Another New Orthodontist Graduates with $1M+ in Student Loans

[mmc12]

What country might that be? In which country, where a new grad ortho (like the guy in the first youtube video) can make $200-250k/year for working only 3 days/week as an associate? What country that has reasonably low tax rate like the US? What country that has very high demand for ortho treatments like the US? Can orthodontists in other countries charge their patients $5-7k per ortho case ($10k+ if patient gets phase I and phase II tx or if patients get braces again due to poor retainer wear) like the orthodontists in the US?...and even at such ridiculously high treatment fees, many patients (4+ million patients) in the US are still willing to pay for them.

Is 200-250K a year working three days a week considered normal or "average" for a new ortho grad?

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[charlestweed]

Is 200-250K a year working three days a week considered normal or "average" for a new ortho grad?

Above average for a new grad. That's how much the corp is paying me right now for working 11 days/month. I haven't asked for a raise since 2006. I am surprised that this new grad ortho gets paid so much for working at a private ortho office. Corp offices usually pay more than private ortho offices.

 

[mmc12]

Above average for a new grad. That's how much the corp is paying me right now for working 11 days/month. I haven't asked for a raise since 2006. I am surprised that this new grad ortho gets paid so much for working at a private ortho office. Corp offices usually pay more than private ortho offices.

Are there ortho jobs available in the LA area for new grads?

 

[Anondds87]

Above average for a new grad. That's how much the corp is paying me right now for working 11 days/month. I haven't asked for a raise since 2006. I am surprised that this new grad ortho gets paid so much for working at a private ortho office. Corp offices usually pay more than private ortho offices.

And how much do you make from owning your clinic? (If it's too personal dont answer)
I often wonder how much of a higher ceiling there is for ortho than working for a corp

 

[charlestweed]

Are there ortho jobs available in the LA area for new grads?

Yes. If you don't mind traveling long distance and to multiple offices. Corp jobs are harder to find because the pays are good and doctors don't want to quit their jobs.

 

[charlestweed]

And how much do you make from owning your clinic? (If it's too personal dont answer)
I often wonder how much of a higher ceiling there is for ortho than working for a corp

I work 11 days/month (will only work 9 days this month because 2 of the Tuesdays fall on the 24th and 31st) at 4 of my own offices. I have around 800 active patients. Some them already finished paying for their tx. For the 650-700 active patients who still have a balance, each of them pays me $100-130 (for metal brackets) or $130-150 (for ceramic brackets) per monthly office visit.

I don't make $ 1million a year like Coldfront and Taman.

 

[Cold Front]

I work 11 days/month (will only work 9 days this month because 2 of the Tuesdays fall on the 24th and 31st) at 4 of my own offices. I have around 800 active patients. Some them already finished paying for their tx. For the 650-700 active patients who still have a balance, each of them pays me $100-130 (for metal brackets) or $130-150 (for ceramic brackets) per monthly office visit.

Good info. What’s your monthly % overhead at your office for those 650-700 active patients?



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[charlestweed]

Good info. What’s your monthly % overhead at your office for those 650-700 active patients?



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35--40%

 

[averageasian]

I work 11 days/month (will only work 9 days this month because 2 of the Tuesdays fall on the 24th and 31st) at 4 of my own offices. I have around 800 active patients. Some them already finished paying for their tx. For the 650-700 active patients who still have a balance, each of them pays me $100-130 (for metal brackets) or $130-150 (for ceramic brackets) per monthly office visit.

I don't make $ 1million a year like Coldfront and Taman.

Can I work for you?

also Ive had braces twice. I got them on again in dental school. My resident orthodontist was 100x better than my harvard trained orthodontist. My first orthodontist....just really sucked.

 

[Cold Front]

35--40%

That’s what I thought. How long did it take you to build the practice to 650-700 active and monthly paying patients?


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[charlestweed]

That’s what I thought. How long did it take you to build the practice to 650-700 active and monthly paying patients?


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About 6-7 years. We average around 25-35 starts per month (all 4 offices combined).

Office #1: I started treating my first ortho patients at my wife's office in 2005.

Office #2: in 2006, I built my own office from scratch for $120k ($80k for construction and $40k for equipment and supplies).

Office # 3: In 2007, I started doing ortho at my sister's GP office.

Office #4: In 2009, I bought an existing ortho office from a retired 60 yo orthodontist.

 

[Cold Front]

About 6-7 years. We average around 25-35 starts per month (all 4 offices combined).

Office #1: I started treating my first ortho patients at my wife's office in 2005.

Office #2: in 2006, I built my own office from scratch for $120k ($80k for construction and $40k for equipment and supplies).

Office # 3: In 2007, I started doing ortho at my sister's GP office.

Office #4: In 2009, I bought an existing ortho office from a retired 60 yo orthodontist.

That’s impressive. So the 650-700 active patients are between 4 offices or just 1?

You are unique - very few would plan the way you did. There are 2 general dentists in their 20’s in my city that are about to close their relatively new offices. They spent about $300-400k each to build the offices and are now trying to liquidate everything to settle their business loans with the banks. Smh

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[charlestweed]

That’s impressive. So the 650-700 active patients are between 4 offices or just 1?

You are unique - very few would plan the way you did. There are 2 general dentists in their 20’s in my city that are about to close their relatively new offices. They spent about $300-400k each to build the offices and are now trying to liquidate everything to settle their business loans with the banks. Smh

For all 4 offices.

To me, $300-400k is way too much for an office. I don’t really know what to buy with that much money. I got used to working at simple low tech corp offices ever since I graduated. Therefore, when I set up my own office, I purchased the same equipment and supplies that the corp offices used. I remember when I bought an existing office that used expensive TMA and copper niti wires, I didn’t know what to do with these wires….I ended up selling them on Ebay. A cheap 5 cent stainless steel wire does just as good of a job as a $5 TMA wire.

All 4 offices cost me less than $300k to build. I didn’t have to pay a dime to build 2 of them because I share them with the GP owners. I just pay one GP monthly rent and pay the other GP the % of my collection…. and they are both happy.

 

[gryffindor]

I applaud charlestweed for sharing so freely on here. I will say for those reading at home, to have 25 starts per month at just 1 ortho office would be IMO considered a very healthy one-location office. Those who build the $400K startup practices are most likely looking for a goal like that. It takes time to get there depending on your community and the competition. Practices can definitely be built for less but it's the beautiful offices with a beverage bar complete with a barista and color coordinated fish in the fish tank we see in the magazines and make pre-dents think "WHOA I WANT THAT."

 

[Cold Front]

I applaud charlestweed for sharing so freely on here. I will say for those reading at home, to have 25 starts at just 1 ortho office would be IMO considered a very healthy one-location office. Those who build the $400K startup practices are most likely looking for a goal like that. It takes time to get there depending on your community and the competition. Practices can definitely be built for less but it's the beautiful offices with a beverage bar complete with a barista and color coordinated fish in the fish tank we see in the magazines and make pre-dents think "WHOA I WANT THAT."

I built 2 general dentist offices (separate LLC’s) from scratch for about $500k combined nine years ago. 15 treatment rooms between the offices, all digital, signs and working capital included.

We see a lot of new patients (mostly with state insurances) - 60-70% are pedo. 1 doctor at each office, and a staff of 8 (including 2 hygienists) between the offices. Gross revenue is about $1.7M a year (97% collection rate) with about 45-50% overhead - i’m the landlord at both offices, so $0 rent paid by the offices, hence the lower overhead. The overhead is also highly consolidated and overlap between the offices; 1 payroll account, 1 supplies account, 1 office cleaner, 1 accountant, and so on. Like charlestweed, I watch my numbers very closely. There are no office managers at the offices, but shared management through leadership at each area of the office; front desk leader, clinic area leader and me (team leader).

There are no morning huddles, but a mandatory monthly staff meetings (lunch provided) at each office to discuss all staff issues, patient issues, office production, scheduling, and improvements for the office. The first 3 years, employees were going through a revolving door, replacing someone every few months (average age was under 30). The current team has been with me for 6 years and are all age 40+, and want to retire at the office - I’m 40, the youngest member of my staff. I work 4 days a week, the associate works 5 days a week at the other office.

I speak 5 languages, grew up in 3 different continents of the world and moved to this country at age 23. I didn’t go to DS until age 28 and graduated with about $280k in student loans from a northeast school. No parents helped me pay for education or the businesses. I chose dentistry as a career more for business reasons than being in love with teeth. You have to plan ahead to build and execute goals; I planned everything I have done today in my offices during 3rd year of DS, while everyone else in my class was applying for residencies or just looking forward to graduation. Despite my cautionary posts about dentistry and high student loans, I would say dentistry is still a great field - but you would have to be a certain young dentist to do well in dentistry these days, more than ever before, general dentist or a specialist. We all know which classmates wouldn’t make it in the real world during DS, and there were a lot of them in my class - that’s why I post a lot of skepticism about future of dentistry and most of that is not about the dentist, but the profession in general has changed to keep young dentists in debt for longer period of time.


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[gryffindor]

I built 2 general dentist offices (separate LLC’s) from scratch for about $500k combined nine years ago. 15 treatment rooms between the offices, all digital, signs and working capital included.

Yes, I was referring to the building and growth of an ortho office since this thread was about an orthodontist. Your experience has been awesome to grow two GP practices. I now realize how much business you have to know to run a successful practice. New grad me had no clue. I had to get beaten up by a few associateships first to see how little I knew about the financial side of teeth.

 

[Cold Front]

Yes, I was referring to the building and growth of an ortho office since this thread was about an orthodontist. Your experience has been awesome to grow two GP practices. I now realize how much business you have to know to run a successful practice. New grad me had no clue. I had to get beaten up by a few associateships first to see how little I knew about the financial side of teeth.

In dentistry, the business side is totally a different ball game than clinical dentistry. The less you know about the business side, the steeper the learning curve. To this day, I think I only know 40% or less of what I should know about the business of dentistry - because I hardly go to CE courses, conventions, listen to podcasts and track everything else that can make a practice more efficient. In a way, I’m no where near the optimum level to be a successful dentist - we just simply can’t keep up with the evolving world around us on month to month or year to year basis.

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[SoftGel]

In dentistry, the business side is totally a different ball game than clinical dentistry. The less you know about the business side, the steeper the learning curve. To this day, I think I only know 40% or less of what I should know about the business of dentistry - because I hardly go to CE courses, conventions, listen to podcasts and track everything else that can make a practice more efficient. In a way, I’m no where near the optimum level to be a successful dentist - we just simply can’t keep up with the evolving world around us on month to month or year to year basis.

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Maybe if you spent less time posting everyday on SDN, then you could keep up with everything

No, but seriously... so thankful to Cold Front, Charlestweed and others for sharing so much on these boards. I'm getting insights from you guys that I am not getting anywhere else.

 

[Cold Front]

Maybe if you spent less time posting everyday on SDN, then you could keep up with everything

No, but seriously... so thankful to Cold Front, Charlestweed and others for sharing so much on these boards. I'm getting insights from you guys that I am not getting anywhere else.

Haha! You are not the first to say that.

2TH MVR, Charles, Dr Jeff, TanMan, gryffindor, few others and I are plenty for insights to pre-dents. The dental forums Avengers per se.

One of my mentees got accepted to a local state school this week and I’m now getting ready to take him out for early dinner after my last patient in an hour. As much as I should be busy doing something at the office - a lot of things at my practices are now on autopilot at this point in my career. Less and less needy staff and tenants over time, that’s why I teach a dental assistant course on Saturdays to keep things interesting.


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[DrJeff]

Haha! You are not the first to say that.

2TH MVR, Charles, Dr Jeff, TanMan, gryffindor, few others and I are plenty for insights to pre-dents. The dental forums Avengers per se.

One of my mentees got accepted to a local state school this week and I’m now getting ready to take him out for early dinner after my last patient in an hour. As much as I should be busy doing something at the office - a lot of things at my practices are now on autopilot at this point in my career. Less and less needy staff and tenants over time, that’s why I teach a dental assistant course on Saturdays to keep things interesting.


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Maybe we need some "superhero style" OSHA approved personal protection gear SDN capes to wear in our offices!

In all seriousness, I can say that it is quite enjoyable to participate in this forum, as I can certainly say that it's quite the journey to go on from pre-dent to dental student to resident (if applicable) to associate to business owner/partner and to try and share some of what I have experienced along that ride, as well as pick up some SOLID tidbits from others who actively participate in this board who have taken similar journeys through the student to dentist pathway!

Also Coldfront, congratulations on having a mentee gettimg accepted to d-school! I know what a cool thing that is, as over the almost 20 years I have been in my practice now, my partner and I have had that same cool experience with 6 people who have gone from patients to patient mentees through dental school and now colleagues (2 orthodontists, 1 pedo, 1 prosth, and 1 GP, and one current 3rd year dental student thinking about Oral Surgery)

To any student who participates in this forum, I wold highly encourage all of you post graduation to find some way to help "give back" to this wonderful profession in whatever way you find passion to do so, and help keep this profession to be a rewarding one for future dentists!

 

[Cold Front]

Also Coldfront, congratulations on having a mentee gettimg accepted to d-school! I know what a cool thing that is, as over the almost 20 years I have been in my practice now, my partner and I have had that same cool experience with 6 people who have gone from patients to patient mentees through dental school and now colleagues (2 orthodontists, 1 pedo, 1 prosth, and 1 GP, and one current 3rd year dental student thinking about Oral Surgery)

To any student who participates in this forum, I wold highly encourage all of you post graduation to find some way to help "give back" to this wonderful profession in whatever way you find passion to do so, and help keep this profession to be a rewarding one for future dentists!

That’s my exact sentiment. The Saturday course I teach is a 9 week course for the young patients who ask me about the profession. It’s relatively a concise eye-opener course to the profession, and it comes with a dental assistant diploma and certification. It’s the basics of basics, and it’s giving the students a taste of the profession and the confidence to move forward to the next step if they choose to. So far, I have 1 student who got into dental school, 1 applying in May and 2 applying to hygiene schools in May as well. It’s a remarkable feeling that you were part of a process that helped someone achieve the next chapter of their lives.

Speaking of mentorship, my mentor before dental school, and the dentist I shadowed and wrote me the letter of recommendation to dental school is an associate of mine at one of my offices today. We reconnected 7 yrs after I graduated from DS through an associate position ad I placed online - a full circle after a series of events, plus we are very very good friends now. It’s one of the few lucks I had in the profession and in life.


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[charlestweed]

I can't believe it has been12 years since I joined the forum. I came to know about this forum when I typed in the search words "orthodontist salary"....it was a slow morning at the corp office and I was bored. And the SDN thread below was one of the top search results. This was also my very first SDN post. At that time, I only had 2 offices. One of the them, that I started from scratch, was only 1.5 years old. I worked 6-7 days/week....19-20 days/month for the corp...every Saturday and some Sundays at my own offices. Until now, I still work 3 Saturdays and 3 Sundays a month.

orthodontist

I was looking at the salary on salary.com and was really surprised that orthosdontists makes less than general dentist Orthodontist 25th%ile Median 75th%ile $93,246 $113,501 $137,622 I know orthodontist is really hard to get into, so I figure they would make more...

forums.studentdoctor.net

 

[9blade]

I guess this guy better hope Bernie becomes president

 

[paamp]

That’s my exact sentiment. The Saturday course I teach is a 9 week course for the young patients who ask me about the profession. It’s relatively a concise eye-opener course to the profession, and it comes with a dental assistant diploma and certification. It’s the basics of basics, and it’s giving the students a taste of the profession and the confidence to move forward to the next step if they choose to. So far, I have 1 student who got into dental school, 1 applying in May and 2 applying to hygiene schools in May as well. It’s a remarkable feeling that you were part of a process that helped someone achieve the next chapter of their lives.

Speaking of mentorship, my mentor before dental school, and the dentist I shadowed and wrote me the letter of recommendation to dental school is an associate of mine at one of my offices today. We reconnected 7 yrs after I graduated from DS through an associate position ad I placed online - a full circle after a series of events, plus we are very very good friends now. It’s one of the few lucks I had in the profession and in life.


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Just curious, what net worth are you trying to hit for retirement? Also, the overhead number you quoted in an earlier post (45-50%), does that include the salary you take out for yourself?

 

[Cold Front]

Just curious, what net worth are you trying to hit for retirement? Also, the overhead number you quoted in an earlier post (45-50%), does that include the salary you take out for yourself?

My assets (retirement accounts and real estate) can fluctuate with economy, but if all goes in my favor, I have the option to fully retire in my late 40’s (I’m 40 today). But there is still a good chance I will still do some dentistry after I hit that goal - and with no debt, it will be easy money at that point.

Yes, my overhead was low, close to the 40% range - because I’m both the landlord and tenant.


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[Blueshirts]

My assets (retirement accounts and real estate) can fluctuate with economy, but if all goes in my favor, I have the option to fully retire in my late 40’s (I’m 40 today). But there is still a good chance I will still do some dentistry after I hit that goal - and with no debt, it will be easy money at that point.

Yes, my overhead was low, close to the 40% range - because I’m both the landlord and tenant.


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Happy bday

 

[Cold Front]

Happy bday

Thanks. I meant I am (already) 40.


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[P7898]

Actually, it would still be bad. That additional $100-150k income would be pre-tax income. So it would be closer to $60-100k for post-tax (additional $5-8k a month). That would not put a lot of dent to his $1M debt - which as he said needs $5-6k a month in interest alone. That’s a lot of fire to put out... not to mention his new office debt, if he has a mortgage, auto loans, credit card debts, and the cost of his lifestyle. You could probably get around $1M debt with $400k a year income, but I would guess 90% of your peers would not - because of their personal finances would not be as strict as yours. Ultimately, stagnant Ortho service fees will never keep up with the rising tuition (and compounding interest). Student loans almost doubled the past 10 years, while ortho fees pretty much stayed the same - and that trend will continue every year for the foreseeable future. That’s the bottom line.


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To build off of Cold Front... you are in a different tax bracket then someone that makes $200-$250k so really it is not that much once taxes are taken out - if you are at $400k unless you are an owner because then you have right offs and a more fruitful tax return.