Practicality of Oral Surgeon.

[mmpatel0]

Hi Guys,

This is a second part to this thread (http://forums.studentdoctor.net/showthread.php?t=1019175)

Basically, I am a newly grad private practice general dentist considering a path in oral surgery and am starting to have doubts about the financial opportunity cost of pursuing oral surgery.

First of all, let's set aside the fun factors of oral surgery (orthognathic, pathology and etc) and think about practical aspect of private practice oral surgery.

With economic downturn, GPs have extended their scope of practice encroaching into simple implant placement. Perios have extended their scope of practice into 3rd molar ext and sedation. So, this means that there will be less and less easy cases for oral surgeons to take.

So, is spending 4 years working like a dog AND spending rest of your life going after GPs asking for patient referrals worth the effort? (please leave passion out of this) 4 years is enough time to become a seasoned general practitioner with possibility of opening own private practice.

Any thoughts? I need opinions from surgeons who are actually in private practice.

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[dcshus]

Hi Guys,

This is a second part to this thread (http://forums.studentdoctor.net/showthread.php?t=1019175)

Basically, I am a newly grad private practice general dentist considering a path in oral surgery and am starting to have doubts about the financial opportunity cost of pursuing oral surgery.

First of all, let's set aside the fun factors of oral surgery (orthognathic, pathology and etc) and think about practical aspect of private practice oral surgery.

With economic downturn, GPs have extended their scope of practice encroaching into simple implant placement. Perios have extended their scope of practice into 3rd molar ext and sedation. So, this means that there will be less and less easy cases for oral surgeons to take.

So, is spending 4 years working like a dog AND spending rest of your life going after GPs asking for patient referrals worth the effort? (please leave passion out of this) 4 years is enough time to become a seasoned general practitioner with possibility of opening own private practice.

Any thoughts? I need opinions from surgeons who are actually in private practice.

Don't do it. If there is doubt in your mind now, imagine how you will feel when you're paged at 3:00am to sew up some drunk guy who doesn't want you there. Not to mention the days when you work 36 hrs straight. Most of us (OMS's) eat, drink, sleep our profession and couldn't imagine doing anything else. I would gladly make 1/2 what my general dental colleagues make to continue doing what I do. No offense intended...but stay in general dentistry or consider another specialty. Everybody in dentistry does well. My father in law is a general dentist that makes more money than I could ever dream, without the added liability, taking call, other negatives of choosing this lifestyle.

 

[CMistry]

To survive OMFS residency requires passion. You can't simply "leave passion out of this". No offense OP but it sounds like you're more concerned about the financial aspect than the surgery. It would be tough to survive 4/6 brutal years with only the hope of money keeping you afloat (not saying it can't be done).

 

[Localnative]

To survive OMFS residency requires passion. You can't simply "leave passion out of this". No offense OP but it sounds like you're more concerned about the financial aspect than the surgery. It would be tough to survive 4/6 brutal years with only the hope of money keeping you afloat (not saying it can't be done).

I wholeheartedly agree.

OP, here is a broad sweep of life since deciding on a career in OS.
Residency: 14 straight months of butt reaming internship WHILE attending medical school classes, Q2 trauma call most months of OS residency not including chief year which is Q1, 120+ hrs of back breaking work per week including 20+ days in the OR, taking tons of **** during almost a year and a half of general surgery, browbeating at every level of the hierarchy, eating and ****ting on the fly for 6 straight years, an emotionally draining chief year which will eat your heart out.
Practice: Alternating Sundays I travel to 2 different offices 1 hour away to see Medicaid patients who don't give a rat's ass about their health. Mondays the same thing expect that drive is 1.5 hours one way. Tuesdays and Thursday, 6 hour round trip to work in some practices up north. Wednesday traveling around to make ends meet. Friday I do my own thing however it's only that one day because I'm not busy enough to sustain any more than that (everyone and their brother in my area claims to be an oral surgeon). Taking call at a number of hospitals without appropriate compensation (lets call that a labour of love). OH yeah, liability/health insurance/association costs totalling approximately 40,000 bucks a year b/c I'm basically self employed or part time and don't have any benefits. Let's say I sleep 4-5 hours per night on average and take off 1 week per year.

You really gotta love this life. Stick to GD if you don't have the stomach for it. This is a difficult life, don't do it for the Benjamins (there are plenty of OSs getting out of residency who claim to be making 400,000 working their dream job 3.5 days a week. I call bull****.

 

[gryffindor]

So, is spending 4 years working like a dog AND spending rest of your life going after GPs asking for patient referrals worth the effort? (please leave passion out of this) 4 years is enough time to become a seasoned general practitioner with possibility of opening own private practice.

I would bet that no surgeon out there ever desires to cut another crown or composite prep no matter how much you paid them. Passion has a lot to do with what you are asking. For a surgeon, it is worth 4 years working like a dog to know that you will never have to use your DDS to do another crown prep. Going after GPs, well that is the life of any specialist.

 

[AChad26]

I wholeheartedly agree.

OP, here is a broad sweep of life since deciding on a career in OS.
Residency: 14 straight months of butt reaming internship WHILE attending medical school classes, Q2 trauma call most months of OS residency not including chief year which is Q1, 120+ hrs of back breaking work per week including 20+ days in the OR, taking tons of **** during almost a year and a half of general surgery, browbeating at every level of the hierarchy, eating and ****ting on the fly for 6 straight years, an emotionally draining chief year which will eat your heart out.
Practice: Alternating Sundays I travel to 2 different offices 1 hour away to see Medicaid patients who don't give a rat's ass about their health. Mondays the same thing expect that drive is 1.5 hours one way. Tuesdays and Thursday, 6 hour round trip to work in some practices up north. Wednesday traveling around to make ends meet. Friday I do my own thing however it's only that one day because I'm not busy enough to sustain any more than that (everyone and their brother in my area claims to be an oral surgeon). Taking call at a number of hospitals without appropriate compensation (lets call that a labour of love). OH yeah, liability/health insurance/association costs totalling approximately 40,000 bucks a year b/c I'm basically self employed or part time and don't have any benefits. Let's say I sleep 4-5 hours per night on average and take off 1 week per year.

You really gotta love this life. Stick to GD if you don't have the stomach for it. This is a difficult life, don't do it for the Benjamins (there are plenty of OSs getting out of residency who claim to be making 400,000 working their dream job 3.5 days a week. I call bull****.

Wow you are painting a really bleak picture of OMS. I have done 5 externships getting ready to send my PASS application in in two days, and thought I knew exactly what I was getting into for residency, but is private practice really like this now? I can't imagine... I haven't ever been told that it is this difficult to find work by anyone.

 

[UNLV OMS GUNNABE]

don't worry it isn't that bad

 

[Localnative]

don't worry it isn't that bad

UNLV- And how do you know? Didn't you just graduate from a fellowship and are considering another?

Before you opine about private practice, spend some time outside the confines of academia. You may get a nice dose of reality.

OP- Listen, I'm not trying to sugar coat. I don't speak for the entire cadre of OS operating in brick and mortar practices. It is about location, and about being an informed new grad. Be wary of signing an associate contract ... having a lawyer go through it with you with a fine toothed comb will prove to be very eye opening. Consider supply and demand and what sort of practice you want to be in. I know guys practicing in WV, NC, Montana who are doing fine in their full scope practice working 4 days a week and not killing themselves. Of course, the need is there in those communities. Stay away from FL, NY, Cali, big metro areas. Start looking at your employment options 1-2 yrs in advance of graduation from residency. Contact OS guys practicing in areas you are considering and get a fair assessment of what its like. Go to the AAOMS meeting as a resident, network with guys in practice, etc. I'm not trying to throw a monkey wrench in your plans. But this is reality where I practice, and I make every effort to adapt. But for some, it's not that hard.

 

[UNLV OMS GUNNABE]

UNLV- And how do you know? Didn't you just graduate from a fellowship and are considering another?

Before you opine about private practice, spend some time outside the confines of academia. You may get a nice dose of reality.

OP- Listen, I'm not trying to sugar coat. I don't speak for the entire cadre of OS operating in brick and mortar practices. It is about location, and about being an informed new grad. Be wary of signing an associate contract ... having a lawyer go through it with you with a fine toothed comb will prove to be very eye opening. Consider supply and demand and what sort of practice you want to be in. I know guys practicing in WV, NC, Montana who are doing fine in their full scope practice working 4 days a week and not killing themselves. Of course, the need is there in those communities. Stay away from FL, NY, Cali, big metro areas. Start looking at your employment options 1-2 yrs in advance of graduation from residency. Contact OS guys practicing in areas you are considering and get a fair assessment of what its like. Go to the AAOMS meeting as a resident, network with guys in practice, etc. I'm not trying to throw a monkey wrench in your plans. But this is reality where I practice, and I make every effort to adapt. But for some, it's not that hard.

I'm not sure why but you sound so angry in your posts. yes it is true I'm going into academics (where the money is even worse), but I do know a lot of people in the private world and I know the details of their contracts. yes you need to be smart and you can't just walk in anywhere and kill it but there are plenty of good jobs out there. my point is just that it isn't all doom and gloom.

 

[briansle]

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