Lets talk about "Build New Office from Scratch"

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happyk9

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Hi all. Many of us have read "Let's Buy a Dental Practice".

http://forums.studentdoctor.net/threads/lets-buy-a-dental-practice.739665/page-21

Thanks for Dr. Hammer's awesome post!

I am contemplating creating a new practice from scratch. To be completely honest, after two month research, exploration and initial steps (Location exploration, scouting real estate, equipment/supply review, creating a business plan, developing a marketing plan, cash flow analysis, exploring finance options, Branding, designing logo, office layout, exploring incorporation, etc), I am shocked by the massive size of this undertaking.

Is there anyone out there who has tried this and been successful? If so, can you share some wisdom? Thank you in advance for your help.

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Immediately out of dental school in 2000, I borrowed $100k from Henry Schein to build a 3-ops practice from scratch. It was plumbed for 3 chairs but I only put in 2 chairs at first to save money. Total cost of everything was around $80k back then. Coldfront would the best resource cause he opened a few new practices recently from scratch. My net profit before tax was $175k 1st year, $225k 2nd year, $300k 3rd year and so on. Just stay away from California and you'll have much a better chance for success and early retirement.
 
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Thank you Daurang. After two months careful research, I think I have found an ideal location for my future office. Thank God it is not in California. It is located in a busy strip mall and nearest dental office is 2 miles away, so the competition is not very strong. The only problem is that it is kinda big for a new dentist: 3000 sq ft. The rent will be approximately 3300$/month. I am worrying about the construction for such big office would be also too expensive for me. There will be some empty space I would not use in the first several years. But I was always told that the most important thing for setting up a dental office is LOCATION, LOCATION and LOCATION. My gut tells me that this place is the best place for me. A colleague suggests me to hire an associate when the practice is stable. How do you think?
 
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Sounds like a good opportunity. As for the abundance of space right now. I would think that unless the physical layout of the space is quite funky, that the design work could be done in a way that would make the future (hopefully) expansion somewhat of an "add another module" onto the office to augment the initial flow pattern rather than necessitating a complete redesign.

I had about 10 years ago a former classmate of mine move his existing small start up into a much larger space (again it was location, location, location that made his move too good of an opportunity to pass up even though the space itself was about 50% larger than he needed at that time. Henry Schein was and still is) his main supply vendor, and they worked with him design wise to basically take his square shaped slab space he bought and then break it up into 3 smaller rectangular spaces. he built in the "middle" rectangle 1st, and the design was done so in a way that if and when he needed more space (this 1st upgrade space wise was less than 2 years later and his second about 2 years after the 1st) all the addition construction was done while the adjacent rectangular space was still separate from the initial space, and then following the original master layout plan when the addition was done, all they needed to do to connect was just remove some dry wall over a section of wall that was initially studded out for a doorway and it was ready to seemlessly integrate into the initial space. Provisions were even made in the initial design for easy upgrading capacity wise for the compressor systems for the suction and hand pieces.

He probably ended up spending at most and extra 10 grand in the initial design and building phase to do it this way, BUT he's convinced that he more than saved that amount many times over when he made the subsequent future expansion into the adjacent rectangular spaces.

If you have this type of conversation with the designers, about what you have available now vs. what you NEED now and what some of your future plans could be when the practice grows, then it will make future changes, when your practice is up and running and seeing patients daily, much easier
 
Yes 3000sf is too big for a dentist. 1500sf is good but it is better to have it and not need it than to need it and not have it later. $3300 is really cheap rent if you're convinced it is a a great location. Design it in such a way as to allow for expansion later; or you can even sublease it out to a dental lab in the back
 
Dr. Jeff. Thank you! This is a great idea! I have designed the office layout myself based on my experience and after reading this book : THE ADA PRACTICAL GUIDE TO DENTAL OFFICE DESIGN. It is a very nice book and I highly recommend to people who wants to setup a practice from scratch. Your words enlightened me that I can divide the property I am interested into two parts and separate them by dry walls after master construction is done (dental pluming, flooring).

I have semi-related questions. For a moderately renovated operatory room, what is the average cost per st ft for renovation? How about the overhead area such as patient waiting area, stuff room, bathroom etc?
 
Thank you Dr. Daurang. I was thinking about subleasing it. But the landlord (a big real estate company )was kinda arrogant and wouldn't consider it. :(

Yes 3000sf is too big for a dentist. 1500sf is good but it is better to have it and not need it than to need it and not have it later. $3300 is really cheap rent if you're convinced it is a a great location. Design it in such a way as to allow for expansion later; or you can even sublease it out to a dental lab in the back
 
Hi all. Many of us have read "Let's Buy a Dental Practice".

http://forums.studentdoctor.net/threads/lets-buy-a-dental-practice.739665/page-21

Thanks for Dr. Hammer's awesome post!

I am contemplating creating a new practice from scratch. To be completely honest, after two month research, exploration and initial steps (Location exploration, scouting real estate, equipment/supply review, creating a business plan, developing a marketing plan, cash flow analysis, exploring finance options, Branding, designing logo, office layout, exploring incorporation, etc), I am shocked by the massive size of this undertaking.

Is there anyone out there who has tried this and been successful? If so, can you share some wisdom? Thank you in advance for your help.

As @Daurang mentioned, @coldfront bought a building and rents out other spaces in the building to cover his overhead. I think this is the way to go.
 
Immediately out of dental school in 2000, I borrowed $100k from Henry Schein to build a 3-ops practice from scratch. It was plumbed for 3 chairs but I only put in 2 chairs at first to save money. Total cost of everything was around $80k back then. Coldfront would the best resource cause he opened a few new practices recently from scratch. My net profit before tax was $175k 1st year, $225k 2nd year, $300k 3rd year and so on. Just stay away from California and you'll have much a better chance for success and early retirement.
Yes. I basically had Daurang as my SDN mentor to the real world as a dental student. Pretty much followed his philosophy to open small 3 chair office through Henry Schein.

Graduated: 2010
First Practice: Late 2010
2nd Practice: 2012
3rd Practice: 2013

Overhead: 35% on average for all practices.

Revenues: Typically $700k a year is the goal at each office, they are all on track for 2014.

The key to new start-up is: LOCATION, LOCATION, LOCATION!

I will post more tips soon.
 
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Yes. I basically had Daurang as my SDN mentor to the real world as a dental student. Pretty much followed his philosophy to open small 3 chair office through Henry Schein.

Graduated: 2010
First Practice: Late 2010
2nd Practice: 2012
3rd Practice: 2013

Overhead: 35% on average for all practices.

Revenues: Typically $700k a year is the goal at each office, they are all on track for 2014.

The key to new start-up is: LOCATION, LOCATION, LOCATION!

I will post more tips soon.


good to hear your success, looking forward to your tips (even though I am barely about to start dental school).

Based on your profile, are you really starting up in Boston? If so, thats good to hear you're doing well from what I heard is a saturated area (or at least I've always heard all big cities are saturated)
 
good to hear your success, looking forward to your tips (even though I am barely about to start dental school).

Based on your profile, are you really starting up in Boston? If so, thats good to hear you're doing well from what I heard is a saturated area (or at least I've always heard all big cities are saturated)
Actually, I'm in the Midwest. A city of about 1 million people, with dental school, and bunch of 55+ years old dentists. Very large and mixed demographics, to the level that all fast food chains test their new products in this market first.

Advise #2:

How to look for a great location?

I typically scout for high traffic (both by car and foot), to target more visibility and exposure from prospective patients. Retail plazas is my favorite location.

My offices typically see 100-150 new patients a month.

I would also recommend Loopnet.com to find such leasable spaces in any location in the entire country.
 
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Dr. Cold Front, how did you promote your new practice? How early did you start it? Another question, did you hire somebody to negotiate Insurance enrollment when you started? Who do you recommend?
 
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Dr. Cold Front, how did you promote your new practice? How early did you start it? Another question, did you hire somebody to negotiate Insurance enrollment when you started? Who do you recommend?
The location promotes itself. With good visibility, high traffic, busy adjacent anchor store (I like grocery stores), then you don't need to market.

At one of my offices, I have a large chain grocery store as an anchor store. It draws 1,000's of customers, and they all park the same car park my office shares with the grocery store. 100's of people walk in front of my offices every day (maybe 100's more after I close). At my second office, there is a Chipotle next door, the line is so long in there, anyone who goes to chipotle would know how busy they are.

Location is the #1 decision in any business. I don't think most dentists should see their practice as a "destination location", you can't set yourself up as a library, or post office in terms of location. Dentistry requires better access, specially where people find it more convenient. You might get away with it as a specialist as a destination location, but not for general dentists - unless they are in a medical facility.

Insurance enrollment is also known as creditedentialing process. I'm a provider for most major PPO's - like Aetna, MetLife, delta dental and so on. You typically call them and talk to their creditentialing team, and they will fax or email you their 50 pages form. My front desk girl had experience in that, so all I did was sign the pages she labeled for me. They usually collect information about you (license numbers, DEA number, malpractice, etc) and the business information (contacts, tax ID, business hours, etc) to upload that information to their provider list. You can typically expect 30-60 days for your application to be approved with a provider number. That's what you will use to submit claims to each insurance.
 
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The location promotes itself. With good visibility, high traffic, busy adjacent anchor store (I like grocery stores), then you don't need to market.

At one of my offices, I have a large chain grocery store as an anchor store. It draws 1,000's of customers, and they all park the same car park my office shares with the grocery store. 100's of people walk in front of my offices every day (maybe 100's more after I close). At my second office, there is a Chipotle next door, the line is so long in there, anyone who goes to chipotle would know how busy they are.

Location is the #1 decision in any business. I don't think most dentists should see their practice as a "destination location", you can't set yourself up as a library, or post office in terms of location. Dentistry requires better access, specially where people find it more convenient. You might get away with it as a specialist as a destination location, but not for general dentists - unless they are in a medical facility.

Insurance enrollment is also known as creditedentialing process. I'm a provider for most major PPO's - like Aetna, MetLife, delta dental and so on. You typically call them and talk to their creditentialing team, and they will fax or email you their 50 pages form. My front desk girl had experience in that, so all I did was sign the pages she labeled for me. They usually collect information about you (license numbers, DEA number, malpractice, etc) and the business information (contacts, tax ID, business hours, etc) to upload that information to their provider list. You can typically expect 30-60 days for your application to be approved with a provider number. That's what you will use to submit claims to each insurance.

Thank you Dr. Cold Front! There is a very nice big grocery store, Chinese Buffet, Burger King and other stores in the strip mall I am interested. So I think the location is perfect. The parking lot is huge and just by a major road. I was told that a hospital is going to be built two blocks away. I guess I will be making good profit by selling this practice when I get retired.

Also thanks for the info of creditedentialing process. The question I was asking in my last post actually is the negotiation with the PPO Insurance for the "write-off" they enforced on dentists. When I worked as an associate before, I was shocked and disgusted by how much of the "write-off"s ruled by those greedy PPO insurance companies. Later I was told by someone that some company and dentist co-op organizations can help dentists to negotiate "write-off"s with those insurance companies. I just wonder whether you have such experience and can guide me.

Another question, which brand of work station do you recommend? How about chair? Compressor and Vaccum?

Thanks again!
 
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"3 practices"

Overhead: 35% on average for all practices.

interested in how you achieve this.

do your associates also do hygiene? do you have hygiene float between all three locations? centralized FD?
 
Not calling BS Coldfront, but please explain how you got to 35% OH in a large retail plaza? I also disagree with location, location, location as everyone just googles now a days. It seems to be working for you however so don't change a thing!
 
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Location is everything!!! Have a good location with high traffic count and you don't need to advertise much. Constant stream of new patients, emergencies, and walkins are more profitable than old reliable patients. My overhead has been 25%-35% over 14 years, cause my construction with all equipments totaled only $80k for a one man operation. I can't imagine 35% overhead if hiring a full staff plus doctor.
 
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I still disagree. If you need to go to a chiropractor, what do you do? Google! OR a friend may recommend someone.
 
Looks like this thread may have died off, but it's a good topic to revisit. I have been following hammer's post from a while back and it has helped me along immensely as I started by practice from scratch.

Here is a little about me:

May 2011- Graduated dental school.
Sept 2011 to Present - worked as an associate at a Medi-Cal Mill. Gained experience, speed and confidence. Learned the business side, insurance side of how to run the practice.
Sept 2013 - After looking for practices to purchase for about 3 months, I couldn't find anything I was looking for. I came across a building for sale in my home town that used to be an old vet office. The price had been slowly reducing as it was sitting on the market with no interest from other buyers. Purchased building and got financing for remodel and practice equipment from Wells Fargo Bank SBA.
Oct 2013 - Filed articles of incorporation to be an "S" Corp.
Oct 2013 to Aug 2014: Gutted entire building, build a 3 op practice with room to expand. Bought most items used, refurbished.
Aug 2014 - Opened for practice, part time (I was still associating to pay the bills).
Coming up on our 1 year anniversary here, I'd say we are doing pretty good. About 40-50 new patients a month with a 3 day work week.

My advice is to suck up as much information as you can from mentors, and the companies that you are associating for. They have done research and studied, and you can learn a ton from their successes and their failures. I also read many books - while building this practice I probably read close to one book a month to learn about standard business practices, marketing, accounting, incorporating etc.

I myself, find the business side of dentistry to be the most fascinating. Building a practice from scratch is one of the most rewarding experiences, but it definitely is not for everyone. If you are someone that won't invest in learning the business side of dentistry, then either buy an existing practice or work as an associate.

I'm happy to help others who are going through the same process and would love to hear how everyone else is doing with their own ventures.
 
Looks like this thread may have died off, but it's a good topic to revisit. I have been following hammer's post from a while back and it has helped me along immensely as I started by practice from scratch.

Here is a little about me:

May 2011- Graduated dental school.
Sept 2011 to Present - worked as an associate at a Medi-Cal Mill. Gained experience, speed and confidence. Learned the business side, insurance side of how to run the practice.
Sept 2013 - After looking for practices to purchase for about 3 months, I couldn't find anything I was looking for. I came across a building for sale in my home town that used to be an old vet office. The price had been slowly reducing as it was sitting on the market with no interest from other buyers. Purchased building and got financing for remodel and practice equipment from Wells Fargo Bank SBA.
Oct 2013 - Filed articles of incorporation to be an "S" Corp.
Oct 2013 to Aug 2014: Gutted entire building, build a 3 op practice with room to expand. Bought most items used, refurbished.
Aug 2014 - Opened for practice, part time (I was still associating to pay the bills).
Coming up on our 1 year anniversary here, I'd say we are doing pretty good. About 40-50 new patients a month with a 3 day work week.

My advice is to suck up as much information as you can from mentors, and the companies that you are associating for. They have done research and studied, and you can learn a ton from their successes and their failures. I also read many books - while building this practice I probably read close to one book a month to learn about standard business practices, marketing, accounting, incorporating etc.

I myself, find the business side of dentistry to be the most fascinating. Building a practice from scratch is one of the most rewarding experiences, but it definitely is not for everyone. If you are someone that won't invest in learning the business side of dentistry, then either buy an existing practice or work as an associate.

I'm happy to help others who are going through the same process and would love to hear how everyone else is doing with their own ventures.


Congratulations
From the bottom of my heart.

I am happy for you....

Thank you for sharing, and explaining it in such a understandable bullet manner.
 
I came across a building for sale in my home town that used to be an old vet office. The price had been slowly reducing as it was sitting on the market with no interest from other buyers. Purchased building and got financing for remodel and practice equipment from Wells Fargo Bank SBA.
Athe bills).
Congrats!

I agree on all counts, except buying a building and doing a scratch startup at the same time. Thats usually 2 sizeable debts, although I don't know how cheap you bought your building for. Most lenders are not comfortable doing both for a new business, and with no cash flow track record.

For me, I did a ground up commercial building through a different SBA lender. It's a more expensive route, 100% financing, and more scrutiny. It was built to accommodate other tenants too.

Congrats again, it sure takes guts!
 
Looks like this thread may have died off, but it's a good topic to revisit. I have been following hammer's post from a while back and it has helped me along immensely as I started by practice from scratch.

Here is a little about me:

May 2011- Graduated dental school.
Sept 2011 to Present - worked as an associate at a Medi-Cal Mill. Gained experience, speed and confidence. Learned the business side, insurance side of how to run the practice.
Sept 2013 - After looking for practices to purchase for about 3 months, I couldn't find anything I was looking for. I came across a building for sale in my home town that used to be an old vet office. The price had been slowly reducing as it was sitting on the market with no interest from other buyers. Purchased building and got financing for remodel and practice equipment from Wells Fargo Bank SBA.
Oct 2013 - Filed articles of incorporation to be an "S" Corp.
Oct 2013 to Aug 2014: Gutted entire building, build a 3 op practice with room to expand. Bought most items used, refurbished.
Aug 2014 - Opened for practice, part time (I was still associating to pay the bills).
Coming up on our 1 year anniversary here, I'd say we are doing pretty good. About 40-50 new patients a month with a 3 day work week.

My advice is to suck up as much information as you can from mentors, and the companies that you are associating for. They have done research and studied, and you can learn a ton from their successes and their failures. I also read many books - while building this practice I probably read close to one book a month to learn about standard business practices, marketing, accounting, incorporating etc.

I myself, find the business side of dentistry to be the most fascinating. Building a practice from scratch is one of the most rewarding experiences, but it definitely is not for everyone. If you are someone that won't invest in learning the business side of dentistry, then either buy an existing practice or work as an associate.

I'm happy to help others who are going through the same process and would love to hear how everyone else is doing with their own ventures.
Thanks for sharing your story, kokobean.

I saw in your signature that you graduated from NYU in 2011. How are you handling the debts (if there is any)? I got accepted into MWU and have been very concerned about the amount of debts. I am interested in having my own practice someday but paying the debts ASAP will be the first priority. I just want to hear more of your personal tips or things that you found helpful.
 
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Congrats!

I agree on all counts, except buying a building and doing a scratch startup at the same time. Thats usually 2 sizeable debts, although I don't know how cheap you bought your building for. Most lenders are not comfortable doing both for a new business, and with no cash flow track record.

For me, I did a ground up commercial building through a different SBA lender. It's a more expensive route, 100% financing, and more scrutiny. It was built to accommodate other tenants too.

Congrats again, it sure takes guts!

Congrats to you also Coldfront. I agree that the building purchase and startup practice simultaneously is not for everyone. I got the building for a pretty cheap price since it was a fixer. The monthly payments on it is less than the rent would have been in the area. I did not finance the building purchase with SBA- just the improvements and equipment.

If you have saved enough and can purchase a building or space, I'd always recommend it. The worst part is putting time and money into remodeling a space and then be at the mercy of the building owners if they choose to change terms of the lease or jack up the rent. Furthermore, I've learned that rent is something you've paid and lost forever. Own a space and at least you are building up equity in something you may use for other purchases in the future.

Great that you can accommodate other tenants at your location. Sounds like a pretty sweet deal.
 
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Thanks for sharing your story, kokobean.

I saw in your signature that you graduated from NYU in 2011. How are you handling the debts (if there is any)? I got accepted into MWU and have been very concerned about the amount of debts. I am interested in having my own practice someday but paying the debts ASAP will be the first priority. I just want to hear more of your personal tips or things that you found helpful.

Yes, I have debts. My entire 4 years was completely financed with loans and I graduated in the 300k range. It's a little bit scary, but you really just have to think of it in terms of cash flow. As long as you've got a good monthly cash flow going, the debts will take care of themselves.

I did things a little differently. Yes, it's good to pay loans and debts off as soon as possible. But if I had done that right out of school I would have no practice right now. I saved a great deal during my 3 years associating and that allowed me to start my own practice. You could always wait 7-10 years after you've paid off the loans completely and start then.. But to me the opportunity cost would have been substantially more. My biggest fear was not that I'd have student loans by the time I was 40- it'd be that I'm 40 years old and still be working as an associate and not own a practice myself. You just have to know what path you think is right for you and plan accordingly.

The tips I have for those starting dental school are:
1) go to the cheapest school possible- no one truly cares where you graduated from.
2) live like a student and minimize your loans as much as possible
3) once you graduate plan to continue to live like a student and save as much as possible.
 
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Yes, I have debts. My entire 4 years was completely financed with loans and I graduated in the 300k range. It's a little bit scary, but you really just have to think of it in terms of cash flow. As long as you've got a good monthly cash flow going, the debts will take care of themselves.

I did things a little differently. Yes, it's good to pay loans and debts off as soon as possible. But if I had done that right out of school I would have no practice right now. I saved a great deal during my 3 years associating and that allowed me to start my own practice. You could always wait 7-10 years after you've paid off the loans completely and start then.. But to me the opportunity cost would have been substantially more. My biggest fear was not that I'd have student loans by the time I was 40- it'd be that I'm 40 years old and still be working as an associate and not own a practice myself. You just have to know what path you think is right for you and plan accordingly.

The tips I have for those starting dental school are:
1) go to the cheapest school possible- no one truly cares where you graduated from.
2) live like a student and minimize your loans as much as possible
3) once you graduate plan to continue to live like a student and save as much as possible.
Thank you so much for answering. I'll keep those tips in mind!
 
I was wondering if you could possibly put some numbers to your years. I will be graduating in 2017 with about 400k of debt. I've been reading things and talking to people and I'm thinking that buying a practice after a short period of time would be much more beneficial in the long run as opposed to being an associate and trying to pay off that mountain of debt before buying a practice. What kind of change in income did you see between graduating and working for a couple years and then the income now with the practice? Are you trying to pay off student loans or are you trying to take care of the practice first? What is your life style like now? Thanks!
 
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Congrats to you also Coldfront. I agree that the building purchase and startup practice simultaneously is not for everyone. I got the building for a pretty cheap price since it was a fixer. The monthly payments on it is less than the rent would have been in the area. I did not finance the building purchase with SBA- just the improvements and equipment.

If you have saved enough and can purchase a building or space, I'd always recommend it. The worst part is putting time and money into remodeling a space and then be at the mercy of the building owners if they choose to change terms of the lease or jack up the rent. Furthermore, I've learned that rent is something you've paid and lost forever. Own a space and at least you are building up equity in something you may use for other purchases in the future.

Great that you can accommodate other tenants at your location. Sounds like a pretty sweet deal.
My goal is to sell dental offices and keep the ownership of the buildings they are leasing in about a decade or so (in my 40's).

Dentistry is a human capital driven business, and can expose you easily if you have medical or disability leave. That's where real estate investment can help in the event you can't work or retire early.

Anything worth doing will be difficult and stressful, but in the end it will be worth it.
 
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Looks like this thread may have died off, but it's a good topic to revisit. I have been following hammer's post from a while back and it has helped me along immensely as I started by practice from scratch.

Here is a little about me:

May 2011- Graduated dental school.
Sept 2011 to Present - worked as an associate at a Medi-Cal Mill. Gained experience, speed and confidence. Learned the business side, insurance side of how to run the practice.
Sept 2013 - After looking for practices to purchase for about 3 months, I couldn't find anything I was looking for. I came across a building for sale in my home town that used to be an old vet office. The price had been slowly reducing as it was sitting on the market with no interest from other buyers. Purchased building and got financing for remodel and practice equipment from Wells Fargo Bank SBA.
Oct 2013 - Filed articles of incorporation to be an "S" Corp.
Oct 2013 to Aug 2014: Gutted entire building, build a 3 op practice with room to expand. Bought most items used, refurbished.
Aug 2014 - Opened for practice, part time (I was still associating to pay the bills).
Coming up on our 1 year anniversary here, I'd say we are doing pretty good. About 40-50 new patients a month with a 3 day work week.

My advice is to suck up as much information as you can from mentors, and the companies that you are associating for. They have done research and studied, and you can learn a ton from their successes and their failures. I also read many books - while building this practice I probably read close to one book a month to learn about standard business practices, marketing, accounting, incorporating etc.

I myself, find the business side of dentistry to be the most fascinating. Building a practice from scratch is one of the most rewarding experiences, but it definitely is not for everyone. If you are someone that won't invest in learning the business side of dentistry, then either buy an existing practice or work as an associate.

I'm happy to help others who are going through the same process and would love to hear how everyone else is doing with their own ventures.




If possible, could you tell us where the practice is located at ?
 
I was wondering if you could possibly put some numbers to your years. I will be graduating in 2017 with about 400k of debt. I've been reading things and talking to people and I'm thinking that buying a practice after a short period of time would be much more beneficial in the long run as opposed to being an associate and trying to pay off that mountain of debt before buying a practice. What kind of change in income did you see between graduating and working for a couple years and then the income now with the practice? Are you trying to pay off student loans or are you trying to take care of the practice first? What is your life style like now? Thanks!

Upon graduating I found work as an associate for a Medi-Cal mill. It isn't the most glamorous work life but I got compensated pretty well. I worked a lot and was up to my eye balls in amalgam - by the end of each day I had some pretty sore hand and shoulders and was exhausted. I pushed through it though and just thought of it as a well paid residency. They pay you based on commission at this job, but in general though you get paid 170-200K.

One thing you notice while getting paid here is that the more you earn, the more goes to Uncle Sam. I started realizing that I was making a lot more on some months but it wouldn't be worth it, because I'd just get more taxes deducted from my gross pay. This is what really gave me that last motivation I needed to open my own practice .

It's been almost one year now and I work three days at the same Medi-Cal mill as an associate and three days at my own office.
The first few months at my office I did not take out a pay check. All income the practice got I just reinvested back into the practice. I was living off of just my associateship which was around 7-10K (gross pay) per month.
I could be paying myself now from my own practice, but I still haven't. I want to grow my practice as fast as I can before I take any income out for myself. The income I'm getting as an associate is paying my student loan bills (I'm paying the minimum of ~3K a month) and my other bills. There isn't plenty left over, just enough.

Lifestyle wise, I am pretty conservative now. I bought a CPO car, rent a cheap place and don't really spend extravagantly on vacations or weekend dinners/nights out like I know a lot of my friends do.
 
My goal is to sell dental offices and keep the ownership of the buildings they are leasing in about a decade or so (in my 40's).

Dentistry is a human capital driven business, and can expose you easily if you have medical or disability leave. That's where real estate investment can help in the event you can't work or retire early.

Anything worth doing will be difficult and stressful, but in the end it will be worth it.

Yes! I love your thinking. :)
 
Upon graduating I found work as an associate for a Medi-Cal mill. It isn't the most glamorous work life but I got compensated pretty well. I worked a lot and was up to my eye balls in amalgam - by the end of each day I had some pretty sore hand and shoulders and was exhausted. I pushed through it though and just thought of it as a well paid residency. They pay you based on commission at this job, but in general though you get paid 170-200K.

One thing you notice while getting paid here is that the more you earn, the more goes to Uncle Sam. I started realizing that I was making a lot more on some months but it wouldn't be worth it, because I'd just get more taxes deducted from my gross pay. This is what really gave me that last motivation I needed to open my own practice .

It's been almost one year now and I work three days at the same Medi-Cal mill as an associate and three days at my own office.
The first few months at my office I did not take out a pay check. All income the practice got I just reinvested back into the practice. I was living off of just my associateship which was around 7-10K (gross pay) per month.
I could be paying myself now from my own practice, but I still haven't. I want to grow my practice as fast as I can before I take any income out for myself. The income I'm getting as an associate is paying my student loan bills (I'm paying the minimum of ~3K a month) and my other bills. There isn't plenty left over, just enough.

Lifestyle wise, I am pretty conservative now. I bought a CPO car, rent a cheap place and don't really spend extravagantly on vacations or weekend dinners/nights out like I know a lot of my friends do.

Do you pay taxes on the practice income that you reinvest?
 
Do you pay taxes on the practice income that you reinvest?

No - I spend that money I reinvest, on marketing, more equipment/supplies etc so there really is nothing left over to tax.
 
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My goal is to sell dental offices and keep the ownership of the buildings they are leasing in about a decade or so (in my 40's).

Dentistry is a human capital driven business, and can expose you easily if you have medical or disability leave. That's where real estate investment can help in the event you can't work or retire early.

Anything worth doing will be difficult and stressful, but in the end it will be worth it.

What kind of entity have you set up for your business? Did you form a separate one for the building and another for the practice itself?
 
No - I spend that money I reinvest, on marketing, more equipment/supplies etc so there really is nothing left over to tax.

Great!
Can you deduct student loans from taxes as a "business/educational expense?"
 
Great!
Can you deduct student loans from taxes as a "business/educational expense?"

I was looking into this recently actually. Turns out that since we are a specialized professional, a corporation can pay your student loans for you as an incentive. If your corporation does this however, you will have to claim this 'incentive' as income on your tax return, similar to claiming a bonus on your regular income.

In the end the IRS has figured out this tax loop so it doesn't help much to have a corporation pay student loans.
 
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