Howard Speaks: Studying the Chances for Success by Dr. Howard Farran

Dentaltown Magazine

by Howard Farran, DDS, MBA, publisher, Dentaltown magazine

U.S. Bureau of Labor statistics released in mid-May reported that more than 20.5 million people lost their jobs in April, due largely to the COVID-19 pandemic. That includes 1.4 million people who worked in health care fields, 503,000 of them in dental offices.

Eighteen million jobs are expected to be reinstituted when the pandemic recedes—but when is that going to happen? If this pandemic lasts a full two years, as some people are saying, we’re only six months in—we’ve got a year and a half to go.

Before the pandemic, how many of your patients visited your practice only because they had dental insurance? Our services are favored by people who have heavily subsidized dental insurance, but 20?million people just lost any employee-paid insurance coverage they might have had.

Plus, about 20% of our patients won’t return to the dental market until a COVID-19 vaccine is available. It’s going to be a long press—dental office revenue for 2020 is probably going to be only 30%–50% of pre-pandemic levels.

If you’ve been out of school for four to six years, it’s time to get your own practice.

Owner dentists will want the entire schedule for themselves; they’re not going to hire new associates to cover any excess demand. Meanwhile, COVID-19 will create a boom for dental practice transitions. Many dentists who had practices for sale de-listed them right after the pandemic hit, out of fear, but they’ll put them back on the market soon.

While 40% of dentists say they’re thinking about selling their practices to a dental service organization, some of the largest DSOs are wanting to see a practice’s numbers before they consider buying. Plus, Moody’s has downgraded the debt of a few of the largest DSOs. If America doesn’t open back up soon, many DSOs will not make it.

Cheap money is fuel for the supply-and-demand equation. The same amount of financing is available as before, and business brokers are already reporting practice sales again.

If you graduated in the COVID-19 Class of 2020, this might be the best time in the world to go back and get a specialty.

As far as earning potential, oral surgery has always been No. 1, with doctors signing base salary packages of $300,000 and earning 45% of production. Some dentists straight out of school are earning $750,000.

No. 2 is endodontics—like it or not, insurance or not, people have got to get out of pain. Endo has always been profitable, but the numbers are drifting downward. Endodontists used to do eight or nine root canals a day, but lately they’re using microscopes from start to finish and even trying to attach nerve endings, so they’re doing four or five per day, and fewer procedures mean less income.

Your odds of success will be better in almost any specialty instead of general dentistry. The only exception is orthodontics, which I think is going to be under tremendous pressure for the next two decades.

Orthodontists already faced competition from direct-to-consumer options; then, after the coronavirus outbreak, specialists who’d always chosen to look down on teledentistry as subpar and second-rate treatment found themselves particularly ill-equipped to survive. This is a human-to-human pandemic, and virtual business models are perfectly suited to help us treat patients through this. If orthodontists don’t embrace this technology, they could find themselves out of business.

For the rest of us: Keep one eye on your costs and one on your safety, and we’ll get through this!



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