Penalty for hard work?

[WhichRoom]

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Is it true that once you chose to specialize you are prohibited from practicing any general dentistry in the future?? I just don't get why such a rule would be instated. Lets say I wanted to specialize in ortho/endo, I always pictured my practice would eventually be like such a scenario:
I run a general dentistry practice and when a patient needs braces or a very complex root canal, I dont have to refer them to anybody except myself. This would allow me to enjoy the variability of general dentistry and not have to lose patients, and money, when aesthetics or complex cases come to my table. Why would somebody care what I chose to do after residency, is an OMFS considered to 'above' performing a root canal for some cash? In a sense, is there a hard work penalty😡???

-Heated

 

[Daurang]

Go ahead and do it. See if any general dentist will send you referral once they realize you're taking all their other works too.

 

[persenmi]

I don't have an answer for you but one of the dentists I shadowed gave me the impression that it's not economically viable to pay for all the tools necessary for complex root canals/braces/etc. and only do those procedures occasionally. Sure, you could do it, but the real question is, is it worth it? If the numbers add up, I have every intention to run my practice this way too (only referring out it I absolutely have too).

 

[dentalWorks]

Go ahead and do it. See if any general dentist will send you referral once they realize you're taking all their other works too.

even insurance companies won't refer GP cases to you if you declare yourself (for example) an orthodontist.

Isn't it illegal to open an office with 2 different specialties under the same doc? Like GP and Orthodontist?

 

[WhichRoom]

It just seems like how can enough people have braces that I am busy working from 9-5 everyday? I had braces for like 5 years (snaggle) and I saw my ortho like 4 times a year @ ~20mins a time. I just worry about being locked in on ortho and not having work?

 

[Mackchops]

If this is the kind of practice you want why would you specialize? You specialize because you want to limit your practice to that area of specialization. If you don't want to just do root canals you don't become an endodontist... duh!

Become a GP and take CE for endo and ortho. You can do all the root canals and wire bending your little heart desires.

 

[NotPennysBoat]

If this is the kind of practice you want why would you specialize? You specialize because you want to limit your practice to that area of specialization. If you don't want to just do root canals you don't become an endodontist... duh!

Become a GP and take CE for endo and ortho. You can do all the root canals and wire bending your little heart desires.

This 👍

Also, if you are in the right area, you would have plenty of patients to keep you busy as an orthodontist. I shadowed an ortho who sees 80-100 patients a day. Our city's total population is 75,000 and we have 5 very busy orthodontists.

 

[1992Corolla]

Is it true that once you chose to specialize you are prohibited from practicing any general dentistry in the future?? I just don't get why such a rule would be instated. Lets say I wanted to specialize in ortho/endo, I always pictured my practice would eventually be like such a scenario:
I run a general dentistry practice and when a patient needs braces or a very complex root canal, I dont have to refer them to anybody except myself. This would allow me to enjoy the variability of general dentistry and not have to lose patients, and money, when aesthetics or complex cases come to my table. Why would somebody care what I chose to do after residency, is an OMFS considered to 'above' performing a root canal for some cash? In a sense, is there a hard work penalty😡???

-Heated

Look up the word 'specialty'. The reason you choose to specialize is because you don't want to do all the other stuff not in the scope of gen dentistry. Can you do ortho as a general dentist? Yes, but you are held to the same standards as an orthodontist. Same with Endo.

You can still do endo and ortho minus the residency however, just choose cases wisely. Your patients will actually like you better for sending them to someone who can do it faster and better - because it is all they do.

 

[jay47]

There is no rule that says what the OP is insinuating. An orthodontist can do endo if they want. Why they would do that, I don't know. But once you graduate dental school you can do whatever you want- the trick is that you will be held to the same standard as specialists nationwide when you do a Le Fort, so like another poster said, just choose your cases wisely.

 

[ducks8]

I'm not a dentist yet and I don't know all the different aspects of running a business. But this is my input. I feel that if you don't refer out and keep all these cases, I think it's more for your own benefit (your wallet), and not so much for the patient's best interest.

If you want to specialize, you will definitely have enough patients, especially if you're good and you have a good relationship with the general dentists in your area. Don't specialize and then become a general dentist, you're never going to get any patients for your specialty through referrals and all the specialty work you do is on your own patients, which I would think is not enough to be worthwhile.

If you want to be a general dentist, you are capable of performing more procedures and you could keep the "easy" cases. But I think as a general dentist, you would typically want to refer out. My reasoning for this is 1) you're going to spend more time on the case and possibly struggle when a specialist can probably do a better job in less time and 2) some patients that go to the specialist might not have a general dentist that they go to regularly (that's why they're now an emergency case at the specialist) or they don't like their current dentist and that's when referring out can benefit you since the specialist can recommend you as a dentist since you're helping him/her out by referring patients to them all the time. This would benefit you in the long term too, because you don't make money off of your referrals for the one time you send them out, but you will hopefully still see your patient every 6 months, and if the specialist refers someone to you, you just received another patient that you can potentially see every 6 months, therefore, making back the money you "lost" by referring out. This in my mind makes sense (and what I would do since I'm leaning towards just general) but maybe this doesn't happen in the real world... I don't know.

 

[phremius]

I am a general dentist. I do some ortho, but I refer the ones that do not fit into my GP business model out. I usually never refer out endo, except some re-treats. I never refer to perio as we do surgeries in house and I work with OS for implants. My criteria for selecting specialists to work with are simple: 1) do you have good social skills? 2) are you going to take care of my patients and make me look good as well 3) are you going to bail me out when I need to? 4) are your fees more or less in line with expectations of my patient base?

It just doesn't make sense for a specialist to do general dentistry stuff, it takes a whole different set of inventory and skill-set. There is a difference between being able to do it, and being able to do it proficiently and comfortably for the patient. Plus if any specialist i work with did general dentistry stuff on a patient that I referred I will pick a new specialist; and spread word amongst the local GPs.

I have noticed that patients generally do not like to be referred. Majority of consultants I've spoken with and utilized advocate trying to keep as much as possible in house. Referrals, communicating with specialists, and then maintaining treatment momentum with patients gets difficult. While when we as dentists refer we think:

"I'm transferring you to someone who is more proficient at this than I"

the patients are thinking: "great I have to arrange my life to schedule another appointment with some other kind of dentist just to get this thing and then i have to go back to you to finish this other thing and is the new guy going to be weird or nice what is he/she going to charge me what is going on... I'll just get my teeth cleaned and figure it out later" The patients want to come in, get **** taken care of, and leave and not have to come back. Don't think of dentistry just as a clinician, try to think of the experience from a complete stranger to dentistry who is your everyday average patient.

I know in dental school the going to specialists for consultations etc is hammered, but it would behoove you, your employment prospects, and the health of your practice to keep everything in house.

 

[newyorkblork]

Is it true that once you chose to specialize you are prohibited from practicing any general dentistry in the future?? I just don't get why such a rule would be instated. Lets say I wanted to specialize in ortho/endo, I always pictured my practice would eventually be like such a scenario:
I run a general dentistry practice and when a patient needs braces or a very complex root canal, I dont have to refer them to anybody except myself. This would allow me to enjoy the variability of general dentistry and not have to lose patients, and money, when aesthetics or complex cases come to my table. Why would somebody care what I chose to do after residency, is an OMFS considered to 'above' performing a root canal for some cash? In a sense, is there a hard work penalty😡???

-Heated

I think you're getting mad over nothing. If you're a GP who did continuing education in fields you enjoy, you could probably retain more patients than specializing in, say, Endo, and then "keeping patients".

Think about how many GP's an Endo has to flirt with to keep a practice going.

Now think about spending 2-4 years of your life to keep patients from ONE practice. That's pretty much economic fail.

Food for thought:
You wasted a very, very competitive slot in an Endo, Ortho, or OS residency so that you could be a GP and not have to refer a few patients a month. Instead of utilizing that specialized knowledge to benefit the community by providing specialized care, you've decided you'd rather be a slightly better GP.

Who's penalizing who?

 

[charlestweed]

Is it true that once you chose to specialize you are prohibited from practicing any general dentistry in the future?? I just don't get why such a rule would be instated. Lets say I wanted to specialize in ortho/endo, I always pictured my practice would eventually be like such a scenario:
I run a general dentistry practice and when a patient needs braces or a very complex root canal, I dont have to refer them to anybody except myself. This would allow me to enjoy the variability of general dentistry and not have to lose patients, and money, when aesthetics or complex cases come to my table. Why would somebody care what I chose to do after residency, is an OMFS considered to 'above' performing a root canal for some cash? In a sense, is there a hard work penalty😡???

-Heated

I never view not being allowed to perform general dental procedures as a punishment. I decided to specialize because I didn’t want to perform the procedures that I am not good at…such as doing RCT and crown prep on #15, calming down an uncooperative kid, making full/partial dentures etc.

It just seems like how can enough people have braces that I am busy working from 9-5 everyday?

That’s the beauty of being a specialist. To earn the same income as a GP (I am assuming that the GP is a solo practitioner and doesn’t hire associate), the specialist doesn’t have to work from 9 to 5, 5 days a week. I choose to work 5 days/week because I hate staying home doing nothing.

I had braces for like 5 years (snaggle) and I saw my ortho like 4 times a year @ ~20mins a time.

I think your parents were too busy to drive you to see your ortho. This was why you had to wear braces for 5 years. I see my ortho patients at least 12 times in a year.

 

[3rdMolar]

A dentist I shadowed had an endodontist working in their practice on alternating Saturdays.

I think the Endo was making ~60% of cost and the GP took what was left after collections. The Endodontist was a prof. at a local dental school and did it mainly to keep up his speed.

Earning 40% of Endo treatments, just for providing space and overhead sounds like a good deal to me if you can swing it.

 

[tinman831]

The ADA code of ethics states that if you advertise yourself as a "specialist", then you are limited to procedures in that field. If you want to perform general dentistry, then you have to consider yourself a general dentist.

 

[Ostracized]

The ADA code of ethics states that if you advertise yourself as a "specialist", then you are limited to procedures in that field. If you want to perform general dentistry, then you have to consider yourself a general dentist.

Interesting. In Canada there is no such restriction, though in reality most specialists keep to their specialty.

What about grey areas? Endodontists doing implants, for example?

 

[jay47]

The ADA code of ethics states that if you advertise yourself as a "specialist", then you are limited to procedures in that field. If you want to perform general dentistry, then you have to consider yourself a general dentist.

The key word is "advertise" . Just put up a sign that says "dentist" and you can still do anything you want, regardless of whether you have done a residency in endo or other specialty.

 

[DrReo]

The key word is "advertise" . Just put up a sign that says "dentist" and you can still do anything you want, regardless of whether you have done a residency in endo or other specialty.

It's not practical though. How many general dentists are going to refer their endo patient to the "dentist" and not endodontist...