'Should I specialize?'

I recently had a third-year dental student reach out to me with some questions. I found the resulting conversation interesting, compelling, and a great thought experiment. I love meeting and talking to young, intelligent, motivated people who are finding their way in the world.

Dental student: Dr. Burris, I am a third-year student in the top 5% in my class. While I fully intend on applying to orthodontics residencies, sometimes I ask myself if it's the right move.

It's definitely what I would prefer to do if I had the choice, but I am also business-oriented. On top of that, the laws are stacked against specialists, so if I even considered offering whitening or doing some hygiene, I would be wrecked. So my question to you is, "What would you do if you were in my position?"

Benjamin Burris, DDS.

Dr. Burris: If I were in your situation, no way I would go to an orthodontics residency. I would find an orthodontist I respected and offer my services while signing a stiff noncompete contract. I'd be clear in telling him or her what I was doing -- wanting to learn how to do orthodontics without having to waste time in school and pay to learn. I would make it clear that I was willing to do whatever needed to be done and be paid very little for the opportunity on top of this noncompete contract. I would do this for a couple years; that way you could learn how to practice and run a business. Then I would go out on my own and have a multispecialty practice.

Dental student: So you are saying you would employ a young orthodontist, make him sign a noncompete, charge per-case fees, then go and do some endodontic and implant continuing education? The "ortho" dream is dead.

Dr. Burris: I'm saying I would employ a young general dentist who wants to learn to do orthodontics properly only if he or she was the right person with the right mindset, the right work ethic, and the right people skills. I'm saying if I were a dental student I would not go to residency; I would convince someone to pay me very little to work hard and learn what I needed to know.

Dental student: It sounds like you believe that building a direct marketing ortho practice with some referrals here and there is still less desirable than going the super general practitioner route and hiring associates, branding multiple practices, and so on. To me I can certainly see how that would be more profitable, but something deep down was hoping you would say, "Being an orthodontist is the best job in the world."

Dr. Burris: Think apprenticeship instead of residency. That's what I would do, but I'm at the age where I'm not proud and degrees mean nothing. Look, you can do just fine and even do well doing orthodontic residency and entering traditional orthodontic practice. But I'm saying that you can do just as well or better with an education instead of a degree and save yourself two to three years of your life and some money. I'm not saying you shouldn't do orthodontics.

Dental student: I would guess it takes much longer to build an ortho practice compared with a general practice as well. Those are more years down the tube. I'll be honest, though, I think I would enjoy ortho more as a daily job.

Dr. Burris: No doubt. I'm not saying you shouldn't do ortho. I'm just telling you what I would do in your position, knowing what I know. Find a great retail location and open a general practice. Build it up and bring in associates and open ortho out of that. Or go to residency and enjoy another couple years of fun and no responsibilities.

Ben Burris, DDS, is an orthodontist, writer, speaker, philanthropist, activist, and patient advocate. He can be contacted at OrthoPundit.com.

The comments in this article are not meant to be taken as financial advice but are for illustration only. The author and DrBicuspid.com recommend that you always consult with your financial planner before making any significant changes in your financial or tax situation.

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