Let's Buy a Dental Practice

[youknowthedrill]

My dentist is located in an office building with other medical professionals (physicians, PT, and one other dentist) near the hospital in our town. At certain times of the day it is hard to find a parking space. Just curious about the number of parking spaces that are needed for a busy office with one dentist?

---

Members don't see this ad.

 

[diagnodent]

As a practicing dentist who has viewed this thread over the past few years I just want to give every dentist or student a word of caution before claiming that the "hammer" is a dental genius. If anything this is a thread that you should follow In Oder to know what not to do. Sorry to burst your bubble. 838k in loans should equal a 1.4 million practice with a net of 600k. Sorry hammer you bought In to everyone here giving you props and not reality

 

[kdawg]

As a practicing dentist who has viewed this thread over the past few years I just want to give every dentist or student a word of caution before claiming that the "hammer" is a dental genius. If anything this is a thread that you should follow In Oder to know what not to do. Sorry to burst your bubble. 838k in loans should equal a 1.4 million practice with a net of 600k. Sorry hammer you bought In to everyone here giving you props and not reality

Not sure I can believe someone who can't spell or punctuate.

What a cowardly low-blow man. You have thread-envy or something? Hammer has volunteered his life experiences willingly to provide some thought, discussion, and guidance for students. We can take it or leave it.

If you really care about "cautioning" your fellow colleagues, I invite you to stick around and defend your comments.

 

[Oracle DMD]

As a practicing dentist who has viewed this thread over the past few years I just want to give every dentist or student a word of caution before claiming that the "hammer" is a dental genius. If anything this is a thread that you should follow In Oder to know what not to do. Sorry to burst your bubble. 838k in loans should equal a 1.4 million practice with a net of 600k. Sorry hammer you bought In to everyone here giving you props and not reality

I agree w/ kdawg. Hammer has offered to share his experiences for younger dentists to think about, so if you want to start another thread where you can share your very own brand of dentistry Gospel....feel free.

 

[diagnodent]

I knew I would criticized for my comments but I stand by them. There have been many pre-dents and dental students on this thread in awe of hammer. I just want them all to take this thread with a grain of salt. If you want my story here it is....

10 years practicing
Have an associate
Practice collects 1.7 million FFs

The thing you all need to learn to do is how to read a profit and loss statement
How to market
How to manage people

The best thing to do is follow Scott leune and productive dentist academy

Sorry my grammar isn't great but an iPad is hard to type with

 

[The Hammer]

I knew I would criticized for my comments but I stand by them. There have been many pre-dents and dental students on this thread in awe of hammer. I just want them all to take this thread with a grain of salt. If you want my story here it is....

10 years practicing
Have an associate
Practice collects 1.7 million FFs

The thing you all need to learn to do is how to read a profit and loss statement
How to market
How to manage people

The best thing to do is follow Scott leune and productive dentist academy

Sorry my grammar isn't great but an iPad is hard to type with

Please feel free to point out my errors and explain why what I've done is a bad idea. I am always open to constructive criticism but to just show up and say "If anything this is a thread that you should follow In Oder to know what not to do" just makes you a troll.

You also haven't read the thread very closely or you would know that this thread is barely a year old, so it would have been impossible for you "As a practicing dentist who has viewed this thread over the past few years"

Also if you had actually read the thread you would know that my debt breaks down this way:

239K for my current practice
200K for a new building
100K for working captial/ new equipment
300K is debt I incurred in my divorce

Nowhere did I say that I was giving $838K for a single practice, I have no clue what gave you this idea.

I also haven't tried to give anyone the impression that I am a dental "guru" I have just posted a thread about my experiences and what I am doing in buying a new practice. Everyone is free to see me as a good example or horrible warning and to take away whatever "advice" they see as meaningful whether it be good or bad.

 

[Cold Front]

I knew I would criticized for my comments but I stand by them. There have been many pre-dents and dental students on this thread in awe of hammer. I just want them all to take this thread with a grain of salt. If you want my story here it is....

10 years practicing
Have an associate
Practice collects 1.7 million FFs

The thing you all need to learn to do is how to read a profit and loss statement
How to market
How to manage people

The best thing to do is follow Scott leune and productive dentist academy

Sorry my grammar isn't great but an iPad is hard to type with

Scott is great, but Hammer offers a different advice too. It all depends where you are practicing and how efficient you are running your office. I could have moved to Texas where Scott practices, where the economic growth is best in the nation, and collect over $1 million a year in a very short time. But no, I decided to stay in the Midwest and can easily collect half of that in my 1st year of practice, and be close to my family and people I grew up with. Money isn't everything, even Scott has a thread on that. Goal is to enjoy life with good financial plan, and don't become paper chaser. Some people are simply addicted to success, and turn their offices to franchise businesses, others simply are content and as happy as the top 1% income dentists.

I approve all Hammer's advice, and many other practice owners like him on these forums. The is no 1 best person to follow, but many people to learn from.

 

[kdawg]

Scott is great, but Hammer offers a different advice too. It all depends where you are practicing and how efficient you are running your office. I could have moved to Texas where Scott practices, where the economic growth is best in the nation, and collect over $1 million a year in a very short time. But no, I decided to stay in the Midwest and can easily collect half of that in my 1st year of practice, and be close to my family and people I grew up with. Money isn't everything, even Scott has a thread on that. Goal is to enjoy life with good financial plan, and don't become paper chaser. Some people are simply addicted to success, and turn their offices to franchise businesses, others simply are content and as happy as the top 1% income dentists.

I approve all Hammer's advice, and many other practice owners like him on these forums. The is no 1 best person to follow, but many people to learn from.

 

[diagnodent]

Sorry for disrupting the perfect thread and poster. I'm not a troll and have received private messages stating that this has been thread worship for a while. I'm not all about money but want a life that provides me with time and money and happiness. And I'm sorry I over estimated your net debt, I just added the numbers quickly.

I' m not stating to be a dental business genius because I take my ideas from everyone else. But everyone thinks you are a dental business genius and the fact that someone called you out on it and you responded inappropriately makes me think that you started believing it yourself.

Sorry to burst everyone's bubble

 

[SoulPower]

Sorry for disrupting the perfect thread and poster. I'm not a troll and have received private messages stating that this has been thread worship for a while. I'm not all about money but want a life that provides me with time and money and happiness. And I'm sorry I over estimated your net debt, I just added the numbers quickly.

I' m not stating to be a dental business genius because I take my ideas from everyone else. But everyone thinks you are a dental business genius and the fact that someone called you out on it and you responded inappropriately makes me think that you started believing it yourself.

Sorry to burst everyone's bubble

You didn't burst anyone's bubble, you actually haven't retorted anything specific to hammer's discussions. I think the reason this thread is so popular is because most of us are not business majors and do not understand exactly what goes into creating a practice and brand. Hammer has been offering advice that makes sense, i.e. marketing, buying supplies, hiring, location that all makes sense from a practical standpoint but most of us have not thought about since we are applying or in dental school and there's just no time for that.

And the fact that you have not contributed anything except a blanket statement saying "he is wrong" pretty much makes you wrong. Remember this is a forum for "discussing" topics not throwing out generalizations without backing them up.

I'm not berating you or anything but you should take a step back and look at your posts anonymously and it comes off pretty dickish.

 

[diagnodent]

There is no such thing as a "goldmine" or "sure thing" or whatever else type of practice name you want to call it. Like I said you need to learn how to read a profit and loss. When evaluating a practice the numbers are important.

Employee salaries should be 20-25%
rent under 5%
lab 7-10
Phone/utilities 2-3
Bank fees1-3
advertising 2-8% the higher it is means there should be More new patients
Take out amortization and depreciation because that is false overhead and it will be higher when u first buy it
Supplies 5-7
Office supplies1-3
Miscellaneous 1-5

You are looking for ways to make profit in your practice and your loan can't be deducted except for the interest which is amortization

Hope that is specific enough for u all who think I contribute nothing

Next time read my post where I said learn how to read a p&L or where I say learn how to manage and market

 

[SeattleRDH]

There is no such thing as a "goldmine" or "sure thing" or whatever else type of practice name you want to call it. Like I said you need to learn how to read a profit and loss. When evaluating a practice the numbers are important.

Employee salaries should be 20-25%
rent under 5%
lab 7-10
Phone/utilities 2-3
Bank fees1-3
advertising 2-8% the higher it is means there should be More new patients
Take out amortization and depreciation because that is false overhead and it will be higher when u first buy it
Supplies 5-7
Office supplies1-3
Miscellaneous 1-5

You are looking for ways to make profit in your practice and your loan can't be deducted except for the interest which is amortization

Hope that is specific enough for u all who think I contribute nothing

Next time read my post where I said learn how to read a p&L or where I say learn how to manage and market

Please don't take this thread to negative town. The Hammer has been encouraging SDNers to participate in this discussion and make predictions about what they are going to face in the "real world". We are not all going to practice in a mid-size town in Tennessee but the conversations that have been going on in this thread have helped us to think about how our future practice will fit into our patient's demographic.

The percentages you list are good to know but they can differ from place to place. For example:
A marketing budget is unnecessary in rural areas where there is a shortage of dentists and everyone knows everyone anyway
20-25% employee salaries are ideal but what if there aren't enough hygienists in the area and you have to pay above market to find a good one? Also, are you outsourcing your bookkeeping and payroll or does your well-paid OM cover this?
I agree with rent at 5%, but some people want to own their building

It really only takes one CE in practice management to come up with the "ideal" budget but how one achieves this is what this thread is touching on. Besides, this thread is a fun read. It makes me inspired to find my "sure-thing" and avoid the "shiny trap".

I hope when people pose their questions to Hammer in this thread that practicing dentists (like yourself) add to the discussion by describing what works for them. What were you looking for when you bought your practice? What traps did you fall into? If none, then how did you find *your* goldmine?

 

[diagnodent]

Payroll is done by my accountant because they keep track of taxes and 401k contributions. It's easy just send an email with the hours employees worked.

Office managers are unneeded. I am the office manager. Typically in most practices with a om they are just glorified overpaid receptionist. For the cost of one om you could get 2 employees. All banking and bill paying should be done by you to prevent any embezzlement. Any hiring should be done by you. Unless your office does like 2-3 million you don't need a om.

All these percentages are for any place. The way overhead is controlled is by raising prices, getting more patients, or reducing payroll. Most practices have payroll way out of line because they either have no systems or management principles which makes them need more staff. Or have grossly overpaid staff. Everything comes down to systems and efficiency.

 

[charlestweed]

Payroll is done by my accountant because they keep track of taxes and 401k contributions. It's easy just send an email with the hours employees worked.

Office managers are unneeded. I am the office manager. Typically in most practices with a om they are just glorified overpaid receptionist. For the cost of one om you could get 2 employees. All banking and bill paying should be done by you to prevent any embezzlement. Any hiring should be done by you. Unless your office does like 2-3 million you don't need a om.

All these percentages are for any place. The way overhead is controlled is by raising prices, getting more patients, or reducing payroll. Most practices have payroll way out of line because they either have no systems or management principles which makes them need more staff. Or have grossly overpaid staff. Everything comes down to systems and efficiency.

I run my business pretty much the same way. I also let my CPA take care of the payroll. The CPA emails me the amount and then I write the check to each of my employee. I am the manager of all 3 of my offices. I place most of the supply orders myself because I can negotiate for better prices with the sell reps. The main duties of my office manager (or the glorified overpaid receptionist) are to help me sell cases (and gets $20 bonus for every case acceptance), bill insurance companies, clean the office, and answering phone calls. I pay her less than I pay my ortho RDAs.

 

[Cold Front]

I run my business pretty much the same way. I also let my CPA take care of the payroll. The CPA emails me the amount and then I write the check to each of my employee. I am the manager of all 3 of my offices. I place most of the supply orders myself because I can negotiate for better prices with the sell reps. The main duties of my office manager (or the glorified overpaid receptionist) are to help me sell cases (and gets $20 bonus for every case acceptance), bill insurance companies, clean the office, and answering phone calls. I pay her less than I pay my ortho RDAs.

I never quite understood why orthodontists have multiple offices. Isn't that building/buying 3 offices, and being at 1 of 3 different locations at any given time? isn't the overhead for this model high (3 rents, 3 utilities, 3 of almost everything except employees)?

Or is this a way an orthodontist to keep him/herself busy as oppose to 1 office? I couldn't imaging running between 3 offices, I might end up at the wrong office one morning.

 

[charlestweed]

I never quite understood why orthodontists have multiple offices. Isn't that building/buying 3 offices, and being at 1 of 3 different locations at any given time? isn't the overhead for this model high (3 rents, 3 utilities, 3 of almost everything except employees)?

Or is this a way an orthodontist to keep him/herself busy as oppose to 1 office? I couldn't imaging running between 3 offices, I might end up at the wrong office one morning.

I wish I have enough ortho patients to stay busy at 1 location. In order for me to work at my office 5 days/week, I have to have about 1500 active ortho patients (or 60 new starts a month). All 3 of my offices only have about 700 active patients....11-12 work days/month should be enough to take care of these 700 patients. I lower the overhead and gain additional income by working for a dental chain on the days I don't work at my own offices.

Actually, it is not bad to travel to different offices. I don’t have to face the same group of boring staff every day.

 

[The Hammer]

I run my business pretty much the same way. I also let my CPA take care of the payroll. The CPA emails me the amount and then I write the check to each of my employee. I am the manager of all 3 of my offices. I place most of the supply orders myself because I can negotiate for better prices with the sell reps. The main duties of my office manager (or the glorified overpaid receptionist) are to help me sell cases (and gets $20 bonus for every case acceptance), bill insurance companies, clean the office, and answering phone calls. I pay her less than I pay my ortho RDAs.

Great post. I totally agree with letting your CPA do the payroll. Mine even prints the checks for me to sign. I get a P and L each week with a monthly total P and L at the end of the month.

 

[Cold Front]

Great post. I totally agree with letting your CPA do the payroll. Mine even prints the checks for me to sign. I get a P and L each week with a monthly total P and L at the end of the month.

My CPA does everything, but payroll. I do mine through ADP. It's $50 per pay period (ppp), and I do it online from anywhere (even if I'm traveling). CPA has access to the ADP payroll info, and he writes the $50 off from the LLC taxes. All payroll reports are also online, and I get quarterly reports in the mail. Free W-2's for all my staff at the end of the year.

 

[7 Iron]

Great post. I totally agree with letting your CPA do the payroll. Mine even prints the checks for me to sign. I get a P and L each week with a monthly total P and L at the end of the month.

Do you guys use a full-time CPA who works at the office? Or do they act as an independent contractor type employee that only works a few hours a month for the office?

 

[The Hammer]

My CPA does everything, but payroll. I do mine through ADP. It's $50 per pay period (ppp), and I do it online from anywhere (even if I'm traveling). CPA has access to the ADP payroll info, and he writes the $50 off from the LLC taxes. All payroll reports are also online, and I get quarterly reports in the mail. Free W-2's for all my staff at the end of the year.

Cold Front would you please talk a little about ADP , what it is and what it does for you. I think that it would add alot to this discussion

 

[The Hammer]

Do you guys use a full-time CPA who works at the office? Or do they act as an independent contractor type employee that only works a few hours a month for the office?

Mine has his own office and I pay via retainer (a flat fee). He has computer access to my office computers so he is able to print off whatever Dentrix reports he needs.

 

[omaralt]

guys payroll is soo easy, why would you pay somebody to do it? it literally takes me a few mins to do my own payroll via quick books. i just enter the number of hours worked; checks are printed out, taxes automatically paid and i'm done.. the biggest down side is no direct deposit and thats where companies like ADP come into play

 

[The Hammer]

guys payroll is soo easy, why would you pay somebody to do it? it literally takes me a few mins to do my own payroll via quick books. i just enter the number of hours worked; checks are printed out, taxes automatically paid and i'm done.. the biggest down side is no direct deposit and thats where companies like ADP come into play

Dr. Omar would you mind explaining what ADP is and what they do for you. I think knowing about them would be a great help to readers of this thread.
Thanks!

 

[omaralt]

Dr. Omar would you mind explaining what ADP is and what they do for you. I think knowing about them would be a great help to readers of this thread.
Thanks!

i dont use adp; i do my own payroll. from what i understand they're just a payroll managing company. you tell them how many hours each employee worked (they already have the rate they get paid) and they issue the checks directly from them. they also provide direct deposit. i do the same on my own (minus the direct deposit) in 10 mins every two weeks

 

[charlestweed]

Since I am clueless about accounting, I let my cpa do everything for me. He charges me an annual fee of $3000 (I pay him $750 quarterly) for doing personal and corporation income tax filings, book keeping and payroll. When doing payroll, he keeps track of the taxes and 401k. At the end of each month, he tells me how much I have to make the electronic payment to EFTPS. At the end of each quarter, he tells me how much I need to write the check to EDD. In addition to the cpa fee, I also have to pay another guy, my pension administrator, $1200/year for doing the 401k.

Every year in October, I meet with my cpa. He looks at my income and the amount of estimated taxes that I paid during the first 3 quarter (Jan-Sept) and he offers me list of things that I should do in the 4th quarter in order to avoid paying a large amount of taxes on April 15….such as buy more dental supplies and equipments, pay higher estimated taxes (if I underpaid) or pay less estimated taxes in (if I overpaid) etc.

 

[Cold Front]

Cold Front would you please talk a little about ADP , what it is and what it does for you. I think that it would add alot to this discussion

The following is what includes in my bi-weekly ADP services:

1. Payroll (can be done from anywhere; office, home, while being on vacation).
2. Checks, Direct Deposit, Tax Filing, FSDD, EE Access, Electronic Reports.
3. Delivery of Paystubs, New Hire Reporting, HR411 Essential
4. Updated Poster Compliance, GLI, GPS, SUI Mgmt.
5. Pay Services (for receiving any of the Services that require ADP to impound funds from my account to pay my third-party payment obligations e.g., 401K, etc)
6. Year-End W2's for all my staff (free).

My payroll takes 10 mins too, but the point is that this is so convenient and easy AND ADP fee is a full tax write-off.

ADP also offers a referral incentives, where they waive fees if you refer a friend or a client who needs ADP services. I'm referring a friend to ADP, if he accepts it, I will not pay any ADP fees for few months.

 

[saddlesniffer]

Newbie here. I have been lurking around in this thread for awhile and I have to say that this thread is awesome. The hammer has given the real world reality of dentistry. I myself have been pissed on as an associate the first four years after dental school. Finally I decided to end it and start my own. It was not easy starting from scratch but if I could say the one thing that helped me achieve success it would be having a good chair side personality. You can do the best dentistry in the whole world but if your personality stinks (or lack of) then you are screwed. Reading hammers posts I can tell that his success had alot to do with his personality. I will try to post later about my travels in starting a practice from scratch. Its a b!tch, but possible if you do your homework right.

 

[saddlesniffer]

Oh, I have been practicing for 13 years in sunny SoCal.

 

[The Hammer]

Newbie here. I have been lurking around in this thread for awhile and I have to say that this thread is awesome. The hammer has given the real world reality of dentistry. I myself have been pissed on as an associate the first four years after dental school. Finally I decided to end it and start my own. It was not easy starting from scratch but if I could say the one thing that helped me achieve success it would be having a good chair side personality. You can do the best dentistry in the whole world but if your personality stinks (or lack of) then you are screwed. Reading hammers posts I can tell that his success had alot to do with his personality. I will try to post later about my travels in starting a practice from scratch. Its a b!tch, but possible if you do your homework right.

Please please share more of your experiences with opening your own practice. It is very important to see how other people have gone into private practice and not just get one opinion. so please continue with your posts

 

[The Hammer]

Wow this thread is now over !00,000 views

 

[steedums]

How did you find the practices you looked at/purchased?

 

[yappy]

I have a question for the HAMMER: How do specialists market to GP's to get patients? or on the flip side, as a GP how do you decide which specialist to refer to?

 

[Cold Front]

I have a question for the HAMMER: How do specialists market to GP's to get patients? or on the flip side, as a GP how do you decide which specialist to refer to?

The ortho guy I refer to invited me to have a lunch at his office before I started referring patients to him. He did a presentation on the cases he worked on before. He also does TMJ cases, which is rare for an orthodontist, and created his own appliances to prevent patients from getting orthognatic surgeries. He is in his late 60's and taught at 4 dental schools (BU, Tufts, Case and MN) before entering private practice. I learned quite a bit from him, he even comes down to my office to treatment plan challenging cases together. As a result, her refers patients to me too after seeing my work.

Before you refer your patients to a specialist, do a lot of research. It really comes down to developing a professional relationship, common philosophies, and not just getting referral cards from a specialist in the mail (like my local endodontists), I rarely refer to them - thanks to Tulsa Dental endo system.

 

[stdmufin27]

That only took me 5-6 hours to get though. But very awesome Hammer!!!!!

 

[pacificNW]

Took me 10+ hours to read this thread in its entirety during the past 24 hours.

The thing that I found most meaningful was the candor and the sincerity. The earnestness. Perhaps we did get a bit into thread worship, but there was a reason for that. I don't think someone dropping in and reading for a few minutes will fully experience the intensity of the sincerity presented the the big H.

What I hope I can add for someone is the importance of integrity throughout all of your existence as a dentist. I just graduated from school and am not socially well connected with other dentists: no family dentists, my friends aren't dentists. I don't play golf, and I don't want to.

To me, acting with transparency is a sign of integrity. Hammer has posted here for over a year with incredible transparency and really put himself out there. There is an emotional aspect to this thread that I have never, never come across reading any other thread. It stems from the big H not trying to make himself seem better than he is. At one point referring to treatment plan acceptance as "getting the patient to drink the Kool Aid" if I remember correctly. Who would say that? Very few that I have met are willing to see themselves as honestly and with as little pretense as this man has.

He's even posted his picture and outed his identity, for those of us who have read carefully. That's a big risk. It partially reads like someone publishing their private journal on the web. That might be some cool thing to do if it were a blog, but as dentists, we must all be constantly aware of the impression we make on others. Our professional reputation is everything, so for the big H to lay it all out like this, his ex partner, ex wife, experiences... this is a level of openness and earnestness that is hard to match.

In addition, the good man has spent many, many, many hours answering questions for pre-dents, dents, and associates.

 

[pacificNW]

Leaving his status as "pre-dent" another small indication of his humility. FWIW, I have not had any interaction with the Hammer beyond this thread.

For diagnodent, I think you do raise at least one good point, with regards to the debt. To my mind, the big H is not in a great situation to be out for this long and owe this much. Granted, he could have 1,000,000 in a retirement plan, but given his openness this is probably not likely. Still, a divorce and a legal skirmish with a partner do not help with debt accumulation or building wealth. But H has listed multiple reasons for each practice purchase, and I found his advice insightful.

Back to "integrity", for the pre-dents and the DS1's & 2's. I was successful in the clinic at my school even though I pushed many instructors buttons (unintentionally and intentionally) during the first two years. It came back to haunt me in the form of a damaged reputation amongst my peers. But my patients were another matter. I always tried to do everything I could to get them to have an effective hygiene regimen.

If I could recap, there was a point deep within the thread where (perhaps H, perhaps another) said that patients do not trust the dentist, so it's the staff that sells treatment plans.

To that I say, people are smart. Even dumb people are smart. Almost anyone can tell when another human cares about them. It's a subtle and sub-conscious thing, but there's a difference between "being a good dentist" and (forgive the caps) REALLY ****ING CARING ABOUT YOUR PATIENTS' ORAL HEALTH.

What does this have to do with buying a practice? Well, I'm arguing that the best practice you can have is one in which you earn each patient's deep trust. Again, I know I'm green, but I think the only way the patient can trust, truly trust the dentist, is if the patient knows that the dentist wants what's best for the patient. If you can steer your actions to this end, you will have amazing "treatment plan acceptance" as that phrase goes.

Although I have great, great respect for the big H, I would argue that signs and advertising are an indication that you aren't doing things right (as well as you could). If you have your patient's trust, modest requests for referrals from satisfied patients should generate more than enough new patients.

Obviously, if someone shows why any of this is bogus, I'll be the first to admit that I know very little. Thank you to anyone who reads this.

 

[SeattleRDH]

To that I say, people are smart. Even dumb people are smart. Almost anyone can tell when another human cares about them. It's a subtle and sub-conscious thing, but there's a difference between "being a good dentist" and (forgive the caps) REALLY ****ING CARING ABOUT YOUR PATIENTS' ORAL HEALTH.

Amen.

 

[Stacker]

OK who wants to hear about buying a dental practice in the real world? Well join me as I venture into the world of debt, a retiring owner/dentist, practice brokers, issues with the remaining staff, retaining patients, talking with the bank for a loan, pouring over financials, demographic surveys, production predictions, future overhead calculations, interior design, logo design, practice rebranding, advertising, patient recruitment, staff recruitment, debt management and having a hostile ex-wife who still lives in the area. Plus I will try to address issues that are unique to recent grads looking to go into practice and to answer any questions that you might have. Also I am going to use real numbers but I will change just enough information so that I don't violate any confidentiality agreements that I have already signed. So lets get started

lawls "hostile ex-wife"

 

[kdawg]

Although I have great, great respect for the big H, I would argue that signs and advertising are an indication that you aren't doing things right (as well as you could). If you have your patient's trust, modest requests for referrals from satisfied patients should generate more than enough new patients.

Obviously, if someone shows why any of this is bogus, I'll be the first to admit that I know very little. Thank you to anyone who reads this.

To be honest, I'm kind of tired of hearing this. I feel like it has gotten crammed down my throat while I've been in school, like "if you have anything more than just your name in the phone book you are an unethical, overtreating, phony dentist". Gimme a break. It's a different era of dentistry than 30 years ago when advertising was frowned upon. And you can't put up a sign in front of your place or "you aren't doing things right"? Surely you can't be serious.

Asking for referrals from patients is just INTERNAL marketing, isn't it? The only difference is you're asking your patients to do your advertising for you...for free.

Many of the dentists whom I admire greatly are big on marketing. They are good people, they do excellent dentistry, and their patients love them. They all preach how new patients are the life-blood of the practice. And depending on the dentist-to-patient ratio in your area you can't just live off internal referrals.

I defer to The Hammer and you other dentists that have more experience than me, however.

 

[SeattleRDH]

Bump

 

[Dig it the most]

Best thread I've seen yet...

 

[Noelle23]

Asking for referrals is the cheapest and best marketing out there! I am a treatment and marketing coordindator for an orthodontist and we do a post treatment consult after our patients get their braces off. We have a professional photographer in our office one half day a week and they take the BR photos. So, at their first retainer check they come into my office/exam room and I present the photo with their intial photos. We then tell them how much we have enjoyed them as a patient and that we will miss them and that they need to replace themselves with someone else I schedule their next retainer check and see if there is any other family members that need to get in for an exam or if it is mom or dads turn. I probably schedule 4-5 patients a week from these post tx consults. We get the most new patients this way and it's free. Well, I guess we do pay for the photographer. But you could implement something like this by just printing off before and after photos.

I encourage our staff to ask for referrals all the time! I set internal contests to get the staff to ask and its been extremely successful. I have worked with some of the best practice management companies and they will tell you this works tremendously. If your a dentist that doesn't have what I like to call "sparkle" then you need to hire someone that does! It can make or break your practice. Expecially in this economy. Post recession customers/patients are much different than what they used to be and they go through stages of buying called "conditions." They shop around until all of their conditions are met. My point being, marketing and a well rounded practice is most important. Being a great dentist is not the only thing you need!!
Cheers!

 

[txdds2012]

As much as I would love to impress you with my vast knowledge of reading population demographics I'll be honest with you. I don't use them. I figure that someone with a degree in marketing has already done that for me so here's what I look for

1. First it has to be an area that I want to live in. It has to be close to a major interstate and it has to be within 30 minutes driving time to a decent sized city

2. I look at the stores within 2 miles of the office. Super-Walmart is good, Lowe's, Home Depot and Super-Target even better. These are big chains that are much better at determining the discretionary income of the local population than I am. Their demographic for the most part are the people I want for patients so if they have invested in the area I figure that I will be ok too.

3. I look at the restaurants. McDonald's meh, same for Pizza Hut and Subway. Starbucks is good, Olive Garden, Red Lobster and Panera Bread are great. Once again the demographic that they are looking for is essentially the same that I want so if they are around then I will be OK.

4. I look at the churches. Not so much the denominations but the physical structures. Are they recent structures in good shape with "Family Life Centers" or as we use to call them gyms? This lets me know that the area has new families with younger children. It also lets me know that they have a decent amount of money to be able to tithe enough to fund a building program

5. I look at the housing situation. Are there new subdivisions being built? How about new apartment complexes? Both of these indicate a younger population moving into the area. These people will hopefully become your longtime patients

6. I look at what the major industries in the area. Not just in the immediate community but also in the region. I prefer a mix of industries both blue collar and white collar without any one particular industry dominating. The wider the mix the more resistant the local economy will be to the fluctuations of the economy.

7. And I will finally look at the number of dentists in the area. What type of practices they have, how old they are, how long they have been there, what does the physical structure of their office look like, how much do they charge, what does their staff look like, does the dentist live in the area or do they live elsewhere and commute in, what services do they provide, what sort of marketing do they do etc etc.

The first 6 points tell me if the area can support me, the last point lets me know what I will need to do to dominate the market. If you haven't figured it out already this is the stuff that I am constantly thinking about.

Hi Hammer,

Great posts, thank you for being so open and helpful!

I was wondering how you would go about finding out #7?

 

[thyagar3]

And not including the 6000 former patients that I have still in the area.

Wow, Hammer you are a dental boss. Would like to get in touch with you soon, I have a dental school interview coming up and need your advice on how to impress them.

 

[DentalDamnIt]

Every new associate should use this as benchmark for nego salary, esp in California and esp for those who plan to work for a dental mill in California.

Gentle Dental in No. Cal offering a new grad 25% of collections ONLY (12/2011). HMO heavy and ... remember 25% of ZERO is still ..... Zero.

Great thread!!!

The ideal associateship is offered this:
$500 daily guarantee (8-9 hours daily) with 30% of production over $1,650. (i.e. this is a guarantee of $120k year + incentives for both dentist and offices)

A compromise is the following:
$400 daily guarantee (8-9 hours), with 35% collections over $1,200 in more dental plan based offices. (i.e. this is a guarantee of $96k a year + very very big incentive for high producers)

Now very few offices are offering salaries like these nowadays due to economy, but should be your ideal as you start looking.

 

[NonTradHopeful]

Awesome thread...very informative.

 

[vienhuynh]

Been reading for a few hours now, I making this thread my homepage.

 

[little Buddy]

Is it possible to use fringe benefits to payoff your student loans if you own the company?

 

[yappy]

I've wondered this too.

Is it possible to use revenue from your practice to pay off things like your student loans (claiming them as business expenses) or a 'company car' or maybe a rental property?

This way you would not have to use income that was taxed as income to pay off loans or a car etc. etc.

EDIT: I'm just thinking how cool would it be to pay for almost all the expenses in life without using income but instead non-income-taxed dollars. Not only would alot of things be paid for with pre-tax dollars but it would lower your 'draw' so you were in a lower marinal tax rate.

Is it possible to use fringe benefits to payoff your student loans if you own the company?

 

[wired202808]

I've wondered this too.

Is it possible to use revenue from your practice to pay off things like your student loans (claiming them as business expenses) or a 'company car' or maybe a rental property?

This way you would not have to use income that was taxed as income to pay off loans or a car etc. etc.

EDIT: I'm just thinking how cool would it be to pay for almost all the expenses in life without using income but instead non-income-taxed dollars. Not only would alot of things be paid for with pre-tax dollars but it would lower your 'draw' so you were in a lower marinal tax rate.

nice try but the govt thought of that one. you cant do that because your student loans have nothing to do with your current business. The funds used to pay for d-school are associated with being a dentist, not operating practice XYZ. Yes i know that w/o the schooling there would be no business, but you cant go back and claim expenses before the business was established. If it was that easy, everyone would do it.