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The Future Of Dentistry Is Cr*p...


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It is actually a reciprocal agrewment between several countries for dentists.

 

The MDs who want to work in urban areas simply can't if there is no funding for them. It is different for dentists whose employment is not tied to hospital resources for the most part. I.e. it isn't as simple as what you are trying to say. There are also financial incentives to work in more rural areas for MDs.

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 One of my professors from dental school joined the corporate world of dentistry and he spoke of a future where the big guys with the suits make big bucks and the working dentists get chump change. 

 

This very much reminds me of the effort by ON government. in a recent bill, to gain more control of MD, especially family MDs. Essentially instead of corporate personnels earning the big money managing DDS, it'll be bureaucrats earning big money managing MDs. Of course the government is sneaky in that they don't want MD to become employees of the government, because then they can join CUPE and have all those expensive pensions and benefits. They want an environment whereby MDs, as independent contractors, will be cannibalizing each other for the little bits of money government hands out (aka hard budget cap). For those who don't know, provincial College of Physicians has the ultimate control over number of licenses issued, so in essence MDs have very little control over the supply. MDs are also at a disadvantage because they have no control over hospital budget, and cannot bill outside of OHIP.

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I agree with your frustration, its a ton of debt for a career that may or may not give you financial security. With the influx of foreign dentists, its definitely becoming oversaturated. I like how the American system only recognizes Canadian grads as equal, making it a longer path for foreign trained dentists to get licensed but the government sees it differently. For me personally, I worked and owned in the GTA for 6 years but once I saw three clinics open up within 1 km of each other, I knew that was it. I decided that moving to the states was a better option for me at the time (the dollar was at par and I had PR status). Now, I own 4 practices and work 2 days a week, making a good income and raising the family.

I'm a little confused are you saying that the employment climate is better for dentists in the US, or was it just better at the time? I ask because from what I've heard you guys have it worse then us 

 

Edit: this is what I'm referring to http://forums.studentdoctor.net/threads/do-not-go-into-dentistry-trust-me-it-is-saturated.1170539/

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I love dentistry, and even if I was not aiming for the "big bucks", I was pretty sure that I could make at least 120-130k as an associate somewhere around Montreal (with the debts, that is the amount I was aiming for to live comfortably). With all the negative things I heard on this forum about the future of dentistry, I'm feeling less and less enthusiastic about my choice, and I'm in the process of changing my career path... That's too bad.

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I love dentistry, and even if I was not aiming for the "big bucks", I was pretty sure that I could make at least 120-130k as an associate somewhere around Montreal (with the debts, that is the amount I was aiming for to live comfortably). With all the negative things I heard on this forum about the future of dentistry, I'm feeling less and less enthusiastic about my choice, and I'm in the process of changing my career path... That's too bad.

 

Me too, the competition is too much to handle. I literally just went to Rona to make a little house improvement and I peaked at the newspapers they had at the service desk and right on the front page "Free Dental teeth whitening". I can't put up with that, I'm sorry. I can't imagine the amount of money we'll have to spend to advertise our clinics in order to gain a few more patients...it's like opening a restaurant now like come on.

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I don't understand why even if there's a shortage of doctors in Canada (or so they say), how come the OMA doesn't accredit foreign dental school and allow internationally trained MD's to come practise here? Wouldn't that solve the problem? Apparently that's what the government thought when they opened that door for internationally trained dentists. 

There's no shortage anymore. A mild distribution problem, but absolutely no shortage. Its very oversaturated in many areas, particularly surgical. The jobs literally do not exist in some areas

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Me too, the competition is too much to handle. I literally just went to Rona to make a little house improvement and I peaked at the newspapers they had at the service desk and right on the front page "Free Dental teeth whitening". I can't put up with that, I'm sorry. I can't imagine the amount of money we'll have to spend to advertise our clinics in order to gain a few more patients...it's like opening a restaurant now like come on.

 

 

I understand. In my case, I was not looking to open my own practice, I wanted to be an associate. But with the amount of debt in front of me, If I end up with a salary lower than 120-130k I don't think it's worth the time and the effort. It was never a question of living the big life, or driving a BMW, I wanted to be a dentist because I truly enjoy oral health and the surgical aspect of the profession, but with all the people around saying it's going to be bad (less than 100k as a new grad, or even less than 130 as a senior associate...), It's getting hard to move forward. My girlfriend and my family live in Montreal, and I don't see myself moving 2 hours out of the city to make money. 

 

I was optimistic, now I feel a little bit depressed to be honest.

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There's no shortage anymore. A mild distribution problem, but absolutely no shortage. Its very oversaturated in many areas, particularly surgical. The jobs literally do not exist in some areas

 

There is a "mild distribution" of dentists as well, and the government decided to train an additional hundreds of dentists per year in order to fix that but it didn't, it just caused over-saturation. However, this isn't a problem in MD's, you don't see 3 family clinics within 1km fighting for patients in local newspapers. I just find it sad. 

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I understand. In my case, I was not looking to open my own practice, I wanted to be an associate. But with the amount of debt in front of me, If I end up with a salary lower than 120-130k I don't think it's worth the time and the effort. It was never a question of living the big life, or driving a BMW, I wanted to be a dentist because I truly enjoy oral health and the surgical aspect of the profession, but with all the people around saying it's going to be bad (less than 100k as a new grad, or even less than 130 as a senior associate...), It's getting hard to move forward. My girlfriend and my family live in Montreal, and I don't see myself moving 2 hours out of the city to make money. 

 

I was optimistic, now I feel a little bit depressed to be honest.

Yea, don't get me wrong, 100k is a good salary, but unfortunately not for dentistry. Dentists are supposed to be professionals who trained for 4 years of their life studying non stop and stressing over competitive admissions....and taking on considerable debt... it's not worth it!

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If it makes you feel any better you guys could always try joining the dental officer program with the military, they pay for your tuition and give you a yearly salary during school and you have a guaranteed 140k salary after you graduate. I've always wanted to be a part of the forces and i figured this was the best contribution I could make while also pursuing my passion and possibly staying here in ottawa (no guarantees), however i understand that the military is not for everyone. 

 

As for this thread its too depressing, I'd rather dig my head in the sand as dumb as it might sound. 

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Actually in healthcare buildings, you will see the number of FMs outnumber any other healthcare practitioner. We are talking 40 in a 4 floor building. And they do actually have a solid amount of patients each.

 

A good way to put it is that in dentistry, it is a free for all but if you were to do the same thing and spread out all the MDs from hospitals the same way dentists are, you would feel the same vibe of oversaturation. Sunny is correct. It is a distribution issue for both dentists and physicians.

 

Also, dentistry is ELECTIVE care so with all the competition these days, you will need business sense to do well. Having a DDS/DMD does not guarantee a high salary, it gives you the opportunity to make a high salary. That and its other benefits make it still a great career (think Malkynn) but you need to be smarter about things. It is not what it used to be but many things aren't either these days.

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Actually in healthcare buildings, you will see the number of FMs outnumber any other healthcare practitioner. We are talking 40 in a 4 floor building. And they do actually have a solid amount of patients each.

 

A good way to put it is that in dentistry, it is a free for all but if you were to do the same thing and spread out all the MDs from hospitals the same way dentists are, you would feel the same vibe of oversaturation. Sunny is correct. It is a distribution issue for both dentists and physicians.

 

Also, dentistry is ELECTIVE care so with all the competition these days, you will need business sense to do well. Having a DDS/DMD does not guarantee a high salary, it gives you the opportunity to make a high salary. That and its other benefits make it still a great career (think Malkynn) but you need to be smarter about things. It is not what it used to be but many things aren't either these days.

 

Sigh. Too bad dental clinics don't have a solid amount of clients each. Some do and some don't. New grads are very likely to end up in the "don't" due to their inexperience and it shouldn't be that way. All I'm saying is dentists shouldn't have to FIGHT for patients, it's getting crazy. 

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There are many reasons why some dentists are much more successful than others (in no particular order): business acumen, interpersonal skills (patients want to come to a great personality who is ethical and trustworthy and calms them down), clinical skills (for example, you are able to be better at your hand speed and skill and you cause minimal pain), expansion of services (CEREC, STO, Powerprox, etc.), competitive pricing, and etc. Not every dentist is struggling but it is not as much of a guarantee these days for sure. You need to possess some if not all of the above traits I described to do well. Create your own niche. Remember, in dentistry: you are your own brand.

 

I think the competition is insane but there is reason why some dentists win the fight you are talking about. And it is not all coincidence. It takes a lot of calculation and trial and error. It is stressful (production goals can be very stressful) but there is still a big reward. It is not all doom and gloom as this thread is making it. Dentistry is evolving. Also, the oversaturation is ONLY one of its issues. The lack of billing fee increases, the ability for denturists and hygienists to create their own practices without any dentist involved are other issues. But dentistry in Canada still has its good points: lower corporate tax, no PPO or HMO or Medicaid, very little corp penetrance, and etc. For every pain point, there is still a point to be hopeful for. No career is perfect. While dentists should not fight for patients, dentists should not expect patients to show up at their door. Patients are frugal and smarter about oral health these days. The internet can provide ample information (reviews, etc.) for them to make more education decisions about who their practitioner may be. Once again, this career is evolving. One needs to learn to adapt.

 

Medicine is safer (relative to dentistry) but it is facing its own share of issues these days. And the issue is that medicine is a career where for sure your location is secondary to being able to find a job. This is just one of the many sacrifices MDs make. Nothing is easy out there.

 

Cheers

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There are many reasons why some dentists are much more successful than others (in no particular order): business acumen, interpersonal skills (patients want to come to a great personality who is ethical and trustworthy and calms them down), clinical skills (for example, you are able to be better at your hand speed and skill and you cause minimal pain), expansion of services (CEREC, STO, Powerprox, etc.), competitive pricing, and etc. Not every dentist is struggling but it is not as much of a guarantee these days for sure. You need to possess some if not all of the above traits I described to do well. Create your own niche. Remember, in dentistry: you are your own brand.

 

I think the competition is insane but there is reason why some dentists win the fight you are talking about. And it is not all coincidence. It takes a lot of calculation and trial and error. It is stressful (production goals can be very stressful) but there is still a big reward. It is not all doom and gloom as this thread is making it. Dentistry is evolving. Also, the oversaturation is ONLY one of its issues. The lack of billing fee increases, the ability for denturists and hygienists to create their own practices without any dentist involved are other issues. But dentistry in Canada still has its good points: lower corporate tax, no PPO or HMO or Medicaid, very little corp penetrance, and etc. For every pain point, there is still a point to be hopeful for. No career is perfect. While dentists should not fight for patients, dentists should not expect patients to show up at their door. Patients are frugal and smarter about oral health these days. The internet can provide ample information (reviews, etc.) for them to make more education decisions about who their practitioner may be. Once again, this career is evolving. One needs to learn to adapt.

 

Medicine is safer (relative to dentistry) but it is facing its own share of issues these days. And the issue is that medicine is a career where for sure your location is secondary to being able to find a job. This is just one of the many sacrifices MDs make. Nothing is easy out there.

 

Cheers

 

I see your point but while some dentists may be winning the fight, they're the long standing clinics (long term patients + word of mouth) But for someone who isn't practising right now, what would make a customer come to me once I graduate with no clinical experience outside of school? I would have to either associate (with very little % salary if I'm not grossing enough due to over-saturation) or open my own clinic and spend A TON of money to advertise and promote my clinic in hopes of getting customers to choose my practise instead of the one across the street. 

 

My point is I thought dentists could focus on dentistry and love their profession. Boy was I wrong...nowadays dentists focus on advertising their clinics in local newspapers, on billboards and on the radio. 

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From what I hear, its pretty bad in the GTA, Vancouver and Montreal but better in other parts of the country. I can't speak on behalf of all of the US but the employment environment for dentists in my state (and city for that matter) is good. I've hired new grads and there isn't much fuss about saturation, with people finding employment relatively easily. I know that NYC and SF/LA have saturation problems, but I'd think its still better to practice in the states. Without disclosing too much about myself, I live in an urban centre, love my job and staff. My overhead is lower than my Canadian orthodontic friends, my taxes are less and my cost of living is significantly lower than the GTA (but of course I have to pay for full health insurance). Apparently, Toronto's real estate market has been going through the roof, only adding to the misery of people trying to settle down and raise a family. That thread was an interesting read, but I'm guessing the stigma is that dentistry = $$$ with less hours of work = high-roller lifestyle. You have got to work hard and like Lebron James says..nothing is given to you, everything is earned. The potential to make money is there, its about proper execution, which can be done. 

 

Easier for an orthodontist though, they're not as saturated. However, in 10 years, for GP's, I see them at the same level as pharmacists, job opportunity wise. Salaries will continue to drop, and the dentist/population ratio will skyrocket leading to declining income. It's already at like 120k, it'll probably drop to 80 by then. Take away tax and loans and you're left with ~50k to start a family and enjoy your life after 4 hard years of studies (excluding undergrad and countless nights studying + stressing about admission). I would literally choose any other career if that's the case. 

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From what I hear, its pretty bad in the GTA, Vancouver and Montreal but better in other parts of the country. I can't speak on behalf of all of the US but the employment environment for dentists in my state (and city for that matter) is good. I've hired new grads and there isn't much fuss about saturation, with people finding employment relatively easily. I know that NYC and SF/LA have saturation problems, but I'd think its still better to practice in the states. Without disclosing too much about myself, I live in an urban centre, love my job and staff. My overhead is lower than my Canadian orthodontic friends, my taxes are less and my cost of living is significantly lower than the GTA (but of course I have to pay for full health insurance). Apparently, Toronto's real estate market has been going through the roof, only adding to the misery of people trying to settle down and raise a family. That thread was an interesting read, but I'm guessing the stigma is that dentistry = $$$ with less hours of work = high-roller lifestyle. You have got to work hard and like Lebron James says..nothing is given to you, everything is earned. The potential to make money is there, its about proper execution, which can be done. 

 

 

may I ask how much your overhead and production is this year? dr:hyg production ratio? thanks how do you keep overhead low?

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I see your point but while some dentists may be winning the fight, they're the long standing clinics (long term patients + word of mouth) But for someone who isn't practising right now, what would make a customer come to me once I graduate with no clinical experience outside of school? I would have to either associate (with very little % salary if I'm not grossing enough due to over-saturation) or open my own clinic and spend A TON of money to advertise and promote my clinic in hopes of getting customers to choose my practise instead of the one across the street. 

 

My point is I thought dentists could focus on dentistry and love their profession. Boy was I wrong...nowadays dentists focus on advertising their clinics in local newspapers, on billboards and on the radio. 

 

A couple of things. The first few years are not about just making money to pay off debts - it is to build hand skill and speed. Second, why would you ever build a practice if there is one across that street - that is a setup for disaster. Third, there are plenty of startups in Canada and USA that have done extremely well - well how did they do it: advertising, Breakaway method, and the other things I already listed that are vital towards a successful practice in my previous post. Sure they have it tough in years 1-3, but most by year 4 do very well. And no, it is less about clinical skill (patients have a tough time knowing what good dentistry is) but about personality, business acumen, and how they feel about the staff, fees, and the facility, and how accommodating the practice is for them. Successful dentists have told me that people drive 1-1.5 hours just to see them. I am sure they could have saved a lot of commute time by going somewhere else... but they didnt... well why is that.

 

Also, it is known that you should spend 5-10 percent of your net income towards advertising, especially during the infancy years. Dentistry is a business as much as it is an art and a science. This is a numbers game - on DentalTown, everything is a number. Daily production goals, production per chair per month, percent overhead management, average income of individuals within a certain diameter, etc. Everything is calculated, every visit is tracked, every payment is noted, everything is numbers.

 

In the States, plenty of MDs advertise on billboards. Also, many established practices do not advertise as much anymore because word-of-mouth for them already provides enough NPs (new patients) and they have flexibility to dismiss patients that are deemed inappropriate for them to work with. 

 

Not true about ortho FYI. Ortho is getting saturated because GPs and pedos can do ortho as well through CE. Ortho is also being commoditized via DIY braces which is being advertised at $1500. There are not enough ortho patients per office and so orthos need to build multiple practices to keep themselves busy. 

 

And since when is dental salary at 120K. I thought you knew about incorporation and that average ADA and CDA stats prove otherwise. It is much higher than that. Or else, it makes 0 sense to have an associate.

 

For income to drop to 80K, you would need to produce about 200K annually on 40% OH. That would be like 1K a day. If you were to sit around for 5 hours a day and only work 2.5 hours a day, sure you would only produce 1K a day. 

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From what I hear, its pretty bad in the GTA, Vancouver and Montreal but better in other parts of the country. I can't speak on behalf of all of the US but the employment environment for dentists in my state (and city for that matter) is good. I've hired new grads and there isn't much fuss about saturation, with people finding employment relatively easily. I know that NYC and SF/LA have saturation problems, but I'd think its still better to practice in the states. Without disclosing too much about myself, I live in an urban centre, love my job and staff. My overhead is lower than my Canadian orthodontic friends, my taxes are less and my cost of living is significantly lower than the GTA (but of course I have to pay for full health insurance). Apparently, Toronto's real estate market has been going through the roof, only adding to the misery of people trying to settle down and raise a family. That thread was an interesting read, but I'm guessing the stigma is that dentistry = $$$ with less hours of work = high-roller lifestyle. You have got to work hard and like Lebron James says..nothing is given to you, everything is earned. The potential to make money is there, its about proper execution, which can be done. 

 

I could not have said it better. Things are not given, they are earned. This is one example of someone who did just fine and is having a good time with the field of dentistry. Good stuff.

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A couple of things. The first few years are not about just making money to pay off debts - it is to build hand skill and speed. Second, why would you ever build a practice if there is one across that street - that is a setup for disaster. Third, there are plenty of startups in Canada and USA that have done extremely well - well how did they do it: advertising, Breakaway method, and the other things I already listed that are vital towards a successful practice in my previous post. Sure they have it tough in years 1-3, but most by year 4 do very well. And no, it is less about clinical skill (patients have a tough time knowing what good dentistry is) but about personality, business acumen, and how they feel about the staff, fees, and the facility, and how accommodating the practice is for them. Successful dentists have told me that people drive 1-1.5 hours just to see them. I am sure they could have saved a lot of commute time by going somewhere else... but they didnt... well why is that.

 

Also, it is known that you should spend 5-10 percent of your net income towards advertising, especially during the infancy years. Dentistry is a business as much as it is an art and a science. This is a numbers game - on DentalTown, everything is a number. Daily production goals, production per chair per month, percent overhead management, average income of individuals within a certain diameter, etc. Everything is calculated, every visit is tracked, every payment is noted, everything is numbers.

 

In the States, plenty of MDs advertise on billboards. Also, many established practices do not advertise as much anymore because word-of-mouth for them already provides enough NPs (new patients) and they have flexibility to dismiss patients that are deemed inappropriate for them to work with. 

 

Not true about ortho FYI. Ortho is getting saturated because GPs and pedos can do ortho as well through CE. Ortho is also being commoditized via DIY braces which is being advertised at $1500. There are not enough ortho patients per office and so orthos need to build multiple practices to keep themselves busy. 

 

And since when is dental salary at 120K. I thought you knew about incorporation and that average ADA and CDA stats prove otherwise. It is much higher than that. Or else, it makes 0 sense to have an associate.

 

For income to drop to 80K, you would need to produce about 200K annually on 40% OH. That would be like 1K a day. If you were to sit around for 5 hours a day and only work 2.5 hours a day, sure you would only produce 1K a day. 

 

These numbers may seem unrealistic right now (1k a day) but trust me we're not far off. Just to let you know there's a dental clinic inside walmart that opens 8am-8pm 6 days a week. If this trend continues, private practises will stand no chance against a big chain (like opening your own retail store next to walmart) and dentists will be forced to work for the big boys like pharmacists are right now. It's where this industry is headed, like it or not. you'll be force to work underpaid by the big chains because it's bringing them big bucks and you have no other choice - either that or no work at all and no feeding your family. 

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Dentists working in corps can get compensated very well (do not mix corp with poor compensation) but lose autonomy and get burned out very quickly. 

 

I mean this is now IMO a moot discussion, none of us are really here to convince you if dentistry is good or not. Clearly you do not think so, but please do not denigrate the profession and questioning its future with many assumptions. If you want a guaranteed salary with a nice lifestyle, nothing will be handed to you like that. 

 

Pharmacists make a good salary. They do good work. There is oversaturation but it is a good field.

 

1K a day is like 1 crown. Nothing else. No hygiene. No x-rays. 

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If you follow the Raptors - their coach always says: Hard things are hard.

 

Nothing ever comes easy these days. Working hard does not guarantee you anything, it merely gives you a higher chance of success. Give me a higher chance any day of the week.

 

That's what I'm saying: working hard during undergrad and getting into dental school used to guarantee a high salary and a prestigious profession which is no longer the case. 

 

I can think of so many disadvantages with corporate dentistry for the dentists: 

-no more freedom

-you can't pick your own hours

-you can't own your own business (and invest in the property of your dental clinic)

-you can't hire a team and work together as a family

-you don't choose how much money you make, it's given to you and you have no choice but to accept it.

 

The opposite is all the reasons I wanted to go into dentistry.

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Doing medicine is not a guarantee these days either - and they are getting hammered with their own set of problems.

 

Corps are not the norm in Canada and won't be for some time. Even in the States, corps are everywhere but people can still do fine as peactice owners. Tougher, but fine.

 

Perhaps your view of dentistry is stuck in the golden ages, but like most healthcare professions that sadly isn't the case anymore and you will have to accept that. You can still achieve all the bullet points you listed (actually Pauls brother is doing phenomenally well in a suburb as a practice owner who created his own practice 4 years ago) but you need to be smarter about things.

 

Cheers

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