does dental school prepare you to start up your own practice?

[jl1616]

In dental school, do they help you in any way prepare for starting up a practice? Or, is this something you figure out on your own through other resources?

---

Members don't see this ad.

 

[Lesley]

In dental school, do they help you in any way prepare for starting up a practice? Or, is this something you figure out on your own through other resources?

Question #1: No
Question #2: Yes

 

[DrJeff]

Question #1: No
Question #2: Yes

Agree 100%😱

The biggest problem with trying to learn a how to run a business and learn all about dentistry is that there just isn't even close to enough time to be an expert at both in 4 years of schooling. Dental school will teach you the fundamentals of dentistry (diagnosis, treatment planning, and treatment techniques), and you'll be very solid at them after d-school. Unfortunately, most d-school curriculums when it comes to running a business are sparse at best, and often will be looked at as a "blow-off" course by many students.

Unless you happen to have a brilliant mind for business and maybe an additional degree as a M.B.A. or a C.P.A. or even a J.D. with a business interest, I'd go as far as saying that you shouldn't be running the business side of your dental practice yourself. Just about every practice out there will enlist the help of various outside sources for running the business side of their practice. From C.P.A's to business and insurance consultants, to tax and contract attorneys. There's just too many variables and tax laws to completely understand on your own in addition to worrying about all the dental problems, for you to do it all on your own, and if your doing some of the business side of things wrong, it could end up costing you ALOT of $$😱

 

[OceanDMD]

I think start-up practices are becoming less and less prevalent. When you consider the trend in more dentists retiring than graduating, this means more practice aquisitions available. I think the poll of percentage of dental students who start a practice after graduation was less than 5% when I graduated(2005).

 

[Holy Thursday]

In dental school, do they help you in any way prepare for starting up a practice? Or, is this something you figure out on your own through other resources?

There's a girl here in my residency who said that they had an extensive senior year project at their school (UoP) where they had to basically choose a location, choose equipment, design the layout of the office, and on and on. It was considered a really big project as most students actually use that business plan for real.

 

[Daurang]

I strongly disagree with DrJeff regarding enlisting and wasting all your money on all the consultants he suggested. The only consultant you need is probably a CPA to get the bank statements reconciled and pay the various taxes.

Starting and running your practice is easy though it can be hard in the beginning (but so is starting anything). Last I checked dental offices has the second highest startup success rate of any business. Find your space, sign your lease, get a no collateral construction and business loan from Schein/Patterson and they'll come by and design the office to your satisfaction for free. Then call an Asian or Mexican builder rather than the one they recommend since they always do it for so much cheaper. Go to city hall and sign up your business. Sign up with Delta, Cigna, BCBS, Metlife, etc. Buy a $500 Dell computer and a $69 dental software program and do your own billing; it's easier than anatomy! Have your wife, sister, mother, or brother work front desk and assist for the first few months. Don't get expensive unnecessary toys like laser, Cerec machine, the Wand, air abrasion, digital xray, camera, complicated dental software, nitrous oxide, and consultants because they cut deep into your bottom line and further your debt. It would be nice for everyone to have a Nordtrom-type practice, but there aren't too many rich people so having a Walmart-type practice in keeping everything cheap, basic, and simple works just as good and bring in just as much money if not more!

 

[aphistis]

There's a girl here in my residency who said that they had an extensive senior year project at their school (UoP) where they had to basically choose a location, choose equipment, design the layout of the office, and on and on. It was considered a really big project as most students actually use that business plan for real.

We had to do that this past semester at IUSD. As part of our practice management course, we had to submit a complete business plan. I didn't take the project too seriously since I'm doing a GPR after school and I'm plenty busy working toward graduation in the meantime, but the people buying out or starting scratch practices all seemed to think it was a pretty helpful assignment.

 

[xxxTheDonxxx]

I strongly disagree with DrJeff regarding enlisting and wasting all your money on all the consultants he suggested. The only consultant you need is probably a CPA to get to bank statements reconciled and pay all the different taxes. Starting and running your practice is easy though it can be hard in the beginning (but so is starting anything). Last I checked dental offices has the second highest startup success rate of any business. Find your space, sign your lease, get a no collateral construction and business loan from Schein/Patterson and they'll come by and design the office to your satisfaction. Then call an Asian or Mexican builder instead of the one they recommend because they always do it so much cheaper. Go to city hall and sign up for your business. Sign up with Delta, Cigna, BCBS, Metlife, etc. Buy a $500 Dell computer and a $69 dental software program and do your own billing; it's much easier than anatomy! Have your wife, sister, mother, or brother work front desk and assist for the first few months. Don't get expensive unnecessary toys like laser, Cerec machine, the Wand, air abrasion, digital xray, camera, dental software, consultants, etc. because they cut deep into your bottom line and further your debt. It would be nice for everyone to have a Nordtrom-type practice, but there just aren't to many rich peple so having a Walmart-type practice in keeping everything cheap, basic, and simple works just as good and bring in just as much of not more money!

Wow! these are the same advices i got from a dentist who has been practicing for over 30 yrs.

 

[Daurang]

reserved...

 

[Stelon]

I strongly disagree with DrJeff regarding enlisting and wasting all your money on all the consultants he suggested. The only consultant you need is probably a CPA to get to bank statements reconciled and pay all the different taxes. Starting and running your practice is easy though it can be hard in the beginning (but so is starting anything). Last I checked dental offices has the second highest startup success rate of any business. Find your space, sign your lease, get a no collateral construction and business loan from Schein/Patterson and they'll come by and design the office to your satisfaction. Then call an Asian or Mexican builder instead of the one they recommend because they always do it so much cheaper. Go to city hall and sign up for your business. Sign up with Delta, Cigna, BCBS, Metlife, etc. Buy a $500 Dell computer and a $69 dental software program and do your own billing; it's much easier than anatomy! Have your wife, sister, mother, or brother work front desk and assist for the first few months. Don't get expensive unnecessary toys like laser, Cerec machine, the Wand, air abrasion, digital xray, camera, dental software, consultants, etc. because they cut deep into your bottom line and further your debt. It would be nice for everyone to have a Nordtrom-type practice, but there just aren't to many rich peple so having a Walmart-type practice in keeping everything cheap, basic, and simple works just as good and bring in just as much of not more money!

Excellent advice.

 

[DrJeff]

I strongly disagree with DrJeff regarding enlisting and wasting all your money on all the consultants he suggested. The only consultant you need is probably a CPA to get to bank statements reconciled and pay all the different taxes. Starting and running your practice is easy though it can be hard in the beginning (but so is starting anything). Last I checked dental offices has the second highest startup success rate of any business. Find your space, sign your lease, get a no collateral construction and business loan from Schein/Patterson and they'll come by and design the office to your satisfaction. Then call an Asian or Mexican builder instead of the one they recommend because they always do it so much cheaper. Go to city hall and sign up for your business. Sign up with Delta, Cigna, BCBS, Metlife, etc. Buy a $500 Dell computer and a $69 dental software program and do your own billing; it's much easier than anatomy! Have your wife, sister, mother, or brother work front desk and assist for the first few months. Don't get expensive unnecessary toys like laser, Cerec machine, the Wand, air abrasion, digital xray, camera, dental software, consultants, etc. because they cut deep into your bottom line and further your debt. It would be nice for everyone to have a Nordtrom-type practice, but there just aren't to many rich peple so having a Walmart-type practice in keeping everything cheap, basic, and simple works just as good and bring in just as much of not more money!

Well we may disagree on some issues, but I can honestly say that I'll agree with you about not using a practice management consultant, my partner and I currently don't, and never have. Frankly how we run our practice might give a few practice management consultants a heart attack😉 😀 But it works for us. Where I would advocate getting some consulting help is when you get some employees(who you're not realted too) and you're dealing with retirement plans, health insurance for your employees, and your own personal and practice insurances. Case in point. My partner and I just recently switched accountants, and after talking with the new accountant about the type of practice overhead insurance we have (we actually had a water line to our pan processor rupture this past spring and flooded 1600sq.ft of floor area of my office and did almost $100,000 in damage and had 1/2 of our operatories unusable for 2 weeks😱 ). Our new accounatnt reccommended an insurance consultant, who reviewed all of the practice/personal insurance we carry. She ended up making a wide range of reccomendations for us that ended up with us getting better coverage for our personal disability policies, our disability buy-out policies, our practice overhead insurance policies, car insurance, personal liability umbrella policy, and personal life insurance, and all of this will actually end up saving me almost $2,000 a year over what I was currently paying in premiums with much higher and better coverage.

I'll definately differ with you on the idea of signing up for just about every insurance plan out there. Where I practice is way more of a "walmart" area than a "nordstrom" area as you put it. My local area economy is mainly supported by agriculture, hourly employees at multiple factories/distribution centers (International paper, United foods{makes the buns for McDonalds}, Lowes and Frito-lay) as well as hourly employees of the Connecticut Casinos. In my practice, we're only signed up with United Healthcare's high end plan (this is the one that the employees of the State of Connecticut, and hence many of the local town employees have). We dropped, Delta dental, and will likely drop United Healthcare at our next renewal period, and never signed up with any other companies. We didn't see a mass exodus of patient when we dropped delta (and we have over 500 patients with Delta insurance), and have gained the autonomy over our fee schedule. I honestly feel that if you've gone through d-school and actually our putting the gloves on and actually working on patients, then you should have the ability to determine what is fair compensation for what you do, not some number cruncher who is more interested in improving the insurance companies bottom line than compensating you for you work. Signing up with many insurance plans can greatly limit that autonomy you have, since just about every plan you sign up for will have a clause that states that the most you can charge for a procedure is the lowest billable amount for any company (i.e if the maximum that Delta will let you bill for a prophy is $70, but Aetna will only allow a maximum of $65 for a prophy, then Delat will only reimburse the $65 and you can't bill the patient the difference😡 ) Be carefull with insurance companies, and don't be afraid to get outside help when you need it!

 

[I'mFillingFine]

get a no collateral construction and business loan from Schein/Patterson and they'll come by and design the office to your satisfaction for free.

ooooh, how does this work? Sounds intriguing.

I'm new at all this, so excuse my ignorance.

 

[Daurang]

Most dentist construction/business loans through the major dental supply companies are relatively easy and require no collateral. I was +6 months delinquent many many times on my student loan payment but they didn't care. They'll lend you $200k-$300k easily simply because you're a dentist.

 

[Daurang]

I didn't say sign up with every insurance out there. Just Delta alone there are many types with many fee schedules like Delta Care(insultingly crappy), Delta Preferred (crappy), DeltaUSA(ok), Delta Premiere for union (crappy), DeltaPremiere(ok). The newbie dentist will learn to adjust accordingly and it's no big loss since you have a slow empty office in the first 6 months anyhow. I stopped seeing DeltaCare and DeltaPreferred a month after I open my practice because their fees were insulting.

 

[Lesley]

I didn't say sign up with every insurance out there. Just Delta alone there are many types with many fee schedules like Delta Care(insultingly crappy), Delta Preferred (crappy), DeltaUSA(ok), Delta Premiere for union (crappy), DeltaPremiere(ok). The newbie dentist will learn to adjust accordingly and it's no big loss since you have a slow empty office in the first 6 months anyhow. I stopped seeing DeltaCare and DeltaPreferred a month after I open my practice because their fees were insulting.

Delta Premiere, it's our only participating insurance plan.👍

After twenty years of participating with many insurance plans, this was the only one we felt compeled to maintain. We have a lot of insurance patients too. Many left after we stopped participating. We were prepared for a drop in patient hours, and it happened. Considering the area where we practice, we would not have done this if we weren't ready financially for a downsized schedule. We're still standing and a lot happier. We have no regrets with our decision. Many of the fees we were accepting for over two decades were insulting. It was time and we were ready. Once we made our decision, within six months, we notified the patients, insurance companies and dropped all the plans, with the exclusion of Delta Premier.

 

[DrJeff]

ooooh, how does this work? Sounds intriguing.

I'm new at all this, so excuse my ignorance.

The loan part has been covered already, you're a dentist, your earning potential is good, your chance of defaulting on the loan is small, they'll loan you the $$.

The design part is easy too, your local rep from your big distribution company (sullivan schien/patterson, etc) will have one of their staff office design consultants/architects meet with you to get ideas as to what you want for your office design wise, budget, etc. they'll then draw up some plans and go over them with you, you'll make changes (as needed), and when your ready they'l work with your contractor(s) to get the project done, and oh yes, your distribution rep will then sell you all the equipment you'll ever need to get up and running and set you up for service of that equipment as needed. What they loose $$ wise in picking up the design fees for you, they more than make up in the equipment sales from you. Throw in the interest on the business/construction loan their floating to you, and thats why their more than happy to take care of you.

 

[Empty pockets]

In dental school, do they help you in any way prepare for starting up a practice? Or, is this something you figure out on your own through other resources?

no

 

[TonyProMed]

I have been in the marketplace for some time and wanted to share what I have seen out there in terms of financing.

While acquiring a practice seems like the best approach "in some cases it is" Startups for recent grads tend to be more aggressive then acquisitions. For those that want to startup I say go for it!

Few things to consider for financing:

• write a business plan
• get demographics - think ratios - dentists to people http://www.bestplaces.net/
• find a good commercial realtor and local equipment specialist
• get multiple bids from contractors
• try to establish leasehold improvements budget and stick to it
• get contractor to take a look at the lease agreement and space before you sign
• download earth.google.com and type in location then type dentists to find nearby competition
• think of parking problems traffic and access points to complex
• try to find a space that is going to be in the range of $3000 a month ask about triple net or added fees
• get your corporate papers in order http://www.legalzoom.com/
• Start thinking about insurance
• Get a associate position to maintain your finances while you startup
• Keep your credit in order pull it from sources like http://www.creditexpert.com

These are just a few of the biggest items I see that become a problem for startups.

Tony Urresti
ProMed Financial
888-277-6633 phone
888-577-6633 fax
tony@promed-financial.com