Private Practice Physician vs. Private Practice Dentist

[dentalman09]

Hi, my name is Jason. I am currently a college senior who has been accepted to UCLA School of Dentistry. I entered college as a biology major with the default path of medicine. Until my junior year, after spending a summer with my mentor and family friend, I realized I wanted to become a dentist. I have a true interest in working within the oral cavity, especially implants, cometics, cleft palates (oral surgery), endo, etc. Also, I place the lifestyle that many dentists cherish on top of my priority list---the ability to have hobbies, spend time with family/friends, own practice, autonomy, and less managed healthcare.

However, once I was accepted to dental school, these thoughts of medicine came back. I did not choose dentistry as a back-up, as I have a 3.85 GPA and MCAT score of 34 during my junior year (I still took it while I was shadowing my mentor during the summer).

As I read on various forums on SDN and talking to physicians, I do not want to live their typical lifestyle of 55-65 hours/week, on call, loss of autonomy, managed health care (Kaiser), decreasing reimbursements, etc. It seems that most M.D. graduates go this path of working at an academic hospital and becoming an attending....doing rounds, filling out paper, ditations, meetings, etc. I do not want that. I am not chasing the MD degree or prestige. I have an honest interesting in both fields, since they provide services to patients. I have shadowed both professions and can find myself doing both.

I guess my question or concern regards the possibility of practicing medicine in a private practice similar to dentistry? I want to open a private practice, work with a staff, 40 hours a week, nice living, nice lifestyle, positively affect other lives, provide for my family modestly, and not deal with someone watching over me like insurance companies(possibily drop insurance and take fee-per-procedure) or an MBA. I realize that dermatologist, optomalogist, family practicians, and internist may follow this route, but it doesn't seem as common as dentistry. Also, I seem to hear that FP and internist are having a difficult time working in a solo practice due to insurance regulations and need to do more volume work in order to keep their income high. It seems like everytime I talk to a resident or physician, the hospital setting seems like the norm. I just don't want to limit my options to dentistry (even though I can see myself doing it for 30-40 years) only because I want its lifestyle and financial perks.

Are there options out there similar to dentistry in medicine? Or is that not realistic since insurance rules? Fyi, I don't want to be a plastic surgeon and do cash payments for boob jobs, lipo, or facelifts.

Thank you!

[Please do not make this into a pissing match between dentist and physicians]

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[2ndyear]

Actually, most physicians do not practice in academic settings. Sure, there are many that do, but in general it's not where most people go. Private practice medicine though may not have all of the attributes that you desire in a career. Dermatology may come close, once you're done with residency you will have minimal hospital consults, very few true emergencies, but will still have to deal with insurance companies. For family physicians and general internists it's becoming more and more common to have patients admitted through a hospitalist group so that you may not have to see your own patients when they're hospitalized. But someone still has to be on call to answer questions from patients and in FP, from worried parents and possibly laboring women. But it's worlds apart from practicing dentistry.

As for ophthalmology, the procedures that aren't done in your office are done in a surgery center or the hospital. And someone still has to come in at night to operate on the ruptured globes and detached retinas.

Oral surgery seems like a cool field for you, but you'll spend ALL of time in the hospital in your residency. Once you're done you may or may not be able to limit your practice to more or only office based. If you are in an area where groups share call, you'll be the one coming in at 3 am to fix the bar fight broken mandible, or the homeless guy with a submandibular abscess that's closing off his airway.

Maybe dentistry is a pretty good choice. You can always have a nice private practice, and donate time at the local Medicaid clinic to people who really need it.

 

[Fermata]

Both are pretty cool careers.


You really can't go wrong.

 

[toxic-megacolon]

MANY pediatricians, internists, etc, etc work 30-40 hours per week. The more abusurrd hours are more prevalent in the academic world.

 

[IlianaSedai]

One word: MALPRACTICE. Look up the cost of malpractice insurance in your state for dentistry. Then look it up for a few medical fields (say, family practice, internal medicine, ob/gyn, general surgery). If I remember correctly, dental malpractice insurance is only a fraction of medical malpractice, even for non-procedural fields of medicine (e.g. family practice, internal medicine).

This is one of the reasons why it's much easier to do SOLO practice as a dentist than as a general practitioner in medicine. The high costs of running a general practice in medicine sort of drive doctors to practice in groups in order to break even and then turn a profit. That being said, I've known family doctors practicing in small groups who probably do work 40 hours a week (or at least under 50).

Financially, in most cases (excluding very high paying medical specialties or highly procedural medical specialties with good reimbursement) I think you'd be equal or better off in dentistry, possibly with more time on your hands (or at least with more ability to call your own shots and decide your own hours).

Either way, running a business is a lot of work. If you see patients for a full 40 hours a week, you can be sure that you need additional time to deal with billing, paying bills, and otherwise running the business. In that respect I don't think you'll find the two fields that different.

Medicine is also highly variable depending on the field you'd end up selecting. Dentistry is highly procedural and involves working with your hands. Sounds like your idea of medicine (private practice, office setting?) in most cases would not be -- it's note writing, phone calling, prescription faxing, referral sending, and advice giving. Dentists may share a lot more in common with more procedural, possibly more tertiary care specialties of medicine than they do with general medical practitioners. Private practice is totally different in, say, radiology, general surgery, anesthesiology, ob/gyn. Many of these specialties are hospital based. The only people I can think of who get away with not going near the hospital are family practitioners, internists in general practice, psychiatrists, and some dermatologists. Mostly non-procedural work and very different from garden-variety dentistry which you may find satisfying specifically because you get to use your hands. So these generalizations don't apply to all possible scenarios.

Congratulations on getting into dental school.

 

[ZS4]

Here is how I see it. It depends on your personality. Those who are business minded should be dentists, and those who are employment minded should be doctors.

 

[muhali3]

Here is how I see it. It depends on your personality. Those who are business minded should be dentists, and those who are employment minded should be doctors.

nice 5 year bump...but

"employment minded"? I don't get it. Are you saying doctors can't run their own individual practice or that there is better job security in medicine?

I'm currently debating dentistry vs. medicine as well but I don't think it's just a matter of if you like business but also if you prefer a very nice lifestyle as compared to medicine.

the main excuse for not going into dentistry for most pre-meds is "I don't want to stare at teeth/inside someone's mouth all day". but i bet if dentistry became a medical specialty it would be as competitive as derm (36 hrs/week, 200k+ income, no call). i don't get how treating acne and skin problems is less gross than fixing dental problems. when you're making that much money you don't have to love your job to be happy, you just have to be ok with it.

 

[VA Hopeful Dr]

nice 5 year bump...but

"employment minded"? I don't get it. Are you saying doctors can't run their own individual practice or that there is better job security in medicine?

I'm currently debating dentistry vs. medicine as well but I don't think it's just a matter of if you like business but also if you prefer a very nice lifestyle as compared to medicine.

the main excuse for not going into dentistry for most pre-meds is "I don't want to stare at teeth/inside someone's mouth all day". but i bet if dentistry became a medical specialty it would be as competitive as derm (36 hrs/week, 200k+ income, no call). i don't get how treating acne and skin problems is less gross than fixing dental problems. when you're making that much money you don't have to love your job to be happy, you just have to be ok with it.

This is proven false on a nearly daily basis. If you're making 500k in a job you dislike, odds are you aren't going to be happy. Keep in mind, most of us will have to work 30+ years. If you don't enjoy what you do, those are a very long 30 years.

 

[muhali3]

This is proven false on a nearly daily basis. If you're making 500k in a job you dislike, odds are you aren't going to be happy. Kind in mind, most of us will have to work 30+ years. If you don't enjoy what you do, those are a very long 30 years.

Yes, I agree, but I'm just saying you don't have to love your job to be happy with your life. Even if you like it a little, that is good enough considering you don't have to work that much in the first place and when you're not at work you can use the money you made to buy fun/enjoyable experiences.

For example, I love neurosurgery and had a great time shadowing a neurosurgeon, but I would never become one because although I would love the work that I do, I would hate my life.

I'm basically just saying there needs to be a balance between a rewarding work-life and personal life. In dentistry it's a bit more tilted towards personal life, in medicine towards work-life (of course many practitioners in both professions are happy in both their work and personal lives). But I also see a lot of physicians who neither have a satisfying work-life nor personal-life, and among dentists I don't see that as often/at all. So that's why I'm so undecided right now.

 

[ZS4]

I'm actually asking if its easier to set up a dental practice than a regular doctor's office? I'm asking because just about every dentist I know has his own practice, or works part time (less than 40 hours) at other peoples' clinics, and almost never complains about work. Actually, they are always talking about something else. I can't say the same for doctors I know. Those who do have a private clinic are always crying about insurance companies and all doctors are crying about malpractice. Is it just a rant, or are doctors' lives really tougher than dentists?