Latest Annual Net Income of Specialists....Enjoy

[CaliDDS1986]

I guess each orthodontist has his/her own unique business model depending on where he/she practices. I think if you have unlimited supply of patients who want invisalign tx and a limited supply of experienced ortho RDAs, then Chris Bentson’s business model works well.

You see, here in CA, I have a limited number of active patients and an oversupply of part time ortho RDAs. I only have around 800 active patients and I only need to work 11-12 days/month to take care all of these patients. I have plenty of free time to post on this forum. My office is far from reaching its maximum capacity. That’s why I still have to keep myself busy by working for a chain the other 11 days/month. That’s why I try to keep everything low tech so I can assign tasks for my F/T staff to do to keep them busy.

Some like to pay big bucks on a new technology (ie Invisalign, intraoral scanners, Suresmile, self-ligating brackets etc) to replace human labor (ortho assistants). Some earn their profit by using cheap human labor (ortho RDA’s salaries) and avoiding expensive high tech gadgets.

I have no dog in the fight, I'm just a GP thinking about going back for ortho. In my opinion, the future will be heavy aligner treatment. I guess it depends on your demographic, but in mine all patients ask for it and they won't stop until they hit an office that offers it. If you don't learn it, you run the risk of becoming obsolete in 20 years. In any case, we basically all work for Invisalign or clear correct now whether your a GP or an ortho. Have you seen aligns stock price? Those guys are killing it 100x over!!!

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[CaliDDS1986]

I have no dog in the fight, I'm just a GP thinking about going back for ortho. In my opinion, the future will be heavy aligner treatment. I guess it depends on your demographic, but in mine all patients ask for it and they won't stop until they hit an office that offers it. If you don't learn it, you run the risk of becoming obsolete in 20 years. In any case, we basically all work for Invisalign or clear correct now whether your a GP or an ortho. Have you seen aligns stock price? Those guys are killing it 100x over!!!

BTW @Firm how do you have to spend 200-300k to get good at aligners? There's the learning curve with everything, but can't you assume your charging for those early cases as well? Your not going to work for free.

 

[charlestweed]

I have no dog in the fight, I'm just a GP thinking about going back for ortho. In my opinion, the future will be heavy aligner treatment. I guess it depends on your demographic, but in mine all patients ask for it and they won't stop until they hit an office that offers it. If you don't learn it, you run the risk of becoming obsolete in 20 years. In any case, we basically all work for Invisalign or clear correct now whether your a GP or an ortho. Have you seen aligns stock price? Those guys are killing it 100x over!!!

When you become good at tx planning (from years of clinical experience) and at doing things the hard way (ie the traditional brackets), it's not that hard to switch to an easier mode of tx: Invisalign. It's like switching from driving a stick shift to an automatic transmission. I have zero interest in doing Invisalign now because most of my patients can't afford it. A low income mother of two would rather pay for the cheaper fixed appliances so both of her kids can have a beautiful smile than paying double for Invisalign tx but only one of her kids can have a beautiful smile. I am doing fine without Invisalign. The corporate chain, that I work for, doesn't do Invisalign and they are making millions of dollars every year.

CaliDDS1986, I hope you'll get accepted. When you get out and set up your practice here in CA, you won't have to worry about orthodontists like me, who might take the patients away from your practice because I am more interested in targeting 80% lower income earners. If you are willing to take more risk by taking out more loan to invest in the new technology, then go for it. Many took the risk and become very successfull. Taking risk is the key ingredient for success.

I am not worried about being obsolete in 20 years. I am 45 now and plan to slow down in a couple of years. I'll let my son deal with the future if he plans to follow my footstep and takes over my practice.

 

[Firm]

BTW @Firm how do you have to spend 200-300k to get good at aligners? There's the learning curve with everything, but can't you assume your charging for those early cases as well? Your not going to work for free.

I still have to pay for the training and for the revisions.

 

[Firm]

When you become good at tx planning (from years of clinical experience) and at doing things the hard way (ie the traditional brackets), it's not that hard to switch to an easier mode of tx: Invisalign. It's like switching from driving a stick shift to an automatic transmission..

It's not as easy to switch treatment methods. There is a proven model to copy in traditional orthodontics, there isn't one in aligner heavy practices.

 

[charlestweed]

It's not as easy to switch treatment methods. There is a proven model to copy in traditional orthodontics, there isn't one in aligner heavy practices.

Ortho is no brain surgery. Just like everything else, the more cases you treat, the more you’ll learn. However, being good at Invisalign is not enough. Being good at marketing is more important. The hard part is to get the patients to pick up the phone to call your office. The hard part is to get the patients to accept the treatment. The Invisalign sale reps always act as if we have unlimited supply of patients. As more and more orthos target the same small top 20% income earners, the patients: doctors ratio becomes smaller. A lot of people want Invisalign tx. Who wouldn’t want to have straight teeth without having to wear ugly braces? When the patients realize that they have to put a large initial down payment or they have to have a good credit score in order to get approved for CareCredit, they back out and choose the more affordable fixed appliance tx.

I think you’ll get more invisalign case acceptance if you are willing to absorb the initial cost for the patients and take the risk by offering the same payment plan as the fixed appliances. For me, I am not willing to take that risk. The reason T-mobile and Verizon make a lot of money is everybody can walk away a new Iphone or a Samsung S8 with no down payment and $35 monthly payment.

Another reason I don’t like doing Invisalign or Clear Correct or using other latest technology is I don’t like being dependent on other companies. They can change their policies and prices at any time and I cannot do anything about it. I like to have full control of my own business.

 

[Munks]

[deleted]

 

[2TH MVR]

Well, this thread kind of derailed and became Ortho Business 101. I can't speak for other Orthos, but the economics of making exceptional money in Orthodontics was GREAT (for me) right after I graduated (1993) and continued to 2008 (crash). After that .... my business model did not suit the current business climate. To use Charlestweed's % .... I was trying to treat those 20% high earners and at the same time treat the low fee 80% in the same fashion. Not sure that works .... in this climate. Charlestweed's model is smart since he devotes 100% effort in low overhead with low fees. His practice is one direction with a clear focus. I, like Charlestweed am also balancing private practice and Corp part time. This combination has enabled me to again ... make the same salary, or close to it, that I once enjoyed pre-2008. But ... back then .... I worked 4 days a week. Today I work 6 days a week. I actually do not mind it ... for now.

As for new Ortho grads .... I believe they will be just fine. But they will have to adapt to the new business climate. I agree that aligner treatment is not going anywhere .... if anything it will be become more popular.

Knowing what I know now .... would I have changed anything? Maybe. I've never liked to "sell" or "market" to patients. It feels like we are selling a commodity. I didn't go to school for that many years to sell a set of braces or aligners. But ........ as others have said .... the work is relatively easy. Easy on the body. Most of our patients are happy and healthy. Malpractice is very rare. No midnight emergencies. Not a bad life.

 

[omfsing]

So dentofacial orthopedics is sticking? Interesting

 

[cloth_alert00]

How is the future for prosth? On average, do they make more than GP?

 

[hahadino2771]

this is my view since I did 10+ arches of full crown/bridge/ all on four implant reconstruction.

Prosth
1. you can work as a GP* in mid class neighborhood. Your txplanning skills and ability to diagnose/predict things would be great. You will have confidence to treat very difficult denture cases that I do not enjoy doing
2. or you can work in high end fee for service practice where prosth charge $2000 - 4000 per unit of crown/bridge/veneer.
3. trends are shifting. more and more prosths are surgically trained, and they want to do all their implant surgeries. One prosth around me places 500 implants a year; does 50 full mouth implant recon a year. Another guy 40 miles away from me refers out to OS for implant placement; this guy haven't done any full mouth recon this year but just practices routine crown/bridge.
4. you should talk to practicing prosthodontists about it. Most prosth around me owns their own practice.

you can always learn the technical skills through CEs, implant dentistry, implant surgery, full mouth rehab through CE classes these days. LVI, Spear, Kois, etc. go for i. If you have drive to do and master your skills, you can literally do anything.

However, when it comes to treatmentplanning large complex cases like prosth, it is more important:
1. to undersand Pt's psychology
2. to connect with Pt
3. to have Pt to trust you.
4. otherwise, no one will buy your $20,000 - 50,000 txplans.

this is my 2 cents

How is the future for prosth? On average, do they make more than GP?

 

[TanMan]

How is the future for prosth? On average, do they make more than GP?

I'm weary about prosth, and it requires a special kind of patience to be able to deal with the cases you're referred by the GPs. Looking at it from a liability POV, would you rather do a 100 units on a 100 patients or 100 units on 15 patients. I think your risk is much higher on the 15 patients, since they are more complex and paid more (sometimes they think it's a lifetime warranty). The workup for the cases are also more time intensive. If you enjoy a challenge, go for it; that does not always equate to more money/hour. As mentioned, you'll have to do lots of CE courses, which is OK if you're planning to do this for a long time. I wouldn't want to burn too much money into CE's if I were going to retire earlier and I would not realize my ROI in a timely manner.

 

[periopocket]

ADA Health Policy Institute FAQ – Dentist Income and Gross Billings

Income and Gross Billings
What is a dentist’s average net income?

The average net income for a private practitioner in 2017 was $197,190 for a general practitioner and $320,990 for a specialist.

 

[periopocket]

 

[sb.tnh]

ADA Health Policy Institute FAQ – Dentist Income and Gross Billings

Income and Gross Billings
What is a dentist’s average net income?

The average net income for a private practitioner in 2017 was $197,190 for a general practitioner and $320,990 for a specialist.

Do you know if these numbers include both owners and associates or it it just owners?

 

[periopocket]

Do you know if these numbers include both owners and associates or it it just owners?

I dunno mate....Its confusing, it just says private practitioner, my mom thinks it means owner.....

 

[Wingie]

Do you know if these numbers include both owners and associates or it it just owners?

Both. See Table 1 in the spreadsheet

 

[BYU4you]

View attachment 253162

I don’t know much about this, but seems interesting that for OMFS for example, the gross billing median was somewhere around 1.4 mil and here median income is 330k. That seems a pretty big difference. (Obviously just based on number of respondents for each its probably different groups of people). Wondering how representative this study actually is.

 

[sb.tnh]

Both. See Table 1 in the spreadsheet

OK I see. The average GP owner income is around $215k while the average associate income is $134k. Also the ADA says that they don't have enough data to calculate the average income of new graduates.

 

[DDS9994]

I don’t know much about this, but seems interesting that for OMFS for example, the gross billing median was somewhere around 1.4 mil and here median income is 330k. That seems a pretty big difference. (Obviously just based on number of respondents for each its probably different groups of people). Wondering how representative this study actually is.

Keep in mind these are based on surveys a lot of times from participants, I get them from time to time and toss in the garbage. With that being said the difference you see I suspect may factor in OMFS who are part timers, academia, hospital based, and they skew the income part. At 1.4 million that would double the 330K income.

 

[2TH MVR]

Gross billings (production/collections) minus overhead = net income.

 

[BYU4you]

Gross billings (production/collections) minus overhead = net income.

That’s the pointAccording to this survey for OMFS, median gross billings is 1.4 mil, overhead is 600k and median income is 330k.

Super different numbers. The billings and overhead are probably closer than median income is, as states earlier skewing based on the type of OMFS answering.

 

[2TH MVR]

That’s the pointAccording to this survey for OMFS, median gross billings is 1.4 mil, overhead is 600k and median income is 330k.

Super different numbers. The billings and overhead are probably closer than median income is, as states earlier skewing based on the type of OMFS answering.

I see what your saying. Also remember that actual collections is probably a little lower than billing (production).
Still impressive numbers although the medium income seems low.