Archives for category: Money

Whenever most prospective dental students interview for placement into the dental schools of their choice, they usually cite their desire to “help people” as their motivation for pursuing a career in dentistry.  So, why have so many non-dentists entered into the profession?  Is it their altruistic desire to “help people,” or is it something a bit more self-serving?

The average person reading this article might initially be unsympathetic to the plight of the dentist, as some in the general population have liken dentists to used-car salesmen.  Sorry.  No offense to used-car salesmen.  Several commentaries about the profession have asserted the position that many people feel that most dentists overcharge, and as a result, they have a mistrust of dentists.  Oftentimes, that mistrust usually originates from misinformation, and sometimes, misrepresentation of information from the individuals’ insurance companies and human resources managers.  However, that’s another topic entirely.

To completely understand any argument made on behalf of the dentist, it’s important to understand the dentists’ perspective.  To begin, the cost of dental education has skyrocketed over the past few decades.  According The America Dental Education Association (ADEA), the average debt for graduating dental students, based on a survey of the class of 2016, is $261,149.  However, based on the average cost of dental school tuition, I believe that number should be a lot higher.  Listed below is a compilation of the tuitions for a few schools in major metropolitan areas.  The amounts stated are solely tuition, unless otherwise stated, and does not include additional fees, including instrument fees, states/local fees, books fees or living expenses.

University State In-State Tuition Per Year Out-of-State Tuition Per Year
LECOM School of Dental Medicine Florida $49,700
Nova Southeastern University College of Dentistry Florida $62,350
University of Maryland School of Dentistry Maryland $17,681.50 $32,864.50
University of Mississippi Medical Center School of Dentistry Mississippi $26,800 Not provided on website
Columbia University College of Dental Medicine New York $72,378
New York University College of Dentistry New York $72,904
Boston University Henry M Goldman School of Dentistry Massachusetts $72,000
University of California, Los Angeles School of Dentistry California $43,278.37 (*tuition and total mandatory fees)
The University of Texas Health Science Center San Antonio Texas $24,150 (tuition only)

$38,446 (tuition and fees)

*Tuition rates are cited from the College/University websites

Keep in mind that these aggregate costs, which, in many cases, are upwards of a quarter of a million dollars, are solely for dental school tuition.  These moneys do not include tuition affiliated with other undergraduate or post-baccalaureate degrees or certificate programs that individuals might have sought in preparation for admission into these colleges.  Additionally, the tuitions do not include the additional costs associated with specialty programs that could take an additional two to six years, depending on the specialty program.  That in itself is egregious!  What’s even more egregious is that many graduating dentist are being squeezed from both ends-going in and coming out.  That brings me to the argument against corporate dentistry.

Many individuals affiliated with corporate dental franchises have not assumed any of the risks associated with the profession.  However, they are gainfully partaking in the monetary rewards.  One of the unfortunate sides of corporate dentistry is that some companies do not pay their associates a traditional salary.  Many dentists are compensated based on commission or a “draw,” which could essentially be compared to a pay advanced loan.  For example, if a company agrees to compensate an individual at a rate of $100/day and that individual only earns $80, the company will pay the individual the $100 and the individual will be in the hole for $20, which would be taken from the next pay day, assuming that the individual’s production is above the stated production goal.   The problem with that form of compensation is that, as time progresses, it could become dicey and convoluted, especially when third-party payers are involved.  Imagine trying to keep track of a year’s worth of earnings.

Aside from tuition, there are several financial obligations associated with the dental profession.  Initial state licensure could cost several thousand dollars and require periodic renewal.  Malpractice insurance is also a fundamental part of any dentist’s armamentarium.  Additionally, most dentists participate in routine, continuing education courses to maintain their license and advance their knowledge.  To be fair, many corporate dental practices do assume the cost of providing malpractice insurance coverage and continuing education costs.  However, these companies do have a disproportionate advantage over individuals who have made a sacrificial commitment to the profession.  Sole proprietorship, which is one of several reasons why many have chosen a career in dentistry over medicine, is being threatened, if not obliterated, by corporate dentistry.  Individuals who are saddled by six-figure debt might not be financially prepared or able to compete in the marketplace.

Speaking of marketplace, many Internet sites have ranked dentistry as one of the highest paying profession with starting salaries of over $100,000.  In addition to the private practice arena, the profession of dentistry does offer a variety of areas of practice, including academia, federally qualified health centers and research facilities, just to name a few.  However, the prevalence of those additional opportunities does not change the fact that corporate dental companies have dramatically impacted and influenced the private sector of dentistry.   Additionally, a six-figure salary scaled against and even larger six-figure debt might be more of a risk than a reward for some.  In fact, the larger the salary, the larger the tax implications and the smaller the adjusted gross income, which could make repayment of student loans an overwhelming obstacle to the dentist’s success and independence.

So, where does that leave the fate of the profession?  The truth is, corporate dentistry is hear to stay, and it is not the only variable impacting the dental profession, as evidence by the increasing dental school tuition rates.  These additional variables, which also include the impending burst of the student loan bubble, are multifactorial and beyond the scope of this article.  Nonetheless, corporate dental practices are growing at a rapid pace.  However, that growth could be brought to a screeching halt in the near future.  Life is a balance of risks and rewards, and if future practitioners determine that the risks are greater than the rewards, there could be a decline in the dental school matriculation rate, and hence, the amount of people entering the profession.  I guess we will just have to wait and see.

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Historically, there has always been a subset of the population who has considered money to be a god.  However, in more recent times, society has experienced the progression of money from demigod to supreme being.  In the infamous words of Wu-Tang Clan, “Cash rules everything around me.” Or does it?

 

In today’s culture, money seems to be the ultimate common denominator.  In many cases, it is the pivotal driving force for decision making.  Most people consult their money before they consult their God, family or friends.  Money motivates us.  It drives us.  It seduces us.  The truth is, there is nothing inherently wrong with money.  Money is the world’s currency.  Our capitalistic society is based on commerce, which is ultimately an exchange of goods and money.   The problem occurs when we place the value of money above all else.

 

In the new rat-race normal, big business has become the new big brother.  Its presence is ubiquitous, and its reach extends far beyond the bottom line to the bottom of our wallets.  The concept of enough is unquantifiable and insatiable.  It’s not enough for everyone to have his or her own piece of the pie.  Somehow, many in our society have subscribed to the misguided notion that we all cannot win.  Just look at the level of greed on Wall Street.  Economic goals are moving targets.  The cry for more has become a daily anthem.  The almighty dollar has become the alpha and the omega for many.

Navigating the course of the economic labyrinth is exhausting.  Oftentimes, financial resolutions often boil down to a battle of stamina.  Many company policies are intentionally designed to fatigue the consumer.  The hamster wheel approach to problem resolution frustrates most people into financial surrender.  Fortunately, money is not a God.  God is God, and He still sits on the throne.

“Lay not up for yourselves treasures upon earth, where moth and rust doth corrupt, and where thieves break through and steal,” (Matthew 6:19, KJV).  If we allow money to become our gods, then what recourse do we have when our money fails us? Money will fail us.  It’s not a matter of if.  It’s a matter of when.

Last year, I read a story about a Chinese man, who five years prior, had buried his entire life’s savings.  About a year ago, when he and his family dug up the buried money, they discovered that insects had eaten through most of the man’s cash.  Fortunately, the local bank was able to exchange the salvageable bills, which accounted for approximately half of his savings.  Although this man’s story had some what of a happy ending, what about those who weren’t so fortunate?  What about those who have lost all of their financial wealth and have nothing else to turn to?  What do they do?

Jesus was not oblivious to the value of money in the world’s economic structure (Matthew 17:24-27).  He acknowledged that there was some value to subscribing to the laws of the land.  However, he also asserted that monetary gain should not be the foundation on which we stand.  Wealth and fortune are fleeting.  Life should be built on more stable foundations.  There are things in this life that money cannot buy.  Money cannot buy happiness, freedom, respect or love.  In fact, money is often the cause of strife.  If we rest our hope and dreams on wealth, we will always face chronic disappointment.