Practicing dentists:if you could do it again would you specialize ?

[Kayaker89]

from the general dentists I've talked too, the answer is almost always yes , but using a crystal ball to look 20-30 years into the future will the specialist life style be as nice as it is now? Technology is coming online every year that is making more advanced procedures more and more idiot proof from implants to invisilign. I would think referrals would be harder and harder to come by and you would only get the hardest stuff from the hardest patients . I don't know though maybe over analyzing , what do you think?

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[Daurang]

from the general dentists I've talked too, the answer is almost always yes , but using a crystal ball to look 20-30 years into the future will the specialist life style be as nice as it is now? Technology is coming online every year that is making more advanced procedures more and more idiot proof from implants to invisilign. I would think referrals would be harder and harder to come by and you would only get the hardest stuff from the hardest patients . I don't know though maybe over analyzing , what do you think?

NO

 

[CoachDDS]

I'm 10 years out. In school, I had the desire to do OMFS because I thought that's where all the A players were (and there's some truth to that). I quickly found that while I love the field... I didn't care for the politics that come along with getting into a residency.

Specialist vs GP are very different styles of day to day practice:

Specialist:
Don't have to develop relationships with patients
Have more of a "corner" on the market
Don't have to be as insurance dependant
Practice in a narrower procedure spectrum
Requires more years of residency

GP:
You get to know people and develop genuine relationships over the years
More competitive in the market
Need to be much more insurance savvy
As varied and wide a procedure mix as you want
Can start practicing straight out of school

Long story short... general practice is more of a "people practice".... specialists are more of a "procedural practice". The one beautiful thing about being a specialist though is the leverage you have on the market, assuming you're not in an ultra competitive city of 10mil or so.

 

[DrJeff]

NO!

I love the variety being a GP gives me, as well as the simple ability to refer some of my patients who I can't stand to a specialist and let them deal with them!

 

[CoachDDS]

NO!

I love the variety being a GP gives me, as well as the simple ability to refer some of my patients who I can't stand to a specialist and let them deal with them!

Dear lord that is so so so true. Probably the best part about being a GP

 

[480640]

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[DrJeff]

It's not like a specialist can't refuse providing treatment thought, right?

The specialist can if they want to. The GP may slowdown and/or stop their referrals to that specialist though, which generally speaking is the last thing that a specialist wants, especially if it's a GP who gives a decent amount of referrals to that specialist.....

 

[Cold Front]

No. I like the fact that I come to work and have mix procedures; EXT's, pedo, Crown/Bridge, Endo, Removables, Emergencies, etc. I would be bored to death if I was doing same/similar procedures every day, for the rest of my career.

 

[gatorfan99]

Here's the other side (I was a GP for 3yrs): I'm glad I specialized - finding the procedures you enjoy doing and never doing the stuff you always hated (i.e. endo) is awesome! Plus, specialty training makes you realize just how much MORE there is to dentistry and how incredibly basic dental school education is.. Oh yeah, and the pay bump is awesome too.

Plus I am actually able to screen out the "crappy CE B.S." significantly better (here's a hint: if you are taking something and all you have a bright eyed GPs, then its probably garbage)

My suggestion would be to do general dentistry for a few years, see if you really like a certain aspect of it and, only then, consider moving in that direction. Oh yeah, also consider doing an AEGD to get your feet wet into specialty work and some experience.

 

[DoctaFauci]

Here's the other side (I was a GP for 3yrs): I'm glad I specialized - finding the procedures you enjoy doing and never doing the stuff you always hated (i.e. endo) is awesome! Plus, specialty training makes you realize just how much MORE there is to dentistry and how incredibly basic dental school education is.. Oh yeah, and the pay bump is awesome too.

Plus I am actually able to screen out the "crappy CE B.S." significantly better (here's a hint: if you are taking something and all you have a bright eyed GPs, then its probably garbage)

My suggestion would be to do general dentistry for a few years, see if you really like a certain aspect of it and, only then, consider moving in that direction. Oh yeah, also consider doing an AEGD to get your feet wet into specialty work and some experience.

My friend's father is an orthodontist and this was his suggestion: that everyone should be required to do at least a year of general dentistry before deciding to specialize. In medicine, basically everyone has to do a year of internal medicine anyway; dentistry should follow suit, I think. AEGD/GPR would be a much better alternative to arbitrary licensure, in my opinion.

Which specialty did you pursue after being a GP? Do you think the opportunity cost of going back to school was worth it?

 

[Saddleshoes]

from the general dentists I've talked too, the answer is almost always yes , but using a crystal ball to look 20-30 years into the future will the specialist life style be as nice as it is now? Technology is coming online every year that is making more advanced procedures more and more idiot proof from implants to invisilign. I would think referrals would be harder and harder to come by and you would only get the hardest stuff from the hardest patients . I don't know though maybe over analyzing , what do you think?

I came to this discussion late but feel I have something to add...

As a general dentist nearing the end of my career I am very glad I did not become a specialist. Some of the things I enjoyed most in my professional life revolved around VERIETY. For example, over the years I have been able to ply my craft in 8 states and 3 counties. I have worked in clinics, offices, schools, churches, prisons, hospitals, and theaters. I have taken care of condemned murderers and international heroes. I have worked with the newest of new equipment and techniques and I have worked like a dentist in 1920. I have been an Owner, an Associate, an Employee, an Independent Contractor, a Partner, and a Volunteer. I have worked at various times and places because I was paid well, because of a sense of duty, because it was novel and/or fun, and a few time because of a call from God. I have been able to drop everything and take a sabbatical from dentistry twice.

Had I become a specialist I feel my options in my profession and my life would have been narrowed.

 

[gatorfan99]

I came to this discussion late but feel I have something to add...

As a general dentist nearing the end of my career I am very glad I did not become a specialist. Some of the things I enjoyed most in my professional life revolved around VERIETY. For example, over the years I have been able to ply my craft in 8 states and 3 counties. I have worked in clinics, offices, schools, churches, prisons, hospitals, and theaters. I have taken care of condemned murderers and international heroes. I have worked with the newest of new equipment and techniques and I have worked like a dentist in 1920. I have been an Owner, an Associate, an Employee, an Independent Contractor, a Partner, and a Volunteer. I have worked at various times and places because I was paid well, because of a sense of duty, because it was novel and/or fun, and a few time because of a call from God. I have been able to drop everything and take a sabbatical from dentistry twice.

Had I become a specialist I feel my options in my profession and my life would have been narrowed.

That's pretty amazing stuff!

I disagree on narrowing of options as a specialist: specialty care like OMS/Perio (maybe not endo) can offer a huge array of treatments and career options - many of which I wouldn't dream possible as a GP, including treatment I wouldn't dream possible as a GP (you simply don't know what you don't know, there's so much to dentistry, so much beyond the basic education of dental school and general practice)

On top of that, I'm pretty comfortable doing general dentistry procedures, I just choose NOT to do it and focus on my specialty. After all, just like every other dentist, I went to dental school, I just chose to get even MORE educated past that (and past a 1 yr AEGD). So, as a specialist, nothing stops you from doing general dentistry..

Also, being in the military has allowed me to practice dentistry on many many corners of the globe and on a HUGE variety of people..

 

[RoseEndo]

I worked as general dentist for three years and I really enjoyed general dentistry. My general dentistry experience definitely helped me out to communicate better with my GP colleagues. I really believe the best specialist in our town are those with general dentistry experience because they understand restorative part of dentistry. I did a lot of endo procedures as general dentist and I always enjoyed doing endo. I reached the point that I told my colleagues I still choose speciality even-if I get paid as GP everyday but being able to do endo all day.

 

[Wall2Wall]

NO!

I love the variety being a GP gives me, as well as the simple ability to refer some of my patients who I can't stand to a specialist and let them deal with them!

Very well said.

 

[pigman5010]

Here's the other side (I was a GP for 3yrs): I'm glad I specialized - finding the procedures you enjoy doing and never doing the stuff you always hated (i.e. endo) is awesome! Plus, specialty training makes you realize just how much MORE there is to dentistry and how incredibly basic dental school education is.. Oh yeah, and the pay bump is awesome too.

Plus I am actually able to screen out the "crappy CE B.S." significantly better (here's a hint: if you are taking something and all you have a bright eyed GPs, then its probably garbage)

My suggestion would be to do general dentistry for a few years, see if you really like a certain aspect of it and, only then, consider moving in that direction. Oh yeah, also consider doing an AEGD to get your feet wet into specialty work and some experience.

Was it difficult to apply for residency after a few years of practicing experiences? Did that put in in a disadvantage situation compared to those applicants came straight out of dental schools?

 

[321931]

No. There is more opportunity to become a successful practice owner over a specialist for a new graduate. Just google X city dental practice for sale. Just try it. Put your hometown address in. I bet you you can find 10 practices within the area you want to live in...and maybe one or two specialty practices within 20-30 miles. Yes read that correctly and think again.

When GP dental practices sell, they sell the practice based on goodwill and the revenue of the practice. The patient's come to the practice because they like the location and they like the old doctor. So you buy the practice and the charts and patient's still come back. If you look on the market there are tons of decent practices for sale. On the contrary, specialists rarely sell and if they sell, its not a home-run situation. Why? Because specialists depend on referals. They see one patient take out their tooth and then the patient goes back to their GP.

If a dentist has three referalls to endodontists in an area that they have worked with for years...and one retires...and gets taken over, they probably would refer to the guys they have developed working relationships for years. Same deal with start-ups. Good luck competing against an established OMFS/ENDO in the community. There is always the route of "buying" someone out but what ends up happening is that you are on the low end totem pole for the group practice and deal with all the headache patients until the older guy retires which can be for years...and years. Most of my friends that specialized ended up doing a startup...and they will probably make very good money but the cash flow won't be there for the first 1....2....5-10 years until they have a good reputation. With a good GP practice, cash flow is instantaneous.

So whats easier? Working 1 year after graduation, buying a successful practice and maintaining it successful...or going to top 1% of graduates in your class...working 2-4 years in residency...and then coming out with limited options that limit your success/earning potential. So what ends up happening? Dentist buys GP practice that grosses good numbers..., starts cutting down loans, starts putting money away earlier into equity, starts putting money into 401k earlier and stock portfolios...while specialists are still in school/building a practice. That being said, after they graduate, they still need time to find the best place to buy-into...if they even can.

That being said, it's much more lucrative to be a an employee specialist over an employee associate GP. If however, you do land a spot as a beginning owner specialist...you will be in FANTASTIC shape...but as stated before...its not that easy to find that great spot. Just google your city/hometown. Do it before posting a reply.

As an aside from the business aspect, specialist have to deal with all the patient's that GP's can't manage. I've had limited opening patients that needed root canals, and they had to go for three visits to the specialist. I refer distal caries 2-3 mm under the gum to my periodontist to flap and restore. If challenging cases excite you and managing tough clinical situations get's you happy...then go for it. The hardest thing I do...is talk to patients all day long about their lives, kids, new years resolutions....stock market... whatever while doing class 2's and crowns. I don't burden myself with RCT/EXT/Perio surgery...just refer out. In the perfect world...it would be great to just do implant placements as an OMFS, straight-forward endo as an Endodontist...but I see what I refer on the daily basis... and man good luck with those cases.

 

[ncide]

Was it difficult to apply for residency after a few years of practicing experiences? Did that put in in a disadvantage situation compared to those applicants came straight out of dental schools?

Endo residencies favor experience. Many applicants have worked as a GP or gone to an AEGD/GPR before endo residency.

There are other residencies where the same isn't necessarily true.