teeth. I am not a fan of aligner tx due to it's limitations, but understand that it is a desirable option for adults.

Prior to Corps, aligners ..... orthodontists had the monopoly on straightening teeth. We could build numerous offices, hire alot of staff and see ALOT of patients. Easy money. This was the 1st half of my career. Boy. Do I miss it.

Now? No so easy. Too many providers: Corps, non-orthodontists doing ortho, at home DYIers, etc. etc. Look around town. Almost every Dental office has a sign: Gentle Dentistry AND Orthodontics. We're saturated with providers. Even the Corp I work for is having issues with all the other Corps that offer Ortho tx.

As mentioned: the cost of entry is high for the new orthos. I graduated with less than 100K for everything. There are some crazy new orthos with debts in the 800K and higher. With that kind of debt .... even if you wanted to open or buy an ortho practice ..... you would have to take on even more debt.

But. For myself. I have no regrets. Working Corp is easy. Money is sufficient for my needs. No hassles. No stress. At 62 yrs of age .... I continue to love practicing orthodontics. I hope to continue for as long as possible. On my terms.

It was insightful to hear from your perspective, thanks. I’m not a fan of aligners either but it’s here to stay so I’ll deal with it. Did you end up selling your private offices to a younger doc or corporate?

I’m a newer-ish ortho and honestly I think it’s still a great profession. Not experiencing that ‘golden age’ certainly helps because I don’t really understand what I missed out on, and graduating into this environment of corps and ortho GPs seems like just another day in the life to me.

 

[charlestweed]

I don’t really understand what I missed out on, and graduating into this environment of corps and ortho GPs seems like just another day in the life to me.

My very first job (in 2001) was at a corp office. And now, 24 yrs later, I am still at this same Corp office and I am happy. Otherwise, I wouldn’t have stayed there for that long. It's a wonderful specialty.

 

[D1Bound]

maybe I’m blind, but I actually think omfs is not worse than it was decades ago. Maybe even better.

More full scope surgeries in office instead of in the OR, safer anesthesia practices, better implant dentistry in general, etc. The key is to have control of supply and demand of doctors id say, which omfs has done better than probably anyone else in all dentistry

The culture of that specialty is distinct. They are fierce people and will protect their profession at all costs. You will grind harder than any other specialty to get accepted, and then you will suffer 4-6 years of hard labor to get your certificate while constantly being verbally abused all while facing the possibility of getting kicked out.

 

[2TH MVR]

Did you end up selling your private offices to a younger doc or corporate?

I’m a newer-ish ortho and honestly I think it’s still a great profession. Not experiencing that ‘golden age’ certainly helps because I don’t really understand what I missed out on, and graduating into this environment of corps and ortho GPs seems like just another day in the life to me.

I sold both my practices to a private entity (family of orthodontists). One of the practices was located in an office condo that I owned and leased to them. I sold the real estate a few yrs later.

I sold just in time. Any longer and my practices would have been worth nothing. Most Corporates are not buying ortho practices. Why would they? Their niche is generalists and specialists all under one roof. It makes more sense to utilize the building all the time. Most ortho practices are 1-2 days per week per location. Not a great utilization of paid space. Plus. If a Corp wants to add ortho services ... they can just hire an orthodontist.

As for the "Golden Age". The Golden Age was before Dental Corps became so prevalent. The Golden age was generalists and specialists all working together for the benefit of the patient. The general dentists were busy back then where there was no need for them to "dabble" with the specialist procedures. Win-Win. Now? All I see is competition between the generalists and specialists. A dentist does not want to refer a patient to an orthodontist because they do not want to see "revenue" walk out of their office. They can utilize aligners, crown or veneer all the front teeth, etc, etc. There was a time when orthodontist opening new branch offices would carefully "space" themselves away from other orthodontists. Find an area that did not have an orthodontist. Now? Corps don't care. They will open across the street from your established practice.

After all of this. I still have no regrets. Orthodontics is a very cerebral specialty. Procedures are relatively simple. With experience ... diagnosis becomes easy. I love the challenge and enjoy the patient's reaction to seeing their teeth align.

So. Enjoy being an orthodontist changing lives one smile at a time.

 

[yappy]

The culture of that specialty is distinct. They are fierce people and will protect their profession at all costs. You will grind harder than any other specialty to get accepted, and then you will suffer 4-6 years of hard labor to get your certificate while constantly being verbally abused all while facing the possibility of getting kicked out.

I think It’s because their specialty is limited by GME funding and there are logistical bottlenecks to opening more programs like needing to be associated with hospitals. Now with the non-cats it’s easy to see there is enough interest and ability to train more if there were more programs.
It will be interesting to see what happens. I was reading how emergency medicine was in a great position due to limited training programs and then everything went upside down for them after they opened a lot more.

 

[D1Bound]

I think It’s because their specialty is limited by GME funding and there are logistical bottlenecks to opening more programs like needing to be associated with hospitals. Now with the non-cats it’s easy to see there is enough interest and ability to train more if there were more programs.
It will be interesting to see what happens. I was reading how emergency medicine was in a great position due to limited training programs and then everything went upside down for them after they opened a lot more.

If OMS became oversatured it’s all over lol

 

[yappy]

If OMS became oversatured it’s all over lol

It’s happened to other medical specialties too. I personally know a radiation oncologist who struggled to find work because the field is saturated. No one is immune.