Lower income for Pediatric dentists due to Obamacare? Is the Pedo residency still worth it?

[pedped]

I love pediatric dentistry and I would like to do it, but there are also bills/loans to pay... I have to decide now - Pedo or GPR residency?

What do you think:

- will the income of pediatric dentists get lower due to Obamacare? e.g. more kids on Medicaid - less self paid cases, lower payments via insurance companies etc... Will pediatric dentist have to see more patients than in the past to make the living (less time for patient)?

- Do you think Obamacare will have a big impact on General dentists/their income and their private practices?

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[lwen5]

Pediatric dentists should fear the burgeoning explosion of residency programs, propped up by federal grant money, more than anything. I think they will have to see more patients to make the same and I've heard the same from dentists. More competition and the fertility rate of the nation has gone down, even in the minorities which have high fertility rates (and who will most certainly be leeching off of Medicad).

Obamacare doesn't affect dentistry that badly. But there is a bill being proposed cause the "Comprehensive Dental Reform Act" being introduced by useful idio.t socialist Sneator Bernie Sanders and Elijah Cummings. This bill will hurt private practice dentists and give mid-levels and corporate chains a lot of power. The bill is still a bill and it won't get passed probably until after the 2016 election, when Hillary and the rest of liberal wolves come to power in 2016 again. We will have to wait until 2016-2020 to really see what dentistry's final fate will be. Pray that the people of America aren't so stupid this time when they go to the polls.

 

[lwen5]

Also I would like to add, I think it is not worth becoming a pediatric dentist. There is nothing good happening for this specialty. There is no light at the end of the tunnel for it.

 

[pedped]

Yes, this is exactly what bothers me too... Most kids will be on Medicaid, insurance companies will push the payments down, there will be too many Pediatric dentists (already are...) and you will have to make 30 patients/day to make the living... (which obviously will lower the level of treatment, as there will be very short time per patient)

So, as I see it right now - better option would be to go for GPR and have adult&Peds patients together... be universal...

 

[Wax n Relax]

Yes, this is exactly what bothers me too... Most kids will be on Medicaid, insurance companies will push the payments down, there will be too many Pediatric dentists (already are...) and you will have to make 30 patients/day to make the living... (which obviously will lower the level of treatment, as there will be very short time per patient)

So, as I see it right now - better option would be to go for GPR and have adult&Peds patients together... be universal...

Most pediatric dentists see 50+ patients a day anyways. It is about efficiency. And yes, the appts are very short for a reason. You are working on 4 year olds with the attention span of a goldfish.

 

[pedped]

Most pediatric dentists see 50+ patients a day anyways. It is about efficiency. And yes, the appts are very short for a reason. You are working on 4 year olds with the attention span of a goldfish.

Do you mean the "money mill" kind of practice with several chairs where the Peds dentist jumps from patient to patient after the assistents prepare them? This is not the kind of treatment I would like to offer. You do not have the time to communicate with the kids, if you have anxious patients, you want to use nitrox, sedation etc... - from my experience Peds dentist had up to 20 patients per day (plus cleanings...).

50+ patients per doctor/day seems to me a bit too much to offer sufficient level of treatment...

But I'm affraid that it may look like this under Obamacare... which is bad and sad...

 

[CaliDDS1986]

Obamacare won't lower the income of peds. The dramatic rise in the number of residency spots the past few years will, especially since peds income is based on volume.

 

[ucla2134]

Please don't go into specialty just because of $$$$ signs. Not everyone has the personality for pediatric dentistry. You'll be miserable for the rest of your life of choosing any specialty base on the dollar signs.

 

[pedped]

Please don't go into specialty just because of $$$$ signs. Not everyone has the personality for pediatric dentistry. You'll be miserable for the rest of your life of choosing any specialty base on the dollar signs.

I have worked with Peds patients - I love it - I'm just afraid, that the level of treatment will get lower due to the fact, that you will have to see much more patients to earn the living - that's my current problem - if I go for Peds specialty, it's 2 years with small residency income and then you may end with less money than general dentist (as Peds under Obamacare...). So, it may be better to go for GPR (which is just for 1 year) and then be general dentist who can treat both- adults and kids...

 

[Shunwei]

Obamacare won't lower the income of peds. The dramatic rise in the number of residency spots the past few years will, especially since peds income is based on volume.

In my class a whopping 1/4 of my classmates applied pedo residency. At that time it was the hotcake. It was just like a decade ago when everyone was chasing after a seat in ortho, and just like in ortho the # of residency seats, due to demand (and greed of programs), is increasing way too fast. This boom will deflate the value of the residency undoubtedly.

 

[gryffindor]

In my class a whopping 1/4 of my classmates applied pedo residency. At that time it was the hotcake. It was just like a decade ago when everyone was chasing after a seat in ortho, and just like in ortho the # of residency seats, due to demand (and greed of programs), is increasing way too fast. This boom will deflate the value of the residency undoubtedly.

I get the feeling that Pedo is the new Ortho.

And the # of seats in ortho did not increase due to demand because demand has always been there. They increased due to greed combined with the ease in which a program can be opened and accredited. It's like two lawn chairs from Costco in your garage could suffice to get initial accreditation for an ortho program.

 

[lwen5]

I'm sure there are pediatric residency programs that charge tuition and if not, there soon will be ones that will charge tuition (especially the ones with a prestigious titles, like UPenn). It is like ortho residencies, with like 30 residents. Just look at Lutheran Medical Pediatric Residency Programs. They take 48 people each year!

With gullible dental students and the federal government acting like Santa Claus with hardworking Americans' tax-payer dollars, there is truly something to be said:
"Ain't no business like the education business!"

 

[Shunwei]

I get the feeling that Pedo is the new Ortho.

And the # of seats in ortho did not increase due to demand because demand has always been there. They increased due to greed combined with the ease in which a program can be opened and accredited. It's like two lawn chairs from Costco in your garage could suffice to get initial accreditation for an ortho program.

That's what I mean, the demand drove the addition of programs which can charge students a gazillion because people desperately want it. Nowadays everyone and their mother can run an ortho program. I have no doubt that some programs if not so will start charging tuition if this pedo craze continues.

 

[Silent Cool]

That's what I mean, the demand drove the addition of programs which can charge students a gazillion because people desperately want it. Nowadays everyone and their mother can run an ortho program. I have no doubt that some programs if not so will start charging tuition if this pedo craze continues.

Many programs already do charge tuition, among them NYU, UNLV, USC, Loma Linda, Tufts, and BU.

http://www.aapd.org/residency_program/

 

[Silent Cool]

I get the feeling that Pedo is the new Ortho.

And the # of seats in ortho did not increase due to demand because demand has always been there. They increased due to greed combined with the ease in which a program can be opened and accredited. It's like two lawn chairs from Costco in your garage could suffice to get initial accreditation for an ortho program.

Haha, I almost spit my coffee out when I read that.

 

[Silent Cool]

I'm sure there are pediatric residency programs that charge tuition and if not, there soon will be ones that will charge tuition (especially the ones with a prestigious titles, like UPenn). It is like ortho residencies, with like 30 residents. Just look at Lutheran Medical Pediatric Residency Programs. They take 48 people each year!

With gullible dental students and the federal government acting like Santa Claus with hardworking Americans' tax-payer dollars, there is truly something to be said:
"Ain't no business like the education business!"

 

[gryffindor]

That's what I mean, the demand drove the addition of programs which can charge students a gazillion because people desperately want it. Nowadays everyone and their mother can run an ortho program. I have no doubt that some programs if not so will start charging tuition if this pedo craze continues.

That's true. Just sucks that the demand was there for a good 40 years before our cultural (access to care!) and economic (unlimited student loans!) landscapes changed and vultures decided to take advantage of it.

 

[Shunwei]

A

That's true. Just sucks that the demand was there for a good 40 years before our cultural (access to care!) and economic (unlimited student loans!) landscapes changed and vultures decided to take advantage of it.

All I am hoping for is that the field can be sustained for another 20-25 years, so I can make my money and then either do something else or work part time while collecting my dividend stream. The country is going socialist soon and the field is also setting itself up for a train wreck.

 

[Silent Cool]

A

All I am hoping for is that the field can be sustained for another 20-25 years, so I can make my money and then either do something else or work part time while collecting my dividend stream. The country is going socialist soon and the field is also setting itself up for a train wreck.

And it's all because of federal intervention into the marketplace.

 

[saru24]

These worries are too far fetched to worry about at this time. They can't even get Obamacare set up right, didn't 6 people sign up the first day. Even if it does change, you'll learn to adapt. Pediatric dentists are used to seeing volume anyway. Unless caries vaccine comes out (they've been talking about it for 40 years now) or dental assistants could/would want to start prepping baby teeth, I would recommend pedo- if you have an inkling of interest in it. Even with the new spots opening, there is still plenty of opportunity for a GOOD pediatric dentist and if you really want to do crowns and dentures after a residency you still can.
Yes I am biased for pedo as I am a pediatric dentist.

 

[lwen5]

A

All I am hoping for is that the field can be sustained for another 20-25 years, so I can make my money and then either do something else or work part time while collecting my dividend stream. The country is going socialist soon and the field is also setting itself up for a train wreck.

I'm actually very interested in this. I was thinking I might have maybe just 10-15 years after im done with dental school to be in the field of dentistry. I do want to have something else on the side, though. I feel like dentistry is much more conducive to allowing one to engage in something else. I do not feel that way about medicine.

For all you dentists out there: How many dentists do you know have another business in something non-dentistry related?? What type of business are they usually in?

 

[pedorox]

I agree that if you're only doing this for the money, there's no way you'll get through pedo.

However, why is everyone always talking about there's a shortage of dentists/pediatric dentists/etc? I feel like this shortage talk is being used by these "educational institutions" for profit. Now if you analyze the shortage, it's not the major cities; it's always in the rural areas. I am from a rural area, and see the effects it has having the nearest dentist be 42 minutes away in rural PA. Has the increase in the number of dental schools or dental school graduates helped these areas? Has the increase in the number of residency spots helped these areas? NO! Most of these dentists end up in the saturated areas anyway. We have had 1 dentist for the past 28 years here in my area, who as a I mentioned before is 42 minutes away. He bought the practice from a guy who owned it for the previous 20 years. So for the last 48 years, there has been only one dentist in my area. You look at California, where the desert areas have severe shortages. People there used this "shortage" to build more dental schools in Southern California (Ponoma and soon San Diego), which happens to be the most saturated area in California. Also, by increasing the number of spots, I believe it is becoming less competitive and less qualified people will be allowed to be dentists. Is that really what we want in our profession?

There's no law saying there must be a dentist practicing in rural areas, and quite frankly there will never be. Adding expanded function hygienists won't solve the problem either, because most will also want to go to metropolitan areas, not rural areas. Yet, we continue to say there's a shortage. Well folks, there is a shortage in rural areas, but to say we are fixing it by increasing the number of dentists is an artificial fix. You'll only saturate areas more and more that already have dentists. How many fresh graduates in California work as hygienists to start? I know a friend who graduated last year who is doing just that.

Additionally, I agree with the Santa Claus theory. However, I think once the government pulls out the money, you'll see residency programs shut down left and right. I was actually told this at a recent interview.

Just my two cents. In the end, I realize I'm just one voice.

 

[Shunwei]

I agree that if you're only doing this for the money, there's no way you'll get through pedo.

However, why is everyone always talking about there's a shortage of dentists/pediatric dentists/etc? I feel like this shortage talk is being used by these "educational institutions" for profit. Now if you analyze the shortage, it's not the major cities; it's always in the rural areas. I am from a rural area, and see the effects it has having the nearest dentist be 42 minutes away in rural PA. Has the increase in the number of dental schools or dental school graduates helped these areas? Has the increase in the number of residency spots helped these areas? NO! Most of these dentists end up in the saturated areas anyway. We have had 1 dentist for the past 28 years here in my area, who as a I mentioned before is 42 minutes away. He bought the practice from a guy who owned it for the previous 20 years. So for the last 48 years, there has been only one dentist in my area. You look at California, where the desert areas have severe shortages. People there used this "shortage" to build more dental schools in Southern California (Ponoma and soon San Diego), which happens to be the most saturated area in California. Also, by increasing the number of spots, I believe it is becoming less competitive and less qualified people will be allowed to be dentists. Is that really what we want in our profession?

There's no law saying there must be a dentist practicing in rural areas, and quite frankly there will never be. Adding expanded function hygienists won't solve the problem either, because most will also want to go to metropolitan areas, not rural areas. Yet, we continue to say there's a shortage. Well folks, there is a shortage in rural areas, but to say we are fixing it by increasing the number of dentists is an artificial fix. You'll only saturate areas more and more that already have dentists. How many fresh graduates in California work as hygienists to start? I know a friend who graduated last year who is doing just that.

Additionally, I agree with the Santa Claus theory. However, I think once the government pulls out the money, you'll see residency programs shut down left and right. I was actually told this at a recent interview.

Just my two cents. In the end, I realize I'm just one voice.

There isn't a shortage and there never was. Many people don't realize how dirty and scheming the educational institutions can be. My view of the ivory tower has gone from one of respect to one of "**** them." These people will concoct lies and fabricate studies to justify their myth of shortages so that their student loans and educational/research grants can pay their salaries. I even suspect that the ballooning student loan situation is a feeble attempt by the left to try and compensate for the sure failure of the tax/social security/welfare system. By placing students under a massive yoke of a student loan with interest for a long time, it is a nice source of long-term income for the government as well.

 

[gryffindor]

Additionally, I agree with the Santa Claus theory. However, I think once the government pulls out the money, you'll see residency programs shut down left and right. I was actually told this at a recent interview.

Just my two cents. In the end, I realize I'm just one voice.

That's interesting that an interview told you the government will pull the residency funding. There was a very short stint from like 2002 - 2004 where nearly ALL dental residencies got GME money - those in the schools in addition to the ones in the hospital that always had the money. Places that were previously charging high tuition were suddenly waiving tuition from this newfound money source and some were even paying their residents - schools like UOP Ortho, Penn Endo etc. I don't remember why the funding happened to begin with, but that ended really fast. I remember thinking at the time that we as a country are spending so much money on a war that we have to pull dental residency funding to pay for it. The residents who trained during that time were really lucky. So if it got pulled once, it could certainly get pulled again...

Edit - I will also add that I heard once long ago that GME funding for hospital dental residencies comes from a different pot than GME funding for medical residencies. The medical residency funding and thus the spots are very tightly controlled which is why you don't see medical residencies opening so quickly or adding spots to programs so quickly, but the dental residencies spots have no such controls so maybe someone capitalized on this loophole and now here we are with a million new pedo programs...

 

[lwen5]

There isn't a shortage and there never was. Many people don't realize how dirty and scheming the educational institutions can be. My view of the ivory tower has gone from one of respect to one of "**** them." These people will concoct lies and fabricate studies to justify their myth of shortages so that their student loans and educational/research grants can pay their salaries. I even suspect that the ballooning student loan situation is a feeble attempt by the left to try and compensate for the sure failure of the tax/social security/welfare system. By placing students under a massive yoke of a student loan with interest for a long time, it is a nice source of long-term income for the government as well.

Amen. Educational institutions and many of the academics who work in them are complete slimebags. I hate how many of them like to paint private practice doctors as money grubbing villains, when we ALL know it isn't the case. They will do anything for their stupid research grants and publicity. The worst academics are from the Ivy-leagues. The worst healthcare academics I've heard are Zeke Emanuel (the architect of Obamacare) and useful idio.t Atul Gawande (the doc who made some dumb hospital checklist). It is sad because the public will always believe these fools who will flaunt their academic standing and can talk smoothly.

It would be absolutely hilarious if Wall St (which funds the dental chains) got into the business of starting dental residencies (that charged lots of tuition).

 

[Silent Cool]

There isn't a shortage and there never was. Many people don't realize how dirty and scheming the educational institutions can be. My view of the ivory tower has gone from one of respect to one of "**** them." These people will concoct lies and fabricate studies to justify their myth of shortages so that their student loans and educational/research grants can pay their salaries. I even suspect that the ballooning student loan situation is a feeble attempt by the left to try and compensate for the sure failure of the tax/social security/welfare system. By placing students under a massive yoke of a student loan with interest for a long time, it is a nice source of long-term income for the government as well.

Shunwei has once again hit the nail on the head.

Let's consider an undergraduate student with 50K of debt who enters a private dental school and then enters one of the aforementioned Pedo residencies that charge tuition.

Assuming an interest rate of 7.35% (it's lower now but was that value until just recently), that student would owe ~850K at the end of a Pedo residency.

Let's assume the avg. Pedo income of 350K in a state like California.
That's a take-home of $186472 (paycheckcity.com)
If our theoretical Pedodontist is on a 2o-year student loan payback plan, then the yearly loan payments will be $81324.

If you combine that with yearly taxes of $163528, then you are losing a total of $244852 each year to state and federal taxes and student loan payments (which are basically a tax).

244852/350000 ~0.7

So, federal and state government is getting about 70% of your income--for 20 years in that scenario. Notice that I didn't include the cost of practice purchase (which you would need to get that 350K+ income), which means your take-home is even less for at least 7 years (typical practice loan period).

At least in France only folks making ~1 million+ are taxed at 70%. Here in the good ol' USA those of us trying to better ourselves through education (and earning A LOT less than a million) could effectively be 'taxed' at 70%.

How screwed up is that? Those with rich parents paying for the whole thing could care less. And many of them will inherit a practice from their parents as well. Those of use paying for our education will end up further behind the 8-ball all because of government intervention into the marketplace.

 

[pedorox]

There's a major flaw in the sytem, no doubt. You look at places like the multiple LMC programs. 48 spots in total. That's crazy! They obviously are capitalizing on whatever loophole you are referring to with dental residencies. Look at all their residencies they have available. I know many people look down upon LMC, but in this world of "dirty politics," everyone running a residency must wish they could be like Lutheran. I wonder how much they bring in? Anyone know?

 

[gryffindor]

It would be absolutely hilarious if Wall St (which funds the dental chains) got into the business of starting dental residencies (that charged lots of tuition).

Sadly it's already been done.

http://www.lasvegassun.com/news/2006/jun/28/dental-fix/

I suspect the chains study this case closely on how to not run a dental residency so version 2.0 won't fail like this venture did.

 

[pedorox]

Sadly it's already been done.

http://www.lasvegassun.com/news/2006/jun/28/dental-fix/

I suspect the chains study this case closely on how to not run a dental residency so version 2.0 won't fail like this venture did.

Is it ironic that Lutheran's main site is close to wall street?

 

[Shunwei]

Shunwei has once again hit the nail on the head.

Let's consider an undergraduate student with 50K of debt who enters a private dental school and then enters one of the aforementioned Pedo residencies that charge tuition.

Assuming an interest rate of 7.35% (it's lower now but was that value until just recently), that student would owe ~850K at the end of a Pedo residency.

Let's assume the avg. Pedo income of 350K in a state like California.
That's a take-home of $186472 (paycheckcity.com)
If our theoretical Pedodontist is on a 2o-year student loan payback plan, then the yearly loan payments will be $81324.

If you combine that with yearly taxes of $163528, then you are losing a total of $244852 each year to state and federal taxes and student loan payments (which are basically a tax).

244852/350000 ~0.7

So, federal and state government is getting about 70% of your income--for 20 years in that scenario. Notice that I didn't include the cost of practice purchase (which you would need to get that 350K+ income), which means your take-home is even less for at least 7 years (typical practice loan period).

At least in France only folks making ~1 million+ are taxed at 70%. Here in the good ol' USA those of us trying to better ourselves through education (and earning A LOT less than a million) could effectively be 'taxed' at 70%.

How screwed up is that? Those with rich parents paying for the whole thing could care less. And many of them will inherit a practice from their parents as well. Those of use paying for our education will end up further behind the 8-ball all because of government intervention into the marketplace.

Failure is already at hand with 1 out of 7 student loans being defaulted. However, with the compounding power of those loans that are being paid it may still be profitable. But I do know that increases in loans cannot continue at the current pace or else no one will be able to afford it soon.

 

[lwen5]

Is it ironic that Lutheran's main site is close to wall street?

Sadly it's already been done.

http://www.lasvegassun.com/news/2006/jun/28/dental-fix/

I suspect the chains study this case closely on how to not run a dental residency so version 2.0 won't fail like this venture did.

Hahahahah. That is absolutely hilarious with UNLV getting their residencies banked by Wall St. Thank you for that link gryffindor that absoutely made my evening!

 

[saru24]

Take as much loans as you want. Just get fixed interest. Just like this decaying, mismanaged by wannabe Euro socialists country, go into as much debt as you want. Hyperinflation is on its way…….You'll pay your 500,000 dollar debt with one month of work!

 

[DrDoofenshmirtz]

I have worked with Peds patients - I love it - I'm just afraid, that the level of treatment will get lower due to the fact, that you will have to see much more patients to earn the living - that's my current problem - if I go for Peds specialty, it's 2 years with small residency income and then you may end with less money than general dentist (as Peds under Obamacare...). So, it may be better to go for GPR (which is just for 1 year) and then be general dentist who can treat both- adults and kids...

Look at some real numbers. A pediatric dentist straight out of residency is offered about 100k more than a general dentist for an associate position. Sure the political landscape is changing, but it always does. Do peds if you like it, if not then go do your GPR. The greatest benefit of peds isnt the $$$, it's working with kids (and better yet, not having to work on adults).

The fact is all general dentistry (including peds) is volume based.

 

[CaliDDS1986]

Look at some real numbers. A pediatric dentist straight out of residency is offered about 100k more than a general dentist for an associate position. Sure the political landscape is changing, but it always does. Do peds if you like it, if not then go do your GPR. The greatest benefit of peds isnt the $$$, it's working with kids (and better yet, not having to work on adults).

The fact is all general dentistry (including peds) is volume based.

Not true. The key to success in general dentistry is passive income and FFS patients. Don't believe me? Go shadow a Medicaid mill where the associates see 30 patients a day. While in peds, the norm is more patients, in general dentistry that's the low point of the totem pole.

 

[yappy]

Sadly it's already been done.

http://www.lasvegassun.com/news/2006/jun/28/dental-fix/

I suspect the chains study this case closely on how to not run a dental residency so version 2.0 won't fail like this venture did.

As a profession dentistry doesn't have any integrity.

 

[sarah_bellum]

This may be the worst thread I've ever made the mistake of reading on SDN.

 

[lwen5]

This may be the worst thread I've ever made the mistake of reading on SDN.

This may be the most useless post of the thread I've ever made the mistake of reading. Just kidding. But why is this a bad thread?

 

[Shunwei]

Not true. The key to success in general dentistry is passive income and FFS patients. Don't believe me? Go shadow a Medicaid mill where the associates see 30 patients a day. While in peds, the norm is more patients, in general dentistry that's the low point of the totem pole.

All of this is highly location-based. The trend nowadays for GPs is also for more insurance-based pts as well. FFS is good of course but my perception is that they are getting fewer and fewer. If you are strictly a cosmetic high-end practice sure, but most family general dentistry is heading towards insurance.

I think a 100k gap for fresh pedo associate is too optimistic. I don't think its that much.

 

[Shunwei]

As a profession dentistry doesn't have any integrity.

Lets not be too harsh on dentistry. I think anytime you deal with money people gets slimy, not just dentistry. It's not like fields like medicine, law, or finance don't have people out to play dirty.

 

[EtchNRinse]

This may be the worst thread I've ever made the mistake of reading on SDN.

I completely agree with this sentiment. The majority of this thread is really disturbing and I hope the moderators shut it down. Yes, many of us are under the weight of tremendous debt accumulated through outrageous tuition. I understand the ambition to get rid of this ball and chain, but to presume that dentistry wouldnt be fulfilling without "money" is absolutely absurd. Im ashamed that many of you think that "success" in our profession is equated to how much you net in a given year. This type of thought is the main reason the view of our profession has changed in the public eye. What happened to service? What happened to leaving our community better than you found it?

I went into dentistry specifically to work in public health and serve the less fortunate. This is not a self righteous tirade, as I know some aren't cut out for it, but its disheartening that some of you think serving medicaid patients is low on the "totem pole."

 

[Shunwei]

I completely agree with this sentiment. The majority of this thread is really disturbing and I hope the moderators shut it down. Yes, many of us are under the weight of tremendous debt accumulated through outrageous tuition. I understand the ambition to get rid of this ball and chain, but to presume that dentistry wouldnt be fulfilling without "money" is absolutely absurd. Im ashamed that many of you think that "success" in our profession is equated to how much you net in a given year. This type of thought is the main reason the view of our profession has changed in the public eye. What happened to service? What happened to leaving our community better than you found it?

I went into dentistry specifically to work in public health and serve the less fortunate. This is not a self righteous tirade, as I know some aren't cut out for it, but its disheartening that some of you think serving medicaid patients is low on the "totem pole."

Don't you think that you are overreacting a bit by requesting that it be shut down. It is very fortunate that you are happy with just the nature of the work itself. However, for most normal people dentistry is a job that pays the bills and serves the loans. Therefore, in this end, it is perfectly rational and acceptable for people to care about how much they make. For me personally, if dentistry is not paying me what it is now, I wouldn't do it because of all the psychological and physical toll this job entails. So while I respect those of you who say that you do dentistry for the sake of itself, lets not pretend that worldly concerns are insignificant. In the end, to each his own.

 

[lwen5]

I completely agree with this sentiment. The majority of this thread is really disturbing and I hope the moderators shut it down. Yes, many of us are under the weight of tremendous debt accumulated through outrageous tuition. I understand the ambition to get rid of this ball and chain, but to presume that dentistry wouldnt be fulfilling without "money" is absolutely absurd. Im ashamed that many of you think that "success" in our profession is equated to how much you net in a given year. This type of thought is the main reason the view of our profession has changed in the public eye. What happened to service? What happened to leaving our community better than you found it?

I went into dentistry specifically to work in public health and serve the less fortunate. This is not a self righteous tirade, as I know some aren't cut out for it, but its disheartening that some of you think serving medicaid patients is low on the "totem pole."

Amazing you think the thread should be shut down because it focuses on income. I doubt you would be in this profession if you made lower than 50k and had to pay above 300k for just tuition. Im ashamed that many people like you think that just because someone is worried about their income, means that they cannot be an ethical dentist. What if a dentist who doesn't like treating Medicaid populations, starts a program that increases STEM major participation in kids from poverty-stricken families?

 

[EtchNRinse]

H

Amazing you think the thread should be shut down because it focuses on income. I doubt you would be in this profession if you made lower than 50k and had to pay above 300k for just tuition. Im ashamed that many people like you think that just because someone is worried about their income, means that they cannot be an ethical dentist. What if a dentist who doesn't like treating Medicaid populations, starts a program that increases STEM major participation in kids from poverty-stricken families?

Have we seen this board lately? It's all about, "what's the starting salary," or "low income for pediatric dentists." Listen, I agree with being concerned about making enough to live on and pay debt, but when it's solely focused on equating money to success then we are very much getting away from what it means to provide healthcare. This looks very poor on our professions and precisely why many want to develop mid level dental providers. A storm is coming and we will lose control of our profession because we are clearly not servicing the need. There is a shortage in my area for pediatric dentists and dentists in general who treat Medicaid patients. The problem is no one wants to hurt their bottom line.

Who said you couldn't be an ethical dentist? I don't believe I said that. Im just shocked that all the emphasis is on money and not patient care.

I'm not even sure what your last question was asking to be honest.

 

[Shunwei]

H


Have we seen this board lately? It's all about, "what's the starting salary," or "low income for pediatric dentists." Listen, I agree with being concerned about making enough to live on and pay debt, but when it's solely focused on equating money to success then we are very much getting away from what it means to provide healthcare. This looks very poor on our professions and precisely why many want to develop mid level dental providers. A storm is coming and we will lose control of our profession because we are clearly not servicing the need. There is a shortage in my area for pediatric dentists and dentists in general who treat Medicaid patients. The problem is no one wants to hurt their bottom line.

Who said you couldn't be an ethical dentist? I don't believe I said that. Im just shocked that all the emphasis is on money and not patient care.

I'm not even sure what your last question was asking to be honest.

If there is a shortage of dentists treating Medicaid patients then I'd say its time for the government to stop low balling dentists who break their backs and spend time dealing with ungrateful patients and no shows. In the end, you get what you pay for. Paying someone Medicaid fees and expect them to buy into the socialist and welfare ideals is too much to ask for.

 

[lwen5]

H


Have we seen this board lately? It's all about, "what's the starting salary," or "low income for pediatric dentists." Listen, I agree with being concerned about making enough to live on and pay debt, but when it's solely focused on equating money to success then we are very much getting away from what it means to provide healthcare. This looks very poor on our professions and precisely why many want to develop mid level dental providers. A storm is coming and we will lose control of our profession because we are clearly not servicing the need. There is a shortage in my area for pediatric dentists and dentists in general who treat Medicaid patients. The problem is no one wants to hurt their bottom line.

Who said you couldn't be an ethical dentist? I don't believe I said that. Im just shocked that all the emphasis is on money and not patient care.

I'm not even sure what your last question was asking to be honest.

Amazing you think that those who want to develop mid level dental providers are actually interested in providing healthcare. The people interested in that are the people who are solely interested in money and are really unethical: the for-profit educational lobby and the corporate chains.

You do realize medicaid reimbursement is a joke and dentists who take it usually take a loss, right? Do you know how much of a pain it is to bill Medicaid? Shunwei is right on the money when talking about no-shows. There are many Medicaid patients who misbehave when they are in the office.
My last point was to prove that Medicaid services to poor kids isn't going to lift them out of poverty. Attaining a STEM job, will. Let's focus more effort on the latter.

The reason the storm is coming is because of the cozy relationship between big-government liberals and Wall St, as well as the American population whose mob mentality is this: "Spend money on ipods, plasma TVs, alcohol, jaunts to Vegas, but magically not find money to pay for basic dental checkups. But who cares? We can just tax those eviiil rich people and have them pay for it!"

Dentists who have no interest in treating Medicaid are not even remotely the reason our profession will be messed up. I am for helping WORKING poor people who DESERVE to be helped and taxing 'rich people' who did NOT earn their money in ethical ways. As Thomas Jefferson once said, "The democracy will cease to exist when you take from those who are willing to work and give to those who would not."

 

[yappy]

Amazing you think that those who want to develop mid level dental providers are actually interested in providing healthcare. The people interested in that are the people who are solely interested in money and are really unethical: the for-profit educational lobby and the corporate chains.

You do realize medicaid reimbursement is a joke and dentists who take it usually take a loss, right? Do you know how much of a pain it is to bill Medicaid? Shunwei is right on the money when talking about no-shows. There are many Medicaid patients who misbehave when they are in the office.
My last point was to prove that Medicaid services to poor kids isn't going to lift them out of poverty. Attaining a STEM job, will. Let's focus more effort on the latter.

The reason the storm is coming is because of the cozy relationship between big-government liberals and Wall St, as well as the American population whose mob mentality is this: "Spend money on ipods, plasma TVs, alcohol, jaunts to Vegas, but magically not find money to pay for basic dental checkups. But who cares? We can just tax those eviiil rich people and have them pay for it!"

Dentists who have no interest in treating Medicaid are not even remotely the reason our profession will be messed up. I am for helping WORKING poor people who DESERVE to be helped and taxing 'rich people' who did NOT earn their money in ethical ways. As Thomas Jefferson once said, "The democracy will cease to exist when you take from those who are willing to work and give to those who would not."

I cannot agree more with what you have written. The takers have learned that they can use the government to squeeze the makers - welcome to the new idiocracy. What is hilarious is it will be presented as "moral" or "fair" by those who everything to gain and nothing to lose.

Maybe it's just the culture shock of moving to a blue state recently; but, if I hear one more low-skilled-low-wage-uneducated-democrat cry for more "fairness" in their life I'm going to end up in a nut house. I wish I could move to the US that existed 60 years ago minus the racism and sexism.

 

[gryffindor]

I went into dentistry specifically to work in public health and serve the less fortunate. This is not a self righteous tirade, as I know some aren't cut out for it, but its disheartening that some of you think serving medicaid patients is low on the "totem pole."

If you go work in a public health facility, do you understand that someone else is paying to keep the lights on and pay the for rent and equipment there? Who is paying for the dental chairs and dental instruments and the amalgam capsules and the salaries of the dental assistants and front desk? Not you personally. These are costs we have to carry out on our own in in our private practices no matter who we serve. If you serve only unprofitable patients, you won't be able to keep your doors open let alone pay your student loan or basic living expenses. This is simple math and basic business common sense. It has nothing to do with wanting to earn only zillions of dollars as a dentist.

That said, I do treat Medicaid for ortho in private practice. Why? In my office, the kids in town who have Medicaid attend the local schools and are classmates with the kids who don't have Medicaid. Coverage is only for more complex cases so I get a chance to treat something more interesting than a mild class I crowding case on a patient with a high-maintenance mom who freaks out if there is a slight marginal ridge discrepancy. The state cleaned up the billing last year so it is not that difficult and payment is prompt. In another practice where I work, we see all the cleft and syndrome patients for free and don't even bill Medicaid for these kids because the office doesn't want to bother based on their experiences with the old billing (I am going to try and help them fix that). The only reason we can treat them for free is because there are enough earnings from the private patients to be able to offer this as a charity service.

In both offices, some families really appreciate it and are dedicated. We try to screen for the ones who seem like they will be good patients. But other families clearly don't care. Like the dad who called to say he couldn't bring his daughter to her appointments anymore because she went to go live with her mom. That could be a legitimate reason to not bring the daughter, except in this case her mom lives in the next town over from the office and probably lives closer to the office than dad. When the state agrees to cover treatment and it is free for the recipient, who cares if her canine stays impacted or not? Apparently neither mom or dad.

 

[EtchNRinse]

If there is a shortage of dentists treating Medicaid patients then I'd say its time for the government to stop low balling dentists who break their backs and spend time dealing with ungrateful patients and no shows. In the end, you get what you pay for. Paying someone Medicaid fees and expect them to buy into the socialist and welfare ideals is too much to ask for.

I agree with you that reimbursements should be higher for certain procedures. I think everyone can agree on that point. However, I disagree that you patients are "ungrateful." Sure, there are some who think they are owed certain things but thats across the board no matter what realm of dentistry you practice in. Quite a bit of stereotyping going on here.

 

[Shunwei]

Just came across this article this morning on MSN:

http://money.msn.com/health-and-lif...spx?post=d7ae72e3-cbec-4d8c-a1f7-0661aee7f6f8

No surprise here, just further confirmation that healthcare is going down the drains really fast. When I was planning my career change from STEM, I had seriously considered the MD as well. The increased time commitment nonwithstanding, the thing that concerned me the most was the impending government intrusion into the system. Glad I didn't go that route. With the current trend the quality of the care will trend down because in the end you get what you pay for, and not to mention the increased corruption and inefficiency of government-managed healthcare. The thing is that the government has too much invested in the system to back off or quit, so they will make it "work" one way or another, so eventually enrollment will increase. Those MDs that resist contracts will eventually either retire, be forced to enroll due to decreased patient volume, or suffer decreased salaries due to loss of patient pool. The sad thing is that in the end, most people still buy on price, so they have no idea the kind of damage this system can have on healthcare.

My guess is that the same thing will eventually happen to dentistry as well, but we do have a bit of a buffer. Ironically, the decision of the AMA long ago to bar dentistry from their ranks may have saved us, for now. My prediction is that in about 20-25 years dentistry will be regulated like medicine, but at least I will be able (hopefully) to retire in good condition with ample money for myself.

 

[EtchNRinse]

Amazing you think that those who want to develop mid level dental providers are actually interested in providing healthcare. The people interested in that are the people who are solely interested in money and are really unethical: the for-profit educational lobby and the corporate chains.

You do realize medicaid reimbursement is a joke and dentists who take it usually take a loss, right? Do you know how much of a pain it is to bill Medicaid? Shunwei is right on the money when talking about no-shows. There are many Medicaid patients who misbehave when they are in the office.
My last point was to prove that Medicaid services to poor kids isn't going to lift them out of poverty. Attaining a STEM job, will. Let's focus more effort on the latter.

The reason the storm is coming is because of the cozy relationship between big-government liberals and Wall St, as well as the American population whose mob mentality is this: "Spend money on ipods, plasma TVs, alcohol, jaunts to Vegas, but magically not find money to pay for basic dental checkups. But who cares? We can just tax those eviiil rich people and have them pay for it!"

Dentists who have no interest in treating Medicaid are not even remotely the reason our profession will be messed up. I am for helping WORKING poor people who DESERVE to be helped and taxing 'rich people' who did NOT earn their money in ethical ways. As Thomas Jefferson once said, "The democracy will cease to exist when you take from those who are willing to work and give to those who would not."

I never once said that mid level providers are interested in providing healthcare....never once. I dont agree with the model at all in fact. What Im worried about is politicians, etc believing that in order to fix the shortage, they should develop another role in dentistry that could potentially provide substandard care. Shouldnt we all be worried about that? As my point above, there should be an adequte level of reimbursement (we have to meet in the middle somewhere). The public persona of dentists among politicians is that we wont see medicaid patients, and for the most part, theyre right. The trouble with this is, theyre making the policy and we will be stuck with the consequences. Can we not agree that our ADPAC doesnt really hold much weight?

What I disagree with is that notion that Medicaid patients are "grubbing" off the system, or that they "misbehave." Im surprised that this generalization doesnt offend more people. Many of my patients are workign 2 jobs and trying to provide the best for their family. If we dont see them, they end up in the ER costing the system thousands more.