Dentists' Hourly Income Better Than Orthopaedic Surgeons'

Laird Harrison

February 24, 2012

February 24, 2012 — After subtracting for the cost of training, dentists make about $99 an hour, beating orthopaedic surgeons but losing out to lawyers, in a comparison of well-paid professions, according to a study presented this month at the American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting.

The study, by Suneel B. Bhat, MD, an orthopaedic surgery resident, and colleagues at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, found that studying to be an orthopaedic surgeon was a "poor financial investment" compared with studying law, dentistry, or anesthesia nursing.

"Our study, the first direct comparison of the financial return of orthopaedic surgery to other professions, highlights the point that there is a relatively lower financial value incentive for qualified individuals to enter orthopaedics compared to several other professions, which could potentially have far-reaching implications on career choice and subsequent access to care for patients," the authors conclude.

To see which professions make the most money, Dr. Bhat and colleagues collected income figures from surveys done by professional associations and other sources. The medical professions' income data were from 2008 and 2009, but the law profession data were from 1997.

The researchers noted that raw income does not accurately reflect the return on investment in education. To better capture the differences, Dr. Bhat and colleagues estimated after-tax income, savings and interest, and liabilities such as student loans and the amount of education needed to be licensed.

They assumed that educational loans would be deferred until the annual liability was less than 25% of earnings, and that interest on the loans was 8.25%.

In addition, they assumed that the individual would save 0.15% of earnings after achieving a stable income.

The researchers found that dentists earned a cumulative career total of $6,866,796. That was less than the $10,756,190 made by orthopaedic surgeons, the $8,381,250 made by lawyers, and the $7,338,412 made by nurse anesthetists, but more than the $3,867,504 made by nurse practitioners.

Of course, inflation eats up a lot of those earnings. Assuming a 5% inflation rate, the researchers came up with $1,855,430 as the cumulative career earnings for dentists in real dollars. After adjusting the numbers for the other professions, they still found that dentists came in fourth of the 5 professions.

However, these figures still do not give an accurate comparison of the income from different fields, the researchers say, because some professionals work more hours than others. And apparently dentists work less than surgeons.

Dentists took in $99 per hour, which put them second. Only lawyers made more, at $130 per hour. Orthopaedic surgeons took in $88 per hour, nurse anesthetists made $93 per hour, and nurse practitioners made $49 per hour.

Dentists might be doing even better relative to lawyers than these figures suggest, certified public accountant Bassim Michael, president of Michael & Co CPAs in Fresno, California, told Medscape Medical News.

Michael, who has clients in all these professions and clients around the country, said the fact that the lawyer figures came from 15 years ago was significant. The recession has hammered the legal profession, and so have cut-rate online services such as LegalZoom.

"Lawyers are not making that much money anymore," said Michael. "I've seen cases where lawyers went from a very decent law school and they still had a hard time finding a 6-figure salary."

For their part, orthopaedic surgeons are contending with lower Medicare reimbursement.

Dentists, too, are under pressure, Michael added. "What we're seeing in some of the larger cities is that some dentists are having trouble finding jobs," he said. "A lot of big cities are saturated. Basically, the only opportunity is to buy a practice."

High unemployment has deprived many patients of the means to pay for dentistry. "They may not be doing the 6-month cleaning. They may be putting it off and putting it off."

Michael sees the patients' tight budgets reflected in the figures that his dentist clients give him. "When I look at the overhead for my dentists, I see them spending less on lab fees and more on supplies. That means they're doing more fillings and fewer crowns. They are trying to do repairs."

Young dentists graduating with student debt of $250,000 or more are in the hardest spots, but even established dentists are working harder, said Michael.

To make ends meet, a lot of the dentists are freezing employees' wages, shopping more aggressively for deals on supplies, and in some cases buying from overseas labs.

Do the latest employment figures offer hope?

"I see the economic picture getting worse, not better," Michael said.

American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting: Presentation 746. Presented February 10, 2012.

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