Travel dentist who does Extractions/sedations

Started by Teeth&titanium95$$
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Teeth&titanium95$$

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Hey guys,

Been a traveling oral surgery focused provider (not board OMFS) for a while now — mostly extractions, wisdom teeth, IV sedations, and the occasional implant. I used to roll into offices, use their stuff and their assistants, but I’m finally going 100% independent. Bringing my own supplies, hiring my own team, and now I can do IV sedation after obtaining my sedation permit

The big question is how to make every single day count for max profit. Those of you who are already doing this full-time as traveling dentist — how do you keep the chairs slammed? What’s your best move when negotiating with the office owners to get them booking 15-25 patients a day (including the higher-paying cases)? How do you get them to actually route the big All-on-X type patients your way instead of keeping them for their local guy?

Also, worth pushing 2+ hours into the really rural areas or should I stay closer to the cities?

Would love to hear what actually worked for you
 
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Teeth&titanium95$$ said:
Hey guys,

Been a traveling oral surgeon for a while now — mostly extractions, wisdom teeth, IV sedations, and the occasional implant. I used to roll into offices, use their stuff and their assistants, but I’m finally going 100% independent. Bringing my own supplies, hiring my own team, and now I can do proper IV moderate sedation.

The big question is how to make every single day count for max profit. Those of you who are already doing this full-time as traveling OS — how do you keep the chairs slammed? What’s your best move when negotiating with the office owners to get them booking 15-25 patients a day (including the higher-paying cases)? How do you get them to actually route the big All-on-X type patients your way instead of keeping them for their local guy?

Also, worth pushing 2+ hours into the really rural areas or should I stay closer to the cities?

Would love to hear what actually worked for you
Click to expand...
“proper IV moderate sedation” tells me you’re not omfs
 
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Just curious, how much do you usually take home for a set of fully bony wisdom teeth with iv sedation?
 
Just word of advice, now that you are doing your own iv sedation, dont try to slam your schedule. Allow adequate time for your patients to wake up and dont leave them until at least their eyes are open and can follow commands. Make sure you travel with all emergency meds.

Have four assistants. Two with you in the surgery, one taking care of post op pt and one seating the next surgery pt.

I also wouldnt call yourself OS. Not only misleading but also illegal.

Good luck!
 
Colastick said:
Just word of advice, now that you are doing your own iv sedation, dont try to slam your schedule. Allow adequate time for your patients to wake up and dont leave them until at least their eyes are open and can follow commands. Make sure you travel with all emergency meds.

Have four assistants. Two with you in the surgery, one taking care of post op pt and one seating the next surgery pt.

I also wouldnt call yourself OS. Not only misleading but also illegal.

Good luck!
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Appreciate the advice, yes I have 4 anesthesia certified dental assistants, and thinking of hiring a nurse who can place IV and do post-op monitoring. I would say I am very slow and careful with sedation part. And the post is edited
 
Teeth&titanium95$$ said:
Appreciate the advice, yes I have 4 anesthesia certified dental assistants, and thinking of hiring a nurse who can place IV and do post-op monitoring. I would say I am very slow and careful with sedation part. And the post is edited
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You can hire a nurse if you want but you can probably go without one and save the cost. Hiring a RN is much more costly than a DA. If you stay in the room with the patient until they are pretty awake, a well trained DA should be able to discharge them. If my post op patients are still little sedated, i just stay in the room and finish paperwork and review the next patients so i make most of my time
 
SuxDrugs&Rocuronium said:
No GP should be traveling to do moderate sedation. My advice is stop before it’s too late
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Hey everyone,

Just wanted to clear things up real quick. I did extensive training in OMFS but didn’t finish the program, so I’m not board-certified and I’m definitely not claiming to be an oral surgeon. The post was originally AI-generated, I corrected it, but I kept the first short draft because my question was just about the business side and I didn’t want to overload it with personal details.

I totally get why people here are protective of the profession — I respect that a lot. It just helps when we have the full context before making assumptions.

For what it’s worth, I only do moderate conscious IV sedation and I’m actually extra careful with it (probably more cautious than a lot of OMFS folks). As an example, there was an OMFS program director in Ohio who ended up losing both his anesthesia permit and dental license because of general anesthesia/deep sedation issues. I don’t have a deep sedation permit and I don’t carry Prop with me.

Public forums make it easy for things to get blown out of proportion when the whole story isn’t there. Thanks for letting me clarify, appreciate it.
 
Colastick said:
You can hire a nurse if you want but you can probably go without one and save the cost. Hiring a RN is much more costly than a DA. If you stay in the room with the patient until they are pretty awake, a well trained DA should be able to discharge them. If my post op patients are still little sedated, i just stay in the room and finish paperwork and review the next patients so i make most of my time
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Yes, thank you. Only thing is that some offices double book me with non sedation cases so I had to jump around sometimes but wanted to pick everyone's brain on this.

Also, for others who insinuated that I run an unethical business. Have mercy and understand the full story: I travel to rural areas where patients have to travel 45+ mins to see private practice OMFS, wait at least few weeks for a consult, and pay double fees losing all their dental insurance allowances. My business model is to help patients and office owners at the convince of me traveling few hours daily to their offices, so patients can stay at their home dental clinic and save lots on fees, and some have even emergencies where I travel to take care of their dental abscess since most OMFS have tier levels in terms of scheduling where a patient with an infected tooth needs to wait 6 weeks to see an OMFS compared to a sinus lift or dental implant case.

Don't judge the book by its cover and don't go randomly throwing **** on people posting like we're in a high school FB group.
 
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Teeth&titanium95$$ said:
Hey everyone,

Just wanted to clear things up real quick. I did extensive training in OMFS but didn’t finish the program, so I’m not board-certified and I’m definitely not claiming to be an oral surgeon. The post was originally AI-generated, I corrected it, but I kept the first short draft because my question was just about the business side and I didn’t want to overload it with personal details.

I totally get why people here are protective of the profession — I respect that a lot. It just helps when we have the full context before making assumptions.

For what it’s worth, I only do moderate conscious IV sedation and I’m actually extra careful with it (probably more cautious than a lot of OMFS folks). As an example, there was an OMFS program director in Ohio who ended up losing both his anesthesia permit and dental license because of general anesthesia/deep sedation issues. I don’t have a deep sedation permit and I don’t carry Prop with me.

Public forums make it easy for things to get blown out of proportion when the whole story isn’t there. Thanks for letting me clarify, appreciate it.
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Two intern years is not extensive training in OMFS. I saw your post on Reddit. I’m also not an OMFS, but I am an expert in sedation/anesthesia. There’s a reason why DAs go to three years of residency to travel and provide sedation/anesthesia. It’s hard enough when you’re in the same location everyday, but if you’re traveling to a different office each day there are so many moving parts and things that can get missed and go wrong. Are you prepared to handle a patient that has runs of VTach in an unfamiliar office? What about the patient that lies about npo status and aspirates mid procedure? The dental office that brought you in isn’t gonna be any help. Their staff isn’t trained to help (that’s why they’re bringing in someone). Especially if you just got your permit, all that means is you’ve met the bare minimum qualifications. You don’t have the experience to be doing this and I recommend you get a lot of cases under your belt before thinking about traveling to perform sedations.

And if you’re trying to maximize your day by seeing 15-25 patients while doing moderate sedation, you’re gonna kill someone. There’s a reason most DAs done see more than 10 patients in a day
 
SuxDrugs&Rocuronium said:
Two intern years is not extensive training in OMFS. I saw your post on Reddit. I’m also not an OMFS, but I am an expert in sedation/anesthesia. There’s a reason why DAs go to three years of residency to travel and provide sedation/anesthesia. It’s hard enough when you’re in the same location everyday, but if you’re traveling to a different office each day there are so many moving parts and things that can get missed and go wrong. Are you prepared to handle a patient that has runs of VTach in an unfamiliar office? What about the patient that lies about npo status and aspirates mid procedure? The dental office that brought you in isn’t gonna be any help. Their staff isn’t trained to help (that’s why they’re bringing in someone). Especially if you just got your permit, all that means is you’ve met the bare minimum qualifications. You don’t have the experience to be doing this and I recommend you get a lot of cases under your belt before thinking about traveling to perform sedations.

And if you’re trying to maximize your day by seeing 15-25 patients while doing moderate sedation, you’re gonna kill someone. There’s a reason most DAs done see more than 10 patients in a day
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Idk where the two intern years are coming from and circulating the internet on me now LMAO. Plus, I can say the same thing about you claiming to be an expert in sedation/anesthesia but you didnt directly say I am anesthesiologist. I'm not going to reply to the rest of your comment to fuel this negativity nor qualify myself to you by explaining what I do and do not carry with me when I work. The question was simple and logistical/operational, if you run this model of travel OS or travel surgical dentist and have value to add, then please share. If not, then you should stay silent.
 
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Teeth&titanium95$$ said:
Idk where the two intern years are coming from and circulating the internet on me now LMAO. Plus, I can say the same thing about you claiming to be an expert in sedation/anesthesia but you didnt directly say I am anesthesiologist. I'm not going to reply to the rest of your comment to fuel this negativity nor qualify myself to you by explaining what I do and do not carry with me when I work. The question was simple and logistical/operational, if you run this model of travel OS or travel surgical dentist and have value to add, then please share. If not, then you should stay silent.
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Ok here it is. I am a dentist anesthesiologist aka an expert in the field of anesthesiology. Also calling yourself an OS without completing a residency is a violation of the dental board in most states. Your arrogance will kill someone
 
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Can you clarify to me, where you got that "calling yourself an OS without completing a residency" from? Again, the post is edited. You can either say some value or please don't further comment
SuxDrugs&Rocuronium said:
Ok here it is. I am a dentist anesthesiologist aka an expert in the field of anesthesiology. Also calling yourself an OS without completing a residency is a violation of the dental board in most states. Your arrogance will kill someone
Click to expand...
 
Teeth&titanium95$$ said:
Can you clarify to me, where you got that "calling yourself an OS without completing a residency" from? Again, the post is edited. You can either say some value or please don't further comment
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“Been a traveling oral surgery focused provider (not board OMFS) for a while now“

Very specific wording to make people think you’re OMFS trained but not board certified. So where did you do your residency?
 
I personally have never met a GP doing itinerate surgery like an OMFS does. I hope you’ve got airway equipment ready. Are you only doing ASA1/2?
 
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Board certified 6-year MD OMFS here. This is also not written by ChatGPT.

Everything is fun and games, until someone dies. Then you lose everything, like the Ohio doctor.

Oral surgeons protect each other, because we know each other's training, and bad things can happen.

An oral surgeon on the boards will crucify you if something happens with one of your patients.

Do you know how to treat laryngeospasm and brochospasm? How many of them have you encountered in your training?

Have you ever had to emergently intubate someone? Like when there is a lot of blood in the airway?

How close is the closest ER if you have to send someone there? If it's a big city, there's one probabably 5-10 min away. If it's a small rural town, it might be farther than that.

I understand the ASA 1 and 2, healthy 16-18 year old wisdom teeth, that you'll never have to see again.

But All-on-X? what if there's a problem? they have to wait the once a month you're there to get a follow up?

I understand the hustle, but you should be more careful about your case selection, than trying to get as many patients as possible.
 
You guys are being quite harsh on the OP. Cant stop people from trying to make a living. By having the sedation permit, legally the OP is supposedly qualified to do this just like omfs or dental anesthesiologist.

I agree with all the concerns people have as well however. It is honestly an issue with the state dental board having a low bar for granting sedation permits and allowing people to do this with little oversight. People who feel strongly about this issue should take it up to their respective dental boards and not to the OP.
 
Colastick said:
You guys are being quite harsh on the OP. Cant stop people from trying to make a living. By having the sedation permit, legally the OP is supposedly qualified to do this just like omfs or dental anesthesiologist.

I agree with all the concerns people have as well however. It is honestly an issue with the state dental board having a low bar for granting sedation permits and allowing people to do this with little oversight. People who feel strongly about this issue should take it up to their respective dental boards and not to the OP.
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That’s a good point.
 
Teeth&titanium95$$ said:
Hey everyone,

Just wanted to clear things up real quick. I did extensive training in OMFS but didn’t finish the program, so I’m not board-certified and I’m definitely not claiming to be an oral surgeon. The post was originally AI-generated, I corrected it, but I kept the first short draft because my question was just about the business side and I didn’t want to overload it with personal details.

I totally get why people here are protective of the profession — I respect that a lot. It just helps when we have the full context before making assumptions.

For what it’s worth, I only do moderate conscious IV sedation and I’m actually extra careful with it (probably more cautious than a lot of OMFS folks). As an example, there was an OMFS program director in Ohio who ended up losing both his anesthesia permit and dental license because of general anesthesia/deep sedation issues. I don’t have a deep sedation permit and I don’t carry Prop with me.

Public forums make it easy for things to get blown out of proportion when the whole story isn’t there. Thanks for letting me clarify, appreciate it.
Click to expand...
Just wanted to pile on: if your original post were AI-generated, why did you need AI to generate basically 8 sentences for you? If my surgeon needs AI to write 8 sentences asking how to maximize profit, I would question his/her ability to be "more cautious than a lot of OMFS folks."
 
Colastick said:
You guys are being quite harsh on the OP. Cant stop people from trying to make a living. By having the sedation permit, legally the OP is supposedly qualified to do this just like omfs or dental anesthesiologist.

I agree with all the concerns people have as well however. It is honestly an issue with the state dental board having a low bar for granting sedation permits and allowing people to do this with little oversight. People who feel strongly about this issue should take it up to their respective dental boards and not to the OP.
Click to expand...

I went to a remote anchorate course, which was meant for oral surgeons, and a lot of general dentist were there.

They wanted to learn how to do zygomatic implants, pterygoid implants, transnasals, but some of them have never even done an All-on-X before.

All of them were struggling with dissections. I had one ask me how far the infra orbital nerve was. I've done so many ZMC fracture repair/Lefort I's that this was second nature to me, as with all of my OMFS colleagues. But for someone to not know where things are, how are they supposed to perform things safely in patients?

Of course, you are allowed to do anything you want. But if things go wrong, a specialist will be on the board, and they will be judged on how they would be doing, on a specialist level.

So question is, does OP want to work for a long time? or does he want to make a lot of money at once, and then something goes wrong, gets sued, and lose everything?
 
AlbinoPolarBear said:
I went to a remote anchorate course, which was meant for oral surgeons, and a lot of general dentist were there.

They wanted to learn how to do zygomatic implants, pterygoid implants, transnasals, but some of them have never even done an All-on-X before.

All of them were struggling with dissections. I had one ask me how far the infra orbital nerve was. I've done so many ZMC fracture repair/Lefort I's that this was second nature to me, as with all of my OMFS colleagues. But for someone to not know where things are, how are they supposed to perform things safely in patients?

Of course, you are allowed to do anything you want. But if things go wrong, a specialist will be on the board, and they will be judged on how they would be doing, on a specialist level.

So question is, does OP want to work for a long time? or does he want to make a lot of money at once, and then something goes wrong, gets sued, and lose everything?
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They should stick to doing resins, crowns, and anterior/premolar/easy molar NSRCT, simple extractions, etc. That's what they trained to do in dental school. Everyone seems to want to be an OMS and make the money of an OMS without going to residency. If I dropped out of residency, I would respect what I am, and what I am not. Looks like there needs to be some legislation to stop this tomfoolery.
 
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It’s unfortunately just getting worse and worse. At least where I am. The implant companies and these remote anchorage courses cater to general dentists. Why? Because there’s a lot more of them than specialists.

Within 5-10 years OS will just be a scut job of fixing complications and taking out thirds at the inferior border of the mandible.
 
amali said:
It’s unfortunately just getting worse and worse. At least where I am. The implant companies and these remote anchorage courses cater to general dentists. Why? Because there’s a lot more of them than specialists.

Within 5-10 years OS will just be a scut job of fixing complications and taking out thirds at the inferior border of the mandible.
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Dude there is no way lol I refuse to believe that
 
Colastick said:
You guys are being quite harsh on the OP. Cant stop people from trying to make a living. By having the sedation permit, legally the OP is supposedly qualified to do this just like omfs or dental anesthesiologist.

I agree with all the concerns people have as well however. It is honestly an issue with the state dental board having a low bar for granting sedation permits and allowing people to do this with little oversight. People who feel strongly about this issue should take it up to their respective dental boards and not to the OP.
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I don’t think we are. Saying “well the dental board allows it” is a weak argument. Let me ask you this, if it were your family member who was the patient being sedated, would you want some newbie who just got certified and is traveling to the office for the day to be the provider for the procedure and sedation? Hell no you wouldn’t. Just because something is legal doesn’t mean it’s appropriate or ethical. And you can bet any attorney will tear OP apart if he had any adverse event
 
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SuxDrugs&Rocuronium said:
I don’t think we are. Saying “well the dental board allows it” is a weak argument. Let me ask you this, if it were your family member who was the patient being sedated, would you want some newbie who just got certified and is traveling to the office for the day to be the provider for the procedure and sedation? Hell no you wouldn’t. Just because something is legal doesn’t mean it’s appropriate or ethical. And you can bet any attorney will tear OP apart if he had any adverse event
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That may be true. But this dangerous act is yet allowed and legal. If there is a loop hole or an easy way out, people will take that route. Can't blame people for wanting to do what omfs does without omfs training. Gotta blame the system and try to fix the system itself.
 
Aren't the owners profiting when you do an all on x case versus them sending it out of their office? I'm not doing sedation or all on x, but if an office is slow I give them more time to book patients and if i want more days I just call more offices lol..
 
SuxDrugs&Rocuronium said:
I don’t think we are. Saying “well the dental board allows it” is a weak argument. Let me ask you this, if it were your family member who was the patient being sedated, would you want some newbie who just got certified and is traveling to the office for the day to be the provider for the procedure and sedation? Hell no you wouldn’t. Just because something is legal doesn’t mean it’s appropriate or ethical. And you can bet any attorney will tear OP apart if he had any adverse event
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Sux, did you discuss in your residency about the laws regarding GPs and sedation? Any political activism in this area?
 
D1Bound said:
Sux, did you discuss in your residency about the laws regarding GPs and sedation? Any political activism in this area?
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Should the same should be done for OMS? Realistically how many codes do you guys run in residency? How many in practice? If you are not routinely coding patients you should not be providing general anesthetics.
 
yappy said:
Should the same should be done for OMS? Realistically how many codes do you guys run in residency? How many in practice? If you are not routinely coding patients you should not be providing general anesthetics.
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The goal of good anesthesia training is to not be routinely running codes on the ASA 1s and 2s who are good candidates for open airway sedation. At my program we are learning how to manage pts under sedation from day 1. Many of my friends at programs that do head and neck cancer routinely are managing patients in the ICU and even us at a non cancer program still spend 2 additional months in the SICU on top of all of the other training we get. I think you have a gross misunderstanding of what OMFS residency is and that is ok. It’s not your fault most people do
 
yappy said:
Should the same should be done for OMS? Realistically how many codes do you guys run in residency? How many in practice? If you are not routinely coding patients you should not be providing general anesthetics.
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run codes during anesthesia and icu rotations, mock codes monthly in clinic. If you routinely run codes in real life you’re doing it wrong. You know not of what you speak.
 
yappy said:
Should the same should be done for OMS? Realistically how many codes do you guys run in residency? How many in practice? If you are not routinely coding patients you should not be providing general anesthetics.
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Provider should run mock drills to stay fresh but no one should be routinely coding patients. You do understand that a coding patient means they’re pretty much dead right?
 
D1Bound said:
Sux, did you discuss in your residency about the laws regarding GPs and sedation? Any political activism in this area?
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Not really, we have our opinions about it and I think many gps lack adequate training for it (you don’t know what you don’t know) but I don’t see it changing anytime soon unfortunately
 
Colastick said:
That may be true. But this dangerous act is yet allowed and legal. If there is a loop hole or an easy way out, people will take that route. Can't blame people for wanting to do what omfs does without omfs training. Gotta blame the system and try to fix the system itself.
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But it’s not unreasonable for professionals who hold the title of doctor to have personal accountability
 
You alluding to not being a board-certified OMFS makes me think that you are a recent graduate who is board-eligible OMFS. Could you imagine how confused your patients must be as far as your credentials? Also, what is your definition of extensive OMFS training? Did you make it through all of gen surg + anesthesia training, do a non-cat or drop out during medical school? I think the issue people have with this post is that you're beating around the bush about your training.
 
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Teeth&titanium95$$ said:
Hey guys,

Been a traveling oral surgery focused provider (not board OMFS) for a while now — mostly extractions, wisdom teeth, IV sedations, and the occasional implant. I used to roll into offices, use their stuff and their assistants, but I’m finally going 100% independent. Bringing my own supplies, hiring my own team, and now I can do IV sedation after obtaining my sedation permit

The big question is how to make every single day count for max profit. Those of you who are already doing this full-time as traveling dentist — how do you keep the chairs slammed? What’s your best move when negotiating with the office owners to get them booking 15-25 patients a day (including the higher-paying cases)? How do you get them to actually route the big All-on-X type patients your way instead of keeping them for their local guy?

Also, worth pushing 2+ hours into the really rural areas or should I stay closer to the cities?

Would love to hear what actually worked for you
Click to expand...

It really depends if the offices you're traveling to can deliver a lot of patients to you within the shortest period of time and provide you with enough rooms to churn all those patients quickly. On your end, you need to work quickly, have an efficient team to follow you from room to room, monitor your patients, and turnaround rooms quickly for the next batch of patients.

Maximum profit means the most efficient workflow and turnaround and delivering the most amount of high productive patients within a short period of time. With the workflow, you need to see how many patients they can deliver to you per hour, and whether they can provide you with x rooms to be able to see those patients within a given time period. Depending on your state laws, you could theoretically numb and sedate each patient moving from room to room and once you have the onset of sedation, you start and finish the procedures as quickly as possible to turnover the rooms, then find a way to do recovery as fast as possible. From what I recall, some OS groups just use ketamine and get them out quick.

All on X can be tricky sometimes, as you might have some curveballs like having to stop every so often if the patient is having a laryngospasm, and so on. Easier to just chuck 3rds all day long and make lots of money with a lot less upkeep and liability.

You go where there is demand and money. You won't know until you try it out at each office as it is not just the area but the office(s) ability to deliver patients. Exhaust your options in the suburban/city regions first before having to travel 2+ hours, since you can jump around offices within shorter distances and you will have less staffing issues. If you're traveling 2+ hours, that cuts into your hourly significantly. For example, if you are making 3000 an hour, they book you for 6 hours, but then you have to travel, that cuts your hourly to 2250 per hour. That's a huge cut.

Anyway, just don't kill anyone, otherwise, you'll probably have to move elsewhere and deal with abitration/litigation. Also, practice in states that have limited liability and tort reform if you have the choice. IANAL, but a lawyer once told me that if you had the choice to permanently debilitate someone or kill them, the latter choice is preferable as it is less expensive. Thank goodness, in bread and butter general dentistry, you gotta be incredibly negligent to do either if you're practicing within your scope of practice.
 
TanMan said:
Maximum profit means the most efficient workflow and turnaround and delivering the most amount of high productive patients within a short period of time. With the workflow, you need to see how many patients they can deliver to you per hour, and whether they can provide you with x rooms to be able to see those patients within a given time period. Depending on your state laws, you could theoretically numb and sedate each patient moving from room to room and once you have the onset of sedation, you start and finish the procedures as quickly as possible to turnover the rooms, then find a way to do recovery as fast as possible. From what I recall, some OS groups just use ketamine and get them out quick.
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He cannot use ketamine, nor can he sedate multiple patients simultaneously, nor can he sedate and leave the room. Cutting corners to maximize profits is how you make the headlines
 
amali said:
It’s unfortunately just getting worse and worse. At least where I am. The implant companies and these remote anchorage courses cater to general dentists. Why? Because there’s a lot more of them than specialists.

Within 5-10 years OS will just be a scut job of fixing complications and taking out thirds at the inferior border of the mandible.
Click to expand...
nothing you can't learn with a 2 day CE course 😉
 
Pralk Nekorf said:
nothing you can't learn with a 2 day CE course 😉
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For some reason my gut is telling me that someone who is ready to throw down 60-80k on major surgery for implants up in their skull isn’t going to go with some hotel CE flunky. It’s going to be with an OMFS and a prosthodontist. That’s what I would want my grandma to have. It’s not even a debate.
 
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D1Bound said:
For some reason my gut is telling me that someone who is ready to throw down 60-80k on major surgery for implants up in to their skull isn’t going to go with some hotel CE flunky. It’s going to be with an OMFS and a prosthodontist. That’s what I would want my grandma to have. It’s not even a debate.
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i really hope so, but you never know. i am seeing more and more super gp's with the sky as the limit
 
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SuxDrugs&Rocuronium said:
He cannot use ketamine, nor can he sedate multiple patients simultaneously, nor can he sedate and leave the room. Cutting corners to maximize profits is how you make the headlines
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If I may ask, why he/she cannot do the following? Is it due to laws (state), best practices, safety concerns, etc...? I don't do sedation myself due to risk/liability, but I'm just going off on what I hear OS groups are doing in my area.

D1Bound said:
For some reason my gut is telling me that someone who is ready to throw down 60-80k on major surgery for implants up in their skull isn’t going to go with some hotel CE flunky. It’s going to be with an OMFS and a prosthodontist. That’s what I would want my grandma to have. It’s not even a debate.
Click to expand...

You'll be surprised on how much marketing wins over credentials especially with the advent of SMM. It's almost self defeating in a way that those that really do their research are the ones that are the pickiest, with the most exacting standards, and seeking those with the credentials and best reviews. In a way, those that don't have the credentials, less than stellar reviews, and so on will be the ones who will get easier AND willing to pay patients.
 
TanMan said:
If I may ask, why he/she cannot do the following? Is it due to laws (state), best practices, safety concerns, etc...? I don't do sedation myself due to risk/liability, but I'm just going off on what I hear OS groups are doing in my area.



You'll be surprised on how much marketing wins over credentials especially with the advent of SMM. It's almost self defeating in a way that those that really do their research are the ones that are the pickiest, with the most exacting standards, and seeking those with the credentials and best reviews. In a way, those that don't have the credentials, less than stellar reviews, and so on will be the ones who will get easier AND willing to pay patients.
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You know what, you have a point. I have a relative that blows money left and right that has gotten tricked by a Nigerian prince scam on Facebook. I’m being way too logical for the majority of the public
 
TanMan said:
If I may ask, why he/she cannot do the following? Is it due to laws (state), best practices, safety concerns, etc...? I don't do sedation myself due to risk/liability, but I'm just going off on what I hear OS groups are doing in my area.
Click to expand...
All of the above. Some states explicitly prohibit the use of ketamine unless the provider has a permit for deep sedation/GA. But it’s also the standard of care because it’s very difficult to stay in the moderate sedation plane with ketamine. It’s also not a reversible agent like midazolam/fentanyl. It has some not so great side effects that I don’t believe most moderate sedation providers are equipped to handle.

The ASA standards are that a qualified provider be present at all times while a patient is under sedation. This would preclude leaving the operatory or having multiple patients sedated at the same time. Assistants are not considered qualified providers so you can’t have them monitor alone unless the patient is awake and pretty much ready for discharge.
 
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