Will Ortho become like Pharmacy?

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D1Bound

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I want a specific thread for the state of Orthodontics. When I was growing up this was the golden specialty. Now, there are factories sorry I mean programs pumping out 45 residents a year. What is going to happen to Orthodontics? Will new grads be doomed straight to corporate with super saturated job markets similar to pharmacy? Let’s discuss

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In many healthcare professions, corporate will take over. Will it happen in your relevant lifetime? Maybe not. Could it happen in 50-100 years? Yeah why not?
Already seeing corprotization of dentistry, already seeing for profit hospitals and for profit hospital residency spots in medicine, ortho/omfs/ped/perio/omfr/prosth/etc are not immune.
 
there will be downward pressure on incomes in specialties but the floor will still be GP income otherwise there'd stop being an incentive to specialize (unless you absolutely hated general but the actual number of people like that are relatively small I'd wager and not enough to influence salaries further down but I could be wrong)
 
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there will be downward pressure on incomes in specialties but the floor will still be GP income otherwise there'd stop being an incentive to specialize (unless you absolutely hated general but the actual number of people like that are relatively small I'd wager and not enough to influence salaries further down but I could be wrong)
I think you should right about the floor of ortho income being the same as gp income. Logic says if orthos started making the same as GPs they would just work in GP offices doing a mix of GP and ortho. Theoretically this is the same for every specialty.
But I think the reason ortho has the potential to be lower than GP salary is there are so many people who genuinely hate working as a dentist that they would happily work as an ortho for less. I don't think this is the same for any other specialty, because the work of any other specialty is too similar to a GP in the sense that there are needles, blood, hard on the body etc. I think ortho is the most different aspect within dentistry.
Would I still do ortho? Yes. Would I do it if the cost of all my education for dental and ortho was around 700k? That's risky, I wouldn't do it
 
LOL. Ortho and pharmacy. I can see it now. Stop at local Walgreens, CVS, etc, etc. Go thru the drive thru. Pick up your prescriptions and at the same time .... pick up your next set of aligners. All at the drive thru window.

I see where this thread is going. Orthodontics and Pharmacy are different. Pharmacists are mostly an expense for most Corps. Orthodontists are producers.

Yes. Supply and demand. More orthodontists could mean downward trend re: salary IF ..... IFFFFFF supply (orthos) out-paces demand.

From where I'm sitting (Corp orthodontist for the last 5 years ...... previous private practice for 25 years). There is HUGE demand for orthodontics. And there is no denying that orthodontics is the BEST lifestyle, least stressful, easiest on the body specialty in dentistry. I make more money working at the Corp than my last 5 years in private practice. Seriously. And little to no stress. Clock in. Clock out. Done.

Comparing ortho to pharmacy. No.

How about all my fellow brother and sister general dentists? New schools opening all the time. In a saturated city .... there are general dentists on every corner. GPs are everywhere. Dental Corps opening all the time hiring tons of new dentists. What about the non-dental corps like Walmart, CVS, Walgreens, etc, etc. They're starting to offer dental services (general dentistry) in house.

We're all in the same boat. Corporate take-over. Good and bad.
 
LOL. Ortho and pharmacy. I can see it now. Stop at local Walgreens, CVS, etc, etc. Go thru the drive thru. Pick up your prescriptions and at the same time .... pick up your next set of aligners. All at the drive thru window.

I see where this thread is going. Orthodontics and Pharmacy are different. Pharmacists are mostly an expense for most Corps. Orthodontists are producers.

Yes. Supply and demand. More orthodontists could mean downward trend re: salary IF ..... IFFFFFF supply (orthos) out-paces demand.

From where I'm sitting (Corp orthodontist for the last 5 years ...... previous private practice for 25 years). There is HUGE demand for orthodontics. And there is no denying that orthodontics is the BEST lifestyle, least stressful, easiest on the body specialty in dentistry. I make more money working at the Corp than my last 5 years in private practice. Seriously. And little to no stress. Clock in. Clock out. Done.

Comparing ortho to pharmacy. No.

How about all my fellow brother and sister general dentists? New schools opening all the time. In a saturated city .... there are general dentists on every corner. GPs are everywhere. Dental Corps opening all the time hiring tons of new dentists. What about the non-dental corps like Walmart, CVS, Walgreens, etc, etc. They're starting to offer dental services (general dentistry) in house.

We're all in the same boat. Corporate take-over. Good and bad.
Orthodontics may be a great gig for you since tuition back in your day was worth $100 and a few guitar lessons in trade. Ortho now costs an insane amount of money and the market will be flooded in the next decade. I’m not an economist but it just doesn’t look good when a program is pumping out 45 residents a year.
 
Orthodontics may be a great gig for you since tuition back in your day was worth $100 and a few guitar lessons in trade. Ortho now costs an insane amount of money and the market will be flooded in the next decade. I’m not an economist but it just doesn’t look good when a program is pumping out 45 residents a year.

So don’t do it then? Sometimes it’s about more than money
 
I don't understand your question. The doomsday isn't here yet.

Yes, the days of hanging your shingle in your choice of prosperous suburbs with zero orthodontists are over. But there is a much larger market now as well compared to the good old days. There is so much bad ortho being done, there is a lot of full priced re-treatment to go around to be done by orthodontists that know what they're doing.
 
I don't understand your question. The doomsday isn't here yet.

Yes, the days of hanging your shingle in your choice of prosperous suburbs with zero orthodontists are over. But there is a much larger market now as well compared to the good old days. There is so much bad ortho being done, there is a lot of full priced re-treatment to go around to be done by orthodontists that know what they're doing.
Agreed.

I see a lot of orthodontists in my city making a very good income (>500k ) with minimal experience (<5 yrs following graduation).

Personally I have no issues seeing more ortho schools open. It only increases the access of orthodontists to patients. As far as the quality of the training for the newer larger schools, it’s still far better than the avg gp trying to perform ortho and getting in way over their heads.
 
Agreed.

I see a lot of orthodontists in my city making a very good income (>500k ) with minimal experience (<5 yrs following graduation).

Personally I have no issues seeing more ortho schools open. It only increases the access of orthodontists to patients. As far as the quality of the training for the newer larger schools, it’s still far better than the avg gp trying to perform ortho and getting in way over their heads.
What if that great salary doesn't persist with all these grads being pumped out? Also, 500k sounds like a great salary. When you're staring down 400k+ of dental school loans with 300-400k from ortho and accruing interest, that doesn't look that great. Maybe if you someone was able to live in their car for a few years in their late 20s early 30s out of residency.
 
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What if that great salary doesn't persist with all these grads being pumped out? Also, 500k sounds like a great salary. When you're staring down 400k+ of dental school loans with 300-400k from ortho and accruing interest, that doesn't look that great. Maybe if you someone was able to live in their car for a few years in their late 20s early 30s out of residency.
If I’m not mistaken you want to become an omfs.
Is this correct ?

Someday if you actually make it into residency and graduate as an oral surgeon you will realize that some of your greatest referrals are orthodontists.

Treat them well and stop starting threads like this.

The more orthodontists means : the more third molars and premolars/impacts canines for all oral surgeons lol.
 
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If I’m not mistaken you want to become an omfs.
Is this correct ?

Someday if you actually make it into residency and graduate as an oral surgeon you will realize that some of your greatest referrals are orthodontists.

Treat them well and stop starting threads like this.

The more orthodontists means : the more third molars and premolars/impacts canines for all oral surgeons lol.
This thread is made with genuine concern for the field of orthodontics. Orthodontics was my first love for dentistry and I still wouldn’t count it completely out of my future. I want to know if orthodontics is still going to be a decent field to pursue especially after some of the things I’ve heard real orthodontists say. I know I take after my mentor @bigtimehoosier a bit but I’m not trolling with this thread.
 
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What if that great salary doesn't persist with all these grads being pumped out? Also, 500k sounds like a great salary. When you're staring down 400k+ of dental school loans with 300-400k from ortho and accruing interest, that doesn't look that great. Maybe if you someone was able to live in their car for a few years in their late 20s early 30s out of residency.

The one with broken back would be the OMFS though.
 
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The one with broken back would be the OMFS though.
Lol hey there’s no denying that. Perhaps there should be a further push for ergonomics in oral surgery
 
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Orthodontics may be a great gig for you since tuition back in your day was worth $100 and a few guitar lessons in trade. Ortho now costs an insane amount of money and the market will be flooded in the next decade. I’m not an economist but it just doesn’t look good when a program is pumping out 45 residents a year.
It’s true that tuition was much less 20-25 years ago. I believe 2THMVR went to a program that paid him. I went to a public ortho program that only charged me $13k/year (only $5k for in-state residents). That’s why we, older orthodontists, were able to afford to have a lot of nice things….a big house in an upscale neighborhood, new expensive cars every 2-3 years, expensive vacation trips (and paid the staff to travel to attend the AAO convention with them), and having multiple investment properties etc.

Due to the high student loan debt, today new grad orthos will not have “lavish” lifestyle that we, older orthodontists, had but they should still be in much better financial shape than most people. It’s not easy to make money nowadays…even with a college degree. Today new grad orthos may not be able to afford a 5000+sf house like us, old guys, but they shouldn’t have any problem getting a 3000-3500sf house, which is still a very nice one. They may not be able to drive a Porsche 911 like 2THMVR but they shouldn’t have any problem buying a $70-80k car, which is still a very nice one. If I were a new grad ortho and only made half as much as what I am making right now, I would still be very happy….even when I had to pay $800k-1million in student loan debt. The job is easy. The assistants do most of the hard work for me. And the chance of getting sued is almost zero.

When you are a student, you may find it fun and stimulating to perform difficult surgical procedures. That’s because you are practicing under someone else’s (your instructor’s) license. Wait until you graduate from dental school and start working in the real world….I think you will change your mind, especially when you have to do these challenging procedures every single day….on older medically compromised patients. Practicing general dentistry (and oral surgery) is very stressful. That’s why some of them quit their jobs and decided to go back to school for ortho.
 
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What if that great salary doesn't persist with all these grads being pumped out? Also, 500k sounds like a great salary. When you're staring down 400k+ of dental school loans with 300-400k from ortho and accruing interest, that doesn't look that great. Maybe if you someone was able to live in their car for a few years in their late 20s early 30s out of residency.
A person with a $500k/year income shouldn’t have any problem paying back a $1+million debt. He should be in much better financial shape than someone who only makes $200k/year and has zero debt. And the assistants do most of the hard work for him.
 
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It’s true that tuition was much less 20-25 years ago. I believe 2THMVR went to a program that paid him. I went to a public ortho program that only charged me $13k/year (only $5k for in-state residents). That’s why we, older orthodontists, were able to afford to have a lot of nice things….a big house in an upscale neighborhood, new expensive cars every 2-3 years, expensive vacation trips (and paid the staff to travel to attend the AAO convention with them), and having multiple investment properties etc.

Due to the high student loan debt, today new grad orthos will not have “lavish” lifestyle that we, older orthodontists, had but they should still be in much better financial shape than most people. It’s not easy to make money nowadays…even with a college degree. Today new grad orthos may not be able to afford a 5000+sf house like us, old guys, but they shouldn’t have any problem getting a 3000-3500sf house, which is still a very nice one. They may not be able to drive a Porsche 911 like 2THMVR but they shouldn’t have any problem buying a $70-80k car, which is still a very nice one. If I were a new grad ortho and only made half as much as what I am making right now, I would still be very happy….even when I had to pay $800k-1million in student loan debt. The job is easy. The assistants do most of the hard work for me. And the chance of getting sued is almost zero.

When you are a student, you may find it fun and stimulating to perform difficult surgical procedures. That’s because you are practicing under someone else’s (your instructor’s) license. Wait until you graduate from dental school and start working in the real world….I think you will change your mind, especially when you have to do these challenging procedures every single day….on older medically compromised patients. Practicing general dentistry (and oral surgery) is very stressful. That’s why some of them quit their jobs and decided to go back to school for ortho.
You speak from a lot of experience. You are an asset to students on these forums. 1 million in debt with interest makes someone like me queasy thinking about it. Your perspective makes it seem like it really isn’t that bad. I’ve heard that same line about people quitting to go back to ortho. In reality, how many people are actually doing that?
 
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You speak from a lot of experience. You are an asset to students on these forums. 1 million in debt with interest makes someone like me queasy thinking about it. Your perspective makes it seem like it really isn’t that bad. I’ve heard that same line about people quitting to go back to ortho. In reality, how many people are actually doing that?
Yeah, $1 million in debt is a lot and you should be worried. I was too when I knew that if I included my fiance’s debt (she went to USC…4 years DDS + 3 years perio), our total student loan debt would be $450k. I was still in school and I didn’t know if both of us could make enough to pay back the loans after graduation. Even back then, I was told that perio was a dying specialty. I took a chance and married her any way. Thanks God, my wife is also a very hard worker. We both worked 6 days/wk. That’s why we could afford to buy a house and then an existing perio practice for my wife in less than 6 months after graduation. And our total debt amount went up to $1+ million ($450k student loans, $380k home loan, $120k practice loan, and 2 leased car). With our good income, we didn’t have any problem paying back the loans.

As long as you don’t plan to work 4 or less days a week, you should be fine.
I’ve heard that same line about people quitting to go back to ortho. In reality, how many people are actually doing that?
Not very many do for a lot of reasons:

-They are older and have kids to support.
-Their spouse can’t move with them because of their job. So their only option is to apply to an in-state program. This would significantly reduce their chance of getting in.
-They don’t have good enough stats to get in. They didn't try hard in dental school because they didn't plan to specialize. They didn’t do research when they were in dental school. Research is not required for ortho but having one helps a lot.
-Too expensive. Many tried to avoid applying to expensive programs. Applying to fewer programs reduces their chance of getting in. Programs that are cheap and short (2yrs instead of 3yrs) are super hard to get in because everyone wants to go to these programs.

I actually know a lot of people who switched to ortho. My little sib at my ortho program had practiced general dentistry for 7 years....he's married with 2 kids. When I went to NYU for an interview, I met an ortho resident, who had practiced perio for 9 years. I also knew a couple of OS residents who dropped out and applied for ortho. I also knew a couple of pedodontists who switched ortho.
 
Charlestweed a new documentary came out and the gentleman who had a million dollars in debt from D school + ortho had the guts to be featured. He has the opposite opinion that his pathway was not worth it, sadly he nearly broke down in tears while being filmed. I appreciate a lot of your advice over the years. The million dollars for ortho concept though, in reality, at least from this gentleman’s perspective is debilitating. I only am putting this out there because I know at some point some pre-dent will do a google search and use this thread as their “research”. I mean no disrespect by disagreement.
 
Might be the ortho Mike Meru which is old news. A million dollars in debt. I cannot comprehend the logic in borrowing this much money for a JOB. If you owed a million dollars plus (been there) for a home, practice and some school debt. Well. That's different. The home (especially now) and the practice debt are investments with tax saving strategies.

I mentioned this before. They hired this new ortho at my place of employment. This ortho owes a little over 800K. All of his effort goes into paying the loan with essentially nothing going towards saving, investments, etc. You slave away at Corporate paying taxes. There's no tax saving strategies in trading time for a paycheck. It works great for me, but my situation is different. I owe nothing.

Ortho is still a great profession. But not at all costs.
 
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Might be the ortho Mike Meru which is old news. A million dollars in debt. I cannot comprehend the logic in borrowing this much money for a JOB. If you owed a million dollars plus (been there) for a home, practice and some school debt. Well. That's different. The home (especially now) and the practice debt are investments with tax saving strategies.

I mentioned this before. They hired this new ortho at my place of employment. This ortho owes a little over 800K. All of his effort goes into paying the loan with essentially nothing going towards saving, investments, etc. You slave away at Corporate paying taxes. There's no tax saving strategies in trading time for a paycheck. It works great for me, but my situation is different. I owe nothing.

Ortho is still a great profession. But not at all costs.
The new ortho hire you mention will be the unfortunate reality for many students. It makes this neat profession seem out of reach.
 
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Charlestweed a new documentary came out and the gentleman who had a million dollars in debt from D school + ortho had the guts to be featured. He has the opposite opinion that his pathway was not worth it, sadly he nearly broke down in tears while being filmed. I appreciate a lot of your advice over the years. The million dollars for ortho concept though, in reality, at least from this gentleman’s perspective is debilitating. I only am putting this out there because I know at some point some pre-dent will do a google search and use this thread as their “research”. I mean no disrespect by disagreement.
I heard both orthos’ (Meru’s and another guy’s) stories on Dave Ramsey’s show. The reason they were in financial trouble was neither of them made over $250k/year….and neither of their wives worked. It seemed like neither of them was in a panic mode because if they were they could have worked more days to increase their incomes. Dr. Meru could have sold his house to pay down the student loan debt but he didn’t. On one of his home made videos, he showed a helicopter ride that he rented for his kid’s birthday. He drove a Tesla. He took vacations regularly. You are not supposed to take vacation when you’re broke.
 
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Might be the ortho Mike Meru which is old news. A million dollars in debt. I cannot comprehend the logic in borrowing this much money for a JOB. If you owed a million dollars plus (been there) for a home, practice and some school debt. Well. That's different. The home (especially now) and the practice debt are investments with tax saving strategies.
Home loans and student loans are different…one can be discharged in bankruptcy and the other one can’t be. But to me, they are the same because the required monthly repayment amounts for all debts are the same. Because of these debt repayments, I couldn’t spend my hard earned money on things that I like to spend on....had to make sacrifices. These debts still forced my wife and me to work 6 days/wk. I was still under the same financial stress and the only way to eliminate this stress is to work hard and become debt free ASAP. That's the Asian mentality. We, Asians, are very afraid of debt. You don't see a lot of foreclosure in communities that have a lot of Asian homeowners.
I mentioned this before. They hired this new ortho at my place of employment. This ortho owes a little over 800K. All of his effort goes into paying the loan with essentially nothing going towards saving, investments, etc. You slave away at Corporate paying taxes. There's no tax saving strategies in trading time for a paycheck. It works great for me, but my situation is different. I owe nothing.
If this ortho is in his early 30s and makes over $300k/year, he should be fine because he has plenty of time to work to save for his retirement. I owed more than $1million when I was in my early 30s…..and and over $2 million in total debt when I was in my mid 30s. I didn’t start setting up a 401k account until I was 33-34yo. I am about to turn 51 and was debt free 2 years ago.
Ortho is still a great profession. But not at all costs.
No, not at all costs, especially if you are picky about the job offers (don't want to work on the weekends, don't want to travel to multiple ofices, don't want to work for a GP etc) and are not willing to work 5 or more days/wk.
 
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Home loans and student loans are different…one can be discharged in bankruptcy and the other one can’t be. But to me, they are the same because the required monthly repayment amounts for all debts are the same. Because of these debt repayments, I couldn’t spend my hard earned money on things that I like to spend on....had to make sacrifices. These debts still forced my wife and me to work 6 days/wk. I was still under the same financial stress and the only way to eliminate this stress is to work hard and become debt free ASAP. That's the Asian mentality. We, Asians, are very afraid of debt. You don't see a lot of foreclosure in communities that have a lot of Asian homeowners.

If this ortho is in his early 30s and makes over $300k/year, he should be fine because he has plenty of time to work to save for his retirement. I owed more than $1million when I was in my early 30s…..and and over $2 million in total debt when I was in my mid 30s. I didn’t start setting up a 401k account until I was 33-34yo. I am about to turn 51 and was debt free 2 years ago.

No, not at all costs, especially if you are picky about the job offers (don't want to work on the weekends, don't want to travel to multiple ofices, don't want to work for a GP etc) and are not willing to work 5 or more days/wk.
The Asian mentality huh. It appears the Caucasian mentality trumps it from what I see on the internet. The Caucasian mentality paved the way for van life. The ultimate frugal lifestyle.
 
The Asian mentality huh. It appears the Caucasian mentality trumps it from what I see on the internet. The Caucasian mentality paved the way for van life. The ultimate frugal lifestyle.
It still costs a lot for such van lifestyle. Solar panels and battery powered generator are not cheap to set up. And you still have to worry about power outage when there is no sun during the cold winter months. You have to pay for repairs and maintenances. You have to worry about where to safely and legally park your van at night. People still consider you “homeless.”

It’s much cheaper and more comfortable to share a room with a roommate and drive a beat up car. That’s what we did when we first came to America. My dad and I shared a 2 bedroom apartment with complete strangers….a married couple with 1 kid. We found them through a very popular Asian classified ads in our community. We only paid $200/month for a room....free water and electricity. The rent for 1 bed aparment at that time (1986) was around $500/month and with my dad’s income of $800/month, we couldn’t qualify to rent such apartment. When my mom and my siblings reunited with us (through US chain migration policy) in America, we bought a 4 bedroom house for $134k. We lived in 1 bedroom and the garage and rented out the other 3 rooms to 3 different strangers.
 
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It still costs a lot for such van lifestyle. Solar panels and battery powered generator are not cheap to set up. And you still have to worry about power outage when there is no sun during the cold winter months. You have to pay for repairs and maintenances. You have to worry about where to safely and legally park your van at night. People still consider you “homeless.”

It’s much cheaper and more comfortable to share a room with a roommate and drive a beat up car. That’s what we did when we first came to America. My dad and I shared a 2 bedroom apartment with complete strangers….a married couple with 1 kid. We found them through a very popular Asian classified ads in our community. We only paid $200/month for a room....free water and electricity. The rent for 1 bed aparment at that time (1986) was around $500/month and with my dad’s income of $800/month, we couldn’t qualify to rent such apartment. When my mom and my siblings reunited with us (through US chain migration policy) in America, we bought a 4 bedroom house for $134k. We lived in 1 bedroom and the garage and rented out the other 3 rooms to 3 different strangers.
That story commands respect
 
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That story commands respect
@charlestweed is the embodiment of the American Dream!

4AE5E10C-8E68-4B30-9478-92648A37C98F.jpeg


Big Hoss
 
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God bless America
 
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My back is fine. I operate standing up, and I am constantly walking from the consult area to the surgery area…and back again. If I had my wife app that counts her steps, I bet I would have at least 167.

Thanks for asking.

God Bless America.
 
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I think the question should be, will dentistry be like pharmacy and the answer would be.. probably yes in 10 yrs from now or max 15-20 yrs.
 
I think the question should be, will dentistry be like pharmacy and the answer would be.. probably yes in 10 yrs from now or max 15-20 yrs.
Maybe don't drown yourself in 400k+ debt to see a handful of patients a week in an overcrowded and controversial residency program like GSO if you think the field is going to go the way of pharmacy in the next decade?
 
I think the question should be, will dentistry be like pharmacy and the answer would be.. probably yes in 10 yrs from now or max 15-20 yrs.
I think dentistry is more comparable to the medical market than pharmacy. We don’t sell manufactured goods like pharmacy; we sell services.
 
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I have a personal service corporation because I provide a service.

But, at the end of the day, I am there to take care of the patient.

“The best interest of the patient is the only interest to be considered…”
 
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