Why you (probably) won’t “live like a student”

[Thehighwind87]

If you had to start over, what profession do you favor? In Asia, the COL is way less but there are no jobs. Here in the States, there are jobs but one can't afford to buy a house, go to college, and get healthcare. I worry for my kids.

I would still be a dentist. Listen this is the facts about me- I am overall happy with my job choice but disappointed where the field is going.

I graduated in 2010 with a reasonable debt and a great income. Houses were cheap, along with stocks and whatnot.

I’ve compounded wealth and I’m happy for it, but I don’t kid myself when I see the route that dentistry is going. I see the cost of living going up, along with the practice overhead and I’ve seen the same revenue… but less take home year over year. Covid and 10-20% inflation really put the nail in the coffin for my outlook on the field.

That’s it. I’m just realistic about it all. Charles says work more and work harder… yes you are working harder and more for less overall. Eventually people in the job say- It ain’t worth it anymore… so by that metric I’m in that camp.

---

Members don't see this ad.

 

[Molar Whisperer]

Northeast! Practice 25 minutes outside of one of the largest cities in the country.

IMO, the NE is the fashion capital where everyone wants to look good (have nice teeth). Cali is Hollywood. The people in the Midwest, Plains, and the South want to look their Sunday Best. Then there is the Pacific NW. We were voted the worst dressed and very few practice organized religion (go to Church). I grew up in a Bible Belt State where it is the butt of jokes about toothless people and inbreeding. It is not minority friendly and there is nothing to do. The irony is the Pacific NW is heading to that direction (toothless). Hopefully it will not be minority unfriendly.

 

[charlestweed]

most students won’t be debt free and making 400k in their 20s. I don’t know anyone in my class that that’s going to be the case. Maybe they’ll have strong income, but debt free? No way. Not a chance. A few have had their parents pay tuition.

I wasn’t debt-free (although I didn't have a lot of student loans like today new grads) …..and I didn’t make anywhere near $400k in my 20s either. I graduated at 29. Being/drowning in debt (over $1M if I also included the home loan + car loan + practice loan) helped motivate me to work harder….forced me to find ways to cut cost (hiring fewer staff, buying low tech chairs and refurbished equipment) when I started my own office. Working on the weekends was the only way to increase my income so I could afford to do both: having a nice doctor’s lifestyle and being able to pay back debt at the same time. I didn’t really have any other choices. If I didn’t make enough to pay the bills, the banks would take my house and cars. After paying all the bills, I didn’t have any extra money to invest (except for the 401k). I didn’t realize buying a house that I lived in was a form of investment until I sold it. I was lucky that the home value went up when I sold it….and I used the profit to pay off my student loans. I wouldn’t have had the same drive and motivation to work the way that I did if I was debt-free and had rich parents who helped pay for everything.

Hard work has rewarded me a lot of things:
1. I gain the clinical experience quickly. Busy schedule helped me come up with new ideas and methods (and then I trained the staff) to allow me treat the patients faster and with fewer mistakes. I’ve learned to manage the chair time more efficiently.
2. I quickly grow my business and build my reputation. The higher volume of patients that I treat, the more word-of-mouth referrals I get.
3. I paid off all of my debts faster than if I only worked 4 or less days/wk.
4. Being financially independent makes me worry less about things like economic recessions, high gas prices, inflation, a malpractice law suit, a board complaint etc. I love my job more.

So to me, one good thing about being in debt was it forced me to work hard to pay it back. It can’t just disappear. And I wouldn't trust/count on the politicians’ promises to forgive your loan.

 

[D1Bound]

I wasn’t debt-free (although I didn't have a lot of student loans like today new grads) …..and I didn’t make anywhere near $400k in my 20s either. I graduated at 29. Being/drowning in debt (over $1M if I also included the home loan + car loan + practice loan) helped motivate me to work harder….forced me to find ways to cut cost (hiring fewer staff, buying low tech chairs and refurbished equipment) when I started my own office. Working on the weekends was the only way to increase my income so I could afford to do both: having a nice doctor’s lifestyle and being able to pay back debt at the same time. I didn’t really have any other choices. If I didn’t make enough to pay the bills, the banks would take my house and cars. After paying all the bills, I didn’t have any extra money to invest (except for the 401k). I didn’t realize buying a house that I lived in was a form of investment until I sold it. I was lucky that the home value went up when I sold it….and I used the profit to pay off my student loans. I wouldn’t have had the same drive and motivation to work the way that I did if I was debt-free and had rich parents who helped pay for everything.

Hard work has rewarded me a lot of things:
1. I gain the clinical experience quickly. Busy schedule helped me come up with new ideas and methods (and then I trained the staff) to allow me treat the patients faster and with fewer mistakes. I’ve learned to manage the chair time more efficiently.
2. I quickly grow my business and build my reputation. The higher volume of patients that I treat, the more word-of-mouth referrals I get.
3. I paid off all of my debts faster than if I only worked 4 or less days/wk.
4. Being financially independent makes me worry less about things like economic recessions, high gas prices, inflation, a malpractice law suit, a board complaint etc. I love my job more.

So to me, one good thing about being in debt was it forced me to work hard to pay it back. It can’t just disappear. And I wouldn't trust/count on the politicians’ promises to forgive your loan.

I completely disagree with the mindset that being over borrowed will essentially force you to be better. Most people will not be able to make ethical treatment plans if they’re moving so fast to pay for their “doctor lifestyle.”

 

[Molar Whisperer]

I completely disagree with the mindset that being over borrowed will essentially force you to be better. Most people will not be able to make ethical treatment plans if they’re moving so fast to pay for their “doctor lifestyle.”

As mentioned a few times in my prev posts, I see a lot of unnecessary work and unethical tx planning such as SRPs, surgical extractions on perio mobile teeth, restorative work, etc. I saw a provider complete I&Ds on individual teeth instead of quadrant like #12, 13, 14, 15 (3-4 codes for UL). How does one tx plan SRPs with no bone loss....they have 6 mm pockets....BS

 

[charlestweed]

I completely disagree with the mindset that being over borrowed will essentially force you to be better.

Being in debt helps motivate you to work harder. Working harder means working more hours per day…..working on the weekends….traveling to more than one office etc. It also means that you are willing to accept more insurance plans (even though some of the plans don’t pay you much) so you can welcome more patients (and not just the top income earners) to your office. If your office is built from scratch, this should help fill your appt book. It’s better to make something than sitting around doing nothing and still have to pay the fixed expenses like staff salaries and rent. Working harder also means to you have to put in extra effort to keep your patients happy so you can get more referrals. Reputation can’t be built overnight.

You become a better clinician when you work harder. You gain more clinical experience when you treat more patients, when you treat more difficult cases, when you deal with more complications etc. Doing repetitive work helps make you faster and more efficient….. and you will make fewer mistakes. I haven’t yet met a successful dentist who is lazy. Yes I see older dentists who work less hours and less days but that’s because they don't have any more obligations (no more debt, kids are getting older etc) to fulfill. But they used to work very hard when they were younger…..when they first opened their office.

When a person signs up for IBR and makes the monthly loan repayment that is below the interest amount, he/she tends not to realize that he/she has a debt problem….he/she doesn’t feel the urgency to do something to eliminate the debt.

Most people will not be able to make ethical treatment plans if they’re moving so fast to pay for their “doctor lifestyle.”

Most people? Do you have any evidence to prove this? You can’t just assume that most high earning dentists are unethical. Dentistry is a business and to grow your business, you need to have a good reputation….you need word of mouth referrals. If you do bad dentistry and are unethical, no one will refer friends and family members to you. When you are a specialist, your work will not only be judged by the patients but by the general dentists as well. Remember, we each have a dental license and we have to protect it.

 

[D1Bound]

As mentioned a few times in my prev posts, I see a lot of unnecessary work and unethical tx planning such as SRPs, surgical extractions on perio mobile teeth, restorative work, etc. I saw a provider complete I&Ds on individual teeth instead of quadrant like #12, 13, 14, 15 (3-4 codes for UL). How does one tx plan SRPs with no bone loss....they have 6 mm pockets....BS

How do you proceed with those teeth with 6mm pockets? If there’s no evidence of bone loss, or calculus, I would start them off with a prophy, interdental brushing, and see what happens. If it doesn’t resolve, I’d be leaning towards SRP. If there’s bleeding upon probing, I’d probably do the same thing.

 

[charlestweed]

As mentioned a few times in my prev posts, I see a lot of unnecessary work and unethical tx planning such as SRPs, surgical extractions on perio mobile teeth, restorative work, etc. I saw a provider complete I&Ds on individual teeth instead of quadrant like #12, 13, 14, 15 (3-4 codes for UL). How does one tx plan SRPs with no bone loss....they have 6 mm pockets....BS

If patient has insurance, I believe you have to submit the radiograph and perio charting to the insurance company to show bone loss in order to get paid for the SRPs.

 

[charlestweed]

All the power to you! Work hard. You’re investing wisely and won’t have to practice for 40 years if you don’t want to. People should learn from that. I’m not saying $500 crowns are a great thing, but it’s better than working a desk job, where you’re replaceable by AI and not making $500 for a 20 minute procedure. Most people don’t even make $500/day let alone $500 for a single procedure. This is where perspective matters.

Yeah, be happy with the position you are in right now. You and I have the same perspective. We, dentists, are luckier than a lot of people (at least 80% of them don’t make anywhere near what we make). One should not compare his/her salary to those of the older dentists, who made more than him/her (because of the better insurance reimbursement in the past)….. It doesn’t do anything for him/her…it just makes him/her more depressed.

 

[Molar Whisperer]

If patient has insurance, I believe you have to submit the radiograph and perio charting to the insurance company to show bone loss in order to get paid for the SRPs.

Yes, I understand. However about 6 years ago, I was working at a DSO where the hyg gets production for SRPs and Arrestin placements. I did an exam without finding any tx needed. Hyg then came in to probe and give a perio assessment. About a couple of months later, I received a Board Complaint. The pt went to another dentist who said he did not need SRPs (honest dentist). Apparently my hyg probed 6-7 mm pockets on x-rays with no bone loss (I don't know how they submitted their findings to ins or pt pay full fees). The Board examiner knew a lot of shady things going on with that DSO and told me he is glad I'm not working there anymore. I believe the hyg still works there through a source.