Author | Ji Porcelain
Editor | Che Moumou
The geographic contempt chain of dentist income
March 22, the domestic oral chain medical company Ruier Group landed on the Hong Kong Stock Exchange, the Hong Kong stock market's first oral specialty chain enterprises, but also become the first national brand chain of listed companies in China's oral industry.
Its listing has brought private dental clinics and high-income dentist groups into the public eye. According to financial data, Ruier Dental, which focuses on high-end dentistry, the average income of a full-time doctor is 1,287,900 yuan, and its chief restorative dentist, Dr. Huang Jiansheng, said on Weibo that Ruier has the highest salary of 6,700,000 yuan.
That's a pretty staggering number. In the Internet, which is known for its high salaries, the annual salary (total package income) of Ali P7 is only 1.2 million at the highest.
At first glance, dentistry seems like a much more worthwhile industry for young people to enter than the internet. But is that really the case?
Like many industries in China, there are income gaps within the dental profession based on city and years of experience, but the income gap within dentists is tens of times higher.
In a fourth-tier city, for example, an average dentist earns around $100,000, and a director can earn up to $200,000 to $300,000, while a dentist in a first-tier city can easily earn more than a million dollars.
I talked to a dentist in a fourth-tier city in Sichuan, and in her account, I realized that a dentist in a first- or second-tier city and a dentist in a fourth-tier city and below are like two completely different jobs, with completely different consumer demographics, local markets, and even ways of earning big bucks.
"Persuade someone to study medicine, and heaven help you."
"Ten thousand dollars a month is still not a good job."
Song Yuanyuan works as a dentist in a fourth-tier city in Sichuan with a population of just over 2 million people, and she actually works two jobs: one full-time at a public hospital, and the other part-time at a private clinic, where the former gets 7 or 8,000 a month, and the latter gets 2,000 a month, which adds up to about 10,000 a month.
It's a lot more than that.
In the local area, where urban residents earn just over 3,000 a month, her income is pretty good for the area. And the first-tier cities despite the gap, but because of the different speed of urban development, this gap is bound to exist.
"So why do you say, 'Persuade someone to study medicine and heaven will strike them dead'?"
Song Yuanyuan said, rather helplessly, "Because studying medicine is a big investment with little output."
A complete medical school education takes 8 years, 5 years for undergraduate + 3 years for graduate students, but for many people in small cities, 8 years of study is too long, and the ongoing investment in tuition will not be able to afford it, so many people will choose to finish the undergraduate 5 years to try to enter the hospital work.
And in Sichuan, because of the West China Stomatology sign in, the whole doctor industry, especially in the field of stomatology, the involution is very serious.
When Song Yuanyuan graduated, one of the smoother paths was to apply for the West China Border Support and Poverty Alleviation Program, support for three years, and then join a better local hospital in Chengdu with the bonus points of this experience. This is the path that Song Yuanyuan took.
The view outside the hospital when Song Yuan Yuan was involved in the Border Support Program - image courtesy of the interviewee
But during her three years of support, the winds of involution blew from east to west, and the educational requirements of Chengdu's tertiary hospitals went from undergraduates to postgraduates and even PhDs . After Song Yuan Yuan support, it is difficult to stay in Chengdu, so layer by layer down, and eventually only found a fourth-tier city of public hospital work.
And if you want to find a better job, you need at least an undergraduate + postgraduate studies, plus 2 or 3 years of work experience in a quality medical unit, which takes 11 years overall.
"In 11 years, you've accumulated a lot of things and doubled your income long ago in other professions, but as a doctor, it's all just beginning."
And next, to get a pay raise, you need to squeeze your way up the ladder, a process that usually takes anywhere from 6 10 years, and is undoubtedly even more difficult in smaller cities where everyone has their eyes on the position, and many promotions take even more than 10 years.
"But you do it for a couple of decades, make it to director, get 30,000 a month, and you're at the top. And that's with working six days a week and being busy every day."
As a result, a public dentist in a first-tier, fourth-tier city mostly earns between $100,000 and more than $300,000 officially, and while the bottom line is secure, the ceiling upward is low, basically an income that can be seen at a glance.
"So would private practice be better?"
"Private clinics want to live, but also need years of accumulation of users, or it is very easy to go bankrupt, and the development of public hospitals in the time needed to reach the hands of income is not much difference."
On Volkswagen Dianping, search for Chengdu Dental Clinic, there are more than 7600 results, the competition is great
At the same time, the doctor is not an easy profession, the patient comes more easily busy, the night every doctor has to work the night shift, from 8 pm has been on duty until 8 am. Although all the people who study medicine know that staying up all night is not good, but every person who is a doctor, but have to stay up all night.
Busy, often night shifts, income is stable but not much change, these factors led to Song Yuanyuan on the study of medicine this matter of disillusionment, she repeated many times in the chat: "persuade people to learn medicine, heaven and earth."
"Dentists in small cities have to give lectures and sell books to make money."
How do doctors in small cities get rich?
But after listening to Song Yuan Yuan's explanation, two questions surfaced:
One is why dentists in first-tier cities can earn so much? A difference of tens of times is hard to attribute directly to 'different rates of urban development'.
Second, why do dentists in smaller cities that people usually come across seem to be quite wealthy?
It is in these two questions that Song Yuan Yuan points out the differences in market conditions and career paths faced by first-tier, new first-tier, and lower-tier cities.
The income gap for dentists comes primarily from fees and number of visits.
In the cost component, because 90% of the consumables come from abroad, there is not much difference in the cost of consumables between the coast and the interior; in terms of equipment, there is a certain cost difference between domestic and imported, but this difference will be compensated for by the fees charged, and hospital clinics using good equipment are oriented towards the middle and high-end population, and the overall fees will be higher.
Inside private clinics, usually include dental chairs, filming machines and other equipment, but the difference between imported and domestic
But what really opens up the gap in this charge is technology.
In first-tier cities, highly skilled dentists can charge tens of thousands of dollars for a single tooth. The locals are willing to pay for technology. But this willingness to pay is still basically only in the first-tier and new tier cities that are more economically developed.
In the fourth-tier cities where Song Yuanyuan works, most consumers don't have the concept of "teeth matter.
They usually wait until the toothache is too much for them to bear before they come to see a doctor, at which point they usually need to have a root canal. The cost of a root canal is usually 400,500 yuan, plus the use of equipment, the doctor's time and effort, and the minimum cost of the procedure is 1,500,000 yuan. And this is unacceptable to most of the local population. This amount of money can even support the expenses of some families for a month.
Song Yuanyuan was impressed that often 15 or 16 year olds would come to the clinic with a broken tooth, and when she told their parents that they needed a root canal, which would cost about 2,000, the first thing many of the parents would say was, "Can we pull it out?"
"In a lot of small, inland cities, dentistry is not a necessity. For many locals, even if they have no teeth, they can still live by eating porridge boiled softly, then this is not a thing." Song Yuan Yuan summarized, "Different lines of other cities face consumer groups, is completely different."
This is a direct result of the fact that in lower tier cities, a lot of dental business does not penetrate strongly.
"For example, regular checkups, scaling, we have this concept here very few; for example, the treatment of general dentistry, root canal treatment, endodontic surgery, denture repair, etc., most of them will also be dragging their feet and refused to come; as for the willingness to spend money on orthodontics, implantation of even fewer, because many people feel that this money is expensive to spend, and unnecessary. "
Teenagers who visit the dentist
The lack of concepts of dental care and dental care, and the limited average local income level ultimately leads to fewer people coming to see the dentist, and fewer people willing to spend a lot of money on their teeth, as well.
Within the dentist community, there is actually a clear perception of this status quo:
"If you want to do a good job in dentistry, you can do it in the first tier, the new first tier, the second tier look at the city, the third tier look at individual cities, and then there is not much money to be made down the line."
"So how do the dentists who seem to be very rich make their money?"
Song Yuan Yuan waved her hand, "Why, that's a different path. Climb up the ladder, climb to professor, go out and give speeches, lectures, teach students, open tutoring classes, go earn other income. Those are the big ones."
"Is there no way out for the average doctor in a small city?"
Song Yuan Yuan looked at me with a smile and shook her head. The look seemed to say: are you dreaming?
Dental rivers and lakes, the stark gulf between large and small cities
"Dentists want to be rich, you have to rely on the **** with the rich. "
In the path of dental career development, first-tier, new first-tier cities and low-tier cities show a stark gap.
In the more economically developed cities, the local population generates a demand for dental care, cosmetic care, and is willing to pay with it. This is also true from the experience of developed countries: There is a strong correlation between the growth of the dental industry and rising income levels.
In the United States, for example, in 1966 1987, the U.S. per capita GDP grew from $4,000 to $20,000, and the oral healthcare market experienced high growth in the process, with per capita dental expenditures growing from $15.2 to $104.5, at a compound annual growth rate of 9.6%.
And around 1980, when disposable income per capita in the US reached $9,000, the high-value, non-Medicare reimbursed items in dentistry, implants and orthodontics, ushered in rapid growth, which likewise corroborates the fact that incomes reach a certain amount before dentistry sees rapid growth.
There is a clear positive correlation between the U.S. per capita dental expenditures and income
In 2017, China's first and second-tier cities per capita disposable income of $9,000 or nearly $9,000 in an industry research report, some analysts will be "implantation and orthodontics" is considered to be the future of the dental industry in China's two gold mines. In one industry research report, some analysts regard "implants and orthodontics" as two gold mines for the future of China's dental industry. However, in low-tier cities, many people's demand for teeth is still stuck in the "can be used on the line" basis, willing to pay for the willingness is very low.
Song Yuanyuan added: "Whether in public hospitals or clinics, the main way to earn money is to have more people come to see the doctor and pay. But we usually see down, 5 can have a willingness to cure is good. And they usually go for the cheapest kind."
So the differences in economic income, awareness of dental visits, and willingness to pay ultimately led to the differences in the development of tier 1, new tier 1, and lower tier dentistry, as well as the chasm between doctors' incomes.
Can the listing of the first dental stock benefit the entire industry? I'm afraid this requires a question mark.
In the lower tier cities, consumer demand, ability, and the market has not yet been developed, talk about a lot of money, I'm afraid it is difficult.
Dentistry development so far, the internal competition has become very fierce. Song Yuan Yuan in Sichuan, because of the existence of the West China Stomatology resulting in fierce competition, has developed to the doctor + good internship to enter the better dental hospital in Chengdu.
And the old first-tier cities of Beijing, Guangzhou and Shenzhen, because of the early development and high income, the degree of involution is even more serious.
And this kind of involution, at the same time, causes the double result of uneven distribution of medical resources between different cities, and the power of medical resources is greater than the demand of the city.
The dental industry in East China is significantly higher than in other regions Source: Dr. Dental Prospectus
This is an industry that is very much influenced by geography. All Song Yuan Yuan can hope for is that the concept of oral care and economic development in lower tier cities can develop in tandem.
She got into the industry because dentists have more freedom (they can be in hospitals or clinics), and only when the demand is there will she have the flexibility to pursue the life she wants.
Dentists will also continue to sink
The current state of development of stomatology in different cities is a microcosm of China's past rapid development and the different rates of development between cities.
This rate of difference is not limited to the income level, but includes the public consumption concept, industry development, personnel employment and other aspects.
The Internet has smoothed out some of the regional differences to a certain extent, but when the industry has landed in a specific city, different urban temperament, different urban citizens, that is, the development of the industry in the local present a completely different appearance.
The saying, "If a tangerine is born in Huainan, it is an orange; if a tangerine is born in Huabei, it is a hedgehog," still applies today.
But on the other hand, it means opportunity.
With the potential for oral development in lower tier cities yet to be fully realized, whoever can cultivate the consumption habits of users in these areas and build up a highly loyal user base will become the new unicorn in the lower tier market.
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