Let's Buy a Dental Practice

[The Hammer]

I would think that it would be a no-brainer to rehire the OM. You can always train someone to answer the phones for you. Especially, if it someone who you have worked with and are comfortable with and they share/understand your vision for the practice, then they are worth 10x what you would have to pay your ex-partner, am I right?
It does suck to have to give your partner the satisfaction of paying him even more money, but I say just suck it up and then use the OM to dominate!

yeah it does suck but the person that I am rehiring is more than worth the money and my ex-partner is not going to be happy

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[DrDientes]

Are we on the right track? I mean the OM has the best knowledge of how the practice runs, in terms of scheduling patients, collecting money, training new employees. You can probably assess a dental hygienist skill, and there are probably always hygienist to hire right? Or is there a shortage of them?

 

[Drabuisa]

I would think that you're going to get the office manager. I feel like you can train all the other positions, but the OM plays a crucial role in the flow of your money.

 

[The Hammer]

OK yes I am rehiring the OM. She has been with me for years, she knows dentrix from top to bottom and I trust her with my life. The practice already has two hygienists and the patients will know them and be a familiar face to keep them anchored to the practice when I take over.

My OM was with me when I changed my practice from a basic general dentistry practice to what it was when I sold it. She knows me, she knows how I work and how I want the practice to run. She is more than worth the $5000.

I have hired another assistant who is AWESOME and I have worked with her before and she has been patiently waiting for me to return to the area so she can leave the dentists she is working with and come to work for me.

The two most important positions in the dental office are the OM and the hygienists. A good OM should direct the day to day flow of the office and allow you to concentrate one the dentistry. Hygienists are the ones who keep patients coming back to your office and convince them to get the treatment that you recommend. Assistants can come and go. I have trained tons of assistants and they will bond with patients but not to the degree that your hygienists will.

Now about assistants. If you can find a good assistant with experience in a dental office then great. But if you can't then learn how to train a good assistant. My best assistants were young women barely out of High School who were also single mom's. I usually found them working full time at a grocery store or Wal-Mart.

A young woman who has no husband, has a very young child and still manages to go out and get a full time job is someone you will not have to teach how to work. She could be sitting on her butt making babies in the trailer park and living off of welfare, but instead she is working her ass off in some low paying dead end job because she wants a better life.

I would usually have them come observe for a month or two just to see if they were going to be OK with dentistry and to see how professional they would be in the office. If they did OK then I would hire them and have them work in the front office and learn how to do that job and I would pay their tuition to attend Dental Assisting school at night. I would also start working them in the back to get them familiar with the job that they will be doing. Once they passed the RDA exam I would move them into the back to assist.

I have probably trained 10 assistants that way. All of them are still in dentistry. 3 of them went on to become assistants. When you do this you are taking a hard worker and giving them a career instead of a long line of dead end , soul crushing jobs. And you usually wind up with an extremely loyal and hard working employee

 

[Seahawk]

Oh boy, can't wait for Monday!

The logo looks sweet by the way. Did you do it yourself?

 

[KinKs]

OK yes I am rehiring the OM. She has been with me for years, she knows dentrix from top to bottom and I trust her with my life. The practice already has two hygienists and the patients will know them and be a familiar face to keep them anchored to the practice when I take over.

My OM was with me when I changed my practice from a basic general dentistry practice to what it was when I sold it. She knows me, she knows how I work and how I want the practice to run. She is more than worth the $5000.

I have hired another assistant who is AWESOME and I have worked with her before and she has been patiently waiting for me to return to the area so she can leave the dentists she is working with and come to work for me.

The two most important positions in the dental office are the OM and the hygienists. A good OM should direct the day to day flow of the office and allow you to concentrate one the dentistry. Hygienists are the ones who keep patients coming back to your office and convince them to get the treatment that you recommend. Assistants can come and go. I have trained tons of assistants and they will bond with patients but not to the degree that your hygienists will.

Now about assistants. If you can find a good assistant with experience in a dental office then great. But if you can't then learn how to train a good assistant. My best assistants were young women barely out of High School who were also single mom's. I usually found them working full time at a grocery store or Wal-Mart.

A young woman who has no husband, has a very young child and still manages to go out and get a full time job is someone you will not have to teach how to work. She could be sitting on her butt making babies in the trailer park and living off of welfare, but instead she is working her ass off in some low paying dead end job because she wants a better life.

I would usually have them come observe for a month or two just to see if they were going to be OK with dentistry and to see how professional they would be in the office. If they did OK then I would hire them and have them work in the front office and learn how to do that job and I would pay their tuition to attend Dental Assisting school at night. I would also start working them in the back to get them familiar with the job that they will be doing. Once they passed the RDA exam I would move them into the back to assist.

I have probably trained 10 assistants that way. All of them are still in dentistry. 3 of them went on to become assistants. When you do this you are taking a hard worker and giving them a career instead of a long line of dead end , soul crushing jobs. And you usually wind up with an extremely loyal and hard working employee

This info is invaluable. I mean, its just ingenious. Go to Wal-mart, look for a hardworking girl, teach how to fish and you have a damn grateful and loyal employee who can add to the business and who can better take care of her family - you don't have to go on a mission to Kenya to give back.

Keep dropping gems Big Homie (Hammer) keep dropping gems.

Now, Hammer, how do you decide how to pay your employees. From the very first time I thought about this, I have always wanted to pay my employees extremely well and perhaps better than what is normally paid for their respective positions. I want to support their ambitions and when I do well, I want them to do just as well. How do I determine how to go about this without affecting my income.

 

[8 SNAKE]

Now, Hammer, how do you decide how to pay your employees. From the very first time I thought about this, I have always wanted to pay my employees extremely well and perhaps better than what is normally paid for their respective positions. I want to support their ambitions and when I do well, I want them to do just as well. How do I determine how to go about this without affecting my income.

Sounds like you want to create some type of an incentive system that is based on the performance of the practice.

Hammer, do you have any experience doing something like this?

 

[The Hammer]

Sounds like you want to create some type of an incentive system that is based on the performance of the practice.

Hammer, do you have any experience doing something like this?

Man I love you guys. You ask such great questions, I had totally forgotten to talk about how to pay your employees so I am glad you asked.

OK how do you pay employees? First if you haven't bought Stephen P. Robbins book "The Truth about Managing People" stop reading this thread, go to this link and buy one and read it. Even if you haven't started dental school the information in this book is so valuable that you should read it now and integrate it into your vision. Here's the link

http://www.amazon.com/Truth-About-Managing-People-ebook/dp/B00142KQD4/ref=sr_1_4?ie=UTF8&m=AG56TWVU5XWC2&s=digital-text&qid=1280104222&sr=8-4

Here is the thing about incentives, once you start one your employees will always expect it so be careful what sort of incentives that you give.

After I had owned my practice for a year I started an incentive plan. I would calculate how much the monthly goal would be . I figured out how many days the hygienist were working and calculate that they did 8 adult prophys with Bitewings every day that they worked. Then I calculated how many hours I would work during the month and multiply it by what I wanted to produce per hour ( I started off in 1997 at $175 and hour and when I sold in 2009 I was doing more than $825 an hour). I would add those two numbers together and that would be the monthly goal. Also the front desk would have to have a collections percentage of 98% or better for the month as well. If we produced $5000 over goal at 98% then everyone got a $100 bill. Let me give you an example of the calculation: (the numbers I am using are not real, I used easy numbers to help the calculations be easier to understand)

Production for the month of June 2010
Number of hygiene days: 22
Number of hours worked per day: 8
Hygiene fee for adult prophy with bitewings: $100
Hygiene production: 22 days x 8 hours per day = 176 hours
176 hours x two hygienists = 352 hours x $100 per hour = $35,200 for the month of June

Doctor production: number of days worked = 22 x 8 hours per day = 176 hours

Doctor production per hour goal = $350 x 176 hours = $61,600 production goal for the month of June

Hygiene production goal for June = $35,200
Doctor production goal for June = $61,600

Total production goal for June = $96,800
Incentive goal for June ( $96,800 + $5000) = $101,800
98% of $101,800 = $99,764 for the Month of June
I had 6 staff members at the time so my out of pocket expense was $600. We almost always did the $5000 over the production goal and the staff was always happy to get the money. That was $600 well spent as far as I was concerned. I'm going to next post about the best type of incentives to motivate your staff

 

[JDIZNEY]

Best thread I have ever read! Life Changing. HaHa No but seriously...

 

[KinKs]

Another gem for my jewelry box.

Hammer, what about a base pay. Lets say you decide to hire a new front desk person tomorrow. How would you decide what the starting salary should be. And when you get to that, let me know how you determine raises too.

 

[The Hammer]

Another gem for my jewelry box.

Hammer, what about a base pay. Lets say you decide to hire a new front desk person tomorrow. How would you decide what the starting salary should be. And when you get to that, let me know how you determine raises too.

Base pay is always dependent upon the applicant's previous experience. Usually if they have no experience I'll start them out at $10. If they have experience I'll usually try to match or raise their previous salary.

I would do staff reviews in March. The reviews were just that, I would go over their job performance and make suggestions as to what they needed to change and commend them for what they were doing right.

In June I would do salary reviews. If they had made the improvements that I suggested in March ( if they needed any) I would raise them .25-$1.00 an hour as long as the practice was on track with its financial goals for the years

 

[The Hammer]

OK here's what on the agenda for the upcoming week unless I get sidetracked

1. The Rise and Fall of Dr. Ziggy Hammer and the Spiders From Memphis

2. The best type of incentives to give your employees and the difference between an employee who works for money and an employee who views their salary as an affirmation of their performance

3. Let's Go Get Some MONEY!!

Eventually at some point I am going to give you the secrets on how to hire the absolute best people for your office. If I get sidetracked please remind me. It is invaluable information

 

[The Hammer]

Hello my dental pals, it's story time so gather around the campfire with Uncle Hammer as he recounts his epic struggles to overcome evil wizards, ogres, dragons and crown preps on #30 on a patient with a hyperactive tongue and a hair trigger gag reflex. It's a little story that I like to call.........

Dr. Ziggy Hammer and the Spiders from Memphis
(all apologies to David Bowie)​

Way back in 1989 I was a senior at UT in Knoxville. I was getting a BA in microbiology and zoology with a minor in classics. I was supposed to have graduated in 1988 but I broke my left leg in 8 places on a skiing trip and had to drop out of school for a little while (6 months actually) while my leg healed.

During my convalescence UT went from a quarter system to semesters and my college hours were screwed up. So I decided to become a fifth year senior and get a double major. My fifth year was actually pretty fun, I was working for a concert promoter and living in a frat house and I had a brand new 5.0 Mustang. For a redneck like me it was heaven.

I had entertained the idea of becoming a doctor for sometime. I had shadowed dentists, orthodontists and oral surgeons and I had also worked at an ER to see how I felt about medicine. Eventually I decided that I wanted a Masters in Biology concentrating in physiological genetics which fascinated me. One professor I was working for was looking for the genetic origin of spicule formation in embryonic brittle stars and the other professor I was working for was doing some ground breaking working in recombinant DNA research, using e.coli plasmids as vectors for gene insertion. The modified plasmids' e.coli hosts were then grown in agitation vats and eventually harvested. I spent a lot of time taking care of those stinky vats and it was those vats that eventually made me take the first steps to becoming a dentist.

One Saturday night I had been in the vat lab all day. I had been studying for some test that I had coming up. It was approaching midnight so I took a break and went back to my room. The girl that I was dating at the time was studying economics at Vanderbilt and we had an arrangement that when we were apart for a weekend one of us would call the other at midnight. It was her turn to call me so I went back to my room and waited for her call. Midnight on a Saturday night my frat house was swarming with activity. Some people were going out and some were coming back in. Everybody seemed to be doing something or someone and it all looked like fun to me. I went in my room and my roommate was having sex with his girlfriend in the upper bunk of our bunk beds. I said "Don't mind me" and they didn't, they just kept doing what they had been doing before I got there.

At the stroke of Midnight the phone rings and it is my girlfriend Kim calling from Nashville where it is 11pm. The conversation went something like this:

Me: Hello.
Kim: Hey sweetie what are you doing? (lots of crowd noise in the background)
Me: Oh the usual. Watching Jeff and Lisa screw while talking to you on the phone.
Kim: AGAIN? Do they actually ever go out and do anything?
Me: Nope, they only leave for Cool Ranch Doritos, KY and antibiotics (Kim laughs). So what are you up too.
Kim: Oh well the girls and I met some nice guys from Europe and we have been showing them Nashville. We went to the Boundary and now we're at Mere Bulles (a chic wine bar) drinking wine and watching them try to decide which one of us they are going to try to f$ck. (Kim laughs again)
In the background some dude with an accent says "Come on Kim (he pronounces it KEEM) come back and drink some more wine with us.
Me: Well it looks like Mr. Continental has his eyes on you. Ask him if it is fashionable in Milan to walk around with my foot up his *****. (Kim laughs)
Kim: Oh, don't worry sweetheart, these guys are paying for everything and once they run out of money, I run out the door. International relationships are for the UN not the K I M.
Me: Well cool then, I've got to get back to my vats and I'll let you get back to the Euro-trash. I love you.
Kim: I love you too have fun in the lab. (Kim hangs up)

Once I got back to the vat lab I was feeling depressed. "So this is what my life has come to," I thought to myself. While my girlfriend was out having fun scamming wine off of some European doucebags who were trying to establish international trade relations with my girlfriends private parts I was watching vats full of e.coli ever so slightly jiggle. It was at that moment that I had a profound WTF epiphany. I thought to myself "WTF am I doing? I don't want to spend the next 3 years stuck in a lab much less the rest of my life here. I'm going to apply to dental school first thing in the morning." And that's exactly what I did.

The story continues in my next post.........

 

[New2Philly]

Hello my dental pals, it's story time so gather around the campfire with Uncle Hammer as he recounts his epic struggles to overcome evil wizards, ogres, dragons and crown preps on #30 on a patient with a hyperactive tongue and a hair trigger gag reflex. It's a little story that I like to call.........

Dr. Ziggy Hammer and the Spiders from Memphis
(all apologies to David Bowie)​

Way back in 1989 I was a senior at UT in Knoxville. I was getting a BA in microbiology and zoology with a minor in classics. I was supposed to have graduated in 1988 but I broke my left leg in 8 places on a skiing trip and had to drop out of school for a little while (6 months actually) while my leg healed.

During my convalescence UT went from a quarter system to semesters and my college hours were screwed up. So I decided to become a fifth year senior and get a double major. My fifth year was actually pretty fun, I was working for a concert promoter and living in a frat house and I had a brand new 5.0 Mustang. For a redneck like me it was heaven.

I had entertained the idea of becoming a doctor for sometime. I had shadowed dentists, orthodontists and oral surgeons and I had also worked at an ER to see how I felt about medicine. Eventually I decided that I wanted a Masters in Biology concentrating in physiological genetics which fascinated me. One professor I was working for was looking for the genetic origin of spicule formation in embryonic brittle stars and the other professor I was working for was doing some ground breaking working in recombinant DNA research, using e.coli plasmids as vectors for gene insertion. The modified plasmids' e.coli hosts were then grown in agitation vats and eventually harvested. I spent a lot of time taking care of those stinky vats and it was those vats that eventually made me take the first steps to becoming a dentist.

One Saturday night I had been in the vat lab all day. I had been studying for some test that I had coming up. It was approaching midnight so I took a break and went back to my room. The girl that I was dating at the time was studying economics at Vanderbilt and we had an arrangement that when we were apart for a weekend one of us would call the other at midnight. It was her turn to call me so I went back to my room and waited for her call. Midnight on a Saturday night my frat house was swarming with activity. Some people were going out and some were coming back in. Everybody seemed to be doing something or someone and it all looked like fun to me. I went in my room and my roommate was having sex with his girlfriend in the upper bunk of our bunk beds. I said "Don't mind me" and they didn't, they just kept doing what they had been doing before I got there.

At the stroke of Midnight the phone rings and it is my girlfriend Kim calling from Nashville where it is 11pm. The conversation went something like this:

Me: Hello.
Kim: Hey sweetie what are you doing? (lots of crowd noise in the background)
Me: Oh the usual. Watching Jeff and Lisa screw while talking to you on the phone.
Kim: AGAIN? Do they actually ever go out and do anything?
Me: Nope, they only leave for Cool Ranch Doritos, KY and antibiotics (Kim laughs). So what are you up too.
Kim: Oh well the girls and I met some nice guys from Europe and we have been showing them Nashville. We went to the Boundary and now we're at Mere Bulles (a chic wine bar) drinking wine and watching them try to decide which one of us they are going to try to f$ck. (Kim laughs again)
In the background some dude with an accent says "Come on Kim (he pronounces it KEEM) come back and drink some more wine with us.
Me: Well it looks like Mr. Continental has his eyes on you. Ask him if it is fashionable in Milan to walk around with my foot up his *****. (Kim laughs)
Kim: Oh, don't worry sweetheart, these guys are paying for everything and once they run out of money, I run out the door. International relationships are for the UN not the K I M.
Me: Well cool then, I've got to get back to my vats and I'll let you get back to the Euro-trash. I love you.
Kim: I love you too have fun in the lab. (Kim hangs up)

Once I got back to the vat lab I was feeling depressed. "So this is what my life has come to," I thought to myself. While my girlfriend was out having fun scamming wine off of some European doucebags who were trying to establish international trade relations with my girlfriends private parts I was watching vats full of e.coli ever so slightly jiggle. It was at that moment that I had a profound WTF epiphany. I thought to myself "WTF am I doing? I don't want to spend the next 3 years stuck in a lab much less the rest of my life here. I'm going to apply to dental school first thing in the morning." And that's exactly what I did.

The story continues in my next post.........

Have you ever thought of becoming a humor novelist? This is really entertaining, and dentistry and humor have traditionally has had a good relationship.....

Also, I like your bonus scheme that you mentioned in a earlier post ($100/mo for going $5000 over goal). It reminded me of a study that was done a few years ago where they found that small rewards given throughout the year is more encouraging then one big bonus given after a review. I am sorry I don't remember the details...
Thanks for the info

 

[The Hammer]

Have you ever thought of becoming a humor novelist? This is really entertaining, and dentistry and humor have traditionally has had a good relationship.....

Also, I like your bonus scheme that you mentioned in a earlier post ($100/mo for going $5000 over goal). It reminded me of a study that was done a few years ago where they found that small rewards given throughout the year is more encouraging then one big bonus given after a review. I am sorry I don't remember the details...
Thanks for the info

Have you read "The Truth About Managing People" by Stephen P. Robbins? Get it and read it NOW!! I'm not kidding, that is the best book about doing things like what you mentioned to motivate your staff. It is great!

As an aside my father managed the floor of a large company that built parts for planes, wings, tails etc. He worked 100% with men. One day I asked him what his managerial philosophy was. He said "Some men manage using a carrot tied to a stick. I find the stick works better all by itself"

 

[New2Philly]

Have you read "The Truth About Managing People" by Stephen P. Robbins? Get it and read it NOW!! I'm not kidding, that is the best book about doing things like what you mentioned to motivate your staff. It is great!

As an aside my father managed the floor of a large company that built parts for planes, wings, tails etc. He worked 100% with men. One day I asked him what his managerial philosophy was. He said "Some men manage using a carrot tied to a stick. I find the stick works better all by itself"

Thanks for the book idea, I will definitely get it.

 

[Blue Panther]

Hammer, can you quickly comment on your physical health and how you have maintained your health while practicing dentistry. I ask because I work out regularly but have had problems with my lower back and I am only 23.

 

[JPevzner]

Hello my dental pals, it's story time so gather around the campfire with Uncle Hammer as he recounts his epic struggles to overcome evil wizards, ogres, dragons and crown preps on #30 on a patient with a hyperactive tongue and a hair trigger gag reflex. It's a little story that I like to call.........

Dr. Ziggy Hammer and the Spiders from Memphis
(all apologies to David Bowie)​

Way back in 1989 I was a senior at UT in Knoxville. I was getting a BA in microbiology and zoology with a minor in classics. I was supposed to have graduated in 1988 but I broke my left leg in 8 places on a skiing trip and had to drop out of school for a little while (6 months actually) while my leg healed.

During my convalescence UT went from a quarter system to semesters and my college hours were screwed up. So I decided to become a fifth year senior and get a double major. My fifth year was actually pretty fun, I was working for a concert promoter and living in a frat house and I had a brand new 5.0 Mustang. For a redneck like me it was heaven.

I had entertained the idea of becoming a doctor for sometime. I had shadowed dentists, orthodontists and oral surgeons and I had also worked at an ER to see how I felt about medicine. Eventually I decided that I wanted a Masters in Biology concentrating in physiological genetics which fascinated me. One professor I was working for was looking for the genetic origin of spicule formation in embryonic brittle stars and the other professor I was working for was doing some ground breaking working in recombinant DNA research, using e.coli plasmids as vectors for gene insertion. The modified plasmids' e.coli hosts were then grown in agitation vats and eventually harvested. I spent a lot of time taking care of those stinky vats and it was those vats that eventually made me take the first steps to becoming a dentist.

One Saturday night I had been in the vat lab all day. I had been studying for some test that I had coming up. It was approaching midnight so I took a break and went back to my room. The girl that I was dating at the time was studying economics at Vanderbilt and we had an arrangement that when we were apart for a weekend one of us would call the other at midnight. It was her turn to call me so I went back to my room and waited for her call. Midnight on a Saturday night my frat house was swarming with activity. Some people were going out and some were coming back in. Everybody seemed to be doing something or someone and it all looked like fun to me. I went in my room and my roommate was having sex with his girlfriend in the upper bunk of our bunk beds. I said "Don't mind me" and they didn't, they just kept doing what they had been doing before I got there.

At the stroke of Midnight the phone rings and it is my girlfriend Kim calling from Nashville where it is 11pm. The conversation went something like this:

Me: Hello.
Kim: Hey sweetie what are you doing? (lots of crowd noise in the background)
Me: Oh the usual. Watching Jeff and Lisa screw while talking to you on the phone.
Kim: AGAIN? Do they actually ever go out and do anything?
Me: Nope, they only leave for Cool Ranch Doritos, KY and antibiotics (Kim laughs). So what are you up too.
Kim: Oh well the girls and I met some nice guys from Europe and we have been showing them Nashville. We went to the Boundary and now we're at Mere Bulles (a chic wine bar) drinking wine and watching them try to decide which one of us they are going to try to f$ck. (Kim laughs again)
In the background some dude with an accent says "Come on Kim (he pronounces it KEEM) come back and drink some more wine with us.
Me: Well it looks like Mr. Continental has his eyes on you. Ask him if it is fashionable in Milan to walk around with my foot up his *****. (Kim laughs)
Kim: Oh, don't worry sweetheart, these guys are paying for everything and once they run out of money, I run out the door. International relationships are for the UN not the K I M.
Me: Well cool then, I've got to get back to my vats and I'll let you get back to the Euro-trash. I love you.
Kim: I love you too have fun in the lab. (Kim hangs up)

Once I got back to the vat lab I was feeling depressed. "So this is what my life has come to," I thought to myself. While my girlfriend was out having fun scamming wine off of some European doucebags who were trying to establish international trade relations with my girlfriends private parts I was watching vats full of e.coli ever so slightly jiggle. It was at that moment that I had a profound WTF epiphany. I thought to myself "WTF am I doing? I don't want to spend the next 3 years stuck in a lab much less the rest of my life here. I'm going to apply to dental school first thing in the morning." And that's exactly what I did.

The story continues in my next post.........

So you basically decided to apply to dental school because you were tired of staring at boring-ass microorganisms and wanted to have that player lifestyle while messing around with people's teeth. I like your style.

 

[The Hammer]

So you basically decided to apply to dental school because you were tired of staring at boring-ass microorganisms and wanted to have that player lifestyle while messing around with people's teeth. I like your style.

Dentistry had the hours, the money and the mix of business and healthcare that I liked. I love to be around people and I could not imagine spending 18 hours in a lab and maybe talking to one other person. Being able to keep bankers hours and still make well into the 6 figures was what really seals the deal

 

[The Hammer]

Oh boy, can't wait for Monday!

The logo looks sweet by the way. Did you do it yourself?

Thanks! Yes I designed the logo. I designed the logo for my last practice as well. I find that people feel like they are getting something special when they go to a dental office called something other than the doctors name. Think about it, if you needed dental work and you were looking in the yellow pages which one would appeal to you:

Dr. Tim Kaplan DDS
Family and Cosmetic Dentistry

or

Tennessee Center for Restorative Dentistry
Dr. I.M. Hammer DDS

 

[The Hammer]

Hammer, can you quickly comment on your physical health and how you have maintained your health while practicing dentistry. I ask because I work out regularly but have had problems with my lower back and I am only 23.

I married a Physical Therapist so I got some personal attention. My ex-wife help me a lot with proper posture while I worked. In addition to proper posture I also used high powered loops (3.5 eventually to 6) Good lights and a great dentist chair that supported my lower back. And I can't stress the importance of stretching especially your lower back. Anytime that I get out of my chair I make my hands into fists and press them in my lower back. Then I lean back while pressing my fists into my lower back and hold that position for 30 seconds that really seemed to help

 

[joyride]

I married a Physical Therapist so I got some personal attention. My ex-wife help me a lot with proper posture while I worked. In addition to proper posture I also used high powered loops (3.5 eventually to 6) Good lights and a great dentist chair that supported my lower back. And I can't stress the importance of stretching especially your lower back. Anytime that I get out of my chair I make my hands into fists and press them in my lower back. Then I lean back while pressing my fists into my lower back and hold that position for 30 seconds that really seemed to help

Hammer you're dead on about the loupes. I just switched last week from 2.5x to 4.3x with a really really powerful headlight and my posture completely changed overnight.

 

[The Hammer]

Hammer you're dead on about the loupes. I just switched last week from 2.5x to 4.3x with a really really powerful headlight and my posture completely changed overnight.

Its funny but I bought the 6x while I was teaching at Midwestern and all the students were saying "why did you get such powerful loops? Are your eyes getting old?"LOL

The better I see the less I have to move and the better my back feels at the end of the day/

Also I used these chairs and I loved them, they really supported my back

http://www.rgpdental.com/

And check out this website for orthopedic solutions for dentists

http://www.posturedontics.com/index.php

 

[8 SNAKE]

Hammer, have you read Jack Stack's The Great Game of Business? If so, I'd like to hear your philosophy and/or application of open-book management in a dental practice.

 

[The Hammer]

Hammer, have you read Jack Stack's The Great Game of Business? If so, I'd like to hear your philosophy and/or application of open-book management in a dental practice.

I haven't read it but if you can explain its basic premise I'll tell you what I think about it

 

[beta]

Hello Mr. Hammer,

Excellent thread! I hope you have time to keep posting
just a silly question: you mentioned some numbers after subtracting the overhead, the money for the loan etc. that was the office profit for the month. did you include a salary for you as a dentist in the overhead or it is out of the office profit number you got in the end after subtracting all the things mentioned ? thank you, and sorry for the silly q.

 

[The Hammer]

Hello Mr. Hammer,

Excellent thread! I hope you have time to keep posting
just a silly question: you mentioned some numbers after subtracting the overhead, the money for the loan etc. that was the office profit for the month. did you include a salary for you as a dentist in the overhead or it is out of the office profit number you got in the end after subtracting all the things mentioned ? thank you, and sorry for the silly q.

Normally the doctor would have a "draw" which is a salary included in the overhead. In my examples I didn't include the draw in the overhead because I was wanting to give an extreme example. If you have 65% overhead and aren't getting a draw can you still pay off your loan and make enough money to live off of. If you can then you are going to be fine. If you can't you may be ok but you may also have a couple of lean months and you might not be able to take a paycheck. I always try to figure out what is the worst thing that can happen and how best to manage it.

 

[Seahawk]

Thanks! Yes I designed the logo. I designed the logo for my last practice as well. I find that people feel like they are getting something special when they go to a dental office called something other than the doctors name. Think about it, if you needed dental work and you were looking in the yellow pages which one would appeal to you:

Dr. Tim Kaplan DDS
Family and Cosmetic Dentistry

or

Tennessee Center for Restorative Dentistry
Dr. I.M. Hammer DDS

Never thought about that before. Definitely sounds much better/more upscale and sophisticated.

I would definitely choose option #2 if I was some random person looking for a dentist.

 

[DrReo]

Normally the doctor would have a "draw" which is a salary included in the overhead. In my examples I didn't include the draw in the overhead because I was wanting to give an extreme example. If you have 65% overhead and aren't getting a draw can you still pay off your loan and make enough money to live off of. If you can then you are going to be fine. If you can't you may be ok but you may also have a couple of lean months and you might not be able to take a paycheck. I always try to figure out what is the worst thing that can happen and how best to manage it.

What percent do you typically pay yourself then?

Also, what do you typically do with the remaining money? Any tips and tricks?

 

[David1991]

I'm very strongly considering joining a frat next year as a sophomore because, although my grades were very good last year, I felt like I had no social life between all the studying, classes, sleeping, working out, etc.. other than occasionally catching a meal with some friends. Some people have told me "your grades will drop" and that it might not be smart but I've also heard it's a good idea. I found out this week that my dentist actually joined a frat, but I know it wasn't as competitive then and I think he took some time off before going back.

But it looks like it went well for you? Were you in the frat early on or only in the 5th year, and how did it affect school performance?

Thanks!

 

[BrainsOut]

I'm sorry for my absence - I've undergone surgery. Anyways, I'm coming back with a few questions for now and hope they're not too late:

1. Hammer, who is your target customer - are they white or blue collar?
One might say why would these two be mutually exclusive, but I think in the long run you have to project an image that is more inclined toward one of them, and secondly, you had to prefer one of those when choosing and rebuilding your practice.
So far you've spoken in favor of blue collars, and there are many obvious benefits, e.g. they have bigger dental needs, but at the same time you've pointed out that average income in the office's area is a key factor.
So how do you choose to balance these two?

2. Are you going to hire an associate? How do you foresee the overhead might change? How does it change usually?

3. In the previous practice you had a distinct separation in terms of what procedures which one of you two is going to perform, are you going to introduce a similiar scheme in TCfRD?

3. You're stressing the restorative part of dentistry in the name of your practice. Are you going to eschew surgery etc completely? Will you continue to build your practice image and market it based on that?

4. Since you've mentioned it a couple of times, are implant restorations going to be a huge part of your business? How much more expertise these procedures require than the regular crowns and bridges. What percentage of GPs does that? In my country, in an upper-middle class dental office (thats how I divide them a typical fee for an implant is ca. $1200 and then the crown with that ca. $900. Is it similarly profitale in the US?

5. The previous doc in #3 had pretty laid back hours. What will your hours look like? Are you going to work full time from the start? If not, how will you manage your stuff, as they might feel shortchanged for not having the opportunity to earn as much money as they could.

Take your time

Thank you for giving out so much to the community
Also, when are you going to start the office? What is slowing you down right now?

 

[8 SNAKE]

I haven't read it but if you can explain its basic premise I'll tell you what I think about it

The premise is an open-book style of management where you would literally go through all of the line items in your practice's books at regular intervals with everyone in the practice. You would also make sure that each member of your team understood exactly how his/her role impacted the numbers. The idea is to have a staff who is educated in how your business operates so that your meeting become like a scorecard in a game. Since the players (employees) know all of the rules, they can get their heads in the game and have fun winning (making the business money). Obviously, the employees would also have a vested financial interest in the success of the business.

It sounds like you did that to some extent (and maybe all the way) with the incentive system that you had in your former practice. I'm just not sure to what extent you went through the numbers with your employees.

 

[grt398]

This is one of the most fascinating threads I've ever come across. It needs to be sticky'd and you should strongly consider condensing this stuff into some kind of book. I'm not even pre-dental and I'm riveted. Please keep up the posting, a lot of this stuff is good for ANY independently owned business.

 

[The Hammer]

Hey everybody sorry for the absence, I'll be traveling again tomorrow but hopefully I will be able to answer some more questions and post Part 2 of Dr. Ziggy Hammer and the Spiders from Memphis. Or "How Dressing up as Count Chocula one summer got me into Dental School.

 

[The Hammer]

OK I will address all of the questions that you guys have asked but since my brain is on autopilot I'll just continue my dental saga:

Part 2 - Getting into Dental School using a Fax Machine

So late on that Saturday night I decided I was going to dental school. The following week I filled out all the proper applications, got my referral letters and all of that stuff and mailed it off to UT Memphis. There was just one problem. The deadline for the dental school applications was February 28, I had mailed my application in the first week of May. D'oh!

So the first week of June my girlfriend and I go and spend a week in Florida and when we get back home there is a letter from UT Memphis in my mailbox. My girlfriend says "Looks too thin to be anything but a rejection letter" and she was right. It basically said "Thanks for applying but you missed the deadline by 2 months please reapply in September." Oh well I thought, I'll just continue towards a masters and see what happens.

Then I had a thought. I thought, well I am going to send the Dean of Admissions a letter expressing my disappointment and my desire to apply in the Fall. If nothing else it will get my name in front of this guy's face so that maybe he will remember me when I reapply. So I took a nice piece of stationary and typed out (yes I used a typewriter) a letter that basically said "Dear Dean Dowdle, I am disappointed that I missed the deadline but I'll apply again this fall if you have any suggestions that would make me a more competitive candidate please give me a call Hugs and Kisses, I.B. Hammer 555-555-5555."

Then I thought "what will make sure that this lands in his hands and not just the trash?" Well at that time faxes were the new cool thing (this was 1989) and it just so happened that I had access to one (at least when the real users weren't looking). So I made a very official coversheet using the UT Knoxville's presidents stationary and put something like "Urgent for your eyes only" and put Dean Dowdle's name on it and faxed it off to him. Well apparently my scheme worked because he called me the next day.

We had a nice talk and basically he reiterated that I had sent my application in too late and that they already had the class set at 70 and if any of those students dropped out they had a waiting list as well but I should reapply in the fall. I thanked him for his time and told him that if he could think of anything that would help me to get in to please let me know. He said he would and hung up.

So now what was I going to do? Well if my fax scheme worked once it should work again so I made another cover sheet using the Presidents stationary and put a message like "Urgent, please review immediately" and faxed it off a letter thanking the Dean for his call. About a week later he called again and commended me on my persistance and asked me "to please stop faxing him because when the secretary sees that it is from UT's President she about kills herself running up the stairs to get the fax to him immediately." I told him I would. He then said "Well if you aren't doing anything on July 13th why don't you come down and I'll give you a tour of campus. The dental school is closed that week so it will be a great time to get a tour. I said I would.

It just so happened that my visit was on a Thursday and I had a Physics test on Friday. So I borrowed $560 from my mom and bought a round trip ticket from Knoxville to Memphis leaving on Thursday morning and coming home Thursday evening. Dean Dowdle told me that he would just be showing me around so to dress casual so I wore a pair of khakis and a white button down shirt. I had my roommate drive me to the airport in Knoxville and I boarded the plane. 50 minutes later we touched down in Memphis and I got a taxi over to the dental school with 30 minutes to spare.

To be continued......................

 

[Blue Panther]

I wish I was back in 1989. Admission folks were so much nicer back then.......

 

[The Hammer]

What percent do you typically pay yourself then?

Also, what do you typically do with the remaining money? Any tips and tricks?

My draw was usually based on what my living expenses were. For example if my mortgage, my utilities and other assorted bills all amounted to $4000 a month then I would usually make my draw $6000-7000. The rest of the money went into maxing out my retirement, reinvesting in the practice etc. As for tricks or tips just hire a very good business savvy accountant who helps you take advantage of the ever changing tax laws.

 

[The Hammer]

I'm very strongly considering joining a frat next year as a sophomore because, although my grades were very good last year, I felt like I had no social life between all the studying, classes, sleeping, working out, etc.. other than occasionally catching a meal with some friends. Some people have told me "your grades will drop" and that it might not be smart but I've also heard it's a good idea. I found out this week that my dentist actually joined a frat, but I know it wasn't as competitive then and I think he took some time off before going back.

But it looks like it went well for you? Were you in the frat early on or only in the 5th year, and how did it affect school performance?

Thanks!

I joined a frat at the end of my second year of college to meet girls. My grades actually improved but it had more to do with the fact that I wasn't touring in a band and was actually attending classes. Also I never studied at the frat house, I always camped out at the library to study and I kept regular hours there. I had study hours set aside just like a job so when I was home I was away from school.

I really liked being in a frat but I tend to enjoy being around people. I don't know how it is at your school but at my school the mid-80's was the last hurrah for frats and they definitely have been on the decline since. I would definitely looking it before rushing. Is the house that you are interested in one that will expand your social network or is it full of douche bag date rapists who will draw penises on your face with a Sharpie the first time that you pass out? These are important questions to ask before you join

 

[TJNova2011]

My draw was usually based on what my living expenses were. For example if my mortgage, my utilities and other assorted bills all amounted to $4000 a month then I would usually make my draw $6000-7000. The rest of the money went into maxing out my retirement, reinvesting in the practice etc. As for tricks or tips just hire a very good business savvy accountant who helps you take advantage of the ever changing tax laws.

Where does the other 35% go then? Just sits in the bank. You do include your $4-7k in your overhead (65%) calculations, correct?

 

[The Hammer]

Where does the other 35% go then? Just sits in the bank. You do include your $4-7k in your overhead (65%) calculations, correct?

Yep. All salaries including your draw are included in your overhead.

 

[The Hammer]

I'm sorry for my absence - I've undergone surgery. Anyways, I'm coming back with a few questions for now and hope they're not too late:

1. Hammer, who is your target customer - are they white or blue collar?
One might say why would these two be mutually exclusive, but I think in the long run you have to project an image that is more inclined toward one of them, and secondly, you had to prefer one of those when choosing and rebuilding your practice.
So far you've spoken in favor of blue collars, and there are many obvious benefits, e.g. they have bigger dental needs, but at the same time you've pointed out that average income in the office's area is a key factor.
So how do you choose to balance these two?

2. Are you going to hire an associate? How do you foresee the overhead might change? How does it change usually?

3. In the previous practice you had a distinct separation in terms of what procedures which one of you two is going to perform, are you going to introduce a similiar scheme in TCfRD?

3. You're stressing the restorative part of dentistry in the name of your practice. Are you going to eschew surgery etc completely? Will you continue to build your practice image and market it based on that?

4. Since you've mentioned it a couple of times, are implant restorations going to be a huge part of your business? How much more expertise these procedures require than the regular crowns and bridges. What percentage of GPs does that? In my country, in an upper-middle class dental office (thats how I divide them a typical fee for an implant is ca. $1200 and then the crown with that ca. $900. Is it similarly profitale in the US?

5. The previous doc in #3 had pretty laid back hours. What will your hours look like? Are you going to work full time from the start? If not, how will you manage your stuff, as they might feel shortchanged for not having the opportunity to earn as much money as they could.

Take your time

Thank you for giving out so much to the community
Also, when are you going to start the office? What is slowing you down right now?

1. My target customer is usually white collar, usually in their late 40s-60s. The "blue collar" that I usually see are people in this same age group who simple have worked hard, put their kids through school and saved their money. I don't necessarily market towards either blue or white collar but more towards people who need a certain type of restorative care.

2. I've thought about hiring an associate and it fact one of my early associates has asked if I would be interested in them coming back to work for me. To be honest I haven't decided if I am going to hire another associate or not. I am going to give it a year and see how busy I am and how much of the type of work that I like I am doing.

Typically an associate will raise your overhead because they typically have a higher salary than your other employees. But usually this higher overhead is offset by keeping your office opening more hours or when you are on vacation or out at a CE.

3. In my previous office I turned the general dentistry over to my partner while I did the bigger cases. I would like to still do more of the bigger stuff but I can't really say right now if it will work out that way. I may have to do some single tooth work while I'm getting re-established

I will stress the restorative dentistry more so than "family dentistry" or "cosmetic dentistry". To be honest I think that both those terms are played out and are virtually meaningless to the general public. I might do some surgery as I did in my last practice but most of the time I am working in conjunction with the OS, the ortho et al.

4. Since I am wedged between the two oral surgery offices and perio offices that I did the majority of their implant restoration for I'm hoping it will be a major part of my practice again. I usually charge $1200-1500 for the crown and abutment for a single implant. And the more complex the case obviously the more that I charge. I don't place implants however.

5. I am going to work full time from the start. Mon-thurs 8-5 and Friday 7-3. I got bills to pay!

 

[David1991]

I joined a frat at the end of my second year of college to meet girls. My grades actually improved but it had more to do with the fact that I wasn't touring in a band and was actually attending classes. Also I never studied at the frat house, I always camped out at the library to study and I kept regular hours there. I had study hours set aside just like a job so when I was home I was away from school.

I really liked being in a frat but I tend to enjoy being around people. I don't know how it is at your school but at my school the mid-80's was the last hurrah for frats and they definitely have been on the decline since. I would definitely looking it before rushing. Is the house that you are interested in one that will expand your social network or is it full of douche bag date rapists who will draw penises on your face with a Sharpie the first time that you pass out? These are important questions to ask before you join

lol thanks a lot. I do definitely want to join one just to force myself to be more social (way too much alone time studying last year) but I'm also definitely worried about a drop in grades and honestly am not big on drinking a lot. I guess I'll see how rushing goes before I decide on any to pledge. And no penises on my face is a requirement

 

[The Hammer]

OK time for more killer and less filler so I am pleased to present

Let's go to the BANK!!​

This is going to be several posts because I am not going to leave any detail no matter how small out.

OK so you have found a practice that you really like and you and the seller have decided on a price. You have gotten estimates on the improvements that you intend on making and you know how much working capital you are going to need. You have a figure in mind of the amount that you need to borrow so it is time to find a lender.

1. USE A LENDER THAT SPECIALIZES IN DENTAL LOANS: A dental loan is not like your typical small business loan. Since most small business fail within 5 years a typical small business loan requires secured collateral. Most new grads don't have any collateral other than maybe a car. Also a new grad typically has a ton of unsecured debt (usually school debt). So to a bank you are a horrible candidate for a small business loan.

But don't despair, because lenders who specialize in lending to dentists know something that the Clydes at the other banks don't know, that is dental offices are a sure bet. Of all the small businesses out there dental offices rarely go bankrupt. Usually only if the dentist has severe health problems or loses their license to practice.

Even if the dentist dies there is insurance to pay back the loan. Even though you already have a lot of debt and are about to assume more debt, as a dentist in private practice you have an enormous potential to earn a lot of money. Also the typical new grad is in their late twenties and in good physical health and is ready to work hard. The dental lenders know this and know that they will get their money back.

So when it comes time for looking for a lender be sure to use the ones that have a history of dental lending. The practice broker should also have some good suggestions on who to use. Also make sure you look at several lenders to see who will give you the best deal.

Right now I am working with Matsco and Bank Of America for my loan. If you go to the ADA website they can give you more lenders that they endorse.

Here is a great article about dental loans that I would suggest printing off and keeping

http://www.aaid-implant.org/uploads/cms/documents/practice_management_selling_or_buying_a_practice.pdf

OK next post, what information you will need to have before you go looking for a loan

 

[youknowthedrill]

Now I know how addicts must feel- I can't wait to get my next fix!

One quick question about dental practice loans- Is it possible to lock into a fixed rate for the longevity of the loan, or are the rates variable?

Please keep the great info coming.

 

[The Hammer]

Now I know how addicts must feel- I can't wait to get my next fix!

One quick question about dental practice loans- Is it possible to lock into a fixed rate for the longevity of the loan, or are the rates variable?

Please keep the great info coming.

Most are fixed. what you want to find is one that has no pre-pay penalty

 

[nitrolegs]

OK time for more killer and less filler so I am pleased to present

Let's go to the BANK!!​

This is going to be several posts because I am not going to leave any detail no matter how small out.

OK so you have found a practice that you really like and you and the seller have decided on a price. You have gotten estimates on the improvements that you intend on making and you know how much working capital you are going to need. You have a figure in mind of the amount that you need to borrow so it is time to find a lender.

1. USE A LENDER THAT SPECIALIZES IN DENTAL LOANS: A dental loan is not like your typical small business loan. Since most small business fail within 5 years a typical small business loan requires secured collateral. Most new grads don't have any collateral other than maybe a car. Also a new grad typically has a ton of unsecured debt (usually school debt). So to a bank you are a horrible candidate for a small business loan.

But don't despair, because lenders who specialize in lending to dentists know something that the Clydes at the other banks don't know, that is dental offices are a sure bet. Of all the small businesses out there dental offices rarely go bankrupt. Usually only if the dentist has severe health problems or loses their license to practice.

Even if the dentist dies there is insurance to pay back the loan. Even though you already have a lot of debt and are about to assume more debt, as a dentist in private practice you have an enormous potential to earn a lot of money. Also the typical new grad is in their late twenties and in good physical health and is ready to work hard. The dental lenders know this and know that they will get their money back.

So when it comes time for looking for a lender be sure to use the ones that have a history of dental lending. The practice broker should also have some good suggestions on who to use. Also make sure you look at several lenders to see who will give you the best deal.

Right now I am working with Matsco and Bank Of America for my loan. If you go to the ADA website they can give you more lenders that they endorse.

Here is a great article about dental loans that I would suggest printing off and keeping

http://www.aaid-implant.org/uploads...e_management_selling_or_buying_a_practice.pdf

OK next post, what information you will need to have before you go looking for a loan

Great stuff hammer...it's definitely going in my newly-created folder labeled "dental legal stuff". I'm also going to add a few links to great articles that that a found from the same author:

"WRITTEN ASSOCIATE DENTIST AGREEMENTS: REQUIRED PROTECTION FOR BOTH PARTIES"

"Successful Strategies in Purchasing or Selling Your Dental Practice"

"SECRETS TO SUCCESSFULLY SECURING THE IDEAL DENTAL OFFICE LEASE
THE “USE” CLAUSE OF THE DENTAL OFFICE LEASE"

enjoy!

 

[Vicarbo]

By the way, the book "The Truth about Managing People" is FREE on Amazon as a Kindle download. http://www.amazon.com/Truth-Managin...QD4/ref=pd_ts_kinc-f_8?ie=UTF8&s=digital-text

Thanks again Hammer!! This thread has better info than my D3 Practice Management course.

 

[The Hammer]

By the way, the book "The Truth about Managing People" is FREE on Amazon as a Kindle download. http://www.amazon.com/Truth-Managin...QD4/ref=pd_ts_kinc-f_8?ie=UTF8&s=digital-text

Thanks again Hammer!! This thread has better info than my D3 Practice Management course.

Thanks for the free link info. That's probably going on my facebook

 

[kdawg]

Hamma,

Found an interesting article where dentaleconomics.com interviews reps from a practice management company, Matsco, and an insurance company about getting a practice loan:

http://www.dentistryiq.com/index/di...issue-6/features/getting-a-practice-loan.html

The article is a year old, so I wonder how applicable the info is. If you have time I would love your input on how accurate their responses are compared to how your recent experience has been. I was especially surprised to see that there are loan limits for new dentists of around $375,000. Is this true?

And while I'm on the subject, what are the major differences/factors that a new grad faces when trying to buy a practice compared with an experienced tooth pimp?

 

[noles]

hey hammer could you go into more detail about what makes up the 65% overhead? for example what % of that 65 is salary, supplies, rent, CPA fees, maintenance, advertising/marketing, etc. i know these can all vary greatly but rough estimates would work, i'm just trying to get an idea of what it comprises of.

also, so as the dentist/owner per MONTH you take a draw/salary of aprox. $6k (included in the 65% overhead) then there is the aprox. $10k (which is the other 35%). do you distribute this 10k to yourself monthly or does it remain in the corp as retained earnings until the end of the year where you would use this money to invest/upgrade the office and then distribute the remainder to yourself?

thanks