It must be draining to be a dentist?

Frankx

Dealing with the physical work of dentistry and the psychology of dealing with patients fears real and imagined pain

LuasSimon

You can think of your overflowing bank account and your villa in the south of France to help you cheer up though !

Rodney Bathgate

LuasSimon wrote: »

You can think of your overflowing bank account and your villa in the south of France to help you cheer up though !

Not to mention the Rolex collection and Tesla.

Frankx

LuasSimon wrote: »

You can think of your overflowing bank account and your villa in the south of France to help you cheer up though !

Ya ok you get the comedy award for that

I the reason I posted was that a couple of things dentists said to me were very powerful

When you go to a dentist and they do an exam

they always give you the bad news first

I don't think they even realize they're doing it

And then they switch to the psychology and the treatment

Frankx

Someone posted here that dentistry was a healing science

I actually think it's a caring science

LuasSimon

LuasSimon wrote: »

You can think of your overflowing bank account and your villa in the south of France to help you cheer up though !

I’d swop it all for a little bit more.

repulsebay321

Frankx wrote: »

Dealing with the physical work of dentistry and the psychology of dealing with patients fears real and imagined pain

The business of owning a practice and keeping patients is tough too. Neck pain can be an issue.

But you have good hours, the opportunity to do highly paid locum work all over the world and can branch out into injecting botox/fillers.

You can do advanced degrees and do oral/maxillofacial surgery in an operating theatre. Cases could involve cleft palate repairs, trauma and oral cancer treatment.

Oral Surgeon

Frankx wrote: »

Dealing with the physical work of dentistry and the psychology of dealing with patients fears real and imagined pain

Yes, we should all be sainted!!

gdpman

LuasSimon wrote: »

You can think of your overflowing bank account and your villa in the south of France to help you cheer up though !

Our practice is mainly medical card patient based in a rural setting.
To extract a tooth I get €33.
From this half is taken by the tax man, I have to pay a receptionist and nurse. Pay €7,000 medical insurance ( so i have to earn €14,000 to pay it) in case I ever get a patient sue. Pay all my normal business overheads. I now have to cover all the costs of personal protective equipment for myself and all the staff to provide a clean and safe environment for patients.
We have had NO help from the HSE.
I really feel like I'm living on the pigs back.!
If one of my children came home and said they wanted to be a dentist I'd throttle them.

Going forward when I close the door realistically no one is going to replace me, so where is the service for medical card patients going to come from.????

McCrack

gdpman wrote: »

Our practice is mainly medical card patient based in a rural setting.
To extract a tooth I get €33.
From this half is taken by the tax man, I have to pay a receptionist and nurse. Pay €7,000 medical insurance ( so i have to earn €14,000 to pay it) in case I ever get a patient sue. Pay all my normal business overheads. I now have to cover all the costs of personal protective equipment for myself and all the staff to provide a clean and safe environment for patients.
We have had NO help from the HSE.
I really feel like I'm living on the pigs back.!
If one of my children came home and said they wanted to be a dentist I'd throttle them.

Going forward when I close the door realistically no one is going to replace me, so where is the service for medical card patients going to come from.????

Two queries

First why would your professional indemnity insurance not get paid from fees as a normal overhead expense of the business before tax and re retirement what would stop you selling the practice to a younger dentist?

McCrack

McCrack wrote: »

Two queries

First why would your professional indemnity insurance not get paid from fees as a normal overhead expense of the business before tax and re retirement what would stop you selling the practice to a younger dentist?

It is, the point being made is that to be able to pay that €7k, he/she has to earn €14k. This is not an expense that can be negotiated nor forsaken.

It is very difficult to sell a predominately State fee dependent practice as the new owner is not able to control fees charged. As expenses associated with running a Practice have risen considerably over the past 10 years, medical card remuneration fees have remained static, not an appealing business to invest in. Also, as State benefit schemes do not cover many procedures, Med card patients often can’t have/don’t want them, so the likes of cosmetic dental treatments are rarely provided, many dentists like doing the more advanced treatments from which they can earn more, if their isn’t a reasonable private fee paying percentage of patients, the dentist is locked in doing extractions and dentures.

whatawaster

Dav010 wrote: »

It is, the point being made is that to be able to pay that €7k, he/she has to earn €14k. This is not an expense that can be negotiated nor forsaken.

It is very difficult to sell a predominately State fee dependent practice as the new owner is not able to control fees charged. As expenses associated with running a Practice have risen considerably over the past 10 years, medical card remuneration fees have remained static, not an appealing business to invest in.

It’s a tax deductible expense, not a personal expense. Therefore you only need to earn 7k in patient fees to cover that 7k expense

whatawaster

whatawaster wrote: »

It’s a tax deductible expense, not a personal expense. Therefore you only need to earn 7k in patient fees to cover that 7k expense

I see what you mean, yes from a taxation perspective you are correct, I suspect what the poster was saying is that to have €7k in his/her bank account to pay that subscription at the start of the year, he she has to have done €14k worth of dental treatments, which on the Med card scheme is a hell of a lot of treatments. I doubt he/she was including all taxation variables. To say you only need to earn €7k to pay a €7k expense is to assume there is no other expense involved in earning that €7k, which of course is not the case.

bikeman1

whatawaster wrote: »

It’s a tax deductible expense, not a personal expense. Therefore you only need to earn 7k in patient fees to cover that 7k expense

Exactly and if you are talking about tax, it only “costs” you €3.5k because with the deductibility of the expense against your profit it reduces your tax bill.

You are going to have a tough audience to make someone feel sorry for the lowly paid dentist!

We all pay tax, so after expenses if you have €120k profit after expenses you pay the same tax as the minister on the same amount!

bikeman1

bikeman1 wrote: »

Exactly and if you are talking about tax, it only “costs” you €3.5k because with the deductibility of the expense against your profit it reduces your tax bill.

You are going to have a tough audience to make someone feel sorry for the lowly paid dentist!

We all pay tax, so after expenses if you have €120k profit after expenses you pay the same tax as the minister on the same amount!

A minister does not have the costs associated with running a clinic, also, I personally wouldn’t mind having their holidays.

I don’t think anyone was looking for sympathy, this is one of the reasons I think Dentists should charge the maximum they can for treatments, you are going to get flack anyway, so you might as well get well paid for it.

padser

Dav010 wrote: »

I see what you mean, yes from a taxation perspective you are correct, I suspect what the poster was saying is that to have €7k in his/her bank account to pay that subscription at the start of the year, he she has to have done €14k worth of dental treatments, which on the Med card scheme is a hell of a lot of treatments. I doubt he/she was including all taxation variables. To say you only need to earn €7k to pay a €7k expense is to assume there is no other expense involved in earning that €7k, which of course is not the case.

I'm pretty sure that's not what the poster is saying. The poster implied that they have to pay 50% tax before paying their insurance.

If they are doing that, they should change their accountant.

More generally, the poster seems to suggest that the taxman takes half and they have all these expenses. But that really is double counting the impact, they deduct expenses and them the taxman takes half of what's left.

padser

padser wrote: »

I'm pretty sure that's not what the poster is saying. The poster implied that they have to pay 50% tax before paying their insurance.

If they are doing that, they should change their accountant.

More generally, the poster seems to suggest that the taxman takes half and they have all these expenses. But that really is double counting the impact, they deduct expenses and them the taxman takes half of what's left.

Maybe the poster will clarify, but, he/she is correct, it could have been worded/explained better though.

The costs of running a clinic are high, when you take all those costs, it is the industry norm for costs to account for 50% of fees earned. You might think how could this apply to a rural practice doing mostly Med card treatments and a big private clinic in Ballsbridge, the fees generated in the rural clinic would be lower but costs such as rental/wages/lab fees/materials costs would be lower where the opposite is likely to be true in Ballsbridge where you might have a higher number of patients paying more, but costs are also much higher.

Over the past 30 years, I have been to many conferences where financial/retirement planning lectures were given, and in all cases, around 50% is the figure given for the costs of providing a treatment. It is an overarching figure, and can be picked apart I’m sure when discussing individual expenses like this, but when all is added up, that’s what usually comes out at the end.

Providing a treatment involves many expenses, insurance is only one of them, perhaps the poster would have been better to have avoided giving the impression that this should be considered in isolation to the other expenses.

gdpman

Just to clarify, I was more concerned generally for the medical card scheme and the patients we have served.
Unlike medical colleagues who receive practice supports for staff and capital equipment medical card dental practices receive nothing.
Young graduates understandably do not want to work in a rural setting and as the demographics of those qualifying change just like in general medical practice there will be an acute shortage of dentists available.
I do not expect sympathy ( I enjoy my job ) but the general population must be prepared that down the line the availability of services especially for medical card patients will not be there, especially in a rural setting.
This will be compounded by the dismantling of HSE child services at local clinics and the expectation that these children will be seen at a local clinic with the introduction of smile agus slainte.
If measures are not taken soon it will be too late, politicians have only been interested in dental services when it concerns orthodontics and an election is looming.!