What Should I Be | Transcript

TRANSCRIPT OF INTERVIEW

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Gary Gordon (Interviewer: 00:00:05): Hello everyone, my name is Gary Gordon. I'm the Founder of WhatShouldIBe.me, and today we are interviewing Dr. Fred Rosen, who is a Dentist. And he's going to walk us through just some of the background information as far as how you can possibly become a dentist, what it might take, the road you'll have to take to get there, what it's like being a dentist, his day-to-day life - just all sorts of information regarding the world of dentistry. So, at this time, I'd just like to introduce Dr. Fred Rosen, let him introduce himself, and maybe tell us a little bit of a background on himself, and then we'll get going with our questions.

Dr. Fred Rosen (Interviewee: 00:00:41): Hi Gary, how are you?

Gary Gordon (Interviewer: 00:00:42): Very good.

Dr. Fred Rosen (Interviewee: 00:00:45): I have been a dentist for forty years. I had a Bachelors Degree from Brooklyn College, and then went to NYU Dental School, which is a four-year program, as all dental schools are today. Then, upon graduation, was fortunate enough to have a General Practice Residency at Long Island College Hospital in New York. When I say fortunate enough, there aren't enough hospital positions to go around for every dental graduate, but it's a wonderful year of continuing education before you prepare yourself to go out into practice. It was probably one of the most exciting times in my career because not only are you doing all phases of dentistry with specialists in every category, you also are on call. Back then there were only two of us, so we were on call every other night. And sometimes you'd get a call for a traumatic injury in the emergency room, and you'd hang around. You would learn a great deal of medicine, not just dentistry.

Gary Gordon (Interviewer: 00:02:11): So this was after the four years of dental school.

Dr. Fred Rosen (Interviewee: 00:02:15): Correct. In fact, after the four years of dental school, once you pass your licensing exams, you are technically allowed to go out and practice dentistry.

Gary Gordon (Interviewer: 00:02:23): Okay. So, people don't need to do what you were fortunate enough to experience by having the hospital internship. But you don't need it. In other words, I know like with medicine, you get a degree, you know, as a doctor. You go to medical school. Then you need to serve like, let's say, in an ER or something like that as part of your residency. But you're saying that that's not required in dental?

Dr. Fred Rosen (Interviewee: 00:02:48): No, it's an optional year that prepares you for practice, regardless of whether it's a general practice or you continue to specialize, like no other year can. When I look back on it, I think that's what made me a dentist.

Gary Gordon (Interviewer: 00:03:11): Wow.

Dr. Fred Rosen (Interviewee: 00:03:12): More so than dental school.

Gary Gordon (Interviewer: 00:03:13): Really? Yeah, well, that makes sense. How difficult, today, is it for a graduate of dental school to find an opportunity like that to go to?

Dr. Fred Rosen (Interviewee: 00:03:28): It's more common today because now some of the dental schools, which didn't exist forty years ago--

Gary Gordon (Interviewer: 00:03:36): Right.

Dr. Fred Rosen (Interviewee: 00:03:37): --have general practice residencies, where it's not in a hospital situation, but in a dental school scenario where they are treating patients, but having a closer one-on-one relationship with an instructor, which is what a general practice residency in a hospital was able to provide. In dental school, you basically have a row of cubicles and you may have on instructor for ten, fifteen, twenty students so that you can try to tap into what instructors know. Just from a time limitation, you don't get the personalized observation that you do once you go out into a general practice residency of some sort.

Gary Gordon (Interviewer: 00:04:32): So, once someone gets out of dental school, what I'm hearing for you is that you kind of still might recommend that they try to get a year in a hospital setting. Is that not true?

Dr. Fred Rosen (Interviewee: 00:04:50): Correct.

Gary Gordon (Interviewer: 00:04:51): Even though they might offer something now in a lot of dental schools, where they do an in-house type of residency, you still think that someone that graduates dental school, afterwards, should still try to find a year's internships that they can do in a hospital as a dentist.

Dr. Fred Rosen (Interviewee: 00:05:08): Yes. One of my jobs is not just treating patients in the office, but I am on the staff of a hospital in my area.

Gary Gordon (Interviewer: 00:05:24): Oh, okay.

Dr. Fred Rosen (Interviewee: 00:05:25): And I do lecture. I will work with the residents - and there are only four in this particular program - on difficult cases. Areas of expertise that I've developed over the years that we're able to work one-on-one with.

Gary Gordon (Interviewer: 00:05:49): Now, when someone serves that year in the hospital, are they getting paid or is it free?

Dr. Fred Rosen (Interviewee: 00:05:53): Yes.

Gary Gordon (Interviewer: 00:05:54): They are getting paid.

Dr. Fred Rosen (Interviewee: 00:05:54): They're getting paid. They get full benefits.

Gary Gordon (Interviewer: 00:05:58): Oh, really? Okay.

Dr. Fred Rosen (Interviewee: 00:06:00): Whereas, I believe, in a dental school situation, you are paying to be in the program.

Gary Gordon (Interviewer: 00:06:08): You're paying to work for free. Okay, I got it.

Dr. Fred Rosen (Interviewee: 00:06:11): You're generating income for the dental school.

Gary Gordon (Interviewer: 00:06:14): Okay. Okay.

Dr. Fred Rosen (Interviewee: 00:06:16): Both, by paying them for the opportunity and for treating patients, whereas in a hospital situation, you do get paid. Not what you might be paid in the outside world, but it's certainly something that you can live on. And I believe, now, it's something like 35/40 thousand dollars.

Gary Gordon (Interviewer: 00:06:41): That's what I was going to guess.

Dr. Fred Rosen (Interviewee: 00:06:43): Yeah.

Gary Gordon (Interviewer: 00:06:43): And it's right - this is 2013, just a benchmark for that.

Dr. Fred Rosen (Interviewee: 00:06:46): Yes.

Gary Gordon (Interviewer: 00:06:47): Because if somebody's listening to this in fifty years from now, I don't want them to say: "What?" Now, tell me about some of the benefits of things that you were able to learn during that year in the hospital that went beyond just what you were taught in dental school.

Dr. Fred Rosen (Interviewee: 00:07:08): First and foremost, traumatic injuries. I mean we would see patients who were in car accidents, athletic injuries, physical assaults, and we had to repair teeth because there were no oral surgery residents. And some hospitals have people going on to specialize in oral surgery so they'll have residents on staff. We had none, so I was taught how to wire fractured jaws - something that I had not done since.

Gary Gordon (Interviewer: 00:07:48): Did someone teach you?

Dr. Fred Rosen (Interviewee: 00:07:49): Yes.

Gary Gordon (Interviewer: 00:07:49): In the hospital?

Dr. Fred Rosen (Interviewee: 00:07:50): There were oral surgeons on staff.

Gary Gordon (Interviewer: 00:07:53): And they were teaching you.

Dr. Fred Rosen (Interviewee: 00:07:54): And they would teach us how to do it.

Gary Gordon (Interviewer: 00:07:55): That's great.

Dr. Fred Rosen (Interviewee: 00:07:55): So that I remember the first fractured jaw I treated. I had been there for about two months. It was two o'clock in the morning. And I must have called the oral surgeon about a half a dozen times in the middle of the night, just going step-by-step, because I was so uncertain.

Gary Gordon (Interviewer: 00:08:19): Right.

Dr. Fred Rosen (Interviewee: 00:08:19): It was a very successful result.

Gary Gordon (Interviewer: 00:08:21): Right.

Dr. Fred Rosen (Interviewee: 00:08:22): I was thrilled when the oral surgeon saw him the next morning, when we made hospital rounds, because we admitted the patient to the hospital, that I had done everything correctly. But you know, not having anyone there to physically hold my hand--

Gary Gordon (Interviewer: 00:08:38): Right.

Dr. Fred Rosen (Interviewee: 00:08:39): --was one of the more nerve-wracking experiences that I've had.

Gary Gordon (Interviewer: 00:08:42): Sometimes it's the best way to learn though. You know? It's like you're thrown out there and you just got to make you way. But luckily, he was there to answer questions throughout the night.

Dr. Fred Rosen (Interviewee: 00:08:51): Yes.

Gary Gordon (Interviewer: 00:08:52): Which is key.

Dr. Fred Rosen (Interviewee: 00:08:54): The repairing fractured teeth - something you do see quite often in practice now, but back then, in dental school, they gave you a lot of instruction, but no patients. I mean that's not the sort of thing you can plan for. They would screen patients for you we treat for different types of procedures - for fillings, for extractions, for gum surgery, for root canal. But someone comes in and breaks a tooth; you don't have the luxury of carefully planning it. You've got to do something to get them out of pain and you've got to do it fast. And this was something that was a wonderful experience, but because there were only two residents, we would have each day divided into a morning and an afternoon session of which we would have specialists. And we would have an orthodontist one morning. We'd have a pedodontist, or children specialist, that afternoon. And so, we would be basically doing a mini-specialty program each half-day. And having one to two specialists at every session and only two residents was great. You can really tap into their knowledge. You can ask questions. They have plenty of time to do it. In a program like that, they would stay later. There were a couple of times where we would have lunch after a morning session or maybe go out with the attending doctor after the afternoon session and have questions. It was the first time, in my educational experience, that you were learning for the sake of learning. Not learning because you had to prepare for an exam.

Gary Gordon (Interviewer: 00:11:14): Right. Right.

Dr. Fred Rosen (Interviewee: 00:11:15): Or pass some sort of requirement. And it was a wonderful, exciting time.

Gary Gordon (Interviewer: 00:11:27): When you were in the hospital, do you think that there would've been much of a benefit to stay doing that longer, or was a year really just enough?

Dr. Fred Rosen (Interviewee: 00:11:40): I think a year was just enough.

Gary Gordon (Interviewer: 00:11:42): Okay.

Dr. Fred Rosen (Interviewee: 00:11:44): In today's world, because over forty years there have been a lot of technological advances, an additional year might be very helpful, but I don't know of any program that has that--

Gary Gordon (Interviewer: 00:11:58): Okay.

Dr. Fred Rosen (Interviewee: 00:11:58): --for general dentistry. Now, if one wants to go on to become a root canal specialist, or oral surgeon, or a periodontist - a gum specialist -, you usually go through a residency like I'm describing and then you go for a two to three-year program, usually, back to the dental school to be able to get the qualifications to become a specialist.

Gary Gordon (Interviewer: 00:12:26): Okay. When you went to the four years of dental school, I'm just trying to really let people get an understanding as to how valuable that year in the hospital is after spending four years rather than just saying: "Well, you know, I've been in school. I need to make some money. I want to go get a job." You know, that type of thing. My question is: Comparing what you learned in that one year in the hospital to what you learned in the four years of the dental school, how much importance do you place on what you learned in the hospital and where do you think you got the biggest education for dentistry? In other words, did you learn more when you were in the hospital or did you really learn more in that four years of dental school?

Dr. Fred Rosen (Interviewee: 00:13:25): Well, four years of dental school is like learning another language. You come in - and there were some students in our dental school class who had fathers or grandfathers who were dentists, or some who had had fathers who were lab technicians, so they had an understanding of the mouth. I had none of that, so I came in having a background in biology and chemistry from college, but having--

Gary Gordon (Interviewer: 00:14:05): No practical experience.

Dr. Fred Rosen (Interviewee: 00:14:06): You know, I didn't. I could barely know an incisor from a molar. And so, the first two years, back then, and they may be a little bit more aggressive today, but the first two years were all -- we never treated a patient. They were all the basic science courses.

Gary Gordon (Interviewer: 00:14:24): Okay.

Dr. Fred Rosen (Interviewee: 00:14:25): In fact, in some of the smaller dental schools, first two years of dental school are combined with the first two years of medical school because they just have a few students and you can't have a whole faculty for, you know -- University of Connecticut, for instance, was just starting. When I was a student, they had sixteen students. NYU had a hundred and seventy-five. So you had a very different -- you could afford a separate--

Gary Gordon (Interviewer: 00:14:59): Faculty. Right.

Dr. Fred Rosen (Interviewee: 00:14:59): --faculty for dental school at NYU. You couldn't at Connecticut. So, they combined everything. And you know, sometimes people think of dentists as tooth mechanics, but our basic science background is the equivalent of medical school.

Gary Gordon (Interviewer: 00:15:21): Okay.

Dr. Fred Rosen (Interviewee: 00:15:22): We're dealing with drugs. When you do anatomy, where you dissect a cadaver, you're doing the whole body. You're not just doing the head and neck. And you are doing pathology. You're learning about diseases of the whole body. They have a separate time where they focus, at the end of each course, on just the oral aspects, but by and large, it's the whole body.

Gary Gordon (Interviewer: 00:15:53): For the first two years.

Dr. Fred Rosen (Interviewee: 00:15:54): For the first two years.

Gary Gordon (Interviewer: 00:15:54): Right.

Dr. Fred Rosen (Interviewee: 00:15:55): Then the second two years, you have certain requirements where you're on the clinic floor. Now, with the basic sciences, you're also doing drilling mannequin teeth.

Gary Gordon (Interviewer: 00:16:09): Okay.

Dr. Fred Rosen (Interviewee: 00:16:10): You're doing fillings, crowns, using impression material so that you're learning some of the dental skills, but they let you loose on the clinic floor for the third and fourth years.

Gary Gordon (Interviewer: 00:16:25): Okay.

Dr. Fred Rosen (Interviewee: 00:16:26): And.

Gary Gordon (Interviewer: 00:16:27): Percentage-wise, during the third and fourth year, how much are you really getting real world experience?

Dr. Fred Rosen (Interviewee: 00:16:35): Most of each day.

Gary Gordon (Interviewer: 00:16:36): Most of each day.

Dr. Fred Rosen (Interviewee: 00:16:37): You would have an hour lecture in the morning.

Gary Gordon (Interviewer: 00:16:41): Okay.

Dr. Fred Rosen (Interviewee: 00:16:42): Before you saw patients, and then you'd have an hour lecture at the end of the day, after you've seen patients. But basically, each day is being scheduled at different clinics, because they would have them -- let's say, for root canal, it was a separate facility for that. So you had only root canal specialists training you. For oral surgery, you had only oral surgeons training you. And you had certain requirements. You had to prepare a certain number of crowns on patients. Certain number of fillings and different types of fillings. Front fillings, which would be more esthetic than the back fillings, so you had to have certain skills for that. Then you'd be scheduled for another time in the denture department, where you'd have to make either partial or full dentures on live patients. And to be able to graduate, you had to have successfully completed X number of fillings, X number of crowns, done X number of extractions.

Gary Gordon (Interviewer: 00:17:59): Now, when did they teach you how to do those different things? In other words, because the first two--

Dr. Fred Rosen (Interviewee: 00:18:04): Those are the first two years.

Gary Gordon (Interviewer: 00:18:06): So, during the first two years, it's kind of, but it's theory. It's not doing it.

Dr. Fred Rosen (Interviewee: 00:18:10): Theory and mannequin teeth.

Gary Gordon (Interviewer: 00:18:14): Mannequin teeth. So, nobody is going: "Ouch!"

Dr. Fred Rosen (Interviewee: 00:18:16): No.

Gary Gordon (Interviewer: 00:18:17): Okay.

Dr. Fred Rosen (Interviewee: 00:18:19): Although, when we were doing impressions, we would try one another.

Gary Gordon (Interviewer: 00:18:22): Oh.

Dr. Fred Rosen (Interviewee: 00:18:23): And back then, the materials weren't the materials we use today.

Gary Gordon (Interviewer: 00:18:28): You gagged a lot.

Dr. Fred Rosen (Interviewee: 00:18:29): You gagged a lot. And I have facial hair. I still remember my partner getting it all over my beard. And today you could just peel it off. Back then I had to chop it off with the scissors.

Gary Gordon (Interviewer: 00:18:45): Okay, so you learned how to do those things in the first two years, and then the third and four is when you're really on a train to get them all done and to get some real world - a lot of real world hopefully - experience in doing them, and get through a certain number of crowns and a certain number of this, and to really get work under your belt.

Dr. Fred Rosen (Interviewee: 00:19:05): But you have certain requirements. They select the cases for you.

Gary Gordon (Interviewer: 00:19:09): Oh.

Dr. Fred Rosen (Interviewee: 00:19:10): The more involved cases they keep for the graduate students - people going on for specialties in different areas. So, basically, you're just getting basically an education. You're not dealing with the involved cases.

Gary Gordon (Interviewer: 00:19:30): Give me an example of a regular versus involved. Like what would be the difference?

Dr. Fred Rosen (Interviewee: 00:19:34): Well, let's say with a root canal. You are dealing with these very narrow and curved canals on some teeth, and then you have very straight wide canals on others. As an undergraduate dental student, they would give you the straight cases that are very easy to get down to the root tip.

Gary Gordon (Interviewer: 00:19:58): Okay.

Dr. Fred Rosen (Interviewee: 00:19:59): For the specialists who were training, they would give them the really difficult cases.

Gary Gordon (Interviewer: 00:20:05): So, you might come out of dental school never having really experience having to do a difficult case.

Dr. Fred Rosen (Interviewee: 00:20:15): Correct. Correct, and that's where the residency--

Gary Gordon (Interviewer: 00:20:20): Right. That's what I was thinking.

Dr. Fred Rosen (Interviewee: 00:20:21): It allows you to expand on your base of knowledge. Now, once you get out into private practice, regardless of which direction you take, there are continuing education courses that you can take to further hone your skills.

Gary Gordon (Interviewer: 00:20:39): Do they let you do things, or is it just kind of like sitting and listening to a lecture?

Dr. Fred Rosen (Interviewee: 00:20:44): There are both. They're called hands-on courses.

Gary Gordon (Interviewer: 00:20:47): Okay.

Dr. Fred Rosen (Interviewee: 00:20:47): And then academic courses. When I first started, there weren't any requirements for dentists in New Jersey to keep up--

Gary Gordon (Interviewer: 00:20:59): Okay.

Dr. Fred Rosen (Interviewee: 00:21:00): --with the changing world. In the 1990s, they finally changed that. Actually, the thing that always baffled me in the early years was that my hygienists had to have five hours--

Gary Gordon (Interviewer: 00:21:15): Right.

Dr. Fred Rosen (Interviewee: 00:21:15): --of continuing education a year. Dentists didn't have to have anything. Now we have to have twenty hours, but most of the dentists I know who are good practitioners far exceed that number. In fact, there is the Academy of General Dentistry, which I'm a member of, that awards a fellowship to a dentist who has more than five hundred hours of continuing education, and then has to complete a two-day examination in all phases of dentistry. They have sections on, let's say, orthodontics, oral surgery, endodontics, which is root canal, and I've been fortunate enough to have achieved that. About maybe ten percent of all dentists do reach that level.

Gary Gordon (Interviewer: 00:22:15): Now, were dentists that got their degree years and years ago grandfathered into not having to get continued Ed?

Dr. Fred Rosen (Interviewee: 00:22:26): No.

Gary Gordon (Interviewer: 00:22:26): Or when that rule came in, all of a sudden, every dentist now has to?

Dr. Fred Rosen (Interviewee: 00:22:29): Every dentist had to have one. The only exemptions that are provided, if you could show, that during that time you were ill and incapacitated, and not able to practice full-time.

Gary Gordon (Interviewer: 00:22:42): Right.

Dr. Fred Rosen (Interviewee: 00:22:42): Or they have a different status. If you're retired, an inactive license, where you can activate it if at some point, later in your life, you want to go back to dentistry, but you don't have to take the time there.

Gary Gordon (Interviewer: 00:22:57): But you're not practicing.

Dr. Fred Rosen (Interviewee: 00:22:58): Correct.

Gary Gordon (Interviewer: 00:22:58): Right. Okay. So, we don't have to worry that when we look at one dentist that might be older, we don't say, "Well, you know, we don't know if he really is continuing," but everybody is continuing.

Dr. Fred Rosen (Interviewee: 00:23:10): I hope that, because after forty years of dentistry, I'm one of those older dentists.

Gary Gordon (Interviewer: 00:23:13): Yeah, but you don't look like one of the older dentists.

Dr. Fred Rosen (Interviewee: 00:23:15): Bless you, child.

Gary Gordon (Interviewer: 00:23:18): Okay. So, that's very, very interesting. So, now, a lot of students, I'm sure, I don't know if you know percentage-wise, but roughly out of a hundred students that graduate dental school, how many of them get a job right when they're done, or try to get a job right when they're done, versus saying and getting either some additional continuing education or internship type of thing in a hospital? What's the percentage of those who just go get a job versus those who get extra education?

Dr. Fred Rosen (Interviewee: 00:23:56): Someone recently told me, at the hospital where I'm on staff, that it's somewhere in the vicinity of like sixty-five percent of graduates go out into practice, thirty-five go into continuing education.

Gary Gordon (Interviewer: 00:24:14): Okay.

Dr. Fred Rosen (Interviewee: 00:24:16): The thing that is just so important to anyone thinking about dentistry is it's not you just get your degree and you stop there. You're either moving forward by taking courses by learning or you're not standing still. You're falling back. Dentistry, over the years, is just so radically changed from when I got out of dental school. And you have been to our office, so you know that it's a modern facility.

Gary Gordon (Interviewer: 00:24:54): Right.

Dr. Fred Rosen (Interviewee: 00:24:55): We have lasers, digital X-rays, but you just don't go out and buy it. You have to know what you're doing and it requires continual training, which, even at this stage of my life, I love. I come back from courses and I will sometimes go for - they have - week-long seminars, full-day seminars, evening seminars in our area, and I already come back very--

Gary Gordon (Interviewer: 00:25:30): Energized.

Dr. Fred Rosen (Interviewee: 00:25:31): --invigorated.

Gary Gordon (Interviewer: 00:25:31): Yeah.

Dr. Fred Rosen (Interviewee: 00:25:33): There's so much stuff out there that's going on.

Gary Gordon (Interviewer: 00:25:36): Now, let's take a look at the before side. Let's go back. Before you even decided to become a dentist, when you were a child, from what you said, I gathered your parents weren't in the field of dentistry because you weren't exposed to it at that point. When did you first get an inclination that this might be something you wanted to pursue?

Dr. Fred Rosen (Interviewee: 00:26:06): Well, my parents were both eight grade graduates.

Gary Gordon (Interviewer: 00:26:11): Okay.

Dr. Fred Rosen (Interviewee: 00:26:12): But they always stressed the importance of education. And I was fortunate enough to have attended three high schools in New York City, where I grew up. We have to pass an entrance exam too and you are on an accelerated course, and I was fortunate enough to have gone to one of them - Brooklyn Tech - and it was an eye-opening experience for me. I mean I did very well with a select group. It was the first time in my life that I really thought that maybe I can--

Gary Gordon (Interviewer: 00:26:56): Do something.

Dr. Fred Rosen (Interviewee: 00:26:57): --do something.

Gary Gordon (Interviewer: 00:26:57): Right.

Dr. Fred Rosen (Interviewee: 00:26:57): You know?

Gary Gordon (Interviewer: 00:26:57): And how old were you?

Dr. Fred Rosen (Interviewee: 00:26:58): I was fourteen. Fourteen or fifteen. Fourteen when I entered. And I remember, in an English class, reading Martin Arrowsmith - about Martin Arrowsmith. The book, Arrowsmith, by Sinclair Lewis. And I was just motivated by the ideals, the dedication, and I decided I wanted to go into the health professions at that point.

Gary Gordon (Interviewer: 00:27:35): Okay.

Dr. Fred Rosen (Interviewee: 00:27:36): I was introduced by the Chairman of the English Department to his cousin, who was an infectious disease specialist for the United Nations.

Gary Gordon (Interviewer: 00:27:53): And this is in high school.

Dr. Fred Rosen (Interviewee: 00:27:54): This is in high school.

Gary Gordon (Interviewer: 00:27:55): Okay.

Dr. Fred Rosen (Interviewee: 00:27:56): And I remember going to the hospital where he was involved with and meeting him, and just in awe of everything, and I knew that I wanted to be in the health professions. By the time I got to college, I realized I can have a very sensitive temperament and I felt I couldn't deal with life or death issues.

Gary Gordon (Interviewer: 00:28:20): When you went to college, what was your thought on what you're going to do - be, whatever - by going to college?

Dr. Fred Rosen (Interviewee: 00:28:29): I wanted to go into the health professions. I wasn't sure which one. But you have to remember this was in the mid-sixties.

Gary Gordon (Interviewer: 00:28:42): Okay.

Dr. Fred Rosen (Interviewee: 00:28:43): I knew that, wherever I was going to go, I would take the right electives and requirements to apply, but I wanted to get a Liberal Arts education.

Gary Gordon (Interviewer: 00:28:56): Okay.

Dr. Fred Rosen (Interviewee: 00:28:57): And I was afraid that, you know, once I got into dental school, I'd be taking just science courses, or medical school.

Gary Gordon (Interviewer: 00:29:06): So you wanted to get some sort of rounded education while you were an undergrad.

Dr. Fred Rosen (Interviewee: 00:29:09): Yes.

Gary Gordon (Interviewer: 00:29:10): Okay.

Dr. Fred Rosen (Interviewee: 00:029:10): And I had a full academic scholarship.

Gary Gordon (Interviewer: 00:29:14): You had a full academic scholarship. Okay.

Dr. Fred Rosen (Interviewee: 00:29:18): I had -- it was the sixties. So, I was Sociology Major. I took poetry-writing courses. I took art courses. I was going to get my Liberal Arts education. This was my last chance before everything went in, but I also took biology electives.

Gary Gordon (Interviewer: 00:29:43): Because you would need them to get accepted.

Dr. Fred Rosen (Interviewee: 00:29:45): Correct.

Gary Gordon (Interviewer: 00:29:45): Right.

Dr. Fred Rosen (Interviewee: 00:29:46): Now, I had been accepted to a number of dental school. Fast forward this to my senior year.

Gary Gordon (Interviewer: 00:29:51): Okay.

Dr. Fred Rosen (Interviewee: 00:29:51): 1969.

Gary Gordon (Interviewer: 00:29:52): Okay.

Dr. Fred Rosen (Interviewee: 00:29:53): And I get a letter in my last semester from the guidance department that I will not be able to graduate not because I'm doing poorly. I wasn't, but because you were required to have a certain number of credits in your major, and then you had to have a certain number of credits in courses related to your major. And I had the right number is sociology, but I then scattered for my other electives. And so, I went to the guidance counselor. I made an appointment with my letters of acceptance to dental schools.

Gary Gordon (Interviewer: 00:30:36): Okay.

Dr. Fred Rosen (Interviewee: 00:30:37): And I said, you know, "You're going to ruin my life." I said, "They're going to send me to Vietnam." And I had a very understanding guidance counselor who allowed organic chemistry to somehow be related to the field of sociology, and the rest is history.

Gary Gordon (Interviewer: 00:30:58): Okay. So, then you went to medical school.

Dr. Fred Rosen (Interviewee: 00:31:02): To dental school.

Gary Gordon (Interviewer: 00:31:02): To dental school. And we had discussed that before - what that entailed, your first two years. All that kind of stuff. And roughly, I don't know if you might know now, but for someone, today, to go to dental school, what is that cost approximately for a four-year dental school today? If they don't have a scholarship.

Dr. Fred Rosen (Interviewee: 00:31:33): If you don't have a scholarship or aid, I believe it's somewhere in the vicinity of sixty to seventy thousand dollars a year.

Gary Gordon (Interviewer: 00:31:45): Really?

Dr. Fred Rosen (Interviewee: 00:31:46): For NYU.

Gary Gordon (Interviewer: 00:31:48): For Dental School.

Dr. Fred Rosen (Interviewee: 00:31:48): For Dental School.

Gary Gordon (Interviewer: 00:31:50): So, that's four years?

Dr. Fred Rosen (Interviewee: 00:31:52): Yes.

Gary Gordon (Interviewer: 00:31:53): So that's two hundred and forty to two hundred and eighty thousand dollars?

Dr. Fred Rosen (Interviewee: 00:31:58): It's staggering.

Gary Gordon (Interviewer: 00:31:59): That's crazy.

Dr. Fred Rosen (Interviewee: 00:32:02): There are a lot of ways, from what I understand, to get aid besides loans. Now, for me, it's totally foreign because, when I graduated NYU, it was the most expensive Dental School in the United States, and forty years ago that was $2,750 a year.

Gary Gordon (Interviewer: 00:32:26): Now, the sixty/seventy thousand. Does that include like room and board, or is that just for?

Dr. Fred Rosen (Interviewee: 00:32:31): That's just for.

Gary Gordon (Interviewer: 00:32:32): That's not room and board. That's just for the school.

Dr. Fred Rosen (Interviewee: 00:32:34): That's just for tuition.

Gary Gordon (Interviewer: 00:32:35): Wow.

Dr. Fred Rosen (Interviewee: 00:32:37): Tuition and supplies, because in dentistry, especially in your pre-clinical years, before they put you on the clinic floor, you have to provide a lot of your own materials. You know, if you're doing mannequin teeth, you provide your own filling material. One of the things that they don't require you to do anymore, which I'm glad to hear, is the students say, "You have to have your own gold," to do gold fillings. Now it's not part of their requirements anymore, but back then, gold was thirty-five dollars an ounce. Now it's a little under sixteen hundred dollars an ounce.

Gary Gordon (Interviewer: 00:33:19): Wow.

Dr. Fred Rosen (Interviewee: 00:33:20): It's mind-boggling to an older practitioner like me what it costs, but I remember when I was a student, hearing from older dentists how staggering the $2,750 was.

Gary Gordon (Interviewer: 00:33:37): Right. Sure.

Dr. Fred Rosen (Interviewee: 00:33:38): To them, compared to what they had to pay. But there is a lot of aid out there, and there are some opportunities to cover some, if not all, of that. One can sign up for the service and, for every year that they pay, you have to give them, as a dentist, once you get out.

Gary Gordon (Interviewer: 00:34:03): Oh.

Dr. Fred Rosen (Interviewee: 00:34:05): There's also the National Health Service, where I believe you can get a similar situation by working on an Indian Reservation, for instance, providing part of the National Health Service and helping to differ some of the costs. But there are a lot of people who graduate heavy into loans.

Gary Gordon (Interviewer: 00:34:23): Well, one of the biggest reasons that What Should I Be is doing this and trying to get information like this to young people or people that are looking to become a dentists is I can't imagine someone spending sixty to seventy thousand dollars, even just for one year, and then deciding this is not for me. You know what I mean? It's like I could take one year after college and say, "Ugh, this is not what I want," but I still now owe sixty to seventy thousand dollars. So, this information that we're getting from you today is really to help let someone know before they step into that world of costs and training is it really something they want to do. So I'd like to also ask you what can someone do during their high school years, during their college years - whatever, early - to help understand if being a dentist is really something that they're going to enjoy, want to do, want to wake up every day and want to be, you know, a dentist as apposed to going through some school and then finding out: "Oh, this is not for me." You know, I don't want to open somebody's mouth." Because in my first four years of school, from what you're telling me, I'm in regular college. I'm not opening somebody's mouth. And then I go to dental school because I think I want to be a dentist and really, in my first year I'm working on dummies, in my second year I'm working on dummies - right -, and not until the third year am I actually in somebody's real mouth. And I could legitimately find myself in the third year, finally saying, "I don't want to work on real people's mouths," for some reason. Something affected them. So, what can someone do early on? Is there any sort of like internship? Can they go to a hospital? Can they get involved or can they do anything to help learn this beforehand?

Dr. Fred Rosen (Interviewee: 00:36:34): I can't think of anything right off the bat, but I know what we've done for students. I have one young fellow right now, who is in high school, who thinks he wants to become a dentist. And in the summer, he's come in like two/three times and he's observed.

Gary Gordon (Interviewer: 00:36:59): Okay.

Dr. Fred Rosen (Interviewee: 00:36:59): You know, with things like privacy laws, we certainly have to ask each patient do they mind.

Gary Gordon (Interviewer: 00:37:07): Right.

Dr. Fred Rosen (Interviewee: 00:37:07): That someone's sitting in for the procedure. And we explain to them. And I haven't had anyone say no, but that's the closest you can get to it. Now, there are other parts of dentistry that one can go in if one doesn't want to--

Gary Gordon (Interviewer: 00:37:25): Touch somebody's mouth.

Dr. Fred Rosen (Interviewee: 00:37:26): Yes.

Gary Gordon (Interviewer: 00:37:27): Okay.

Dr. Fred Rosen (Interviewee: 00:37:27): There is administration. Research.

Gary Gordon (Interviewer: 00:37:33): Okay.

Dr. Fred Rosen (Interviewee: 00:37:34): I had one instructor who's now at the University of Washington. And he was an instructor when I was in school, so he's even older than I am. But he got a degree - a Masters in Sociology - and he does a lot of studies that get published. Trends. You know, active disease. Risk factors for certain types of dental disorders. I don't think he treats patients. He just goes. And there's also, you know, dentists who just become administrators.

Gary Gordon (Interviewer: 00:38:18): And why do they do that do you think?

Dr. Fred Rosen (Interviewee: 00:38:24): They don't like the day-to-day practice of dentistry. And there are a lot of factors to that. Like medicine, insurance dictates a lot. We're not to the point of medicine yet. In dentistry, we've always kind of been a stepchild, but I have a friend who's a second-generation physician who said he wouldn't allow his children to become physicians because he went into it because it was an art and a science, and now it's become a business. That you don't have the say in making decisions for the patients because you have to answer to insurance companies. We don't have that as bad, but I know from colleagues of mine who easily get frustrated. It's something we have to deal with. It's a reality. And they're not going to sit there, complaining about it, but other people don't. There's teaching academics. People who just like to lecture. And I know the Head of the Hospital Program, where I'm at now, was a general practitioner who gave it up. This opening came about and he basically just supervises the residents on the clinic floor, arranges for lecturers to come in, and handles the budget and gets grants, and that's his full-time position. There are other subplots, so to speak, in dentistry that you cannot do solely, but can also temper if you find day-to-day practicing grueling. One of the things that I fell into strictly by accident is I do forensic dentistry. That makes up about maybe ten percent of my practice.

Gary Gordon (Interviewer: 00:40:28): What is forensic dentistry?

Dr. Fred Rosen (Interviewee: 00:40:30): Well, anything that involves the legal system. I got started because I had a patient. This was in 1977. I had a patient who was prosecutor had someone who had gotten away from an armed robbery. They caught him for a second armed robbery and they wanted to tie him into the first armed robbery, and he had dropped his partial denture at the scene of the crime. It's kind of like the reverse Cinderella story with the glass slipper. I went into the courthouse. They got an order for me to exam him, to take impressions of his mouth, and it was definitely him. And I was hooked. The Prosecutors Departments uses me to make dental identifications in homicide cases, abuse cases where there have been bite mark evidence, and now I'm asked to review cases for malpractice and accident cases that are involved in dental injuries.

Gary Gordon (Interviewer: 00:41:43): Now, you had mentioned you do a variety of different things. Forensic dentistry is one, but I want to talk about the different areas that make up your world of the things that you do as a dentist so that people can get a good understanding of, you know, a dentist is not somebody who just comes in after the cleaning, checks the teeth, and leaves, and that's what the dentist does. What things can a dentist do? What things do you enjoy the most? Just I want to talk about those different other things that maybe we don't normally think of when we think of as a dentist.

Dr. Fred Rosen (Interviewee: 00:42:22): For me, the most gratifying parts of dentistry are the cosmetic work. When I say cosmetic, it's not for someone coming in for plastic surgery because they want to look younger. Friday I had a young man who sadly has leukemia. Fell in the hospital, in December, while he was getting chemotherapy. But because of his white cell count, they did not allow him to have his teeth restored. He had broken both front teeth, but they didn't want him in any sort of setting. They wanted him isolated. On Friday, he was able to come in. And here's this very nice young man who like in an hour and a half, with bonding techniques, we were able to give him his smile back.

Gary Gordon (Interviewer: 00:43:21): And bonding involved what?

Dr. Fred Rosen (Interviewee: 00:43:24): Using a tooth-colored composite resin and actually getting it to adhere to the teeth.

Gary Gordon (Interviewer: 00:43:31): Okay.

Dr. Fred Rosen (Interviewee: 00:43:33): It's coloring, shaping. I do have considerable training in this from continuing education courses.

Gary Gordon (Interviewer: 00:43:44): Oh.

Dr. Fred Rosen (Interviewee: 00:43:44): I am a member of the American Academy of Cosmetic Dentistry and go to most of their yearly meetings; and that's one of the areas I lecture at, at the hospital.

Gary Gordon (Interviewer: 00:43:55): Okay.

Dr. Fred Rosen (Interviewee: 00:43:56): But when you can see this young man who does not look very healthy. He just had a marrow transplant. Hope to God that it works well for him, but come in, looking so forlorn because everything's got him down. And even though, compared to the other stuff that he's going through, this is not nearly as significant, you can put a smile on his face.

Gary Gordon (Interviewer: 00:44:25): Sure.

Dr. Fred Rosen (Interviewee: 00:44:25): He loved it.

Gary Gordon (Interviewer: 00:44:26): That's great.

Dr. Fred Rosen (Interviewee: 00:44:26): And this was only -- he will eventually need caps, meaning porcelain pieces to cover the teeth. But the doctor still doesn't want anything invasive. And we're able to do this without having to damage or cause any bleeding, but give him a look that he was happy with. To have a patient who's in pain and be able to get them out of pain is a wonderful, wonderful experience. I've had patients come in. They've been up all night. And they leave, you know, can't wait to go to sleep; catch up on--

Gary Gordon (Interviewer: 00:45:09): Right. Right.

Dr. Fred Rosen (Interviewee: 00:45:11): --lost time. For me, those are the most gratifying--

Gary Gordon (Interviewer: 00:45:15): Okay.

Dr. Fred Rosen (Interviewee: 00:45:17): --experiences. But seeing a patient who might be fearful of coming to the dentist, and there are, whether it's an adult or a child, there are ways of minimizing the trauma to them and putting them at ease. You know, for me, that's what does it. That's what makes it fun getting up every morning.

Gary Gordon (Interviewer: 00:45:45): Okay. What are the different things a dentist, aside from the cosmetic, forensic, root canals, or don't regular dentists typically do root canals?

Dr. Fred Rosen (Interviewee: 00:46:04): You're trained in doing them. Again, modern technology has made root canal nothing like the description that comedians still provide. They talk about an audience that's bad and they go: "They'd rather be having a root canal."

Gary Gordon (Interviewer: 00:46:23): Right. Right. Right. Right.

Dr. Fred Rosen (Interviewee: 00:46:25): Again, it's the kind of training you get. Most dentists are trained in root canal, all depending on the level of training after you get out of dental school. I'd say maybe about sixty percent of dentists do their own. Forty percent will refer some, if not all, cases out.

Gary Gordon (Interviewer: 00:46:47): To a specialist.

Dr. Fred Rosen (Interviewee: 00:46:48): To a specialist.

Gary Gordon (Interviewer: 00:46:49): Okay.

Dr. Fred Rosen (Interviewee: 00:46:51): Implant dentistry is a wonderful field that has developed over the last fifteen years.

Gary Gordon (Interviewer: 00:46:58): And what is that exactly?

Dr. Fred Rosen (Interviewee: 00:46:59): Implant dentistry is the closest that we can now give to patients who are missing teeth to give them what feels like their own back. If a patient is missing a lot of teeth or if they're missing all of their teeth, they would have to have a full denture if they're missing all teeth, partial denture if they're missing a number of teeth; and these are prosthesis that come out that will move. Sometimes they have to have metal hooks that will show. Food gets under them. Patients are -- it's a compromise situation at best. But with implants, you can put in titanium pins into the bone and--

Gary Gordon (Interviewer: 00:47:52): You're making me cringe already.

Dr. Fred Rosen (Interviewee: 00:47:55): I'm sorry.

Gary Gordon (Interviewer: 00:47:57): It's like I really don't love going to the dentist, but okay. So, what you're doing--

Dr. Fred Rosen (Interviewee: 00:48:01): This won't be you.

Gary Gordon (Interviewer: 00:48:02): That's okay. So you're taking something and you're actually almost, in effect, screwing it into somebody's bone as apposed to just sitting on top like a denture would be.

Dr. Fred Rosen (Interviewee: 00:48:12): Correct. And then you can actually put a cap.

Gary Gordon (Interviewer: 00:48:16): Right.

Dr. Fred Rosen (Interviewee: 00:48:17): Or multiple caps that don't come out that feel like your own.

Gary Gordon (Interviewer: 00:48:26): It's in there good basically.

Dr. Fred Rosen (Interviewee: 00:48:27): Yes. You don't want patients to ever reach that level, but the reality of life is that there are patients who have neglected their mouths, whose teeth can't be saved or have had them removed for numerous reasons in the past. This allows us to give them a result that we couldn't before.

Gary Gordon (Interviewer: 00:48:50): Okay. If someone was in high school and they were thinking they might want to be a dentist, how easy will it be for them to contact a local dentist in their office and, if it's not that easy, where would they go if they want to shadow a dentist for a day, get an idea of what it's like to be, and so forth?

Dr. Fred Rosen (Interviewee: 00:49:16): Well, probably the best resource is, if you have a family dentist, ask the family dentist.

Gary Gordon (Interviewer: 00:49:26): Okay.

Dr. Fred Rosen (Interviewee: 00:49:28): I think that most, if not all, dentists would be more than happy to help one of their patients who might be interested--

Gary Gordon (Interviewer: 00:49:42): That feeling.

Dr. Fred Rosen (Interviewee: 00:49:43): --following in their footsteps.

Gary Gordon (Interviewer: 00:49:44): Right. Sure.

Dr. Fred Rosen (Interviewee: 00:49:44): I think it would be very flattering.

Gary Gordon (Interviewer: 00:49:45): Right.

Dr. Fred Rosen (Interviewee: 00:49:46): At least I find it flattering. I've had this happen in the past. Other than that, your local Dental Society. There's the New Jersey Dental Association, and then they have local component societies. To contact them and ask, you know, if there are any dentists who might be able to mentor them. And then, the American Dental Association is another fine resource. But probably, if you're looking for someone locally, the local Dental Society would be a great place to start other than your family dentist.

Gary Gordon (Interviewer: 00:50:27): Now, of the students that you helped - the younger people that came in -, what's their general reaction when they're done? What do they seem to feel like they got from it and things like that?

Dr. Fred Rosen (Interviewee: 00:50:44): All of them seem to have wanted to learn more; have been motivated to follow through. I do have two former patients who are now dentists, who live out of the area, but who went to dental school, who followed me around.

Gary Gordon (Interviewer: 00:51:11): Okay.

Dr. Fred Rosen (Interviewee: 00:51:13): And I mentioned the young man who was in recently. And you know, we try to, because I have a three-dentists office, we were able to select procedures - varied procedures - so that he did get to see someone come in with a broken tooth and have it bonded.

Gary Gordon (Interviewer: 00:51:35): Oh, okay.

Dr. Fred Rosen (Interviewee: 00:51:35): He did get--

Gary Gordon (Interviewer: 00:51:36): That's great.

Dr. Fred Rosen (Interviewee: 00:51:36): --to see an extraction.

Gary Gordon (Interviewer: 00:51:37): Okay.

Dr. Fred Rosen (Interviewee: 00:51:38): So, you know, you see these things live and--

Gary Gordon (Interviewer: 00:51:43): So that might be something that somebody would want to ask their dentist. Like you know, when you schedule me for the day, if I could see some varied type of things.

Dr. Fred Rosen (Interviewee: 00:51:52): That would be ideal.

Gary Gordon (Interviewer: 00:51:54): Yeah, because, you know, the dentist, thinking, might say, "You know, come on in. Yeah, you can watch me," but he might not do what you did and plan out something so that he could have that variety. But if you mention it to the dentist, maybe they would be able to do that. Out of all the student, like in other words, that go to dental school - I don't know -, just rough thought, how many of them go through dental school? I'm just staggered with this freaking cost. They get through, you know, owing a quarter of a million dollars. Okay? How many of them, at that point, decide I don't want dentistry? I don't want to do it, even though I paid and I went through, and I finished.

Dr. Fred Rosen (Interviewee: 00:52:39): I can't say that accurately because my experience with dental students are the residents who are going on for continuing education now.

Gary Gordon (Interviewer: 00:52:48): Do you think it's not really a high percentage? Like it's very little.

Dr. Fred Rosen (Interviewee: 00:52:53): Yeah, I would think it has to be very little.

Gary Gordon (Interviewer: 00:52:55): Okay. Because you know, I'm just comparing that to when someone goes to undergrad. And I think there's a very high percentage of students that get a degree in an undergrad situation and come out, doing something that has nothing to do with what they got in their undergrad. You know what I'm saying?

Dr. Fred Rosen (Interviewee: 00:53:17): I've heard the number that it's - what - you change your profession like an average of six or seven times.

Gary Gordon (Interviewer: 00:53:22): Right.

Dr. Fred Rosen (Interviewee: 00:53:23): Well, in dentistry, I know of very few people who have done that.

Gary Gordon (Interviewer: 00:53:28): Good. Okay, that's great. Because you know, again, it really comes down to finding, as early as possible, whatever it is that you have a passion for. And if you can figure out that maybe dentistry, if that is your passion, you're probably much less likely to jump around from this field to that field - careers.

Dr. Fred Rosen (Interviewee: 00:53:50): You have to have a compassion for people. Speaking just for myself, I love being a doctor. I love helping people.

Gary Gordon (Interviewer: 00:54:05): Okay.

Dr. Fred Rosen (Interviewee: 00:54:06): This is on a Sunday. It's my weekend off, but a patient of last thirty years called me at home last night. And when I'm done here, I'll be meeting the patient at the office. Even though my partner is on call, this patient feels better with me. But I don't mind it because--

Gary Gordon (Interviewer: 00:54:25): You love it.

Dr. Fred Rosen (Interviewee: 00:54:25): I love it. I once advised someone - a family member - who had a degree in economics, who worked for a .COM startup and the .COM bubble burst. And she said, "You know, what do you think if I went to dental school," and I looked at this particular individual and I said, "You'd hate it." I said, "You don't have the temperament to want to--"

Gary Gordon (Interviewer: 00:54:56): Describe that temperament as you see it. Like what's the right temperament? Like the poster child. If you met a young person that's fifteen, sixteen, seventeen, or eighteen years old, describe that person to me that you would say would probably make a good dentist and enjoy the field of dentistry. What would their hobbies be? What would they like? What type of, you know, personality might they have?

Dr. Fred Rosen (Interviewee: 00:55:22): Personality would be very upbeat. Personality of someone who is moodier, who doesn't let things go will die as a very unhappy individual. You won't be successful. Patients can read you. People who are doing it just for the money.

Gary Gordon (Interviewer: 00:55:54): Not good.

Dr. Fred Rosen (Interviewee: 00:55:55): Not good.

Gary Gordon (Interviewer: 00:55:55): Not good.

Dr. Fred Rosen (Interviewee: 00:55:56): I mean it can be a very comfortable profession to go into. Friends of mine who have gone into the business world are doing far superior by and large, but you have to -- I look at my patients as extended family. I love hearing the good stories about people in the practice. And when you hear about people who have passed away, people with illness, people who have had broken marriages, I feel affected by it.

Gary Gordon (Interviewer: 00:56:32): If someone is in high school and they're not a straight A student, and they have to struggle for good grades, is that someone who will have a difficult time, or not necessarily, when they go to dental school?

Dr. Fred Rosen (Interviewee: 00:56:48): It all depends what you're having difficulty with. If you're having difficulty with the sciences, look elsewhere.

Gary Gordon (Interviewer: 00:56:55): Okay. That's good. So, someone who is drawn and able to grasp the sciences, in general - chemistry, biology--

Dr. Fred Rosen (Interviewee: 00:57:07): Physics.

Gary Gordon (Interviewer: 00:57:07): --physics. All three. Oh, wow. I never could do physics. But if you can grasp and do well in those three, you will likely not have a difficult - an overly difficult - time when you get to dental school.

Dr. Fred Rosen (Interviewee: 00:57:22): Correct.

Gary Gordon (Interviewer: 00:57:22): Okay.

Dr. Fred Rosen (Interviewee: 00:57:23): And you need to have a certain amount of manual dexterity.

Gary Gordon (Interviewer: 00:57:27): Okay.

Dr. Fred Rosen (Interviewee: 00:57:29): If you're all thumbs, you don't want to go into dentistry. You'll have some problems.

Gary Gordon (Interviewer: 00:57:37): Okay.

Dr. Fred Rosen (Interviewee: 00:57:38): Now, what they used to do, and I'm not sure what they've changed the last few years on the dental aptitude test, which is the SATs for Dental School.

Gary Gordon (Interviewer: 00:57:50): Okay.

Dr. Fred Rosen (Interviewee: 00:57:52): They used to have chalk carving, where they would give you a knife and a block of chalk, and you would have to see on the screen. You know, besides the written parts, they've give you this manual dexterity test, and you would have to carve and try to duplicate what was on the screen in the block of chalk.

Gary Gordon (Interviewer: 00:58:15): Very cool.

Dr. Fred Rosen (Interviewee: 00:58:17): So that you had to demonstrate some--

Gary Gordon (Interviewer: 00:58:23): Dexterity.

Dr. Fred Rosen (Interviewee: 00:58:23): Yeah.

Gary Gordon (Interviewer: 00:58:24): God. Now, an average doctor - dentist - who doesn't necessarily own the practice, but they're brought into a practice, whether they work at a hospital, whether they work at a private practice. I'm trying to get an idea of what kind of money someone can expect to be earning. Some ballpark. You know, from this to--

Dr. Fred Rosen (Interviewee: 00:58:49): Right out of dental school?

Gary Gordon (Interviewer: 00:58:51): Yeah, let's take it right out of dental school. Let's say they did the year internship at the hospital, because I think, personally, it sounds to me like, if you want to be a dentist, that's almost like something that, if you don't do, you're missing something big.

Dr. Fred Rosen (Interviewee: 00:59:06): I totally agree.

Gary Gordon (Interviewer: 00:59:07): So, you go through that. Now you're bringing in a little bit more also to the table when you get a job, because I now worked a year internship. What kind of money would they expect to get paid, hired by somebody?

Dr. Fred Rosen (Interviewee: 00:59:21): Unfortunately--

Gary Gordon (Interviewer: 00:59:22): We're starting there already, huh? Oh my goodness.

Dr. Fred Rosen (Interviewee: 00:59:25): Sorry. Unfortunately, the number of openings are primarily in a clinic type of atmosphere, where you have an owner dentist who sometimes doesn't even practice dentistry. Just manages a practice. Has lots of dentists working for him.

Gary Gordon (Interviewer: 00:59:46): Twenty seats.

Dr. Fred Rosen (Interviewee: 00:59:49): And they can be paid as low as sixty/seventy thousand dollars.

Gary Gordon (Interviewer: 00:59:54): That's kind of what I was almost expecting you to tell me.

Dr. Fred Rosen (Interviewee: 00:59:59): But even out of a residency program, you are working at a much slower pace than once you have some experience under your belt. So, it's dictated by that. Once you've gotten a little bit more proficient and you've been out for a year or two, you may be able to find a position in a private practice, and there are different ways that you are compensated. But after about four or five years, you could expect to make a hundred and twenty, a hundred and thirty thousand dollars.

Gary Gordon (Interviewer: 01:00:37): Okay.

Dr. Fred Rosen (Interviewee: 01:00:39): And you can go up from there.

Gary Gordon (Interviewer: 01:00:43): What would increase it? In other words, what would get me up to where I'm making 200/250, or can I not?

Dr. Fred Rosen (Interviewee: 01:00:49): Yes, you could.

Gary Gordon (Interviewer: 01:00:50): Okay.

Dr. Fred Rosen (Interviewee: 01:00:52): Just the amount of dentistry you're producing. The amount of procedures and the revenue that you're generating. Now, one of the things that I always caution the residents that I teach is make sure you're working for someone ethical, because there are times - and I see this as a forensic expert--

Gary Gordon (Interviewer: 01:01:17): Yeah.

Dr. Fred Rosen (Interviewee: 01:01:19): --where I'm asked to review cases, where people have had work done that hasn't been necessary just to generate money. So I have a little bit more a jaundice view than maybe someone who doesn't do the forensic work.

Gary Gordon (Interviewer: 01:01:34): Now, let's take just a little bit different. Let's say the person graduates and let's say they get together with a friend - another dentist - and they say, "Hey, let's open up a practice." And of course, now they got more costs. They got to, you know, have money for the building or wherever they're going to have it. They got to pay for the chair. They got to pay for all the equipment and all the other kind of stuff. But let's say they go get a loan or they have the money, or whatever, and they build their own little practice now. Now it's the two of them. On average. I'm just talking on average. Are they going to make much, much more by going through all of that investment? In other words, after they take out a loan and they start their own business, and they start their own practice, and they advertise the business, and you know, they buy all the equipment, and they have the receptionists and the dentists, and they have everybody working for them. At the end of the day, are they going to be coming home with three or four hundred thousand?

Dr. Fred Rosen (Interviewee: 01:02:35): They can. Not right away.

Gary Gordon (Interviewer: 01:02:37): Okay.

Dr. Fred Rosen (Interviewee: 01:02:38): And there are a lot of variable in this scenario. Are they going into this joint practice with each having patients coming with them?

Gary Gordon (Interviewer: 01:02:52): Well, they're probably-- Yeah.

Dr. Fred Rosen (Interviewee: 01:02:54): If they're starting off cold--

Gary Gordon (Interviewer: 01:02:55): Yeah.

Dr. Fred Rosen (Interviewee: 01:02:55): What you very often will wind up doing, if you're a new dentist like that, is you're each going to be moonlight part-time elsewhere.

Gary Gordon (Interviewer: 01:03:04): Wow, because you're not making.

Dr. Fred Rosen (Interviewee: 01:03:05): You're not making.

Gary Gordon (Interviewer: 01:03:06): You don't have enough.

Dr. Fred Rosen (Interviewee: 01:03:06): You know, it's very hard to generate, if you're just starting out, a flow of patients to sustain yourself so that it's not uncommon to work a couple of days a week for another office and work a couple of days a week in your own office until you can establish a following.

Gary Gordon (Interviewer: 01:03:28): When you got started, did you work? You got out of medical school. You went and did your internship. Just taking a real quick scenario of what happened in your career that got you between that point to today. Like: "I worked for this kind of company. Then I worked for this kind of company. Then I met this guy and I opened up this." Just give me that kind of overall view.

Dr. Fred Rosen (Interviewee: 01:03:50): I had an advantage starting out. In my sophomore year of dental school, I met my wife, and her father was a dentist.

Gary Gordon (Interviewer: 01:04:02): Oh.

Dr. Fred Rosen (Interviewee: 01:04:03): So, when I came down here, I went to work for him. It was a little difficult because he was still practicing the same way that he had decades earlier.

Gary Gordon (Interviewer: 01:04:19): Okay.

Dr. Fred Rosen (Interviewee: 01:04:20): And was not progressive. Didn't believe in bonding material. I was just getting started.

Gary Gordon (Interviewer: 01:04:28): Okay.

Dr. Fred Rosen (Interviewee: 01:04:29): But he had tried it unsuccessfully and just didn't. We had philosophical differences, but I also came down -- my older son was born while I was in my hospital program, in New York. And I just couldn't say: "I'm leaving and i don't have any other income."

Gary Gordon (Interviewer: 01:04:54): Right.

Dr. Fred Rosen (Interviewee: 01:04:54): So, I started a practice where I am right now, in Marlton, New Jersey.

Gary Gordon (Interviewer: 01:05:03): That's with him.

Dr. Fred Rosen (Interviewee: 01:05:04): No, I started on my own.

Gary Gordon (Interviewer: 01:05:06): You started on your own.

Dr. Fred Rosen (Interviewee: 01:05:07): But working for him.

Gary Gordon (Interviewer: 01:05:09): Part-time?

Dr. Fred Rosen (Interviewee: 01:05:10): Actually most of the time in the beginning.

Gary Gordon (Interviewer: 01:05:12): Okay. So, you're working for him full-time, and then you started your own thing on the side.

Dr. Fred Rosen (Interviewee: 01:05:17): Correct.

Gary Gordon (Interviewer: 01:05:18): Now, when you started on the side, I guess, I'm gathering, no receptionist, you were doing everything.

Dr. Fred Rosen (Interviewee: 01:05:24): My wife was my receptionist. We had a playpen in one of the empty rooms.

Gary Gordon (Interviewer: 01:05:30): Okay.

Dr. Fred Rosen (Interviewee: 01:05:30): And that's where my son would be. And it was a shoestring budget.

Gary Gordon (Interviewer: 01:05:37): How do you -- you're working for him. How do you get customers to come to the other office without stealing patients?

Dr. Fred Rosen (Interviewee: 01:05:48): Well, we were far enough away so that it wasn't going to be a--

Gary Gordon (Interviewer: 01:05:53): Conflict.

Dr. Fred Rosen (Interviewee: 01:05:54): --problem.

Gary Gordon (Interviewer: 01:05:55): Okay. How did you advertise at that point?

Dr. Fred Rosen (Interviewee: 01:05:57): Well, one of the things that I found is that, back then, they didn't have phonebook ads. They didn't have Internet.

Gary Gordon (Interviewer: 01:06:09): Really?

Dr. Fred Rosen (Interviewee: 01:06:09): It was--

Gary Gordon (Interviewer: 01:06:11): I'm only kidding.

Dr. Fred Rosen (Interviewee: 01:06:11): I'm old. The contacts you make. Neighbors. My wife was in playgroups with other mothers.

Gary Gordon (Interviewer: 01:06:27): But I'm sure having a building - you know, that expense. The mortgage or the rent.

Dr. Fred Rosen (Interviewee: 01:06:33): It was very minimal because - and you've been to my office, Gary.

Gary Gordon (Interviewer: 01:06:38): It was shared?

Dr. Fred Rosen (Interviewee: 01:06:39): No. Well, it was shared by an ophthalmologist--

Gary Gordon (Interviewer: 01:06:41): Okay.

Dr. Fred Rosen (Interviewee: 01:06:41): --who had one room.

Gary Gordon (Interviewer: 01:06:42): Okay.

Dr. Fred Rosen (Interviewee: 01:06:43): And it was a much smaller facility than it is. It's been expanded twice. But it was all wooded area. Where it's located was basically a country road.

Gary Gordon (Interviewer: 01:06:55): Okay.

Dr. Fred Rosen (Interviewee: 01:06:55): Where there's the shopping center across the street was all wooded.

Gary Gordon (Interviewer: 01:06:59): So, like, in today's world, you might have been paying - I'm just going to take a rough guess. I mean you're talking years ago when you did it. But today maybe that space might've cost seven or eight hundred dollars a month.

Dr. Fred Rosen (Interviewee: 01:07:12): Less.

Gary Gordon (Interviewer: 01:07:12): Really?

Dr. Fred Rosen (Interviewee: 01:07:13): Less.

Gary Gordon (Interviewer: 01:07:13): I'm talking today though.

Dr. Fred Rosen (Interviewee: 01:07:14): Oh, in today's.

Gary Gordon (Interviewer: 01:07:16): Yeah, in today's reference.

Dr. Fred Rosen (Interviewee: 01:07:16): Today's reference, yes, it would be about that.

Gary Gordon (Interviewer: 01:07:18): Okay.

Dr. Fred Rosen (Interviewee: 01:07:19): But where there's the Burlington Coat Factory, across the way, used to be all wooded that hundreds would come on Saturday, park their car on the shoulder, and if you had a nervous patient in the chair, the gunshots did not help calm them down.

Gary Gordon (Interviewer: 01:07:36): That's very funny. So, you didn't have your office placed in a high-traffic area. You got it on the backend.

Dr. Fred Rosen (Interviewee: 01:07:44): I got it what I could afford.

Gary Gordon (Interviewer: 01:07:45): Exactly. And so, then you brought in customers a little bit at a time and just built up your practice. And so, how long did it take that you needed to continue working basically full-time for the father before you could say, "Okay, I'm done," and now this is built up enough?

Dr. Fred Rosen (Interviewee: 01:08:02): About six/seven years.

Gary Gordon (Interviewer: 01:08:03): Oh, okay. Okay.

Dr. Fred Rosen (Interviewee: 01:08:06): That wasn't overnight.

Gary Gordon (Interviewer: 01:08:06): Right.

Dr. Fred Rosen (Interviewee: 01:08:07): But then it was sustainable on its own.

Gary Gordon (Interviewer: 01:08:13): Now, when you left the father and were doing it all on your own, would you say that, when you left him, were you making probably almost the same amount of money on your own as you were with him?

Dr. Fred Rosen (Interviewee: 01:08:29): I was making more. I probably could have left maybe a year or two earlier, but it was the uncertainty.

Gary Gordon (Interviewer: 01:08:36): Oh, okay.

Dr. Fred Rosen (Interviewee: 01:08:37): You know, if it had been just my wife and myself without having the child.

Gary Gordon (Interviewer: 01:08:42): The baby. Right.

Dr. Fred Rosen (Interviewee: 01:08:44): It, you know, might've happened much sooner. But as you know, having children changes your view of the world instantly.

Gary Gordon (Interviewer: 01:08:53): Right. So, then how many years later did you maybe connect with another dentist? How long did that take?

Dr. Fred Rosen (Interviewee: 01:09:03): Well, I had brought in two part-time dentists at different times, who I had trained at the hospital.

Gary Gordon (Interviewer: 01:09:11): Okay.

Dr. Fred Rosen (Interviewee: 01:09:12): Who went out on their own because, at that point, I did not have enough to sustain someone full-time. And then, it was 1993 or 1994 that I brought in someone who I had known for a number of years, who was teaching at the University of Pennsylvania full-time. He had taught there for thirteen years.

Gary Gordon (Interviewer: 01:09:42): Wow.

Dr. Fred Rosen (Interviewee: 01:09:43): He's actually the brother and brother-in-law of some very dear friends. He was an instructor. Actually, he was in charge of the general practice residency at University of Pennsylvania.

Gary Gordon (Interviewer: 01:09:54): Okay.

Dr. Fred Rosen (Interviewee: 01:09:55): And we'd always known one another. Not real well, but he asked if he could have a meeting with me. He wanted advice about going into private practice. He wanted to live Penn for a number of reasons. And we seemed to connect. And that was twenty years ago.

Gary Gordon (Interviewer: 01:10:15): So, that was roughly about how many years after you left the father and started your own practice?

Dr. Fred Rosen (Interviewee: 01:10:21): That's about ten years after.

Gary Gordon (Interviewer: 01:10:22): About ten years after that. Okay. And he's now still with you today?

Dr. Fred Rosen (Interviewee: 01:10:25): He's a partner.

Gary Gordon (Interviewer: 01:10:27): Okay.

Dr. Fred Rosen (Interviewee: 01:10:28): And we get along wonderfully.

Gary Gordon (Interviewer: 01:10:31): Great. All right. I think we've covered quite a bit of information for people that are considering being a dentist, and I really appreciate all your advice. Do you have any final thoughts, any comments, any advice that you would want to give to somebody that we maybe haven't touched on? I don't want to put you on the spot because if you say, no, everything was covered, but if you have any final thoughts, you know, as to if somebody is out there thinking about being a dentist, here's one bit of information that I typically share with people that I just want to leave you with. Something like that. Do you have anything?

Dr. Fred Rosen (Interviewee: 01:11:12): Just from my own personal experience, I found something that I love. I was talking to a cousin about a year ago and she asked when I thought I wanted to retire. And I said, "I don't want to retire. As long as I'm physically able, I love what I do." And she looked at me, and she said, "You know how lucky you are?" And I didn't think about it. I've never thought about it in those terms.

Gary Gordon (Interviewer: 01:11:36): Right.

Dr. Fred Rosen (Interviewee: 01:11:36): But you know, if it something, whether it's dentistry or anything else, that you love, it's not going to be. I mean it's not that my day does not have stress. And I certainly don't want to leave anyone with that misunderstanding. For me, I can't have ever seen myself doing anything else. I have a couple of fantasies of being a world class athlete and poet laureate of the United States, but what I knew could really happen for me. This fulfills me in many, many ways. Don't do anything just for the money. I mean you may have to modify it for your personal needs, but find something that you have a passion for. I have a passion for people. I have a passion for wanting to be a doctor to help. If you have anything like that, there are many resources. I believe you can contact me. The information will be--

Gary Gordon (Interviewer: 01:12:43): On the website.

Dr. Fred Rosen (Interviewee: 01:12:43): --on the website. But as I said before, ask your own dentist. Can you walk around? Can you see? See if you like it. If you have any inkling for it. You may not get the complete picture, but it might give you a little bit of an understanding.

Gary Gordon (Interviewer: 01:12:59): Well, I got one question before we go. You wanted to help people. You like people and all that kind of good stuff. What made you pick dentistry in the medical field?

Dr. Fred Rosen (Interviewee: 01:13:09): It didn't have to do with life or death. I sometimes agonize and worry about patients who are having post-operative problems or a root canal that isn't responding. A patient had an extraction and may have some complications from that. And if that keeps me up at night, I knew, early on, I could not. Even with the forensic work, I've stopped dealing with cases that have to do with homicides because it affects me too deeply.

Gary Gordon (Interviewer: 01:13:44): Okay. Good answer. All right. Well, listen, I thank you very much. Dr. Fred Rosen, thank you. And that's it everybody, and just check out the listing for Dr. Fred Rosen on WhatShouldIBe.me, and that's it and wraps us up for today, and we'll be back soon with another interview. Thank you. Bye-bye everybody.