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In many respects, today’s generation of new dentists is inspired by many of the professional qualities that motivated veteran dentists in their day, primarily a strong entrepreneurial drive, control over their time, service to others and working with their hands.
Where do they part ways with their older colleagues? Numbers. Money. And, specifically, debt.
“Admission into dental school is more competitive than it has been in the past,” said Reena Patel, a 2001 graduate of Northwestern University Dental School. “Incoming students really have to be at the top to get in.” Dr. Patel treats patients in Chicago’s Loop and, more importantly, instructs general practice residents at Northwestern Memorial Hospital, where she hears firsthand what’s worrying students and residents.
“One of the biggest burdens that dental students are facing today is the rising cost of tuition,” Dr. Patel said. “It has increased at an exponential rate, and students are graduating with incredible financial debt. This in turn influences the career path they choose. We have seen a shift in students joining corporate dentistry instead of independent private practices.”
Looking at the numbers, there are more accredited dental schools open today (65) than ever before. Applications peeked at nearly 23,000 in the early 1980s, but plateaued at about 20,000 in 2010-11. The cost of pursuing a dental education, even adjusted for inflation and in “real dollars,” has never been higher; averages span from $180,000 (public schools) to $220,000 (private).
Planning, budgeting and managing debt are consuming issues for students. The American Dental Education Association, the American Dental Association and the American Student Dental Association devote time, counseling, research and lobbying efforts to work with dental students and schools or push legislation for income-based loan repayment plans and public service loan forgiveness.
Cobbling together a working life after residency also is difficult. Some choose the stable salary and learning experience in dental service organizations, so-called corporate-owned practices; some chase the finite number of available associate positions; some choose to teach at dental school. Some need to hold down multiple positions just to make their loan payments.
The picture can be gloomy. Today’s graduates face total loans of $180,000 (average 2010 dental school debt) or more, with monthly payments of $1,000 to $5,000, depending on the loan type. While income for new dentists able to start or buy a private practice can exceed $100,000, according to the ADA's 2008 survey on new dentists, 91 percent of new dentists say they couldn’t afford to start their own practice. Salaries for employee new dentists range from $40,000 to $90,000.
“We have noticed in the past years that our residents are not too eager to start their own or buy into solo practices,” confirmed Dr. Patel. “I think financial stability is really the most important factor. Due to their debt/loans, they prefer to join practices that will pay them a ‘guaranteed’ salary.
“Another challenge they face,” she added, “is finding a good associate position. Chicago is an extremely saturated market for dentists. Most of our residents end up working at two or three different offices to make up a full-time schedule.”
Lana Kavetsis of Chicago attests to the financial scramble out of school. After graduating from the University of Illinois at Chicago College of Dentistry in 2007, she pieced together a stint in a corporate-owned office, a teaching position and two different associate’s jobs during the economic downturn, all the while watching dentists postpone retirement and staring at her $220,000 debt.
“I was very stressed out,” she said. “It was a year of sleeplessness.”
But she lived extremely frugally and put almost every penny into repaying her loans, leaving her debt-free in just four years. “It changed all my decisions,” she said.
Dr. Kavetsis is now married and celebrating the first anniversary of her practice in Chicago’s North Center neighborhood. She also serves on the membership committee of the New Dentist Committee at CDS.
Richard Valachovic studies and chronicles the many concerns of dental students at the Washington, D.C.-based ADEA, of which he is president and CEO. But he continues to bear witness to the perseverance and drive of Dr. Kavetsis and other new dentists.
“There’s a strong attraction to traditions,” he said. New dentists “want to be an independent practitioner, to be the individual in charge, to be leaders," he said.
A tradition of working for the dental profession. The Chicago Dental Society was organized in 1864 and incorporated in 1878. The objective of the Chicago Dental Society is to encourage the improvement of the health of the public, to promote the art and science of dentistry and to represent the intrest of the members of the profession and the public that it serves.
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