Ask me anything about practice ownership

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How much do you take home after taxes?
 
Do you refer certain procedures out to specialists? If so, how/what made you pick the ones you refer to?
 
1) How long after dental school graduation did you go into practice ownership? Did you feel comfortable doing most clinical procedures by that time?
2) Did you buy an existing practice or start a new one?
3) How did you decide where to buy/start your practice? (did you go through a practice broker? demographics analysis? did you hire a lawyer/accountant?)
4) What is the hardest part of ownership?
5) How do you go about doing all the administrative tasks involved in ownership in addition to clinical dentistry? Did you hire professionals or an office manager or do you do it all yourself? For example, human resources, taxes, billing, marketing
6) Anything that you wish you did in dental school to prepare for real world dentistry/ownership?
 
ssm38 said:
1) How long after dental school graduation did you go into practice ownership? Did you feel comfortable doing most clinical procedures by that time?
2) Did you buy an existing practice or start a new one?
3) How did you decide where to buy/start your practice? (did you go through a practice broker? demographics analysis? did you hire a lawyer/accountant?)
4) What is the hardest part of ownership?
5) How do you go about doing all the administrative tasks involved in ownership in addition to clinical dentistry? Did you hire professionals or an office manager or do you do it all yourself? For example, human resources, taxes, billing, marketing
6) Anything that you wish you did in dental school to prepare for real world dentistry/ownership?
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1) 8 months after graduation. I was pretty comfortable with most GP procedures and took me a couple of years to get comfortable with most specialty procedures.
2) always buy existing until you reach about 5 offices
3) when you buy an existing practice, you pretty much have to have a broker, attorney, and CPA for the deal.
4) staff, staff, staff
5) since I own multiple offices, I have an internal book-keeper/manager. Together we pretty much take care of the C-suite. Taxes are done by a CPA. Marketing is kept internal.
6) I wish dental schools offer some basic business training electives. I do this for my own alma mater on an annual basis and it always scares me that 99% of graduates don't know crap about owning a practice.
 
laundry said:
I wish dental schools offer some basic business training electives. I do this for my own alma mater on an annual basis and it always scares me that 99% of graduates don't know crap about owning a practice.
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How do you recommend a current dental student learn the basics of owning a practice?
 
What were the early days of practice ownership like? How long before you were able to fill your schedule with patients?
 
hersh_98 said:
What were the early days of practice ownership like? How long before you were able to fill your schedule with patients?
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the beauty of buying existing and not starting on your own is that your schedule is full from day one.
 
laundry said:
I have been a member of this forum since college. I'd love to give some honest insight into the real world for anyone who has a question (remember, no such thing as a dumn question).
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Do you offer sedation dentistry, if so do you use it a lot in your practice and what type of sedation?
Do you utilize laser dentistry if so which model do you use and do you use it for restorative procedures?
 
Rambunctious said:
Do you offer sedation dentistry, if so do you use it a lot in your practice and what type of sedation?
Do you utilize laser dentistry if so which model do you use and do you use it for restorative procedures?
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Sedation is something we are well known for (one-two sedation cases a week)
We have a diode laser which we use for surgery and perio
 
laundry said:
I have been a member of this forum since college. I'd love to give some honest insight into the real world for anyone who has a question (remember, no such thing as a dumn question).
Click to expand...
Dumb*
Sorry if that was rude I just couldn’t resist haha...why do you think the average GP income is so much lower than what you’re pulling in?
 
Thanks for the type correction! Jet-lagged for days...
GoDental101 said:
Dumb*
Sorry if that was rude I just couldn’t resist haha...why do you think the average GP income is so much lower than what you’re pulling in?
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I don't know if it is much lower (lots of stealth wealth types out there). Joking aside, multi-practice ownership isn't for everyone. As to specifics of how I am that much more profitable, without giving away too many secrets (I do consult for a living, after all, as well), I can say that a lot of my clients chase revenue but don't pay much attention at expenses.
 
laundry said:
Thanks for the type correction! Jet-lagged for days...

I don't know if it is much lower (lots of stealth wealth types out there). Joking aside, multi-practice ownership isn't for everyone. As to specifics of how I am that much more profitable, without giving away too many secrets (I do consult for a living, after all, as well), I can say that a lot of my clients chase revenue but don't pay much attention at expenses.
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Multi practice ownership is definitely not for everyone. I did 3 first 4 years out of school, and I realized that was my limit. My businesses generate $3-4M in sales a year (globally - including real estate and side businesses), but I would say you have to have a great team of professionals and people who support your vision around you. Some people do oral surgery for 4-6 years residency to love what they do and make a lot of money, for me it was 4-6 years of all business investments to do what I love doing and make a good living - not so much to do with dentistry itself.
 
What year did you graduate from d-school and which school if you don’t mind sharing?
 
What type of insurance do you accept? If any at all. Also, how free is your schedule? Like say vacation and stuff like that?
 
What do you think about the whole metropolitan vs. rural debate? Do you think it’s better going rural for a young dentist?

Since you became an owner pretty much right away, did you already know how to do a front desk’s job? How to bill procedures? If not, were you afraid of depending on other people and you knowing very little about managing those sectors of the office?

My biggest worry is not knowing the in’s and out’s of other people’s positions and obtain the misconception that they’re essential to the practice.

For example, say your front desk quits and there aren’t many available for hire. Those situations frighten me a bit. How do you overcome this?

Thanks!
 
laundry said:
Only in-network with Delta PPO. Don't take any HMO. Essentially FFS w/ Delta PPO.
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What percentage of patients are FFS vs Delta? What research does a new dentist/specialist have to do to setup a FFS practice?
 
How tough was it to get approved for loans for the practices?

Do you practice in a saturated area, if so how do you compete with corps/other dentists?
 
It's very possible to have a basic drill and fill solo practice (mine) that can net $500k-$1M a year. $1M is really, really hard work that I gave up after one year. $500k is more easily obtainable. Now I'm much happier netting $250k on 20hrs work week, cause I'm sick of working in the mouthholes the past 20 years.
 
ToothJockey said:
How tough was it to get approved for loans for the practices?

Do you practice in a saturated area, if so how do you compete with corps/other dentists?
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Not difficult - banks finance these deals w/ zero down.
My offices are in Bay Area, but we do fine 🙂
 
Daurang said:
It's very possible to have a basic drill and fill solo practice (mine) that can net $500k-$1M a year.
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Especially if you are delta premier, not ppo, like us newer grads are. I would be netting close to 2 mil if it wasn’t for Delta 🙂 Let’s see what comes out of this class action, some five years from now.
 
laundry said:
Not difficult - banks finance these deals w/ zero down.
My offices are in Bay Area, but we do fine 🙂
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How do you set yourself apart? Lower fees or boutique service or...?
 
1) What do you use for marketing and how much of your overhead is it?
2) How much debt did you graduate with?
3) Did you feel like debt held you back from other expenses and ability to obtain loans?
4) Do you recommend AEGD to new graduates?
5) How are you saving for retirement?
6) Do you own the real estate at your offices?
7) Do you have your own implant systems and a CBCT?

Thanks for creating this. A lot of students on here looking for real time answers.
 
What’s the dumbest think you’ve ever done that you would like new grads to avoid doing in their dental career?
 
How many offices do you have?
 
ToothJockey said:
Why though? That would just lower the ceiling of someone with such high business acumen.
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Could still be a good gig though.

OP, have you thought about having one big practice in a solid area versus multiple offices?
 
How much production do you do a year as an individual?
 
Do you still do a lot of dentistry or have you changed to more of running of the business end?

Thank you!
 
P7898 said:
1) What do you use for marketing and how much of your overhead is it?
2) How much debt did you graduate with?
3) Did you feel like debt held you back from other expenses and ability to obtain loans?
4) Do you recommend AEGD to new graduates?
5) How are you saving for retirement?
6) Do you own the real estate at your offices?
7) Do you have your own implant systems and a CBCT?

Thanks for creating this. A lot of students on here looking for real time answers.
Click to expand...

1) With a preface that I run a successful consulting firm for other dentists, as to not seem like it's commonplace, I keep my overhead at 46-58% depending on the office.
2) zero - full ride in college, Dentist-Scientist Training Program (DDS/PhD) full scholarship/grant in dental school
3) not applicable in my case, but generally the answer is no. The only thing a bank cares about is your ability to produce. Those loans are basically a AAA-rated bond for them.
4) Nope. The only time I recommend a 5th year of dental school (aka AEGD) is if you are slow as molasses coming out of school.
5) Another preface, I have biz training from HBS, so I'm not typical in that respect and would recommend professional advice when it comes to investments. My portfolio consists of stocks and commodities (mainly gold), minority shareholding in many other offices (one option of compensation for clients in return for my consulting or leverage positions), and some basic retirement plan that UCSF gave me. I also like being daily liquid with ~800K in assets at any time. My main retirement is based on my companies (practices, consulting firms, real estate llc's) and a couple patents, which would be valued in 8 figures upon sale at current market rate.
6) I do
7) yes and yes - CBCT is an amazing $$$ maker btw
 
monkeykey said:
What’s the dumbest think you’ve ever done that you would like new grads to avoid doing in their dental career?
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I asked a former retired faculty of mine this Q many years ago. His answer was "don't f your assistant".

I haven't done that, but I almost made a mistake of dating my former associate. Don't do it. 🙂
 
Is the dental market in California as bad as it sounds? Seems like you've done pretty well for yourself.
 
So whats the end game here? You gonna build up your practice and eventually consolidate (i.e. sell to the highest bidder private equity/DSO?)


Sent from my iPhone using SDN
 
Life of Pablo said:
3000 for someone who worked on admissions (UCSF nevertheless) when there is a 90% money back guarantee if you don't get in? I can see her right now:

Click to expand...

ToothJockey said:
So whats the end game here? You gonna build up your practice and eventually consolidate (i.e. sell to the highest bidder private equity/DSO?)


Sent from my iPhone using SDN
Click to expand...
Who knows! Night is young
 
You said DSOs are the future, which by growth rates seems likely. What advice do you have for future dentists who want to be private practice owners, rather than employees at DSOs?
 
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