Stay away from orthodontics

[charlestweed]

It has to be a really tough market to have to work out of 6 offices and work on weekends to make a comfortable living. My hat off to you.

It’s not that bad. The driving distances from my house to each of these 6 offices range from 20-45 miles. So it’s pretty much like a GP who drives to the same office every day. That’s how the specialists get their full time work schedule. Most specialists I know also travel.

---

Members don't see this ad.

 

[charlestweed]

When you pay off your business loan (and other loans as well) in a couple of years, a 3% annual rent increase shouldn’t be a huge problem.

 

[2TH MVR]

A lot of how you practice ortho depends on where you set up practice and your practice philosophy. Sounds like Charlestweed sets up next to the low cost Corps and he is attracting patients that are looking for low cost, albeit good orthodontic treatment. His whole practice is FOCUSED on this philosophy and I think this is very wise .... especially in this current environment.

My practice philosophy worked well in the 90-00s. Then after 2008 .... I didn't change anything since I thought everything would go back to the way it was. Well it didn't. I used to be 90% FFS and 10 PPO. The next year it was 80:20 ... then 70:30 ... you get the picture. Large staff. I had these big, fancy offices: floor to ceiling water falls, large game rooms, 8 chairs in each office, soffeted ceilings, 3 rest rooms, computers at each chair, digital xrays, T-Link system (text and email reminders for paitents, CC payments online, patient has secure access to all their financial and treatment information). Multiple office servers with internet connection to allow retrieval of any patient data regardless of which office I was at. Custom designed Hawley rets, multiple colored Pendex, T-Rex appliances, Nance., etc. etc. Both my offices were professionally designed, interior designers, and built by dental specific contractors. My philosophy at the time was to attract higher end, FFS patients and to show GPs,Pedos that their patients were going to state of the art practices. This worked in the 90-00s. Then it did not work. The analogy: I was using a Ferrari to pick up Uber clients.

In other words: your practice philosophy has to be FOCUSED. You can't be an Ortho for every type of patient. Practice in Beverly Hills .... you probably need all the glitz. Practice in a nice medium sized community with mostly working class blue collar patients .... have a clean, but simple practice.

 

[orthostr8]

A lot of how you practice ortho depends on where you set up practice and your practice philosophy. Sounds like Charlestweed sets up next to the low cost Corps and he is attracting patients that are looking for low cost, albeit good orthodontic treatment. His whole practice is FOCUSED on this philosophy and I think this is very wise .... especially in this current environment.

My practice philosophy worked well in the 90-00s. Then after 2008 .... I didn't change anything since I thought everything would go back to the way it was. Well it didn't. I used to be 90% FFS and 10 PPO. The next year it was 80:20 ... then 70:30 ... you get the picture. Large staff. I had these big, fancy offices: floor to ceiling water falls, large game rooms, 8 chairs in each office, soffeted ceilings, 3 rest rooms, computers at each chair, digital xrays, T-Link system (text and email reminders for paitents, CC payments online, patient has secure access to all their financial and treatment information). Multiple office servers with internet connection to allow retrieval of any patient data regardless of which office I was at. Custom designed Hawley rets, multiple colored Pendex, T-Rex appliances, Nance., etc. etc. Both my offices were professionally designed, interior designers, and built by dental specific contractors. My philosophy at the time was to attract higher end, FFS patients and to show GPs,Pedos that their patients were going to state of the art practices. This worked in the 90-00s. Then it did not work. The analogy: I was using a Ferrari to pick up Uber clients.

In other words: your practice philosophy has to be FOCUSED. You can't be an Ortho for every type of patient. Practice in Beverly Hills .... you probably need all the glitz. Practice in a nice medium sized community with mostly working class blue collar patients .... have a clean, but simple practice.

Well said. We were all told by the gurus to do it the way you did it. I'm in the process of trying to evolve. Having built my office 10 years ago and still paying it off, it's not so simple. And speaking of PPO's, for all of the orthos (and I guess GP's doing Invisalign) out there, I just saw that Metlife released an update that if you're in-network you can't charge extra for ceramic brackets or Invisalign. So you have to charge the same price for $50 twins as $2000 lab fee Invisalign. Ha!!!!!! And if Metlife is doing it, the rest of the carriers will eventually follow suit. Try not to spit up your coffee on that. And for the students, here's the translation: Metlife just took the biggest step in years to dictate how we treat and what we can charge, in a way that is not realistic business-wise. And while the older docs can rail about aligners and say they simply won't use them, a younger orthodontist refusing to use Invisalign is like a roofer rejecting ladders. For my dearest fan who calls me Donald Trump, this is "HUGE!"

 

[Firm]

A lot of how you practice ortho depends on where you set up practice and your practice philosophy. Sounds like Charlestweed sets up next to the low cost Corps and he is attracting patients that are looking for low cost, albeit good orthodontic treatment. His whole practice is FOCUSED on this philosophy and I think this is very wise .... especially in this current environment.

My practice philosophy worked well in the 90-00s. Then after 2008 .... I didn't change anything since I thought everything would go back to the way it was. Well it didn't. I used to be 90% FFS and 10 PPO. The next year it was 80:20 ... then 70:30 ... you get the picture. Large staff. I had these big, fancy offices: floor to ceiling water falls, large game rooms, 8 chairs in each office, soffeted ceilings, 3 rest rooms, computers at each chair, digital xrays, T-Link system (text and email reminders for paitents, CC payments online, patient has secure access to all their financial and treatment information). Multiple office servers with internet connection to allow retrieval of any patient data regardless of which office I was at. Custom designed Hawley rets, multiple colored Pendex, T-Rex appliances, Nance., etc. etc. Both my offices were professionally designed, interior designers, and built by dental specific contractors. My philosophy at the time was to attract higher end, FFS patients and to show GPs,Pedos that their patients were going to state of the art practices. This worked in the 90-00s. Then it did not work. The analogy: I was using a Ferrari to pick up Uber clients.

In other words: your practice philosophy has to be FOCUSED. You can't be an Ortho for every type of patient. Practice in Beverly Hills .... you probably need all the glitz. Practice in a nice medium sized community with mostly working class blue collar patients .... have a clean, but simple practice.

This is probably the ortho post of the year. Know your audience and become the orthodontist for that audience. Don't copy others.

 

[Firm]

Well said. We were all told by the gurus to do it the way you did it. I'm in the process of trying to evolve. Having built my office 10 years ago and still paying it off, it's not so simple. And speaking of PPO's, for all of the orthos (and I guess GP's doing Invisalign) out there, I just saw that Metlife released an update that if you're in-network you can't charge extra for ceramic brackets or Invisalign. So you have to charge the same price for $50 twins as $2000 lab fee Invisalign. Ha!!!!!! And if Metlife is doing it, the rest of the carriers will eventually follow suit. Try not to spit up your coffee on that. And for the students, here's the translation: Metlife just took the biggest step in years to dictate how we treat and what we can charge, in a way that is not realistic business-wise. And while the older docs can rail about aligners and say they simply won't use them, a younger orthodontist refusing to use Invisalign is like a roofer rejecting ladders. For my dearest fan who calls me Donald Trump, this is "HUGE!"

I really don't think Metlife understands what they just did. They are only looking at cases on the higher end but this move just increased fees for people on the lower end. I'm a big believer in charging people based on time. Some cases are hard, some are easier but every patient shouldn't pay the same fee. That is what Metlife is trying to do. We are still going to charge the patient more on the difficult cases.

 

[orthostr8]

I really don't think Metlife understands what they just did. They are only looking at cases on the higher end but this move just increased fees for people on the lower end. I'm a big believer in charging people based on time. Some cases are hard, some are easier but every patient shouldn't pay the same fee. That is what Metlife is trying to do. We are still going to charge the patient more on the difficult cases.

Not really following what you are saying. People shop around, so even if it's insurance I'm still careful to charge what I think it's worth in either direction. Until now, the loosey goosey rules of insurance gave us lots of ways to still charge a fair customary fee in most cases. This new rule is tough to work around without outright fraud.

 

[charlestweed]

Everybody wants Invisalign. Who doesn’t want to have straight teeth without having to wear braces? The problem is it’s hard to get the patients to approve the tx because of the required high down payments to cover the initial $2k lab cost. It’s hard to ask for a $2000 down payment when 75% of the population are living paycheck to paycheck (Most Americans live paycheck to paycheck).

Last week, I finished a case with ceramic brackets. The girl is allergic to nickel, an element commonly found in ortho brackets, bands and wires. It's so severe that she can't not wear any metal earings. Her mom couldn’t afford the high cost of Invisalign tx at another office and asked if I could try the ceramic brackets. I did without any hesitation…thanks to the corp job that gave me the opportunity to treat a couple cases like her daughter before. I even put molar bands on her 6s and 7s...no problem at all. Both mom and daughter were happy.

 

[charlestweed]

I really don't think Metlife understands what they just did. They are only looking at cases on the higher end but this move just increased fees for people on the lower end. I'm a big believer in charging people based on time. Some cases are hard, some are easier but every patient shouldn't pay the same fee. That is what Metlife is trying to do. We are still going to charge the patient more on the difficult cases.

Use the “easy” money for treating easy minor crowding/spacing class I cases to pay for the more difficult time consuming canine impaction cases. If you think of it this way, then I think you’ll feel better about charging the same low fee for the more difficult cases.

My OS friend once told me: “the money I make from wisdom teeth extractions and implants helps finance the more difficult, higher overhead, more time consuming orthognathic surgery procedures.”

That’s how big hospitals like Mayo Clinic survive. They use the money they collect from their millionaire patients from the oil-rich countries like the UAE and Saudi Arabia to pay for the patients who don’t have insurance. These rich patients come here for treatments because we have the best doctors in the world.

 

[Firm]

Use the “easy” money for treating easy minor crowding/spacing class I cases to pay for the more difficult time consuming canine impaction cases. If you think of it this way, then I think you’ll feel better about charging the same low fee for the more difficult cases.

My OS friend once told me: “the money I make from wisdom teeth extractions and implants helps finance the more difficult, higher overhead, more time consuming orthognathic surgery procedures.”

That’s how big hospitals like Mayo Clinic survive. They use the money they collect from their millionaire patients from the oil-rich countries like the UAE and Saudi Arabia to pay for the patients who don’t have insurance. These rich patients come here for treatments because we have the best doctors in the world.

The problem is that the easy cases are hesitant to start because they are overcharged. The hard cases always start because it's such a great deal. You are then left with an unfavorable ratio of money losing cases.

 

[charlestweed]

The problem is that the easy cases are hesitant to start because they are overcharged. The hard cases always start because it's such a great deal. You are then left with an unfavorable ratio of money losing cases.

Oh, you can’t lose those hesitant patients to another office by “overcharging” them. That’s like losing an easy anterior endo case to another dental office. Don’t you find it much better to treat several of these easy 12-18 month cases at 30-40% less than the price of the harder 30-36 month impacted canine cases? If I were a GP, I’d rather do 3 incisor RCTs and get paid $400 each than doing 1 molar endo for $1000.

I am sure you there are good reasons that you can't lower your fee. You know about your own office more than anybody here. I don't mean to tell you how you should run your own office.

 

[orthostr8]

Use the “easy” money for treating easy minor crowding/spacing class I cases to pay for the more difficult time consuming canine impaction cases. If you think of it this way, then I think you’ll feel better about charging the same low fee for the more difficult cases.

My OS friend once told me: “the money I make from wisdom teeth extractions and implants helps finance the more difficult, higher overhead, more time consuming orthognathic surgery procedures.”

That’s how big hospitals like Mayo Clinic survive. They use the money they collect from their millionaire patients from the oil-rich countries like the UAE and Saudi Arabia to pay for the patients who don’t have insurance. These rich patients come here for treatments because we have the best doctors in the world.

I understand what you are saying relating to braces. I think most ortho have practiced some variant of what you are saying that our simpler cases help balance out the quadruple impaction nightmares. Although we all know that somehow 25% of the ones we thought would be simple end up utilizing more time and skills than we thought they would, and those patients somehow end up being the ones with late Class III open bite growth.

But as far as Invisalign, given their lab fees, the only way I can apply that prinicipal to the metlife situation would be to charge the Invisalign Express (10 or 14) cases the full fee every single time, and the conversion rate on that would be very low

 

[Solostr8]

Ben is that you?

Lol. No. I am not famous like Ben. I did just pay off my debt from buying my practice (2017). I still can't believe it. 🙂. Ten years of hell

 

[Solostr8]

+1. Many young dentists believe that their piece of paper: DDS, or Specialist earns them the right to a 32 hour work week making 200k.

Wrong.

You still have to work HARD to make it work. You enter a group practice as a specialist...you get the crap cases from the old guys until they retire...then you pass the **** on to the new guy who buys in.

You start-up...it takes years before you even get a cash flow.

You start-up as a specialist? You are begging GP's for referrals. Better stuff that top 1% ego down to get them referrals.

You work for someone else...you just get the pass downs and the crap from everyone until maybe you prove competant.

You buy a practice? You are property of the bank and will be paying them for 7-10 years.

It's a hard reality that alot of new grads go through. Always nice to see them be humbled up 6-12 months later after they have been through the ringer... It's a great "I told you so" moment.

Everything you said here is so true. Grads are going to have to work their asses off...and they should expect to suffer. So pick your poison from the above choices. Will it pay off? It may. Or you may fail, and then have to start over again. There is risk here. No freebees. Working your ass off doesn't guarantee prosperity. You may end up in bankruptcy. Accept the risk. Be smart, work hard, treat your patients and yourself respectfully.

 

[Solostr8]

Is that possible it could drop that low?? How are these people with 600k in Ortho student loans surviving?

Yes .....it's very possible. I didn't take a paycheck for 8 months......nice. Things turned around though....but yeah it does happen....

 

[Solostr8]

I wish it was that simple, and when I was in college and dental school I thought it was. You simply can't compare a hard working individual with 3 jobs and little education trying to make ends meet, to a person with extensive education owning and operating a business. While the latter is obviously overall better off, but that person invested a lot of time, money, and RISK. All of those years of investment in time and finances leads to a lot of debt, and an expectation of an income that allows a certain level of lifestyle, which at least for me did NOT include yachts, luxury cars, or exotic travel. I'm fine driving a Honda and taking a nice family road trip, staying at modest inexpensive homes I find on AirBNB. I DID expect to have a pleasant work schedule and a healthy balance between my family and career. But after you put in all of that effort, you find out that tax law discriminates against small business owners, especially those with educational and business related debt. You find out that a lot of what you were told about your profession is rapidly changing, some arguing for the better and others arguing for the worse. There are lots of variables that determine how each one of us perceives the changes, and this forum really brings that point home. There's no one answer that fits all of us, and I hope you find out that everything you hoped for and expected comes true. Spoiler alert.........it usually doesn't, but most of us come to terms with reality and make it work anyways. For most, it means rolling up our sleeves and rolling with the punches, while a very small minority decide they want to and are able pursue something else. And a certain number gives up and pursues self destruction. Take good enough care of yourself and you'll stick around long enough to see it all.

Wow.....you read my mind!!!! 100%agree

 

[2TH MVR]

Okay. How about the positives. Lets be real. Orthodontics is easy. The procedures are easy. Diagnosing and treatment planning gets easy after some experience. Patients are generally healthy, young and full of life. Our patients look forward to seeing their orthodontist and love how fast their smile improves after every simple appointment. Our work isn't entirely technical and precise. I mean ... I don't have to worry about perfect crown margins. If I don't like a certain tooth position ... hey ... I reverse course and make another adjustment in the wire. Easy-peasy. Bracket comes off. No big deal. Replace it. Staff takes care of the menial stuff. Getting behind with too many patients in the chairs ... well ... looks like some of these patients will get simple reties or changing of the ties. Ortho treatment is carried out over a period of time. Some appts are easy and others are easier. Retainer patient says their teeth are moving. Tighten their Hawley retainer, go to full time wear and come back in 3 months to check. Patient wants to start treatment SAME day .... no problem .... records .... braces .... done.
I enjoyed private practice for many years and now I'm PT in Corp. I am paid relatively well. Life is pretty easy right now.

I have zero regrets about choosing to be an orthodontist. It's a great profession regardless of the current climate.

 

[321931]

Okay. How about the positives. Lets be real. Orthodontics is easy. The procedures are easy. Diagnosing and treatment planning gets easy after some experience. Patients are generally healthy, young and full of life. Our patients look forward to seeing their orthodontist and love how fast their smile improves after every simple appointment. Our work isn't entirely technical and precise. I mean ... I don't have to worry about perfect crown margins. If I don't like a certain tooth position ... hey ... I reverse course and make another adjustment in the wire. Easy-peasy. Bracket comes off. No big deal. Replace it. Staff takes care of the menial stuff. Getting behind with too many patients in the chairs ... well ... looks like some of these patients will get simple reties or changing of the ties. Ortho treatment is carried out over a period of time. Some appts are easy and others are easier. Retainer patient says their teeth are moving. Tighten their Hawley retainer, go to full time wear and come back in 3 months to check. Patient wants to start treatment SAME day .... no problem .... records .... braces .... done.
I enjoyed private practice for many years and now I'm PT in Corp. I am paid relatively well. Life is pretty easy right now.

I have zero regrets about choosing to be an orthodontist. It's a great profession regardless of the current climate.

Most jobs because "easy" when you don't have to work to survive. You are working to just work and pass time. Giving a sense of false security to new guys isn't the best thing because its much much different when you in the other shoes. I bet if you wanted to, you could hang up the drill tomorrow and be financially fine to never work a day again.

Ortho from a clinical standpoint is easy, sure, but what I'm worried about is the climate of the newly minted orthodontist trying to put food on their table- competing against corporate, align technologys, do-it-yourself braces, and gp's treading on their turf. No offense.

 

[2TH MVR]

Most jobs because "easy" when you don't have to work to survive. You are working to just work and pass time. Giving a sense of false security to new guys isn't the best thing because its much much different when you in the other shoes. I bet if you wanted to, you could hang up the drill tomorrow and be financially fine to never work a day again.

Ortho from a clinical standpoint is easy, sure, but what I'm worried about is the climate of the newly minted orthodontist trying to put food on their table- competing against corporate, align technologys, do-it-yourself braces, and gp's treading on their turf. No offense.

No offense taken. I respect your views. I agree that the current economic climate hasn't been kind to orthos, but the profession itself will adapt and thrive. Btw...I still need to work. 🙂

 

[DentistScientist]

What about academic orthodontists? I am also interested in orthodontics because these procedures take up less time than GP so that i can focus more on research, writing grants and publishing papers


Sent from my iPhone using SDN mobile

 

[Big Time Hoosier]

I am also interested in orthodontics because these procedures take up less time than GP

And you make up for that in the volume of patients you see. If you are so set on focusing your energies on research, then just do research. Don’t specialize just for the sake of specializing or to fulfill some vain ambition. Go into a specialty because you genuinely like it.

Big Hoss

 

[DentistScientist]

And you make up for that in the volume of patients you see. If you are so set on focusing your energies on research, then just do research. Don’t specialize just for the sake of specializing or to fulfill some vain ambition. Go into a specialty because you genuinely like it.

Big Hoss

However, the vast majority of dentist scientists are specialists. It has to do with the overlap between their research niche and the specialty field itself. Based on my interactions with NIDCR faculty members and the people whom I met at the AADR meeting, my research background and interests overlap with dentist scientists in omfs and ortho fields. People in these fields are excellent clinicians and also are competitive for NIH R01 and R03 grants. And I am much more interested in OMFS than Orthodontics at this time.

Research in General dentistry is mainly cariology and material science and my research background is far from these topics and therefore I am not into it. And at least in my school, the vast majority of faculty members in the general dentistry don't do much research. They are very busy with treating patients at the faculty practice and are busy grading our preps and restorations. So all they get to do are writing some review articles and working on smaller research projects that are unfortunately not competitive for NIH grants.

 

[charlestweed]

Most jobs because "easy" when you don't have to work to survive. You are working to just work and pass time. Giving a sense of false security to new guys isn't the best thing because its much much different when you in the other shoes. I bet if you wanted to, you could hang up the drill tomorrow and be financially fine to never work a day again.

Ortho from a clinical standpoint is easy, sure, but what I'm worried about is the climate of the newly minted orthodontist trying to put food on their table- competing against corporate, align technologys, do-it-yourself braces, and gp's treading on their turf. No offense.

I am pretty sure 2THMVR is working to save for his retirement and not just for fun right now. It’ll never be enough. Practicing dentistry won’t make you rich. It’s hard to know how much is enough for retirement since we don’t really know how long we’ll live. Even without debt, there are always things to spend….unexpected medical expenses (health insurance doesn’t cover everything), your children get married and you want to give them nice gifts, your children struggle financially (because they didn’t listen to your career advice) and need your help etc.

I agree with 2THMVR that in comparison to general dentistry, os, endo, perio, medicine and other health professions, orthodontists have the easiest job. To make the job more challenging and more interesting (it’s boring sitting around due to a slow schedule day), I try to book as many patients in a day as possible….so I only need to work 4-5 days/month. For the other days in the month, I work at my other satellite offices and for corp offices.

I compete against the corp offices by offering better services, Saturday and Sunday office hours, and more affordable payment plan for my patients. Ortho is also the most overpaid specialty. Even at a deeply discounted fee, I still feel I am over-compensated for the easy job that I have. There is no need for me to increase the fee annually due to increase in rents and other expenses. The good thing is brackets, wires, and other ortho supplies are getting cheaper due to competition among different vendors. Having 6-7 P/T employees is cheaper than having 1-2 F/T employees.

There are plenty of job opportunities for new grad orthos. The problem is they are too picky about the job offers. Every time a new grad ortho asks for advice about a certain job offer at a GP/corp office or about an existing office purchase on the orthotown forum, the majority of the members there advise against it. And their reasons were: you should never work for a GP, the corp office is an evil place, it’s too risky, too many medicaid patients, the pay is too low, the owner orthodontist/GP is too greedy etc.

 

[2TH MVR]

Yep. The opportunities are out there. Just have to think outside of the box. I was just saying that the profession of orthodontics is easier on the body and the mind. Essentially irrefutable. Orthodontists can practice for a long time.

Yes I am semi-retired, but I enjoy working. I would be bored if I didn't work. And yes .... everyone needs money .... including myself.

 

[Big Time Hoosier]

However, the vast majority of dentist scientists are specialists. It has to do with the overlap between their research niche and the specialty field itself. Based on my interactions with NIDCR faculty members and the people whom I met at the AADR meeting, my research background and interests overlap with dentist scientists in omfs and ortho fields. People in these fields are excellent clinicians and also are competitive for NIH R01 and R03 grants. And I am much more interested in OMFS than Orthodontics at this time.

Research in General dentistry is mainly cariology and material science and my research background is far from these topics and therefore I am not into it. And at least in my school, the vast majority of faculty members in the general dentistry don't do much research. They are very busy with treating patients at the faculty practice and are busy grading our preps and restorations. So all they get to do are writing some review articles and working on smaller research projects that are unfortunately not competitive for NIH grants.

I know a few MD/PhDs that practice absolutely zero medicine. They’re committed 100% to research. Reading your posts make it appear you have minimal interest in actually practicing dentistry and that you’re very centered on research, just like these people. Why bother getting clinical training you’re not really going to use? You might be better off doing a research post-doc than a residency.

Big Hoss

 

[DentistScientist]

I know a few MD/PhDs that practice absolutely zero medicine. They’re committed 100% to research. Reading your posts make it appear you have minimal interest in actually practicing dentistry and that you’re very centered on research, just like these people. Why bother getting clinical training you’re not really going to use? You might be better off doing a research post-doc than a residency.

Big Hoss

I see your point. However, the reason I don't write anything about clinical dentistry now is because I only finished my D1. What have I done? I only have taken couple of basic science courses, and have done waxing, couple of preps and restorations, and making impressions. If I volunteer in free clinics, all I get to do are just bringing some burs and sanitizing instruments. While I enjoyed learning the D1 stuff and I appreciated my opportunity to help third and fourth years and local dentists during charity dental clinic events, I don't have enough knowledge and experience to write about clinical dentistry at this point. I anticipate that I would be more clinically informed after completing my third year, the first year I see my patients.

On the other side, before coming to my school and doing the combined program, I have done several years of research at my school, NIH and NIDCR. I have multiple publications and have worked on multiple mentored research projects. During my D1 year, I attended Hinman Student Research Conference and AADR to present my research work and to represent my school's student research. The vast majority of student presenters there were third and fourth years.

By the end of my D2 year, I will be having my very first first author paper in basic science and multiple co-author papers. I am also applying for a small grant given by my school. No student in the entire history my school has ever applied for a grant despite my school being the Top 10 research dental school for more than a decade. This is because in order to qualify, one has to have significant amount of preliminary data.

I met dentist scientists at NIDCR who only do research and also met dentists scientists at multiple dental schools who maintain both clinical practice and research. Despite seeing and hearing about their clinical practice, such as help hosting perio laser clinic for a periodontist scientist, I cannot really write much about clinical periodontology cause all I know are like P gingivitis and pocket depth....

I was also thinking about going to NIDCR for my postdoctoral years if I absolutely dislike clinical practice but so far, I enjoy learning the clinical dentistry.

 

[hahadino2771]

good luck to all the recent grad orthodontists.... god bless your soul... Now, it's on the Wall Street Journal


Mike Meru Has $1 Million in Student Loans. How Did That Happen?

 

[DDS9994]

good luck to all the recent grad orthodontists.... god bless your soul... Now, it's on the Wall Street Journal


Mike Meru Has $1 Million in Student Loans. How Did That Happen?

This guy doesnt exactly make for a sympathetic figure, getting a Benz while in school, getting a used Tesla afterwards those cars still cost over 40 K used, living in a almost 6000 sq foot home in Utah. Anyone think the public is gonna feel bad for this guy? This guy has made a string of bad financial missteps. I don't know what his angle was to publicize all of this or what he was hoping for.

 

[gn4]

good luck to all the recent grad orthodontists.... god bless your soul... Now, it's on the Wall Street Journal


Mike Meru Has $1 Million in Student Loans. How Did That Happen?

I met him at some ASDA events. He made it seem like he could handle the debt. He has a million in education debt and he also has debt from starting his practice. I don't remember if his wife works

 

[Big Time Hoosier]

I don't know what his angle was to publicize all of this or what he was hoping for.

He wants you to open a Go Fund Me account for him so he can pay off that Tesla.

Big Hoss

 

[DDS9994]

I met him at some ASDA events. He made it seem like he could handle the debt. He has a million in education debt and he also has debt from starting his practice. I don't remember if his wife works

As you can see a lot of these guys are for show, big hat no cattle as they say.

 

[Big Time Hoosier]

As you can see a lot of these guys are for show, big hat no cattle as they say.

Definitely hasn’t earned the right to wear this belt buckle.

Big Hoss

PS: Yes, I do own this. And yes, it is massive.

 

[schmoob]

You rode BODACIOUS?!?!

 

[Big Time Hoosier]

You rode BODACIOUS?!?!

Yeah...I wish I could say that’s the origin story of Big Hoss. But, my disability policy prohibits rodeo participation. Otherwise, I would have gone that whole 8 seconds!

For reals though, I was almost trampled to death by a buffalo during a training exercise at Camp Pendleton. Literally thought I was a dead man. That’s just life in the Navy.

Big Hoss

 

[deleted659902]

good luck to all the recent grad orthodontists.... god bless your soul... Now, it's on the Wall Street Journal


Mike Meru Has $1 Million in Student Loans. How Did That Happen?

I think if it's between 1M student loan debt for being an ortho vs 500k debt for being a GP, ortho still wins out. just cuz it's so easy on the mind and the body.

if it's purely financial, then maybe pursuing orthodontics may not be prudent compared to being a GP...However, no one can deny that professional satisfaction and quality of life of an ortho are hard to match.

 

[TanMan]

Yep. The opportunities are out there. Just have to think outside of the box. I was just saying that the profession of orthodontics is easier on the body and the mind. Essentially irrefutable. Orthodontists can practice for a long time.

Yes I am semi-retired, but I enjoy working. I would be bored if I didn't work. And yes .... everyone needs money .... including myself.

Definitely... the orthodontists I talk to in my area seem to share the same sentiments. As a GP, you need to push hard early on and get out as soon as you can. That's why I advocate what I've been advocating all along. To do this (GP) for 20+ years just seems more and more like a prison sentence.

 

[Solostr8]

So true. Been following this thread a few times.

I graduated Ortho in 2006, worked for large group practice for 7 years, at first FT and then slowly cut back as my 2008 private startup grew. Had about 165k in student loans and then 400k business loan for my startup.

My practice grew very slowly the first 7 years, and then began to slowly shrink. The GP's say they're thrilled with my work and most patients seem happy, but the GP's are referring less and less. On my last marketing visit round to GP's I saw 85% had Invisalign marketing materials in their offices. Most of the referrals I get are difficult cases in the treatment or patient/parent demeanor. It's a no win situation with GP's. And 90% of the retiring dentists are closing or selling to corporations or large group practices placing young GP's who don't stick around, so it's impossible to build referral relationships. This trend is only going to continue with more and more women dentists entering the field (who are excellent dentists!!! But many aren't interested in owning FT dental offices so they work for corporations instead or have small PT offices.)

My accountant never explained the ramifications of tax law that my taxable income includes my loan principal payments, so I'm paying taxes on $60k I never see. I look really good on my tax returns though 😉

Ahh....then the headaches of managing and finding qualified staff. And the increasingly unreasonable demands of patients/parents in scheduling, treatment, and finances. I seriously had a mom mouth off at my receptionist that we wouldn't come in on Labor Day to repair a loose bracket that wasn't causing pain. She didn't want him to miss any school.

To make it today in Ortho, you need to be a dynamic personality, a shrewd businessperson, and be a volume producer. And you had better be willing to work non traditional hours. They don't look at you as a doc. They view you like the optometrist at Walmart - you are there to serve their every whim and if you don't they will find someone they think will. My wife shows me Facebook posts where people mouth off about docs who make them wait 10 minutes and can't fit them in if they show up 10 minutes late. And they outright say that we are "service providers," not docs.

And I don't even want to get started on our outdated complementary initial consultation when now everyone is going to 3 or 4 offices for free to see which one of us will bend over backwards enough to need a proctologist to be able to stand up again.

You can't be the guy who works on perfection with a small staff seeing 25-30 patients a day, as I see where it's getting me. While it's not my thing, you probably have to go in the Ben Burris direction and flip off the GP's and get those patients in yourself. Being nice and professional will not get you anywhere. I am NOT saying to do crappy work. But if you keep people in braces an extra 6 months because you want the torques just right and that tiny in/out just perfect on the mesial of the U2, well it's gonna hurt your referrals.

Knowing what I know now, would I have done ortho or dentistry altogether? No. But at this point I don't have much of a choice, especially being married with a bunch of kids.

And corporate ortho is the beast slowly awakening and learning from its failures. It's a while off, but I can't picture a new grad buying my practice based on the trends I see.

So true. Been following this thread a few times.

I graduated Ortho in 2006, worked for large group practice for 7 years, at first FT and then slowly cut back as my 2008 private startup grew. Had about 165k in student loans and then 400k business loan for my startup.

My practice grew very slowly the first 7 years, and then began to slowly shrink. The GP's say they're thrilled with my work and most patients seem happy, but the GP's are referring less and less. On my last marketing visit round to GP's I saw 85% had Invisalign marketing materials in their offices. Most of the referrals I get are difficult cases in the treatment or patient/parent demeanor. It's a no win situation with GP's. And 90% of the retiring dentists are closing or selling to corporations or large group practices placing young GP's who don't stick around, so it's impossible to build referral relationships. This trend is only going to continue with more and more women dentists entering the field (who are excellent dentists!!! But many aren't interested in owning FT dental offices so they work for corporations instead or have small PT offices.)

My accountant never explained the ramifications of tax law that my taxable income includes my loan principal payments, so I'm paying taxes on $60k I never see. I look really good on my tax returns though 😉

Ahh....then the headaches of managing and finding qualified staff. And the increasingly unreasonable demands of patients/parents in scheduling, treatment, and finances. I seriously had a mom mouth off at my receptionist that we wouldn't come in on Labor Day to repair a loose bracket that wasn't causing pain. She didn't want him to miss any school.

To make it today in Ortho, you need to be a dynamic personality, a shrewd businessperson, and be a volume producer. And you had better be willing to work non traditional hours. They don't look at you as a doc. They view you like the optometrist at Walmart - you are there to serve their every whim and if you don't they will find someone they think will. My wife shows me Facebook posts where people mouth off about docs who make them wait 10 minutes and can't fit them in if they show up 10 minutes late. And they outright say that we are "service providers," not docs.

And I don't even want to get started on our outdated complementary initial consultation when now everyone is going to 3 or 4 offices for free to see which one of us will bend over backwards enough to need a proctologist to be able to stand up again.

You can't be the guy who works on perfection with a small staff seeing 25-30 patients a day, as I see where it's getting me. While it's not my thing, you probably have to go in the Ben Burris direction and flip off the GP's and get those patients in yourself. Being nice and professional will not get you anywhere. I am NOT saying to do crappy work. But if you keep people in braces an extra 6 months because you want the torques just right and that tiny in/out just perfect on the mesial of the U2, well it's gonna hurt your referrals.

Knowing what I know now, would I have done ortho or dentistry altogether? No. But at this point I don't have much of a choice, especially being married with a bunch of kids.

And corporate ortho is the beast slowly awakening and learning from its failures. It's a while off, but I can't picture a new grad buying my practice based on the trends I see.

It has been some time since I posted/read comments here. What brought me here had to do with opinions on sharing the after hours phone calls with the dental assistants (my assistants are legally able to do this with their expanded duties certifications in my state).

After reading your post, it seems we are in a similar situation. I'm currently (finally) debt free from my practice. It's taken its toll. Now I am playing "catch-up." I am done with bank loans. This year I dropped around $100,000 in equipment upgrades.....no financing.
I will be struggling for for quite a while despite being free of debt service. I figure by the time I finally get caught up, it will be time to retire LOL. I advised my only child to consider nursing, or a physicians assistant, if she feels that healthcare is the right career path for her.

One thing I am not able to do is sell treatment that I know isn't going to benefit the patient in the long run. We can kid ourselves into lots of early treatment by looking at the before and after photos, but the intelligent and ethically grounded members in our profession recognize that most early treatment is not going to result in a better outcome. I limit my early treatment cases to crossbites with functional shifts, class 3 deep bites that are not obvious surgical cases, serial extraction if appropriate, space maintenance when appropriate. I can't bring myself to practice the way most do in my area. Most GPS still think that early treatment is always better. They believe that if you're not doing large volumes of early treatment, you are an outdated orthodontist. I even have one referral source trying to convince me to refer patients to myofunctional therapists since one of my skeletal open bite patients "relapsed." They believe that this is the state of the art in orthodontic treatment. It puts you in a bind when they're sending you most of your referrals. I've tried to educate this well intentioned referrer, but it didn't go over well. There are tooth vibrators, fast braces, Invisalign only practices, robtoics, incognito, and anything and all labelled as "the latest technology," as if using these modalities in your treatment of patients malocclusions somehow create superior outcomes. How do you compete with this mentality? I know plenty of doctors who take the stance of "if you can't beat them... join them." My bank account and my finances really wish that I would join this group of people, but I cannot do this. Sometimes wish I could, but I know that if I tried to do this, it would never work, not for one day. So I'm the guy that looks at marginal ridges.... I use the patient's Arch form conscientiously. I try my best to get canine guidance and class 1 canines when appropriate, I don't let patients or parents formulate their own treatment (that's my job), and I routinely band second molars except in exceptional circumstances. I also look at my cases when I'm done and I'm critical of the results on every patient. I hope that next month I will be a better orthodontist than I was the the month before. I make mistakes and I try to better myself because of the mistakes I've made. And I do all this because I feel it's the right thing to do. I know it will never be profitable, but I will feel good about what I'm doing. That is the only way I can do what I do. I won't have a lot of money in my bank account, and people won't look at me and think I'm extremely successful, but I can say that I did my best to treat every patient the way that I would want to be treated. Does that count for anything? Yes.....it does matter.

 

[Solostr8]

Good for you. Scottsdale to my knowledge is an intense market. Lots of growth but lots of competition. Selling your office now is real smart as I don't think you will be able to get nearly the same buyout in 10 years, and owning the building is sweet. It sounds like you got to do 2/3 of the career goals of what orthos have been expecting the last 30 years. Sorry you didn't do well enough to buy Tiger Wood's old yacht, though. I'm trying to figure out what to do as my career is only about 1/3 done unless I bolt prematurely. Personally, I don't like what Burris does at all, but given the current trends he saw what needs to be done and did it. Gotta give him credit. While I'm sitting here complaining and contemplating what to do, he went out and did something (while complaining the whole time, too 🙂). I just ordered his book. I read the eMyth for dentists - sort of depressing as it basically says we're doomed as worker/owners. If the Senate version of the tax bill gets passed, the pass-through changes may help a little. If we don't do something as a profession, we're going to become like optometrists. All working for corporations, working harder and more hours, and making less money. Unless tuition gets cheaper, I can't imagine why any bright young male would do it. (I say that, as more women are happy with part time work that pays reasonably well, although all of their part time salary going to pay student debt that doesn't make much sense either.)

As for those of us still out there for the foreseeable future, we had better figure out how to think like corporations or we're screwed. I've contemplated contacting some of my nearest competition to create a large group ortho practice so that we can decrease our overlapping locations to cut costs and join together for buying leverage, and share risk with marketing initiatives, and maybe even bring in a GP or pedo, but I don't think enough of us have that mindset yet and we view each other as competition more than potential partners. If we can do that, there's hope as WE will be creating the corporations that we own and work for, WE will be creating the clinical standards that we all follow together, and WE will be hiring the business grads to run it for us while we do what we like. It will mean sacrificing some of our own individualism in how we treat our cases, but we can't have everything. Better us owning the corporation than the business grads in the suits with a figurehead dentist owner that satisfies state dental statutes.

Any input from the experienced guys on this concept?

I'm typing this with my one-year-old daughter on my lap babbling and playing - priceless. (It's a rare Monday morning I'm not in the office - usually my longest and busiest day of the week.)

Having practiced long enough, I have some inventions that could revolutionize certain areas of orthodontics, and I've even printed prototypes in 3D printer labs, so they seem promising, but I'm not naïve to expect to retire early from an invention. Maybe if my member name was Charles Tweed I'd have a better shot 🙂

Thanks CaliDDS1986, 2TH MVR, and CHARLESTWEED for all the input and experiences. It's nice to see as a group we're all on the same side, even if we have different ways we go about it.

And CaliDDS1986, if you have any further questions don't hesitate. Any significant career change at this stage is big stuff to jump into.

That sounds like a great idea. getting people to jump on board is another story. It sounds like a potentially high risk endeavor, so people who have achieved financial freedom, who also care about the future of the specialty, would be the people I would target.

 

[2TH MVR]

https://nypost.com/2017/09/20/these-are-the-highest-paying-jobs-in-each-state/

Looks like Orthodontists are doing ok. We're not in the soup line yet. 🙂

 

[teehee69]

Been practicing ortho for 5 years. Im very poor . It’s a dead field! Don’t apply

 

[Steins;Gate]

Been practicing ortho for 5 years. Im very poor . It’s a dead field! Don’t apply

Elaborate, please?

 

[teehee69]

Lol epic thread revival.

I started the thread 3 years ago.

Just to throw another wrench in this thread. I’m not an orthodontist.

Just a GP who was jealous I couldn’t get into ortho. I actually have no idea the current market of ortho. Shows you can’t go believing everything you read on the the internet.

Just a reminder to those who don't know.

 

[charlestweed]

It has been some time since I posted/read comments here. What brought me here had to do with opinions on sharing the after hours phone calls with the dental assistants (my assistants are legally able to do this with their expanded duties certifications in my state).

After reading your post, it seems we are in a similar situation. I'm currently (finally) debt free from my practice. It's taken its toll. Now I am playing "catch-up." I am done with bank loans. This year I dropped around $100,000 in equipment upgrades.....no financing.
I will be struggling for for quite a while despite being free of debt service. I figure by the time I finally get caught up, it will be time to retire LOL. I advised my only child to consider nursing, or a physicians assistant, if she feels that healthcare is the right career path for her.

One thing I am not able to do is sell treatment that I know isn't going to benefit the patient in the long run. We can kid ourselves into lots of early treatment by looking at the before and after photos, but the intelligent and ethically grounded members in our profession recognize that most early treatment is not going to result in a better outcome. I limit my early treatment cases to crossbites with functional shifts, class 3 deep bites that are not obvious surgical cases, serial extraction if appropriate, space maintenance when appropriate. I can't bring myself to practice the way most do in my area. Most GPS still think that early treatment is always better. They believe that if you're not doing large volumes of early treatment, you are an outdated orthodontist. I even have one referral source trying to convince me to refer patients to myofunctional therapists since one of my skeletal open bite patients "relapsed." They believe that this is the state of the art in orthodontic treatment. It puts you in a bind when they're sending you most of your referrals. I've tried to educate this well intentioned referrer, but it didn't go over well. There are tooth vibrators, fast braces, Invisalign only practices, robtoics, incognito, and anything and all labelled as "the latest technology," as if using these modalities in your treatment of patients malocclusions somehow create superior outcomes. How do you compete with this mentality? I know plenty of doctors who take the stance of "if you can't beat them... join them." My bank account and my finances really wish that I would join this group of people, but I cannot do this. Sometimes wish I could, but I know that if I tried to do this, it would never work, not for one day. So I'm the guy that looks at marginal ridges.... I use the patient's Arch form conscientiously. I try my best to get canine guidance and class 1 canines when appropriate, I don't let patients or parents formulate their own treatment (that's my job), and I routinely band second molars except in exceptional circumstances. I also look at my cases when I'm done and I'm critical of the results on every patient. I hope that next month I will be a better orthodontist than I was the the month before. I make mistakes and I try to better myself because of the mistakes I've made. And I do all this because I feel it's the right thing to do. I know it will never be profitable, but I will feel good about what I'm doing. That is the only way I can do what I do. I won't have a lot of money in my bank account, and people won't look at me and think I'm extremely successful, but I can say that I did my best to treat every patient the way that I would want to be treated. Does that count for anything? Yes.....it does matter.

I assume you also graduated around the same year (2006?) as Orthostr8. For you to pay off all your debts and to spend an additional $100k in upgrading the equipment without taking out new loan, you must do well as an orthodontist. You must feel very confident in your practice to invest such huge amount of money. I haven’t upgraded anything since I started mine from scratch 12 years ago. That’s because I don’t have any fancy equipment…..paper charts don’t break down and require zero maintenance. My assistant still uses the same XP laptop (that I purchased used on Ebay for $200) for doing patient photo editing. I guess the reason I can get away without being high tech is I am still in my mid 40s and I hide the gray hairs with hair dye. Patients think I am still a young doc, who uses the latest technology . Maybe in 10-15 more years, I will have to purchase more fancy stuff to mask my old age and the wrinkles on my face.

I am surprised that you don’t want your child to follow your footstep and be her own boss. Nothing is worse than being told what to do every single day and getting yelled at when fail to meet the boss’ expectation. My niece is a nurse and she works 10+ hours everyday. The good thing is she still single and has no kid. It must be very hard for someone with kids and has to work 10+ hours. When I see how much free time my wife, who is also a dentist, has for our kids I feel so lucky that I married the right person, who chose the right profession.

When you can bring in a good stable income, you worry less about whether the patients accept the tx or not. With low overhead and a nice associate income from a corp office, I enjoy running my own practice more. Each new patient consultation only takes about 5-10 minutes: 3-5 minutes of doctor’s time and another 2-3 minutes for the manager to present the tx fee…no sellling…no fancy folder…no office tour. When patients already heard good things about you (through word of mouth referrals), you don’t need to sell. Patients come to see you because of your past performance and your honesty. The more patients you treat and make them happy, the more referrals you will get.

 

[2TH MVR]

I guess the reason I can get away without being high tech is I am still in my mid 40s and I hide the gray hairs with hair dye. Patients think I am still a young doc, who uses the latest technology .

Is this you Charlestweed?

 

[HOPAone]

It has been some time since I posted/read comments here. What brought me here had to do with opinions on sharing the after hours phone calls with the dental assistants (my assistants are legally able to do this with their expanded duties certifications in my state).

After reading your post, it seems we are in a similar situation. I'm currently (finally) debt free from my practice. It's taken its toll. Now I am playing "catch-up." I am done with bank loans. This year I dropped around $100,000 in equipment upgrades.....no financing.
I will be struggling for for quite a while despite being free of debt service. I figure by the time I finally get caught up, it will be time to retire LOL. I advised my only child to consider nursing, or a physicians assistant, if she feels that healthcare is the right career path for her.

One thing I am not able to do is sell treatment that I know isn't going to benefit the patient in the long run. We can kid ourselves into lots of early treatment by looking at the before and after photos, but the intelligent and ethically grounded members in our profession recognize that most early treatment is not going to result in a better outcome. I limit my early treatment cases to crossbites with functional shifts, class 3 deep bites that are not obvious surgical cases, serial extraction if appropriate, space maintenance when appropriate. I can't bring myself to practice the way most do in my area. Most GPS still think that early treatment is always better. They believe that if you're not doing large volumes of early treatment, you are an outdated orthodontist. I even have one referral source trying to convince me to refer patients to myofunctional therapists since one of my skeletal open bite patients "relapsed." They believe that this is the state of the art in orthodontic treatment. It puts you in a bind when they're sending you most of your referrals. I've tried to educate this well intentioned referrer, but it didn't go over well. There are tooth vibrators, fast braces, Invisalign only practices, robtoics, incognito, and anything and all labelled as "the latest technology," as if using these modalities in your treatment of patients malocclusions somehow create superior outcomes. How do you compete with this mentality? I know plenty of doctors who take the stance of "if you can't beat them... join them." My bank account and my finances really wish that I would join this group of people, but I cannot do this. Sometimes wish I could, but I know that if I tried to do this, it would never work, not for one day. So I'm the guy that looks at marginal ridges.... I use the patient's Arch form conscientiously. I try my best to get canine guidance and class 1 canines when appropriate, I don't let patients or parents formulate their own treatment (that's my job), and I routinely band second molars except in exceptional circumstances. I also look at my cases when I'm done and I'm critical of the results on every patient. I hope that next month I will be a better orthodontist than I was the the month before. I make mistakes and I try to better myself because of the mistakes I've made. And I do all this because I feel it's the right thing to do. I know it will never be profitable, but I will feel good about what I'm doing. That is the only way I can do what I do. I won't have a lot of money in my bank account, and people won't look at me and think I'm extremely successful, but I can say that I did my best to treat every patient the way that I would want to be treated. Does that count for anything? Yes.....it does matter.

Well said! you speak my mind. Thank you.

 

[2TH MVR]

lmao @2TH MVR comes to mind.

Those were the days.

 

[deleted659902]

When I was exploring working for the Corps .... I was told the same thing from Pac Dental. They do not like to hire orthos who have a separate private practice. But there are other Corp entities out there that will do so. It has to work for them and you. I was lucky in that I was hired part time and when I sold my practice .... they were more than happy to hire me as the full time ortho at ONE office. I do not need to travel to different locations.

@2TH MVR I am curious. Have you met any associate orthodontist in your chain who is 60+ yr old? My hunch is that chains prefer younger orthos.

 

[2TH MVR]

@2TH MVR I am curious. Have you met any associate orthodontist in your chain who is 60+ yr old? My hunch is that chains prefer younger orthos.

Last 2 ortho hires. 71 year old and a fresh out of ortho residency graduate. I'm the 2nd oldest at 56. I trained the new grad. She is very talented and has fit in well so far. The advantage of the old farts is that PT Corp is most likely our last stop. Younger orthodontists may still want to do private practice as a future option. I can't see this as a positive for the Corps.

 

[2TH MVR]

Well said! you speak my mind. Thank you.

my understanding is that DSOs actually prefer debt-ridden new graduates who are more amenable to being molded into their corporate culture and mission than a seasoned, former solo-practice ortho with no debt and big ego. also, did your contract say anything about non-compete clause/starting up in the vicinity?

You are very perceptive ..... "big ego". Yes. I did come in with attitude from having practiced private practice. That is the DREAM for many of the long term young GPs/Specialists who work in these DSOs. That said. I knew IMMEDIATELY how to triage patients and work within that Corp culture. It is different for sure., but no mystery. I am actually thriving in this culture.

I was actually shocked when they hired the 71 yr old ortho. He literally did not know how to enter digital patient information into the chart program. His staff had to do this. He did not delegate many of the procedures which goes against the reality of managing large numbers of patients .... both in Corp and Private.

Not so sure about "molding" debt-ridden graduates into Corp zombies. Corp culture and mission? I don't know. The whole Corp scene is a little funny to myself. It's typical Corp. You have Corp execs who tell the middle managers how to motivate us at the bottom .... the actual providers of dental work. I would not want to be a middle manager. An impossible job. My middle manager actually quit last month. Middle management trying to convince and motivate the dental providers to work harder. It's laughable. What I've observed is that the long termers (both dentists and staff) over time learn to do "just enough" to get by. That's not my personality, but I can see how this attitude is created. But eventually Corp will discover this. They have statistics on EVERYTHING. Just in the last 2-3 months .... an exodontist, an orthodontist and a couple of GPs were let go. All of them were long termers except for one young GP. But seriously ... you have to be REALLY BAD to get fired. I know of another ortho who is on the hot seat.

But sure. Of course Corp will go after those debt-ridden new grads.

And yes. I signed a non-compete clause in my contract. I do know one long termer ortho who started his private practice in another city. He still works Corp PT.

 

[charlestweed]

my understanding is that DSOs actually prefer debt-ridden new graduates who are more amenable to being molded into their corporate culture and mission than a seasoned, former solo-practice ortho with no debt and big ego. also, did your contract say anything about non-compete clause/starting up in the vicinity?

There are 6 orthodontists (myself included), who travel to work at 15-20 corp brand offices in the region. 4 of these 6 orthos are older than 60 yo. I am 47 and the youngest one is 45. The oldest one is older 70 yo and he got an award for being the top producing ortho in the region a few years ago. And I got my award a year after he got his🙂.

The corp don't care about the ortho's age. They actually don't like hiring new grad orthos because they lack the experience to see high patient volume. The patients often get mad because the young doc is too slow and they have to wait too long to be seen. The docs, who complain about every little thing like overbooking, lack of modern equipment, low quality supplies, slow assistants, having to stay late to start a new case etc, will have much higher chance of being let go than the ones who can work with whatever the corp offices provide.

What the corps prefer in an ortho are:
-Being able to produce. The goal is 2-3 starts a day.
-Getting along well with the staff, general dentists, and office manager.
-Has the experience to handle high patients volume and doesn't get a lot of complaints from patients.
- Being flexible with the schedule. Being willing to work on Saturdays and late hours (ie from 10am-7pm). Being healthy and don't call in sick all the time. Doesn't take too many vacations.
-Being able to work with whatever the corp provide.

If you are good and fast like 2THMVR, nobody from above breathes down your neck. They trust you and let you make all the decisions.