Give up six digit job to pursue dentistry. Is it worth it?

[DDS9994]

Yeah I can understand the argument for going to school with high def because the potential is there to make money but I personally don’t buy into it.

What I don’t understand are the people on here encouraging someone to pursue their dreams when there is a pension on the table with 6 figure income... to switch into dentistry. I guess do it if you “love it.”

I have 2 close family friends of my wife and I, we both went to undergrad in Boston together, they both pursued education and work in the Boston Public School system, all four of us are 45, the husband and I were speaking and he told me at 55 both of them will retire with a full pension, that will pay out about 145K for the both of them, full health insurance for life, and the kicker is they have invested wisely as well in IRA, so not top of their pension they have a 7 figure retirement account as well. So withdrawing 145k is like having a little under 4 million with a 4% WD per year. But HEY!! I get to be called DOCTOR, LOL..

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[SnozzBerry]

I have 2 close family friends of my wife and I, we both went to undergrad in Boston together, they both pursued education and work in the Boston Public School system, all four of us are 45, the husband and I were speaking and he told me at 55 both of them will retire with a full pension, that will pay out about 145K for the both of them, full health insurance for life, and the kicker is they have invested wisely as well in IRA, so not top of their pension they have a 7 figure retirement account as well. So withdrawing 145k is like having a little under 4 million with a 4% WD per year. But HEY!! I get to be called DOCTOR, LOL..

And people wonder why some states are legit broke. Public pension funds are probably not going to be a thing for the age cohort of people here on this site.

 

[TanMan]

I wish I can buy a cheap plan like you. I currently pay $1300/month for a PPO plan for my family of 4 because I don't want to be a burden for any of my family members if something happens to me. You can get cancer at any age. My sister, who is a GP, even goes further by purchasing a long term care policy on top of her current healthcare plan. I guess when people make a lot of money, they start worrying about everything and start buying a bunch of insurances to make sure that if something happens to them, they and their love ones won't lose the lifestyle that they currently enjoy.

About half of my patients don't have insurance and they pay cash. Many of them work at places that don't offer them medical/dental insurance such as nail salons, restaurants, mowing grasses etc. The beauty of ortho is the treatments usually require 18-24 months to complete and therefore, we can stretch out the payments to 18-24 month period. We can bypass the insurance companies by offering affordable interest free payment plan directly to our patients. It's like buying an expensive iphone X for $1000 and only need to pay $50 per month....and that's how everybody can afford to have such new fancy phone every 2-3 years.

A lot of my patients have asked me if I offer any discount when they pay the tx in full, instead of making monthly payments. I tell them no. I actually want the patients to make monthly payments instead of paying in full because I want to have the steady monthly income that I currently enjoy. Starting a new ortho case is like getting a client to sign a new gym membership contract. When there are slow months (Sept-Dec) with fewer starts and new patients consultations, my office can still collect the same amount of monthly payments from our active patients....no significant drop in income during those months. There is no drop in income when I close my office for vacation.

If you have family members, pre-existing conditions, and risk factors, I can definitely see the benefit of having a health plan. At least from my personal experience(s), I still found it cheaper to pay in cash than to go through insurance (using friends or other family members as a comparison for similar procedures). I will probably have to take that up when I'm older, but I can see where having money does make you more paranoid in terms of insurance(s). I ended taking up a lump-sum disability insurance and several life insurance policies to cover whether I'm going to be disabled enough not to be able to work or dead. I've taken a more extreme route in where if I'm going to die, I'd rather have them pull the plug than waste anymore financial resources (especially if I'm braindead).

For GP, I think it's a bit different. I'd prefer to get paid upfront w/ no discount than have to go through payment plans. Less chance to default and make sure I have the money ahead of time when service is rendered/completed. I wouldn't want to do an RCTBUCrown if I wasn't going to get paid for it. Also, you can use the money for investments when you have it on hand v. depending on a payment plan income stream.

 

[321931]

I have 2 close family friends of my wife and I, we both went to undergrad in Boston together, they both pursued education and work in the Boston Public School system, all four of us are 45, the husband and I were speaking and he told me at 55 both of them will retire with a full pension, that will pay out about 145K for the both of them, full health insurance for life, and the kicker is they have invested wisely as well in IRA, so not top of their pension they have a 7 figure retirement account as well. So withdrawing 145k is like having a little under 4 million with a 4% WD per year. But HEY!! I get to be called DOCTOR, LOL..

Yup. Agreed. OP if has no debt and making that kind of money can retire way sooner then your public school system friends. If he pursues dentistry, we are talking about a no-end-in sight kind of retirement. Can you make it big like how tanman says its so easy? Yeah I guess. But I personally disagree.

 

[TanMan]

I have 2 close family friends of my wife and I, we both went to undergrad in Boston together, they both pursued education and work in the Boston Public School system, all four of us are 45, the husband and I were speaking and he told me at 55 both of them will retire with a full pension, that will pay out about 145K for the both of them, full health insurance for life, and the kicker is they have invested wisely as well in IRA, so not top of their pension they have a 7 figure retirement account as well. So withdrawing 145k is like having a little under 4 million with a 4% WD per year. But HEY!! I get to be called DOCTOR, LOL..

I wonder about the sustainability of these generous pension systems. Unfortunately, municipalities have gone through bankruptcy and are not necessarily safe from restructuring/default. Underfunded pension liabilities are another bubble that's going to have large ramifications. If municipalities can undergo restructuring, so can the promised benefits. I still think we're in a better position to fend for ourselves than think that a governmental golden goose is going to be there forever.

 

[DDS9994]

I wonder about the sustainability of these generous pension systems. Unfortunately, municipalities have gone through bankruptcy and are not necessarily safe from restructuring/default. Underfunded pension liabilities are another bubble that's going to have large ramifications. If municipalities can undergo restructuring, so can the promised benefits. I still think we're in a better position to fend for ourselves than think that a governmental golden goose is going to be there forever.

Sure its something that is constantly being debated, but even if there is some sort of modification of current pension system that gets blended with some sort of 401K style plan, I suspect it will still be a a good deal. And remember outside of that pension you can still start your own IRA etc. The one thing I notice with dentists and any small business you need to be disciplined and self motivated to save for retirement as its all on your shoulders no one else. Talking to fellow dentists Im still surprised how many have rather little saved compared to how much they make. No matter how you cut it, walking away from a 6 figure job, and a pension, to go into debt 500K not including loss of income, and be done around 40 and start a business going into debt another 500K at least, thats a lot of moving parts to think of, can't afford to screw up or you find yourself working way into your 60s cause you have to..

 

[2TH MVR]

Well. OP ..... Sounds like the answer to your post is a resounding no to a late career change to dentistry.

 

[DocJL]

I can only speak about my area and the major cities around me. It's definitely doable because I don't know of a single dentist in my area (and in the closest major cities) that doesn't have less than a 1MM+ producing office (although admittedly, I am the newbie in my area, I don't know EVERY dentist in my area, and some of these offices have an associate). Even my friends who are relatively slower are producing 1MM+. .

Texas Permian Basin oil fields area?

And let me guess, you are NOT a provider on insurance, so you are not tied to fee schedules, and oversight of insurance dentists?


Your experience is NOT the norm.

And I believe OP even stated he wants to stay in CA?

Good luck paying off $300-500k in debt while working in CA. Might get it paid off right before he retires......

 

[TanMan]

Texas Permian Basin oil fields area?

And let me guess, you are NOT a provider on insurance, so you are not tied to fee schedules, and oversight of insurance dentists?


Your experience is NOT the norm.

And I believe OP even stated he wants to stay in CA?

Good luck paying off $300-500k in debt while working in CA. Might get it paid off right before he retires......

I am definitely in-network with most insurances (except United Concordia, discount plans, HMO's, and fee schedule based insurances). If you stay in CA, you better carve a really good niche market or work in non-saturated area, if there's any.

Edit: Many claim my experience is not the norm, but I would contend that the doom and gloom scenarios that many portray here (or the mediocrity of being a dentist) is not the norm either. The truth is somewhere in the middle. We do a lot better than the general population and I think that everyone here would be able to concede that in the very least.

 

[DocJL]

I am definitely in-network with most insurances (except United Concordia, discount plans, HMO's, and fee schedule based insurances). If you stay in CA, you better carve a really good niche market or work in non-saturated area, if there's any.

Edit: Many claim my experience is not the norm, but I would contend that the doom and gloom scenarios that many portray here (or the mediocrity of being a dentist) is not the norm either. The truth is somewhere in the middle. We do a lot better than the general population and I think that everyone here would be able to concede that in the very least.

Permian Basin area, correct?

and are you saying that your are NOT linked to an insurance fee schedule despite being in-network?

 

[TanMan]

Permian Basin area, correct?

and are you saying that your are NOT linked to an insurance fee schedule despite being in-network?

I'm not in the permian basin area.

I am linked to insurance fee schedules such as Humana, but there are some that have their own secondary fee schedules that provide no real coverage whatsoever. We've been able to determine that they are actually discount plans under the umbrella/logo of insurance.

 

[DocJL]

I'm not in the permian basin area.

I am linked to insurance fee schedules such as Humana, but there are some that have their own secondary fee schedules that provide no real coverage whatsoever. We've been able to determine that they are actually discount plans under the umbrella/logo of insurance.

I don't understand what you were saying when you posted an exception to being a provider on "fee schedule based insurances"?

How big is your town? semi-rural?

Can you share where you are? - a PM is fine if you don't want to post publicly for fear of generating future competition lol.


All other things aside, location is EVERYTHING. The fact that you have also posted that so many (most) of your local dentists are "easily" producing over 1 Million (I believe you said even the "slow" dentists are doing that) makes that all too evident.

More power to you.

But it makes it even more clear that what Rainee and several other experienced GENERAL DENTISTS are saying is true.

The area where you practice is an "outlier".

 

[TanMan]

It's a little hard to comprehend since we were having the same issue wrapping our head around the concept (until we clarified it). So, when we negotiate fees with the insurance, we have a negotiated fee schedule. Initially, when we verify these insurances, the fees we negotiate are the fees we get (except United Concordia, which we dropped quickly). However, one of the trends that we were noticing that some of these insurances had their own separate fees schedules that we did not agree to. These are what are commonly known as "fee schedule based insurances". We found that when we submit claims to these "supposed insurances", that they weren't getting paid. You submit a claim to them, they don't pay much, if anything at all, when they have these separate fee schedules. What we're finding out is that these are essentially discount plans (lower fees) with little/no coverage, associated with the insurance. We opt to tell the patient ahead of time so they can choose to continue with us on a up-front basis (with reimbursement if their insurance pays) or not. Saves us the headache and frustration of patients who claim that they have insurance that covers so and so.

South Texas region, >100k population.

Edit: There was never any disagreement whether location played a factor. As described in all other posts regarding whether dentistry is worth it, it is if you're willing to go anywhere to make money. Supply and Demand still matters even if you have a DDS/DMD. Go to where there's still lots of demand and make tons of $$. I don't know where you guys setup, but my guess would be in more saturated areas. Also, how long have you guys (experienced general dentists) been practicing? I'm probably still a spring chicken in your eyes from the emphasis on EXPERIENCED GP's. One thing that I thought about is that most of these practices have been around longer than mine (and some have associates). I wouldn't know what to tell you in terms of how long it took them to get there, but they aren't doing bad except for the guy who got addicted to coke. Even in a bigger city like San Antonio, my friend/colleague broke the 1MM+ mark pretty quickly. Just because it's a larger city, doesn't mean it's impossible to make good money.