America's Dentist Now Winning Income Race

Physician's Money Digest, February15 2005, Volume 12, Issue 3

For decades, the average income fora general US dentist has laggedbehind that of almost all physicians.Not anymore, according to surveydata from both the AMA and theAmerican Dental Association, which showthat annual incomes for general dentistsrecently have forged ahead of income formany types of practicing physicians.

Wall Street Journal

A recent report(ww.wsj.com) notes that, in 2000, the latestyear for which comparable data isavailable, general dentists had an averageincome of $166,460. In comparison, theaverage family physician earned $144,700,the average internist took in $164,100,and the average pediatrician made$137,800. Observers state that there's littlereason to believe that the comparativeincome picture has changed substantiallyover the past 4 years.

Journal

Just over a decade earlier, accordingto the report, the dental professionwas in the doldrums. Tooth decaywas in decline and a glut of dentistscaused several dental schools toclose. Back then, dentists averaged$78,000, about two thirds of the averageincome for an internist and lower thanincome levels for all types of physicians.Since then, the average income fordentists has more than doubled, whilethe average income for physicians hasgone up by 42%, lower than the inflationrate of 46% over the same period.

Cosmetics, Not Cavities

The rise in income for dentists has comedespite the fact that fluoridation andimproved dental hygiene have slashed thenumber of cavities in 6-to 18-year-olds byas much as 60% from the early 1970s.What has boosted compensation is entrepreneurialin nature—a radical switch inmany dental practices, away from semiannualcheckups and cavity fillings towardpopular cosmetic procedures like bondingand teeth whitening.

Procedures like these don't show up oninsurance company radar screens becausethey are usually paid for, out-of-pocket, bythe patient. The result is that dentists cancharge hefty prices for these proceduresand not fall victim to a managed careplan's cost-cutting ax.

The higher charges also allow dentiststo make better incomes for lesswork. Some dentists report cutting backfrom working 60-hour weeks to spendinglittle more than half that time at workand, at the same time, maintaining oreven improving income levels. Dental careexpenses make up less than 5% of thenation's overall health bill.

Doctors Lag

Physicians, on the other hand, are findingthemselves behind the income eightball.Beset by aggressive cost-cutting bymanaged care plans, along with shrinkingreimbursements from government programslike Medicare, doctors haven't seenanywhere near the income windfall thatdentists have. In fact, according to numberscompensation surveys, income formany doctors has failed to outpace inflationover the past several years.

Even worse, as income for physicianshas stagnated, overhead has increased.Rising malpractice premiums and higherstaffing and office costs have cut into theaverage MD's take-home pay, while theheavier patient load that comes with signingup with a managed care program haslengthened the average doctor's workweek to about 55 hours.

Also, unlike a dentist, the averagephysician has few opportunities to do aradical practice makeover. Where dentistscan market optional treatments thatare outside the managed care scope andpaid for by the patient, most of the servicesa doctor provides lie within thatscope, which means the doctor gets paidaccording to a schedule of fees that themanaged care plan has jawboned downto a minimum.