Practice Management

As we approach the end of the year, you should contact your patients and let them know that they should look at their insurance to see if they have available funds to complete procedures, or fit another cleaning in before the end of the year.  There are standard patient letters that many consultants use to send out to patients.  Or, you can use one of the internet based patient notification systems to let your patients know to use their insurance.  We also have a letter template for insurance notification.  Send us an email ​and we’ll send you a copy of the letter. ​

In the September 2017 subscription of JADA, there is an article titled “Practice Ownership is Declining” by Marko Vujicic, Ph.D.  As the title reveals, the article is about the decline in practice ownership by dentists.  If you have not read the article, I highly recommend it.  The statistics in the article support what we are seeing in the market for dental practice and some of the articles I’ve written recently.  If you do not subscribe to JADA, here are a few of the highlights.

There is a steady decline of practice ownership, especially amongst male dentists.  Approximately 80% of dentists currently own practices.  Rising student debt, the emergence of corporate dentistry, shifting work-life balance preferences were just a few examples of why there is a decline in ownership.  One of the big questions brought up is whether the trend is a big deal.  It was pointed out that practice ownership is highly coveted and one of the reasons that dentists got into dentistry in the first place.  All else being equal, owner dentists earn more than non-owner dentists.  The question is, is practice ownership no longer as coveted as it used to be by younger, early career doctors?

The decline in practice ownership will continue for years to come.  A comparison to the decline in ownership by physicians, which is now below 50%, was used as a comparison.  Hospitals and groups have taken over the ownership of physician practices.  The study states that physicians’ net hourly income is significantly higher than for dentists; Although, I would say that the annual income is higher for dentists, all things being equal.   The author also claims that physicians are happier as a result of not being an owner of a practice.  With reimbursements continuing to decline, dentists will be asked to do more with less.  An emerging emphasis on quality and value will spur changes in dentistry. 

If you have not read the article, I recommend you take a look.  Email me at rod@omni-pg.com and I will send you a copy. You can also go to jada.ada.org and search for “Practice Ownership Is Declining.”

Owning and growing a dental practice can be one of the most challenging things in dentistry.  Advertising for new patients can be hit and miss and expensive.  That’s why one of our favorite strategies is to purchase another practice and merge it into your existing practice.

The reason you would consider doing a merger is because you get all of the revenue and current patients from the new practice, but you don’t get all of the expenses.   You don’t bring over the fixed expenses like rent, telephone, electricity, etc.,  You already have those in your practice and don’t need to incur them again when you bring over the practice you just acquired.

As an example, say you own a practice that collects $600,000 per year. You have overhead of $390,000 with 30% of the overhead in fixed expenses – rent, utilities, insurance, etc., Another practice comes on the market that collecting $500,000 with overhead of $325,000 with fixed expenses again at 30% or $150,000. You purchase the practice for $350,000 giving you a debt service payment of $3,500 per month.  You work closely with the broker to ensure 100% of the patients transfer to your practice. Your practice now goes from $600,000 up to $1.1 million in revenue.  You incur the variable expenses of the second practice, but you do not incur the 30% fixed expenses of $150,000 because you already have rent, utilities, insurance etc., at your current office. In essence, you just gave yourself a $150,000 raise, less $42,000 in debt service and dropped your overhead to the neighborhood of 55%. It would take you much longer to do this if you just did marketing and advertising. By consolidating practices, you get instant growth and income. If you have a practice for sale near you, you should consider merging it into your practice in order to achieve quick growth.

​If you already own a practice, have you ever considered buying an existing practice located close to your first practice and merging them together?  If you ask most doctors, they will say the best way to build a practice is through taking care of your patients and bringing in new patients via word of mouth and marketing.  And, they would be correct.  However, acquiring a second practice and merging the two together makes sense in many ways.

First off, have you ever calculated the cost of acquiring a patient via old fashioned word of mouth?  It requires a lot of work if you include everything from building your brand, training your staff, maintaining a spotless, high-tech practice, etc., the cost could easily be $1,000 per patient.  The cost of acquiring a patient via marketing is even more.  Acquiring a practice with existing patients can typically run from $800 per active patient to $1,000 per active patient.  Slightly less to maybe equal of acquiring a patient through a normal channel.  However, you get a high volume of patients very quickly.

Secondly, you acquire a stream of revenue at a near dollar to dollar relationship.  If the selling practice is producing $500,000 per year, you should be able to repeat the $500,000 in revenue by merging the practices together, or worst case, slightly below the $500,000.  The good news, is you don’t bring over all of the expenses of the selling practice.  You typically can save in a number of ways including reducing staff of the selling practice, utilities are not double as the practices merge to one location, there is only one rent payment (more on that in a minute), only one set of books, so only one payroll service and one bookkeeper and accountant and several other services can be eliminated.  So, while getting the majority of the revenue to increase your practice collections, you only get a portion of the expenses.  This increases the income of the practice owner – you!

Regarding rent, you may initially have to bite the bullet and take on an additional rent.  A perfect scenario is when the seller is month to month on their lease, or a short period left on the lease.  But, if there is a longer period of time left on the lease, you can evaluate the location to determine if it can be sub-leased.  Another scenario may call to take on the second location for a few years while the lease runs out.  This dilutes the savings, but still allows you to increase your collections.

Knowing the value of a Veterinary practice is a vital part of owning and running one. Knowing when to and then actually obtaining Veterinary practice valuations; however, can be complex and stressful. The experts at Omni Veterinary Practice Group understand how confusing the process can be and work hard to ensure as stress free experience, regardless of the reason for looking into valuations.
Common Reasons for Veterinary Practice Valuations
There are several reasons doctors need to know the value of their Veterinary practice. The most common reason is for Veterinary practice transitions or sales. Valuations help to determine if the asking price is reasonable, to figure out a reasonable asking price to begin with, and to ensure the practice is profitable enough to invest in; this is also important to know when considering a merger. Doctors should also get their practice valuated within ten years of retirement and every two years after for estate planning purposes. Therefore, it is important to make sure the valuation is not a cookie cutter process.
Rule of Thumb Should Not Apply
No two Veterinary practices are the same, so no two valuations should be the same. Often veterinary practice valuation are conducted using a rule of thumb method. The method does a major disservice to both the seller and the buyer, as it often does not highlight the practice’s uniqueness and how that influences the actual value of the practice in question. For a true valuation, many aspects of the practice must be taken into account and evaluated by experts with extensive formal training and resulting certifications, such as the experts at OMNI Veterinary Practice Group.
Experience Matters
When looking into Veterinary practice valuations, it is important to make sure the professionals have extensive experience performing said valuations. The team at Omni Veterinary Practice Group; example, have helped hundreds of doctors buy and sell their practices using accurate valuations based on the practice itself and are considered Veterinary industry experts in practice valuations.  As members of the Institute of Business Appraisers and the Practice Valuation Study Club, OMNI Veterinary Practice Group offers accurate and individualized valuations for Veterinary practices in Washington, Oregon, and California.
To learn more about why and how Veterinary practice valuations are conducted, or to request a free consultation in the Washington, Oregon, or California areas, please contact the expert staff at OMNI Veterinary Practice Group. OMNI’s team of experts are dedicated to ensuring each client’s success through transitions, valuations, consulting and other real estate services in the Veterinary field.