entrepreneur Dr. Carmen Leary My Journey Five Reasons to Invest in Your Practice Now If I had It To Do Over... Ignite Your Future
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CLASS OF 2014 | SPRING ISSUE
Business Beyond the Classroom
THE POWER TO CHANGE LIVES
“EARLY ON IN YOUR CAREER, YOU’RE TRYING TO MAKE A NAME FOR YOURSELF AND YOUR PRACTICE. YOU’RE TRYING TO GET YOUR SYSTEMS IN PLACE. THE RIGHT DISTRIBUTOR MAKES ALL THE DIFFERENCE.” DR. ED HOOD Hood Dental Care | Denham Springs, La.
SEE HOW PATTERSON DENTAL SUPPORTS HOOD DENTAL CARE BY VISITING OFFTHECUSP.COM/CHANGINGLIVES.
Patterson supports dentistry’s ability to positively change lives. If you’re ready to lead your patients, staff and practice into a new era of dental care, contact your Patterson representative today!
PATIENT EXPERIENCE, PRACTICE LIFESTYLESM PATTERSONDENTAL.COM | 800.873.7683
entrepreneur Spring 2014 VOLUME 16, ISSUE 2 Editor & Publisher Anne M. Duffy RDH Assistant Editor Michael Duffy Production Ruthie Gordon Publishers Press Inc. Editorial Board Dr. Gene Heller Dr. Harold Sturner Dr.Ryan Dulde Dr. Earl Douglas Rachel Teel Wall, RDH,BS. Dr. Tom Snyder Derek Champange Layout and Design John O’Connor
Class of 2014 Contributors Dr. Edward Hood
Dr. Carmen Leary
Dr. Donald P. Lewis Jr.
Dr. Roger Levin
George P. Farragher
Dr. Gene Heller
Dr. David Rice
Charter Sponsors The Pride Institute The Snyder Group McKenzie Management Caesy Education Systems, Inc. Warner‑Lambert Co. Phillips Health Care Oxyfresh Worldwide
Oral‑B Laboratories Ultradent Products Inc. Procter & Gamble Wm. Wrigley Jr. Corp. Glidewell Laboratories Benco Dental Co. Tess Corp. Dental Care Alliance
Editorial Office 12233 Pine Valley Club Drive Charlotte, NC 28277 704/953-0261 Fax 704/847-3315 firstname.lastname@example.org Send materials to: Dental Entrepreneur Magazine 8334 Pineville Matthews Road Ste. 103-201 Charlotte, NC 28226 When you have finished enjoying this magazine pass it along to a friend and PLEASE RECYCLE Copyright 2013 Dental Entrepreneur, Charlotte, NC Material herein may not be reproduced, copied or reprinted without prior written consent of the publisher. Acceptance of advertising does not imply endorsement by the publisher.
Welcome to Dental Entrepreneur F
CLASS OF 2014 SPRING ISSUE
irst of all, I’d like to say congratulations to the Class of 2014, all of you dental school graduates who will be joining me and the myriad of contributors to Dental Entrepreneur: Business Beyond the Classroom as dental professionals with a Dr. in front of your name.
It’s a heady time, no doubt, but our goal is to be there as a resource to aid your transition. Judging from the past 15 years of cultivating this magazine and online hub, I’ve found that said transition isn’t always as easy as students expect once the textbooks are closed and diplomas are in hand. While your clinical chops are likely approaching world-class at this point, what about the money side of things? What about procuring the right insurance? Hiring the right staff? Buying the right equipment? Realistically, they just don’t have time to teach you everything in dental school. I was recently reminded of our mission statement at a wedding for a friend of mine’s son. It was a jubilant celebration. We laughed, we cried, we danced, we toasted. We had a blast. One of the bride’s uncles mentioned to me after the DJ spun the song “Macarena,” “Good people find good people.” That reassured me that we are on the right track here at DE. This issue is about partnering with good people. I have to say I know all the authors and advertisers personally. I know they truly care about your future, and I hope you will reach out to them so they can mentor you along your journey. Good people finding good people can make things just a little easier, because you realize you are not alone. You may one day want to own your business, but you must realize now that you are not in business by yourself. There are many pieces to your puzzle, and there are people in our publication that know how to put it together. They have been there and done that. Take, for instance, our two profiled docs, Dr. Ed Hood and Dr. Carmen Leary. Read about how they got started and listen to how excited they are about their future as dental owners and professionals. As you will see, it is not always an easy path to what you want, but if you surround yourself with good people, you will ultimately live your dream, whatever that may be. The wonderful thing about dreaming is that it is all yours. So know that there are people out there to help you design and build your dream. You may be in your own business, but not in it alone. In Bob Levoy’s article – and by the way, I highly recommend his book – he shares what he would do differently if he could. I give him two thumbs up for having the courage to share it with you. Gene Heller and Bruce Bryen show you that your fears may be over-exaggerated. If you don’t know how to start the process once your diploma is in hand, reach out to our authors and advertisers. The better you do, the better everyone does. In my many years in the dental industry, I have discovered the industry is made up of good people. We would like to publish you and make you cover stars as we continue to put our stamp on the business of dentistry and contribute to your career, the one you have dreamed about for the last seven or eight years. Dream big and find out what else you don’t know that you don’t know. We are here to help! All the best,
Anne M. Duffy Publisher 2 Spring 2014 Dental Entrepreneur
CLASS OF 2014 SPRING ISSUE VOLUME II
4 Partners in Practice Edward Hood, DDS
6 My Journey Carmen Leary, DDS
8 Building Your Practice Brand – Essential
Business Beyond the Classroom The Power To Succeed 28 Effective Patient Communication Roger Levin, DDS
30 If I Had It To Do Over... Bob Levoy
34 Ignite Your Future David Rice, DDS
for Building Your Personal/Professional Brand After Graduation Derek Champagne
12 Start Out on the Right Foot! Donald P. Lewis Jr., DDS, CFE George P. Farragher, CPA, CFE, CFF
Business Fundamentals 16 The Unrealized Financial Power of the Dental School Graduate Bruce Byren, CPA
22 Will Today’s New Dentist Debt Prevent Practice Ownership? Gene Heller, DDS
26 Five Reasons to Invest in Your Practice Now Wendy Catone William Frazier
Dental Entrepreneur Spring 2014 3
Prologue EDWARD HOOD, DDS
Partners in Practice I
t’s hard to remember what made me want to be a dentist. I don’t have any dentists in my family and, like most people, I never liked going. But it was a service industry, and I guess that was the appeal. I have a servant’s heart, I’m people-oriented – and I loved it from the very beginning. School was difficult, but I loved the environment and working on patients. I feel fortunate that I was led down that path; that I truly found my calling. Dentistry is something you need to be passionate about, and I was. In dental school, I had an instructor whose philosophy was, to paraphrase, “If you treat patients like a patient – not a filling or a crown or a root canal, but Edward Hood, DDS as a patient – the money will take care of itself.” That always stuck with me. When you have a business partner to help take care of a lot of those other things, it’s true. When I built my first office, I didn’t have a business partner like that. I used mail-order catalogs for my supplies, and I would cringe when a salesperson came through the office. I didn’t want to make the business decisions. That’s not what I loved about dentistry. I loved working with patients. It became clear to me that despite my objections, the business decisions were important. I needed a partner to help me with those decisions – and who bet-
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ter than a team that spends all its time helping other practices succeed? There’s an advantage to being able to concentrate on doing dental work – the things you’re trained to do and the things you love to do – and let business partners, like my distributor, help take care of a lot of those other things. To be able to rely on someone to help with those decisions is invaluable. Dentists basically deal with problems all day long. There are very few patients who come in who don’t have a problem. Even when people come in to get their teeth cleaned, it’s a problem – just not a painful one. When you deal with that all day long, you can use some help finding solutions. If I could tell myself anything as a new doctor, I would say exactly that: “Find people you can trust to help you with your decisions, care about your success and will be members of your team.” Early on in your career, you’re trying to make a name for yourself and your practice. You’re trying to get your systems in place. The right distributor makes all the difference. They’re in other practices, know what works and what doesn’t, and
are a great resource for information. After 28 years, I’ve come to realize a lot of dentistry is based on your belief system. To go from one level to the next – like from my first three-operatory practice to my current 11-operatory practice – you have to believe it’s possible. If your distributor knows 15 other people who are succeeding and has helped them do it, they know how you can do it, too. Why not lean on that information? Building a successful practice is like building a house; there are so many decisions to make, and it’s helpful to have a resource. At the end of the day, all the decisions
you make are driven by your relationships with your patients. You want to be able to see a patient who you started seeing at 3 years old, watched grow up and get married, and now bringing their kids. It’s incredibly rewarding and gratifying to see those relationships grow. It’s validation that you’re doing something right when patients keep coming back, refer family and friends, or smile and say, “Look what you did for my teeth.” Similarly, the relationship you have with your distributor means a lot for your practice. The right one has a relationship with you and they know it’s going to be a longterm relationship. It’s not, “What can I do for my benefit right now?”, it’s, “What can we do for our benefit for the long run?” That’s an important distinction. It’s amazing to see what dentistry has become for me. I still love dentistry for
the exact same reasons I did when I came out of school. But the changes from when I built my first three-operatory office to where I am now, I can’t even fathom. The technology has developed so quickly. From practice management, to marketing, to getting patients to keep coming back, there are so many avenues to take in running your practice. In the end, the right business partner makes all the difference. You need the best equipment, technology and support after you purchase it. That’s not all. Software, sundries, practice management, the support team, technical services – they all come into play. When you can get all that from one distributor, it’s a best-case scenario. I’m a normal guy. Growing up, I learned the value of working hard. I went to school and worked hard, and I did the same on my practice. Anyone can do it if
that’s what they desire and dream. People say all the time, “When are you going to retire?” I’m a dentist. That’s my identity, that’s what I do. I love to play golf, I love to hunt, I love to fish. I have a lot of hobbies, but they aren’t my identity. I love what I do, and what I do is my identity. When you love what you do, that comes across to patients. It all comes back to relationships. People don’t buy fillings. They don’t buy crowns. They buy relationships and they buy the way that you treat them. As I look back, those relationships have meant a lot to a hard-working kid who never liked going to the dentist. ■ Dr. Ed Hood owns and operates Hood Dental Care in Denham Springs, La., along with Dr. Mindy Moore and Dr. Andrew Hood, his son.
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Dental Entrepreneur Spring 2014 5
CARMEN LEARY, DDS
decided I wanted to become a dentist my sophomore year at Riverside High School, in Durham, N.C., when I had to solicit ads for the yearbook. I decided to ask a local African American female dentist, who was the parent of a classmate. As I waited in her office and watched her as a businesswoman, clinician and a mother, I began to think of dentistry as a career. I had always loved going to my dentist, as our family dentist, Dr. Paula Coffey, was also female and I always wanted to enter the field of medicine. In my fledgling opinion, Carmen Leary, DDS women were just meant to be dentists, and I knew I must graduate high school with excellent grades attend an excellent undergraduate institution and enter a top dental program. I graduated from Spelman College in Atlanta, GA, with a BS in Biology Cum Laude in 2001, and then entered dental school at The University of North Carolina at Chapel Hill, where I graduated in 2005 with my Doctor of Dental Surgery. I continued my advance training at the Veterans Hospital in Baltimore, Md., and completed a General Practice Residency. My first job as a dentist was in Greensboro, N.C., and later moved to another dental practice in Lexington, N.C. My husband accepted at position as a Finical Advisor in Charlotte, so we moved to the Queen City and I accepted a position in smaller corporate practice there. My first three job opportunities in dentistry had been with corporate companies, so I did not have a true understanding of a solo practice. However, I did know that corporate dentistry was not the place I
6 Spring 2014 Dental Entrepreneur
wanted to stay in dentistry. My decision to venture into a solo practice came after hearing a lecture by Dr. Charles Blair on dental transitions at the Hinman Dental Meeting addressing the pros and cons of purchasing an existing office versus a startup dental practice. It changed my view of my next career move and began the search for an existing practice with Joseph Jordan, esq. My experience with working with Joseph was wonderful. He found an existing practice in the community of Coulwood in the northwest area of Charlotte, near Mountain Island Lake. This office had had only one owner for 41 years at this time of purchase. It was the perfect start to my solo dental career! Two months after entering my new practice, I encountered two challenges. First, I discovered I was pregnant with my second child. Second, my office was too small to support of our patient volume and current and future growth. The practice and I were growing fast! At this time, I enlisted the service of Ken Heilger to aid me in finding larger space to expand my practice. Unfortunately, in the Coulwood/ Mountain Island Lake area, there were not a lot of commercial space options. So, Ken pitched the idea of land acquisition and erecting a new building. I was nervous at first, but in the summer of 2012, I purchased a 7500 sq. foot pad in the Calibridge Commons shopping area. This began my rode to real estate ownership. I got in touch with Rick Whitley from Colony Builders to handle my upfit, which was a great experience. This Spring, 2014, my new 4000 sq. foot, modern, high tech, yet warm and family-friendly practice will be open to serve the wonderful community of Coulwood/Mountain Island Lake, Mt. Holly and the surrounding areas of Mecklenburg and Gaston County.
This journey I’ve been on has not gone as planned. It actually went way better than planned. I credit my success to my external team of Tom Stowe, CPA, Straine Consultants, Merrillee Karanickolas and Kerry Straine, Henry Schein’s Jeff Rice and Jay Barringer, my wonderful husband and Financial Advisor Victor Holloway, and my very supportive parents and sister. When I think of Michael Jordan, Tiger Woods, Tom Brady – the list can go on – these athletes had amazing raw, natural talent. However, they relied on an amazing coach and mentor to direct and see the things you cannot see in yourself. They still do. Dentistry is no different. Solo practioners are not, by any means, solo. It is comprised of an excellent external team and wonderful internal team/staff that take ownership of your vision and embody your passion. The perfect internal team that has “bought into your dream” and has made a pledge to support and implement that dream on your behalf will drive you to success, patient growth and peace of mind. I happen to be a dentist that has both an external and internal support team that is the best, and thus will ensure much success for Leary Family Dentistry now and well into the future. ■ Dr. Carmen Leary has a private practice in Charlotte, NC. She attended The University of North Carolina at Chapel Hill, School of Dentistry and graduated with her Doctor of Dental Surgery in 2005. Dr. Leary completed a general practice residency at the Veterans’ Hospital in Baltimore, MD in 2006 where she focused on oral surgery and comprehensive treatment planning. Dr. Leary is married to her husband, Victor. Carmen and Victor have two daughters, Camille and Kyndall. On her off days, Dr. Leary enjoys traveling and making memories with her family.
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To get started, call 1-888-937-2321 or visit wellsfargo.com/starterkit to request your free Practice Success Starter Kit. Wells Fargo Practice Finance is the only practice lender endorsed by ADA Business ResourcesSM.
ADA® is a registered trademark of the American Dental Association. ADA Business ResourcesSM is a service mark of the American Dental Association. ADA Business Resources is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association. All financing is subject to credit approval. © 2014 Wells Fargo Bank, N.A. All rights reserved.Wells Fargo Practice Finance is a division of Wells Fargo Bank, N.A.
Get the facts with a free Practice Success Starter Kit, including our latest issue of Strategies for Success, a New Dentist Planner, and an easy-to-use business plan template.
Getting Started DEREK CHAMPAGNE
Building Your Practice Brand
Essentials for Building your Personal/Professional Brand After Graduation
raduation is such an exciting time, with your outstanding scholarly achievements being rewarded and recognized. Once all of the celebrating has dwindled, you and your fellow graduates will begin to pursue your professional careers. Perhaps you will be considering an associate position in a private practice or even partnering with a colleague to purchase a practice. Derek Champagne Aside from traditional protocol, including verifying credentials and letters of recommendation, you can be certain that your future employer, bank loan officer, partners and patients are going to Google you! Now more than ever, personal branding is important to most dental/ medical and non-medical professionals. What is a brand? Your brand is simply what people know about you. So be proactive now in creating the impression that you want to make through building your personal brand. Your personal brand is what people (specifically your target employers, colleagues, business partners, community leaders and future patients) learn and recall about you. Remember, the goals of personal branding are to increase networking, shape perception and to build your reputation. Here are some ways to start building your personal brand now and after graduation:
8 Spring 2014 Dental Entrepreneur
Be Intentional. You should have a goal in mind and know where you are going. Each action you take should be done with purpose. Focus on your personal vision and present yourself towards that direction. Establish Yourself as an Expert. Your goal is to establish yourself as an expert in the dental field. Share your knowledge! Write and contribute to newsletters for professional associations,
local publications â€” wherever there is an opportunity. Also, take advantage of any and all speaking engagements at civic organizations, rotary clubs, local schools and elsewhere in your community. Volunteer. Give back to the community where you practice and live. Volunteering at local nonprofits, schools, churches and events where you can showcase your expertise is a great way to give back, establish and build www.dentalentrepreneur.com
At Aspen, owners aren’t on their own. Aspen Dental gives you all the rewards of owning a practice, without all the risks or hassles. • Training and guidance to enhance your clinical and leadership skills • Easier access to capital • High earning potential and the chance to own multiple practices Ready to take the next step? Call 877.330.1349.
Dr. Paul Pimentel and Dr. Jere Gillan
meaningful relationships, as well as gain ongoing exposure as an active and trusted member of your community. Establish Strong Business Relationships. People are more likely to do business with you if they know you on a personal level. Engage and be responsive in person and via social media. Join new dentist groups and continuing education groups, and keep in touch with your fellow graduates. You may also consider finding a mentor. Many new dentists enjoy the benefits of a formal or informal mentorship. Image Essentials Oftentimes, the first impression that a potential employer, associate, or patient will have of you is your photo and bio. Introduce yourself and influence their image of you by presenting a professional quality headshot and well written bio. Take some time to write your bio, highlighting awards or recognitions that you have accepted, hobbies, academic achievements, community work, club affiliations and any other relevant accomplishments. Write it in third person or consider hiring a copywriter to write it for you. Also, have a professional-quality headshot taken and use it in all write-ups and profiles so that your image is consistent. You may be wondering why your personal brand matters. YOU are the name behind your company, and therefore your personal reputation is important. Part of your practice’s value rests in the “name behind the company”. The rise of social media has unequivocally changed the way professionals strategically build their personal brand. It is not a onetime thing, so stay active, be careful what you post, and monitor your reputation regularly. Here are some ways to add online elements to your personal brand: • Participate in multiple social media networking: Join Facebook, Twitter, Google+, YouTube, LinkedIn and Doximity, and be proactive by contributing to social media communities 10 Spring 2014 Dental Entrepreneur
The rise of social media has unequivocally changed the way professionals strategically build their personal brand. within your industry demonstrating how you are up-to-date with trends and news. Keep your profiles consistent throughout each social media platform: messaging, images, etc. Check out Google’s “Me on the Web” or Google Alerts to be notified when your personal data appears on the web and take action to remove unwanted content. Bear in mind, you want to be known in a positive light. Be active on LinkedIn and start connecting. Give endorsements, answer and ask questions to increase your visibility. • Utilize video and image sites to post online presentations and video – Slideshare, Scribd, YouTube, Vimeo, etc. • Purchase a few domain names associated with your name. You should reserve your name if possible (myname. com, myname.net, other) and a practice name that reflects your own name and specialty (mylastnamefamilydentistry.com). If you are considering opening your own practice, intentional branding and marketing is even more critical. One of the first and critical steps in your practice branding will be to develop your corporate identity and brand messaging. The goal of brand building is to stand out, to shape perception and to effectively communicate with your target audience (your patients and future patients). One
of the first steps that I take with clients when building their practice brand is to have them fill out an in-depth questionnaire. The questions touch on subjects such as their passions, hobbies, work ethic, personal values, a list of professional strengths and skills, what makes their practice unique, among others. The key is to know who you are so that you can tell others so they will recognize your unique “signature” (your brand). A corporate identity builds trust and recognition. This is the visual part of your brand that should reflect your company in an honest way and should relate to your industry, your name and defining characteristics about your practice or the competitive advantage that you offer. Be unique and present yourself clearly and dynamically. It is very important that your identity is consistent, with marketing materials that have a similar look and feel. These branded materials will also give your marketing efforts more “bang for your buck” and make your practice more recognizable. Intentional brand building requires planning and ongoing participation but allows you to create your own desired perception and to be an active part in what others think about you. Begin thinking about your personal brand now before you graduate. Enjoy the process of sharing your expertise with others, networking, volunteering and being an active part of your community. Be intentional in building and sharing your brand and unique message and in growing genuine relationships and you will prosper. ■ Derek Champagne is a strategic marketing consultant who specializes in developing, executing, and managing marketing campaigns. He is also the managing partner of Practice Image Builders, a company that specializes in developing medical brands, as well as building websites and social media platforms for practices nationwide. Derek holds a BS in Business Marketing, as well as a Masters in Business Administration. He can be reached at (866) 610-5334 or email: Derek@practiceimagebuilders.com.
Getting Started DONALD P. LEWIS JR., DDS,CFE GEORGE P. FARRAGHER CPA, CFE, CFF
Start out on the Right Foot! â€œBeware and Be Awareâ€? Understanding Dental Health-CareFraud and Abuse
ike all areas of the health care profession, practicing dentists are under scrutiny by government agencies, insurance companies and other regulatory and governing bodies. To protect themselves, dental professionals have to be aware and focus on dental fraud and abuse. Scrutiny or dental health-care fraud and abuse is not likely to change because of the current economic and political environment. Most dentists are professional, caring, ethical and honest. The majority of practicing dentists would never knowingly consider participating in any type of dental fraud, abuse, or
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scam. As a new practicing dentist, you need to diligent to dental fraud and abuse. Your practice could be committing dental fraud without your knowledge, but nevertheless you can be held accountable for the result of the actions of your employees. Having just started your practice, you have worked too long and too hard to allow fraud and abuse to occur. Unfortunately, like any type of business, there is a small but disturbing number who are dishonest. While is can be difficult at times to determine the source of the fraudulent activity, the picture that is being painted is disturbing in situations of fraud, negligence and unethical treatment.
In a recent case, an employee was committing insurance fraud, by submitting false claims and having the remittance sent directly to the employeeâ€™s address. Although the practitioner did not commit the fraud, the fraud was still being committed by his practice. The amount of liability resulting with the practitioner is a legal matter, and an attorney should be consulted. In this case, the practitioner was liable for the refunding
the monies falsely remitted and is under investigation by state authorities. Dental professionals must realize that any claims submitted by their office are their responsibility whether or not they have direct knowledge of the claims submission. So what is dental fraud and abuse? By definition, dental fraud is any act of intentional deception or misrepresentation of treatment facts made for the purpose or likelihood of gaining unauthorized benefits. Acts of dental fraud involve three defining features, which include intent, deception and unlawful gain. These acts involve deceitful practices that are not identified as acceptable and legitimate financial practices. Fraud in the dental profession happens when fraudsters with the means and opportunity take full advantage to unjustly profit. These scams can include, but are not limited to, billing for services not rendered, misrepresenting dates of service, waiving of deductibles and/or co-payments, incorrect diagnoses or procedure codes, over-charging for routine services, or unbundling of procedures. Let’s examine each of these a little closer. 1. Billing for services not rendered – Billing for services that have never been provided or rendered is a common type of dental fraud and abuse.
By definition, dental fraud is any act of intentional deception or misrepresentation of treatment facts made for the purpose or likelihood of gaining unauthorized benefits. For example, the case of a dentist that merely examined the patient but billed for more expensive dental services, including fluoride and sealants. 2. Misrepresenting dates of service – Misrepresenting the dates of service provided is a fraudulent act. The date of the procedure is important to the insurance companies as there may be a waiting period prior to benefits being available. In other instances, the date of service may be changed to take advantage one way or another of the early deductible requirement. The date of service and the date that the dental claim is signed should be the same. Changing the date of service should never be done, as this is dental fraud and abuse. 3. Waiving of coinsurance or copayments – Accepting insurance as payment in full and disregarding the coinsurance payment, copayment,
or deductible results is looked at as overbilling the insurance company. Dentists that are not reducing their fee when they do not collect patient payments are in essence charging inflated fees to the insurance company. Using the inflated fees is considered to be making up for the amount of money lost by waiving the copayment or deductible. Most government health care plans and insurance companies don’t allow providers to waive patient’s deductibles or co-payments. The providers will sometimes justify the waiver of the deductible by saying that they don’t make any extra profit by doing this, there are just helping out their patient who can’t afford to pay balance or co-payment. However, by waiving the coinsurance or copayment the insurance company often ends up paying expenses that they shouldn’t have to pay which results in higher premium costs for policy holders. 4. Misrepresentation of services, incorrect diagnoses, or procedure codes – Providers that bill for false diagnoses or procedures performed could be in the form of changing the code to increase the amount of the claim reimbursement. This also will decrease the patient’s maximum benefit and increases the patient’s out-of-pocket expense. This type of fraud was brought to light when a dentist was providing surgical procedures that were misrepresented. It seems that the provider was performing routine dental extractions and using the procedure code for impacted teeth. It was revealed when the insurance company noticed that the same radiograph was being provided for each patient, with the name being changed! 5. Unbundling of procedures – The American Dental Association (ADA) defines unbundling of procedures as “the separating of a dental procedure into component parts with each part having a charge so that the cumulative
Dental Entrepreneur Spring 2014 13
charge of the components is greater than the total charge to patients who are not beneficiaries of a dental benefit plan for the same procedure.” This scenario is represented by a dentist that was unbundling his procedures to make the total charge increase. For a simple extraction of a tooth, the dentist was charging for not only the extraction, but also for elevating the flap, curetting out the periapical tissue, incision and drainage that was in conjunction with the extraction, and finally for suturing of the socket site. These procedures are all part of the global fee for extraction of the tooth and should not have been unbundled. 6. Upcoding – Upcoding is defined by the ADA as “reporting a more complex and/or higher cost procedure than was actually performed.” The practice of upcoding procedures to bypass insurance company reimbursement limitations and increase practice income is certainly being watched by insurance companies and regulatory agencies. For example, in a case where the perpetrators, without the knowledge of the dentist, coded the services rendered to a higher code to increase the revenue to the practice they managed in order to increase their – or that of their employees – incentive compensation. Based on an anonymous tip, an investigation was started by one of the large insurance carriers which resulted in the ongoing monitoring of the claims submitted by the practice. 7. Performing unnecessary procedures – Performance and billing for treatments not needed or for proving additional services or procedures beyond what was required to increase billings and claims amounts. The bottom line is that we live in a dangerous and unscrupulous world and need to be diligent to protect our assets and reputations. As a young dentist, you need to be schooled on the business side of the practice and need arm yourself with the tools and resources to protect your new
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business. The following suggestions are simple and include: • Seek training on what to look for in your practices daily operations • Obtain the best tools to run and control the business side of your practices, software, analytical tools, etc. Note that the tools you have are only as good as the level you and your team’s working knowledge of the functionality the systems offers. In other words use the training offered by the software providers. • Use the reports your operating systems provide so you are aware of the alerts and trends you need to understand what is happening with your practice. • Obtain qualified Certified Public Accountants, lawyers, trainers and advisors to provide you with the necessary oversight and advice you need. • Run background checks on all employees prior to hire or after reading this article if you have not done so previously. Starting your dental practice is the culmination of many years of study and sacrifice. Make sure that you start out with protecting yourself from becoming a victim of dental fraud and abuse. ■
Dr. Donald P. Lewis, Jr., DDS, CFE Co-Founder / CEO, Pated, LLC/Practice SafeGuardTM Donald P. Lewis, Jr., DDS, CFE is a Diplomate of the American Board of Oral and Maxillofacial Surgery (AAOMS) and is currently in private practice as a leading oral and maxillofacial surgeon in Cleveland, Ohio. He holds a Bachelor of Science degree in Chemistry from Valparaiso University, his Doctor of Dental Surgery (DDS) from Case Western Reserve University School of Dentistry, and his post-graduate Residency in Oral and Maxillofacial Surgery at The University Hospitals of Cleveland.
Fraud Examiner” (CFE) from the Association of Certified Fraud Examiners. He is a highly respected and sought-after lecturer on the subject of white-collar crime. Dr. Lewis´s passion to protect business owners from white-collar crime led him to establish PATedLLC®, of which he is the Founder and CEO. Practice SafeGuardTM is PATed´s first product, and is the only platform dedicated to fraud and embezzlement detection in the healthcare industry. He is also a Professor of Oral and Maxillofacial Surgery at Case Western Reserve University School of Dental Medicine. In his spare time, Dr. Lewis is a high school basketball official, and three times has officiated in the Ohio High School Athletic Association State tournament finals in Columbus, Ohio.
George P. Farragher CPA, CFE, CFF serves as Vice President for Practice SafeGuard and has over 30 years of Forensic Accounting and Financial Investigation experience on both domestic and international investigations and related advisory services. He is a former agent of the U.S. Internal Revenue Service and the Defense Contract Audit Agency of the United States Department of Defense. He is also Regent Emeritus of the Association of Fraud Examiners, a member of the American Management Association´s PanAsian Council and is on the Board of Directors of the Cleveland Council on World Affairs. Mr. Farragher´s global spread of clients include domestic and foreign government agencies, government contractors, private and public corporations, not for profit organizations and international development agencies. He lectures on fraud awareness, detection and investigation programs at corporate, university, accounting and legal communities all over the world.
After losing over $100k to fraud in his practice, Dr. Lewis earned the designation of “Certified
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Business Fundamentals BRUCE BYREN, CPA
The Unrealized Financial Power of the Dental School Graduate Debt and More Debt: What Kind of Financial Power is Available With It? Besides a terrific dental school education, which almost assuredly gets the graduate ready for the clinical side dentistry, what else does he or she have besides the diploma? One thing that those who must finance their education surely have is a large amount of debt. The financial rewards of dentistry may be one of the items that those who entered Bruce Byren, CPA dental school felt would be available to them at some time after graduation. Like most young people today, the time when the rewards will become available was a wish for the present, rather than for some time in the future. So what occurs when the youthful graduate begins a job search as an associate, or when a more mature graduate looks to join a practice with some type of acquisition structured? What does the debt mean to the graduate or to the potential partner? What does the debt mean to the potential lender who will assist the graduate in the financing of the acquisition or startup of his or her own dental practice, at a later date?
borrowing requests. Dentists, especially those who have just graduated, may feel that they don’t have much of an opportunity to borrow, even for the acquisition of an established dental practice. That is an incorrect assumption. Dentists who have advisors assisting them with the financial side of their dental practices know how to arrange borrowings for recent dental school graduates, as well as for the mature practice. Historically, the financial history of dentists has made an impact on lenders who know how to lend to dental practices and to dentists. There is plenty of money available for the dental school graduate from the lending community, provided the graduate has reasonably good credit. It may be surprising, but lenders covet the ability to lend to dentists whether
they are recent graduates or not. Their feeling is that a loan to a dentist is a low risk opportunity for the banks to receive income. The rates and terms of payment may not be to the graduate’s liking, but given a history of on-time payment, the graduate will be able to refinance a first loan and obtain much better rates and terms. Banks with a specialty in lending to dentists count on the financial future of the graduate based on the lenders’ own experience with graduates and seasoned dentists from the past. What Type of Debt is Acceptable to a Dental Lender and what is not? The recent graduate may not categorize debt as a dental specialty lender does.
Loan Payments and Borrowing Capacity It is a strange occurrence that is taking place with financing today as one reads the papers and becomes aware of lenders holding back to small business owner’s 16 Spring 2014 Dental Entrepreneur
What types of debt exist? What is an acceptable type of debt and what is not? Where does the graduate go to borrow to buy into a dental practice or to open a brand new practice, as an example? There are many types of debt, and only a few will be addressed in this article. The debt incurred from education is fairly common and one that dental specialty lenders will accept from a graduate. The payment for that debt should be on time and reasonable compared to the graduate’s current or projected income. If there is an arrearage on a payment, a solid explanation must be forthcoming or an application will most likely be denied for additional borrowing. Assuming that the educational debt is being paid on a current basis, the amount outstanding is not that critical, since a dental specialty lender will look at the potential of the graduate’s financial success for the repayment schedule If a loan is requested to acquire an interest
Credit card debt is not a good thing from an interest rate stand point, as well as from an economic and credit worthiness position. in a dental practice, or to open a startup, the amount of outstanding indebtedness is not important, as long as the payment history is excellent. Credit card debt is not a good thing from an interest rate stand point, as well as from an economic and credit worthiness position. Lenders are afraid of bad financial habits like borrowing on
credit cards. However, if credit card debt does exist, on time monthly payments are important. There may be reasons for the credit card debt such as using it for the ability to eat, during dental school. That is a good reason for credit card debt. Often, a lender will assist in lending enough to retire the credit card debt with a more reasonable interest rate and term than the credit card offers. The most important thing is that all payments remain current. The term “dental lender,” continues to appear in this article. The graduate will learn that it is very difficult to borrow from a local bank – even if there is a friend of the family who is a board member. The local banks typically need good collateral for borrowing, don’t like to see too much debt on someone’s loan application and don’t understand, because of a lack of history in lending to dental school graduates, the safety net that the dental profession affords to a
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ADA Insurance Plans 888-463-4545 www.insurance.ada.org For loan collateral, debt protection, and financial security, dentists rely on the ADA Insurance Plans for best-in-class life and disability insurance, including free coverage for ASDA members during dental school. ADA members benefit from group rates that keep premiums low and hard to beat. GreatWest Life & Annuity Insurance Company insures the ADA Insurance Plans, and protects more than 130,000 dentists, dental students, and their families every year.
ADS Dental Transitions (888) ADS-4237 www.ADStransitions.com ADS is the nationwide leader in dental practice sales, associateships, buy-in/buy-outs, partnerships and appraisals. ADS is comprised of the industry’s most experienced professionals, including dentists, attorneys, and CPAs. We can help you with each step of your next transition. To view a complete list of practice opportunities available in your desired area, visit us at ADStransitions.com. Please see our ad on page 17.
ADS Dental Transitions South 770-664-1982 www.adssouth.com ADS South is the premier dental transition organization in the Southeast. We provide associateship placement, dental practice sales, appraisals, and expert testimony services. Our company was founded over 26 years ago by Earl M. Douglas, DDS, MBA, BVAL, and we continue to control the cutting edge of transition technology. Please see our ad on page 5.
Aspen Dental 877-330-1349 www.AspenDentalJobs.com At Aspen Dental we recognize that our success is a direct result of empowering and supporting ambitious dental professionals. We provide a professional, fast-paced, entrepreneurial work environment based on a mutual respect that keeps our interests aligned together, we build and develop successful, patient focused dental practices. Please see our ad on page 9.
18 Spring 2014 Dental Entrepreneur
Comfort Dental www.comfortdental.com The Best of Both Worlds At Comfort Dental, we combine the old-style neighborhood dental practice with today’s modern group practice. Equity ownership, autonomy, management of your own business, and long- lasting relationships with your patients is combined with our economics of scale, prime locations, mass marketing, and overhead control. It truly is the best of both worlds. See our ad on page 15.
Heartland Dental 217-540-5100 www.HeartlandDentalCare.com Heartland Dental Care is one of the leading dental service organizations in the United States with more than 425 affiliated dental offices within 20 states. It supports over 700 affiliated dentists and 5,000 team members through continuing professional education and leadership training along with a variety of non-clinical administrative services. Please see our ad on page 11.
Henry Schein Nationwide Dental Opportunities 866-409-3001 www.dentalopportunities.com Henry Schein Nationwide Dental Opportunities is the perfect solution for your Dental Associate recruitment needs. Call 1-866-409-3001 today to learn more about improving your opportunities or success. See our ad on the back cover.
Henry Schein Professional Practice Transitions (PPT) 1-800-730-8883 firstname.lastname@example.org www.henryschein.com/ppt Henry Schein Professional Practice Transitions (PPT) is the practice sales division of Henry Schein, Inc. Our affiliation with the largest dental supply company in the country—intent on servicing the practice buyer’s future supply, equipment and service needs, makes PPT the only company with a vested interest in the buyer and a career long trusted relationship with the seller. (Please see our ad on the inside back cover.)
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MacPractice, Inc (402) 420-2430 MacPractice.com
Patterson Dental Advantage (800) 328-5536 www.pattersondental.com
MacPractice DDS is the leading practice management and clinical application for dentists who prefer to use a Mac, featuring electronic insurance submission, Mac native digital radiography and photos, charting, Electronic Dental Records, Kiosk, Web Interface, iPhone Interface, speech dictation, and Mac stability and ease of use. Please see our ad on page 27.
Patterson Dental, a leading distributor of dental products, equipment and technology in North America, is the largest business in the progressive, global Patterson Companies family of businesses. Dental professionals who partner with Patterson enjoy the convenience and assurance of relying on one trusted source for everything they need. Please see our ad on page 31.
Oxyfresh Worldwide Inc. 800-333-7374 ref# R23037601 email@example.com Since 1984 thousands of dental professionals have discovered Oxyfresh’s safe and effective oral health products for use in long-term care and maintenance of their patients. Retail sales, wholesale rebates and “free product” programs allow you to get paid appropriately for providing professional guidance and instruction to your patients.
PARAGON Dental Practice Transitions www.paragon.us.com 866-898-1867 Offices located Nationwide. PARAGON offers professional consultation and related services to healthcare professions with primary emphasis on the dental profession: comprehensive dental practice valuations (including a written valuation and analysis report); practice sales; pre-retirement sales; practice acquisitions; practice mergers; associateships; partnerships; practice consolidations and practice management. References available by request. Please see our ad on page 29.
Patterson Dental 800 873-7683 www.pattersondental.com Patterson Dental Supply Inc. is a full-service distributor of a complete range of dental products and services to dentists, dental laboratories, institutions and other healthcare providers throughout North America. As one of the nation’s largest dental distributors, Patterson Dental sells consumable dental supplies, digital and other dental equipment and practice management software. Please see our advertisement on the inside of the front cover and page 1, and page 21.
Sirona Dental Systems, LLC 800-659-5977 http://www.cereconline.com CEREC AC from Sirona is the most advanced dental CAD/ CAM system available. With its Bluecam, capturing fast, precise digital impressions and then creating high quality esthetic restorations is a reality. CEREC AC delivers access to efficient, precise, scalable and affordable solutions, including CEREC Connect. Call 1-800-659-5977 or visit www.cereconline.com. Please see our ad on page 29.
The Artist Evolution LLC/Practice Image Builders Toll Free: 866-610-5334 www.theartistevolution.com The Artist Evolution is a full service, strategic marketing and design firm with a passion for helping practices around the country to communicate effectively with their target patients, to develop an identifiable brand, and to meet their objectives in a cost-effective way. Please see our ad on page 25.
Wells Fargo Practice Finance 1-888-937-2321 wellsfargo.com/dentists firstname.lastname@example.org Wells Fargo Practice Finance provides customized financing supported by experienced specialists and practical planning resources to help dentists acquire, start and expand their practices. The only practice lender selected especially for ADA® members and endorsed by ADA Business ResourcesSM, we understand the business of growing successful practices and are here to help you achieve your goals. Please see our ad on page 7.
Dental Entrepreneur Spring 2014 19
lender. A number of experienced lenders specialize in lending to dental school graduates and to dentists in general. The graduate should retain an experienced financial dental advisor, such as a dental CPA, and use that person’s guidance to find these dental specialty lenders, avoiding the heartache of being turned down by the local bank. Every attempt at borrowing and credit score request can hurt the graduate’s credit standing, so it is important to be selective with whom the credit applications are going. Are Savings Important to the Graduate? One may wonder how this question even occurs. How can there be savings when there is so much borrowing, the need to pay standard living expenses, such as rent and food, and possibly a car payment as well? Some graduates do their best to save however much they can. They do this at the expense of high credit card debt and live in a miserly fashion in order to have money in the bank. They may think this assists them when they apply for credit. They have high interest rate charges on their credit cards because they are paying the minimum balance to keep the credit card current and increasing the amount they owe since they are paying little against the loan balance. This is a poor method of helping oneself. Think about what the graduate is earning on the savings account, possibly one
half of one percent. Compare that to the interest rate being paid on the credit card, which is probably upwards of 10 percent. It’s beneficial to pay off the credit card as quickly as possible and have less in the bank being saved other than amounts deemed necessary for emergencies, as far as what a lender thinks. The savings will come with the job that the graduate obtains. Most reasonably-successful dental practices have retirement plans that contribute on behalf of the employee and allow the associate to accumulate savings that help reduce income tax liability, as well as save for the future. There is plenty of time for savings as the graduate’s career progresses. The credit score for the graduate plays the most prominent role in financial success. ■
Bruce Bryen is a CPA with over forty years of experience. He is the Managing Partner of his accounting firm, Bryen & Bryen LLP, based in southern New Jersey. Mr. Bryen specializes in deferred compensation, such as retirement planning design; income and estate tax planning; asset protection and structuring loan packages for presentation to financial institutions. Mr. Bryen is experienced in providing litigation support services to dentists with expert witness testimony in matrimonial disputes cases. You may contact Bruce Bryen at 856985-8550, extension 112.
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entrepreneur If you have any questions, comments, or responses to
our magazine, please connect with us on Dental Entrepreneur Magazine — our official Facebook page! Read us online www.dentalentrepreneur.com Send your questions or comments to email@example.com www.dentalentrepreneur.com
20 Spring 2014 Dental Entrepreneur
DIGITAL XďšşRAY UNDER $20K The leader in digital X-ray now offers you the Schick 33 Digital Starter Kit to help you to say goodbye to film.
When you purchase from January 1-April 26 2014, itâ€™s available for under $20,000. The Schick 33 Digital Starter Kit (Patterson Part# 07-0351841) is everything you need, with two sensors, two remotes, two positioning systems and software. Talk to your Patterson representative about current financing specials. Plus, as always, take advantage of Section 179 tax benefits with the purchase of equipment.
Say goodbye to film. And say hello to your new practice.
Business Fundamentals GENE HELLER, DDS
Will Today’s New Dentist’s Debt Prevent Future Practice Ownership?
s I have traveled across the United States recently meeting and speaking with hundreds of new dentists and dental students, most report they have been told (and unfortunately believe and accept) that because of today’s unprecedented levels of school debt, future practice ownership is no longer a possibility for them, even though most went into dentistry hoping to eventually own their own practice. These new dentists go on to report these debt levels are preventing banks from loaning them additional money. And finally, they Gene Heller, DDS believe that this debt, coupled with a changing dental industry infrastructure, will prevent them from future traditional dental practice ownership and will no longer be a reality for most new dentists. Let me begin this discussion by answering the titular question. The answer is NO – traditional ownership is still readily available despite the perceived barriers. Changing Business Models The dental industry delivery model and infrastructure is changing. There are three changes occurring concurrently. First is the business model change occurring as a result of the development of Dental Service Organizations (DSOs) and small, one (or several) owner, multiple-location, group practices. DSOs are typically defined as having more than 10 practice locations, 22 Spring 2014 Dental Entrepreneur
while the smaller groups have 10 or fewer practices under individual or investor ownership and management. Leaders and owners of these two group practice models have figured out differ-
ent management systems to allow for the development of these “investment-type” business entities. These groups are typically buying high-end, highly productive practices and staffing them with new graduates. www.dentalentrepreneur.com
While these groups have been a great source of employment for new graduates, because they typically either target the high-end practices that require several years of experience to handle or are doing start-ups, the emergence of DSOs and small group practices are not preventing new dentists from becoming practice owners. In fact, many of these group practice models actually allow ownership in the various practice operational entities or provide the experience required for future solo practice ownership! The second change in the delivery model for dentistry is within the dental insurance industry. Most new dental insurance plans sold today are primarily PPO (Preferred Provider Organizations) type plans, replacing the traditional indemnity type dental insurance plans. It is estimated that over the past couple of years, traditional indemnity plans represented less than 15 percent of new plans sold, and the number of indemnity plans sold has been dropping annually. Technically, “dental insurance” is not “insurance.” Any insurance plan, by definition, basically says a group of insured people each pay a small amount of money to an insurance pool, and if one of the members of the group suffers an insurable event, the pool of everyone’s contributed money goes to that member who has suffered the loss. Because almost everyone (95 percent) has varying levels of dental disease, the insurance definition does not work. If everyone needs treatment, then the insurance plan is really just an alternative reimbursement system for paying for dental services. The insurance companies providing policies have figured out how to package these programs, collect as much money as possible (the premium) and limit the pay-outs (through deductibles, co-insurance and annual limits), thereby making as much profit for the insurance company as possible. Many years ago, the insurance companies determined another way to decrease their potential risk and increase their profits. If they could persuade dentists to cut their fees in return for being included on an exclusive, limited list of providwww.dentalentrepreneur.com
If everyone needs treatment, then the insurance plan is really just an alternative reimbursement system for paying for dental services. ers, the insurance companies could make even more profit on their plans. Through participation with a “PPO” plan, dentists agree to reduce their fees by 10-30 percent in return for being included on the insurance plan’s list of participating dentists, or preferred providers. This means if the patient has this plan and uses a PPO dentist, the patient is guaranteed a lower fee. While this definitely increases the insurance company profits, it does so at the expense of the dentist’s bottom line profit, with the dentist seeing a dollar-for-dollar decrease on each dollar of fee decrease. However, this is not having an impact on a new dentist’s ability to become a practice owner. The third major industry change is the entrance of the federal government through the Affordable Healthcare Act. There is no question inclusion and mandating of coverage for all children under the age of 21 coupled with the anticipated future inclusion of low income patients will have an impact on dentistry as a whole. However, this is not having an impact on a new dentist’s ability to become a practice owner. Dental School Debt Three arguments are being given as to why today’s dental school debt levels are preventing or will prevent future dental practice ownership. The first, and most significant falsehood, is that banks are not lending to today’s graduates because of their school debt levels. Most readers are well aware that the U.S. has recently
gone through a banking crisis. During this crisis, banks were not lending money to small businesses, either for expansion, ongoing operational working capital, or for acquisition of new businesses. What has not been publicized is that the only group of future business owners not having any and/or having only minor trouble getting loans, either to start-up or to purchase an existing business, was new dentists. Not all, but many lenders, are well aware of the documented lowest failure rate of all small businesses experienced by new dental practice owners. These lenders have aggressively sought new dentists (right through the recession) interested in purchasing an existing practice, and are willing to loan up to $1 million (or more) to these future practice owners at reasonable rates. There are only three requirements for consideration for a practice acquisition loan. The first is a clean credit history. The second is that the purchase produces sufficient cash flow to meet both the businesses operating needs and the dentist purchaser’s personal financial needs. The third is that if this is the purchase of an existing practice, the buyer has the experience and can produce sufficient dentistry to cover all the expenses, both business and personal. Meet these three requirements, and banks are lending to new dentists every day. Banks are readily lending, and today’s high dental education cost and subsequent debt levels are not preventing new dentists from borrowing the money necessary to become practice owners. An emphasis on the experience factor is one change the recent recession has caused within bank lending guidelines for the new dentist. One of the arguments given by those people saying that today’s new dentists will not be able to obtain loans to purchase practices at today’s debt levels is that the new graduate cannot produce enough dentistry to cover all their financial needs, i.e., business acquisition costs and operation, personal needs, and school debt retirement needs. This is why most lenders are requiring one-to-two years of experience prior to consideration for a practice acquisition loan. Dental Entrepreneur Spring 2014 23
What about the unprecedented levels of debt? The reader will note, this was not one of the above three conditions to obtain a loan, i.e., a “limited amount of school related debt. While all banks certainly look at the amount of debt, if the transaction cash flows, a large education related debt level will not prevent new dentists from becoming practice owners. What follows is a comparison of an average practice purchase and school debt repayment requirements today versus ten years ago.
Cash Flow Comparisons For the following comparison please note: 1. Average practice receipts were approximately $500,000 in 2004 and $600,000 in 2013. 2. Practices sold for 60 percent of receipts in 2004 and 65 percent of receipts in 2013. 3. A 60 percent adjusted overhead level was used for columns designated 2004 and 2013. 4. Average school debt is assumed to have doubled from 2004 to 2013 for these calculations. 5. While practice purchase debt retirement was kept constant at 6 percent APR for both 2004 and 2013 and a seven year term was used, in 2013 it was more common for a ten year term, thereby increasing the net after debt cash flow to slightly more than the model shows. 6. A 15-year term was used for the school debt, although a 20-year term is frequently seen today, thereby again slightly increasing cash flow for the 2013 model. 7. The final line below shows what an associate would earn without ownership at each of the Practice Gross Receipt levels. It should be noted that the associate only earns 30 percent of the doctor-only collections, assumed to be 80 percent of the practice gross receipts (the associate does not get paid for hygiene production). Therefore, the associate does not share in the hygienist’s profit the same way the practice owner does. For 2004, if 24 Spring 2014 Dental Entrepreneur
the dentist provider was an associate producing the same amount as they would have as an owner, the calculation is Total Practice Gross Receipts ($500,000) minus estimated Hygiene Receipts ($100,000) equals $400,000 Doctor only Receipts times 30 percent Compensation Rate equals $120,000.
Today’s levels of dental school debt will not prevent new dentists from becoming future practice owners. Ownership is available and anticipated This comparison clearly demonstrates that while educational debt levels are higher, so are average sizes of practices purchased which generates a comparable postoperating expense/post-debt repayment bottom line today versus 10 years ago. A comparison of 2013 Net Pre-Tax/Post-Debt
with 2004 shows a $3,500 annual increase in pre-tax cash flow for 2013, and that excludes any additional cash flow resulting from using a 10-year practice acquisition loan term and a 20-year educational loan repayment schedule. 2003 also demonstrates that if one compares the available ownership compensation after acquisition debt is paid, it is still slightly higher than if the individual was employed as an associate. And this does not take into account the equity being built. At $144,000 associate compensation, 2013 does show an associate position paying $18,000 more than an owner’s net ($126,000), but that excludes the approximately $60,000 in principle (and subsequent equity) the owner would enjoy over the associate. Finally, it should be noted that the average practice purchaser sees a first-year increase in receipts of 10-20 percent. Any additional receipts only have lab fees and supplies as additional expense items, so the profit on the additional receipts is approximately 75 percent, compared to the 60-percent overhead seen by most offices. These highly profitable additional receipts subsequently decrease the overall office overhead percentage. The third column above demonstrates that this additional $100,000 in receipts over the 2013 cash flow model results in $75,000 in additional www.dentalentrepreneur.com
available owner pre-tax compensation, and including the equity build-up, $135,000 more in the first year than being an associate producing the same amount of dentistry. Summary Today’s graduates face a new world of dental delivery options. However, as a practice owner, they will still earn 3-4 times the level of income over the course of their careers when compared with working for someone else and letting someone else take all the profit. Today’s levels of dental school debt will not prevent new dentists from becoming future practice owners. Ownership is available and anticipated to remain available (short of an overall economic meltdown, more severe than the recent recession). That ownership can take the form of a partnership/co-ownership arrangement
in a two- to three-owner group, a larger group, or some DSOs. It can also occur as either a start-up (although much more difficult to secure financing because of lack of initial cash flow), or an outright practice purchase. Banks are lending as long as the new dentist has clean credit, sufficient experience to handle the subject practice and the practice has previously demonstrated the ability to produce enough profit to support the business and the personal needs of the new dentist owner. ■
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Dr. Eugene W. Heller is the Vice-President of Professional Practice Transitions, a nationwide dental practice sales and consulting organization. He can be reached at 1-888477-8552.
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Dental Entrepreneur Spring 2014 25
Business Fundamentals WENDY CATONE WILLIAM FRAZIER
to Invest in Your Practice Now Building From the Ground Up: Purchasing Real Estate Along With Your Practice Now that you are nearing the end of your extensive dental school education, there is no doubt that you are thinking about starting a dental practice or eventually joining one with dreams of expanding the current facility. Have you considered building from the ground up? Today there’s a growing trend among dentists to start from scratch Wendy Catone in order to create an environment that reflects their personal vision and goals. Many have gone a step further, purchasing the commercial real estate underlying the dental office for ultimate control of William Frazier their practice space. Start-up, Expansion, or Practice Update: Designed for Performance Building a well-designed practice from the ground up can positively impact every facet of your business. An effective practice design improves productivity while decreasing stress for staff and patients. It allows you to create an identity consistent with the type of services you wish to provide and communicates the quality of those services. Ultimately, a well-planned dental office environment inspires patient confidence, making that great first impression that drives practice success. Commercial Property: An Investment in Your Future
26 Spring 2014 Dental Entrepreneur
Purchasing the commercial real estate (CRE) that underlies your practice gives you greater control over your office environment while creating a sound footing for future success. Here are five reasons why purchasing now may be beneficial: 1. Property values. CRE values remain below their peak in 2008, which means you can purchase more practice for your investment than you could have just a few years ago. 2. Preferential tax treatment. With 100 percent commercial mortgage interest deductions, depreciation of building expenses and additional tax advantages for commercial property ownership, the actual cost of ownership may be more manageable than you realize. 3. Secure balance sheet. The commercial real estate market appears poised for a recovery. By purchasing now, you lock in monthly payments at below-market rates, allowing you to plan for future expenses and enjoy a more secure cash flow. If the space is larger than your practice currently needs, you can lease to tenants to generate cash flow and expand into the extra space as your practice grows. 4. Retirement options. When it’s time to retire, you can sell both the practice and real estate to help fund your retirement, or sell the practice while keeping the real estate, generating monthly rental income. 5. Favorable rates. Financing rates for commercial property remain at historic lows. It’s not uncommon today for a monthly payment on a 25-year commercial mortgage to be the same or lower than lease payments for a similar space.
Advantages of Using a Specialized Lender Using a specialized healthcare lender for your practice acquisition, start-up, expansion, or construction project can save you both time and money. Unlike most local banks, a specialized lender can combine your practice, equipment and property purchases into one loan package, providing a streamlined process with one credit application, one set of fees and one loan closing. A specialized lender can also provide a broader range of loan options, from short-term fixed rate loans to low, variable-rate mortgages. Some specialized lenders are we stablished in the dental industry and can also provide professional resources and expertise to help make the process easier. So if it’s at all feasible as you look to head out on your own , purchase the commercial real estate simultaneously with your practice acquisition. Together they provide maximum leverage in achieving your long-term financial goals. Wendy Catone –The Florida Business Development Manager for Wells Fargo Practice Finance, Wendy is an experienced consultant and finance expert who’s been servicing the financing needs of healthcare practitioners for over 25 years. Wendy speaks at seminars and professional schools throughout the year. She can be reached at 1-800708-0279 or firstname.lastname@example.org. William Frazier – William Frazier has 20 years of commercial banking experience with Wells Fargo and is currently Vice President, Commercial Real Estate at Wells Fargo Practice Finance. In his role, Will has the privilege of working with doctors to help them achieve their goals of owning their property where their practice resides. Will can be reached at 602-579-2300 or frazierw@ wellsfargo.com. Wells Fargo Practice Finance is a division of Wells Fargo Bank, N.A. All financing is subject to credit approval.
MacPractice integrates into your life and work. Your practice management and clinical software should enable you to run your practice effectively and affordably with confidence. It should integrate with your lifestyle, your iPads, iPhones and Macs at home. You wouldnâ€™t buy a PC for your home, why would you want one in your practice? MacPractice has its finger on the pulse of dental software and technology. Our future-proof solution provides comprehensive functionality to manage your office and patient relationships. An experienced, dedicated MacPractice Practice Consultant is ready to visit your office to demonstrate how MacPractice works â€“ giving you confidence to choose the most capable and powerful dental technology designed specifically for Apple devices.
Macs-imize your practice with MacPractice.
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Simplicity in practice
Power To Succeed ROGER P. LEVIN, DDS
Effective Patient Communication
o build a highly successful practice, you need the excellent clinical skills you acquired in dental school. However, that alone will not guarantee a thriving practice. You and your team must also develop an innate ability to communicate effectively with patients. Young dentists often assume excellent clinical skills are enough to guarantee success. This is not the case. Unless your patients happen to be dentists, they will be unable to judge the quality of care. Patients tend to assess the quality of dentistry based on their own perceptions of customer service and communication exhibited by the team. Outstanding customer service is critical to practice success — and it starts with good commuRoger P. Levin, DDS nication.
Three Ways to Achieve Superior Communication When interacting with patients, don’t just “wing it.” Use effective scripting to stay focused and consistent. Scripting allows you to: 1. Answer all questions thoroughly. When patients ask questions about your services, they are expressing an interest in what you have to offer. You cannot respond with incomplete answers or take days to respond to their telephone calls. When you call your patients back, don’t make them feel like the response was a chore. Demonstrate that you are happy to explain the answers to their questions, and make sure they understand. Levin Group Data Center™ research demonstrates that a majority of patients will not follow through with treatment if they perceive an attitude of indifference toward their concerns. Remember that they chose to be a patient with your practice. Don’t let them regret that decision.
28 Spring 2014 Dental Entrepreneur
2. Learn a minimum of 10 personal facts about a patient. In fact, do this before you initiate any diagnosis or treatment. Once you know 10 things about a person, you have the building blocks for a relationship. Simply being nice does not automatically create a relationship nor does sending recare cards or smiling at the front desk. Obviously, those things are needed but they are only aspects of effective communication. By taking the time to learn about patients, you effectively demonstrate that you care. It also serves as a stepping stone in the doctor/patient relationship. This process encourages people to share information with you. People usually only open up to others if they like them. In my practice management seminars, I always stress that half of the case presentation has nothing to do with the dentistry, but rather with how much patients like the doctor and practice. 3. Discover things that you have in common with patients. There are two ways to approach this strategy. One, try to find broad areas of common interests such as sports teams or reading topics. This is a good starting point and one that should be pursued. However, there is a second much more powerful technique — looking for specific things that you are both passionate about. For example, the doctor and patient are both dog lovers or have children of similar age. This approach allows for a much more powerful and longterm relationship to evolve. Body Language is Communication, Too Patient communication also involves what doctors and teams don’t say to patients. The following tips on body language will help dentists become better overall communicators: • Avoid crossing your arms. Crossed arms and legs convey a closed individual who is not particularly interested
in the patient with whom the doctor is conversing. The position of crossed arms across the chest is an authoritative one, which can be interpreted as talking down to the patient. Closed-mindedness or a lack of willingness to consider the patient’s point of view is also communicated by this stance. • Make good eye contact. Looking away from other people while speaking can be perceived as untrustworthy or dishonest. Excellent eye contact is critical since dentistry is a service that requires a high level of trust. Never allow eye contact to be broken. If the doctor is interrupted by team members during a patient conversation, his or her eye contact will only be sporadic at best. • Shake hands with patients. Shaking hands as you greet patients may seem like obvious advice, but Levin Group finds that many dentists fail to do so. A handshake creates a sense of connection. Patients feel comforted when that connection is made, especially when they may be worried about experiencing pain. Conclusion Patients judge the quality of your practice largely by the way you (and your team) communicate. Verbal abilities and body language affect patient perceptions of quality and customer service, which are vitally important to the success of your practice. Using positive language and adhering to scripts are effective ways to deliver a consistent, effective message to patients. ■
To learn how to run a more profitable, efficient and satisfying practice, visit the Levin Group Resource Center at www.levingroup.com/gp —a free online resource with tips, videos and other valuable information. You can also connect with Levin Group on Facebook and Twitter (Levin_Group) to learn strategies and share ideas.
Don’t Worry About Your Future...Own It!
The Paragon Progressive Ownership (POP) Plan provides a proven means for a new dentist to gradually enter into a co-ownership relationship with an experienced dentist.
Call Paragon for a personal consultation to see if POP is right for you. 866.898.1867 Visit PARAGON.US.COM to sign up for our free newsletter.
CEREC® AC with Omnicam
The most clinically capable CEREC system ever. From single crowns to multiple units, individual quadrants to full arches, CEREC Omnicam “does it all.” Designed for Access Slim, rounded camera tube allows easy rotation of the camera in the intraoral space. Tiny camera tip guarantees the best lens positioning anywhere in the mouth. Color Streaming for Confidence As the camera moves over teeth, a photorealistic clinical image is displayed in full-color with crisp clarity and impeccable detail. Powder Free for Convenience No need to apply reflective medium makes capturing images easier and faster than ever—and with Sirona’s industry-leading precision.
For more information and to schedule a complimentary in-office demo, contact your Patterson representative directly or call 800.873.7683.
Dental Entrepreneur Spring 2014 29
Power To Succeed BOB LEVOY
If I Had It To Do Over....
What older dentists, looking back on their careers, would have done differently
ne of the many questions I’ve asked countless dentists as part of the market research I do for my books and articles is, “Looking back on your career, what would you have done differently if you knew then, what you now know?’” The result has been a veritable treasure trove of wisdom, insights and practical advice.
don’t turn out as expected, the predictable result can include stress, anger and perhaps a parting of ways. Levoy’s Law for new associates: the fewer the surprises, the better. Discuss these topics and any others of importance ahead of time. And when agreement has been reached, put everything in writing. I started my practice with a single
employee who was affordable, but probably not the best person for the job. “Don’t skimp on compensation – especially in the beginning” is the consensus of those dentists who initially underestimated this critical aspect of practice management and later regretted it. Hiring people who are less than qualified to handle such matters as new patient inquiries, scheduling,
Here are a few of these hard learned lessons:
When first starting out as an associate, I should have discussed many job-related details with the senior dentist – before joining the practice.
Many practice owners and new associates fail to adequately discuss such job-related details as productivity expectations, future salary increases, fringe benefits, working hours, time off for continuing education, vacation time and the potential for future partnership. And if a future partnership is an option, what is the timetable and requirements for achieving it? Invariably there are feelings, perhaps strong beliefs, on both sides about such issues that are often widely divergent. Sadly, they’re frequently glossed over, if not avoided altogether, during the initial meetings. Down the road, when things 30 Spring 2014 Dental Entrepreneur
recare appointments and collections in order to save money makes no sense. On the other hand, an experienced staff member on the other hand will also have the know-how to deal with the issues that arise in everyday practice and require tact and skill to properly resolve – tasks with which you don’t want to be involved. These include telephone shoppers, overdue payments, complaints about fees or insurance coverage, missed appointments, and about 101 other situations. If you paid more, you could hire someone with amazing communication skills and experience who could multitask, remember the names of patients, and handle problems with finesse. What would that be worth in the early days of your practice? “Hire the best,” said management consultant Charles Blair, DDS. “Top practices always recruit the highest quality employ-
Top practices always recruit the highest quality employees, even though they cost a little more. ees, even though they cost a little more. Despite the higher cost, they represent an excellent value, since their productivity far exceeds that received from cheaper, but more mediocre employees.” Another common regret pertains to the way needed dental treatment was presented to patients by dentists who were just starting out. “I over-explained everything,” one dentist told me, “and it wasn’t working.”
YOU CHANGE LIVES EVERY DAY.
PATTERSON ADVANTAGE SUPPORTS YOU.
Did you ever have an “Ah-ha!” moment? Maybe it was one of those times when suddenly everything came together and made perfect sense, so basic, you wonder why you didn’t see it before. Mine came when I read that Morton Salt, the world’s leading producer of salt, conducted focus groups to learn why its customers were willing to pay a little more for its salt, even though it is identical to all other salt. The company admitted to the participants that its salt was identical to that of its competitors – and even that it supplied salt to others who sold it for a lower price. The group members responded they would still buy Morton’s salt at the higher price because they trusted the company more than others to provide a fair measure and a clean, uncontaminated product. In other words, trust accounts for the loyalty of Morton Salt’s customers – not to men-
As a dental practitioner, you change lives each and every day, whether it’s relieving a patient’s painful dental condition or helping them achieve the smile of their dreams. The Patterson Advantage program is one of the many ways that we support you in enhancing the patient experience and practice lifestyle.
PATIENT EXPERIENCE, PRACTICE LIFESTYLESM PATTERSONDENTAL.COM | 800.873.7683
Dental Entrepreneur Spring 2014 31
tion their willingness to pay a premium fee. Patients don’t accept your recommendations for implants, crowns, periodontal surgery, orthodontics and endodontics because they truly understand the fine points of what’s involved. They do so because, in a word, they trust you. And once established, case presentation becomes a cinch. Establishing trust, however, is a process, much closer to farming than it is to manufacturing. In my book, 201 Secrets of a High Performance Dental Practice, I devote an entire chapter to this topic as it relates to case presentation and patient acceptance. Here are a few of the hard learned lessons about this process:
• “Be very slow to get into the patient’s mouth,” periodontist. Mitchell T. Cantor D.M.D. M.S.D., told me. “First, get into the patient’s heart; then, the patients head; and then, into the patient’s mouth.” • “Your greatest asset to future happiness and success in dentistry is the time you spend listening to your patients,” said Irwin M. Becker, DDS, consultant and former Chairman of the Department of Education of The Pankey Institute. “This pre-clinical and co-discovery examination time is the activity that really differentiates your practice. It is your premier opportunity to personalize your relationship with each
patient, forming the basis of a trusting doctor-patient relationship. And it permits you to recognize which patients are ready for complete dentistry and which need to start with Phase 1 care.” • “The worst case presentations I do are when I do all the talking,” said Anthony S. Feck, DMD. “When I do that, I don’t have a clue as to what really matters to the patient, and no case presentation can be effective until that is decided. The best way to determine that is to ask good questions and listen carefully to the answers.” • To avoid the problem of over-talking, author/speaker Nate Booth DDS suggested this simple question: “Would you like all the details about the treat-
201 Secrets of a High Performance Dental Practice by Bob Levoy, published by Elsevier/Mosby LEVOY 20 1 SECRET S
HIG CE DEN TAL
S E C R E T S of a
erfo ma Dentha-P nce l Prarc tice
“Bob Levoy practically invented practice management, but God is not finished with him yet. His latest book may be the best book on dental practice management ever written. We liked it so much we’ve recommended that it be the required textbook for our practice management course at Temple University School of Dentistry.”
One of the reviews from www.amazon.com
BOB LEVO Y
This book is a unique compendium of wisdom, insights and practical advice from many of the country’s most successful dentists. It is packed with tested tips, hard learned lessons and action steps to greatly improve patient satisfaction, practice growth and profitability.
Patrick Wahl DMD, MBA
32 Spring 2014 Dental Entrepreneur
ment that needs to be done or just an overview?” • Don’t oversell patients on procedures they don’t really want or can afford. They may later experience “buyer’s remorse.” Dissatisfied with the final result, patients may not follow through with payments, or worse, bad-mouth you to others. Forgo short-term revenue for long-term trust. “I would have spent more time with my family.” Now, while that is sad to say, it is a frequent answer to the questions posed in the opening paragraphs of this article. Many dentists, especially those starting out in practice, put in long hours at their offices, often six days a week. It often results in much borrowing against the future. The assumption? There will always be a future. However, time quickly slips by,
and before you know it, it’s gone. One day they look back and realize that by focusing so exclusively on their practices, they completely missed their children’s youth and their partner’s companionship. An Illinois dentist was torn between having evening hours and being at home with his family. After much deliberation, he put a sign in his reception area that read: “Starting Jan. 1, Daddy’s office will close at 6 p.m.” It was signed, “Debbie and Billy,” and he lostl very few patients. An action step for this last issue is to think about what’s truly important in your life and your practice and guide yourself accordingly. ■ Bob Levoy is the author of 7 books on practice management including 201 Secrets of a High Performance Dental Practice (Elsevier/ Mosby) and 222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices (Jones & Bartlett)
Please reach out to our authors and our advertisers. They care about you and keep us in print!
Business Beyond the Classroom
If you have any questions, comments, or responses to our magazine, please connect with us on Dental Entrepreneur Magazine — our official Facebook page! Read us online www.dentalentrepreneur.com Send your questions or comments to email@example.com www.dentalentrepreneur.com
Dental Entrepreneur Spring 2014 33
Power To Succeed DAVID RICE, DDS
3 Principles Young Leaders Should Strive For “Light a match in a dark room and watch as the light instantly overcomes the darkness. Observe the power and grace David Rice, DDS of that single, solitary flame dancing with life. Now, light several candles and experience the added warmth and comfort extended from that first, vulnerable flame through others.” 1.
Lighting the Match: If you were taking a road trip to a new destination, how would you make sure you found your way?
I’m guessing if you’re anything like me, you’d dial up Google maps on your trusty iPhone or load it into your GPS. Sound familiar? Excellent, because the very first step in becoming a great leader is exactly the same. It’s all about VISION or PURPOSE. YOU need to know where you’re headed. YOU need to share that destination with your team. Think about it. If you don’t know where you’re headed, how will you ever know if you’re on the right track? And to that end, if you don’t know, how could ever expect your team to know? So your first step in becoming a great leader is to know where you want your practice to go. This is your vision, your purpose and is for you to decide. With that in mind, my experience with many young dentists is this is much easier said than done. So
34 Spring 2014 Dental Entrepreneur
here’s a tip. Don’t overthink it, and if you’re having challenges with seeing your exact destination, simplify. Imagine your road trip takes you from Buffalo, N.Y., to somewhere in California. Although you haven’t finalized your city of choice, your vision, you know a few very important things. You know you’re heading west. You know California’s your end goal. And you know you’re going to need to make multiple stops along the way. So again, don’t overthink it. Plan your road trip a stop at a time. Your first critical step is to make your plan and get in the car. 2. Passing the Torch: If you want your team to come along for the road trip, you’ll have to share your plans. Taking a road trip from New York to California is no small journey. The same goes for building the practice of your dreams. So once you know where you’re headed, the key is getting your team to want to go with you. The key is PASSION. Great teams follow leaders who seek first to understand. Great teams are built on the backs of great systems. Passion and excitement fuel both your initial flame and the torch you pass on to each member of your team. Great young leaders are on a mission and are willing to do all the little things that mediocre young bosses are unwilling to do. So what are two of the most critical qualities I’ve experienced? The first is their ability to seek to understand before being understood. Translation – great young leaders
listen. Once your vision is in place and your team knows where you are heading, embrace the mastermind concept. Understand that the whole of your team is more intelligent and more powerful than any one part, including you. While your passion leads the direction of the road trip, your team’s eyes and ears can scout out food, gas and all the sights you want to see on the way. Together you are powerful. The second quality passionate leaders understand is that great teams are built on the backs of great systems. It’s been said that 94 percent of success comes from the system and 6 percent comes from the people. Now that doesn’t mean that your team isn’t critical. They are! That said, imagine you know where you’re headed. Imagine you have a great team that wants to follow you. Imagine how effective you’ll be when you stop at a rest stop and everyone on the team knows exactly what their role is. One of you gets the gas. One of you gets the snacks. One of you checks the tires, while another uses the rest room. You are a finely-tuned machine because everyone knows and fully understands what their role is and how to execute it. Now imagine the opposite. Imagine your rest stop, still with a great team but no system. Every superstar is running around trying pump the gas, check the tires, get the food and use the rest room all at the same time. Measuring the heat. If you want to get to your destination, you’ll have to keep your eyes on your map. Just like there are critical check points in your journey from New York to
California, there are critical check points in the successful dental practice. So last, but certainly not least, great young leaders understand that their success is dependent on measuring results. You need to keep your core values, but your strategies may evolve. You need to embrace change through continual improvement. At the end of the day, your vision and your passion have inspired you and your team to take that road trip. At the end of the day, your success is defined by getting to California. The final piece in making that happen is measuring your results, but maybe a little differently than you might be thinking. It’s true, my experience has taught me to measure all the traditional vital statistics many practice management consultants recommend. I would highly
recommend you do the same. However, great leaders make two measurements most leave out. First and foremost, great leaders always maintain their vision. The core values of that initially lit match always burn. How they ignite the other candles and how they spread the warmth and comfort… that may evolve. Great leaders realize that just as times change, their strategies change too. Here’s an example. Ten years ago a young leader wanted to maintain communication with his patients outside of office hours. His core value of great communications and customer service led him to send out postcards to remind his patients of their next re-care appointment. Fast-forward to today where another great young leader holds that same core value. Would she still send out postcard reminders? Likely
not. Likely today, she would engage her patients through one of the many customized automated email or text solutions. The core value is the same, and the strategy has evolved. The final piece to measuring results is very simply what we’ve just addressed. The final piece is great leaders embrace change. It doesn’t need to be crazy, turn everything upside down change. It simply needs to be constant. Great leaders understand that being a little bit better tomorrow than they were today and a little bit better today than they were yesterday adds up to tremendous results. Imagine you are leading a team of four. Imagine every day each one of you improves in only one aspect. That’s four improvements a day, 20 a week, 80 a month and over 1,400 improvements a year. Imagine your one lit match, your VISION, fueled just a little bit every day by your team, your PASSION and the roaring fire, your RESULTS. Imagine how these three simple principles could igniteYOURFUTURE! ■ Dr. David Rice graduated cum laude in 1994 from The State University of New York at Buffalo’s School of Dental Medicine. In 1995, he completed his general practice residency from the Allegheny General Hospital in Pittsburgh Pennsylvania. With a strong belief in continuing education and mentorship, Dr. Rice went on to complete continuums at the Pankey Institute, The Dawson Center and The Spear Center all while building the Restorative Practice of his dreams and maintaining an associate clinical professorship at the SUNYab School of Dental Medicine. One and a half years ago, Dr. Rice combined his passions for teaching, mentoring and making a difference and igniteDDS was born. Today he continues to maintain his private practice and travels the country inspiring dentistry’s future to live their dream, have great success and to make that same difference that has brought him so much joy. David R. Rice, DDS (716)912-7970 david. firstname.lastname@example.org www.ignitedds.com
Dental Entrepreneur Spring 2014 35
Dental Trade Shows
National Dental Student Lobby Day
102nd Hinman Dental Meeting March 27 -29, 2014 Atlanta, GA
April 7-8, 2014 Washington, D.C. ASDAnet.org/LobbyDay
California Dental Association– Spring Session May 15 -17, 2014 Anaheim, CA 155th ADA Annual Session October 9 -14, 2014 San Antonio, TX Greater New York Dental Meeting November 20 – December 3, 2014 New York, NY Yankee Dental Meeting January 28 – February 1, 2014 Boston, MA
ASDA’s National Leadership Conference Oct. 31-Nov. 2, 2014 Chicago, Ill. The American Student Dental Association is hosting its National Leadership Conference, Oct. 31-Nov. 2 in Chicago. For details visit ASDAnet.org/NLC. The event will provide leadership and business training to dental students across all years. Other benefits of attending: • Experience training in people management, public speaking and presenting, personal finance, practice negotiations, mentoring others and more • Increase the understanding of key issues in dentistry and dental education • Network with students from 60+ U.S. dental schools • Build relationships with exhibitors to fulfill current and post graduation needs Dental Entrepreneur: Business Beyond the Classroom will be there to meet the leaders attending. Please look for us!
Index of Advertisers ADS Dental Transitions South.......................................................................................................... 5 ADS Dental Transitions…………………………………………………………….................................... 17 Aspen Dental................................................................................................................................. 9 Comfort Dental............................................................................................................................ 15 Heartland ................................................................................................................................... 11 Henry Schein Professional Practice Transitions.................................................................... Inside back Henry Schein Nationwide ..................................................................................................Back cover MacPractice................................................................................................................................ 27 Paragon...................................................................................................................................... 29 Patterson Dental...............................................................................21, Inside front cover and page 1 Patterson Dental Advantage.......................................................................................................... 31 Practice Image Builders................................................................................................................ 25 Sirona........................................................................................................................................ 29 Wells Fargo................................................................................................................................... 7
36 Spring 2014 Dental Entrepreneur
This represents only a sample of our practice listings. For a complete listing, visit www.henryschein.com/ppt ALABAMA
Birmingham-Established Practice, Desirable Area, Seller Highly Motivated, GR $596K #AL108
Tucson-4 Ops, 1400 SF, Dentrix & Dexis #12111
When it’s time to buy, sell, or merge your practice, you need a partner on your side! • Practice Sales • Appraisals
San Diego-General Practice, 5 Ops, 1200 SF, Digital X-Rays, GR $442K w/Adj Net $161K #CA130
Denver-5 Ops, Great Start-Up, Location; Growth Opportunity #CA100
Waterbury-Established FFS Practice w/Condo for Sale, Great Patient Base, GR $417K #CT501
Pompano-Small Office w/Great Potential as Start-Up, GR $160K #FL504
Atlanta-4 Op Perio Practice, Excellent Opportunity, GR $834K #GA500
Maui-4 Ops, 1198 SF, 4 Days Hygiene, Pano, Laser, Digital X-Ray, I/O Camera, GR $572K #20101
Blaine County-General Practice, Fee for Service, Great Location, GR $742K #ID103
W Suburbs Chicago-Qualified Buyer to Buy/Merge #22135
• Transition Planning
Marshall County-4 Ops, Office in Town w/Large Lake, GR $293K #IN501 Beattyville-General Practice, 5 Ops, 1000 Active Patients, Equipped for Ortho, GR $415K #KY102 York County-2 Ops w/Room for One More, 1800 SF, Bldg must Sell w/Practice, GR $600K+ #ME100
Prince Georges County-6 Ops, Well-Established, Digital, Dentrix, Strong Hygiene, GR $944K #MD108
Cambridge-3 Ops-Room for 4, Desirable Location, Dentrix, Digital, Cerec #MA107
Clinton Township-Established Family Practice, Owner Retiring, GR$670K #MI108
Western-Great General Practice in a Beautiful Setting, GR $688K #MN100
Gilford-GP/Condo in Lakes Region, Small Emphasis on Perio/Implant Surgery, GR $512K #NH100
Sussex County-2 Ops, Well-Established, Center of Historic Town, GR $400K #392156
Finger Lakes Region-6 Ops, 2000 SF, 1700 Active Patients, Real Estate Available, GR $963K #NY121
Coastal Area-Well-Established, Highly Successful, Stand-Alone Bldg, Remodeled, Beautiful! #NC504
S Central-Wonderful Productive Rural Practice, GR $696K #43102
Sharonville/Glendale-6 Ops, 3200 SF, Great FFS GP, Well-Established, RE for Sale, GR$1M #OH104
Tulsa-10 Ops, Pediatric, High Traffic Area, GR $1.2M #OK504
Lackawana County-5 Ops, Stand-Alone Building w/Parking #472007
Scituate-3 Ops w/4th Available, PPO & FFS Patients, Pan, Dentrix, Dexis, GR $454K #RI500
Aiken County-4 Ops, 1750 SF, Stand Alone Bldg, Motivated Seller, GR $250K #SC102
Goodlettsville-Madison-North Nashville Area-3 Ops, 4th Plumbed, Excellent Start Up Opportunity #TN102
Dallas-3 Ops, Prostho Practice, 1200 SFw/Well Designed Lab, GR $300K #TX502
Windsor County-Immediate Sale! Well-Established General Cosmetic Practice, Digital #VT100
Virginia Beach-5 Ops, 1900 SF, Great Growth Potential #VA2409
South Snohomish County-6 Ops, 1700 Active Patients, Strong Hygiene, GR $1.2M #WA500
Washington County-3 Ops, Great Satellite Office, Fully Transferrable Lease, GR $193K #WI100
© 2014 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.
This represents only a sample of our Associate opportunities. For a complete listing, visit www.dentalopportunities.com
Solutions for your Dental Associate recruitment and placement needs! • Placement in private practice, clinics, and dental organizations • Associate candidates and employers • Proactive and results-driven • Personal attention • Experienced professionals
© 2013 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.
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The Spring 2014 edition of Dental Entrepreneur Magazine, featuring Dr. Carmen Leary.