Owning your own Dental Practice. What it was like to start.

Recently I have been taking the time to reconnect with friends in the dental community.  At the Academy of General Dentistry meeting my good friends Esteban and Amanda bit the bullet and purchased their own dental office and recently a dental school classmate of mine Rachel reached out to me asking for some advice.  Most of my time with Esteban was spent updating him on where Katy Trail Dental is now in its time line from start up to seasoned office and geeking out over equipment purchases.  I am so excited for him and Champions Dental and hope he can learn from my experiences and share success.  Rachel wrote me recently and said the following, “I'm starting to get that itch to be an owner and have been preparing for about a year now and looking at practices. Would you mind sharing any advice you've learned along the way?”  My husband, Matt, has mentioned before I should put something together for new practice owners and dentists looking to take the plunge.  I think he is correct so to start, here are the responses I have to Rachel’s first round of questions.  Keep ‘em coming guys!


1.   Did you get a dental specific CPA and lawyer? I feel like the ones that specialize in dental seem to be pretty helpful?

I have had a dental specific CPA for 4 years now.  Michael at Moss, Luss and Womble pretty much runs Matt and my life.  They are excellent and work with clients local and remotely.  Over the past four years Michael has helped Matt and I establish savings parameters, goals and habits as well as limit our spending.  He advised us on life insurance options, disability options, helped with our wills and testaments, helped weigh practice options and did a full analysis of every practice we were interested in acquiring.  He saved me from investing in potentially doomed practices and has helped us live below our means but not on the level of poverty although we joke that I am a dentist on welfare.  At the same time he encourages us to travel and break away from the strict guidelines he has in place for us.  Michael is our confidant and friend and we value his opinion.  I fully trust his suggestions and know he wants us to succeed.  This isn’t a plug for Michael as he isn’t taking new clients but his firm always is.  I bring up my relationship with Michael because you need a good relationship with your CPA.  There were so many questions I had and so many phone calls we needed to arrange to discuss options as these are huge decisions (and transactions) that you want to have conviction behind every one! 


Joe is my attorney at McGregor & Oblad and I can not say enough good things about him.  He may not be versed in Florida laws but I trust Joe with my life although he tells me constantly that this is stupid because he is an attorney and trusts no one, not even his mother!  Joe has been an integral part of my practice start-up.  He too reviewed everything with me and educated me on every part of my lease, loan documentation, employee manual, the list goes on.  He prides himself on being flat fee meaning he charged me once for the entire process a set amount at the end.  He lost on my case with the amount of phone calls we had. 


2.   Did you start from scratch or buy an existing?

I wanted to purchase and purchasing the right practice is economically a smarter decision as you are buying the existing patients and most of my every day is building a reputation in my start up and acquiring new patients.  I am ALWAYS marketing, promoting.  It is a lot, there is no lie.  However, I couldn’t find the right practice.  They were either overpriced, or the dentist wasn’t ready to retire and wanted to transition which would be great if the practice could support two doctors but most can’t.  Many had internal operational issues and flaws that I would meet resistance trying to change or had overpaid employees and high overhead.  That is great after years of service to reward those that have helped you but as a new owner your overhead will be twice the previous owner’s overhead as you will have a hefty practice loan that was needed for the transition.  All that being said, I started from “scratch.”  I found a dental space and old equipment and flipped it but had to build my patient family from the ground up.  And by flipping I mean, literally Matt and I gutted it ourselves and updated the finishes, installed new equipment and I DO NOT recommend doing this yourself, especially without a handy husband.  This was incredibly challenging, not our finest of times together but we made it through and saved a lot of start up capital as well as really know everything about our dental space but boy, that was just too much! As hard as it has been to open your doors and work to fill the schedule from nothing it has been the most rewarding.  I built my brand, I built the office I wanted, I market to the types of patients I want, I hire those I want to work with and want to learn from me, grow with me and embody my treatment and practice philosophies.  Either way, you will feel the reward of owning your own office and either way it will be taxing, and stressful and all encompassing but with a start up, you literally start everything yourself, the Dentrix appointment book, the ledger options, every insurance plan you will file with has to go in the computer from scratch. But, you have the time to do that all…for the most part!


3.   Has it been an overall good experience?

Definitely, without a doubt.  There have been some lows and some scary moments but a friend, a fellow small business owner, not in dentistry told me when they feel burdened and stressed by all the woes you will feel they just think, this is an education and she is exactly right.  I learn from everything.  I learn from every write off I have to take, every conversation I have, every phone call, every time I file with insurance, every social media post, every marketing event and plan, every new hire, every new patient.


4.   Are you still associating on the side and how do you manage both?

I was, 2-3 days a week while starting up.  It was challenging as when I was in my office we were slammed with patients to maximize my time there and my two person team was working almost overtime to prep and help set up the office on my days I was associating.  It was very challenging as they would call me every 5 minutes when I was trying to work in this other office.  In a start-up, there is a problem every day, there is a question every 5 minutes.  I only associated for 2 and a half months as I had to give 60 days notice and in 2 weeks of being in both I new I had to be full time at my office.  When I did go full time, yes there were times that were slow but I used that time to train my team on my values, verbiage, how I do dentistry and market market market.  I filled a lot of the days with meetings and I still do but these meetings were times to meet specialists in the areas, network with other entrepreneurs and vendors and learn the importance of being involved in the community.  Now that we are busier during the day with patient care I leave those meetings to only the lunch hour if I can even get away or the evenings and weekends.  I burn out, I do.  I mean I will be at the office some days by 7:15am to prep for the day and be prepared to delegate some work to my team so I can focus on business related things or plain old patient care and will work through lunch, leave at 5:30 or 6pm and attend a marketing event and still make time to reserve 2 hours of my day for training weight lifting and somehow need to walk the dog or clean his accidents :(.  You have to love what you do or you can’t do it all.  Every now and then I just need a morning where I don’t change out of sweat pants and my friends know they don’t see my weekly anymore, maybe monthly if we are lucky but success is energizing.  Every time that phone rings with a new patient or a positive review comes in, you can bet, I am beaming.  I know you, and you will do just fine :)!