The dilemma of my life :/

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pma96

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Dilemma of my life: to specialize in endo or stay as a GP. I feel like I have decent connections at my school’s program where I may have a shot at getting into endo after my AEGD. I also think it’s now or never, it’ll be really hard to come back to school after I start working. Can’t really find any honest feedback online other than “follow your passion”. In my case, the biggest reason holding me back from endo is that I like other procedures as well and that I’d finish residency at 30. But, I prob could be happy and satisfied just doing endo procedures my entire life if it’s worth it financially and lifestyle wise. I guess I just want honest opinions from dentists out there on wether it’s a good financial and long term investment. GPs: if you liked endo and had an opportunity as a D4 to do an AEGD and then go the endo route and enter the workforce at 30, would you have done it? Dental school and undergrad debt will be ~260k btw. Thanks in advance for any feedback!

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Finishing residency at 30 is not bad at all. I’d do the residency if you have that passion to do endo for the rest of your life.
 
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Do endo.

Gp has terrible outlook moving forward. Endo is still protected in terms of job prospects and income.
 
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You’re being dramatic. First, if you don’t go into endo right away you still are only 28 and a dentist. Young, educated, with a strong earning potential. Second, 4/6 of the residents I was with were all 33+ when we finished residency. Most endo residents are a tad older. Entering endo practice at 30 is great. Practice for 25-30 years and make great money. And you can always go back after practicing a bit. Endo residency isn’t like dental school. You read a bunch but you don’t study like you did in school. Maybe for like a month or so for boards but that’s about it.
 
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Let's talk about the elephant in the room...

What is your student debt right now?
One needs to have plan for the debt issue, long before one makes a choice about further education.

His undergrad debt is low. I would def pursue endo if I were in his shoes. GP ownership is pretty much at the end of its road with inflation/higher costs/stagnating reimbursements and corps will prob have a bigger footprint in the near future.

Endo at least is protected and worth it. Less pumped students into the system and the reimbursement is worth it.
 
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30 is not that old for an endo resident. Financially it makes sense but make sure you actually enjoy endo because it will be a sucky two years (and career?) if you don’t. And that’s IF you get in.
 
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Do it fam. Especially if you enjoy the specialty. My co-resident did peds residency at 37 and finished at 39. Two year trade off for a career you enjoy more? All for it. Plus, those two years will fly by once you get into the groove of things at the program.
 
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Bruh... I practiced for 7 years before going back to Endo. I'll be 38 when I'm done. 2 years is nothing. I wish I'd done it way earlier. Just apply and see!

Are there other factors that would be in the way... like do you want to start a family ASAP?
 
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Thanks everyone for the honest feedback, I really appreciate it!

Bruh... I practiced for 7 years before going back to Endo. I'll be 38 when I'm done. 2 years is nothing. I wish I'd done it way earlier. Just apply and see!

Are there other factors that would be in the way... like do you want to start a family ASAP?
No no other personal factors really. I have no commitments, my family supports every decision, and I can wait a few more years to have kids. I’m a female btw
 
You'll probably be one of the younger applicants or residents for endo, so the age concern isn't really an issue. Most have practiced a number of years before pursuing endo.

Now would be a good time to pursue specialty training since you are not tied down to any specific location, and given that endo is a very competitive specialty, it'll help open up options for yourself if you are able to go anywhere. Like others have pointed out, the field itself is quite insulated. There's a little under 200k dentists in the US, of which about 4k are actively practicing endodontists. The bottleneck of the training keeps it from becoming saturated and keeps endodontists busy.
 
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30 is not that old for an endo resident. Financially it makes sense but make sure you actually enjoy endo because it will be a sucky two years (and career?) if you don’t. And that’s IF you get in.

It's a suckier career competing against corps.... getting squeezed by inflation....

GP dentistry is at the end of the road.

You'll probably be one of the younger applicants or residents for endo, so the age concern isn't really an issue. Most have practiced a number of years before pursuing endo.

Now would be a good time to pursue specialty training since you are not tied down to any specific location, and given that endo is a very competitive specialty, it'll help open up options for yourself if you are able to go anywhere. Like others have pointed out, the field itself is quite insulated. There's a little under 200k dentists in the US, of which about 4k are actively practicing endodontists. The bottleneck of the training keeps it from becoming saturated and keeps endodontists busy.

Yup. Exactly this. Schools be pumping out new grads left and right, corps right around the corner, and inflation eating at the margins of GP practice. Some offices in states are basically doing hygiene at a loss right now. Sad but it will only get worse.

Specialize and get yourself out of this disaster.
 
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I can wait a few more years to have kids.
In your circumstance, having kids before specializing may not be a bad thing. Having kids when you get older gets more difficult.
 
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It seems like you've already had your question answered, but I just want to echo what's been said. Definitely go for it! I worked for 5 years before getting in to residency and yeah, it was tough getting back into the school mindset, but it wasn't impossible. It's definitely easier if you can get in earlier though cuz you'll already be used to being in the school setting. It can be hard having the freedom of private practice and then having a little bit of that taken away.
Endo is the best though. I liked everything about general dentistry, other than dentures (the worst procedure of all time!), but I don't miss any of it anymore. In my opinion, focusing on specific procedures and getting really really good at it is much better than trying to do it all. Also, finishing residency at 30 is very young. I'll be 38 when I'm done and I don't feel that old haha. I've heard other people say this and it's very true - "I've met a lot of general dentists that are unhappy, but only a few endodontists that are unhappy." You'll be very happy as an endodontist.
 
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I think what’s great about endo is that they get to really focus on their patients uninterrupted. This makes your time at work so much more enjoyable. It’s really hard to appreciate as a dental student.

Im a busy GP and cover 2-3 hygienists and a night guard/ appliance delivery every hour on top of my own schedule. That’s at least 4-5 patient interactions per hour. There are some rare circumstances where the hygiene schedule falls apart and I find myself just doing my own thing and I LOVE IT! Imo this is reason enough to specialize.
 
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30 is not that old for an endo resident. Financially it makes sense but make sure you actually enjoy endo because it will be a sucky two years (and career?) if you don’t. And that’s IF you get in.
Endo is boring as hell but still much better than general dentistry. Endo is not that hard after you have done 1000plus root canals. I hate selling optional stuffs to general public, that is the reason i chose endo...
 
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Endo is boring as hell but still much better than general dentistry. Endo is not that hard after you have done 1000plus root canals. I hate selling optional stuffs to general public, that is the reason i chose endo...

I think the majority of people 99% never find their true passion- or if they have a true passion- they can't combine it to make an income.

Endo is endo, OMFS is OMFS, Dentistry is Dentistry. After doing your 1000th root canal, or 1000th ext or 1000th fill. It's all the same.

If I could combine tennis with an income, I would LOVE that job as that is prob my passion.
 
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Endo is boring as hell but still much better than general dentistry. Endo is not that hard after you have done 1000plus root canals. I hate selling optional stuffs to general public, that is the reason i chose endo...
But you still have to convince the general dentist that you are the right person for the job, if you open your own endo office and if there are a few other endo offices in the area.
 
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But you still have to convince the general dentist that you are the right person for the job, if you open your own endo office and if there are a few other endo offices in the area.
yeah, I do...I do have to bring them some chocolate too and repair their perforation cases...but what im talking about is selling optional stuffs to patients. For me a staining is a staining, not a class V caries. I have seen quite a few GPs that upsell un-neccessary treatments to patients etc...As an endo owner, i have to stay late to accommodate their patients too,..
 
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I think the majority of people 99% never find their true passion- or if they have a true passion- they can't combine it to make an income.

Endo is endo, OMFS is OMFS, Dentistry is Dentistry. After doing your 1000th root canal, or 1000th ext or 1000th fill. It's all the same.

If I could combine tennis with an income, I would LOVE that job as that is prob my passion.
Ever consider coaching? My neighbor was a semi pro and while his son is presently playing in HS, the school had asked him to coach Boys tennis. Although he is able to keep running his insurance company, he hated going to all the school athletic meetings. Not sure if you have one as you can have an assoc handle cases while you're away.

One of my trivial passions is that I would love to be an offensive football coordinator. I'll be watching the Super Bowl in a different perspective...appreciating and analyzing all the genius offensive plays. Being an offensive coordinator is great because the coordinator gets credit for the wins in many situations while the head coach gets the blame for the losses.
 
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Endo is boring as hell but still much better than general dentistry. Endo is not that hard after you have done 1000plus root canals. I hate selling optional stuffs to general public, that is the reason i chose endo...
I've done maybe more than 9500 endo cases and I still think endo is hard (granted I stopped doing full time endo back in 2012 when my last DMO closed my position). Now that I'm almost 52, I hate to struggle in any procedure. I will refer all upper molars because I don't want to deal with MB3s or more ( I do use a microscope), and refer bi and trifurcated as well as obliterated canal cases. I'm able to predictably choose cases I can cruise in 30 to 45 min (I go slo-mo so the full strength NaOCl can fully saturate all the nooks and crannies). I understand almost all DAs hate endo but I try to make it fun. I casually structure my appts so that it is entertaining like a talk show/Podcast like atmosphere. Many of my patients say that the visit is their best dental experience. BTW, I don't make as much as those GPs that do unnecessary work.
 
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Ever consider coaching? My neighbor was a semi pro and while his son is presently playing in HS, the school had asked him to coach Boys tennis. Although he is able to keep running his insurance company, he hated going to all the school athletic meetings. Not sure if you have one as you can have an assoc handle cases while you're away.

One of my trivial passions is that I would love to be an offensive football coordinator. I'll be watching the Super Bowl in a different perspective...appreciating and analyzing all the genius offensive plays. Being an offensive coordinator is great because the coordinator gets credit for the wins in many situations while the head coach gets the blame for the losses.

Haha, I'm coaching my daughters to be WTA pros...but if anything I hope they can get a scholarship for tennis to college. That means no tuition!
 
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Dilemma of my life: to specialize in endo or stay as a GP. I feel like I have decent connections at my school’s program where I may have a shot at getting into endo after my AEGD. I also think it’s now or never, it’ll be really hard to come back to school after I start working. Can’t really find any honest feedback online other than “follow your passion”. In my case, the biggest reason holding me back from endo is that I like other procedures as well and that I’d finish residency at 30. But, I prob could be happy and satisfied just doing endo procedures my entire life if it’s worth it financially and lifestyle wise. I guess I just want honest opinions from dentists out there on wether it’s a good financial and long term investment. GPs: if you liked endo and had an opportunity as a D4 to do an AEGD and then go the endo route and enter the workforce at 30, would you have done it? Dental school and undergrad debt will be ~260k btw. Thanks in advance for any feedback!

I have a very good friend and former associate dentist at my office who ended up doing endo. Here is his timeline to give you an idea how he came to that decision and how he felt about that journey:

2013/Age 28: Graduated from d school in the Midwest. He is Canadian and racked up $200-300k in student loans at this point.

2013-2018/Age 28-33: He was very excited early on and took tons of CE courses. He slowly got tired of associating because he wasn’t making enough money to support his new life (marriage life and 2 toddlers). He averaged about $170-200k a year. He is frustrated and applies to only 1 endo program (his alma matar Endo program). He gets waitlisted and gets in few weeks before the program starts

2019-2021/Age 34-36: Covid happened during residency. He does bunch of literature reviews for about 4-6 months. When he comes back to school, sees few patients with N95 masks and tons of social distancing with limited schedule and cases for another 4-6 months. Wife was looking after the kids. No money coming in. Everything on savings and Covid subsidies/Medicaid. Struggle was real!

2022-2023/Age 37-38: First year learning curve was tough, slow first few months with 3-4 cases a day. He switches jobs 3 times first 12 months. He negotiated 40-45% production (maybe collections?) compensation. Some of the jobs required him to work between 2 offices (1 busy office, 1 slow office). He made 300-400k in 2022. He is well aware of high inflation real wages on that income feels like 250-350k today compared to when he was considering endo as a general dentist in 2018. 400k was the average salary for associate endo back then, which is still about the same in 2023. Plus he took out about 300k in additional student loans for endo residency.

Today/Age 38+: I ask him if he would do it all over again? He said 50% of him would say yes, the other 50% no. He said endo is still 90% like general dentistry. You still have to go to work. You still deal with patients from all walks of life and their personalities. You still work on a tooth (you still numb patient, you still take X-rays, etc). So he said nothing real changed, except he is doing 1 procedure much more than general dentists. He advises pre-dents to steer away from dentistry all together. When I ask him would he pursue dentistry if he went back college years. He said no, and it would 100% medicine. He does endo for the income today, but he would leave it in a heartbeat if he could be MD for the same income… because endo is still physically demanding like general dentistry by using both hands and other ergonomics similarities.

There you go. You will know 100% when you cross that bridge. The grass is still always greener on the other side until you walk on it.
 
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I have a very good friend and former associate dentist at my office who ended up doing endo. Here is his timeline to give you an idea how he came to that decision and how he felt about that journey:

2013/Age 28: Graduated from d school in the Midwest. He is Canadian and racked up $200-300k in student loans at this point.

2013-2018/Age 28-33: He was very excited early on and took tons of CE courses. He slowly got tired of associating because he wasn’t making enough money to support his new life (marriage life and 2 toddlers). He averaged about $170-200k a year. He is frustrated and applies to only 1 endo program (his alma matar Endo program). He gets waitlisted and gets in few weeks before the program starts

2019-2021/Age 34-36: Covid happened during residency. He does bunch of literature reviews for about 4-6 months. When he comes back to school, sees few patients with N95 masks and tons of social distancing with limited schedule and cases for another 4-6 months. Wife was looking after the kids. No money coming in. Everything on savings and Covid subsidies/Medicaid. Struggle was real!

2022-2023/Age 37-38: First year learning curve was tough, slow first few months with 3-4 cases a day. He switches jobs 3 times first 12 months. He negotiated 40-45% production (maybe collections?) compensation. Some of the jobs required him to work between 2 offices (1 busy office, 1 slow office). He made 300-400k in 2022. He is well aware of high inflation real wages on that income feels like 250-350k today compared to when he was considering endo as a general dentist in 2018. 400k was the average salary for associate endo back then, which is still about the same in 2023. Plus he took out about 300k in additional student loans for endo residency.

Today/Age 38+: I ask him if he would do it all over again? He said 50% of him would say yes, the other 50% no. He said endo is still 90% like general dentistry. You still have to go to work. You still deal with patients from all walks of life and their personalities. You still work on a tooth (you still numb patient, you still take X-rays, etc). So he said nothing real changed, except he is doing 1 procedure much more than general dentists. He advises pre-dents to steer away from dentistry all together. When I ask him would he pursue dentistry if he went back college years. He said no, and it would 100% medicine. He does endo for the income today, but he would leave it in a heartbeat if he could be MD for the same income… because endo is still physically demanding like general dentistry by using both hands and other ergonomics similarities.

There you go. You will know 100% when you cross that bridge. The grass is still always greener on the other side until you walk on it.

I don't know, the medicine statement I don't 100% believe your friend. Medicine looks great from the outside but those people work a lot more than dentists work. Not many physicians make on average $400k and have the same lifestyle an Endodontists has or work hours
 
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I don't know, the medicine statement I don't 100% believe. Medicine looks great from the outside but those people work a lot more than dentists work. Not many physicians make on average $400k and have the same lifestyle an Endodontists has or work hours
Agreed. I have a couple of friends in medicine right now and we talk about income potential and work/life balance and they all say they're jealous of how my schedule and income will be compared to the stresses we'll face. A lot of MDs have to be on call or work weekend hours and late nights, and we won't have to ever do that.
 
I have a very good friend and former associate dentist at my office who ended up doing endo. Here is his timeline to give you an idea how he came to that decision and how he felt about that journey:

2013/Age 28: Graduated from d school in the Midwest. He is Canadian and racked up $200-300k in student loans at this point.

2013-2018/Age 28-33: He was very excited early on and took tons of CE courses. He slowly got tired of associating because he wasn’t making enough money to support his new life (marriage life and 2 toddlers). He averaged about $170-200k a year. He is frustrated and applies to only 1 endo program (his alma matar Endo program). He gets waitlisted and gets in few weeks before the program starts

2019-2021/Age 34-36: Covid happened during residency. He does bunch of literature reviews for about 4-6 months. When he comes back to school, sees few patients with N95 masks and tons of social distancing with limited schedule and cases for another 4-6 months. Wife was looking after the kids. No money coming in. Everything on savings and Covid subsidies/Medicaid. Struggle was real!

2022-2023/Age 37-38: First year learning curve was tough, slow first few months with 3-4 cases a day. He switches jobs 3 times first 12 months. He negotiated 40-45% production (maybe collections?) compensation. Some of the jobs required him to work between 2 offices (1 busy office, 1 slow office). He made 300-400k in 2022. He is well aware of high inflation real wages on that income feels like 250-350k today compared to when he was considering endo as a general dentist in 2018. 400k was the average salary for associate endo back then, which is still about the same in 2023. Plus he took out about 300k in additional student loans for endo residency.

Today/Age 38+: I ask him if he would do it all over again? He said 50% of him would say yes, the other 50% no. He said endo is still 90% like general dentistry. You still have to go to work. You still deal with patients from all walks of life and their personalities. You still work on a tooth (you still numb patient, you still take X-rays, etc). So he said nothing real changed, except he is doing 1 procedure much more than general dentists. He advises pre-dents to steer away from dentistry all together. When I ask him would he pursue dentistry if he went back college years. He said no, and it would 100% medicine. He does endo for the income today, but he would leave it in a heartbeat if he could be MD for the same income… because endo is still physically demanding like general dentistry by using both hands and other ergonomics similarities.

There you go. You will know 100% when you cross that bridge. The grass is still always greener on the other side until you walk on it.

Yes this is very true.

Alot of posters don't understand that as a specialist- you have to put time and effort into your specialty after school to get specialist money and lifestyle. Alot of posters here think- oh I just endo school and someone hands me a check for 400k the minute I step out the door while seeing 8 patients a day and dictating my own schedule. COMPLETELY WRONG.

My current endo that I refer to basically worked the same as your 2022-23 timeline. Multiple offices- drives alot to random offices in the state 1-2 hour drives- sees tons of patients (and all the HARD cases- as the seniors took the "easy ones") made good money...but was like no thanks this is not what I signed for.

They looked into buying into a practice but that came with its issues (seniority- as the new person you get all the crap cases, and you have to work on building your name even though you are in a partnership to other GP referrals) Anyways they opened up his own practice next to mine and built it up- first two years was super slow and nothing coming in- AKA NO MONEY and had to do 1-2 days at a corp to make ends meet. But today they are doing great. Sees 2 columns of patients and takes their time with it and is having a relatively good work/life balance.

So the morale of the story is: the grass isn't always greener. The specialist I worked with went to school for 3 more years- accumulated 3 more years of debt- work 1-2 years bouncing around associate positions driving all over the state- took 2 more years to build up his own place (before making ENDO $)...and during this time of 7 years of lackluster earnings- I basically paid off all my student loans, built up a 1 mil net worth+ that is compounding as the market goes up, and have my practice almost paid off in 3 more year timeline. By the time they are pretty much done with loans and have a decent portfolio nest egg- I'll be long gone retired. Planning on retirement here in 5-7 years at 40-45.

After all was said and done- I asked my endo friend would they do it again. They said- they LOVE endo, but they would never advise someone to go into ENDO unless they loved it as they said the time, effort, debt, is NOT worth it- if you don't LOVE it.
 
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Nothing in life is easy. There’s no such thing as making money quick and easy. Work is not supposed to be fun. Most people hate their own jobs and tend to think the grass is greener at some other jobs. We, dentists, think engineers have easier job with less debt and physicians have much higher salaries. Many physicians think we, dentists, have better work life balance and wish they should have gone into dentistry in the first place. Engineers also think we, dentists, have an ideal job (recession proof, being your own boss, high salary etc) and many of them decided to go back to school to pursue dentistry. Dentists think dental hygienists make easy money with shorter schooling and smaller debt. Dental hygienists want to be a boss like us, dentists, and some of them went back to school for dentistry.

If you want work to be fun, spend less than you make and pay off all your debt asap. The longer you drag the debt out (ie refinancing to 20-30 years), the longer you will have to be a slave to the banks and the longer you will have to work to pay it off.
 
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I don't know, the medicine statement I don't 100% believe your friend. Medicine looks great from the outside but those people work a lot more than dentists work. Not many physicians make on average $400k and have the same lifestyle an Endodontists has or work hours

Yes. The grass is greener on the other side.
 
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Yes this is very true.

Alot of posters don't understand that as a specialist- you have to put time and effort into your specialty after school to get specialist money and lifestyle. Alot of posters here think- oh I just endo school and someone hands me a check for 400k the minute I step out the door while seeing 8 patients a day and dictating my own schedule. COMPLETELY WRONG.

My current endo that I refer to basically worked the same as your 2022-23 timeline. Multiple offices- drives alot to random offices in the state 1-2 hour drives- sees tons of patients (and all the HARD cases- as the seniors took the "easy ones") made good money...but was like no thanks this is not what I signed for.

They looked into buying into a practice but that came with its issues (seniority- as the new person you get all the crap cases, and you have to work on building your name even though you are in a partnership to other GP referrals) Anyways they opened up his own practice next to mine and built it up- first two years was super slow and nothing coming in- AKA NO MONEY and had to do 1-2 days at a corp to make ends meet. But today they are doing great. Sees 2 columns of patients and takes their time with it and is having a relatively good work/life balance.

So the morale of the story is: the grass isn't always greener. The specialist I worked with went to school for 3 more years- accumulated 3 more years of debt- work 1-2 years bouncing around associate positions driving all over the state- took 2 more years to build up his own place (before making ENDO $)...and during this time of 7 years of lackluster earnings- I basically paid off all my student loans, built up a 1 mil net worth+ that is compounding as the market goes up, and have my practice almost paid off in 3 more year timeline. By the time they are pretty much done with loans and have a decent portfolio nest egg- I'll be long gone retired. Planning on retirement here in 5-7 years at 40-45.

After all was said and done- I asked my endo friend would they do it again. They said- they LOVE endo, but they would never advise someone to go into ENDO unless they loved it as they said the time, effort, debt, is NOT worth it- if you don't LOVE it.

+1

Whether you specialize or not, you will have to work very hard either way. Actually, much harder and longer for specialization - and take much more debt. Debt keeps going up every year, and it will make specialization (or being a general dentist) less attractive over time. It’s just the direction the profession is going now. It will definitely frustrate future dentists, but these are just real world facts.
 
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+1

Whether you specialize or not, you will have to work very hard either way. Actually, much harder and longer for specialization - and take much more debt. Debt keeps going up every year, and it will make specialization (or being a general dentist) less attractive over time. It’s just the direction the profession is going now. It will definitely frustrate future dentists, but these are just real world facts.

Yup...and while there is definitely "specialty money"...I would argue that business sorta puts everyone on even footing. For example we hear about endo making 300...400..500k. Yeah that's great money.

But go look online where you live/work at. There are many GP practices for sale that are 1,000,000 revenue with 50-70% overhead.

What does that mean to you newbies? It means that GP takes home 300..400..500k.

So all in all, Associate Specialists will always outearn a Associate GP. And also as a business owner I would say a specialist has probably an "easier time" achieving higher end income because they are a specialist- but that is just a possibility not a guarantee...so in the real world- a decent GP practice that is running well is probably doing just as well take-home wise as a specialist.

Just food for thought- and another reason why one should only pursue specialty if they TRUELY love and enjoy it.

Just a quick check on my local listings for practices for sale: Local GP practice for sale- collecting 1.3 mil, owner takehome 650k.

Yeah so, the whole speciality money etc, don't worry about that- you should worry more about what you ENJOY. Because at the end of the day, business puts everyone on even footing for earning potential.
 
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To get paid in dentistry, you have to sit down to perform the procedure on your patients. Your daily earning depends on the number of procedures you perform each day and how fast you can complete each procedure. So the more patients you can treat in a day and the more days you work in a week/month (in other words, the harder you work), the more money you will make.

For the specialists to get more patients (procedures), they need to keep as many referral GPs happy as possible. If they can’t get enough patients at their practice (either because they have poor marketing skills or they are in a competitive area), they have to travel to work at multiple offices as an associate. Some specialists don’t want to travel….don’t want to work at GP offices nor for the Corp offices….they reject the reasonable pays that some of these offices offer them…..and they go on here and complain about their specialty.

The specialists make a lot more for each procedure they perform. They don’t have to do the low paid time-consuming procedures like initial exams, cleanings, fillings etc. Yesterday, my wife traveled to work at a GP office (her classmate’s office). It took her less than an hour to place 3 implants and she collected $3600 (my wife gets $1200 for each….the GP charged the patient $1600 each). My wife doesn’t get this easy deal every day. At another office, she has to work 8 hours and gets a flat rate of $1200 a day….this is the lowest offer but it’s near home and the stress level is low….mostly Asian patients and Asian people don’t complain and they respect the doctors.

One of my wife’s GP bosses is doing very well. His office accepts a variety of insurance plans including HMOs and medicaid. The guy knows how to tx plan. He hires OS, endo, pedo, perio, and ortho to work for him. He and his niece are the only GPs in the office but he does most of the hard work because his niece is very slow. He’s just received the good news that his son got accepted to dental school. He’s in his mid 50s and can’t wait for his son to take over.
 
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To get paid in dentistry, you have to sit down to perform the procedure on your patients. Your daily earning depends on the number of procedures you perform each day and how fast you can complete each procedure. So the more patients you can treat in a day and the more days you work in a week/month (in other words, the harder you work), the more money you will make.

For the specialists to get more patients (procedures), they need to keep as many referral GPs happy as possible. If they can’t get enough patients at their practice (either because they have poor marketing skills or they are in a competitive area), they have to travel to work at multiple offices as an associate. Some specialists don’t want to travel….don’t want to work at GP offices nor for the Corp offices….they reject the reasonable pays that some of these offices offer them…..and they go on here and complain about their specialty.

The specialists make a lot more for each procedure they perform. They don’t have to do the low paid time-consuming procedures like initial exams, cleanings, fillings etc. Yesterday, my wife traveled to work at a GP office (her classmate’s office). It took her less than an hour to place 3 implants and she collected $3600 (my wife gets $1200 for each….the GP charged the patient $1600 each). My wife doesn’t get this easy deal every day. At another office, she has to work 8 hours and gets a flat rate of $1200 a day….this is the lowest offer but it’s near home and the stress level is low….mostly Asian patients and Asian people don’t complain and they respect the doctors.

One of my wife’s GP bosses is doing very well. His office accepts a variety of insurance plans including HMOs and medicaid. The guy knows how to tx plan. He hires OS, endo, pedo, perio, and ortho to work for him. He and his niece are the only GPs in the office but he does most of the hard work because his niece is very slow. He’s just received the good news that his son got accepted to dental school. He’s in his mid 50s and can’t wait for his son to take over.

Sounds about right. Business really equalizes the "pay field." In general, one could say for sure- specialists associates def make more hands down then an associate dentist- and in general- specialists have an "easier" time achieving a high income practice (because their procedures pay more/less competition) BUT BUT BUT- there are many GP practices that are solid collecting just as much if not more then specialists.

Business equalizes the playing field in terms of take-home pay...and that actually is the best thing about dentistry. 4 days a week 300-500k. Sign me up. At the end of the day- YOU dictate your terms. See less patients? Go OON/FFS. See more? Go accept insurance. Want to jump around less chairs? Go do Endo or cut back your schedule. At the end of the day business equalizes everything.
 
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Sounds about right. Business really equalizes the "pay field." In general, one could say for sure- specialists associates def make more hands down then an associate dentist- and in general- specialists have an "easier" time achieving a high income practice (because their procedures pay more/less competition) BUT BUT BUT- there are many GP practices that are solid collecting just as much if not more then specialists.

Business equalizes the playing field in terms of take-home pay...and that actually is the best thing about dentistry. 4 days a week 300-500k. Sign me up. At the end of the day- YOU dictate your terms. See less patients? Go OON/FFS. See more? Go accept insurance. Want to jump around less chairs? Go do Endo or cut back your schedule. At the end of the day business equalizes everything.
In dentistry, your income is limited by the number of patients that you have. The more patients to have, the more money you will make even if each patient has a payment cap, which is dictated by his/her insurance company. If you are good and fast and treat more patients per day, you will make more than a dentist who is slow and incompetent. The harder you work, the more money you make. If you are too busy to handle the high patient volume (even when you try to work as fast as you can), you can always hire an associate and in-house specialists to work for you. That’s how dental corps (and successful private practice owners like ColdFront and Tanman) make a lot of money and continue to expand their businesses.
 
Yup...and while there is definitely "specialty money"...I would argue that business sorta puts everyone on even footing. For example we hear about endo making 300...400..500k. Yeah that's great money.

But go look online where you live/work at. There are many GP practices for sale that are 1,000,000 revenue with 50-70% overhead.

What does that mean to you newbies? It means that GP takes home 300..400..500k.

So all in all, Associate Specialists will always outearn a Associate GP. And also as a business owner I would say a specialist has probably an "easier time" achieving higher end income because they are a specialist- but that is just a possibility not a guarantee...so in the real world- a decent GP practice that is running well is probably doing just as well take-home wise as a specialist.

Just food for thought- and another reason why one should only pursue specialty if they TRUELY love and enjoy it.

Just a quick check on my local listings for practices for sale: Local GP practice for sale- collecting 1.3 mil, owner takehome 650k.

Yeah so, the whole speciality money etc, don't worry about that- you should worry more about what you ENJOY. Because at the end of the day, business puts everyone on even footing for earning potential.

Absolutely.

Remember folks, in dentistry, no one makes the same income every year. There are learning-curve years, peak years, and downhill years. Life mostly decides those years for you. It’s like driving on a highway, you go through it with different speeds. So plan wisely, and more importantly, enjoy it at your own pace. It’s not a race. Just because someone makes more money in dentistry, doesn’t make you less worthy… you don’t know their situations and struggles, and vice versa for someone who makes less than you. Get though life with a positive and memorable experience, the same applies for this profession. The golden rule is to develop your skills, get wisdom and the money is just a piece of that puzzle.

At this stage of my career, 13 years out of school, I would trade being wiser and more knowledgeable than making more money. I took a lot of risks when I came out of school; opened my first office within 6 months and was very fortunate to open more practices and other businesses. There comes a point in most dentists life that they just want to enjoy the journey, and money doesn’t fill every void in their needs. But as a young dentist, everything I discussed about dentistry had a $ sign next to it. lol

It’s fun to talk about money, but eventually it will be equally or more fun to talk about the little things about the profession too. I hope the OP finds his zen in this field.
 
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At this stage of my career, 13 years out of school, I would trade being wiser and more knowledgeable than making more money. I took a lot of risks when I came out of school; opened my first office within 6 months and was very fortunate to open more practices and other businesses. There comes a point in most dentists life that they just want to enjoy the journey, and money doesn’t fill every void in their needs. But as a young dentist, everything I discussed about dentistry had a $ sign next to it. lol
Isn’t it nice when you don’t have to think about money anymore? That’s because you are in full control of your personal finance. You have a house, vacation house, commercial buildings, cars etc. That’s your reward for taking the risk and your hard work for the last 13 years. I don’t think you would have this kind of relaxed thinking if you were drowning in debt like many of the recent dental grads are facing right now. It's hard for new grads not to care about money when they have nothing....no house... just a beat up car and a huge debt. And it’s even tougher when one has kids to support.

Money can’t buy happiness but not having enough (and being in massive debt) can lead to some serious problems like divorce, depression, feeling of unworthiness, having suicidal thought, feeling stressed at work etc. I don’t need to ask my wife’s permission whenever I want to help my parents (monetary gifts, fixing their house, buying a car etc). It’s the same when she wants to help her parents. That’s because we have money and the amounts that we helped our parents were so miniscule to us that they didn’t have any negative impact on our finance. We are happy when we can make our parents happy. Not having to fight each other over the money is a good thing in a marriage.

With much higher cost (and the tuitions keep rising) of earning the DDS degree, I think the new grads should focus on making money when they are still young and healthy….making a lot of money….so they can get out of debt as fast as they can. Only when they are debt-free, then they can have a more relaxed view about life like what you and I have right now: less about money and more about other things like health, religion, hobbies, places to visit, spoiling the grand kids etc. While it’s not a race but dentistry does have a limited shelf life…..although it’s not as short as that of an Olympic gymnast or of a NFL running back…..you can’t work forever. The older you graduate from dental school, the less dentistry you can practice and the less money you will earn to pay back the debt and to save for retirement. The older you get, the more pain your body will experience and the less productive dentist you will become. I am in Dave Ramsey's camp.....do whatever it takes to become debt free asap and then you can live and give like no one else. I don’t want to see the young grads, who are drowning in debt, to have to work until they are in their 60s, 70s......That's not living.....that's a life long slavery.
 
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Nothing in life is easy. There’s no such thing as making money quick and easy. Work is not supposed to be fun. Most people hate their own jobs and tend to think the grass is greener at some other jobs. We, dentists, think engineers have easier job with less debt and physicians have much higher salaries. Many physicians think we, dentists, have better work life balance and wish they should have gone into dentistry in the first place. Engineers also think we, dentists, have an ideal job (recession proof, being your own boss, high salary etc) and many of them decided to go back to school to pursue dentistry. Dentists think dental hygienists make easy money with shorter schooling and smaller debt. Dental hygienists want to be a boss like us, dentists, and some of them went back to school for dentistry.
This is true. We tend to highlight the positives of other careers and downplaying the negatives.
 
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Absolutely.

Remember folks, in dentistry, no one makes the same income every year. There are learning-curve years, peak years, and downhill years. Life mostly decides those years for you. It’s like driving on a highway, you go through it with different speeds. So plan wisely, and more importantly, enjoy it at your own pace. It’s not a race. Just because someone makes more money in dentistry, doesn’t make you less worthy… you don’t know their situations and struggles, and vice versa for someone who makes less than you. Get though life with a positive and memorable experience, the same applies for this profession. The golden rule is to develop your skills, get wisdom and the money is just a piece of that puzzle.

At this stage of my career, 13 years out of school, I would trade being wiser and more knowledgeable than making more money. I took a lot of risks when I came out of school; opened my first office within 6 months and was very fortunate to open more practices and other businesses. There comes a point in most dentists life that they just want to enjoy the journey, and money doesn’t fill every void in their needs. But as a young dentist, everything I discussed about dentistry had a $ sign next to it. lol

It’s fun to talk about money, but eventually it will be equally or more fun to talk about the little things about the profession too. I hope the OP finds his zen in this field.

Interesting thoughts. A decade out of school here. I would gladly trade money for time spent doing things I enjoy. That’s why I take 1 1/2 hour lunches everyday where I either play tennis bike or swim or run and work 4 days a week.

My accountant thinks I’m crazy along with my staff but enjoying what you want to do is more important then jamming the schedule with patients to make more money.

If I could go back in time I wish I spent more of my 20s enjoying youth.

When you hit 30s you really feel a hard workout and bad diet. You need to rest well eat well and manage your body to perform at a high level. In my 20s you can drink a red bull sleep 4 hours eat McDonald’s and perform like a champ. I wonder how good in tennis or triathlon I would be if I had my 30s focus in my 20s. One of my biggest regrets was not doing Ironman in Europe. With two kids in the mix that won’t be possible until I’m 40-50.

Life is short. Do what you love. I’m also debating on picking up dnd night when the kids get older. Gotta live life up to the fullest.
 
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Interesting thoughts. A decade out of school here. I would gladly trade money for time spent doing things I enjoy. That’s why I take 1 1/2 hour lunches everyday where I either play tennis bike or swim or run and work 4 days a week.

My accountant thinks I’m crazy along with my staff but enjoying what you want to do is more important then jamming the schedule with patients to make more money.

If I could go back in time I wish I spent more of my 20s enjoying youth.

When you hit 30s you really feel a hard workout and bad diet. You need to rest well eat well and manage your body to perform at a high level. In my 20s you can drink a red bull sleep 4 hours eat McDonald’s and perform like a champ. I wonder how good in tennis or triathlon I would be if I had my 30s focus in my 20s. One of my biggest regrets was not doing Ironman in Europe. With two kids in the mix that won’t be possible until I’m 40-50.

Life is short. Do what you love. I’m also debating on picking up dnd night when the kids get older. Gotta live life up to the fullest.
You have a very nice lifestyle...better than a lot of people who are not in dental field. You will retire earlier than most. And yet, you still think dentistry is not a good profession.

If I could go back in time I wish I spent more of my 20s enjoying youth.
Life is short. Do what you love. I’m also debating on picking up dnd night when the kids get older. Gotta live life up to the fullest.
If you wish to spend more time to do fun things during your 20s, this means that you would have to skip dental school during your 20s because dental school requires a lot more time than a full time job....going to dental school is like serving jail time. And this would delay you from earning a DDS degree (ideally at age 26-27)….and you would have to work longer to become financially independent.

And to have fun in your 20s, you still have to have a job (at least a P/T job) to pay for your hobbies…..unless you are ok with depending on your parents for financial support.

Nothing in life is easy. You have to give up something in order to earn something.
 
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You have a very nice lifestyle...better than a lot of people who are not in dental field. You will retire earlier than most. And yet, you still think dentistry is not a good profession.


If you wish to spend more time to do fun things during your 20s, this means that you would have to skip dental school during your 20s because dental school requires a lot more time than a full time job....going to dental school is like serving jail time. And this would delay you from earning a DDS degree (ideally at age 26-27)….and you would have to work longer to become financially independent.

And to have fun in your 20s, you still have to have a job (at least a P/T job) to pay for your hobbies…..unless you are ok with depending on your parents for financial support.

Nothing in life is easy. You have to give up something in order to earn something.

Oh no I meant after dental school. I graduated at 26, worked 5-6 days a week… worked in a clinic that made me work til 8 pm on off days.

Overall I know what you are saying that all the hard work amounted to what I have today- but I guess what I’m saying is that I def would do it differently and only work 4-5 days no saturdays and no 8 pm hours… spread some things into the routine like workout hobbies etc into the mix.

But I guess if that happened maybe I wouldn’t be in the position I am in today? 🤷‍♀️
 
Isn’t it nice when you don’t have to think about money anymore? That’s because you are in full control of your personal finance. You have a house, vacation house, commercial buildings, cars etc. That’s your reward for taking the risk and your hard work for the last 13 years. I don’t think you would have this kind of relaxed thinking if you were drowning in debt like many of the recent dental grads are facing right now. It's hard for new grads not to care about money when they have nothing....no house... just a beat up car and a huge debt. And it’s even tougher when one has kids to support.

Money can’t buy happiness but not having enough (and being in massive debt) can lead to some serious problems like divorce, depression, feeling of unworthiness, having suicidal thought, feeling stressed at work etc. I don’t need to ask my wife’s permission whenever I want to help my parents (monetary gifts, fixing their house, buying a car etc). It’s the same when she wants to help her parents. That’s because we have money and the amounts that we helped our parents were so miniscule to us that they didn’t have any negative impact on our finance. We are happy when we can make our parents happy. Not having to fight each other over the money is a good thing in a marriage.

With much higher cost (and the tuitions keep rising) of earning the DDS degree, I think the new grads should focus on making money when they are still young and healthy….making a lot of money….so they can get out of debt as fast as they can. Only when they are debt-free, then they can have a more relaxed view about life like what you and I have right now: less about money and more about other things like health, religion, hobbies, places to visit, spoiling the grand kids etc. While it’s not a race but dentistry does have a limited shelf life…..although it’s not as short as that of an Olympic gymnast or of a NFL running back…..you can’t work forever. The older you graduate from dental school, the less dentistry you can practice and the less money you will earn to pay back the debt and to save for retirement. The older you get, the more pain your body will experience and the less productive dentist you will become. I am in Dave Ramsey's camp.....do whatever it takes to become debt free asap and then you can live and give like no one else. I don’t want to see the young grads, who are drowning in debt, to have to work until they are in their 60s, 70s......That's not living.....that's a life long slavery.

Correct. Correct. Correct. lol

Hopefully future dentists can take your advise (and others) seriously.

I don’t know if I would go to d school today if it would cost me a fortune, let alone specialize endo. I would be sweating it. The barrier of entry to this profession becomes more depressing every year, due to high cost.

One of my 4 younger brothers is a pharmacist. He graduated from pharmacy school in 2006. He had to have high GPA and a competitive PCAT score. Fast forward 17 years later, there are dozens more pharmacy schools across the country, and almost all charge a fortune. Many don’t need a PCAT score to apply and pharmacy school enrollment drops 15% across the board, and still dropping every year. You can have 2.5 GPA and still get in. Not sure if some of you know this, but there are 7 more new dental schools in the pipeline and are expecting to open over the next 5 years. This is in addition to the 10 or so that opened over the last 10 years or so. So if you can’t see the parallels yet, dentistry is heading for the same path as pharmacy profession. It will get more expensive to become a dentist, it will get easier to get into schools, and it will be a corporate controlled profession in the long run. Private practice ownership is sliding. Insurance are cutting fees. It’s very hard to get a practice loan these days with high interest rates, etc. The sun is setting on this profession slowly.
 
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3 out 5 of my best men are pharmacists. They echo the same sentiment. In 2010 ish it was all the rage to go to pharm school. Go work anywhere work on your own terms make tons of money. Right now the complete opposite has happened. They all say that pharmacy is in the pits. The only good job is hospital but that is extremely competitive. All the retail pharmacists are suffering long hours and low pay.

Total change and it only happened in 10 years. I see the same happening in dentistry in 10-20 years. Medicine used to be small solo practices… now it’s all gone. It will happen to dentistry. A lil bit slower but the wheels are turning. I plan on selling my practice before that all happens 5-10 years. Then go work for corporation for healthcare and a paycheck- and most likely as a hygienist. Pay me 75-85 an hour and cover my healthcare insurance and I’ll be happy as a bumble-bee. Keeps a good routine going, zero stress, and my investments keep me making money.
 
Oh no I meant after dental school. I graduated at 26, worked 5-6 days a week… worked in a clinic that made me work til 8 pm on off days.

Overall I know what you are saying that all the hard work amounted to what I have today- but I guess what I’m saying is that I def would do it differently and only work 4-5 days no saturdays and no 8 pm hours… spread some things into the routine like workout hobbies etc into the mix.

But I guess if that happened maybe I wouldn’t be in the position I am in today? 🤷‍♀️
I used to hate working at the corp offices that made me work like a dog (80-120 patients a day with only 3 assistants) when was still a slow inexperienced new grad. But I couldn’t complain because I had so much student loan debt….and I wanted to buy a house….and to drive a BMW. Now looking back, I am glad that I had worked the way that I did….NO REGRETS. I’d learned so much from working at these busy corps. When I was ready to open my first office, I knew exactly which items I needed to buy and what not to waste my money on. I learned how to keep low overhead like the corp offices. I spent 2-3 times less than what my colleagues spent on their offices. With low overhead + a stable P/T corp job, I didn’t need to make any sacrifice on the lifestyle. Now with the clinical experience, seeing high volume of patients a day is not as bad as it used to be. I don’t hate working for corps anymore. That’s why I still work part time for them. I wouldn’t be where I am now if I didn’t put in a lot of effort during my younger years…..or if I had rich parents who helped pay for everything. Life’s struggles helped push me to reach my goals faster.
 
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Correct. Correct. Correct. lol

Hopefully future dentists can take your advise (and others) seriously.

I don’t know if I would go to d school today if it would cost me a fortune, let alone specialize endo. I would be sweating it. The barrier of entry to this profession becomes more depressing every year, due to high cost.

One of my 4 younger brothers is a pharmacist. He graduated from pharmacy school in 2006. He had to have high GPA and a competitive PCAT score. Fast forward 17 years later, there are dozens more pharmacy schools across the country, and almost all charge a fortune. Many don’t need a PCAT score to apply and pharmacy school enrollment drops 15% across the board, and still dropping every year. You can have 2.5 GPA and still get in. Not sure if some of you know this, but there are 7 more new dental schools in the pipeline and are expecting to open over the next 5 years. This is in addition to the 10 or so that opened over the last 10 years or so. So if you can’t see the parallels yet, dentistry is heading for the same path as pharmacy profession. It will get more expensive to become a dentist, it will get easier to get into schools, and it will be a corporate controlled profession in the long run. Private practice ownership is sliding. Insurance are cutting fees. It’s very hard to get a practice loan these days with high interest rates, etc. The sun is setting on this profession slowly.
Yeah, dentistry is no longer a 4 days/wk gig due to increase in school debt and increase in competition. Dentistry no longer has the advantage over medicine in term of work hours and salary. New dental grads will have to work the same work long hours and on the weekends like the physicians in order to pay off their debt. Well, at least dentists don’t have to do 3 long years of low paid residency after school.
 
Oh no I meant after dental school. I graduated at 26, worked 5-6 days a week… worked in a clinic that made me work til 8 pm on off days.

Overall I know what you are saying that all the hard work amounted to what I have today- but I guess what I’m saying is that I def would do it differently and only work 4-5 days no saturdays and no 8 pm hours… spread some things into the routine like workout hobbies etc into the mix.

But I guess if that happened maybe I wouldn’t be in the position I am in today? 🤷‍♀️
The average 24-26 yrs old makes 40-50k/yr and work 40-50 hrs/wk. They are not enjoying life like most of us think. They are not spending 2 wks in Paris and Ibiza partying.

People in medicine/dentistry fail to realize that.
 
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Yeah, dentistry is no longer a 4 days/wk gig due to increase in school debt and increase in competition. Dentistry no longer has the advantage over medicine in term of work hours and salary. New dental grads will have to work the same work long hours and on the weekends like the physicians in order to pay off their debt. Well, at least dentists don’t have to do 3 long years of low paid residency after school.

I guess it's a case of the grass is greener on the other side. If you spend a week in my hospital physician lounge, you will hear physicians who wish they had gone to d-school.

I spend some time in this forum to know that dentistry is not sunshine and rainbow. It's a good profession but it's not what most physician think it is.
 
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I guess it's a case of the grass is greener on the other side. If you spend a week in my hospital physician lounge, you will hear physicians who wish they had gone to d-school.

I spend some time in this forum to know that dentistry is not sunshine and rainbow. It's a good profession but it's not what most physician think it is.

Physicians have it hard. I would say tho- it’s easier to be an employee physician compared to an employee dentist.

But business dentist >>>>> physician in general.

While there are some specialities that offer great pay and ownership opportunities ( derm/plastic) it’s suchhhhh a long road… that I still think dental is better.

Dental you just need to graduate… speciality like dermatology or plastics have to be top in class and then take another 4-8 years to specialize…

I always look back and think what if I went into medicine and then I say wait a second if I went into medicine I would still literally be in school- or just now graduating…

While I have been a dentist for the past 4-8 years building my practice and becoming almost debt free on 4 days work week.

No thanks to medicine…
 
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The average 24-26 yrs old makes 40-50k/yr and work 40-50 hrs/wk. They are not enjoying life like most of us think. They are not spending 2 wks in Paris and Ibiza partying.

People in medicine/dentistry fail to realize that.
Majority of 20-30 yr olds can NOT afford to live on their own on that income in most cities, so they live with their parents. Living on 3.5-4k a month after taxes as a single person is closer to 3-3.5k a month. Many take home less than that. With high inflation, that feels like 2-2.5k a month today. The economic realities changed over the last couple of decades.

 
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Majority of 20-30 yr olds can NOT afford to live on their own on that income in most cities, so they live with their parents. Living on 3.5-4k a month after taxes as a single person is closer to 3-3.5k a month. Many take home less than that. With high inflation, that feels like 2-2.5k a month today. The economic realities changed over the last couple of decades.

Well, we in SDN think everyone is making 250k+ working for Google, FB, Apple etc... We also think because we are doctors that most of us have skills to do these jobs.
 
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Well, we in SDN think everyone is making 250k+ working for Google, FB, Apple etc... We also think because since we are doctors that most of us have skills to do these jobs.
Also true. Howard Farran wrote a piece one time on Dental town about the pitfalls about having the doctor mentality. Talked about how we can put ourselves in bad situations because we over-estimate our capabilities (opening businesses in other industries, real estate, investing). Not to say we couldn't do it but that we jump in too soon without taking the time to understand all the nuances. End up convincing ourselves that because we are doctors we can learn it on the fly.
 
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Majority of 20-30 yr olds can NOT afford to live on their own on that income in most cities, so they live with their parents. Living on 3.5-4k a month after taxes as a single person is closer to 3-3.5k a month. Many take home less than that. With high inflation, that feels like 2-2.5k a month today. The economic realities changed over the last couple of decades.

Inflation hurts everyone. We, dentists, are less affected by this because we make good money and our job is stable. It’s not easy to make money these days. Aren’t you glad that you’re a dentist?
 
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