You’ve Closed … Now What?

Part One: Staffing

“But we’ve always done it this way.” Really, is there a more dreaded phrase for the new owner of a dental practice?

Like it or not, chances are good you can expect to hear just that when you take over an existing practice. That’s because when the business is sold, often the staff is the last to know. And most people just don’t like change.

Acquiring a practice also means acquiring the people who come along with it. Since the doctor selling her practice wants to put everything in a positive light to make the sale, she may over exaggerate the staff’s experience, competence or satisfaction – promising you a well-oiled machine that patients adore. 

Whatever the reason a dentist sells their practice, you won’t get to meet the staff until the sale is final and they introduce you as the new owner/boss. I like it best when they do this immediately after dropping the bombshell that they are moving on, before too much behind-the-scenes gossip and speculation can occur. It’s only natural that people will want to know how this will affect them – will they get fired? Suffer a pay cut? Lose their benefits? 

It’s important to greet each new staff member with an open mind and to remember that while you have known about this sale for a while, it’s still quite new to them. I always start out by complimenting the dentist who is leaving and expressing how much I want to continue their legacy of excellent patient care. I am sincere, enthusiastic and speak from the heart. 

I also let the staff know that I am poised for growth and that I welcome their participation on this journey. Things will change, of course; as opposed to winding down and retiring, I am looking to expand the practice and do more with it. 

After acquiring nine practices, I can always tell, pretty much right off the bat, who will stay and who will go. I’d say about 25 to 50 percent of staff members end up quitting. Some don’t want the increased hours I often require, some don’t like working for a woman, and sometimes it’s just not a good fit. And yes, I brace myself for complaints that, “we’ve never done it this way before — we’ve always done it this way.” I will pull that person aside and respectfully let them know I just don’t want to hear it. I am now part of the we, and this is our new approach. 

I will most likely be offering a different health plan than they’re used to, but in the case of senior staff members I want to keep, I grandfather in their co-pay deal. And I strive to make their hourly jobs feel like a career by offering a more structured benefits package, performance-based bonuses, perks like a 401(K) and incentives to those who recommend a successful new hire.

Sometimes there is absolutely nothing you can do to win over a staffer and it quickly becomes obvious that it’s to both your benefit to part ways. I’ve come to learn that the last thing I want is an unhappy employee who may be badmouthing me to the patients, and that my practice will always grow, even when I am temporarily understaffed. That’s something I wish I could have taught my younger self, who took every resignation personally — and almost tragically.

Multiple Practices Can Mean Multiple Problems

Multiple Practices Can Mean Multiple Problems

When you’re the owner, it’s all on you

Fellow dentists often say to me, “You own multiple practices? Wow, that must mean a lot of passive income!” 

On paper, they’re not wrong. But as any business owner can tell you, there’s not much “passive” about it. Especially when a few of your dentists move out of state and you’re scrambling to fill the gap they left behind.

That’s the situation I found myself in last summer. Not only was I experiencing a high-risk pregnancy (which happily had the best of endings), I was filling in for two dentists who followed their spouses to new, faraway jobs. I was doing my regular schedule as both a hands-on dentist and the owner of nine practices, as well as seeing the patients of the two departed doctors. I added to the schedule of my remaining dentists and brought in some temporary help, but was still working six days a week, 10 to 12 hours a day. And I lost a few patients who did not appreciate seeing a new face every time they sat in the chair (and I don’t blame them one bit; consistency is very important to patients).

I learned a lot through that period – chief of which is that when you’re the owner, the buck stops with you. My wonderful staff was sympathetic and supportive, but virtually all of it came down to me. I was the only one who could jump in and keep things running. My staff was counting on me to smooth the waters and make payroll, patients were counting on me to ensure professional and comfortable treatments, landlords were counting on me for their rent, and the bank was counting on me to pay its note on time. And my unborn daughter was counting on me to stay healthy so she could thrive.

That crazy summer (which had the added challenge of the Covid pandemic) taught me that when it comes down to it, there is just no substitute for hard work, persistence and perseverance. 

Eventually I was able to hire new practitioners (more on that in a future blog) and enjoy four glorious months with my newborn daughter away from the offices. I still handled the myriad administrative duties of my nine practices from home, but I love that aspect of the business – keeping all the parts moving and growing is challenging and fun, like working a puzzle. 

So, what’s the takeaway? Owning multiple practices is not for the faint of heart, and it’s not for everyone. Is it right for you? Here’s some issues to chew on:

  • Are you willing to do whatever it takes to keep the offices going, including working so many hours that your arms are aching and you’re developing a stiff neck from so much hands-on work? 
  • On top of all that work in the chair, can you handle the day-to-day details like the supply chain, equipment and staff issues, scheduling and troubleshooting?
  • Most importantly, can you muster the energy and commitment to coolly and clearly predict new challenges and keep an eye on the big picture so you’re constantly growing the bottom line? 

Of course, ownership has wonderful benefits, too. I love running my own business, encouraging my staff to be their very best and, most of all, providing patients with state-of-the-art care. I wouldn’t change a thing, and that is the very best feeling in the world.

Five Myths Dentists Believe about Owning a Practice

  1. I can’t afford it.
  2. Corporations will buy all the best practices.
  3. Owners have a less flexible lifestyle.
  4. As an associate, “it’s not my problem.”
  5. You’re on your own.

At the age of 15, I knew that I wanted to be a dentist and own my practice. This goal spurred me through dental school and impacted all of my decisions. I saw owning a practice as achievable and desirable. But the more that I mentor young dentists, the more I find that many believe owning their own practice is an unattainable goal, or at best, a long way off in the future. In the face of significant debt, lack of business experience, and limited funds, many new dentists believe that working as an associate is the only viable option. There are some myths about owning a dental practice that is widely believed. I want to take a moment and address the five most common misconceptions that might just be keeping you from stepping into success as a dental entrepreneur.

1.  I can’t afford it.

When you graduate from dental school with debt in the six-figure range taking on more debt to own a business can seem counter-intuitive. Who would give me financing to buy a practice? According to Dental Economics (The Case for Private Practice, Jan. 2019) banks are currently willing to loan money to those purchasing a dental practice, and small business loans are very attainable, even for those carrying large debt. This new debt is the kind that will enable the dentist to pay back their student loans and make a more significant profit.

Let’s look at some numbers. As an associate, your income is limited. You are an employee and earn a salary. Any personal expenses you incur cannot be legally written off on your taxes (i.e., meals, travel, car mileage). According to the Bureau of Labor Statistics, the average salary of a dentist as of May 2018 was $175,840. Of this, a large portion will go towards taxes and paying off student loans.

Fast-forwarding ten years, and a dentist working as an associate may have her student debt paid off.

If the dentist were to purchase a practice however, she can make significantly more. The MDA estimates that 49% of Michigan dental practices have incomes of a million or higher.

Instead of believing that you can’t afford to own dental practice, maybe the reality is, you can’t afford not to!

2. Corporations will buy all the best practices

So, you have your small business loan, and you’re ready to purchase a practice.  Aren’t you going to have to compete with large corporations who can write a check and buy a practice?

In actuality, the fact that you are NOT a corporation will play in your favor. Many retiring dentists would rather sell their business to one owner who will care for their patients and respect the character and culture of the practice.

3. Owners have a less flexible lifestyle

Many believe that owning a practice increases your level of responsibility, and the hours you must work to keep the business running. While some business owners feel the need to micro-manage, this does not have to be the case!

I currently own and operate eight dental practices. I built teams in each office and then empower them to work for my success. As an owner, I create my schedule and choose the hours and days that I want to work.

As an associate, there is less flexibility. You will always be at the mercy of the practice owner and the days and hours they want you to work. Taking time off to travel and enjoy personal pursuits will be limited to a narrow window.

So, in reality, the practice owner will always enjoy more flexibility and freedom than a hired associate.

4. It’s not my problem

It’s easy to assume that as an associate, you would bear less responsibility, both legally and within the organization. The prevailing thought is, “it’s not my problem!” As a respected member of the medical community, an associate is just as vulnerable to malpractice lawsuits.

In this age of social media, associates are just as susceptible to bad reviews on Twitter, Yelp, or Instagram in addition to online rating services like

As an employee, it may not be your problem if the technology, systems, or equipment are not up to par, but it will affect your level of excellence.
And you will not be in a position to effect changes.

The business owner is empowered to solve problems and pursue the highest level of service.

5. You’re on your own

If I purchase a practice, don’t I have to be ready to run every aspect of the business? “I’ve never done payroll or purchased software or managed an office,” you might say.

You have just spent several year studying dentistry and preparing to be a medical professional and may feel at a loss when it comes to the realities of running and owning a business.

The good news is, you don’t have to do it all by yourself!

I can help coach you through the details and share what I have learned on my journey. Let’s talk! 

3 Proven Ways to Find a Dental Practice

When we want to buy a car, we go to a dealership or maybe a website like Carvana. If we need a home, we search to Zillow or we find a real estate agent. For almost any other item, we can usually find it on Amazon, and with Prime it will be there in 2 days.

But, where do we go to buy a dental practice?

1. Personal Network — Your Community

In my experience, when your community knows you are looking for a dental practice, the opportunity may come your way with little effort on your part.

Make sure that your friends know that you are actively seeking a dental practice. My personal network has been the source of several of my practice leads.

2. Trusted Advisors

If you have professional advisors in your life (accountant, lawyer, physician, financial advisor), utilize their networks.

Chances are they have other dentists as clients and may be aware of those desiring to retire. In 2014 the baby-boomer generation began to reach retirement age, so the number of retiring dentists is currently very high.

Advisors also have professional relationships that can assist you; my accountant connected me to a dentist that ended up selling me his practice.

3. Letter of Introduction

This idea may seem “old school” but can be very effective.

Acquire a list of current dentists from your state dental association and send out a letter introducing yourself. Explain that you are looking to purchase, and offer to connect by phone or in person.

Who knows, you may be precisely who a retiring dentist is looking for!



Challenges in Owning Your Own Dental Practice


If you know me at all, you know that I am a huge advocate of dental entrepreneurship. I believe the autonomy of being your own boss creates a life of freedom, flexibility and the opportunity for unlimited financial success.

The reality is, there will be significant challenges along the way.  The biggest learning curves for me happened in the areas of systems organization, human resources, and vendor relationships. Ironically, patient care was the least of my troubles!

Dental school did an excellent job preparing me to care for my patients, but the majority of my business knowledge came in the form of on the job training.

1. Organization

When I transitioned from associate dentist to owning and operating my practice I jumped right into patient care. I was confident that I was serving my patients well, but I didn’t have systems in place for the daily operations of my business. As a result, I didn’t receive timely compensation. I was contacting each patient’s insurance company for the first time on the day of service. The patients were not being asked to pay upfront.

I have since learned that a bit of research into the leading insurance companies can streamline this whole process. Forms and documents are available online to register as a provider with the insurance companies, as well as the necessary forms for the patients.

Create a checklist for your staff, to confirm the insurance company has everything they need to process your request. You can receive electronic payments from most companies. This can reduce the wait time of compensation from weeks to days.

Before your doors open, spend some time researching how you will organize your systems. There are many software options available to ease daily operations and workflow, and it’s much better to have these systems in place before you ever see your first patient.

 2. Human Resources

As a new practice owner, I suddenly found myself hiring and managing employees.  From the person who greets the patients at your front desk, to dental assistants, hygienists, and associate dentists, each team member will affect the success of your practice. I was not prepared for the reality of hiring, firing, and the difficult conversations I needed to have regularly.  Dental school did not teach me how to confront employees who were not behaving professionally or how to negotiate salaries.

One piece of advice I can pass along is to have a clear job description for each staff role, as well as a salary cap. Know exactly who you are looking for to fill each position and an explicit parameter for each salary.

3. Vendor Relationships

To run a successful dental practice you will need to build relationships with a wide range of vendors. From website development to dental supplies and everything in between, knowing who to hire and how to negotiate can save you dollars and headaches. I learned the hard way that you can’t always trust people. I poured a lot of money into a website design only to find out that the marketing person plagiarized the content from another dentist’s site in Texas. You don’t know what you don’t know! Or as Maya Angelou said “When you know better, you do better.” Having a mentor who is experienced in running a dental practice is invaluable. A mentor can introduce you to vetted vendors and you can avoid making costly mistakes.

You can avoid the tough, new business owner lessons . I can help. Let’s connect.