ADA Brief on Dentist Income

[Complete_newbie]

The problem with dentistry would be

1. Heavier student loan debt

2. Practice buying / building expense.

I think it'll be easily 1M of debt to get going with 400K income. I think medical sub specialists come out ahead pretty quick in that scenario.

[AnesPain]

Vagabond MD wrote:

I have spoken to dentists, prospective dentists, and the parents of prospective dentists over the years, all of whom believed that the financial outlook for dentists was much brighter than for MDs (with the exception of my father, a retired orthodontist!).

The argument was that dentists run a “cash” business and could charge whatever they wanted–and get it–with minimal interference from insurance companies and government entities. I always thought that this was overly optimistic and am not surprised that income among dentists may also be stagnant. After all, the same people who do not have money to pay for health insurance, deductibles, medication copay and other out of pocket medical costs don’t suddenly have an extra $5000 for crown and bridge work– or do they?

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While they do run into more insurance problems, they do generate plenty of cash business.  You would also be surprised how many people are willing to drop that kind of cash on their mouths (it's a much more emotional justification).  I provide anesthesia services for a group of my college friends who are in a dental practice together.  My own patients who won't pay/complain about their copay at my office, will come in there and drop several thousand dollars (mostly through care credit) on dental work and sedation at their office.  I have had another one of my patients ask me to wave our fees (the sames ones I have no power to negotiate) because she needed to pay for dental work and the dentist would not reduce his/her fees.  I think to some degree there is a different mentality (almost entitlement) when it comes to medical care.

I think if you can stay out of corporate dentistry, market well, and find the proper niche, you can still be very successful as a dentist.  My friends do very well, I would say better than the average MD in town.  Considering 2 completed a one year GPR, one dental school only, and 1 a 3 year residency in prosthodontics, it is even more impressive.

[scott]

I wouldn't necessarily agree with the heavier student loan debt and practice/building purchase be a reason the medical sub-specialties to come out that much ahead.  I'm 46 years old and have been practicing for 20 years.  I work 8-5 three days a week (Wednesday off) and 8-2 on Friday. As a solo practicing dentist (who sells no products to my patients), the office grossed approximately 1.3 million last year with a 65% overhead. I generally work 175-180 days per year and take 6 weeks off every year.

All that being said, the Dental Service Organizations are definitely impacting the new grads and will have a major impact on the profession in the next several years.  To combat this, many dentists are likely going to move towards a group practice model so we can compete with the hours the Aspen, Pacific and Heartland dental DSO's offer. As others have said, the quality of care varies when it comes to the corporate model because they are more concerned with the numbers as opposed to what may be in the best interest of the patient.  Where the solo practitioner has the advantage however, is that we don't answer to anyone else except our team and the patients and we are able to build lasting relationships with both.

[Complete_newbie]

So your net is ~450K

How long did it take you to get there? I mean there is a ramp up period. Lets say you get out of dental school at 28 yrs (24 avg age of entrance + 4). Now you go further in debt close to a million (includes dental school debt) to start practice. You are not hitting 1 million gross. Far from it. You build practice and it takes you 5-8 years to hit like 250K net, then another 5-8 years to hit peak near 400-425k. By now you are in your 40s.

Here is MD. Finish medschool 28. Then lets pick EM. Out at 31. Starting pay 250K. 2 year partner 350K. So at 35 he is already making more and has less debt than the dentist. Specialist? Lets pick me. I am 31 right now. Will be 32 mid december, but I start my job in July. 350K start + 50 K bonus. 2 year partnership 600K. Vacation of 10 weeks btw. My debt isn't as much as a dentist.

[MochaDoc]

Rb52dds wrote:

The student debt and DSOs have ruined the profession for new grads. I won’t encourage my kids to be dentists unless I can pay their tuition.

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How will paying for your kids' dental school tuition address the issue of lower pay? Even if they don't have to take the first low-paying offer they receive, won't their incomes still be negatively impacted by the fact that the majority of newly minted dentists will? Basically, if everyone else is willing to work for $2/hour it's unlikely they'll be able to negotiate $10/hour for the same job.

[scott]

Complete_newbie wrote:

So your net is ~450K

How long did it take you to get there? I mean there is a ramp up period. Lets say you get out of dental school at 28 yrs (24 avg age of entrance + 4). Now you go further in debt close to a million (includes dental school debt) to start practice. You are not hitting 1 million gross. Far from it. You build practice and it takes you 5-8 years to hit like 250K net, then another 5-8 years to hit peak near 400-425k. By now you are in your 40s.

Here is MD. Finish medschool 28. Then lets pick EM. Out at 31. Starting pay 250K. 2 year partner 350K. So at 35 he is already making more and has less debt than the dentist. Specialist? Lets pick me. I am 31 right now. Will be 32 mid december, but I start my job in July. 350K start + 50 K bonus. 2 year partnership 600K. Vacation of 10 weeks btw. My debt isn’t as much as a dentist.

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For me personally, I graduated when I was 26 with 125K student loan debt (in 1997).  I worked as an associate for 4 years making 150-200K and paid off my student loans before purchasing a practice in 2001. Practice purchase was around 475K. That was paid off within 5 years. After buying the practice is where the quick ramp up period began. Honestly I don't remember what I was bringing in right away, but I know it was 250-300K and that has steadily increased. I built a building(and have a tenant leasing space) in 2012...that should be paid off in 2022.  I agree that I'm at my peak earning years right now, and I work 30 hours a week and have for the last 15 years. This has helped me avoid some burnout (although I wouldn't mind cutting back to three days a week sometime in the not too distant future - and that will likely involve me bringing in an associate).

I'm not saying one is better then the other and by all means congratulations to you for picking such a great career. I am simply responding to the OP regarding dentists salaries. For private practitioners not in the corporate world, this is woefully low. I would be curious to see what the results would be if the study only entailed private practicing dentists not affiliated with corporate dentistry.

[scott]

MochaDoc wrote:

Rb52dds wrote:

The student debt and DSOs have ruined the profession for new grads. I won’t encourage my kids to be dentists unless I can pay their tuition.

Click to expand…

How will paying for your kids’ dental school tuition address the issue of lower pay? Even if they don’t have to take the first low-paying offer they receive, won’t their incomes still be negatively impacted by the fact that the majority of newly minted dentists will? Basically, if everyone else is willing to work for $2/hour it’s unlikely they’ll be able to negotiate $10/hour for the same job.

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Paying for the kids dental school tuition doesn't address the lower pay, but it does address the fact that the kids won't come out of school with any debt. So even at lower pay (150-200K) the fact that there is no debt will certainly get the kids off to a great start for their career.

[Zaphod]

The difference is dentists make a lot for time spent working, which is important. I mean if you dont like your income work an hour longer or the full week. Those that do will do well when others simply dont care to.

[pfaucette]

Complete_newbie wrote:

So your net is ~450K

How long did it take you to get there? I mean there is a ramp up period. Lets say you get out of dental school at 28 yrs (24 avg age of entrance + 4). Now you go further in debt close to a million (includes dental school debt) to start practice. You are not hitting 1 million gross. Far from it. You build practice and it takes you 5-8 years to hit like 250K net, then another 5-8 years to hit peak near 400-425k. By now you are in your 40s.

Here is MD. Finish medschool 28. Then lets pick EM. Out at 31. Starting pay 250K. 2 year partner 350K. So at 35 he is already making more and has less debt than the dentist. Specialist? Lets pick me. I am 31 right now. Will be 32 mid december, but I start my job in July. 350K start + 50 K bonus. 2 year partnership 600K. Vacation of 10 weeks btw. My debt isn’t as much as a dentist.

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Your comparison isn't exactly apples to apples.  Why not compare a general dentist to a general practitioner/internal medicine doc?  Specialists in dentistry tend to make much more than generalists, similar to medicine.  I know orthodontists and oral surgeons who earn $1 million+ a year.

 

[Complete_newbie]

Well you have a point. Still "super" specialist MDs - Neurosurgeons, plastics, cards (PP partner) can generate more than that.

I am a radiologist. While this is a specialty its not really a "super" specialty.

How many OMFS graduate in a year? Bet that number is probably close to neurosurgeons.

I suppose more gradation in medicine than dentistry.

Private practice family docs DO make 400k in their practice. Similar to general dentist who owns his/her practice. The trend to corporatization and higher debt is MORE prevalent in dentistry than in medicine, which to me, makes it less appealing was my point.

[LongInTheTooth]

Besides being a retired dentist, I am still a tax accountant who still does tax work for physician and dentist friends.  It has been my observation that the net income depends on how hard you work.  Dentists probably make more per hour than physicians but choose to work less hours.  Physicians annual income is usually more because they worked harder.  A major factor in either field is how good a business person they are.

My advice to any young person going into healthcare is to never choose your specialty based upon income potential in that field.  Choose the field you like most and that is where you will make the most money.  If generating income is your primary goal, then you probably messed up by becoming a healthcare provider.  The people who now make the money in healthcare are the CEOs, MBAs, etc. who hire the licensed healthcare providers to be the new "burger flippers" for their hospitals, DSOs, MSOs, etc.

[Complete_newbie]

Good point.

Modern burger flippers.

"That may be, but at least I won't be unoriginal. But I mean, if you have a problem with that, I mean, we could just step outside - we could figure it out." - Good Will Hunting.

[Rb52dds]

If my kids passionately want to be dentists, I will find a way to pay for it. I often wonder since dental school is often the equivalent of $300k-$400k today if I wouldn't be better off telling them to be a teacher or engineer and put that money in a trust fund or something for them instead. Takes a lot of years even making good money to save that kind of money. Imagine just giving a 25 year old kid $400k.... it doubles every 7 years theoretically....is education the best investment?

I understand I'm an outlier. I work 2.5 days a week and net around $400k as a owner dentist. I have 2 full time associates and that is its own headache. Dental specialists I know are making 7 figures.... but work harder. I could make double what I do working full time... but at some point how much money do you need? I am thankful we have the flexibility we do. I've seen my brother in law who's family practice work 50+ hours a week for $250k....

Point of all of this is that the freedom and lifestyle I've enjoyed is much more difficult for new grads. It took me about 10 years to get over the $350k mark. I graduated at 24.... so since 34 I was at that level. I also see my practice as an asset I can sell when I'm done--current value is over $1M. I will say $400k as a business owner is not as good as $400k as an employee. I am jealous of some of the retirement plans and other benefits some mention on WCI..... I have zero benefits. My spouse has a nice teaching job with great benefits so that combination has served us well.

[Practice]

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<div class="pageContent"><form class="InlineModForm section" action="inline-mod/post/switch" method="post" data-imodoptions="#ModerationSelect option" data-controls="#InlineModControls" data-cookiename="posts">Here's a link to a summary article:

<a href="http://www.dmdtoday.com/news/how-dentists-income-has-faired-since-the-recession?utm_source=Informz&amp;utm_medium=Dentis t%27s+Money+Digest&amp;utm_campaign=DMD%5FNewslett er%5F12%2D21%2D16">http://www.dmdtoday.com/news/how-dentists-income-has-faired-since-the-recession?utm_source=Informz&amp;utm_medium=Dentis t%27s+Money+Digest&amp;utm_campaign=DMD%5FNewslett er%5F12%2D21%2D16</a>

A few quotes for the article and the actual ADA Brief:

"In 2015, general dental practitioner net earnings averaged $179,960. Those owning their own practices averaged $195,200 while non-owners netted approximately $132,370. Dental specialists brought home more, averaging around $320,460.

However, when adjusted for inflation, the average net income for all general dental practitioners has decreased substantially since the peak value was recorded in 2005. That year, the average net income was $219,638.

On the supply side, new research shows that the supply of dentists is expected to increase in the coming years. If the dental sector is indeed entering an era of flattening total dental spending and an increasing supply of dentists, this will have important implications for the bottom line of dental practices."

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I'm dunno, this is just too general. If a dentist even does just a little bit of marketing they could probably beat these numbers, significantly. Everyone is going to need a dentist. We eat more sweets than ever and that just simply rots teeth over time, and people will have to go to the dentist. The problem is that most dentist are introverts and don't do any marketing at all.

Most just get an office and hang a sign up and wait for patients. If a dentist spend time just learning some basic marketing techniques, and these days it's easier than ever with social media, then they can make more money than these average numbers.

[Peds]

FYI this is a 3 year old thread for those catching up.