Every graduating orthodontic resident faces this question. All react differently based on who they are and what they want but most fall into one of two broad categories. Let’s discuss the options logically.

  • I want to live where I want to live!
    My professors all tell me to “go where you want to live and you’ll do just fine.” WARNING! That advice may have been good 20 years ago but these days it’s not that simple given the amount of competition out there and the rising cost of doing business. Well, unless you happen to want to live in an area that needs an orthodontist! Usually the residents I talk to want to go to LA or The Bay Area or NYC or Boston or Chicago or Atlanta or Utah or Portland or wherever the weather/amenities are great, the cost of living is high and there are a bazillion orthodontists already. And that is fine. You can choose to go to those areas… but don’t whine and cry when you can’t find a job, “have to” work for a dreaded corporate practice or have a tough time building a practice. Another reason I hear for going to a specific area (usually very competitive and desirable as well) is, “my family, my spouse, my fiancé or my girlfriend/boyfriend want me to live there”. Again this is a fine way to choose where you will invest your life’s work and risk millions of dollars on your one chance to live your dream, but don’t complain if it doesn’t work out. Deciding where to live and practice is a BUSINESS DECISION – or at least it should be. If you decide based on other factors then you cannot reasonably expect your business to do well. Plus, if you fail, I assure you that your family, spouse’s parents, fiancé (and his or her family) or your girlfriend/boyfriend (and his or her family) will not take the blame for your failure. It will be squarely on your shoulders so choose wisely!
  • I want to go where there is a need and I can make money!
    This is by far the less popular choice among residents but it is the path to success and happiness. If you go where there is opportunity then life is easy, practices are for sale, cost of living is low… all because, by their nature, places that need orthodontists are not nearly as cool or as desirable. I am from the East Coast and grew up on the beach but I chose to practice in nowhere Arkansas because I was scared of going broke, because I found a practice I could afford, because I found a seller who would finance the practice and because there wasn’t a ton of great customer service in the area. My wife and I felt we had the best chance of doing well there and we were right! Now we can do what we want, when we want. You can have that too. Go where there is a need, prosper, enjoy life and fly first class wherever you want whenever you want!

Deciding where to live and practice is a big deal. It’s probably in the top 5 and maybe the top 3 most important choices in your life. Don’t make it lightly. Don’t make it for the wrong reasons. And, when you totally ignore this advice as all residents do, don’t cry about struggling or being broke.

4 thoughts on “Where Should I Live & Practice?

  1. Do you happen to have any knowledge on evaluating population numbers and number of orthodontists in an area? As most (not all) orthodontic patients are children, is there a ratio of orthodontists: children in a community that is a good predictor of having an opportunity to be successful in that area (barring other things such as contacts in the community, your business approaches, marketing, etc..)?

  2. The number of orthodontists in a given area per capita is important but it’s not the only factor. You must consider the sophistication level of those orthodontists as well as any sophisticated PCDs doing Ortho and aligners well or at least in significant volume. It seems that most orthodontists across the country are in areas ranging from 8000-18000 people per orthodontist if you consider the entire market and not just the city limits. It rarely seems to be greater or less but there are exceptions. The Internet is great and demographic info is really available. Another option is to go to post offices and look at the delivery area.
    The ideal locations in my mind are large concentrations of people with several orthodontists who are old school and/or unsophisticated. The only thing better than that is if no one in the area is catering to traditionally underserved people. There are opportunities everywhere if you’re willing to break with tradition and make decisions based on business principles.

Comments are closed.