Dental Practice Buyer FAQ
by Megan Urban, Practice Transition Specialist
Where / How do I start?
Where do you want to live? Not that you can’t change your mind and sell, move, or buy again. But it’s typically best to determine where you want to live, such as in close proximity to family members, or near an airport, or close to beaches and surfing, or near ski resorts. Are you a city dweller? Are you a nature enthusiast?
Next, contact a reputable transition consultant/broker to discuss the general process and to get answers to your questions. This broker will also recommend dental lenders, dental CPAs, and dental attorneys.
What is your confidence level with all procedures? For example, if you do not yet place surgical implants, you will want a practice that doesn’t place implants. However, if placing implants in a particular practice keeps their production numbers high, it might make sense to consider the practice and keep the seller on for these procedures until you can take them on.
If you are currently working, be sure to print out a production by procedure report so your advisors can see what experience you have.
Can I afford a practice?
We can recommend several dental specific lenders to assist you and they expect you to have student debt. They will ask you for your tax returns and debt details such as student loans, cars loans, home mortgage, etc. Then once you find a practice that you like, the bank will analyze the cashflow of the practice and work with you to determine if or how much they can lend on that specific opportunity.
Do I need to utilize a dental-specific lender, attorney, and CPA?
Sometimes dental buyers have a relative that is an attorney or another advisor, but when both the buyer and seller utilize dental specific folks, the job gets done correctly and in a timely manner. You are a dentist but may not feel confident with complete boney third molar extractions. It’s the same thing. Using the right people will give you the best experience and result.
What do I need to know about a practice?
The listing transition consultant will provide a Prospectus reflecting all the important aspects of the practice and can walk you through the details. No practice is perfect, and you will want to go in knowing what is happening now and areas of future opportunity. Below are just a few of the items that may be in the Prospectus and if it’s the practice you want, you will have due diligence time later and we can provide an example of how the process typically works.
- Cash flow
- Procedure frequency
- Active patient count
- Accounts receivable and credit balances
- Hygiene stats
- Insurance participation
- Team information
What else should I know or think about?
The listing transition consultant will provide you with a Closing Checklist of what needs to be addressed. Your consultant/broker will work closely with your other advisors to complete a Letter of Intent and conduct due diligence. Your attorney will complete all purchase and sale documents, non-compete agreements, redo treatment provisions, etc. Your CPA will help with taxes relating to the purchase, and set up payroll and accounting, etc.
Should / Can I purchase the real estate?
Many young dentists assume they can’t afford the real estate piece or that the seller wants to wait to sell in the next year or so. We strongly believe the best person to own the dental real estate is the dentist practicing there. Depending on the cash flow of the practice, you may not need any money down and if you do, the seller will often carry the loan on the down payment and the bank will carry the remainder.
Do I have to keep all or most of the existing staff?
It is recommended that you do keep the existing staff. If they are good at their jobs and have well-established relationships with the patients, their presence most definitely contributes to a smooth practice transition.
However, there are always exceptions. If the practice overhead is very high due in part to high salaries of some staff members, then it may be recommended that staff be cut back. Or there may be instances where a seller has kept an underperforming employee on board and letting that person go may be a healthy decision for the overall morale of the other employees.
In Summary
The sooner you purchase a practice, typically the more money you make over the life of your career. The more you make, the more your CPA gets involved to assist you to keep more of what you make by implementing tax and retirement planning. So, start today by talking with your practice transition specialist/broker.
Read MoreNew Year’s Resolution for Associate Dentists in 2022
By Happy New Year! We would like to wish you a new and improved year over 2020 and 2021. If you’re like most people, you have set some New Year’s resolutions. Perhaps one of them is going to the gym. Another may be eating healthier. A third popular one is spending more time with family and friends. Statistics show that on average, it takes 32 days before people give up on their resolutions. My thought is, why wait? I’m having a hot fudge sundae for lunch and not going to the gym! But how about a resolution to further your career as a dentist?
One way to further your career may be to learn a new procedure or two. As an associate or existing practice owner, you can improve your skills and your income by learning new procedures. A few suggestions would be to advance your endo skills. Maybe you know enough but just haven’t had any advanced training. There are a lot of courses to further advance your endo skills. You can also learn how to place implants. There are probably a lot of patients in your practice who want an implant, but don’t want to go to another office. If you’re a general dentist, you can also learn how to do some form of orthodontics with either Invisalign, ClearCorrect, or another company’s process. Learning a new procedure can make you more marketable as an associate and as a practice owner.
Another way to further your career may be to find a new associate position. If you’re frustrated in your current role because you’re not allowed to do anything more than hygiene checks and fillings, maybe it’s time to look elsewhere. The state associations list openings in their classified ads. If you’re not happy where you are, staying there will make you disgruntled with dentistry and cause you nothing but grief.
A third way of expanding your career in 2022 is by purchasing a practice. Practice owners make 15% to 20% more than associate dentists. They also build equity in their practice typically paying off their entire loans in 10 years. If you purchased a $500,000 practice and simply sustain its production, you now have earned 15% to 20% more per year PLUS you’ve earned $500,000 of equity in your practice. If you grew it 10% per year, you now have over $1 million in equity. I know many associate dentists are afraid of owning a practice. They think Dental Service Organizations (DSOs) are going to take over the world and they get better deals on supplies. First of all, DSOs will not be taking over the world. There will always be room for individual practice owners. In fact, if I had a choice, I would prefer to go to an individual owner before I would go to a DSO or group-owned practice. I think most people would agree. Regarding better deals on supplies, I’ve had several supply reps tell me that they would give the same deal to an individual as they would to a DSO. Supplies as a percentage of gross revenues make up a small number. So, even if they did get better deals, it would not make that big of a difference. Don’t be afraid of owning a practice and competing against the big guys. You can provide a much better and more personalized experience than they can.
These are just a few ideas for your New Year’s resolutions if you haven’t come up with your own. Now, go to the gym, grab a salad and then, go improve your career!
Read MoreDid You Achieve Your Goal in 2021?
Did you reach your goals this year? Was one of them to buy a practice by the end of 2021? Ahem, it’s December. You know who I’m talking about! Do you remember when the year started back in January, and you said to yourself, and perhaps to some of your family and friends, “This is the year I’m going to buy a practice!” Well? What happened?
Did you know that on average a dental practice owner makes 20% to 25% more than an associate dentist? Practice owners also build up equity in their practice similar to owning a house. A million-dollar practice with no debt will give you a million dollars in equity. Did you know that most practice owners tend to be happy in their dental profession? Practice owners get the privilege of setting their own hours. They get to choose which procedures they want to do and which procedures they want to refer out. They also hire their own staff and let go of those that they don’t believe are doing a good job. Practice owners even get to pick out the music that gets played at the practice. Although, staff may overrule you on that last one.
We gave buyers a mulligan in 2020. Covid-19 hit us all pretty hard. I caught it early and it took most of the year for me to get back to normal. The industry reeled for a few months due to the Covid shut down and various mandates provided at the federal and state levels. But after the shutdown was over, patients came back. Practices came back with a vengeance. Offices that were collecting $80,000 per month prior to the Covid-19 shutdown were producing $80,000 or even more upon the re-opening. In 2021, I would say the majority of practices are back at full capacity. We can’t predict when this Covid craziness will go away, especially with a new variant popping up every six months or so. But we can say that dental practices are resilient.
Those of you who kept your goals and purchased a practice in 2021 are doing well. The practices they purchased are at least producing what they were producing prior to them acquiring the practice. They took out a 10-year loan and they are now 1/10 of the way to paying off their practice debt. Think about those who purchased a practice five years ago. They’re halfway to paying off their practice debt. If they purchased a million-dollar practice, they now have $500,000 of equity in their practice. A half a million dollars! I tell the story of a dentist who would come to our buyer’s seminars year after year. At year 7 this dentist came to our buyer’s seminar, and I called her out. I pointed out that if she would have purchased the first practice that I showed her 7 years ago with a 7-year loan, she would have had the practice paid off. The practice was a $950,000 practice. She would have equity of close to and if not more than $1 million if she would have just taken action. That motivated her to purchase a practice a few months after the buyer’s seminar. The practice she purchased was three miles from the first practice I had shown her 7 years earlier!
So, as we end the year and you start to think about your goals for next year, think beyond the goal. What can you do better this year that will help you reach the goal of purchasing a practice in 2022? Make finding a practice to buy a priority. In the not-so-long run, you will be thankful you did. The brokers at Omni are always available for a phone call to discuss what you need to do to purchase a practice. Just pick up the phone and give us a call – 877-866-6053.
Read MoreTop 5 Fears Dentists Have About Practice Ownership (And How to Overcome Them)
There are many advantages to owning a dental practice over being an associate dentist and not owning a practice. For one, the average dental practice owner makes approximately 20% more in income than an associate dentist working for someone else. A dental practice owner also gets to choose what procedures he or she wants to perform, refer out, or delegate to an associate (if there is one). They can also choose their own hours; pick the days they want to work and how much vacation they want to take. So, why aren’t dental associates owning practices? What are they afraid of? Here are a few fears we have encountered by dental associates and how to overcome those fears:
- Fear of the unknown – Associates feel they don’t have the experience in owning a practice. They don’t know what to expect. They haven’t managed staff. They haven’t kept financial records. They don’t know what marketing to put in place. They don’t know what benefits to give employees, how to hire or fire employees, or even how to balance a checkbook.
Fear not, you don’t have to know everything at once. You know how to do dentistry. That’s the first step in owning a practice. You have a few years of experience working as an associate in a dental practice. You’ve observed the owner working with and managing staff. You may have experience leading a team in school, playing sports, etc. These are all examples of good experience in leading and handling staff. You don’t have to know how to keep books right away. We suggest getting a dental bookkeeper and then getting educated on reading financial statements and eventually doing your own books if you’d like. This can happen over time. The bottom line is if you are good at what you do and willing to learn the other parts of practice ownership, you’ll be just fine. - Fear of taking on more Debt – Read Robert Kiyosaki’s book, “Rich Dad, Poor Dad”. Not all debt is created equal. There is good debt such as student loans and practice debt that helps generate an income and there is bad debt such as credit card debt where you just borrowed money because you wanted something. Practice debt used to buy a practice that will help you make more money and build equity in an asset (the practice) is a positive thing. As long as it’s a good practice with good cash flow, you’ll be money ahead in the long run.
- Fear of the DSO (Dental Service Organization) or Group Practice Giants – Don’t fear the giants. They have their own niche targeting dental shoppers looking for the lowest price on a cleaning, crown, or teeth whitening. They also have a high turnover in their staff and doctors. You will provide excellent service with the same staff and dentist that the clients will see every time they come to your office. In a corporate environment, they’re not sure which dentist or hygienist they’re going to get next.
- Fear of not knowing what to look for – This is a valid concern. You can educate yourself in a number of ways. There are great resources via Dentaltown, dental podcasts, YouTube, etc., that can help you know what to look for. Quite simply, you start by looking at your desired location, then look at the cash flow of the practice and after that, you can get into the details. There are consultants and brokers who can also help you with reviewing practices. Identify your team that will help you overcome this fear.
- Fear of a recession – Recessions happen, typically every 8 to 10 years and last 10 to 12 months. You cannot avoid recessions or downturns in the economy, it’s part of life. But, during recessions, employees typically get laid off from work. If you own your own practice, you’re probably not going to fire yourself. You’ll keep yourself employed and busy. Owning a practice is a deterrent from getting laid off during a recession.
These are a few of the fears that we’ve seen over the years, and there are others as well. But the best thing you can do is educate yourself and talk to practice owners, brokers and bankers. Seek advice and counsel from everyone you can. This will help you make a wise decision in moving forward with practice ownership.
Read MoreTips for Managing Your Team When Acquiring a Dental Practice
When you purchase a dental practice, you aren’t just responsible for the building and equipment, but you also have a big role to play in making sure that new and existing team members come together smoothly. This can be a delicate process and quite difficult to navigate on your own, but there are a few tips you can follow to make everyone’s lives a lot easier.
Value Your Acquired Team Members
It should never be a case of “out with the old, in with the new” when it comes to putting together a dental team for your newly bought practice. The acquired team members have a lot of value and are an integral part of the relationship the practice has with the patient base. They may also be a big reason that many patients decide to stick with the practice. It’s essential to let existing team members know that they are important and take the time to communicate any changes on how the office will be run. Try to be patient if the transition seems slow because this will make things much more seamless compared to trying to implement whole new systems right off the bat.
Prepare for Bumps
Some of the team members at your newly purchased practice may have been there for decades or done things very differently under the previous owner. Any big changes you make will almost inevitably lead to some dissatisfaction and conflict, so it’s important to be mentally prepared that not everyone is going to like your decisions, even if you know they are in the best interest of the practice. Make it apparent that the lines of communication are always open so that team members can express grievances through the right channels. It’s also important to let your incoming staff know that they may need to help the acquired team acclimate to any shifts in day-to-day operations (they should be instructed on productive ways to do this).
How a Dental Consultant Can Help
Before you find yourself dealing with a mixed dental team, it’s important to work with an experienced consultant when buying a practice so that the transition can be as quick and harmonious as possible. They can help you choose a practice that aligns with your business and personal goals, show you how to train and retrain team members, and help you find the right people so the practice starts on the right foot.
Michael Dinsio has literally helped hundreds of dentists start, buy, and grow countless practices over the years, and Paula Quinn is a practicing hygienist and international speaker with over 30 years of experience as both a dental team member and business owner. Between the two of them, they have comprehensive knowledge of the dental industry inside and out.
Whether you’re thinking about buying a practice or are already in the process of doing so, they can help you get to the finish line with your budget, goals, and sanity all in great shape. If you’re ready to make your life easier, contact Next Level Consultants today.
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