small town dentists

[cluelessdr]

Soon to be D1 and I grew up in a small town. I would like to practice in a small town after graduation, but was wondering if there are any practicing dentists that are in a small town. How is it? I like that there is less competition, but just seems like the patient population will be small because not as many people go to the dentist? Is this true or was only true for my small town? Thanks!

---

Members don't see this ad.

 

[Frychicken]

You’ll make a killing $$$. If you’re the only doc in town in a 100 mile radius, everyone has no choice but to go to you.

 

[charlestweed]

Having fewer competing dental offices around you is a good thing. But you also need to look at the population growth and the job availabilities in your area as well. When people don't have jobs, they are not going to go see the dentists....or they will elect to extract a tooth, instead of paying $2k to save it with RCT and crown. When people don't have jobs, they may leave your town for better job opportunity elsewhere. It's not a good thing when more people are leaving town. For example, dentists in Las Vegas used to make 2-3 times more than dentists in CA. When the economy tanked in 2008, a lot of people left towns and now dentists' incomes in Vegas are tie with dentists' incomes in CA.

When you practice in big cities, you are forced to try to be your best in order to compete againsts other dentists ie better care, better clinical skills, lower fees, accepting more insurance plans, working on weekends etc. Your great business and clinical skills help attract patients away from the less sucessfull dental offices around you. It's the survival of the fittest. People in big cities also care more about their appearances; therefore, they are more willing to pay for highly productive procedures such as implants, veneers, braces etc. High birthrate among Hispanics, large immigration wave from Asian countries, and job opportunities here in Southern Cal have helped my practices a lot.

 

[ToothFairy72006]

my experience practicing in both rural florida and southern california...is the more rural the BETTER. Southern california is oversaturated with dentists, insurances pay very little and very HMO driven forcing you to work really hard and make less than the average dentist. When I practiced in florida, case acceptance was higher, alot of dentures, extractions, partials, root canals and crowns. Rural areas patients tend to pay cash. you will do well in rural

 

[cluelessdr]

then why doesnt everyone just live in rural areas? or is that what is slowly happening?

 

[cluelessdr]

Having fewer competing dental offices around you is a good thing. But you also need to look at the population growth and the job availabilities in your area as well. When people don't have jobs, they are not going to go see the dentists....or they will elect to extract a tooth, instead of paying $2k to save it with RCT and crown. When people don't have jobs, they may leave your town for better job opportunity elsewhere. It's not a good thing when more people are leaving town. For example, dentists in Las Vegas used to make 2-3 times more than dentists in CA. When the economy tanked in 2008, a lot of people left towns and now dentists' incomes in Vegas are tie with dentists' incomes in CA.

When you practice in big cities, you are forced to try to be your best in order to compete againsts other dentists ie better care, better clinical skills, lower fees, accepting more insurance plans, working on weekends etc. Your great business and clinical skills help attract patients away from the less sucessfull dental offices around you. It's the survival of the fittest. People in big cities also care more about their appearances; therefore, they are more willing to pay for highly productive procedures such as implants, veneers, braces etc. High birthrate among Hispanics, large immigration wave from Asian countries, and job opportunities here in Southern Cal have helped my practices a lot.

how do you check to see the population growth of a town?

 

[charlestweed]

how do you check to see the population growth of a town?

I don’t know. I think there are some companies out there that do the demographic analyses for you but I see no reason to waste my money on those companies. I set up my practices where I wanted to live and where I could still maintain the part time employment at the corp offices. Having a stable income from corp offices while trying to run my newly built office helped reduce the stress level.

What I wrote above were from my personal experience....from what I've seen both at my own and corp offices. A lot of Hispanic families have more than 2 kids and many of them get married and have children at very young age. Some of my patients, whom I treated when they were teenagers, now have their own kids and want me to put braces on their kids. A lot of times I thought I was done with treating all the kids in the family....and then on one fine day, the dad or mom brought in another younger child for me to treat....and that's their 4th or 5th child. I currently treat a family of 6: both parents and their 4 kids.

In recent years, I’ve seen a lot of young teenage Vietnamese and Chinese patients, who speak English with an accent. Obviously, these kids were not born and raised here.

 

[Gyuji]

Are the Hispanics children on MedicAid? Because a lot of Hispanics, especially the Mexicans and Central Americans, tend to leave the country to get cheap dental care like my relatives and even myself. The ones I see here, like my really young cousins, go to theAmerican dentists because of MedicAid. My aunts, mother, and others just find it absurd with the prices in the U.S. and just go to Honduras and get the whole full service for like $75 and plus more on the pharmaceutical products to "import" into the country.

And bring in Miami, a lot of the general population tend to avoid getting dental care within the country and plus there's several illegall-operating unlicensed dentists around the area. I've been seeing less dental offices in the southern part of Dade County as a lot of offices been closing.

 

[charlestweed]

Are the Hispanics children on MedicAid? Because a lot of Hispanics, especially the Mexicans and Central Americans, tend to leave the country to get cheap dental care like my relatives and even myself. The ones I see here, like my really young cousins, go to theAmerican dentists because of MedicAid. My aunts, mother, and others just find it absurd with the prices in the U.S. and just go to Honduras and get the whole full service for like $75 and plus more on the pharmaceutical products to "import" into the country.

And bring in Miami, a lot of the general population tend to avoid getting dental care within the country and plus there's several illegall-operating unlicensed dentists around the area. I've been seeing less dental offices in the southern part of Dade County as a lot of offices been closing.

Yes, a lot of them are but less than 5% of them have severe enough problem to qualify for free orthodontic tx. The majority of them ended up paying me cash….who wouldn’t want their kids to have a beautiful smile? And my offices offer them the deal they can’t refuse: low down payment of only $200-300 and low interest free monthly payments. They can spend $10+k for their daughters’ quinceanneras so there’s no reason why they can’t afford to pay for ortho tx, that cost much less. It’s a huge loss not to welcome these patients to the office. The more patients you treat and the more happy patients you have, the more referrals you will get. One kid can refer 5-6 kids from his school’s basketball team.

I also accept a lot of transferred cases that were started in TJ, Mexico because the patients grew tired of long distance drive every month. Many of my colleagues are afraid to take over these cases. For me, I don’t mind at all. The more cases I treat, the more experience I gain.

I came to this country as a political refugee. I can really relate to these patients because they and I have very similar childhood experience.

 

[Saddleshoes]

Soon to be D1 and I grew up in a small town. I would like to practice in a small town after graduation, but was wondering if there are any practicing dentists that are in a small town. How is it? I like that there is less competition, but just seems like the patient population will be small because not as many people go to the dentist? Is this true or was only true for my small town? Thanks!

I spent the first 8 years of my career in a small farming town. Answers to you questions to follow...

1. How is it? Fine! I did quite well financially and professionally. There were personal limits that eventually caused me to move on.
2. Not as many people go to the dentist? Not true. I think I saw the same proportion of "insured" in my population that my big city guys saw. I also saw more of the "poor" than my big city friends saw because I was the only option in town. Were as my big city friends did not see these folks because they went to "public aid" clinic.

One thing to think about...
If you elect to live in the same small town as you practice you had better have great people and clinical skills, because you will be seeing your patients every day.

 

[ToothFairy72006]

I will advise you speaking as a General Dentist...any big city is HMO driven especially California. You will end up playing a game of what to refer to and what to keep because many HMOS pay the GP dentist next to nothing for rcts and exts. it doesnt feel like dentistry to me as it did in florida.

 

[charlestweed]

Most private dental practices don't take HMO plans because they end up losing more money by accepting them. Patients with HMO plans have to go get treatments done at the corp offices.

There are still plenty of cash and PPO patients. If you are good, they'll come to see you. Many of my referring dentists are doing very well here in CA. And many of them accept medicaid. My sister, who is also a general dentist, is doing very well with just 2 chairs and 1 assistant. Low overhead is key.

 

[ysrebob]

There is certainly less competition; that's axiomatic. For this reason it takes less business acumen to succeed as a rural dentist, but on the other hand maybe more clinical experience.

To do well in a small town practice (unless you are so rural that people literally have no alternative but to come to you), you need to be likeable and seen as trustworthy. You'll be under a social microscope in a way your city peers would have a hard time understanding. It would be good if you became a member of a local church and the Rotary or Ruritans or etc, and bad if you drive a too-flashy car or live in a too-big house. You'll be seeing your patients every time you go to the grocery store, so you better remember their names and be able to ask about their kid who just went off to college. For some of us, this is exactly how we WANT to live, but it's not for everyone. The grass is always greener on the other side, and I think sometimes dentists in urban/suburban areas forget the social meaning of electing to live and practice in small town America. Wanting to have a "gold mine" practice with less competition is a pretty flimsy pillar to arrange your and your family's whole life around.

The other thing to know is that if you get rural enough to escape all competition, you will also be rural enough to have very limited specialist referral options. You're not going to have the option of kicking that batsh*t crazy five year old who needs a pulp/SSC over to your friendly local pedodontist, because that office is an hour away.... it's just you and the nitrous. Calcified #14 needing a root canal -- that's you too. Phobic guy with an abscessed #30 with dilacerated roots that needs EXTed on a Saturday morning -- all you. If you can't or won't, people will hold that against you. If you try and mess up, word will get around quickly in a small town and people will hold that against you too.

Small town America is great for anyone who wants to own a small traditional private practice, be a respected part of the local community, work hard for a living and prosper. Great for a clinically confident and independent-minded person who feels at home in a small town. My advice to any new grad who fits this mold is to associate in urban /suburban practice for a year or two to build experience, and then head for a small town where you are needed.

NOT a great fit for somebody who just wants to get rich (frankly you wouldn't be able to display wealth in a rural area anyway, without consequences), isn't clinically experienced, and/or doesn't really want to be part of small town life. If you attach a lot of importance to being conspicuously successful, you'll probably be better off and happier in the 'burbs where professional competition is now a fact of life - you'll just have to be a better businessperson.

 

[ysrebob]

OP, in answer to your original Q... to make a go of it, in rough terms you need a local population of at least 2K for even a small office (since only half of Americans routinely go to a dentist, and even a small office needs a thousand or so active patients). A population of 4K+ would be better especially if there is much poverty. This number would include people living out in the rural areas around your small town: anyone who would naturally come into your town for shopping/services.

 

[Ximilara]

Most private dental practices don't take HMO plans because they end up losing more money by accepting them. Patients with HMO plans have to go get treatments done at the corp offices.

There are still plenty of cash and PPO patients. If you are good, they'll come to see you. Many of my referring dentists are doing very well here in CA. And many of them accept medicaid. My sister, who is also a general dentist, is doing very well with just 2 chairs and 1 assistant. Low overhead is key.

Are your friends in SoCal or the Bay?

 

[charlestweed]

Are your friends in SoCal or the Bay?

My friends and I are practicing in So Cal…LA, San Bernadino, Riverside and Orange counties.