What are the max earnings of a general dentist vs. specialists?

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Dmill220

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I've heard about how to optimize a general dentist office. There's plenty of videos and podcasts about the "Million Dollar Practice" or "2.5 Million in Earnings" but I never see anything about optimizing for specialties. Is the earnings ceiling higher in general dentistry? Or will specialists likely beat out most general dentists in the end?

Thanks for any replys!

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I've heard about how to optimize a general dentist office. There's plenty of videos and podcasts about the "Million Dollar Practice" or "2.5 Million in Earnings" but I never see anything about optimizing for specialties. Is the earnings ceiling higher in general dentistry? Or will specialists likely beat out most general dentists in the end?

Thanks for any replys!
All location and person and setup dependent.
 
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All location and person and setup dependent.
I understand that's the case with any dental office. What I want to know is if a general dentist has the potential to make more than a specialist working similar hours in a similar environment. General dentists can expand there practice and do a lot more hygiene, do some CE and add other services, while specialists are more limited in scope, but generally start earning more than a GD. Who has the highest earnings ceiling?
 
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What I want to know is if a general dentist has the potential to make more than a specialist working similar hours in a similar environment.
What’s a similar environment? As others have said, way too many variables to answer this. But most specialist associates are going to make more than GP associates. Most specialist owners who have high volume clientele are going to make more than GP’s with high volume clientele. But GP’s that have managed to build a high volume of implant based restorations and other fixed work could easily make more than specialists.
 
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An OS or endo that had a crazy efficient wizzy/RCT factory could really do some damage. A GP who's more of a CEO could also do some damage. When you start making a lot of money though it's pretty easy to make more of it with other income sources. I think the line about associate vs associate the specialist winning is probably true.
 
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Theoretically, one could establish the next gentle dentle, take it public, and make 500 million. Is it likely? Probably not. That’s why it’s not really helpful to look at the tails of a distribution
 
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Generally speaking ... most specialist offices will make more than their GP counterparts. At least that was my observation while networking with many GPs during my private practice days. Of course ... there are always those outlier GP practices.

Another issue is office overhead. GP offices typically had overhead figures in the 60% and higher category. Most were in the mid 70's%. Endo practices probably have the lowest office overhead %. Most ortho practices are around 50% overhead. Not sure about the other specialties.
You only keep what you don't spend.
 
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I understand that's the case with any dental office. What I want to know is if a general dentist has the potential to make more than a specialist working similar hours in a similar environment. General dentists can expand there practice and do a lot more hygiene, do some CE and add other services, while specialists are more limited in scope, but generally start earning more than a GD. Who has the highest earnings ceiling?

Procedure wise, I’ll probably have the potential to make more than my classmates from school. If I book a full day of 3rds under sedation in an efficient practice, a general dentist just can’t beat that.

However, with that said, many of my classmates will definitely be making more money than me. They could run multiple practices, they can use hygiene to their advantage, they aren’t doing a bunch of in-depth consults and follow-ups like I would have to do, they probably have lower overheads, they don’t need to take hospital call. Specialists become specialists because they like the clinical stuff. The real money is on the business side, which general dentists get into way more than specialists.
 
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Another variable that I observed in 24 yrs of practice is that specialists need referrals from GPs. Pts don't walk in to a specialist office out of the blue (maybe Pedo) while the GP can charm the pt to accept $30k and up worth of work. If a new, young, inexperienced, unknown specialist opens up shop, chances are, he/she may not get the pt volume. Many GPs try to do a lot of specialty work like molar RCTs, implants, ortho, etc cutting into the specialists' pie. An owner plumber can make more money than specialists.
 
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Another variable that I observed in 24 yrs of practice is that specialists need referrals from GPs. Pts don't walk in to a specialist office out of the blue (maybe Pedo) while the GP can charm the pt to accept $30k and up worth of work. If a new, young, inexperienced, unknown specialist opens up shop, chances are, he/she may not get the pt volume. Many GPs try to do a lot of specialty work like molar RCTs, implants, ortho, etc cutting into the specialists' pie. An owner plumber can make more money than specialists.
Yup, the success of a specialist depends on how well he communicates with the general dentists and the quality of his work. The job of the specialists is to the GPs’ lives easier.
 
Yup, the success of a specialist depends on how well he communicates with the general dentists and the quality of his work. The job of the specialists is to the GPs’ lives easier.
Don't get me wrong...specialist in general make more than GPs as they deserve. GPs have more variables. I feel sorry for our Orthodontist who owes $800k. His wife has not passed her Optometry Board and they are expecting their first child. If it was me, I wouldn't be able to sleep at night wondering how I'm going to provide especially during a possible recession when pts might not have the means. As long as the Specialists can control their debt, avoid legal problems and divorce if possible, they can live the lifestyle of the top 2 or 1%.
 
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Don't get me wrong...specialist in general make more than GPs as they deserve. GPs have more variables. I feel sorry for our Orthodontist who owes $800k. His wife has not passed her Optometry Board and they are expecting their first child. If it was me, I wouldn't be able to sleep at night wondering how I'm going to provide especially during a possible recession when pts might not have the means. As long as the Specialists can control their debt, avoid legal problems and divorce if possible, they can live the lifestyle of the top 2 or 1%.
Good advice for all dentists.
 
Don't get me wrong...specialist in general make more than GPs as they deserve. GPs have more variables. I feel sorry for our Orthodontist who owes $800k. His wife has not passed her Optometry Board and they are expecting their first child. If it was me, I wouldn't be able to sleep at night wondering how I'm going to provide especially during a possible recession when pts might not have the means. As long as the Specialists can control their debt, avoid legal problems and divorce if possible, they can live the lifestyle of the top 2 or 1%.

You have very little control over your school debt amount (ie living with roommates, eating rice and beans to save money). But you have full control of how much you can make after graduation. No one can stop you from working 6 days a week. If I were that orthodontist, I would work 6 days a week to bring up my income to at least 350k a year ($1200 a day is the minimum pay for a new grad ortho). With such income, I would sleep very well at night... and have nice future plan for the new born baby. A $800k debt should be paid off in less than 5yrs if the wife passes the board and starts working.

Who say you can't enjoy life when you work 5-6 days a week? Currently, spend my day at the Trump Hotel in Miami.
 

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You have very little control over your school debt amount (ie living with roommates, eating rice and beans to save money). But you have full control of how much you can make after graduation. No one can stop you from working 6 days a week. If I were that orthodontist, I would work 6 days a week to bring up my income to at least 350k a year ($1200 a day is the minimum pay for a new grad ortho). With such income, I would sleep very well at night... and have nice future plan for the new born baby. A $800k debt should be paid off in less than 5yrs if the wife passes the board and starts working.

Who say you can't enjoy life when you work 5-6 days a week? Currently, spend my day at the Trump Hotel in Miami.
Have a nice time in Miami and eat some good Cuban and Jamaican food. I think he is doing everything right...he works for Corp Mon-Thurs and at his own clinic Fri and Sat while his wife manages. I wouldn't live in the most expensive apt in his suburb. I think he has it way harder than you. He's 35-36 and makes good income but he has no house and I don't know how he funds his retirement portfolio other than Corp 401k. Not sure if his folks are helping him as Asian cultures usually do (not mine though).
 
Have a nice time in Miami and eat some good Cuban and Jamaican food. I think he is doing everything right...he works for Corp Mon-Thurs and at his own clinic Fri and Sat while his wife manages. I wouldn't live in the most expensive apt in his suburb. I think he has it way harder than you. He's 35-36 and makes good income but he has no house and I don't know how he funds his retirement portfolio other than Corp 401k. Not sure if his folks are helping him as Asian cultures usually do (not mine though).
It’s very obvious to me that he doesn’t get any help from his family. That’s why he has to work crazily hard like this. He works hard. He deserves to live in a nice apt. It’s still much cheaper than owning a house. With $800k debt and the current mortgage interest rate above 6%, I wouldn’t buy a house at this time either. I would focus on paying down the student loans first. He’s only 35-36. When I was at his age, I owed more than $2 millions (home loan and investment property loans). And I was able to pay all of them off when I was 49. I think he’ll reach this goal when he is at my age.

Yeah, he has it way harder than me. My wife works and his wife doesn’t work. Hope she’ll pass her optometry board soon.
 
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It’s very obvious to me that he doesn’t get any help from his family. That’s why he has to work crazily hard like this. He works hard. He deserves to live in a nice apt. It’s still much cheaper than owning a house. With $800k debt and the current mortgage interest rate above 6%, I wouldn’t buy a house at this time either. I would focus on paying down the student loans first. He’s only 35-36. When I was at his age, I owed more than $2 millions (home loan and investment property loans). And I was able to pay all of them off when I was 49. I think he’ll reach this goal when he is at my age.

Yeah, he has it way harder than me. My wife works and his wife doesn’t work. Hope she’ll pass her optometry board soon.
Wow Dr. charlestweed, you're amazing! I know you always recommend working 6 days a week to reach your goals. I understand being a GP is different than ortho but I get exhausted after working one 8 hr day! The most I ever worked in a week was five, 10 hr days and was on-call the same week before my overseas trip. It could be any combination of factors but I was miserable throwing up with the chills during that trip.

I grew up in an area worlds different than your So Cal. According to the 2010 census, my hometown median family income was $27k/yr. When I first moved to the Pacific NW in 2002, I was so worried about not failing and having to go back home with my tail between my legs like my father believed. Houses here were 3 times more expensive than in my home state. I was determined by doing a lot of procedures other dentists in my Corp wouldn't do. I had a colleague in the USAF that was a comprehensive dentist (specialist of everything) and I was able to use him as a mentor along with OS and endo specialists in the Corp. To give a perspective, my dad had to pay extra for his custom 3k sq ft house to about $350k in 1982 because his builder went bankrupt. One of my colleague's parents bought a 2700 sq ft house in Carmel CA (sorry, not in So Cal) in 1979 for $179k. They sold it in 1999 for $4M while we sold my dad's house last year for $190k (appraised at $150k). For many reasons, I wished I didn't grow up in that environment. The most was the stunting of my development similar to a frog in a well.
 
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Wow Dr. charlestweed, you're amazing! I know you always recommend working 6 days a week to reach your goals. I understand being a GP is different than ortho but I get exhausted after working one 8 hr day! The most I ever worked in a week was five, 10 hr days and was on-call the same week before my overseas trip. It could be any combination of factors but I was miserable throwing up with the chills during that trip.

I grew up in an area worlds different than your So Cal. According to the 2010 census, my hometown median family income was $27k/yr. When I first moved to the Pacific NW in 2002, I was so worried about not failing and having to go back home with my tail between my legs like my father believed. Houses here were 3 times more expensive than in my home state. I was determined by doing a lot of procedures other dentists in my Corp wouldn't do. I had a colleague in the USAF that was a comprehensive dentist (specialist of everything) and I was able to use him as a mentor along with OS and endo specialists in the Corp. To give a perspective, my dad had to pay extra for his custom 3k sq ft house to about $350k in 1982 because his builder went bankrupt. One of my colleague's parents bought a 2700 sq ft house in Carmel CA (sorry, not in So Cal) in 1979 for $179k. They sold it in 1999 for $4M while we sold my dad's house last year for $190k (appraised at $150k). For many reasons, I wished I didn't grow up in that environment. The most was the stunting of my development similar to a frog in a well.
Yeah, it’s tough working 6 days/wk as a GP. I had done this for a year: working 5 days/wk, 10+ hours a day at a GPR program and moonlighting on Saturdays. I was 26 yo. It’s much easier to do this when you are still young and healthy ….when you have no kid (or have kids who are still very little). I’ve never suggested working 6 days/wk for the entire career. You may only need to do this the first 6-7 years… until you bring the debt amount down to a manageable level….until you save enough for a down payment on our first house…or until your office, that you set up from scratch, gets enough patients to fill the appt book.

It’s common sense. If you asked Dave Ramsey, I am sure he would suggest the same thing. With so much student loan debt, today new grads don’t have any choice. Working 6 days/wk is their only choice. 20 years ago, I had choices because I owed much less in student loan. I could easily get by with working 2 days/wk. But I still elected to work 6 days/wk because I wanted to achieve the financial freedom ASAP. The future is filled with so many uncertainties (your health, the economy, inflation, oversaturation of dentists, dental insurance reimbursements, technological changes in dentistry etc). The sooner you achieve your financial freedom, the sooner you won’t have to worry about work. I have zero worry about this upcoming recession.
 
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Yeah, it’s tough working 6 days/wk as a GP. I had done this for a year: working 5 days/wk, 10+ hours a day at a GPR program and moonlighting on Saturdays. I was 26 yo. It’s much easier to do this when you are still young and healthy ….when you have no kid (or have kids who are still very little). I’ve never suggested working 6 days/wk for the entire career. You may only need to do this the first 6-7 years… until you bring the debt amount down to a manageable level….until you save enough for a down payment on our first house…or until your office, that you set up from scratch, gets enough patients to fill the appt book.

It’s common sense. If you asked Dave Ramsey, I am sure he would suggest the same thing. With so much student loan debt, today new grads don’t have any choice. Working 6 days/wk is their only choice. 20 years ago, I had choices because I owed much less in student loan. I could easily get by with working 2 days/wk. But I still elected to work 6 days/wk because I wanted to achieve the financial freedom ASAP. The future is filled with so many uncertainties (your health, the economy, inflation, oversaturation of dentists, dental insurance reimbursements, technological changes in dentistry etc). The sooner you achieve your financial freedom, the sooner you won’t have to worry about work. I have zero worry about this upcoming recession.
You will be impressed with these 2 dudes especially this periodontist. I met him in '07 while I was working every other Sat doing full time endo. He had just graduated DS and was in his 1st yr perio residency. He moonlighted every Sat at the Corp doing implants, and perio. He does residency M-F 8 to 5 and afterwards moonlighted at Emergency Dentistry from 6 pm to 11 pm. He does Sun where and when he can. Of course he had no family at that time. The other guy is an Endodontist. He has 2 practices and works 2 days at the Corp. He too doesn't have a family. The GPs I've encountered that did 6 days are the ones starting their practices and working at the Corps. Doing GP at the Corp is very exhausting as I mentioned before and I don't know anyone doing 6 days for them.
 
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You will be impressed with these 2 dudes especially this periodontist. I met him in '07 while I was working every other Sat doing full time endo. He had just graduated DS and was in his 1st yr perio residency. He moonlighted every Sat at the Corp doing implants, and perio. He does residency M-F 8 to 5 and afterwards moonlighted at Emergency Dentistry from 6 pm to 11 pm. He does Sun where and when he can. Of course he had no family at that time. The other guy is an Endodontist. He has 2 practices and works 2 days at the Corp. He too doesn't have a family. The GPs I've encountered that did 6 days are the ones starting their practices and working at the Corps. Doing GP at the Corp is very exhausting as I mentioned before and I don't know anyone doing 6 days for them.
My wife also moonlighted at a private GP office on Saturdays during her perio residency. That’s where she met the co-associate dentist, who later bought a busy HMO practice and became her boss. In addition to perio, this GP boss also hires in-house endo, OS, pedo, and ortho to work for him. While in residency, my wife also volunteered to work at the school’s emergency department a few nights a month. That’s where she learned how to extract 3rd molars fast. It’s easier to do all these when you are young, single, and have no kids. I didn’t marry my wife until we finished our residencies.

My wife didn’t use all of her moonlighting income to pay down the debt. She spent a large portion of it on clothes and nice designer handbags. Life’s too short. Gotta enjoy it. At least the money came from her sweat and labor and not from the borrowed money.
 
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All location based and skill based. It is not soo much of a toss up as associate GP vs associate specialist (associate specialist usually wins). However, it is all about how hard you work, efficiency, attitude, and willingness to learn new things. If you have this then income is not an issue.

It is ALL ABOUT DEBT TO INCOME RATIO. If you can go to school to be a GP for $300k and go somewhere rural and work 5-6 days a week for a year and push $250-$300k as a new grad then that is a good return instead of going to specialty school and paying tuition while the $300k accumulates interest..... just my point of view. You can have the sam argument being a specialist but really if debt is low and you want to work hard as a GP then you should make $200k+ as a new grad.

Just work hard and have a good attitude. it will take you far in life for whatever you choose.
 
May be difficult to answer but what’s the typical salary difference between working 4, 5 and 6 days? Is it as easy as taking the daily minimum and multiplying it by the number of days you’d work in a year? Assuming you don’t buy a practice initially.
 
Currently, own 2 GP dental practices, and make 1.2 mill net a year excluding taxes. Keep overhead as low as you can. I do everything myself (taxes, insurance, etc)
 
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Depends on the job. At the current job that I’ve been working for a year I do 4 days/week and make around $150k. Yes I’m paid on a % production so I could have made more but the problem is this practice does not have enough patients for me. Therefore I don’t have the option to add a 5th day and make more at this practice. At the new job that I am about to switch to, my daily guarantee is $800 for 5 days/week, so that’s a guarantee of $200k (800/day x 22 days/month x 12 months) a year before any of the bonus. Of course I’ll probably have to work much harder at this new job, but as a young dentist I’m willing to add a 5th day of work for an extra 50k a year, as advised by some of the practitioners in this board.
what state? rural?
 
4 months out of school and our office is on pace to do 1.2 mil at 40% OH. Do the math. I make more than most of my specialists already.

Do what you want to do. Ultimately business decisions and treatment acceptance will effect your income more than anything else. If you’re a nerd you’re not going to make a lot of money.
 
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4 months out of school and our office is on pace to do 1.2 mil at 40% OH. Do the math. I make more than most of my specialists already.

Do what you want to do. Ultimately business decisions and treatment acceptance will effect your income more than anything else. If you’re a nerd you’re not going to make a lot of money.
40% overhead is really low for a general practice. What's the secret?
 
4 months out of school and our office is on pace to do 1.2 mil at 40% OH. Do the math. I make more than most of my specialists already.

Do what you want to do. Ultimately business decisions and treatment acceptance will effect your income more than anything else. If you’re a nerd you’re not going to make a lot of money.
Wow
 
4 months out of school and our office is on pace to do 1.2 mil at 40% OH. Do the math. I make more than most of my specialists already.

Do what you want to do. Ultimately business decisions and treatment acceptance will effect your income more than anything else. If you’re a nerd you’re not going to make a lot of money.

Ridiculous statement.
 
4 months out of school and our office is on pace to do 1.2 mil at 40% OH. Do the math. I make more than most of my specialists already.

Do what you want to do. Ultimately business decisions and treatment acceptance will effect your income more than anything else. If you’re a nerd you’re not going to make a lot of money.

He is a beast. I produce $130-100k a month depending on the month I am a new grad. General dentist. I am considered a "nerd" because I am just an associate. I do no implants, molar endo, or third molars. I do bread and butter with ext, endo, pedo, and Invisalign.
 
40% overhead is really low for a general practice. What's the secret?
I think that if you take the time to see where one can cut costs and put a little elbow grease into an office then you can be at 40% I know a handful of people who have this and they keep track of everything and do not rely on a practice manager to manage this. The person who is going to take the best interest in your practice or whatever you own is you.
 
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40% overhead is really low for a general practice. What's the secret?
I’m not in a high end city with crazy costs. My rent is 19k a year. My highest paid staff is 40/hr. My fixed costs are super low. I use good labs for less remakes and honestly im not a stickler about supply costs.

We’re in a strip mall and honestly the outside of our office is not much. We take tons of PPOs but that gets us like 50 NP/mo.

For us PPOs get patients in the door but if you get pretty good treatment acceptance and have low fixed costs it’s basically just a marketing expense.
 
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Ridiculous statement.
Lol, sorry if you don’t like it. People buy things from people they like. If you’re a dork talking to them about their VDO they’re not buying anything from you because you’ve confused them.
 
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He is a beast. I produce $130-100k a month depending on the month I am a new grad. General dentist. I am considered a "nerd" because I am just an associate. I do no implants, molar endo, or third molars. I do bread and butter with ext, endo, pedo, and Invisalign.
Yeah that’s great. We only work 3-4 days a week.

I don’t mean nerd as in know a lot about dentistry. I mean it as can’t talk to patients clearly and on their level cause of being socially awkward.

But yeah I just started placing implants, I do very few molar endo, and I take out 3rds.
 
I don’t mean nerd as in know a lot about dentistry. I mean it as can’t talk to patients clearly and on their level cause of being socially awkward.
I understand what you're saying. When I was training in the hospital for my current job, after the physicians had done their rounds in the patients' rooms, there was one thing that all the patients seemed to make remarks about afterwards. They never were in awe of the physicians' understanding of medical science or the human body, or expressed remorse of their diagnosis. Anything like that. All of the comments seemed to center on the doctors' bedside manners. This is not to say that doctors don't have any, just remarking on what I remember. No matter the patient's age, medical IQ, social class, any of that stuff. "Man, that ortho guy was such a jerk, he just walked in here, basically told me there's a chance I might be disabled for a long time because of my injury, then just walked right out. Cool story, bro, thanks..." things like that.

It doesn't matter how smart you are or how much better you were than your peers while in school. What patients will remember is how you made them feel. If they feel listened to and they trust you, they will more likely adhere to the plan of care. I'm sure for dental, that means they'll accept (and pay) for the treatment plan.
 
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I understand what you're saying. When I was training in the hospital for my current job, after the physicians had done their rounds in the patients' rooms, there was one thing that all the patients seemed to make remarks about afterwards. They never were in awe of the physicians' understanding of medical science or the human body, or expressed remorse of their diagnosis. Anything like that. All of the comments seemed to center on the doctors' bedside manners. This is not to say that doctors don't have any, just remarking on what I remember. No matter the patient's age, medical IQ, social class, any of that stuff. "Man, that ortho guy was such a jerk, he just walked in here, basically told me there's a chance I might be disabled for a long time because of my injury, then just walked right out. Cool story, bro, thanks..." things like that.

It doesn't matter how smart you or how much better you were than your peers while in school. What patients will remember is how you made them feel. If they feel listened to and they trust you, they will more likely adhere to the plan of care. I'm sure for dental, that means they'll accept (and pay) for the treatment plan.
Reminds me of one of those random memories that've stuck with me. During an os externship over the summer, we were wiping up and head wrapping post-orthog when a bit of blood accidentally got on the wrap. The chief made a comment while laughing that, while you can be a fantastic surgeon and reconstruct their face but which leaves them with a lot of pain post-op, the number one thing some patients will later complain about is if their skin isn't perfectly blood/iodine-free and pretty and the head wrapping isn't all white and spot free.
 
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Lol, sorry if you don’t like it. People buy things from people they like. If you’re a dork talking to them about their VDO they’re not buying anything from you because you’ve confused them.

I have seen many successful nerds in dentistry.
 
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I am a nerd
Aren’t we all….nerds? Most people don’t go to schools for 8+ years like us. Some of us spent additional 2-6 years to specialize afterward. While in college, we had had to give up on social life and study hard to earn good grades and DAT scores so we could get into good (and cheap) dental school. Some of us had to do research and other extracurricular activities to increase our chance of getting into dental school. Another reason why we had to give up on social life was we were all broke (had to live on the borrowed money)……without money, can’t afford to have fun. For other college kids, who pursued a 4 year degree, they didn’t have to give up on their social life because having a low GPA didn’t matter much.

I love dentistry because of the good income and job stability it provides. But I don’t like talking to people (the patients and the referring GPs)…..and try to please them. That’s why I prefer treating the low income Hispanic and Asian patients (they rarely ask questions, they trust the doctors, and they don’t sue). I treat high volume (and work harder) to make up for the low fees.
 
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