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January 30, 2005
DDS vs. MD, reprise
In response to a comment posted regarding my reference to a Wall Street Journal article here:
Ok, here we go.
The first perspective which this article has assidiously taken- in terms of financial loss and gain. The cosmetic dentist makes more.
Assidiously? Assiduously.
Your argument turns on general dentistry after your opening lines. You know that "cosmetic" is a bit of a bad word and inappropriately helps your "noble profession” argument. So, correct--partially. A strictly cosmetic practice is fundamentally limited in a business sense, as only a very small portion of the general population is willing to pay $20,000 to $30,000 for a complete smile makeover. The demand simply isn't there despite what you see on extreme makeover. Yes, a cosmetic dentist’s income is more on average than that of a general physician, but because everyone needs a dentist at some point and because 2010 is predicted to mark the greatest shortage of dentists per capita (look here), a general dentist who utilizes a central self-management system can realize the unlimited business expansion potential of general dentistry and completely trample the revenue seen by a cosmetic dentistry practice and family medicine practice put together. A general dentist who does not wish to have much to do with the business aspect of his practice might be lucky to pull in less than $100,000 a year, so a family medicine practioner might make more in this case. All in all, dentistry is unique among the various healthcare professions in that it allows the ultimate fusion of a healthcare profession and the business world. Enough of the business clarification.
The second- in real world and societal contributions. Primary care physicians save lives, extend lives, heal and care for patients from birth to death. They are underpaid, underappreciated, and overburdened.
Have you have ever cured someone from excruciating pain associated with a softball-sized abscess resulting from a necrotic tooth? If for some reason such a patient initially presents to your practice instead of mine, please remember to whom you will be referring. And please consult your Pharmacopoeia for the appropriate antibiotic regiment before you prescribe. You guys are always getting that wrong, and I frequently have to wait a bit before I can start the patient on the correct meds. Have you ever completely changed someone’s life via self image and confidence by making them a presentable smile? I’d say that’s a pretty sizable societal contribution, or at least my 41-year-old former hockey player patient who was brought to tears after getting his front teeth replaced thinks so. People need teeth to eat—have you ever made dentures for a migrant worker hasn’t enjoyed solid food for 15 years? Have you ever seen a suicidal patient in your hospital’s psych ward completely cured once a dentist diagnosed and treated him for a severe temporomandibular joint disorder? He sent me a ham the past two Christmases. Juicy. You do realize that people see their dentist far more often than their physicians, don’t you? It’s a fact. I continue to refer patients to YOU for previously-undiscovered diabetes, hypertension, arrhythmias, eating disorders, thyroid problems, psychological disorders, and skin cancer. I have found and excised a few cancerous oral lesions before they had time to kill the patient. Do you still think I don’t contribute much to society?
It's a lot easier to write about working 110 hour weeks than actually doing them. Try it.
And then there’s one of the main reasons I got into dentistry in the first place—I want the ability to have, spend time with, and support a large family. Might that be considered noble? I don't question the MD's workload for a second. I could have chosen medicine—I got a 33 on the MCAT—but as you pointed out, a medical career just wouldn’t have allowed that.
Finally do not confuse medical training with dental training. While the dentist is no doubt skilled, I know first hand the difference in professional schooling and post educational training entails amongst the two [sic]… Med school is hell- pure and simple.
Oh, come on! Dental school is IDENTICAL to medical school in the first two years—they are BOTH absolute hell and a great way to lose weight! Both schools have the SAME courses the first two years, but we have dental-related and craniofacial courses on top of that, not to mention all of our preclinical model-based how-to-drill work! The major differences arise in our third years. While you are doing your clinical rotations and attending classes here and there, we are still attending classes every morning, attending rotations, and treating patients under supervision.
There is a very good reason why medical school is more competitive than all other professional schools. What is often perceived as arrogance on part of doctors stems from the lack of appreciation or knowledge of what medical training consists of.
This is completely and utterly incorrect. Dental school admittance is far more competitive than that of medical school. Period. There are some 130 medical schools (not including DO schools or schools in the Caribbean) in the United States and only some 49 dental schools. (Look here and here.) There are more and more graduating physicians and fewer and fewer graduating dentists.
In fact, the number of medical school applicants is on a steady decline has been so for a number of years, while the number of medical schools has increased. (Look here, here, here, and here.)
The number of dental school applicants has increased dramatically in the past few years alone, and the number of dental schools has been on a steady decline. (Please look here!)
Consider my state-run dental school and my class of 66 people. Throw in equal opportunity for women (down to 33 places) and affirmative action (down to 16 seats). Now factor in the 2400 applications received in 2000 by my school alone and the fact the two of the four dental schools in Illinois closed in 1990 and 1999. Need I say more?
Even still, there is a back door in the field of medicine--the DO. I’m sure you know all about it, so I won’t go into it. And what about those medical schools in the Caribbean? This does not exist in dentistry in any way, shape, or form. I know for sure some people who are but definitely should not be physicians, but there is not one person in my dental class I wouldn’t bring my kids to.
And then there is residency.
After the initial four years, dentists’ residencies are not mandatory. I’ll give you that. However, dentists may elect to complete an official general practice residency associated with a dental school or a hospital or a residency in orthodontics, periodontics, pediatric dentistry, or oral surgery. Unofficial residencies almost always occur in the form of an associateship when a new graduate works with an established dentist, though.
It’s attitudes like yours and general lack of knowledge about the field that keeps dentistry one of the best overlooked professions a person can get into. Hey, it’s fine by me. I still return to my home town to people who think dental school is some sort of technical two-year program that someone might do even instead of college. In the end, as your author name indicates, you are a medical student. I’m sure you’ll come to realize and understand what I say here in the last few years of your medical training. I invite you to report back when you’re out to see whether or not you may have changed your mind.
Posted by Richard at January 30, 2005 03:12 PM
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