Current State of Transitions Market
So, where are we now? In an article I wrote for the Washington State Academy of General Dentists called The Perfect Transition Storm, I explain that we’re experiencing an anomaly in the practice transition market. I have been working with dentists since 2004 helping them transition into or out of a practice. There have been times when interest rates are good, but there are not many buyers. There have been times when the economy was doing well, but not many sellers selling their practices. But, in the past almost 15 years, I have never seen a time when everything aligned so well. Here’s how this adds up:
- The transition market is still a sellers’ market. There are not many “good” practices on the market. Good practices are producing over $600,000 per year with 65% or less overhead and at least 10 to 20 new patients per month.
- Banks love dentists. The default rate is below .0125% for dental practices. More and more, banks have been seeking to lend to dentists to buy practices. Recent offers from some banks include 1.78% interest rate for the first two years adjusting to 4.9% for 10 years after that. The average rate currently is 5.125% on a 10-year term loan.
- The economy is strong. Many dentists I talk to tell me that they are busy. Patients are employed and either has the funds or have insurance to get theirs and their family’s dentistry done.
- Competition for the good practices is up. We are starting to see corporate practices such as Heartland come into the Northwest and other markets seeking out practices grossing over $800,000 in collections. Small group practices are also out there looking for good practices. We also have solo buyers looking to acquire their first practice.
- Practices values are up due to demand for good practices. A typical practice may sell for 70% to 75% of collections in an average market. We’re now selling practices for 5% to 10% higher, mainly due to demand.
Mesh this all together and you get a formula for a good transition market. There’s high demand for good practices. Interest rates are low. Practice values are above normal ranges. If you are thinking about selling within the next 3 to 5 years, it would be prudent to sit down with your financial advisor, broker, or other advisor to take a look at your situation. Timing can be everything and good markets don’t last forever. We would be happy to buy you a cup of coffee and discuss your situation and help put a plan in place to make sure you are in the best position for when it’s time to transition. Contact us today! 877-866-6053.
Analyzing a Lease in a Practice Aquisition
When you get a copy of the lease, you or your advisor should contact the landlord or property manager. Be sure the seller has informed the landlord that they are selling the practice first. If there is a short time left on the lease, the landlord may be willing to do an extension on the lease. You can put conditions on the extension that can include getting a tenant improvement credit to cover new paint, carpet, etc., free rent for a few months, lower rent, etc., I’ve even had a situation where the landlord loaned money to the tenant to completely remodel the practice.
Remember that everything is negotiable. Don’t automatically assume the lease is set and you cannot change anything. At the same time, know how to negotiate. If you go for a home run right off the bat, you may turn off the landlord and they won’t be willing to negotiate. If you’re working with a broker, it’s best to let them handle the negotiating. They’re the experts and can save you thousands if done right.
5 Red Flags to Watch for When Buying a Practice
There are a few things you should be wary of when buying a practice. These are not necessarily deal breakers, but things to bring up and analyze with your team when you are buying a practice.
- ALL THE TREATMENT IS DONE – You can run an unscheduled or untreated treatment plan report that should give you an idea of treatment on the books. You can also look at the number of true active patients and compare that to the annual collections to see if there is potential treatment. If annual collections are $500,000 and there are 1,500 active patients, there’s a good chance there’s work to be done. If annual collections are $500,000 and there are 400 active patients, start asking questions.
- OVERPAID STAFF – Annual staff salaries typically run around 20 to 25% of the annual collections. When you get up to the 35 to 40% area, you are in for some bad news for the staff. An older practice with long-tenured staff may have dental assistants who get annual salary increases and now their making $30/hr. The same with hygienists. Or, they are receiving an incredible benefits package of health insurance, retirement plan, gym memberships etc., This can be cured, but if you plan on keeping the staff, be prepared for a discussion on reducing benefits and/or pay.
- OUT OF CONTROL COLLECTIONS – You can typically tell how good of a job the front desk is doing by looking at the accounts receivable balances. The total amount should not be above 125% of your monthly collections (adjusted for insurance discounts). The insurance aging report should be pretty clean with only small dollar amounts in any of the aging buckets. If the aging balance is too high, or the insurance aging is high, you will either need to retrain the front desk or hire a replacement in the future.
- SECRETIVE SELLER – If you are asking for reports or questions from the seller and they are giving you run around answers, you may want to think about moving on. If the tax returns do not match to the annual collections reports, something funny is going on. You should expect straight and quick answers, unless the seller is away on vacation or overly busy.
- EQUIPMENT NOT WORKING – I am surprised how buyers don’t have someone go through and make sure all of the equipment isn’t working. You would hate to go in on your first day and have equipment not functioning. The equipment supply companies will typically come out at no charge and go through your equipment to make sure it’s working. If it looks old and in disrepair, it will give you a good peace of mind to have it checked out.
All of these red flags can be fixed, so they are not deal breakers. But, if you do run across any of these red flags, be sure to have your team of experts, CPA, consultant, equipment rep, etc., dig a little deeper and make sure you are getting what you think you are getting.
Get in the Game
Well, GET IN THE GAME! I’m not talking about football, I’m talking about reaching your potential and owning your own veterinary practice. Too many doctors sit on the sidelines waiting for the perfect opportunity to go in. You need to create your own opportunity. An opportunity to show and improve your skills by purchasing or starting your own practice. I know several doctors who I’ve been “thinking about” a practice or a startup location for 7+ years! If they would have purchased the first practice they considered, their practice would be almost paid off and worth over $500,000. That’s an opportunity cost of a half million dollars. Let me say that again in another way, you threw away $500,000!
I know everyone’s situation is different, but we have shown a lot of practices and start-up locations to doctors where those practices and locations were picked up by another doctor. That doctor got in the game and grew those practices in some cases to over $1 million. On average practice owners make 20% more than employee veterinarians, retiring with $400,000 more in their pocket.
If you’re still undecided after this pep talk, give us a call and we’ll be happy to coach you through the process. (877) 866-6053
Maximize Your Practice Value
Freshen up your practice – Buyers like to see a fresh, clean and somewhat updated practice. That does not mean you need to do a complete remodel and spend a $100,000. It does mean you need to take a look at your flooring and your walls. If you have large holes in your wall or your flooring was leftover linoleum from World War II, you should fix the holes and put in new flooring. Talk to your landlord, sometimes they will help with the cost. If you have equipment that is held together by the “fix everything” duct tape, contact your local equipment rep and have it fixed.
Update your technology – We run into an occasional practice owner that considers indoor plumbing as new technology. If you are in that category, or if you have not done any technology updates since Richard Nixon was president, you should look into digital x-rays and other technology that will not only appeal to buyers but will help you increase your production in the practice. Contact your equipment rep for the latest and great technology.
Financial Review – Have a meeting with your financial planner or advisor to see where you currently stand with your retirement portfolio. This will help determine how soon you can possibly retire, how much more you may need to put away to retire and/or how much you need to get out of your practice sale in order to retire.
Practice Valuation – You should get a valuation done on your practice. This will help your financial planner and you see where you stand with your entire portfolio. Some doctors rely heavily on their practice sale to be a piece of their retirement nest-egg, so if you don’t know what your practice may be worth, you don’t know what size of nest-egg you have. Call Omni for a free snapshot valuation.
Clean up your books – If you have been aggressive in running expenses and other items through payroll, you should work on making sure the books are clean. If you have multiple practices, but run all of your income and expenses through one tax id number, you should ensure you can separate the income and expenses of both practices. Meet with your CPA to analyze your numbers and see if you are in line with industry averages.
Grow your practice – One of the worst things you can do is take your foot off of the gas pedal. If you want to maximize the value of your practice, keep production at least level with prior years. A growing practice sells quicker and easier than a dying practice. If you don’t know how to grow your practice and make it more sellable, contact a consultant, or have a practice assessment done.
These are just a few items that you can do to help prepare your practice for a sale. If you work on these items now and over the next 3 years, you will maximize your practice value, enlarge your pool of potential buyers and be able to sell your practice quicker.


