Is specializing an easier way to earn more in dentistry? (Comments/advice appreciated)

[LFA20]

I am a general dentist currently fulfilling my obligation back in the military. I will be done with my commitment in 2022. Lately I have been thinking about what I want to do after my commitment and specializing have been coming up in my mind once in a while.

Here’s why I want/it makes sense for me to specialize (in endo)

1. I enjoy doing rct
2. On average specialists make more than general dentists working less hours/seeing less patients.
3. I am not a business oriented person(not saying I can’t learn it but I prefer not to deal with headaches of running it)
4. I will have the gi bill benefit so I can attend state any state school
In the country tuition free. I also will be receiving housing allowance under this benefit during school.

Here are my worries about specializing (in endo)

1. Finding employment might be difficult. Might need to juggle multiple offices to find Full time employment
2. A lot of the cases I will be doing will be tough.
3. Delaying income for 2 years by going into residency
4. As a specialist you actually need to be more business oriented?? Since you rely a lot on referrals. I am fine with working for someone forever however. Not sure how sustainable it is to do this.

Any comments or advice is appreciated

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[FutureDent020]

You pretty much nailed all the pros and cons. I pretty much feel the same way. You know yourself better than anyone. I wasn’t comfortable running around, working 2-3 rooms with hygiene checks while still doing my best dentistry. I also liked doing everything myself. I didn’t like my assistants doings temps, impressions, occlusion, etc. And yea, you’ll see less patients as an endodontist while making good money. But the easiest case you will see will be a straight forward mandibular/ max molar. And while those are straight forward for us, they still carry a level of difficulty that’s above a lot of general dentistry. I remember my director negotiating an MB2 with 8 files for about 20 min one day. Looked at me, smiled and jokingly said, you sure you want to do this for the next 30 years.

 

[321931]

As an associate specialist- you will make more money.

As a specialist owner- you are on even playing fields with a decent GP practice. Meaning- both have theoretically the same earning potential.

That being said, "3. I am not a business oriented person(not saying I can’t learn it but I prefer not to deal with headaches of running it) " is huge misconception.

It's not hard. If you can go through dental school, learn the pathways of the krebs cycle, physiology, and human anatomy....then how can you not learn how to read a P/L, negotiate a lease, evaluate overhead etc etc. It's not hard.

 

[2TH MVR]

Just do it. Attend endo residency. It's what you want. Especially with your situation.

 

[allDAT]

No question a well run and popular endo office is more profitable than even a huge GP practice with multiple employee dentists.

Endo overhead is around 50% on a light schedule. 40% overhead for a busy office. General dentists are lucky to have 60% overhead if they’re doing all the dentistry and 70% OH is now common. If you’re paying an associate to do the work, maybe you clear 10% off their collections, but it can often be less (like 5% if you value having a good associate and compensate him or her well).

I would not worry about your employment options after specializing. You may work part time but take home a full time GP income for example. As endo, I would recommend just starting your own practice while you travel to one other GP office or work at an FQHC while you build it up. You only really need 2 chairs setup and in many markets your rent is paid by doing 1-3 RCTs/month.

 

[Saddleshoes]

How do you feel about the "suck up" game?
As a dental specialist you need to curry favor with all the GP's in your area. (Particularly when you start out.) That can be an unpleasant part of the job. You will find you don't like many of these people personally and/or professionally but you NEED them.
If the "suck up" game goes against your grain, I would suggest forgetting endo and become a great GP.

 

[2TH MVR]

How do you feel about the "suck up" game?
As a dental specialist you need to curry favor with all the GP's in your area. (Particularly when you start out.) That can be an unpleasant part of the job. You will find you don't like many of these people personally and/or professionally but you NEED them.
If the "suck up" game goes against your grain, I would suggest forgetting endo and become a great GP.

Much easier when your younger and full of energy. When I 1st came out .... I was pretty busy networking. I literally would visit EVERY GP and Pedo within a 10-15 mile radius of my office. Sometimes even farther. I joined the local rotory club. Became involved with the local dental society. Joined a study club. I wined and dined those GPs because they were partly responsible for my success early on. As you get older ... of course .... your "suck up" efforts start to lessen. Plenty of new specialists will try to take a GP from you. This issue with specialists competing for GP referrals in the same area can spark "referral wars" with competing specialists. When I was younger there was this unwritten code .... that if a GP office was RIGHT NEXT TO YOUR OFFICE .... other similar specialists would not "suck up" to that GP. Now with all the saturation ..... all's fair. Dog eat dog. No honor anymore.

Different specialists require different levels of "suck up" as you say. The Orthos and Pedos can market directly to the public. Most Pedo and Ortho practices exist in retail areas in full display to the public. Walks-ins welcome. Word of mouth can return plenty of new patients. The "suck up" factor would be pretty high with OMFS, Endo and Perio. These specialties require more direct referrals from GPs. When was the last time you saw an OMFS or ENDO practice right next to Starbucks?

 

[Rambunctious]

I am a general dentist currently fulfilling my obligation back in the military. I will be done with my commitment in 2022. Lately I have been thinking about what I want to do after my commitment and specializing have been coming up in my mind once in a while.

Here’s why I want/it makes sense for me to specialize (in endo)

1. I enjoy doing rct
2. On average specialists make more than general dentists working less hours/seeing less patients.
3. I am not a business oriented person(not saying I can’t learn it but I prefer not to deal with headaches of running it)
4. I will have the gi bill benefit so I can attend state any state school
In the country tuition free. I also will be receiving housing allowance under this benefit during school.

Here are my worries about specializing (in endo)

1. Finding employment might be difficult. Might need to juggle multiple offices to find Full time employment
2. A lot of the cases I will be doing will be tough.
3. Delaying income for 2 years by going into residency
4. As a specialist you actually need to be more business oriented?? Since you rely a lot on referrals. I am fine with working for someone forever however. Not sure how sustainable it is to do this.

Any comments or advice is appreciated

General, specialist, does not matter. Owning your own business opens up so much more opportunities for investment and that's how you make big money.

 

[LFA20]

How do you feel about the "suck up" game?
As a dental specialist you need to curry favor with all the GP's in your area. (Particularly when you start out.) That can be an unpleasant part of the job. You will find you don't like many of these people personally and/or professionally but you NEED them.
If the "suck up" game goes against your grain, I would suggest forgetting endo and become a great GP.

What if I decide to just work for someone forever? (In house endo or corporate). I would not need to suck up correct?

 

[2TH MVR]

What if I decide to just work for someone forever? (In house endo or corporate). I would not need to suck up correct?

Sure, but why limit yourself to one form of practice. Why not diversify your options. Small low overhead private practice along with a PT job for someone else. Then you only need to suck up a little. Seriously. Asking for referrals isn't that difficult and is necessary when you own your own practice. Re: referrals. Just need to be realistic. I could go out to lunch with 10 GPs and only one of them might try me out with a patient referral. It does get old though.

 

[allDAT]

What if I decide to just work for someone forever? (In house endo or corporate). I would not need to suck up correct?

Good endodontists and oral surgeons don’t have to play many games to gain the trust of a GP. The main thing that both have to do is answer their phone during an emergency and see the patient. That can be hard on the specialist if they have a family and need to be home, but if a good referring dentist calls and asks for help, you’re expected to help. But, this should be one of the reasons you chose to specialize (gaining joy from helping your colleagues).

Perio might have to cater to the GP a little more because there’s a reluctance to refer for chronic periodontitis.