The business of Dentistry.

[harkkam]

Im not hoping to start a flame war but I wanted to ask a few questions on the money aspect of dentistry. I am a student in undergrad so I havent entered into dental school but I hope too soon. Im asking these questions because I realize that being a good dentist is not all about being a good dentist. It means being a good business man as well. So since my education is easier at the moment comapred to what it will be in Dental school if I get in. I have devoted myself to learning more about loans, leases, intrest rates etc.

So my first question is based on an observation. Dental offices seem to have lots of overhead about 70% or so. What can be done to lower that?

Since I am not in dental school, I dont know if I am going to specialize or not, I might not like it. But if I was to be a specialist then I know I cannot see patients without a referal from a general practioner. Is it possible to be a specialist and still perform procedures that general practioners do, and only with a referal would you treat patients in your specialty?

So this way you can have a general practice and a specialty practice together.

Which type of dentist has more capacity to earn. Does the gp who see's many patients or the specialist who will naturally see fewer patients earn more net.

I was thinking since looking at the ADA statistics that specialists make 300K and above, that since they are seeing fewer patients then a gp does in a year. I would assume that there overhead would also be smaller since you dont have to expend as much to buy supplies and etc. That means your making more per patient as a specialist.

My eventual plan is to buy up a practice after two years of graduation to gain experience and then to buy up another one five years or sooner after that. I would hire a fresh graduate to run the second office.

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[makushin]

Im not hoping to start a flame war but I wanted to ask a few questions on the money aspect of dentistry. I am a student in undergrad so I havent entered into dental school but I hope too soon. Im asking these questions because I realize that being a good dentist is not all about being a good dentist. It means being a good business man as well. So since my education is easier at the moment comapred to what it will be in Dental school if I get in. I have devoted myself to learning more about loans, leases, intrest rates etc.

So my first question is based on an observation. Dental offices seem to have lots of overhead about 70% or so. What can be done to lower that?

Since I am not in dental school, I dont know if I am going to specialize or not, I might not like it. But if I was to be a specialist then I know I cannot see patients without a referal from a general practioner. Is it possible to be a specialist and still perform procedures that general practioners do, and only with a referal would you treat patients in your specialty?

So this way you can have a general practice and a specialty practice together.

Which type of dentist has more capacity to earn. Does the gp who see's many patients or the specialist who will naturally see fewer patients earn more net.

I was thinking since looking at the ADA statistics that specialists make 300K and above, that since they are seeing fewer patients then a gp does in a year. I would assume that there overhead would also be smaller since you dont have to expend as much to buy supplies and etc. That means your making more per patient as a specialist.

My eventual plan is to buy up a practice after two years of graduation to gain experience and then to buy up another one five years or sooner after that. I would hire a fresh graduate to run the second office.

If you want to be a specialist and do GP procedures, don't specialize.

 

[capisce?]

If you want to be a specialist and do GP procedures, don't specialize.

I'm a pedo and I do GP procedures all day---restorative.

 

[Rube]

So my first question is based on an observation. Dental offices seem to have lots of overhead about 70% or so. What can be done to lower that?
...

From everything it sounds like you want to make a lot of money as a dentist by keeping overhead low and filling your time with all kinds of GP procedures in your specialty practice.. is that about right? I guess you are worried that if you don't do GP procedures you won't be busy or you'll make less than you could for your time in the office?

The truth is, as you set up your own unique practice you'll get the hang for what to cut to lower overhead.

As far as specialty work goes, everyone is a specialist in a way. A GP specializes in crown, bridge, operative, implants and hygiene planning. An OMS does wizzies, an endo does RCT, a pedo does kid dentistry (most of the above), an ortho does braces, a perio does gum surgeries.

The point is you develop a scope of practice and you tend to stick with it for your patients sake (you can't really still do good crown and bridge as an OMS 7 years out) AND because if you start doing restorative or operative as an endodontist, your referring GP won't like you too much. Another good reason most stick to a set of procedures it that you can't be very productive if your office system is set up to do general dentistry and you start taking on 3rd molar endo or taking out 3rds. Specialty work sometimes gums up your machine. Most dental offices run on a system and that is where you maximize your profits. The system produces far more money than the occasional 3rd molar extraction and molar endo. Some effectively incorporate limited specialty work, but in general you don't want to compromise your system for 500 bucks here and there.

There is plenty of money as a GP or a specialist and you will be busy.

 

[johntara04]

Im not hoping to start a flame war but I wanted to ask a few questions on the money aspect of dentistry. I am a student in undergrad so I havent entered into dental school but I hope too soon. Im asking these questions because I realize that being a good dentist is not all about being a good dentist. It means being a good business man as well. So since my education is easier at the moment comapred to what it will be in Dental school if I get in. I have devoted myself to learning more about loans, leases, intrest rates etc.

So my first question is based on an observation. Dental offices seem to have lots of overhead about 70% or so. What can be done to lower that?

Hire effectively. Only hire people you need, cross train them, keep them busy. Only buy the supplies you need. I see too many dentists that have reps come into their offices and end up buying every gadget/mouth rinse/flouride treatment/chapstick that comes in the door. The doctor ends up with a closet full of wonderful things that he never uses. Limit what you do. The less procedures you do, the less supplies needed, the more specialized you can become. That is what makes specialists so effective. They do one thing and they do it great. You will probably not be able to limit your practice to one procedure (though it is possible) but you can develop your niche. The list goes on.

Since I am not in dental school, I dont know if I am going to specialize or not, I might not like it. But if I was to be a specialist then I know I cannot see patients without a referal from a general practioner. Is it possible to be a specialist and still perform procedures that general practioners do, and only with a referal would you treat patients in your specialty?

Why would you do general dentist procedures? You will lose money if you do that. You paid a lot to specialize, concentrate on that and become the best you can become.

So this way you can have a general practice and a specialty practice together.

Which type of dentist has more capacity to earn. Does the gp who see's many patients or the specialist who will naturally see fewer patients earn more net.

The specialist.

I was thinking since looking at the ADA statistics that specialists make 300K and above, that since they are seeing fewer patients then a gp does in a year. I would assume that there overhead would also be smaller since you dont have to expend as much to buy supplies and etc. That means your making more per patient as a specialist.

True.

My eventual plan is to buy up a practice after two years of graduation to gain experience and then to buy up another one five years or sooner after that. I would hire a fresh graduate to run the second office.

That is a fine plan. Many dentists do this. Good luck.

 

[charlestweed]

These are all great answers.

My wife (perio) and I (ortho) have 2 separate offices but we share the same office manager, DA, RDA’s and receptionist. They can assist us on most perio and ortho procedures. This helps reduce our overhead to 45%. Some of my colleagues spend 80-90k dollars on a digital Pan/ceph X ray machine. I think my 16k non-digital Pan/ceph machine produces better quality radiographs than their digital machine.

 

[OceanDMD]

These are all great answers.

My wife (perio) and I (ortho) have 2 separate offices but we share the same office manager, DA, RDA’s and receptionist. They can assist us on most perio and ortho procedures. This helps reduce our overhead to 45%. Some of my colleagues spend 80-90k dollars on a digital Pan/ceph X ray machine. I think my 16k non-digital Pan/ceph machine produces better quality radiographs than their digital machine.

So you hand trace your cephs rather than digital analysis? Isnt this a bit more time consuming? I have not seen a regular pan that even comes close to our digital picture. What type of panorex are you using?

 

[charlestweed]

So you hand trace your cephs rather than digital analysis? Isnt this a bit more time consuming? I have not seen a regular pan that even comes close to our digital picture. What type of panorex are you using?

The cheapest one that you can find… it's the PC1000/Laser1000 by Panoramic Corportion. The pano alone costs about 9000. A combined pan/ceph unit costs about 14k but I paid 16k b/c I stretched the payment to 3 years. I originally rented this machine and paid 25 dollars per image. But after I tried it for 2 weeks, I decided to buy it b/c I was impressed with the image quality. The image quality it produces is much better my other more expensive Belmont Pan/ceph machine…better than Gendex (a place where I work uses this) machine. I guess the explanation for this amazing quality is that every time you take x ray on this machine you have to re-calibrate the laser point (it only takes a few seconds to do this).

It usually takes less than 5 minutes to do one tracing. I use mostly Steiner's analysis and a few Tweed and Ricketts measurements. I just couldn't see how investing on an expensive digital X ray machine would help boost the production.

 

[gryffindor]

So you hand trace your cephs rather than digital analysis? Isnt this a bit more time consuming? I have not seen a regular pan that even comes close to our digital picture. What type of panorex are you using?

You could scan the film and now it becomes a digital file. You could also put it up on a wall mounted light box and take a digital photo of it - that's what I do since I always forget how to use the scanner. This works for pans but i don't know if it will work for cephs.

 

[ItsGavinC]

Which type of dentist has more capacity to earn. Does the gp who see's many patients or the specialist who will naturally see fewer patients earn more net.

Not all specialists see less patients than a GP. Pediatric dentists can see 40+ patients each day, as can orthodontists.

 

[aphistis]

Not all specialists see less patients than a GP. Pediatric dentists can see 40+ patients each day, as can orthodontists.

And you're welcome to them.