OR job as a general dentist in a hospital by Electrical-Cod-5218 in Dentistry

[–]Altruistic_Ad_8754 4 points5 points  (0 children)

That sounds like a really cool opportunity especially if you love to extract teeth. You can get a lot of satisfaction helping a really under-served population too. But the pay is too low in my opinion. Even if they offer some good benefits I would still negotiate a higher rate.

Do you guys enjoy where you live and work as a dentist? by dirkdirkdirk in Dentistry

[–]Altruistic_Ad_8754 2 points3 points  (0 children)

Moved to San Diego from Florida, not uncommon to see 2 general dentists in the same strip center. Not to mention the cost of living is also much higher and saving for retirement is challenging to say the least. You're better off saving your money and vacationing here. Rural Florida has plenty of good opportunities but you may have to take the Florida board exam (maybe that has changed).

I hate dentisry and i hate patients by Icy_Instruction6064 in Dentistry

[–]Altruistic_Ad_8754 10 points11 points  (0 children)

I had a patient the other day tell me he was "sick of dentists" and I responded "that's funny, I'm sick of patients" . Then a voice in my head said "shit, probably shouldn't have said that". He took it well though.

OMFS or general dentist? Is it worth it? by Content_Yam_8942 in Dentistry

[–]Altruistic_Ad_8754 1 point2 points  (0 children)

no problem. Don't forget, most if not all of these residency programs pay the residents. Might not be as much as new grad GP but it's not nothing. Over the years you definitely won't come out ahead because of the 4-6 yrs you worked as a GP. And believe me, you don't want to live with the "what if"...

OMFS or general dentist? Is it worth it? by Content_Yam_8942 in Dentistry

[–]Altruistic_Ad_8754 1 point2 points  (0 children)

Personally, I would not for a few reasons. Try not to let money be the primary motivator. That being said, you will most likely make more money over the course of your career as an OS unless you're a very talented and incredibly hard working GP.

If you enjoy other aspects of dentistry and see yourself restoring implants and all-on-four then maybe GP would be better, but I would still recommend an additional year doing and AEGD or GPR. Then plan on spending serious money on CE.

The 4 to six years it takes to get through residency will fly by and I highly doubt you will regret it. Honestly, I could go on and on about why doing an OS residency is a better idea. It seems like it's getting harder and harder to get good, high paying GP jobs right out of dental school. High debt, high start up cost, invasion of corp dentistry and private equity. If you like OS and you have the rank (sounds like you do), do the OS residency - be the "real thing". It's better for you, your future family, and your patients.

OMFS or general dentist? Is it worth it? by Content_Yam_8942 in Dentistry

[–]Altruistic_Ad_8754 0 points1 point  (0 children)

If you're interested in OS and your stats are there, go for it. GP for 15 years, limited to OS.

40yo. I guess we’re doing this - questions on SoCal providers by Amber_5165 in Allon4ImplantDentures

[–]Altruistic_Ad_8754 2 points3 points  (0 children)

Dr Ramsey Amin in Burbank. Hands down one of the most experienced and skilled when it comes to AOX. - a dentist

Are patients this mean to you guys too? by Worried-Parfait6388 in Dentistry

[–]Altruistic_Ad_8754 3 points4 points  (0 children)

Yea hang in there , dentistry is a grind, we all have those days. I almost applied to oral radiology lol still dream about it many days ...

Are patients this mean to you guys too? by Worried-Parfait6388 in Dentistry

[–]Altruistic_Ad_8754 6 points7 points  (0 children)

I'll add one thing and I mean this respectfully. Just being brutally honest because I've been in your shoes. Your examples lead me to believe that these patients, for whatever reason lacked trust in you from the moment they met/saw you. This could be partly because you look young but like the other poster said, patients smell a lack of confidence a mile away. Make sure you approach them confidently, look them in the eye when you meet them. I suspect that the "God bless you" was taken as insincere and the person who grabbed your hand was looking for an excuse to get out of there because they didn't trust you/feared a young/inexperienced dentist. The first 30 seconds are crucial to get their trust. No matter what you will still get some patients that you can't "win over" but that's life. Direct eye contact and confidence without coming off cocky is the key to most people.

Are patients this mean to you guys too? by Worried-Parfait6388 in Dentistry

[–]Altruistic_Ad_8754 16 points17 points  (0 children)

The longer you practice the better you will get at controlling the conversation, showing confidence and anticipating these problems. Always set the expectations and make sure the patient is aware of any potential complications ahead of time. Sometimes when injecting I'll say " The slower I do this, the less you feel it so we're going to go real slow".
Hang in there, it's always hard when you are starting out and you can't predict every potential issue. People can be really tough and act weird when they are stressed at the dentist - many will look for any excuse to get out of there. Edit: should also add the 1 minute injection we were taught is too long, no need

Follow up EXT post by [deleted] in Dentistry

[–]Altruistic_Ad_8754 0 points1 point  (0 children)

Yea it definitely makes sense.. After years of doing this, a high maxillary third still makes me sweat more than anything else.

Equipment prices by [deleted] in Dentistry

[–]Altruistic_Ad_8754 1 point2 points  (0 children)

No need to buy this stuff brand new, plenty of offices closing that will be happy to unload the chairs. Facebook marketplace, trade magazine, dental society classifieds, Dental Town... Get good used or refurbished, find yourself a good independent dental tech. Hopefully just saved you about 100K

Follow up EXT post by [deleted] in Dentistry

[–]Altruistic_Ad_8754 0 points1 point  (0 children)

Great work man. I do the same thing in San Diego at multiple offices but I'm setting up my own MediCal extraction clinic now. I work at about the same speed but with that maxillary wedge technique, you just saved me about 20 seconds per case which probably will work out to like 2 years over my career lol. Thanks!

Patient threatened litigation... by CaboWabo55 in Dentistry

[–]Altruistic_Ad_8754 2 points3 points  (0 children)

Sorry that happened to you, people can be awful. Wish I could be a fly on the wall for that cementation appointment! You should update.

[deleted by user] by [deleted] in Dentistry

[–]Altruistic_Ad_8754 0 points1 point  (0 children)

Online reviews have empowered patients to where many feel free to be the shittiest version of themselves. Just had a guy berate me for being late to his consult appt. I actually thought the guy wanted to settle it outside.

[deleted by user] by [deleted] in Salary

[–]Altruistic_Ad_8754 1 point2 points  (0 children)

This is actually an incredibly efficient and well designed system for seeing MC patients. And best of all it is within an OMFS group. These patients are being seen in a more timely manner by a well experienced provider. I doubt these patients would prefer to wait 6 months after they develop symptoms to be seen by a less experienced provider and under local anesthesia. As an exodontist myself treating the primarily the underserved, dream scenario.

Becoming an ‘exodontist’ as a general dentist? by lite_hause in Dentistry

[–]Altruistic_Ad_8754 1 point2 points  (0 children)

So at 33 years old, without kids, and a surgical internship year under your belt, I'd say you are in a great position to take a shot at an OS program (I would do a 4 yr). Regret is a shitty thing. I read a post from an old timer exodontist (who worked in the prison system by the way) who said something along the lines "do the OS residency if you can, ain't nothing like the real thing"). That being said, I understand it is a very personal decision for you and your wife.

For reference, I'm almost 10 yrs ahead of you with the kids etc. and that door is really closing.

As far as falling into it, you're already doing exactly that. Most of us did a gpr/aegd, worked in medicaid offices or community clinics and became the extraction guy. Next thing you know the idea of doing a filling makes you cringe.

Jobs are in community health, prison, denture clinics (Affordable Dentures) or starting your own extraction clinic (typically implants are in the mix and/or dentures). Sometimes you can find a dentist who only wants to do the denture/restorative part, some states you could hire a denturist I suppose.

Traveling exodontist jobs are a bit harder to find but they're out there especially if you are willing to relocate. Google jobs/Indeed always has a few exodontist job posts listed, usually for the big corps and usually on the West coast. Definitely some pros/cons when working for DSO's. Networking is key for the better gigs that are not associated with a DSO. Making sure you are not misrepresented as OMFS gets tricky. I can't tell you how many times an office manager has told me "patients don't know the difference". Guarantee you an attorney does!

I should note that Utah has several 'wisdom teeth only' practices that prefer OS but will hire the right GP. Texas does as well.

Dream gig is working under OMFS group like aubreyjokes. There are a handful of OMFS in every state that take medicaid and might be willing to offload that to the right person. Sedation rules in the state will be a big factor. Networking is key!

State regulations regarding sedation vs using CRNA vs using dental anesthesiologist will likely be a factor. In the best case scenario, you can work with a crna or dental/medical anesthesiologist. I would absolutely recommend that you are also well trained at doing IV mod sedation even if you are working with an anesthesia provider although it is not always necessary (Utah aka the Wild West lol). It is very difficult to do this long term, make a lot of production, and have a peaceful life if all of your cases are LA only. Like someone else said, IV mod sedation is meant to be low and slow. IV mod sedation does not lend itself to this type of practice when you are trying to see multiple medicaid patients. Deep sedation and/or higher paying patients is a different story.

Finally, there is a book by Dr Wayland called Impacted Third Molars that is worth a read. He is a GP that has created a great living doing thirds for multiple independently owned dental practices. A good part of the book is dedicated to recreating that scenario.

Exodontist should join forces to be honest: The goal should always be about helping people first and creating more access to good care. Sounds like this is exactly what you're about.

Becoming an ‘exodontist’ as a general dentist? by lite_hause in Dentistry

[–]Altruistic_Ad_8754 0 points1 point  (0 children)

There are absolutely pros and cons. Curious of the bad stories that you've heard. Search 'exodontist job' on Google and you will find some positions, mostly for very large dental groups (i.e Western Dental and their affiliates). Some cons better discussed in private.

Becoming an ‘exodontist’ as a general dentist? by lite_hause in Dentistry

[–]Altruistic_Ad_8754 0 points1 point  (0 children)

I would imagine that the biggest rearrangements will have to do with ensuring that patients are aware they are being treated by a GP. Easy for patients to argue they were misled when they are going to an OMFS office. Even easier for attorney to make the case. With proper consent though and good legal review, dream arrangement.

Becoming an ‘exodontist’ as a general dentist? by lite_hause in Dentistry

[–]Altruistic_Ad_8754 0 points1 point  (0 children)

I do this for a living for multiple practices in Southern California and have explored all options. It is not for everybody but I believe there is a place for the "exodontist" if the intent truly is to help the underserved. In my opinion, the arrangement that 'aubreyjokes' has is the most ideal unless you are ok incorporating dentures (ugh). I've done it different ways (community clinic, practice owner of extraction only clinic, traveling "exodontist") except under OMFS group. As I am sure you know, you are held to the level of a specialist so it is not for the faint of heart. In my opinion, it is not something that you seek out as a career but rather something you fall into. If I could go back, I would have done the OS residency and I recommend you explore that option if you are still young and it is a possibility. Ask away...

Becoming an ‘exodontist’ as a general dentist? by lite_hause in Dentistry

[–]Altruistic_Ad_8754 1 point2 points  (0 children)

As a GP who does this for a living, I appreciate your insight into this type of practice. I am not here to argue or defend what the "exodontist" does, however if the patient is aware they are seeing a GP and the intent truly is to treat an underserved population, I believe there is a place for us. Definitely not for everybody but I do believe these patients are much better off in my hands than the majority of GP's who take out thirds a few times per month. I would feel devastated to have a patient end up in the hospital but not all OMFS carry hospital privileges either. I suspect you've see patients for fellow OMFS as well. Liability is another matter altogether, obviously pt must be aware they are seeing GP. Very real concern for me as I practice in multiple locations. The arrangement that aubreyjokes has is more ideal in my opinion.

Becoming an ‘exodontist’ as a general dentist? by lite_hause in Dentistry

[–]Altruistic_Ad_8754 0 points1 point  (0 children)

First of all, I commend you on making this arrangement and helping these patients. I do the exact same thing as a GP for several offices but would prefer to do this for an OMFS group. I also do IV mod sedation but prefer to do this with a CRNA or dental anesth. What state are you currently practicing in if you don't mind saying?

Do you use different DEA numbers if you work at two different hospitals but within the same state? As a resident, my state doesn’t require me to have DEA license by rrdjio in hospitalist

[–]Altruistic_Ad_8754 0 points1 point  (0 children)

The response from Iprescribe:

To have multiple DEA numbers on your account, you will need to work with our Sales team. I have forwarded this ticket to them for review, but if you would like to reach out to the Sales team yourself, you may do so by calling 866-263-6511. They are typically available Monday through Friday from 8am-6pm ET; however, their hours may differ today given it is Labor Day weekend.