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ortho - the international C.E. magazine of orthodontics

ortho1_2012 I 11 practice matters_ staying competitive I _PrivatepracticeorthodonticownershipinAmer- ica is and will continue to be one of the best income producingvocationsinallofdentistryandmedicine. However, running a successful practice is increas- ingly complex and the path leading to financial suc- cess seems steeper than past years. The winds of change and challenge vary in direc- tion and intensity, but are relentless as they push practice owners to learn, adapt and implement the ideas, strategies and products necessary to stay competitive and clinically relevant. This article will look at the current orthodontic market in the United States from the perspective of the practice owner. We’ll glance back at past norms, look at where we are now and discuss a few of the trends we’re seeing in the profession looking for- ward. Put your seat belt on, this can be a bumpy ride. _Doctor demographics The U.S. Census Bureau reports there are about 312millionpeoplelivingintheUnitedStates.Toserve the dental needs of this population, the U.S. Depart- ment of Labor’s Occupational Outlook Handbook reports there are currently about 136,000 general dentists working in the United States. Orthodontists are the largest dental specialty group with a force of about 9,500. Of the 65 orthodontic residency programs in the United States, the total resident enrollment at any given time is about 975, with about 360 residents graduating each year. Program length varies be- tween 24 and 36 months. Currently, 17 programs offer 24 months, 15 programs offer 30 months and 33 programs are in the 36-month range (each of these are ranges as some programs are 26 months or 33 months, as an example). Growthinthenumberofprograms,andtherefore residents,hassubstantiallyincreasedinthelastdec- ade. Primarily, programs at Jacksonville, Denver and Las Vegas each started with an original class size of about 14 residents, though the University of Nevada has recently dropped back down to four residents per class. In addition to these three large programs, the University of Southern Nevada in Henderson began in late 2008 and offers an MBA along with an ortho- dontic certificate, accepting 10 residents per year. SetonHillUniversity,inGreensburg,Pa.,begananew orthodontic program in July 2010 and will graduate its first class of six in December. Collectively, these new programs produce about 54neworthodontistsperyear,an18percentincrease in the number of orthodontists coming out per year compared with a decade ago. This increase in the number of new orthodontists is currently intersecting with a larger number of pediatric dental offices bringing orthodontics in- houseandanincreasingnumberofdentalclinicsand corporate-managed dental offices adding ortho- dontics into their business model. In addition, recent economic times have caused many orthodontists to extend their careers, giving investment portfolios and retirement funds time to rebound, resulting in fewer practice owners retiring. Thesefactorshaveresultedinanagingorthodon- ticprofession.Accordingtothe2011JournalofClini- cal Orthodontics 2011 Practice Study, the current mean age of an orthodontist is 54, and he/she has been practicing for 23 years. Both of these statistics are 30-year highs. As the profession ages, opportunities for practice purchases have remained scarce. One measurement ofsupplyanddemandistheAAOPracticeOpportuni- tiesServices(POS),whichreported143opportunities Author_Chris Bentson, President, Bentson, Clark & Copple The business of private practice orthodontics in the United States