"I think we're reaching a breaking point where people are starting to reflect and say, 'Man, I don't know if the juice is worth the squeeze anymore.'" — Dr. Paul Etchison
Recorded live at Voices of Dentistry 2026 in sunny Gilbert, Arizona, Alan sits down with a VOD favorite, Dr. Paul Etchison of the Dental Practice Heroes podcast. They dive deep into the staggering reality of modern dental school debt, the "juice vs. the squeeze" of ownership, and why dentists should probably stay away from the restaurant business.
The financial landscape for new dentists has shifted dramatically. Alan and Paul compare the "then vs. now" of education costs:
The 1997 Reality: Alan graduated with roughly $85,000 in debt.
The 2009 Reality: Paul finished with around $235,000.
The 2026 Reality: In-state tuition at schools like the University of Michigan can exceed $400,000 before living expenses, often resulting in $4,000–$5,000 monthly loan payments right out of the gate.
While ownership comes with "headaches," Paul argues it remains the most viable path to outrun massive debt.
The Associate Cap: Even high-producing associates (doing $2M/year) are limited by their percentage. An owner doing the same production sees a significantly higher return.
Value Creation: To be a top-tier associate or a successful owner, you must move beyond "bread and butter" dentistry and master communication and case presentation.
Deep Dive vs. Scattershot: Instead of taking random weekend courses, find a specialty you enjoy (Endo, Ortho, etc.) and commit to it.
The Endo Struggle: Paul and Alan discuss the importance of "reps" and why waiting for the "perfect" case often prevents you from ever getting good at the procedure.
The Microscope Factor: Using a scope can find the MB2, but it doesn't necessarily make you faster without the volume of experience.
If dentistry vanished tomorrow, what would these guys do?
The Sausage and Bread Theory: Alan highlights small businesses in Northern Michigan that succeed through curation rather than volume.
The Bourdain Warning: A nod to Anthony Bourdain's Kitchen Confidential, which famously warns dentists against buying restaurants just because they "throw a good party."
Some links from the show:
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