Pedo or Gen. Dentistry

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bentwires5

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I have the opportunity to go to a LMC pedo residency or go into practice with a family member that owns a few offices(which will need to be updated over the next few years)

My heart is not set on becoming a pediatric dentist but I feel like there would be more opportunity in doing so.

Any advice is appreciated
 
Why even apply if you dont want to do it. You better want to be dealing with buckwild 3 year olds and 8 year old gigantic babies if you choose pedo.
 
I think if you have a wonderful opportunity waiting for you, go for it! It might open up many doors for you in the future. You never know if that opportunity will still be there in 2 years! Good luck.
 
I hate treating crying uncooperative kids but if being a pedo allows me to make more and work shorter hours than doing general dentistry, then I would specialize in pedo. I’d rather do a simple Ag filling than doing a 2nd molar RCT but I’d rather be an endodontist than being a GP. It is ok to pick a profession that you like (even if that profession doesn’t pay you much) if you are a young single person. You can always work 10 hours a day, 7 days/week to make up for the low wage. If you plan to get married and have kids, I think you would want to have a job that pays you well and allow you work fewer hours so you can support your kids and still have time for them. I never wanted to stay single for the rest of my life; therefore, I specialized.
 
I have the opportunity to go to a LMC pedo residency or go into practice with a family member that owns a few offices(which will need to be updated over the next few years)

My heart is not set on becoming a pediatric dentist but I feel like there would be more opportunity in doing so.

Any advice is appreciated

What about bending wires instead of pedo?
 
I hate treating crying uncooperative kids but if being a pedo allows me to make more and work shorter hours than doing general dentistry, then I would specialize in pedo. I’d rather do a simple Ag filling than doing a 2nd molar RCT but I’d rather be an endodontist than being a GP. It is ok to pick a profession that you like (even if that profession doesn’t pay you much) if you are a young single person. You can always work 10 hours a day, 7 days/week to make up for the low wage. If you plan to get married and have kids, I think you would want to have a job that pays you well and allow you work fewer hours so you can support your kids and still have time for them. I never wanted to stay single for the rest of my life; therefore, I specialized.

What about marrying another dentist?


I have the opportunity to go to a LMC pedo residency or go into practice with a family member that owns a few offices(which will need to be updated over the next few years)

My heart is not set on becoming a pediatric dentist but I feel like there would be more opportunity in doing so.

Any advice is appreciated

Pedo has gone bust. With Obamacare now forcing insurance companies to cover pediatric dental care, new educational mills and private equity backed chains are popping up all over the place. Some of them take like 40 residents per PGY. Lutheran Medical is one that comes to mind. There will be a massive oversaturation of pedo. I doubt it will be worth the opportunity cost to specialize. Just be a GP.

In terms of worth specializing

OMFS > Endo > Ortho > Perio > Pedo > Prostho > Dental Anesthesiology>>> Anything else I might have forgotten
 
What about marrying another dentist?




Pedo has gone bust. With Obamacare now forcing insurance companies to cover pediatric dental care, new educational mills and private equity backed chains are popping up all over the place. Some of them take like 40 residents per PGY. Lutheran Medical is one that comes to mind. There will be a massive oversaturation of pedo. I doubt it will be worth the opportunity cost to specialize. Just be a GP.

In terms of worth specializing

OMFS > Endo > Ortho > Perio > Pedo > Prostho > Dental Anesthesiology>>> Anything else I might have forgotten
I can validate your statement by where you place DA. You are definitely clueless regarding DA.

However, you bring a valid point regarding the Lutheran "small/kool smiles" Medical approach.
 
I can validate your statement by where you place DA. You are definitely clueless regarding DA.

However, you bring a valid point regarding the Lutheran "small/kool smiles" Medical approach.
Why wouldn't a cheaper CRNA be hired over a DA? CRNAs in many hospitals have been replacing board certified anesthesiologists. Why wouldn't that happen in dentistry?
 
Why wouldn't a cheaper CRNA be hired over a DA? CRNAs in many hospitals have been replacing board certified anesthesiologists. Why wouldn't that happen in dentistry?
It all depends on the state you work in and who can administer the anesthesia.
How many CRNAs function on their own going practice to practice?
How many have experience with children?
 
How did this thread turn into a specialty ranking which is totally unfounded. The doom and gloom for pedo also happened in the 80s with medicaid cuts, so what. If the ACA actually would work and people actually got the insurance and actually take their kids to the dentists pedo's would do fine. You don't need all fee for service patients to make money.

For the op, if you have some interest in pedo, I would take the opportunity, you could still do pedo when you got out and you would be paid for two years to learn a skill. You can still do as much general dentistry as you want when you get out....I know a few that restore implants. If you can't stand crying kids, and their horrible parents then maybe pedo isnt such a good idea.
 
It all depends on the state you work in and who can administer the anesthesia.
How many CRNAs function on their own going practice to practice?
How many have experience with children?

Funny this topic comes up. There are actually quite a few CRNA contractors out there going to dental offices (and other offices).

http://www.pugetsoundanesthesiaservice.com/
http://www.sleepinsafety.com/
http://www.sedationdentistry-specialists.com/our-staff/nancy-beckman-crna-ms/
http://www.endospec.com/our-services/i-v-sedation-services/
http://pennvalleyanesthesia.com/
http://sweetdreamsanesthesia.com/#services

That said, there are also MDAs and DAs doing the same thing:

http://www.drtarg.com/

http://www.socaldentalsedation.com/
 
What about marrying another dentist?




Pedo has gone bust. With Obamacare now forcing insurance companies to cover pediatric dental care, new educational mills and private equity backed chains are popping up all over the place. Some of them take like 40 residents per PGY. Lutheran Medical is one that comes to mind. There will be a massive oversaturation of pedo. I doubt it will be worth the opportunity cost to specialize. Just be a GP.

In terms of worth specializing

OMFS > Endo > Ortho > Perio > Pedo > Prostho > Dental Anesthesiology>>> Anything else I might have forgotten

Thanks, pre-dental student, for your accurate and completely reasonable approach to evaluating dental specialties.
 
If anyone here is curious about all things sedation, I highly recommend checking out the Anesthesiology section of the Dentaltown.
 
With you being a dental resident I would be interested in your opinions on the future of the dental specialities. Any thoughts?

The future of dental specialties? As in general dentists will take over the dental world? I would bet big money that most GPs would refer a psycho child almost instantly. There will always be cases to refer to every specialty out there because that is the nice thing about being a GP. You can refer whoever and whatever case you want. Also, location is huge.
 
With you being a dental resident I would be interested in your opinions on the future of the dental specialities. Any thoughts?
You can only rely on the actual data we have, which says that on average every dental specialty makes more money than general dentistry. There are a zillion exceptions, of course. Resident board legend Gary_Ruska once described it this way:
"Gary "Stay away from my 1040" Ruska here,

Here are some more recent numbers, (c) ADA 2006 (income survey from 2005), for full-time practitioners (1600 hours or more/year)

1. OMFS: $408,570 for 1920 hours/year
2. Endo: $362,700 for 1824 hours/year
3. Pedo: $337,800 for 1728 hours/year
4. Ortho: $309,970 for 1728 hours/year
5. Perio: $295,630 for 1824 hours/year
6. Prosth: $232,310 for 1920 hours/year
7. General: $210,280 for 1728 hours/year

Hourly income (estimated):
1. OMFS: $213
2. Endo: $199
3. Pedo: $195
4. Ortho: $179
5. Perio: $162
6. Prosth: $121
7. General: $122

Source: ADA surveys, Income from the Private Practice of Dentistry. (c) 2006, American Dental Association, Chicago, IL.

If you comment on this, please remember/do the following:
1. These numbers are for private practitioners, not researchers or academics.
2. These numbers are for full-time practitioners, not once-a-week people.
3. These number represent averages and, as such, you may know someone who makes much, much, much more or much, much, much less. GR (and most everyone else on this board for that matter) doesn't care about this orthodontist you know who makes $100 million dollars a year (pinky to upper lip).
4. If you want to debate these data, provide a source such that your description does not resemble the Dark Helmet monologue to Lonestar in Spaceballs.
5. Listen to the Bob Dylan song "The Times They Are A'Changin'" --> dentistry is, economically speaking, where medicine was 25 years ago. History is going to repeat itself real soon. For a sneak peak, look at medicine circa 1994 - present.

How do these numbers compare to medicine? Who cares. You're a dentist and will likely make more the 95% of the US population (even after the implementation of Obamacare or whatever the end-product is called). Be happy and study hard."
 
The future of dental specialties? As in general dentists will take over the dental world? I would bet big money that most GPs would refer a psycho child almost instantly. There will always be cases to refer to every specialty out there because that is the nice thing about being a GP. You can refer whoever and whatever case you want. Also, location is huge.

Except that the trend nowadays is for GPs to do more and more and keep everything "in-house," as corporate dentistry likes to call it. Personally, my specialist colleagues get very little from me since I do almost everything, and I think that would be the trend going forward. It doesn't mean that GPs will necessarily "take-over" the dental world or do harm to patients (I still refer out the most sticky cases), but I do think the amount of specialty cases referred out is getting fewer.

While I definitely refer out "psycho" children, for every one I refer out there are 8-9 that I can treat well, so pedos don't get much from me either.
 
@Shunwei

I have heard that referrals are necessary for a specialist to be successful; however, what is keeping a specialist like a pedo or orthodontist from marketing directly to patients? Why are GP referrals necessary in those specialties?

Also, because fields tend to become more regulated, rather less regulated, do you think that standards of care & credentialing in dentistry may increase such that GPs are no longer able to be as cavalier as they are today? There is precedence for this if you consider the specialization that has occurred in medicine.
 
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@Shunwei

I have heard that referrals are necessary for a specialist to be successful; however, what is keeping a specialist like a pedo or orthodontist from marketing directly to patients? Why are GP referrals necessary in those specialties?

Also, because fields tend to become more regulated, rather less regulated, do you think that standards of care & credentialing in dentistry may increase such that GPs are no longer able to be as cavalier as they are today? There is precedence for this if you consider the specialization that has occurred in medicine.

To my knowledge there is no reason why any patient cannot go straight to a specialist or why a specialist cannot advertise for straight patient care. The referrals that you hear about are just because GPs are the first line of defense and therefore the most likely sources of patient cases. While most patients have a general dentist, they don't necessarily even know what a dental specialist is, and even if they do, they might find the higher specialist fees a turn-off. So in short, I think specialists are more shielded from the general populace which is why the general dentist, whom the population deals with more directly, is the more common referral source.

I actually don't think that GPs will be more "regulated" as time goes on; on the contrary, based on the existence of so many CEs that GPs can take nowadays, I think invasion of what's considered specialist turf is already in full swing. I don't necessarily think that this is a bad thing IF a GP knows his boundaries and don't overstep it. For example, I do my own crown lengthening surgeries, but only for posterior teeth; for anterior teeth where the gingival margins are much more aesthetically demanding, I always refer to a periodontist. And I don't do endo retreats and full-bony 3rds either, because I regard those cases' difficulty as specialist-level and in any case the pros/cons of doing those cases do not justify my time. However, my main beef nowadays is how corporate dentistry, along to a minor extent the increasing saturation of dentists, is forcing GPs to do more and more of these extreme specialist cases.

Personally, because I can do so much of my own cases, the cases that I do refer to my specialist colleagues probably comprise no more than 5% of my cases, so I am pretty much self-sufficient and they are not getting much from me. But I have no problems referring out when necessary. Just have to use good judgment.
 
@Shunwei

I agree with what you said re: corporate dentistry. I think that setting up conditions (via saturation, corp. dent., or decreased reimbursement) that make dentistry less successful, or less safe, will undermine the profession and cause people to lose their trust in dentists. It's a similar to how family medicine docs have been forced into seeing patients in <10 min because of plummeting reimbursement; setting up a condition where the difference between PA/NP/MD is no longer distinguishable.

Hopefully the corp trend is reversed or has meet their max level of market share.
What do you think of a dentist-lead "group practice" model that has GP partners and specialist partners?
 
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@Shunwei

I agree with what you said re: corporate dentistry. I think that setting up conditions (via saturation, corp. dent., or decreased reimbursement) that make dentistry less successful, or less safe, will undermine the profession and cause people to lose their trust in dentists. It's a similar to how family medicine docs have been forced into seeing patients in <10 min because of plummeting reimbursement; setting up a condition where the difference between PA/NP/MD is no longer distinguishable.

Hopefully the corp trend is reversed or has meet their max level of market share.
What do you think of a dentist-lead "group practice" model that has GP partners and specialist partners?

Personally, I really dislike group practice. The concept looks good on paper, but in reality the politics, hassle with co-ownership, don't nearly justify the theoretical cost savings. Not worth the headaches.
 
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