USC First YR Cost of Attendance $162k 2022-2023

[2TH MVR]

Dentistry money is slipping away from dentists, and is increasingly going to corporations.

Agree. But lets be clear that WE the dentists and current patient trends have all played some part in this.

There was a time that is was unethical to advertise our services on billboards, sandwich boards, newspapers, magazines, etc. Attorneys were doing this cheesy advertising, but the dental profession along with medical profession felt it was unethical to do external advertising. Getting patients was all about work of mouth, meeting people at community meetings, orgnaized dental govt, sponsoring kid's sport's teams, etc. etc. Now? Facebook, YouTube videos, instagram, along with all the other social media sites. During my time I worked Mon thru Thurs with reasonable hours. I also charged a fee that was commensurate to my time, and expertise. I earned referrals through my efforts at relationships with the GPs and the quality of my work.

NOW. There are advertising EVERYWHERE. Advertising that tells the general public that our SERVICES are now commodities that can have different prices.

So the DENTISTS themselves have evolved into this model. A model that is not like a simple small business, but a model that works like small Corps. It was the dentists that started these large Corp entities. Then it snow balled.

Now. The current gen of patients. WOW. Remote working. Everything is a few keystrokes on your phone. You don't even need to leave your house. Anything and everything can be delivered to you. At any time. You want teeth bleaching. DYI trays. You want teeth straightening? DYI aligners all at home. There was a time when you needed to call a receptionist who probably recognized your name to make an appt. Nope. Not anymore. To a prospective patient .... if they cannot make an appt online .... they will probably just move on. Most do not care about your qualifications or experience.

Patients want cheap prices. Available hours (not hours ideal for the dentist). Online scheduling, paying their bills, able to talk to the dr. after hours (chat).

Next up are those dentists near the retiring age (myself). Can they with their "old fashioned" practices and declining revenue continue practicing privately knowing that every year will be tougher than the last?

As a private practice owner .... I had a small group enrolled for our group health benefits. EVERY year my premiums would increase forcing me to lower the coverages and increase the deductible. EVERY year. I now work Corp. Sold my private practices. Been with this company for over 6 years. My health insurance premium is around $300/month for a family of three. CHEAP. $1500 deductible. Great, quality insurance. I make more money now than I did my last 3-4 years in private practice. My stress levels are essentially nonexistent.

How about all those expensive private dental schools? They keep opening more. And guess what? They have full classes and have to turn away many applicants. Daddy/Mommy money along with gov't blank student loan checks. And now you have indebted students crying foul and wanting the govt to bail them out.

No. The Corps didn't cause any of this. They just took advantage of a business opportunity that we served to them on a silver platter.

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[charlestweed]

Just like the student loans program crossed an event horizon after steering off from the intended original plan by the government.

I think the government will announce another extension this week for the covid student loan forbearances. Either that, or some level of forgiveness based on income. Most dentists will probably not qualify.

Most dentists won’t qualify because they make too much. The loan forgiveness program (if approved) should only be for those who chose a wrong career and don’t make enough to pay back their student loans.

 

[Cold Front]

Most dentists won’t qualify because they make too much. The loan forgiveness program (if approved) should only be for those who chose a wrong career and don’t make enough to pay back their student loans.

Yes. There will be a “targeted” forgiveness through existing programs. If you are struggling financially through a certain profession that pays ridiculously low, the odds of your debt being cancelled is pretty high. I think it’s crazy when dentists are taking out highest student loans out there, and their debt to income ratio is equal to much lower income professions, many dentists should qualify for a some sort of a relief.

 

[charlestweed]

Yes. There will be a “targeted” forgiveness through existing programs. If you are struggling financially through a certain profession that pays ridiculously low, the odds of your debt being cancelled is pretty high. I think it’s crazy when dentists are taking out highest student loans out there, and their debt to income ratio is equal to much lower income professions, many dentists should qualify for a some sort of a relief.

The debt to income for dentists may be similar to other lower pay professions but it’s only at the beginning because most of the new grad dentists are slow and clueless. They have nothing to prove to their employers. As they gain more experience in subsequent years, they can find better paying jobs and can significantly lower the debt to income ratio. When they open their own office, the sky’s the limit.

many dentists should qualify for a some sort of a relief.

No, they shouldn’t. They can "fool" the system by working less days to keep their income really low…..what prevents them from doing that? I think the current PSLF system, which will help erase the dentist’s entire student loan amount after 10 years of working for a government health clinic, is a fair one. Military scholarship is another fair one.

 

[DrJeff]

Most dentists won’t qualify because they make too much. The loan forgiveness program (if approved) should only be for those who chose a wrong career and don’t make enough to pay back their student loans.

Unless there's a good, long, hard look at what ultimately lead to the massive amount of student loan debt in the first place (in a nutshell the federal gov't taking over the student loan business and with little descretion over the years just allowing more and more loans to be taken out, which the colleges know and thus keep raising their tutitions because they know they can get get the gov't to give out more and more loans which will positively affect their bottom lines, often with negative longterm financial consequences for those who matriculate their for numerous majors that they offer) I am against a loan forgiveness program, as it may feel good now, but ultimately has a great potential to be example number 37623 of the government trying to "fix" a problem, that just ends up creating another problem down the road.

If they start a forgiveness program now, we all can be pretty sure that it will end up becoming a greater and greater amount over time (with greater and greater costs to the taxpayer), since the primary cause of the problem is never addressed, simply because that is a tougher choice to make, often because it involves potentially alienating a certain donor/voter base.

 

[pubhealthdent]

I believe that it is in the loan promissory notes now. The caveat being that I’m not sure how feasible it is for dentists to find stable employment at a nonprofit. Physicians can usually just do academic medicine or work at a non profit hospital. Are there many nonprofit in denistry? I’m not sure.

Tons of nonprofits in dentistry but the majority are rural which most people don't want to do. I graduated in 2018 with 15+ contract offers from FQHCs across the country. The jobs are there if you can be flexible geographically

 

[Cold Front]

Tons of nonprofits in dentistry but the majority are rural which most people don't want to do. I graduated in 2018 with 15+ contract offers from FQHCs across the country. The jobs are there if you can be flexible geographically

The same phenomenon in rural dental job openings is happening in medicine and other healthcare rural jobs. The days of people commuting far or living in rural areas in general are slowly fading. Urbanization is close to 90% in this country, it’s the percentage of the nation’s population living in a city. It is expected to be close to 100% in few decades. That number was 50% when my parents were born, even less for people born before them and still living. Humans are like a bee hive, almost all of us want to be in a city, not matter how much money is offered to us to live and work in a rural area. Hence why most dentists in rural America struggle to sell their practices or simply walk away.

 

[Chief's Pineapple]

The same phenomenon in rural dental job openings is happening in medicine and other healthcare rural jobs. The days of people commuting far or living in rural areas in general are slowly fading. Urbanization is close to 90% in this country, it’s the percentage of the nation’s population living in a city. It is expected to be close to 100% in few decades. That number was 50% when my parents were born, even less for people born before them and still living. Humans are like a bee hive, almost all of us want to be in a city, not matter how much money is offered to us to live and work in a rural area. Hence why most dentists in rural America struggle to sell their practices or simply walk away.

Indeed. And with more young people delaying marriage, and delaying having children as well, there really is no need to move out of the bustling city now is there? I mean how many people who had to WFH during Covid moved out of the city, or even suburbs, and have regretted it? Definitely not all, but I'm sure a significant amount.

As a personal example, a good buddy of mine moved out of a major metro area, but not out to the country, to another major metro area to WFH, because that's just where he wants to be, high home prices and everything. He will probably move out to the surrounding suburbs, but he will never leave the metro area entirely I think. It just doesn't seem like an option.

 

[pubhealthdent]

Indeed. And with more young people delaying marriage, and delaying having children as well, there really is no need to move out of the bustling city now is there? I mean how many people who had to WFH during Covid moved out of the city, or even suburbs, and have regretted it? Definitely not all, but I'm sure a significant amount.

As a personal example, a good buddy of mine moved out of a major metro area, but not out to the country, to another major metro area to WFH, because that's just where he wants to be, high home prices and everything. He will probably move out to the surrounding suburbs, but he will never leave the metro area entirely I think. It just doesn't seem like an option.

You do realize there will always be people who don't want to live in the city? I'm more than happy living and working in a town of 2000 being 2-2.5 hours from several larger cities. I work in a very busy practice making $300k+. No way I'd get that in a bigger city without having to compromise a much higher COL and all that nonsense that comes with big city living

 

[voxveritatisetlucis]

These cities (NYC, SF, LA) are only really fun if you have significantly more money than a doctor or dentist could hope to make. trust funders, hedge fund moguls, professional athletes etc. even 300k in nyc doesn’t get you much,

 

[Chief's Pineapple]

You do realize there will always be people who don't want to live in the city? I'm more than happy living and working in a town of 2000 being 2-2.5 hours from several larger cities. I work in a very busy practice making $300k+. No way I'd get that in a bigger city without having to compromise a much higher COL and all that nonsense that comes with big city living

I never said there weren't. I was agreeing with Cold Front's post regarding the trends towards urbanization. My point I was trying to make was that some people (a lot of them, it looks like) like the city or its immediate surroundings, and aren't exactly clamoring for the small town life you mentioned above. Obviously some do, but the numbers say they are the minority. Nothing wrong with it, just stating an observation.

These cities (NYC, SF, LA) are only really fun if you have significantly more money than a doctor or dentist could hope to make. trust funders, hedge fund moguls, professional athletes etc. even 300k in nyc doesn’t get you much,

I respectfully disagree with this. I "only" made a fraction of the listed amount when I lived in a major city at my last job, and I had plenty of fun. Would my lifestyle have changed if I had made 10x more? Probably. Did I waste my time away at night, laying there in bed wishing I had more money, so I could really have some fun? No. And none of my friends did either. It's all relative anyways. What some of you guys may think is an average or below average lifestyle, I think may be just fine.

We all have different wants and needs. Some of us hate crowds and city life, some enjoy it. Some love the Great Plains/Midwest, some need to be on a coastal city. Etcetera, etcetera...

 

[Cold Front]

You do realize there will always be people who don't want to live in the city? I'm more than happy living and working in a town of 2000 being 2-2.5 hours from several larger cities. I work in a very busy practice making $300k+. No way I'd get that in a bigger city without having to compromise a much higher COL and all that nonsense that comes with big city living

Not everything is about money when it comes rural vs city. One major negative about rural area dental offices… if the local sheriff or mayor or the person with the biggest mouth in the area doesn’t like you, the rest of the community/many of your patients will probably not be a big fan of you.

 

[Cold Front]

These cities (NYC, SF, LA) are only really fun if you have significantly more money than a doctor or dentist could hope to make. trust funders, hedge fund moguls, professional athletes etc. even 300k in nyc doesn’t get you much,

That’s not just dentistry, but almost any other business with a lot of similar saturated businesses in the same city will also find it challenging to grow and be successful.

 

[Chief's Pineapple]

That’s not just dentistry, but almost any other business with a lot of similar saturated businesses in the same city will also find it challenging to grow and be successful.

Exactly. When I lived in ND, there was a single plastic surgeon in our hospital system. But he wasn't from ND, he was from FL. He owned property in both states, and would fly home to Miami from time to time. A nurse who I worked alongside with, who happened to also be from Miami, asked this surgeon why he was so many years outside of residency and still wanted to practice in flyover country. He said that South FL has more plastic surgeons on every corner than Starbucks, that here in ND he had basically no competition and could charge the fees he wanted. He didn't have to market himself at all as he was kept so busy anyways. It would not have been the same for him had he returned to Miami. Of course, it wasn't about money for him. He liked getting it, sure, but he was also okay with where he lived.

It goes back to my point that, if you're okay with an "undesirable" location (undesirable being relative and varies for each person), then more power to you for practicing in that location. But all the money in the world won't be enough if you don't like the area you reside in.

 

[Cold Front]

Exactly. When I lived in ND, there was a single plastic surgeon in our hospital system. But he wasn't from ND, he was from FL. He owned property in both states, and would fly home to Miami from time to time. A nurse who I worked alongside with, who happened to also be from Miami, asked this surgeon why he was so many years outside of residency and still wanted to practice in flyover country. He said that South FL has more plastic surgeons on every corner than Starbucks, that here in ND he had basically no competition and could charge the fees he wanted. He didn't have to market himself at all as he was kept so busy anyways. It would not have been the same for him had he returned to Miami. Of course, it wasn't about money for him. He liked getting it, sure, but he was also okay with where he lived.

It goes back to my point that, if you're okay with an "undesirable" location (undesirable being relative and varies for each person), then more power to you for practicing in that location. But all the money in the world won't be enough if you don't like the area you reside in.

I bet you a person from ND can get plastic surgery procedure done cheaper and sooner if they fly to Miami than go to that Miami plastic surgeon practicing in ND. That’s the beauty of supply and demand, there are winners and losers on both sides in rural versus urban healthcare services.

No the same example, but I have seen patients who flew to Turkey (the country) to get a full smile reconstruction and hair transplants at a fraction of what it costs here in this country. Apparently, Turkey is the Mecca of these type of procedures for all over the world. TikTok and social media in general has become a big marketing tool for them. It’s very common to see people with post-op swollen faces and patches on their head at Turkish airports flying back to their home countries.

 

[LFA20]

You do realize there will always be people who don't want to live in the city? I'm more than happy living and working in a town of 2000 being 2-2.5 hours from several larger cities. I work in a very busy practice making $300k+. No way I'd get that in a bigger city without having to compromise a much higher COL and all that nonsense that comes with big city living

Are you married? or in a relationship? Not saying its impossible but I find it very difficult to be in either one if living in rural areas.

 

[Cold Front]

There were about 120 rural hospital closures between 2010 and 2019. Federal relief over the past two years helped stabilize facilities and the pace of closures slowed. That assistance was temporary, however, and rural hospitals continue to struggle financially and have had difficulty recruit nurses and other healthcare employees.

Combine that with less and less providers willing to work in a rural area every year without a very BIG incentive. In my state, they offer $25-30k/yr student loan forgiveness if you practice in a rural area. It’s always been at that 25-30k/yr for the past 10 years or so. When you adjust for inflation over that period, it feels like $10k/yr forgiveness. Which is another major issue. The incentives are not aligned with the economic realities of the present, specially when student loans have been increasing higher than inflation for the same period.

 

[Chief's Pineapple]

Are you married? or in a relationship? Not saying its impossible but I find it very difficult to be in either one if living in rural areas.

It's fine if both people enjoy that lifestyle. But like you said, if the significant other does not enjoy that lifestyle, then practicing there will be for nought. Of course, one could also say that if the marriage didn't last the rural lifestyle it wouldn't have lasted at any other setting either. What do I know though.

There were about 120 rural hospital closures between 2010 and 2019. Federal relief over the past two years helped stabilize facilities and the pace of closures slowed. That assistance was temporary, however, and rural hospitals continue to struggle financially and have had difficulty recruit nurses and other healthcare employees.

Combine that with less and less providers willing to work in a rural area every year without a very BIG incentive. In my state, they offer $25-30k/yr student loan forgiveness if you practice in a rural area. It’s always been at that 25-30k/yr for the past 10 years or so. When you adjust for inflation over that period, it feels like $10k/yr forgiveness. Which is another major issue. The incentives are not aligned with the economic realities of the present, specially when student loans have been increasing higher than inflation for the same period.

It's not just rural hospitals

I watched a short documentary once about rural hospital closures. Not sure if it was in the same documentary, but I also watched a snippet about a hospital in Philadelphia that served the, err, under-served, and it was bought by a private equity investor and then shut down. Residents who moved cross-country to start their, err, residencies, all lost their jobs. Nurses and other staff too. They got sued apparently, due to a claim that the investor only bought the struggling hospital to close it and gain the valuable real estate it sat on. I didn't follow up on what happened, though. But the gist was there: can private equity buy struggling hospitals to just shut them down to get more money from the real estate? Does this start a precedent across the country?

 

[charlestweed]

The same phenomenon in rural dental job openings is happening in medicine and other healthcare rural jobs. The days of people commuting far or living in rural areas in general are slowly fading. Urbanization is close to 90% in this country, it’s the percentage of the nation’s population living in a city. It is expected to be close to 100% in few decades. That number was 50% when my parents were born, even less for people born before them and still living. Humans are like a bee hive, almost all of us want to be in a city, not matter how much money is offered to us to live and work in a rural area. Hence why most dentists in rural America struggle to sell their practices or simply walk away.

The upward trend of people who want to move to big cities should help most of us, dentists, who like to practice in big cities. More people in big cities = higher demand for having beautiful healthy smiles. People in big cities tend to care more about the appearance (espcially their teeth) than people in rural areas. I remember when I did my ortho residency in KY, I saw many adults walking around with missing anterior teeth….and they didn’t seem to care.

 

[charlestweed]

That’s not just dentistry, but almost any other business with a lot of similar saturated businesses in the same city will also find it challenging to grow and be successful.

The dentists who work hard and take better care of their patients will beat the dentists who spend less time on their patients....who take vacations all the time. That’s why you still see lots of successful dentists who are practicing in big cities. Competition helps improve quality of care in dentistry. Doctor patient relationship is very important.

The same applies to other businesses. There are plenty of restaurants here in CA. And the restaurants that provide good food and customer services don’t have any problem attracting customers. At some restaurants, it takes more than an hour to get seated.

 

[Cold Front]

I watched a short documentary once about rural hospital closures. Not sure if it was in the same documentary, but I also watched a snippet about a hospital in Philadelphia that served the, err, under-served, and it was bought by a private equity investor and then shut down. Residents who moved cross-country to start their, err, residencies, all lost their jobs. Nurses and other staff too. They got sued apparently, due to a claim that the investor only bought the struggling hospital to close it and gain the valuable real estate it sat on. I didn't follow up on what happened, though. But the gist was there: can private equity buy struggling hospitals to just shut them down to get more money from the real estate? Does this start a precedent across the country?

I remember watching the same documentary about rural and urban hospitals being purchased by larger networks. Instead of improving the struggling city hospitals, it turns out the bigger hospitals acquisitions were all about going after the prime land the struggling hospitals were sitting on. Which was nuts!

If you are an interested in this topic, I have a good book that expands on this subject very well in my library. I first heard about it on my local NPR radio. You can buy a copy on Amazon through the link below.

The Hospital: Life, Death, and Dollars in a Small American Town by Brian Alexander

https://www.amazon.com/Hospital-Death-Dollars-Small-American/dp/1250237351

 

[Cold Front]

The dentists who work hard and take better care of their patients will beat the dentists who spend less time on their patients....who take vacations all the time. That’s why you still see lots of successful dentists who are practicing in big cities. Competition helps improve quality of care in dentistry. Doctor patient relationship is very important.

The same applies to other businesses. There are plenty of restaurants here in CA. And the restaurants that provide good food and customer services don’t have any problem attracting customers. At some restaurants, it takes more than an hour to get seated.

The really good restaurants are rare, so everyone wants to go there. I read somewhere that 8 out of 10 new businesses fail in 5 years. In my experience, I believe most dentists will be fine financially, but will never be close to being wealthy by any stretch of the imagination. In fact, most will have to work relatively hard to make $200-250k/year, which isn’t what it use to be as recent as 5-10 years ago.

 

[Chief's Pineapple]

I remember watching the same documentary about rural and urban hospitals being purchased by larger networks. Instead of improving the struggling city hospitals, it turns out the bigger hospitals acquisitions were all about going after the prime land the struggling hospitals were sitting on. Which was nuts!

If you are an interested in this topic, I have a good book that expands on this subject very well in my library. I first heard about it on my local NPR radio. You can buy a copy on Amazon through the link below.

The Hospital: Life, Death, and Dollars in a Small American Town by Brian Alexander

Amazon product

 

[percyeye]

There are definitely pros and cons to both ways of living. As someone said earlier not everyone wants to live in a large metro. I lived in a large city and then moved rural. I work less, make way more money and have seen my net work grow exponentially more than it would have if I stayed in a city. We have the freedom of time and money to travel frequently and going back into the city it gives me anxiety to see a Doctors office on every corner knowing the competition is fierce. There would be some strip mall areas that had multiple dentist offices in the same location, it seemed crazy while right down the street there were Dental Schools pumping out new grads.

Rural is all just crappy middle of nowhere. There are nice areas with resort lake towns. The surgeons here have $million dollar lake homes that maybe cost $1-1.4 million mansions that would probably be in the $5-$10 million dollar range I'd guess somewhere like LA. And they usually have a 2nd home somewhere like Florida or AZ. I recently had a surgeon friend that was offered 2.5x more in a more rural midwest area than in a city and they are considering it even though they grew up in SoCal most of their life.

I still miss things about the city and like to go back and visit but no way I could give up my current trend of money and net worth growth.

 

[HMI]

I rarely post on SDN, but honestly, I'm not sure if working hard gonna cut it anymore when you have an oversupply of dentists and corporation on top of that. I was looking at my schedule the other day comparing 2019 with now ( I opened my current office early 2019 from scratch with zero charts after selling my 1st practice in the same year), back in 2019 towards the end of year we were open 4-5 days/week with enough patient on the schedule to be somewhat busy, but now, even with 1300+ charts we are barley able to open 3.5 days a week and can barley stay busy for 3 days; cancelation, INS crap, people not paying, people price shopping left and right. The other day my ortho friend called me complaining he doesn't have enough new starts or referral. yes, we are in southern California, a competitive market, but things are headed the wrong direction. If there are any Pre-Dents reading this, think twice before going into dental school; you are getting yourselves into world of debt just to get your DDS or DMD so that you take out more debt to become practice owner so then you can work the rest of your lives paying back loans and living paycheck to paycheck (unless you have rich parents, but I am talking in general). Oh, and on top of all these there are apparently dental schools now not requiring DAT (DAT optional, whatever that means), sounds familiar? Law, Pharmacy school. here's a link to this new dental school not requiring DAT:

Workman School of Dental Medicine - Workman School of Dental Medicine

Earn your DMD at the High Point University Workman School of Dental Medicine. We are the only private dental school in North Carolina and are currently accepting applications for our inaugural class. Our students will receive an exceptional dental medicine education in an inspiring environment...

www.highpoint.edu

I really hope this is a typo.

 

[DrJeff]

The dentists who work hard and take better care of their patients will beat the dentists who spend less time on their patients....who take vacations all the time. That’s why you still see lots of successful dentists who are practicing in big cities. Competition helps improve quality of care in dentistry. Doctor patient relationship is very important.

The same applies to other businesses. There are plenty of restaurants here in CA. And the restaurants that provide good food and customer services don’t have any problem attracting customers. At some restaurants, it takes more than an hour to get seated.

I think though that you have to look at things not just from the "the financial success of my practice is the most important measure" and also bring into the quality of life issue that taking time off, especially if you have kids living at home, adds to your overall well being.

Frankly, as I am now a year away from having both of my kids out of the house and in college, my wife and I regret a bit NOT taking more family vacation time with our kids, especially over the last 10 years or so, where they were old enough to not have to plan for naps, short length adventures, etc. That really was exacerbated by these last couple of COVID years where I had it in my head that I basically HAD to work all the time to keep the cash flow going and shouldn't take extra time off more than my normal 3 day weekend my schedule gives me every week. The burn out factor from that, on top of being in practice now for closing in on 25 years, was frankly a STUPID way to look at things.

Frankly I wish that I had taken 3 or 4 full weeks off each of the last few years (as I did prior to COVID) to not only enjoy some experiences with my family, but also just to let my mind get away from all of the stresses of the last few years, let alone the stresses of running a business. The reality is that if doing so caused my year end production to go down a couple of percent, the reality is that it wouldn't of been the end of the world, I still would of been able to pay my staff and my self everything expected, and frankly I probably would of had a few less situations where the stress seemed much greater than the actual issue infront of me dictated.

I guess to me ultimately, I get more now that I am in my 50's than when I was in my 30's and 40's that I want to not have what defines me be primarlity associated with what I do at work when my loupes are on and my gloved hands are holding a handpiece that is spinning away in a patients mouth, that the times you take to do things outside of work that you enjoy, with people that you enjoy, is ultimately far more rewarding that what the profit/loss statement that the accountant provides my practice shows (as long as it is a profit ) . That was summed up to me by my mother recently when she told me that she probably apprecaites the time she gets to spend with her grandkids at the ages they're at now (mainly teenagers) than she did with my brother and I when we were teenagers as she didn;t get how busy was really was with other things at that time, and things that really weren't as important as it seemed like they were at that time, since it's the memories with family that are ultimately far more satisfying than all of the various PTA and youth sports committies she chaired and volunteered for outside of her "regular" job of an elementary school teacher. I get that way more now that I did a few years ago, and fully have been trying to adjust things in my life away from work and more towards family and fun, which ultimately to me is the more important thing and makes me feel way more successful than just simply monetary measures

 

[charlestweed]

I think though that you have to look at things not just from the "the financial success of my practice is the most important measure" and also bring into the quality of life issue that taking time off, especially if you have kids living at home, adds to your overall well being.

Frankly, as I am now a year away from having both of my kids out of the house and in college, my wife and I regret a bit NOT taking more family vacation time with our kids, especially over the last 10 years or so, where they were old enough to not have to plan for naps, short length adventures, etc. That really was exacerbated by these last couple of COVID years where I had it in my head that I basically HAD to work all the time to keep the cash flow going and shouldn't take extra time off more than my normal 3 day weekend my schedule gives me every week. The burn out factor from that, on top of being in practice now for closing in on 25 years, was frankly a STUPID way to look at things.

Frankly I wish that I had taken 3 or 4 full weeks off each of the last few years (as I did prior to COVID) to not only enjoy some experiences with my family, but also just to let my mind get away from all of the stresses of the last few years, let alone the stresses of running a business. The reality is that if doing so caused my year end production to go down a couple of percent, the reality is that it wouldn't of been the end of the world, I still would of been able to pay my staff and my self everything expected, and frankly I probably would of had a few less situations where the stress seemed much greater than the actual issue infront of me dictated.

I guess to me ultimately, I get more now that I am in my 50's than when I was in my 30's and 40's that I want to not have what defines me be primarlity associated with what I do at work when my loupes are on and my gloved hands are holding a handpiece that is spinning away in a patients mouth, that the times you take to do things outside of work that you enjoy, with people that you enjoy, is ultimately far more rewarding that what the profit/loss statement that the accountant provides my practice shows (as long as it is a profit ) . That was summed up to me by my mother recently when she told me that she probably apprecaites the time she gets to spend with her grandkids at the ages they're at now (mainly teenagers) than she did with my brother and I when we were teenagers as she didn;t get how busy was really was with other things at that time, and things that really weren't as important as it seemed like they were at that time, since it's the memories with family that are ultimately far more satisfying than all of the various PTA and youth sports committies she chaired and volunteered for outside of her "regular" job of an elementary school teacher. I get that way more now that I did a few years ago, and fully have been trying to adjust things in my life away from work and more towards family and fun, which ultimately to me is the more important thing and makes me feel way more successful than just simply monetary measures

Yeah, when you practice in a saturated market like CA, you have to work much harder to compete against other private offices and corp offices in the area. It takes a lot of time and effort to build the reputation. As soon as you stop spending time to run and manage your office, it declines quickly. That’s what happened to my wife’s practice. My wife stopped going door to door to meet the referring GP when our youngest child started 5th grade. And her practice went from opening 16 days/month down to just 4 days/month now. She used to work 6 days/wk…now she only works 1 day/wk. And that’s ok because we already paid off our student loans.

A lot of my friends, who are at my age, still have to worry about work, paying the home mortgage, saving for retirement, inflation, recession etc. I recently bought a house (downsizing) and moved to this new neighborhood. I notice that all of my new neighbors (except one) are older than me (I am at your age….50). Many of them still have to work full time. Many of them still probably have a home mortgage to pay.

I have zero regret. I would be a huge regret for me if I didn’t work hard right after graduation….when I was in excellent health....when ortho was still in its golden years. Now, even if I wanted to make more to save for my retirement, I couldn't because I am not in the same health shape as I once was. Now, ortho is in decline…. there are not enough ortho patients to keep you busy even if you want to work hard now. It feels good to be debt-free. It feels good to see my kids growing up with a much better lifestyle than what my parents gave me. Many years ago, when my kids were still very young, I had always had the fear of getting a terminal illness… and death etc. Who would take care of my helpless kids? Now, being financially independent, I no longer have such fear. If something very bad happens to me, my kids will be fine…..their college tuitions will be paid for….all my investment properties will become theirs.

I think taking off for 3-4 weeks for vacation is way too long. I am the type of person who hates to sit around doing nothing at home. It killed me when I had to stay home 2.5 months during the Covid shutdown 2 years ago. Last week, we spent 8 days vacation in Miami and Key West areas….and both of my kids felt it was long enough.

If I had regret for working so hard in the past, I wouldn't come on here to share my wonderful life experience with the students and new grads. In comparison to other health professionals (physicians, pharmacists, PA, nurses), I still work way less than them. Gotta work hard now if you don't want to work when are in your late 50s and 60s. It's your fault, if you can't give your kids the good life like their friends at school have....like what your parents gave you. I you choose to work less and earn less revenue, then don't go around and complain that dentistry is a horrible profession.

It feels very good not to be a slave to the banks.

 

[Roto Picante]

I think though that you have to look at things not just from the "the financial success of my practice is the most important measure" and also bring into the quality of life issue that taking time off, especially if you have kids living at home, adds to your overall well being.

Frankly, as I am now a year away from having both of my kids out of the house and in college, my wife and I regret a bit NOT taking more family vacation time with our kids, especially over the last 10 years or so, where they were old enough to not have to plan for naps, short length adventures, etc. That really was exacerbated by these last couple of COVID years where I had it in my head that I basically HAD to work all the time to keep the cash flow going and shouldn't take extra time off more than my normal 3 day weekend my schedule gives me every week. The burn out factor from that, on top of being in practice now for closing in on 25 years, was frankly a STUPID way to look at things.

Frankly I wish that I had taken 3 or 4 full weeks off each of the last few years (as I did prior to COVID) to not only enjoy some experiences with my family, but also just to let my mind get away from all of the stresses of the last few years, let alone the stresses of running a business. The reality is that if doing so caused my year end production to go down a couple of percent, the reality is that it wouldn't of been the end of the world, I still would of been able to pay my staff and my self everything expected, and frankly I probably would of had a few less situations where the stress seemed much greater than the actual issue infront of me dictated.

I guess to me ultimately, I get more now that I am in my 50's than when I was in my 30's and 40's that I want to not have what defines me be primarlity associated with what I do at work when my loupes are on and my gloved hands are holding a handpiece that is spinning away in a patients mouth, that the times you take to do things outside of work that you enjoy, with people that you enjoy, is ultimately far more rewarding that what the profit/loss statement that the accountant provides my practice shows (as long as it is a profit ) . That was summed up to me by my mother recently when she told me that she probably apprecaites the time she gets to spend with her grandkids at the ages they're at now (mainly teenagers) than she did with my brother and I when we were teenagers as she didn;t get how busy was really was with other things at that time, and things that really weren't as important as it seemed like they were at that time, since it's the memories with family that are ultimately far more satisfying than all of the various PTA and youth sports committies she chaired and volunteered for outside of her "regular" job of an elementary school teacher. I get that way more now that I did a few years ago, and fully have been trying to adjust things in my life away from work and more towards family and fun, which ultimately to me is the more important thing and makes me feel way more successful than just simply monetary measures

Amen, work is not life.

 

[charlestweed]

Just found out that my office manager got Covid. I told my wife that I will cancel all of my patients for tomorrow but she insisted not to that. My wife begged me to let her go to work with me so she can help cover for the office manager. I hope my wife will know what to do. As of right now, she doesn’t even know (neither do I) how to use the credit card machine to collect payments from patients. It’s gonna be a wild day tomorrow.

It’s cool that my wife and I will have lunch together tomorrow. Yay! more bonding time for us. Looks like my wife will have to help me again this coming Saturday as well. It's cool to be my own boss. Who says work can't be fun!!! Why must fun and work be separate activites?

 

[voxveritatisetlucis]

Interesting

 

[Cold Front]

Interesting

Inflation was 9.1%, so dentists real income declined if the service index was 1.9%.

There is a shortage of dental workforce; assistants and hygienists. So wages will be the number 1 inflation for dentists, and they will have to pay that cost out of their bottom line. Therefore less income, specially if there is a recession; reduction of dental services volume.

 

[odontoblaster90210]

Inflation was 9.1%, so dentists real income declined if the service index was 1.9%.

There is a shortage of dental workforce; assistants and hygienists. So wages will be the number 1 inflation for dentists, and they will have to pay that cost out of their bottom line. Therefore less income, specially if there is a recession; reduction of dental services volume.

Well, that 1.9% increase is just for the month of June. The CPI increase was 9.1% from 1 year ago. The CPI is 1.3% for just the month of June. So actually, the service index increase was actually greater than inflation, which is good.

 

[2TH MVR]

Not to be a downer, but the recession along with the historic inflation is going to be a real killer. People (patients) will start to entrench very soon if not already. It's a weird time right now. In Phx-Scottsdale .... the (Temp) run-up in housing values combined with the out of control inflation, high gas prices, airline issues, staffing shortages, etc. etc. ........................ Just a weird time. This is a very different recession compared to the 2007-2009 great recession.

I don't see how people living paycheck to paycheck can deal with the cost of gas right now. Credit card balances are going to sky rocket.

Throw in the drought in the SouthWest. Holy crap.

The good news. Like all recessions. It will pass. Wash-Rinse-Repeat.

 

[charlestweed]

The good news. Like all recessions. It will pass. Wash-Rinse-Repeat.

In other words, we will be fine. Just work hard and save. We are living in the best country in the world. The recession and the inflation in the US aren't the worst. Other countries depend on our economy and they are facing much worse economic problems than us. Americans might pay more for college and healthcare than people in other countries but there are plenty of things that are much cheaper in the US. If you live in developed countries like Japan, Germany, France, expect to pay more for things like cars, gasoline, food, beer, shoes, iphones etc. Dentists in the US make a lot more than dentists in other countries.....thanks to the free market capitalism.

2THMVR and I are both older dentists and we have experienced more than one recession. We both have worked for a long time…. have paid off all our debts….and have saved for our retirements. Therefore, we don’t see this current recession as a big deal. This recession is the first one for many young grads and of course, they are scared. It’s like their first car wreck. I think when these young grads reach our ages (20+ years from now), they won’t see the recessions, which will inevitably happen again and again, as a big deal either.

 

[Cold Front]

I don't see how people living paycheck to paycheck can deal with the cost of gas right now. Credit card balances are going to sky rocket.

Throw in the drought in the SouthWest. Holy crap.

The good news. Like all recessions. It will pass. Wash-Rinse-Repeat.

Exactly. We are most likely in the middle of a unconfirmed recession and the Feds are raising rates like we are not in one. All data needed to confirm a recession are not available yet and are backward looking. The housing market is one of the areas of the economy the Feds wants to cool off. It’s starting to, as housing demand slow down is good to take some of the inflation crisis, but too much slow down is very bad. The Feds have a very difficult task to soft land the high inflation, but it’s very unlikely as most of inflation is still in the hands of the consumers who are still spending money on credit cards that were paid off the last couple of years through an overprinted stimulus money, and energy markets that are still too hot due to capacity constraints. So the economy is in recession, we just don’t know how deep it will be. Meanwhile… Biden went to the Middle East to get some gas for America!