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My View: Yes I still believe

July 15, 2013

By Walter F. Lamacki, D.D.S.

Ordinarily I don't comment on a letter to the editor. However, I've had my say and it is the reader's turn. A letter concerning my screed, "Is Dentistry Still a Good Career Path?" in the September/October issue of the CDS Review—wherein I stated that becoming a dentist is a good business decision—merits a reply.

First, the letter:

You don't know me but I'm a young dentist in the Chicago suburbs. I get the CDS Review and read the articles fairly regularly. Your article spoke to a growing concern of mine, and I have been looking for an outlet that might be able to not only answer my question but also hopefully ease my concerns. I am happy to read that you are optimistic about the future of our profession, but as a general dentist in practice for two years in this market, I have an outlook of pessimism. I have been reading the history of dental education, specifically, the output of practitioners by dental schools. It concerns me that while I keep hearing that, there is a shortage of dentists. Has anyone ever had difficulty finding a dentist within 55 miles of Chicago? I understand that nationally it may be a different picture, but along with astronomical tuition rates (it used to be under $10,000 per year at the University of Illinois at Chicago College of Dentistry), there is a dentist on every block in the Chicagoland area, and many of those dentists are saddled with massive debt loads. And now we must face a massive influx of competitors from the Midwestern University College of Dental Medicine, where class size is 125 students.

The American Dental Association's figure of $194,000 as the average income is, I think, misleading in the Chicago area. I know none of my colleagues are even in that range on the high end. I have a hard time believing with supply costs going up and demand going down (much higher ratio of dentists to population), and subsequently reimbursement rates for procedures going down, that my generation and the ones that follow will be able to compete in a completely oversaturated market.

Both offices in which I work are associate-to-sale situations, and it is a very intimidating time to consider investing in a dental office with my outlook.

—Name withheld upon request

Our young dentist has a point; there seems to be no shortage of dentists in Chicagoland, especially in the more affluent neighborhoods. And he is right, of course, 125 new graduates of the Midwestern University College of Dental Medicine will be entering the profession in three years. Nationwide, eight new dental schools have either broken ground or have blueprints in hand, impacting an already fragile economic landscape for dental practice.

Our young dentist has trouble believing that the average general dentist nets $194,000 per year, according to a 2009 survey by the American Dental Association. The Department of Labor is less sanguine; in a 2010 analysis, it pegs the figure at $146,920. They estimate that income growth in the next 10 years will be 21 percent higher for dentists than the general workforce.

I called this young dentist to learn more about him. What I found is typical of many of our young colleagues. He works in two high-volume, low-fee practices. He is recently married, and although his dental school debt is manageable, together he and his wife have sizable educational debt. His classmates have similar experiences.

I asked if he attends his branch meetings: "I've gone to some," he said. Do you have an accountant familiar with the business of dentistry, I asked. "No, not really," he responded.

"I'm familiar with your branch and am certain you would be warmly welcomed. You can not underestimate the value of networking with your colleagues and being mentored by more experienced dentists," I told him. I also gave him the name of an accounting firm that has vast expertise in associating, buying and selling dental practices.

"I will hound you to death, if you do not follow up," I added.

Yes, I still believe dentistry is a good business decision. More dentists are retiring than entering practice and the scope of dentistry is expanding. Whether the income of a dentist is $194,000 or $147,000, it is higher than most other professions. However, young dentists will need to make informed choices to succeed. Unfortunately, good business practices are not taught in dental schools whose curricula are overcrowded. It has to be learned in continuing education, course by course, by experience and by mentorship.

I was pleasantly surprised when he emailed back a few days later telling me he had made an appointment with the accountant and asking how to start in organized dentistry. I will call him from time to time to see how he's progressing.

The longest journey begins with the first step. Reach out and help a young colleague. It will benefit you both.

Dr. Lamacki is the editor of the CDS Review, the journal of the Chicago Dental Society. His comments, reprinted here with permission, originally appeared in the December 2012 issue of that publication.

Editor's note: The Commission on Dental Accreditation notes the growing emphasis on teaching practice management skills in dental schools, and indicates that this has become increasingly important in recent years. For example, Standard 2-18, Practice Management and Health Care Systems of the Accreditation Standards for Dental Education Programs implemented July 1, requires that graduates be "competent in applying the basic principles and philosophies of practice management, models of oral health care delivery, and how to function successfully as the leader of the oral health care team." Standard 2-18 was enhanced from its prior version, which required that graduates acquire learning at the understanding level. For more information, visit online (PDF).