Dental Entrepreneur | Fall 2011

entrepreneur ☛ The Five Ways to Open a Practice ☛ Your Career Options: Employment or Ownership?

The Search for the Holy Grail of Dentistry

class of 2012 | fall issue

dental

Business Beyond the Classroom

P110369 (9/10)

PArtnerShiP. integrity. INNOVATION. At Patterson Dental, we are proud to connect you with innovative tools and resources so that you can focus on providing expert dental care.

Patterson Dental is the company you can call on for everything from operatory equipment, digital X-ray products, dental practice financing and innovative CAD/CAM impressioning solutions as well as the service and support to seamlessly integrate these technologies into your practice.

As the dental industry has evolved and practice needs have expanded, we’ve grown to meet your needs, with 88 branch offices nationwide and more than 1,500 sales representatives and equipment specialists in the U.S. and Canada.

Let us be your partner in providing everything you need to excel at dentistry.

Contact your Patterson representative, local branch or call 1-800-873-7683

dental

entrepreneur Fall 2011 Volume 14, issue 1 Editor & Publisher Anne M. Duffy RDH Assistant Editor Michael Duffy Brad Beauchamp Production/Accounting Kitty Beauchamp Director of Advertising Linda Hart Editorial Board Dr. Gene Heller Scott Mahnken Allen Schiff, CPA Dr. Tom Snyder Dr. Harold B. Sturner Dr. Joe Rubino Layout and Design John O’Connor

Class of 2012 Contributors Bruce Bryen, CPA Edward C. Challberg, CPA Dr. John H. Jameson Dr. Roger Levin John McDonnell Brendan Morrissey, CEO Kathleen M. Roman Dr. Tom Snyder Dr. Richard Weinman David Woods

Charter Sponsors Oral‑B Laboratories Ultradent Products Inc. Proctor & Gamble Wm. Wrigley Jr. Corp.

Glidewell Laboratories Benco Dental Co. Tess Corp.

Dental Care Alliance

The Pride Institute The Snyder Group McKenzie Management Caesy Education Systems, Inc. Warner‑Lambert Co. Phillips Health Care Oxyfresh Worldwide

Editorial Office 12233 Pine Valley Club Drive Charlotte, NC 28277 704/953-0261 Fax 704/847-3315 ADuff2@aol.com Send materials to: Dental Entrepreneur 7422 Carmel Executive Park #107 Charlotte, NC 28226 704/846-7089 Fax 704/846-7304 Linkbeau@aol.com When you have finished enjoying this magazine pass it along to a friend and PLEASE RECYCLE Copyright 2011 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.

2 Fall 2011 Dental Entrepreneur

Welcome to Dental Entrepreneur

class of 2012 fall issue

L

ast spring, I had the privilege of attending the student luncheon at the Thomas P. Hinman Dental Meeting in Atlanta, Georgia. Every year, the Hinman Committee invites all of the attending students to a delicious spread to kick off the weekend. At the luncheon, General Chairman Dr. Edward Pafford and his committee chairs gave the students an overview of the courses and the technical exhibits and invited them to partake in all the parties over the next two days. This is true Southern hospitality!

It was my pleasure to meet so many amazing young men and women about to graduate to begin their careers as dental professionals. They looked so bright-eyed: eager to embark on the next chapter of their lives. Surely, by the end of the weekend, their heads were spinning from all the new and exciting discoveries they encountered. Yes, dentistry can be exhilarating. As in everything – it is what you make it.

It takes integrity to view dentistry as a constantly evolving industry, and meetings like the Hinman have a way of making the ongoing education fun.

It’s easy to stick with what you’ve learned in school and consider the matter resolved, but that doesn’t leave any room for the innovative technologies and techniques that arrive each year. Perhaps the dated tools won’t be noticeable for the first few years, but in time, it will affect business. As a dentist, it’s critical that the learning never stops.

Everybody understands the importance of a strong team. We here at Dental Entrepreneur: Business Beyond the Classroom believe you may be in business for yourself, but not by yourself. And so we have built a team of experts to help you get started.

David Woods, transition specialist and VP for Paragon, highlights two key factors in any successful practice in his article kicking off this issue. Dr. Tom Snyder, Director of practice transitions for the Snyder Group/Henry Schein PPT, offers a critical overview of employement versus ownership. CPA, Edward C. Challberg, speaks about the risks present in today’s uncertain economic climate. And John McDonnell, from American Dental Sales, shares all the secrets to making the right purchase for you.

Be smart and reach out to our experts with your questions and concerns.

They want to hear from you and have dedicated their professional lives to your attainment of the “Holy Grail of Dentistry”. If you keep pushing yourself to learn and grow, success will be downright inevitable.

All the best,

Anne M. Duffy Publisher

P.S. We are doing our part to keep up with you! Dental Entrepreneur will be available (for free) in the spring on the Apple iPad. Watch for our new app in the APP Store. www.dentalentrepreneur.com

class of 2012 fall issue Volume i

dental

entrepreneur’s

Contents Prologue

4 The Search for the Holy Grail of Dentistry David Woods

Getting Started 8 Your Career Options: Employment or Ownership?

Tom Snyder, DMD, MBA

10 What Organizational Format is Most Efficient Bruce Bryen, CPA

12 The Five Ways to Open a Practice

Business Beyond the Classroom Practice Builders 28 Effective Online Marketing Can Help Dental Practices Gain New Patients Brendan Morrissey, CEO

30 Five Things Every Young Dentist Should Know When Entering Practice Roger P. Levin, DDS

The Power To Succeed 34 Hinman 100–Year Legacy Offers Value to Emerging Dentists Richard Weinman, DMD

John McDonnell

Business Fundamentals 16 A Successful Strategy for New Dentists in a Difficult and Uncertain Economy Edward C. Challberg, CPA

20 Physical Safety from Violence in the Dental Practice Kathleen M. Roman, M.S.

24 Developing Your Technology Approach John H. Jameson, DDS

www.dentalentrepreneur.com

Dental Entrepreneur Fall 2011 3

Prologue David Woods

The Search for the Holy Grail of Dentistry T

his year another set of fresh faces will obtain diplomas certifying them qualified and competent to practice dentistry. To this new phase of their journey they bring energy and enthusiasm, hopes and dreams. Most have high expectations of earning substantial incomes, working four day weeks, being their own boss, and finding joy and satisfaction from their service to others; something we like to call the Holy Grail of Dentistry. All of them arrive in the wet finger world of private practice with cer-

4 Fall 2011 Dental Entrepreneur

tain expectations about what it will take to achieve their goals and obtain the Holy Grail. But sadly, as with the fabled knights of King Arthur’s court, many of them are soon disillusioned, and only a few will actually obtain the prize.

If we survey graduates in the same class from any dental school in the country we find this same phenomenon. Seventy-five or eighty dentists with the same degree, from the same school, doing much the same clinical work, working about the same amount of hours, yet some are

earning over $250,000 per year while others are barely making $75,000. As early as three or four years out, some of these young denDavid Woods tists will already own substantial practices with plenty of fee-for-service patients. Their incomes will be well into six figures, and they will have time to

www.dentalentrepreneur.com

travel, to explore their personal interest and to spend with their children. They will already be setting aside significant amounts of money for their future, and by the time their incomes and interest in dentistry peak out in their mid to late 40’s, they will be financially free to pursue a wide variety of options. But they will be the minority.

The ADA reports that only about five percent (5%) of dentists are able to retire comfortably by age 65. Years after graduation, most dentists from your class will still be wondering how the others do it.

Four or five years out, many will still be gutting it out in startup practices, hoping patients will show up before their bank line runs out. Most will still be associates, hanging on and waiting until their host decides to let them own a piece of the pie; waiting for their turn to get back as much as they have put into their career.

Why does this happen? Why are some dentists so much more successful than others? After almost twenty-five years of first hand experience, we can summarize it in just two words, willingness and knowledge, and in that order.

Willingness is an attitude. It is what we call an enabling or empowering attitude.

It is that quality which allows for everything else to happen. Willingness is being willing to accept the possibility that you don’t really know what to do. It is being willing to accept guidance from others. It is being willing to accept and take risks.

It is being willing to make and keep commitments. Yes, willingness is an attitude.

It is the attitude of success.

Contrast that with the young doctors that come out of school thinking that somehow their dental diploma has someway imbued them with the answers to life’s great questions; who inwardly believe that they are different than their predecessors; that the business part is easy or just plain common sense; that their particular abilities will allow them to beat the odds. They really believe that their associateship will actually work, because they alone know the secret to structuring the world’s greatest associateship; they know how to build the perfect practice

www.dentalentrepreneur.com

from scratch in less than three years; they know just where to go for financing; and finally, they know the secret to attracting and keeping vast numbers of quality feefor-service patients. They, of course, know so much that they don’t need anyone else

And finally, you need to know how to treat and serve your patients so well that they will never leave; not for a PPO, not for another dentist, not for anything.

That’s it. to show them.

Let’s suppose for a moment you are willing to do whatever it takes to make your career in dentistry the very best it can be. The question now becomes, “What does it take?” We know from experience that there is virtually no correlation between clinical perfection and practice success. Some of the best clinical dentists we know experience high stress, continual staff turnover, and low productivity. When they get together at the dental society meetings they stand around bemoaning the difficulties and pressures of private practice, and the fact that they can’t make any real money in dentistry. Listen closely to what they are saying: “there are just too many dentists, too many cut-rate dental plans, too much advertising, too few patients who appreciate their work, too few patients willing to accept treatment, too many whining staff members, too many government regulations, too few hygienists, blah, blah, blah.”, poor fellows.

Down the street, their colleague (who graduated in the bottom half of his or her class) is experiencing something much

different. Their same staff has been with them for years; ever since they bought the practice from Dr. Smith (or Dr. Jones or Dr. Whomever). They are friendly, motivated, and extremely good at what they do. They really enjoy working together and share a common vision of why they are there and what they need to do to meet the needs of their patients. Last year each staff member received just under $5,000 in bonus income, placing each one’s individual compensation well above the industry norms. Nevertheless, the doctor took home over 45% of his practice collections. That came out to just under $250,000 working the same 32 hour week as his or her neighbors up the street. This doctor earns enough to set aside a significant amount toward savings and investments. By the time his or her practice earnings peak out in their mid to late 40’s they will be financially free.

Let’s see, here we have a clinically average dentist who somehow has plenty of fee-for-service patients, a motivated and happy staff, works a four day week, earns a net income in the top 4% of all dentists, and will be set for retirement before he or she turns 50. If there really is a Holy Grail in dentistry, this person has found it. Sounds like a very successful dental practice, wouldn’t you say? Does it sound like yours? Does it sound like something you would like to have? You can have it, if you are willing, and if you know what to do to get it!

What kind of knowledge is required?

First, you need to know how to acquire and retain large numbers of fee-for-service patients. Second, need to know how to acquire and train a motivated, topnotch staff. And finally, you need to know how to treat and serve your patients so well that they will never leave; not for a PPO, not for another dentist, not for anything.

That’s it.

That’s it? Yes, that’s it. Are you surprised? It sounds awfully simple, doesn’t it? And in a lot of ways it is simple.

Simple stuff that anybody ought to be able to do - right? So why then don’t more dentists have practices overflowing with happy staff members serving loads of fee-

Dental Entrepreneur Fall 2011 5

for-service patients? Maybe it’s not so easy after all. Maybe things get confused in the vast gulf of reality between talking about it and actually doing it.

So what is the first key to any successful practice? It all starts with patients.

Without patients you have nothing but equipment and a lease on some real estate. I am always amazed at how many young dentists think that because they have a location and some equipment they have a practice. Wrong. Those things can be had just about anywhere. They are commodities which can be acquired anywhere, at any time, from any vendor or leasing agent. In a way, patients are also commodities, only they are not so plentiful, and are much more precious, as any practicing dentist will tell you.

Nevertheless, fairly large groups of quality patients can be acquired. Sometimes they come with equipment, a location, and a staff. Sometimes they even come with a doctor willing to do some of the production. Sometimes they come with only their charts and a letter of endorsement from the one guy they have trusted for thirty years or more. Amazingly, if the proper steps are taken, over 95% of them will typically show up to let the new doctor treat them.

All you have to do is be willing to make the journey with someone who knows the way. Just remember that most of your colleagues will seek dentistry’s sacred Holy Grail, yet few will ever find it. Now you know why.

Remember, for the noble Knights of the Round Table, the requirements of success were virtue, humility and the sinless life. ■

David Wood’s academic background is in Business with an emphasis on Marketing. He is a graduate of Mississippi College.

David has managed and acquired multiple businesses in the Mid South prior to joining PARAGON. Over the past ten years he has assisted many PARAGON clients across the nation with their transition needs. He has been involved in the development of many of PARAGON’s current transition programs including presales, mergers, consolidations as well as co-ownership arrangements. David currently serves as PARAGON’s Vice President overseeing operations in the Southern United States. His primary duties with PARAGON include the recruitment, training, and daily transition support of PARAGON consultants.© Paragon, Inc. All rights reserved.

Business Beyond the Classroom ADCPA (503) 485-9252 www.ADCPA.org

Please reach out to our advertisers. They care about you and keep us in print.

dental

Business Beyond the Classroom

entrepreneur If you have any questions,

Resource Guide

The Academy of Dental CPA’s (ADCPA) is a national association of accounting firms that specialize in delivering creative solutions that meet the unique needs of the dental profession. The ADCPA is comprised of 24 firms, representing in excess of 7,000 Dental Practices, that provide progressive consulting, accounting and tax services. Please see our ad on the back cover.

comments, or responses to our magazine, please write us at: Dental Entrepreneur Magazine, 7422 Carmel Executive Park #107, Charlotte, NC 28266 or e-mail us at:

ADS Transition Specialists (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 13.

ADuff2@aol.com or Linkbeau@aol.com

www.dentalentrepreneur.com

6 Fall 2011 Dental Entrepreneur

www.dentalentrepreneur.com

Join us Atlanta IN

100 Hinman

FOR THE

TH

MARCH 22 – 24, 2012 DON’T MISS THE CENTENNIAL HINMAN! • Introducing, a new 3-day, educational track, “Emerging Dentist’s Survival Guide” • An exciting Exhibit Hall with two Hinman Eateries, complimentary snacks, drinks & Wi-Fi access • Introducing the “New Product Pavilion” & “100 Years of Hinman” in the Exhibit Hall • Diamond & $100 bill giveaways to celebrate 100 years of Hinman • “The Parties of the Century” for Dentists & Auxiliaries on Friday night • Special Keynote Address with Former First Lady, Laura Bush

Featured Clinicia ns Dr. E. Pat Allen Mr. Kirk Behrendt Dr. Joseph A. Blaes Dr. Jeff J. Brucia Dr. Joe H. Camp Dr. Anthony R. Cardoza Dr. Gordon J. Christensen Dr. Harold L. Crossley

Dr. Connie L. Drisko Dr. Robert R. Edwab Dr. John C. Flucke Dr. Gregory J. Folse Dr. Henry A. Gremillion Dr. Harald O. Heymann Dr. Frank L. Higginbottom Dr. Randy F. Huffines

Dr. Mark E. Hyman Dr. Robert A. Lowe Dr. Stanley F. Malamed Dr. Thomas R. McDonald Dr. Dale A. Miles Dr. P. D. Miller Dr. Gregory L. Psaltis Dr. John A. Svirsky

Register between December 1, 2011 & February 23, 2012 to take advantage of discounted pre-registration fees.

For more information or to register online, visit www.hinman.org.

HinmanDentalEntrepreneur.indd 1

9/14/11 12:08 PM

Getting Started Tom Snyder, DMD, MBA

Your Career Options: Employment or Ownership?

M

any of you are facing staggering dental education debts ranging from $250,000 to $400,000. Beginning your dental career with this amount of debt can certainly cloud your vision about owning a practice. For some of you, becoming a long term associate may be the only option you feel that you have, but this may not be the case!

In this article, we’ll explore several options for you to consider, and how the economics of owning a dental practice may still be your best path to financial success.

BECOMING AN ASSOCIATE Over the last ten years, we have seen a dramatic growth in Dental Service Organizations or Dental Management Companies. There are currently in excess of 170 companies, ranging in size from companies with 5 locaThomas Snyder, DMD, tions to an excess MBA of 250. Many have acquired practices that require the seller to remain with the business anywhere from two to four years. Since these companies are “growth oriented,” they’ll need even more dentists to staff their locations. Furthermore, DSO’s will also need replacements for those sellers who will be completing their post-sale commitment as they enter retirement. So the need to recruit a growing number of recent grads will only increase. Several of the national

8 Fall 2011 Dental Entrepreneur

companies have been recruiting at many dental schools, offering very competitive starting salaries with good fringe benefit packages.. Additionally, based on the location of their practices, student loan repayment options may also be available.

Consequently, a growing number of you will consider this choice to be an attractive option after graduation. We also have seen a growing trend for new graduates to reject the career path of owning a solo practice. Today, approximately 64% of dentists today are considered solo independent practitioners. This ratio is down substantially from ten years ago! This trend will continue as more graduates prefer working with “another doctor” rather than practicing alone. For some of you, considering a long-term affiliation with a Dental Service Organization will be your career choice, desiring the security and benefits this model can provide. For many others, however, it will be a bridge to a career in owning your own dental practice or starting a practice.

PRIVATE PRACTICE The majority of dentists still want to own their own businesses or become a co-owner in a group practice. So, you have three pathways to consider in private practice; starting a practice from scratch, purchasing a practice to become a sole owner, or becoming an associate leading to a co-ownership position.

START-UP This path is still a viable in markets that have strong positive growth. Over the past several years, the Great Recession has

taken its toll on dental start-ups, especially in markets that have been hit hard by the economy. Lenders have seen an increased number of business failures with start-ups so some lenders are quite stringent on loaning money for such a venture. Since many start-ups range from $300,000 to $450,000, you really have to be successful in the first few years of operation or the debt service may overwhelm you. So, considering a start-up in today’s economy requires careful pre-planning accompanied by an exceptional marketing plan.

Demographics of the area and population are key as well here, so investing in a professional demographic analysis is a must!

In the end it’s the patients that will make you successful, so if you cannot attract a steady and growing patient base, the outcome is obvious.

PURCHASING A PRACTICE I have a natural bias to either purchasing an existing practice or becoming a partner in an established practice. In both cases, you are dealing with an established patient base and doctor goodwill and most importantly, a historical cash flow!

If you consider purchasing a practice with a high gross revenue , do not back away from a larger practice If you are capable of doing the dentistry, you can be properly rewarded for assuming the risk of buying a larger practice.. To illustrate this point, assume that you purchase with a gross revenue of $700,000 practice that realizes annual profits of 40% or $280,000 a year,. Over a 20-year period, without ever considering any increases in practice growth and net income, the accumulated

www.dentalentrepreneur.com

income could translate into $5.6 million in earnings! Let’s assume that you paid $420,000 for this practice and loan payments were made over ten years at an interest rate of 7.5%. That would translate into annual payments of $59,454 over the course of your loan. Does borrowing $420,000 for a practice that can produce potentially over $5 million in lifetime earnings seem to be a worthwhile investment? The answer, of course, is “yes.”

While it is true that assuming a large amount of practice acquisition debt seems imprudent when you may owe hundreds of thousands of dollars in outstanding student loans, you may want to rethink this assumption. The purchase of a dental practice with good profit margins is essentially ensuring a larger income stream for you now and in the future. Furthermore, banks are not afraid to loan you the funds to purchase the practice as long as you have good credit and proof that you can produce dentistry at a level to sustain the debt service. Banks that specialize in dental lending make their decisions not only on your credit worthiness, but also on the cash flow of the practice you are purchasing.

With interest rates still hovering in single digits, the time is right for taking advantage of these market conditions that enable you to invest in a high grossing practice. Lower interest rates translate into more purchasing power for you, thus enabling you to afford a practice with a higher gross revenue.

CO-OWNERSHIP If you prefer not to work alone, joining a practice as an associate with the opportunity for a buy-in is a worthwhile alternative. For the same reasons as buying a cash flow when purchasing a dental practice, becoming a partner in a profitable practice with good cash flow and growth potential can also be a successful career choice. Obviously, being able to share responsibility and have compatible personalities are key ingredients to any co-ownership arrangement, whether it’s one dental partner or multiple dental partners.

www.dentalentrepreneur.com

sitions for The Snyder Group/Henry Schein Professional Practice Transitions. A transition services consulting firm that specializes in practice valuation, practice sales as well as designing associate and partner relationships.

He can be reached at (800) 988-5674 or email: HYPERLINK “mailto:tsnyder@snydergroup. net” tsnyder@snydergroup.net The firms’ website is www.snydergroup.net

In the end, your options are wide open even though at this stage you feel that it will be a daunting task. Careful consideration of all options and understanding the pluses and minuses of each choice is key for you to become a successful practitioner. ■ Dr. Tom Snyder is Director of Practice Tran-

he

t uild

b We

y

eb

tic rac

p

ur

yo of

g

din

vi pro

you

ha

wit

nd bra

and

you ing d i rov pr ing y, p ket t r i t a n em ide ary ll th a ess c h t e i r n w you ials h r t i e t tw l ma rra nec n o efe r c to n and ta nt e i –a t y t pa i n st. mu co e com l ab ord aff ice act

e siv n e reh and age p g m k co ndin pac a y br ntit ide ogo

eL s* * ctic s Card lopes a r e P s v ine /En Bus rhead chure* re* o s* te Let rral Br t Card rochu nt e B e n Ref intme r view elopm v e o e v p D O ics Ap ice esign/ Gra ph t c e Pra ite D na g uded bs g i e S W cl r erio ting In t x E n Pri All

00

,9 $12

age k c Pa IN dia e lM cia o S U CL

DE

S

866-610-5334 • www.practiceimagebuilders.com Your package includes all graphic design, brand consulting, copy writing, web design and hosting, and printing and shipping of 1,000 quantity* of each all marketing materials.

Dental Entrepreneur Fall 2011 9

Getting Started Bruce Bryen, CPA

What Organizational Format is the Most Efficient?

A

s a recent graduate, you will be working in a dental practice that has its legal business structure as one of the following:

1. LLC 2. LLP 3. C Corporation 4. S Corporation 5. Proprietorship 6. Hybrid of one of the above 7. Other Your employment contract will be with one of the above business entities, and you may not have the knowledge to discern why your employer chose a particular type of legal entity for their practice. As you will learn, each legal business structure involves different Bruce Bryen, CPA financial and tax components; with some businesses, the chosen business structure of the owner can greatly hinder the bottom line.

The choice of an entity should be carefully considered, as there are many financial and tax aspects as well as legal protections that each type of entity affords. If your goal is to learn the clinical as well as business end of the practice, and to eventually buy or start up your own dental practice, then it is critical to understand how to manage your practice as efficiently as possible. You want to earn as much as you can for the effort that you will be putting into your practice from a clinical perspective, and retain as much of those 10 Fall 2011 Dental Entrepreneur

earnings from an income tax point-ofview as well. The legal protection of those assets from creditors and others is also an important factor that varies depending on the type of business entity that you choose.

What are Some Advantages and Disadvantages of Each?

Each business structure has its own distinct advantages and disadvantages. It’s important to understand the variations between them before you launch your own practice.

The LLC is a separate format in which the dentist is afforded the legal protection of a corporation and yet does not have the formal requirements of reporting income as an employee in the form of a w2. The income or loss from this type of dental practice flows through to the personal tax return of the dentist directly from the LLC. There are no potential double taxes to pay, which is the case typically in one type of corporation commonly referred to as a C Corporation. Tax and financial considerations are available in the form of the management of tax filing requirements, rather than a tax requirement due when your paycheck is issued as an employee of a corpora-

tion. The cash and financial management availability is better served because of the frequency requirement of the tax payments for yourself, as the owner. All other financial and cash management issues are similar to any other type of business venture. Equipment and other tax write offs are more easily attained with this type of entity than with corporations because of tax rules involving equity in the venture and credit for loans to be counted as equity. You can learn more of the specifics of these rules as you hire or retain individual advisors such as CPA’s or dental practice consultants.

The LLP is similar to the LLC in almost all aspects. Depending upon the state in which you decide to practice, a require-

www.dentalentrepreneur.com

ment for either the LLC or the LLP will be the legal response to the actual entity to be formed and registered with that particular state, but from a federal government point of view, they are similar. The advisor that forms the entity for you will have the knowledge from the particular state in which you decide to practice as to whether the LLC or the LLP is the correct form.

What about the Other Types of Entities?

The next two types of business entities listed are the C Corporation and the S Corporation. Each of these legal formats provides protection from creditors. They each require the owner who works at the dental practice to be paid in the form of salary, like any other employee. Payroll taxes are due, most often, when the payroll check is issued. Cash and financial management are less important regarding issues of compensation to the owner because there is little that can be done concerning how payroll tax issues are managed. Other financial management issues are, of course, very important, just as with the LLC or the LLP. The C Corporation is an entity that files a tax return and pays its own tax when income is left in it. Sometimes advisors refer to this concept as double taxation and shy away from giving advice about the use of this type of entity. Dental CPAs, who are commonly the most sought after because of experience and knowledge in working with dentists, will use the C Corporation and make sure that no double tax occurs by providing excellent and timely advice to the dentist regarding how to disburse its income. Upon the sale of a dental practice, the stock of the C Corporation provides an excellent source for the lowest tax treatment for the seller.

This is one of the reasons that advice to use a C Corporation as your legal entity, may be picked.

The S Corporation provides the same legal protection as the C Corporation but has the property of requiring only one federal tax. It is a flow through entity, similar to the LLC and the LLP. Its income or loss is reported by the owner(s) on their www.dentalentrepreneur.com

personal tax returns and no federal tax is due from the entity.

The Proprietorship and Other Legal Entities The proprietorship is probably the easiest form to use for the start up dental practice. This format does not require a separate business entity to be formed.

There is no legal protection afforded to the dentist. All of one’s assets are exposed to creditors or other plaintiff. There are no payroll tax requirements such as those in the corporations. Reporting requirements for the owner are less than with any other type of entity. The profit or loss of the practice is reported on a separate schedule of the personal tax return. When a dentist has little in the way of assets or has a large amount of debt and little to lose, this type of entity may be popular because there are few costs associated with its formation compared to all other types of legal entities. The need for an attorney for formation purposes is minimal for protective and tax purposes because there is less to protect and fewer tax considerations available to the proprietor. As more income is earned and more assets are acquired, the need for more sophisticated approaches to entity formation should be addressed.

There are other types of entities as well, all of which are complex. It is very important to retain an advisor with experience in working with dentists. Unfortunately, your first employer may not have the knowledge to assist you. He or she may think they know the intricacies of the business world, but their expertise probably comes from their own experience.

Contact a CPA as the first step to learning how to proceed with your business experience and get their resume for your review before retaining that CPA. 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. â–

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 856-985-8550, extension 112.

Business Beyond the Classroom

Resource Guide

ADS 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 17.

Air Force Reserve 800-289-6695 AFReserve.com/HQ

The Air Force Reserve offers dentists challenging part-time opportunities with lifelong rewards. Receive world-class specialized training with continuing education that will enhance your civilian opportunities. Gain valuable experience while caring for our nation’s finest. Special financial incentives available for some specialties. Discover where the rewards of service and healing take flight. Please see our ad on page 19.

Dental Entrepreneur Fall 2011 11

Getting Started

The Five Ways

John McDonnell

to Open a Practice W

hen most practices are sold today, the seller leaves either immediately or within 3-6 months; however, there are other options available to the seller for the sale and transition of their dental practice. If a dentist is interested in having a transition plan to ensure selling their practice at its peak and having their earnings during that time period John McDonnell also be at their highest, planning and choosing one of the following five (5) options will be a positive path to pursue.

1. Sell the practice and leave 2. Sell the practice and stay 3. Delay the sale of the practice 4. Equity Buy-in Buy-out (Partnership) 5. Merge in – Merge out OPTION #1 SELL THE PRACTICE AND LEAVE Selling the practice and leaving is still the most common of practice sales in our industry. In this option. the seller normally leaves immediately following the sale or within a 3-6 month period. The reason for leaving so soon is that many of the solo practices do not have enough patients or a space large enough to have two full time dentists in the office simultaneously. As the buyer needs to pay the overhead of the practice, themselves and the bank loan for the practice purchase, there is nothing left for the seller.

12 Fall 2011 Dental Entrepreneur

Benefits To The Buyer When The Seller Leaves 1. The new owner can be in control and develop the practice in their own style.

2. The patients won’t have the long term seller in the office and will be more open to seeing the new owner.

3. The buy is taking over for a senior doctor so will likely attract and get referrals for younger families.

4. A buyer can make equipment and systems changes that they want without the seller standing in the way.

OPTION #2 SELL THE PRACTICE AND STAY ON AFTER THE SALE:

What if you could sell your practice and your office space if you own it at the Fair Market Value for each and stay on after the sale continuing to enjoy performing dentistry and earning a fair compensation for 2 to 10 years or more depending on your age and exit timetable? When we interview dentists who are preparing their exit strategy, the common theme that we hear is that they still enjoy dong the dentistry, taking CE courses and seeing the patients, but they do not like running the business, dealing with insurance companies and handling staff issues.

www.dentalentrepreneur.com

as it allows the seller to stay in control of the practice, maximize their earnings and gives them an opportunity to sell the practice at its peak. This option requires the office space to be large enough for at least two full time dentists. It also requires the practice to either have enough patients and work for two full time dentists or have the potential of patients to be served. If not, the practice will need to have a pro-active marketing plan for new patients so that the two dentists can be productive full time.

This option is similar to the sell and leave strategy in that there is a signed asset purchase agreement with a specific target date for the practice sale. There is an assoOPTION #3 DELAYED SALE OF THE ciate with and employment agreement for PRACTICE: the period of time between joining the This option is becoming more popular and the sale date.

This ADSNL_003 Half Page Ad REV2.qxd:Layout 1 practice 2/14/09 6:36targeted PM Page 1 Benefits Of Keeping The Seller Practices After The Sale 1. When the practice can support two full-time dentists, the former owner can be the best choice to be the associate of the new owner.

2. Because of the clinical and management skills of the seller, this can be a valuable resource for the new owner.

3. Patients are more likely to remain with the practice and not leave when the seller stays on after the sale.

4. When the seller performs procedures that the new owner does not, these procedures can continue to be provided in the practice.

time period is normally 1-5 years depending on the needs of both the seller and the future buyer associate. At the end of the 1-5 year period the associate purchases the practice by borrowing 100% of the sale price to be paid to the seller on the pre-arranged target date for the closing. A methodology is agreed upon in the beginning to calculate the sale price at the time of the closing and is part of the mutually beneficial agreement signed at the start of the process. This agreement includes a 3-6 month time period during which both the host dentist and associate can terminate the delayed sale purchase agreement without any penalty in case they do not work well together.

Benefits For The Buyer To Choose A Delayed Sale

Make the perfect transition

Making that first transition into your career is the most important decision you will ever make. For more than 30 years, ADS and its local transition specialists have helped dental graduates like you make the perfect first transition. As the nationwide leaders in practice purchases, we know the best opportunities wherever it is that you want to be. We are dedicated to your success.

Get off to the perfect start. Visit us online to find your local ADS representative.

ADStransitions.com/localrep www.dentalentrepreneur.com

Dental Entrepreneur Fall 2011 13

1. The buyer has a chance to get to know the patients in the practice, the staff and the office systems. So by the time the delayed sale is implemented, a smooth transition can occur.

2. As the buyer works in the practice for 1-5 years before the purchase takes place, the patients are familiar with the buyer and the production schedule is in place.

3. As the delayed purchase takes place when there is enough production for two dentists, the seller normally stays on after the delayed sale takes place.

The seller’s performance is steady and gives the new owner stability.

OPTION #4 EQUITY BUY-IN BUY-OUT (PARTNERSHIP) Over the last 30 + years approximately 25% of all dental practices have chosen to be partnerships. This percentage has not fluctuated more then 2% over those years.

This option requires a space and practice large enough for at least 2 full time dentists. The number of years needed to justify this option for the senior dentist we feel is 5-20 from the retirement of the host seller. If a dentist has practiced solo for over 30 years and is in their 60’s we do not feel that this option is viable at that stage of practice.

This option is particularly applicable to an owner who currently has a good associate in place or is in the process of choosing a new associate. This strategy is for the owner who wants the peace of mind of having their heir apparent under contract with a plan for the equity buy-in buy-out partnership in place. Often good people (owners and associates) say they will discuss a transition plan in the future and the future never comes. And without a win-win plan they normally fail in their attempt to have a partnership. We suggest that the discussion happen early on and that agreements for the partnership be signed by all in the beginning. This will insure the successful process of a buy-in buy-out partnership strategy.

14 Fall 2011 Dental Entrepreneur

Benefits For Buyer To Choose The BuyIn Buy-Out Partnership Option 1. This option gives the buyer a clear track to an equity potion instead of being in a dead end employee job.

2. Many buyers want to be in a practice with another dentist to share ideas and case presentation options.

3. Having a partnership can allow the partners to have a reduced weekly work schedule if they so choose.

OPTION #5 MERGE-IN MERGE-OUT: When a dentist practices in a home office or does not want to sign a new long term lease in a professional building, the merge out strategy is a good option.

The practice can be merged into a larger practice close by and the selling dentist can move with the patients for a period of time earning compensation after the sale. When the selling dentist can come with the patients for a period of time this assures the buyer that the patients will come to their practice.

Assuming that the selling dentist’s office is large enough for 2 full time dentists or more then the merge–in strategy in can be implemented. If a young dentist in the area has a smaller office space or a following of patients, they can purchase the seller’s practice and merge their patients and practice into the larger space. This again may allow the seller to remain in the practice if they choose seeing patients.

The merge –in merge- out option allow the seller to get the maximum practice sale value. When they merge the practices many of the expenses are lower while the earnings in the joined practice are positive so a positive cash flow for the buyer should result as well.

Benefits Of The Merge-In Merge-Out Option 1. This allows a young dentist who has started a new practice to seek out a senior dentist practice and merge it into their new space. This strategy can jump start the production of a start up.

2. This allows a young dentist with a

following of patients to purchase a practice and space and move these patients into a new office space.

3. As this strategy consolidates the expenses of the two practices and eliminates the fixed costs of one practice, it can be a very lucrative option.

It is very important that every new owner plans ahead for their entrance into practice. The earlier the better! Too many times the new owner moves too quickly without considering all of the available options.

However if you start early and commit to a healthy transition plan all of the above options will be open and available to you.

When you implement a plan you will likely make an informed choice thus assuring your success as a new owner. And more importantly you will reduce your stress knowing you have made a good choice.

How To Explore The (5) Options To Buy A Practice 1. Choose a transition organization that specializes in practice transitions 24/7 365 days a year and does not have other products and services to sell.

2. Have the practice you have selected valued by a qualified, experienced transition specialty organization in the dental industry.

3. Decide what you want to do about your entrance into practice strategy and what your timetable is.

For a transition to be successful, it must work for both the buyer and the seller.

Know your options as you begin the process of looking for work after graduation.

For both the buyer and the seller, THE TIME TO PLAN IS NOW. JUST DO IT! John F. McDonnell is the founder and president of the ADS McNor Group, a dental brokerage and practice transition firm focusing on the MD, DC, VA, PA, DE and WVA areas. He is the past president of ADS (American Dental Sales). He can be reached at johnfm@adstransitions.com or (888) 419-5590 x410 or (888) 419-5590 x410.

www.dentalentrepreneur.com

Scheduling DR (Digital Radiography)

Chart

iPhone Interface

iPad Interface

MacPractice DDS 4.1

EDR (Electronic Dental Record) Orthodontic / Endodontic Charting

Notes Attachments

MacPractice EHR Certification - MacPractice DDS 4.1 is 2011/2012 compliant and has been certified by CCHIT速, an ONC-ATCB, in accordance with the applicable certification criteria for Eligible Providers adopted by the Secretary of HHS. This certification does not represent an endorsement by HHS or guarantee the receipt of incentive payments.

CCHIT速 is a registered mark of the Certification Commission for Health Information Technology.

MacPractice 4.1 CC-1112-769760-1

Visit MacPractice.com for product information, trade shows, presentations, screenshots and a demo.

Business Fundamentals Edward C. Challberg, CPA

A Successful Strategy for New Dentists in a Difficult and Uncertain Economy

Y

ou will soon graduate or have just graduated. You plan to work as an associate for several years and then own a practice. Imagine yourself in the future. What do you need to do between now and then to be successful?

Improve Your Clinical Skills Yes, you learned a lot in dental school.

Now you have to get better and faster.

The greater number of procedures that you can do well and quickly the more value you can deliver to your patients.

Invest in continuing education and Edward C. Challberg, constant improveCPA ment. The result will be a practice that is more productive and profitable.

Establish Mentor Relationships Owning your own practice can be an intimidating challenge. Lots of things can go wrong. Costly mistakes can be made.

The dental community has a wealth of knowledge and expertise available to you.

Join your local dental society. Socialize and get to know many members. When appropriate talk about your plans with more experienced members. Many will be more than happy to offer sage advice, words of caution, and share stories of their satisfying accomplishments as well as challenges along the way. These kinds of relationships can be invaluable in guiding you along your own path.

Learn to Manage and Lead 16 Fall 2011 Dental Entrepreneur

You will quickly discover that being a good clinician is only part of your job. You also need to be a good business manager and a good leader. A manager maintains good systems, oversees the daily operations of the practice, and develops a wellfunctioning dental team. A leader communicates the practice goals, sets the tone, raises expectations, and inspires team members to do their best.

You learn to manage and lead by managing and leading. Any activity that allows you the opportunity to organize and direct people toward a goal will likely develop valuable skills for your practice. Opportunities are all around you.

Actively participate in your dental society, organize a social event, teach a class, coach an athletic team, or run a charity drive. Start as soon as you graduate so that by the time you are ready to acquire a practice you have some valuable experience to draw on. Start small and test the waters. As you grow and gain confidence there will be opportunities to do more.

Manage Your Debt If you are like most new dentists you probably have school debt. In a few years you will borrow money to purchase a practice. Later you will want a home that will require more borrowing. Therefore, the better you manage your debt the more

money you will save.

Get organized. Summarize your debt in a notebook or electronic file by listing all your loans, lines of credit, and credit cards on one page if possible. Next to each indicate the purpose, current balance, interest rate, monthly payment, and months remaining until paid off. Behind this cover sheet or file have a section for each set of loan documents or in the case of a credit card, your last statement. This organization will help you and your CPA analyze and restructure your debt resulting in lower costs.

Know your credit score and improve it. Through consumer credit reporting companies such as Equifax, Experian, or TransUnion you can obtain your credit score for a modest fee as well as obtain a free credit report. The internet can provide you information about improving your score. A high credit score will qualify you for the lowest interest rates.

On a $500,000, 30 year loan a 2% interest rate difference is $231,264. This is the cost of having a low credit score.

www.dentalentrepreneur.com

Decide to Start or Purchase a Practice You will have to make a decision whether to start a practice or purchase a practice. Compare and contrast each alternative. Each requires different planning considerations.

• Generally, if practices are available in your area buying is normally easier than starting a practice.

• Whether you start a practice or buy a practice, you will likely borrow $300,000 - $600,000 to get started.

From the bank’s perspective a startup is more risky. Therefore they will charge you a higher interest rate than if you were to borrow the money for a purchase.

• If you start from scratch the practice will reflect your vision and style from the beginning. buy 1 ADS.south209 2/25/09 1:42 IfPMyouPage a practice you will have to slowly

transform and mold the practice into your own which may require time, resources, and outside help.

• If you start a practice you will have to hire and train employees. When you buy a practice the team is included and they are likely to be experienced, knowledgeable, and familiar with the patient base. On the other hand, if the team has problems you are acquiring that as well.

• If you start a practice you will likely have time to build up your speed and confidence as your practice grows. If you buy a practice you will have to immediately produce at a high level because you will likely be stepping into the shoes of a dentist who has been practicing for 25 – 35 years.

Caution – If you acquire a practice that is larger than your capabilities

the practice will contract until it matches your abilities. However, your practice acquisition debt doesn’t change. This can develop into negative cash flow.

• If you start a practice you can eventually equip it with all the latest technology. Everything will be new and in excellent condition. If you buy a practice usually the equipment will be older, dated, approaching obsolescence, and in need of some repair, if not replacement.

• If you start a practice your efforts will be directed toward attracting patients to the practice (external marketing). In order to be highly successful you will likely need the advice and coaching of a dental marketing consultant which can be costly. If you buy a practice you

Practice Makes Perfect “Dr. Earl Douglas and the staff at ADS South have been real helpful in steering me in the right direction in the purchase of my first practice. Dr. Douglas’s experience, organization and detail-orientation, pointed out to me where improvement is needed and how to go about achieving it.”

Elizabeth H. Guerrero, DDS Get off to the perfect start. Call your ADS transition specialist for AL, GA, LA, MS, NC, SC, TN and VA today.

ADS South (770) 664-1982 ADSsouth.com www.dentalentrepreneur.com

Dental Entrepreneur Fall 2011 17

will likely be striving to keep your present patients happy and satisfied so they refer more patients (internal marketing).

Assemble Your Advisors To own a dental practice you will need to consult with essential advisors: • Practice Broker – The broker facilitates the transition of the practice from seller to buyer. The broker will provide you information about practices that are for sale. The seller pays the broker a 10% commission for selling his or her practice. The buyer pays nothing.

• Attorney – Your attorney reviews the sales-purchase agreement with you, reviews the lease on the space, and assists you in forming a corporation or similar entity depending upon the state in which you practice.

Select an attorney who has experience working with dentists.

• Dental CPA – Your dental CPA evaluates the practice to determine whether it is financially sound,

reviews the asset allocation in the agreement, projects the tax implications of the purchase, projects the cash flow of the practice, performs a cost segregation, determines the best entity or form in which to practice, and drafts a business plan.

• Insurance Agent – Your insurance agents review your insurance coverage including professional liability, personal and overhead disability, property, life, health, auto, and workers compensation.

• Lender – The lender evaluates your credit worthiness, establishes the terms of the dental practice acquisition loan, provides funds to purchase the practice, and tracks your practice performance while the loan is outstanding.

Make a Plan Owning your own practice is a big investment with many complex challenges. What you do from graduation to ownership is critical. Put your plan in writing. Include the following:

Business Beyond the Classroom The Artist Evolution LLC Toll Free: 866-610-5334 www.theartistevolution.com

Resource Guide

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 9.

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 23.

Henry Schein Professional Practice Transitions (PPT) 1-800-730-8883 ppt@henryschein.com 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 careerlong trusted relationship with the seller. (Please see our ad on the inside back cover.)

18 Fall 2011 Dental Entrepreneur

1. A vision of the practice you want to have.

2. Checklists of things to do and people to contact.

3. Strengths, Weaknesses, Opportunities, Threats – List your personal strengths that you bring to your profession which might include strong clinical skills, personality, or organizational ability, to name a few. List your personal weaknesses.

Perhaps your communication skills need honing or perhaps you have a hard time getting organized. What can you do to improve in those areas? List external opportunities.

Perhaps you want to live in a rural area that is currently underserved by the dental community. Last, list external “threats” that you might encounter. Perhaps you want to practice in an area dominated by a single large company from which you would attract many patients. If that company were to move, shut down that location, or lay off substantial workers your practice might be severely impacted.

4. Create a timeline from the present to the time that you feel ready to acquire a practice of your own. On that timeline enter what needs to be accomplished and when.

5. Be flexible. Things change. Be ready to revise and update your plan.

Getting started in the dental profession in an uncertain economy can be either an exhilarating or frustrating experience depending upon how well you prepare and plan. Develop a strategy and follow a personal plan that will take from you from where you are now to ownership of a practice. You will succeed. ■

Ed owns and manages a CPA firm in San Rafael, California that exclusively serves dentists. Ed is a member of the American Institute of Certified Public Accountants (AICPA), the California Society of CPAs, and has been an active member in the Academy of Dental CPAs (ADCPA) since 2001. www.dentalentrepreneur.com

Text CHAT to 71212 to reach an advisor**

AirForceReserve

@AirForceReserve

USAirForceReserve

IT’S A DIFFERENT WORLD.

For more information scan this QR code with your smart phone*

Serving part-time in the Air Force Reserve gives me experiences unavailable in my daily practice. It also provides additional benefits like paid CMEs and hands-ontraining. I learned dentists come in as officers and that the Air Force Reserve is offering generous signing bonuses. Best of all, I’m able to serve my country from where I live.

800-257-1212 • AFReserve.com/HealthPro G U I D I N G A N D P RO T E C T I N G A M E R ICA * Use a smart phone with a QR code scanner app to learn more about AFR news and events * * M e s s a g e a n d d a t a r a t e s m a y a p p l y. Te x t C H AT t o 7 1 2 1 2 t o i n i t i a t e a n S M S c o n v e r s a t i o n w i t h a n A i r F o r c e R e s e r v e a d v i s o r. Te x t S T O P t o 7 1 2 1 2 t o o p t o u t . Te x t H E L P t o 7 1 2 1 2 f o r m o r e i n f o r m a t i o n . T h i s p r o g r a m e m p l o y s o p e r a t o r s w h o a r e p a i d t o p a r t i c i p a t e i n c h a t . H o u r s o f o p e r a t i o n : M o n d a y t h r o u g h F r i d a y, 8 : 0 0 a m t o 1 1 : 0 0 p m E S T. S e e p r o g r a m t e r m s a n d c o n d i t i o n s a n d p r i v a c y p o l i c y a t h t t p : / / s m s . a f r e s e r v e . c o m .

Business Fundamentals Kathleen M. Roman, M.S

Physical Safety from Violence in the Dental Practice

As you think about upcoming clinical experience, remember that there are lots of different types of risk assessments. Here’s one that you can’t afford to overlook.

S

afety plans address a variety of risks. Remember when you were little and every October your school celebrated Fire Prevention Month? Many of us still recall the visits of important dignitaries, like real firemen or Smoky the Bear, to our classrooms. Through educational programs aimed at kids, schools also encouraged parents to check for fire hazards in the home and to take steps to correct them. Today, millions of homes and businesses have fire extinguishers Kathleen M. Roman, and smoke alarms, M.S at least in part because of the benefits of a proactive national fire safety program.

Years later, because of local fire codes, you probably continue to benefit from this national program through an inoffice fire safety plan. In addition, you may also have taken the safety approach a step further and implemented protection plans for bad weather and possibly even for earthquakes, depending on what part of the country you live in.

But there’s another type of risk that you may not be prepared to deal with.

What are you doing to protect yourself, your staff, and your patients from physical violence? Statistically, the odds are greater that you will be harmed by a violent person than by a powerful storm.

According to a study by the Bureau of Labor Statistics (BLS), “health care and social service workers are frequent victims of violent assault at work.” In some parts 20 Fall 2011 Dental Entrepreneur

of the country, healthcare professionals are classified in the job category most atrisk to become victims of violent crimes.

The dental office isn’t immune to violence. Over the past 15 years, the Joint Commission has received reports of 256 crimes in a variety of healthcare facilities. That may not seem like a lot but, interestingly, the majority of these crimes have occurred within the past five years.

When this report was published, in June 2010, over 100 violent episodes had been reported just in the previous three years.

This shows a significant increase with each ensuing year. In addition, the Joint Commission alert noted that the report numbers are likely quite low because of “significant under-reporting.”

Much of the statistical information reported on violence in the healthcare environment is drawn from hospitals.

Because the literature lacks statistics about assaults on office-based healthcare, it may not be a good idea to assume that the dental office is a safe haven. Rather, state and local crime monitoring agencies may be better resources for dentistry-specific statistics.

Evidence suggests that, once a dental office or worker is targeted by a violent offender, they may actually be at higher risk for the following reasons.

First, the average dental office has fewer employees than the average medical office.

Security experts remind their clients of the old adage, “there is safety in numbers.” Second, the ratio of female to male employees is typically higher in dental practices than in many other healthcare settings. Violent individuals may feel

safer acting out in an environment that is composed of a small group, almost all of whom are women. In addition, the upward trend in the number of female dental school graduates has contributed to a commensurate increase in the number of all-female dental offices.

How to begin: First, acknowledge the possibility that you, or the people you work with, can be victims of threatening or violent behavior. This is an unpleasant thought and one that most of us would rather ignore. But, take into consideration the fact that, even though you’ve probably never had a fire in your office, you are nonetheless prepared for the possibility that one might occur. Because of your school training, and local fire codes, this preparedness has become an accepted part of your business process. Continuing this line of thinking, just because you’ve never had a violent episode in your office doesn’t mean that you never will. The time to develop a plan is before you need one.

Conduct a risk assessment. Include staff when you conduct a risk assessment.

Violence can occur in a variety of ways and a team approach increases the odds of prevention or successful management.

Keep in mind that several states have reported acts of domestic violence in the healthcare setting. Employees who are at risk of domestic violence may be even more vulnerable at work because the threatening individual knows where and when the intended victim is are most likely to be at work. Employers have a duty to take into account the possibility of such risks and utilize appropriate measures to manage them. www.dentalentrepreneur.com

Here are just a few questions that might help you get started in assessing the physical risks associated with your practice: • How secure are doors and windows, especially back doors or seldomused hallway entrances?

• Must staff or patients leave the actual office in order to use a lavatory? What security measures need to be in place to protect them while they are outside the actual walls of the office?

• Is there need for a code lock system to reserve access to the lavatories only to those individuals who have been given a code? Is the code changed regularly?

• Are hallways adequately lit and does building management use cameras, employees, or hired security staff to survey the building and parking areas?

• Does staff education include 9:22 AM P111386a.qxd:Layout 1 2/25/11

What are you doing to protect yourself, your staff, and your patients from physical violence?

Statistically, the odds are greater that you will be harmed by a violent person than by a powerful storm. required compliance with management of known security risks?

Examples: “We never open the back door without first looking through the peephole;” “When working alone Pagein1the office, all doors must be

kept locked;” or “After hours emergency calls from unknown individuals are referred to the local ER.” • Do employees typically park within view of the office windows? Are employees encouraged to walk out of the office together, especially in wintertime when it may be dark outside at the end of the business day?

• Are you prepared to deal with a variety of possible threats or violence? Examples: a) an irate patient or family member; b) a stranger; c) a former employee; d) a current employee – possibly someone who has just been fired; e) a family member of acquaintance of a current or former employee; f ) a person who claims to be an investigator of regulatory auditor, but who refuses to produce proper identification; g) other examples that you and your staff may have experienced.

• Whose job will it be to talk with a threatening patient or an intruder?

Practice Growth... with Patterson Dental

> Practicing dentistry is your responsibility.

Helping your practice grow is ours.

That’s why we created the Patterson Advantage® membership program. Unlike any other membership program in the industry, Patterson Advantage helps you grow your business. Through your everyday purchases, you’ll earn Advantage Dollars that you can use to reinvest in technology and equipment for your practice.

Practice growth with Patterson Dental. Contact your Patterson representative, call 800.873.7683 or visit www.pattersondental.com today to learn more about the Patterson Advantage program.

P111386a (2/11)

www.dentalentrepreneur.com

Dental Entrepreneur Fall 2011 21

• What conversational skills might be needed to help defuse verbal confrontations?

• Who would determine whether or not patients need to be moved from treatment areas or if people in waiting rooms need to be evacuated?

• Whose job will it be to call building security or the police?

• How will the incident be documented once it has been resolved? Who will conduct and ensure that a postincident debriefing occurs? Will it include: a) assessment of how well the team managed the incident; b) de-stressing; c) fine-tuning the current process to help improve the team’s performance in potential future events.

Walk through various scenarios with your staff. Discuss management strategies. Here is a real example. Late one Friday evening, a female dentist received a call from a man who claimed to be one of her patients and who begged her to come to her office to examine an injury he said he’d sustained in a fist fight. The dentist went to her office and opened it only to be attacked by a stranger who demanded money and prescriptions for drugs. Fortunately, her boyfriend arrived

at the office and confronted the attacker who ran away. Had the attacker been armed or more combative, this incident might have had a catastrophic ending. In this case, the doctor might have advised the caller to go the hospital ED for an initial assessment and to call the hospital to report the possible arrival of the patient and that, based on an initial exam, she could be called in to see the patient.

Don’t panic. Acknowledgement of the need for a security system should not make your staff fearful. Rather, having a plan and knowing when to swing into action can reduce anxiety. Once you identify possible risk exposures, you can implement responses to be used by you and your staff, including outreach to safety/security experts and/or local law enforcement professionals. Then, just as you conduct periodic fire prevention reviews, you can also be prepared to deter/ manage threats to you or anyone associated with your practice. ■ Kathleen M. Roman, M.S., is risk management education leader for Medical Protective – the nation’s oldest professional liability insurer, exclusively serving the healthcare professions since 1899. Kathleen can be reached at: kathleen.roman@medpro.com

Business Beyond the Classroom

Resource Guide

Lightspeed Multimedia, Inc. Email: john@jumptolightspeed.com www.jumptolightspeed.com

Don’t settle for the same generic look as every other dental professional in the area! Stand out with a professionally designed image created for you and your practice. Please see our ad on page 31.

MacPractice, Inc (402) 420-2430 MacPractice.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 15.

The Book of Odds. http://bookofods.com/content/view/print/678590 Insurance Information Resources Ttp://insureinfoblog.com/2011/06/a-goodsummer-safety-plan-don’t.html U.S. Dept. of Labor Occupational Safety & Health Administration Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers. 2004. http://www.osha.gov/Publications/OSHA3148/ osha3148.html Washington State Department of Labor & Industries. Workplace violence in Health Care Settings.

2006. http://wa.gov/safety/Topics/ AtoZ/wpvhealthcare.asp 3U.S. Dept. of Labor Safety and Health Topics: Workplace Violence. 2010 http://www.jointcommission.org/assets/1/18/ SEA_45.PDF. Op.cit.

The Joint Commission. Sentinel Event Alert.

Issue 45: Preventing Violence in the Health Care Setting. June 2010. http://www.jointcommission.org/sentinel_event_ alert_issue_45_preventing_violence_in_the_ health_care_setting_/ Gillespie, G., L., Gates, D. M., Nutler, M., et al.

Workplace Violence in Healthcare Settings: Risk Factors and Protective Strategies. Rehabilitation Nursing. Vol. 35, No. 5, Sept.-Oct. 2010. http://www.rehabnurse.ord/pdf/rnj325.pdf U.S. Dept. of Labor Safety and Health Topics: Workplace Violence. http://www.osha.gov/SLTC/workplaceviolence/ index.html Additional Resources: McNight’s Long-Term Care News & Assisted Living. June 2010. http://www.mcknights.com/recent-rise-inhealthcare-facility-violence-may-be-higherthan-statistics-show-joint-commission-warns/ article/171820/ Center for Personal Protection & Safety: Workplace Violence in Health Care Settings.

2010. h t t p : / / w w w. f h a . o r g / a c r o b a t / J o h n W / CPPSHealthcareWPV.pdf

22 Fall 2011 Dental Entrepreneur

Violence against Women at Work. Department of Health & Human Services on Women’s Health.

Posted May 18, 2011. http://www.womenshealth.gov/violence-againstwomen-at-work.cfm

www.dentalentrepreneur.com

PUBLICATION WO # 134790

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.

SIZE 7” x 10” NOTES 4-color

The average Aspen Dental Practice Owner spent less than 2 years with Aspen Dental prior to becoming an Owner.

597572

Tremendous Earning Potential • Defined Career Path to Ownership Proven Practice Model • Comprehensive Marketing & Business Support Ongoing Professional Development

Dental Entrepreneur

IO #

Practice Made Perfect

Dentist opportunities available nationwide!

877-330-1349

SCREEN

We’ve got the perfect opportunity for you!

Join Aspen Dental – the premier network of dental practices.

100 lpi

Connect with us:

AspenDentalJobs.com/100

Aspen Dental is an EOE.

Business Fundamentals John H. Jameson, DDS

Developing Your

Technology Approach

D

ental school seems to appeal to grounded people who want a career where they can follow a process and accomplish good things for people. That’s you and me, for the most part. We dentists like checklists and processes and orderly steps. Then the sales reps start calling and telling us about benefits of new equipment.

Coaches explain what visual aids we John H. Jameson, need for commuDDS nication and even personnel management. Soon, our heads are spinning and we’re crying out for a checklist again.

The fact is that there is much more to dentistry than our orderly ten step prep procedures. Managing personnel, running a business, making smart investments and living our life requires a level of critical thinking, creativity, and strategy whether we like it or not. Here’s a quick checklist of how you can develop your technology strategy. Embrace your new era as a dentist and reach out for help when you need to break any overwhelming issue down into a measurable, accomplishable task list. You can do this.

Developing your technology strategy boils down to this checklist. ✓ Vision ✓ Strategic planning ✓ Communication ✓ Decision making

24 Fall 2011 Dental Entrepreneur

✓ Time management ✓ Delegation and motivation ✓ Ergonomics When it comes to your vision, ask yourself what role technology will play in reception; clinical production; business administration; back office; and consultation systems of your practice. Outline exactly what you want in terms of your ideal practice.

Never let the technology dictate your budget. Plan strategically so that

3%-5% of collections per year are allocated for technology. Always get competitive proposals from multiple sources that include a detailed statement of work. Value the relationships you have with reps, but require them to give you the information you need to adequately compare and justify your decisions. Allow them to work for you.

Purchase the training and get coaching for every system affected by your new technology. Your strategic plan also needs to address wiring. For example, wiring new structures

www.dentalentrepreneur.com

CEREC ® 3D Software powered by Biogeneric: Predicts perfect proposals with a single click.

Natural form and function is now as easy as scan, click, mill.

CEREC Biogeneric Software effectively reads the morphology of the patient’s own dentition to predict the right form and function for all restorations. Based on comprehensive morphological analysis of thousands of actual teeth instead of arbitrary “tooth libraries,” CEREC Biogeneric Software allows you to create inlays, onlays, crowns, veneers and temporary bridges with just a single click. Ideal form, function and occlusion— CEREC 3D Software powered by Biogeneric does it with ease. Simply scan, click, mill and admire.

• Clinically and functionally valid proposals every time • Automatic process: a single click produces the natural restoration • Unrivaled ease-of-use lets you focus on your practice and not complex software manipulation

To experience the power and simplicity firsthand, contact your Patterson representative:

800-873-7683 www.CEREConline.com

CAD/CAM FOR EVERYONE

DENTAL_SPRING-WORKING.indd 19 SI20-104818_BioGenericAdV5_7x10.indd 1

3/14/113:33 9:51PM PM 3/2/11

is far less expensive prior to wallboard/sheetrock installation. Consider CATV wiring in addition to data wiring. Local support is very important and so it’s wise to involve local support with vendors. Strategic planning needs to address the issue of survivability – how strong your back-up systems are, how your licenses are stored and software discs are protected, etc.

Communication is one of the most important areas. This is not a “fluff” topic or something you can disregard if you don’t view yourself as a talkative type. You MUST let the team share in your vision and talk openly and honestly about roles and responsibilities. Explain to your team the financial investment you’re making in their training so they develop a sense of appreciation that you’re investing in their skills. One to three months after training, keep your team engaged in making the systems that surround your technological investment work.

They could elect a problem troubleshooter or vendor liaison; a primary and secondary person for imaging questions; a primary and secondary person for business office issues; etc. Explain the importance of sharing the knowledge. Establish usage guidelines that can be used for training, accountability

and general practice protocol. For example, note that there will be no unauthorized software downloaded or emailing/surfing on clinical computers or the server. Arrange an organized, confidential way to store user accounts and passwords. These expectations and the procedural guides need to be developed into written, encompassing image capture, case presentation preparation, inventory control, supply management and all systems touched by the new technology.

Calculate and establish a budget and a timeline and then stick with it. Decision making is crucial to the success of your technology implementation. Choose to finance the entire project; it provides a predictable payment plan, and a phased implementation can take advantage of falling technology prices. Don’t weigh options so long that you never MOVE. Get professional assistance/consulting to assure a higher return on your investment and a greater confidence level that you’ve considered all of the options and are prepared to lead your team to successful implementation. Then make a decision and stay committed.

Manage your time and leverage your team as much as possible to streamline your protocols. For example, if the technology

Business Beyond the Classroom

Resource Guide

Oxyfresh Worldwide Inc. 800-333-7374 ref# R23037601 aduff2@aol.com

Since 1984 thousands of dental professionals have discovered Oxyfresh’s safe and effective oral health products for use in longterm 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. Ad on page 27.

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 Supply Inc. 800-659-5977 http://www.cereconline.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.

26 Fall 2011 Dental Entrepreneur

you’re considering is a camera or cameras, take a team approach to imaging in the clinical environment. Using lighter cameras can reduce the need for two people. Multiple cameras mean less set up time. The best goal is a camera (intra and extra) in every hygiene room. Standardize your imaging routines – when to capture, what to capture, sequence of capture, hands-off procedure.

Delegation can be scary but it can be mastered to the benefit of all involved.

Treatment coordinators and clinical assistants or business team members should perform 90% of the case presentation assembly. Doctors should NOT be manipulating case presentation images, in most practices.

Celebrate your team’s victories and hold them accountable for specific improvements so that delegation is successful and your team can thrive as you spend your time in the most productive manner.

Don’t forget to consider ergonomics.

For example, monitor mounting and chair placement may seem like trivial issues to you and your staff, but your back and stress level will be crying out if you aren’t careful.

Makes sure your purchase are comfortable for all practitioners. Don’t take this lightly.

Be comfortable and take care of yourself.

In Summary Sequencing into your paperless, forwardfocused practice can have a systematic approach. If you’re not going to make it to the ADA Vegas Office Design Symposium to hear more, then contact our corporate office and we’ll send you a few free slides planned for that presentation, outlining our sequencing recommendations. Meanwhile, hopefully this checklist helps you begin developing your technology strategy. Keep us posted and best wishes to you in the practice of your dreams! ■

John H. Jameson, DDS, is chairman of the board for Jameson Management, Inc., an international dental coaching firm addressing marketing, management and clinical systems of practices worldwide. Visit www.JamesonManagement.com or call 877.369.5558 for more information.

www.dentalentrepreneur.com

Practice Builders Brendan Morrissey

Effective Online Marketing Can Help Dental Practices Gain New Patients

A

s students, you’ve no doubt learned about the latest dental procedures and tools. You’ve been taught how to interact with patients. You’ve learned about licensure and insurance.

However, you probably haven’t learned about how to effectively market a dental practice. Perhaps you think that’s the responsibility of your practice manager or that you can learn as you go. Since your practice will be your livelihood, it behooves you to learn enough about marketing to make the right decisions on where to allocate resources.

The Changing Landscape It used to be that a Yellow Pages ad (“the bigger, the better” the ad rep tells you) would suffice in terms of providing sufficient exposure for a practice. To gain additional exposure, some practices might take out a run of print ads in local newspapers or lifestyle magazines.

Brendan Morrissey Other practices engaged in direct mail marketing with rented lists based on demographic criteria. As broadcast restrictions eased and competition increased, dentists started advertising on TV and radio.

With the advent of the digital age, practices need to take a hard look at their marketing mix. Yellow Pages, print, direct mail and broadcasting no longer yield the same results they once did, due largely to the explosion of digital media and the 28 Fall 2011 Dental Entrepreneur

popularity of Internet search engines.

According to media consulting firm BIA/Kelsey, 97 percent of consumers now use online media or search engines to research products or services in their local area. There has been such a massive shift in consumer behavior that if your business isn’t discoverable online, you are losing potential customers daily.

Some enterprising practices have even committed to social media, starting Facebook fan pages and Twitter accounts.

While at no cost to operate, these outlets must be consistently maintained in order to gain any traction.

Online Search According to the Pew Internet & American Life Project, 87 percent of Internet-connected adults conduct online search, an activity second only to email usage. And these adults aren’t just the under40 crowd. More than 85 percent of “Older Boomers” (ages 56-64) search online.

It’s not surprising that online media is now one of the most effective ways to reach new patients, especially for local businesses.

The above statistic aren’t just critical for online retailers, it’s also important intelligence for brick-and-mortar businesses like dental and orthodontic practices.

Does this mean that traditional forms of advertising are dead? Not necessarily.

Nevertheless, it’s critical that your marketing message be displayed where your target consumers are spending their time.

Nowadays, that means online.

Think about it. When was the last time you or your classmates picked up a Yellow Pages directory? These unwanted deliveries probably went directly into your recycling bin.

Online search enables you to tightly target your ideal consumer, making your marketing investment more efficient than ever before. You can also compete effectively against more established competitors.

According to online search leader Google, prospects aren’t just typing “dentist,” “porcelain veneers” or “chipped tooth” into the search box. They’re entering specific terms like “pediatric dentist Atlanta” or “laser teeth bleaching San Diego.” Half of these localized search results also show a map to give your business even more exposure. Not only can Google, Bing and Yahoo! inform a local consumer that you provide the service they need, these search engines can quickly point them right to your virtual (website) and actual doorstep.

Go it Alone or Seek Help?

Deciding to rethink your marketing mix and placing a greater focus on your online presence is simply a first step. Far more important is how you choose to implement an online marketing strategy.

Do you, as a business owner or partner, have the time to learn the complexities of online marketing and spend time every day monitoring and managing the process? Most do-it-yourself search marketing campaigns yield few ad impressions and qualified clicks, and at much higher costs per conversion.

Sedaion Dental Care (www.sedationdentalcare.net), based in Raleigh, North Carolina, used to manage its own online campaigns. Realizing the huge time commitment was not an effective use of their time and not providing the desired results, the practice sought help from an online marketing firm. Within four months of www.dentalentrepreneur.com

launching a professionally-managed online ad campaign, Sedation Dental saw a six-fold increase in the number of clickthroughs on its ads, while reducing its online advertising costs by 41 percent.

Dr. Daniel Davidian, owner of Sedation Dental, says the new online ad campaign produced more high-quality inquiries and secured significantly more new patients.

“It’s clear that the prospects being delivered by the new system are precisely targeted and far more likely to book an appointment. This has completely reshaped, and dramatically improved, our approach to online advertising.”

One important distinction needs to be made: not all online marketers are the same. Almost everyone “knows a guy” who says he can do online marketing or “SEO.” Armed with basic knowledge of Google Analytics, he excitedly reports back to you about your number of hits, clicks, site visitors and time spent on your site.

That is, until he gets distracted and forgets to send you updates, doesn’t closely monitor changes in keyword searches or simply employs a “set it and forget it” strategy.

A dedicated online marketing partner can drive increased local sales opportunities and targeted online exposure by providing technology-driven online marketing that addresses your specific business and related brands.

The Right Questions If the decision has been made to engage an online marketing partner, here are six questions to ask to gauge their experience and professionalism: 1. Is it a core competency? Many marketing and PR firms, as well as independent consultants, offer online marketing and SEO services. If it’s simply an add-on, you’ll want to examine their services and successes closely.

2. Ask about their technology. Online marketing is increasingly complex and impossible to effectively manage without advanced, proprietary software tools. A human simply can’t control a campaign with 42 categories, 1,000 keywords, hundreds of bid changes, and 200 variations of your search and display (banner) advertisements.

3. What support do you provide? Will you talk with a live person who has the expertise to guide your online marketing to success? Will they consult with you and adjust the approach as your business evolves and grows?

4. Ask about industry focus.

Developing a knowledgebase within a particular industry enables a partner to maximize results based on the data and shared knowledge of your market.

Ultimately, this results in more quali-

fied leads for less cost.

5. Do they provide meaningful and concise reporting? One of the biggest benefits of online marketing versus traditional media is the measurable tracking of data. Is your partner providing insight to success rates?

Conversions? Cost per click? Ask for sample reports.

6. What technical credentials do you have? What accreditations and partnerships with manufacturers does your provider have? Do they have entire teams fully certified by the major search engines, ad networks, etc.?

As you contemplate making the move into online marketing, pick partners that will truly help your business succeed and give you the same type of support you give your patients. That way, you are maximizing your opportunities with new potential patients while staying focused on your own practice. ■

Brendan Morrissey is CEO of Netsertive (www.netsertive.com). He has over 15 years’ experience in digital media and early-stage companies emphasizing online and mobile marketing technology. Morrissey holds a B.A. in economics from the University of Massachusetts, Amherst.

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. www.dentalentrepreneur.com

Dental Entrepreneur Fall 2011 29

Practice Builders

Five Things Every Young Roger P. Levin, DDS

Dentist Should Know When Entering Practice Introduction For those entering practice today, here’s something to keep in mind—the rules have most definitely changed. How practices grew and succeeded in the past no longer works.

As a third-generation dentist and CEO of an international dental management consulting firm, I have had the opportuRoger P. Levin, DDS nity to gain a unique perspective on dental practices. In my father’s and grandfather’s day, opening a dental practice was far less complicated. When I began practicing, I saw the beginning of enormous change taking place within our field. It has been snowballing ever since!

Young dentists today have challenges that never existed before. Debt levels, the recession, a changing insurance landscape and a host of other factors are making dental practice more challenging than ever before. However, what has really happened is that dental practices have been forced to operate more like businesses if they wish to grow over a lifetime.

The Dentist As Entrepreneur The opportunity for a dentist to be successful in practice is very high. The real question—how successful will each

30 Fall 2011 Dental Entrepreneur

dentist be? The followings strategies will help improve practice performance and ensure a higher level of success.

1. Reduce debt quickly Dental school debt can be crushing.

Even with new dental schools opening to accommodate high demand, the tuitions are a significant obstacle to financial independence for young dentists. And, of course, practices have become more

expensive to open as well. Dentists should meet with financial planners as early in their career as possible. Too many young dentists think that having such high debt means they have to pay it off before worrying about financial planning. Doctors can begin to structure their debt in different ways that allow them to pay down debt, have a reasonable income and save for long-term retirement.

Recently, I met a dentist with a practice experiencing slightly below average

www.dentalentrepreneur.com

production. He had never taken a penny out of his savings since the day he started earning money as a dentist. While his practice performance was somewhat low, his net worth was excellent. One word of caution to young dentists—don’t overspend on the practice or in your personal life. You can “have it all” right out of the gate but doing so can mean a very bad long-term financial situation.

2. Market your practice Dentists used to feel that marketing was only necessary when the practice was slow. Today, nothing could be further from the truth. To illustrate the point, Levin Group has now tracked more than 2,000 general dentists who entered our internal marketing consulting programs to evaluate performance. How effective is internal marketing? Ninety-nine percent of practices with strong internal marketing experience growth.

The challenge for young dentists is that they do not have many patients. What grows a young practice? In a word—effective marketing, which entails:

One word of caution to young dentists— don’t overspend on the practice or in your personal life.

• Getting out in the community • Tracking and measuring all marketing activities to determine which ones work so that money is spent in the right places • Viewing every patient as an opportunity for referral • Achieving Levin Group’s target of 40-60% of patients referring at least one other patient per year Be careful with some of the new marketing vehicles such as Facebook, Twitter and Groupon. While these social networking sites should be considered as part of a comprehensive marketing plan, they are only a small part of what should be a comprehensive internal marketing strategy.

3. Create step-by-step systems and train the team intensely Most young doctors don’t think that they need formal, documented systems until their practice is busy enough.

Remember that systems are not merely about handling the operations of the practice, but how the practice creates production and profit. For example, the right scheduling system is not just about creating power cells in which to place patients, but also about how to attract and motivate patients to accept treatment and even refer others.

Levin Group teaches that the development of management systems begins with setting targets. Targets are metrics to be achieved such as: • Collecting 99% of fees owed to the practice • Having 40-60% of patients refer at least one other patient • No-show rates below 1% • Increasing the average production per patient annually • Closing 90% of all cases presented

Get more patients.

And look good doing it.

Customized Graphic Design, Marketing and Website Development for Dentists and Dental Practices www.jumptolightspeed.com

www.dentalentrepreneur.com

Dental Entrepreneur Fall 2011 31

Once the targets are established, systems can be built to achieve these targets.

Staff members play a pivotal role in the successful implementation of practice systems. Unfortunately, this does not always happen. Train the team on systems because their performance is more important than ever before. Despite the fact that this is an era where practices are more challenged to grow, doctors still tend to want to play a bigger role than necessary throughout the practice.

The opposite should be the case. Doctors should focus almost exclusively on dentistry and patient relations. Let a trained team handle all other aspects. As a result, practices can grow quickly without having customer service problems along the way.

4. Implement Value Creation Scripting™ as quickly as possible The recent recession caused 75% of all dental practices to decline.1 Younger practices were even more challenged than more established offices for obvious reasons. One of the key factors that has made a tremendous difference in growing young practices is implementing what we call Value Creation Scripting™. While traditional scripting is about clear com-

munication, Value Creation Scripting™ is about influencing behavior. The dental team must be able to influence patients to schedule, refer others, accept treatment, pay bills, etc.

The concept of influencing also assists patients decide to have treatment, refer another individual, accept an appointment time, etc. Influence is about helping patients move toward the desired action rather than simply communicating and explaining what that action might be. A team that can influence patient behavior means the practice can do much more with fewer patients.

5. Begin saving—now Young doctors should begin setting aside income into long-term investments without delay. While this may seem painful at first, a dentist can learn to live on, say, 90% of their personal income as easily as they can learn to live on 100%. Put off a few purchases, invest the difference prudently and within 10 years, the results will be amazing.

Levin Group now projects that most dentists will be working approximately 8-10 years longer than expected unless excellent financial planning is put in place. According to Robert Graham, CEO of RG Capital2, a firm that works

Business Beyond the Classroom

Conclusion Dental practice today is more challenging than in the past. However, many young dentists, as entrepreneurs, are doing extremely well. It is more about applying excellent business principles that are effective in changing economic times than simply opening a practice and hoping all goes well. Proper planning will make an enormous difference in the success of many young dentists.

For all dental students about to enter the field of dentistry, for all young dentists who are still in their start-up phase, don’t let the new economy intimidate you. Know that you’ve made what is still a wonderful career choice! ■ To learn how to run a more profitable, efficient and satisfying practice, visit the Levin Group Resource Center at www. levingroup.com—a free online resource with tips, videos and other valuable information.

1 ©The Levin Group Data Center™ 2 www.rgcapital.net

Resource Guide

Patterson Advantage (800) 328-5536 www.pattersondental.com

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 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 1-800-6595977 or visit www.cereconline.com. Please see our ad on page 25.

32 Fall 2011 Dental Entrepreneur

with many dentists, saving and investing 10% of personal income can make the difference of almost 10 years in planning for retirement.

Please reach out to our advertisers.

They care about you and keep us in print!!

www.dentalentrepreneur.com

Dental Entrepreneur Survey We’d love your feedback! Please fill out our survey. Go to dentalentrepreneur.com and it will redirect you to our survey page. Or fill it out here and mail or fax it to: Dental Entrepreneur, 7422 Carmel Exe Park, St 107, Charlotte, NC 28226. FAX 1-704-846-7304

Name______________________________________________________________________ Email_______________________________________________________________________ College_____________________________________________________________________ Age________________________________________________________________________ In what single area of a dental practice would you like more information?

Would you consider staying in touch with us for the next two years?

____Finances ____Front office - Administration ____Insurance concerns ____Dental equipment ____Other (please specify) _________________________________

____Yes ____By Email? ____Other? (please specify) _________________________________ ____No

How would you like to enter the dental field?

Would you consider writing an article about your first year in practice?

____Start your own practice ____Associateship ____Join an existing practice ____Have not decided ____Other (please specify) _________________________________

____Yes ____No ____Possibly ____Ask me a year after I graduate ____Other (please specify) _________________________________

What could Dental Entrepreneur Magazine do to make it more valuable to you? ___________________________ ___________________________ ___________________________ __________________ What kind of articles would you like to see in future issues of Dental Entrepreneur Magazine? ___________________________ ___________________________ ____________ Are you interested in being able to download Dental Entrepreneur Magazine from the internet? ____Yes

____No

Where would you like to see yourself in five years? ____In a private practice ____In a group practice ____In an educational environment ____In military service ____Other (please specify) _________________________________

What are your major concerns in your career? ____Money issues ____Getting patients ____Harmony within the practice ____Getting loans ____Other (please specify) _________________________________

dental

Business Beyond the Classroom

entrepreneur

If you have any questions, comments, or responses to our magazine, please write us at: Dental Entrepreneur Magazine, 7422 Carmel Executive Park #107, Charlotte, NC 28266 or e-mail us at: ADuff2@aol.com or Linkbeau@aol.com

www.dentalentrepreneur.com

Power To Succeed Richard Weinman, D.M.D.

“Hinman 100-Year Legacy Offers Value to Emerging Dentists”

T

his year, the Thomas P. Hinman Dental Meeting celebrates a century of providing post-graduate education for dental professionals.

It started as a study club and a modest Atlanta Midwinter Clinic held in 1911 in Atlanta, but has grown to become one of the preeminent dental meetings in the country. The man behind the meeting was Dr. Thomas P. Hinman, an Atlanta dentist who many consider to be the forefather of modern dental continuing education. By the age of 40, he was an internationally-renowned lecturer, educator and Richard Weinman, D.M.D. leader in the dental profession – a trailblazer and visionary who saw the value in continuing education.

Even though Dr. Hinman passed away more than 80 years ago, his vision to provide the best possible continuing education continues. Today, attendance at the Hinman Dental Meeting has grown to more than 23,000 dentists, hygienists, assistants, laboratory technicians and office staff from around the world. The meeting also features more than 400 exhibitors, demonstrating the lat-

34 Fall 2011 Dental Entrepreneur

est in dental technology, innovation and consumer care products.

Offering Value to Students While during Dr. Hinman’s day, students weren’t invited to attend the meeting; today, the Hinman Dental Meeting draws more than 800 students every year. And, it’s certainly proven to be a good place for any young dentist to embark on a career in dentistry. While many students are focused primarily on graduation day, the 800+ who attend Hinman annually are looking beyond graduation and beginning to take advantage of the tools and resources a meeting like Hinman – with a 100-year legacy of providing continuing education – can provide.

At the 100th Hinman Dental Meeting, students have access to everything they need to be successful in this profession, including:

such as human resource management, best practices in the office, marketing and social media, office makeovers and financial management.

• New Products & Technology. An important part of any dental meeting is learning about the latest technologies, techniques and products in the industry.

It would be impossible to learn about each and every new product or technology on your own. The advantage a dental meeting like Hinman provides is that all of these advancements are in one place at one time. And, students and new dentists can gain hands-on experience and knowledge in workshops and courses provided by dentistry’s leading authorities, as well as see them demonstrated by the industry’s foremost experts in an exhibit hall environment.

• Emerging Dentist’s Survival Guide.

Meetings like Hinman often offer courses that are designed for the new or emerging dentist. This particular educational track is a new three-day series of courses geared for the business of dentistry. There are a number of course topics, however, that focus on establishing and building a successful practice. Students should look for courses that will help them jump-start their practice – topics

• Valuable Professional Connections.

When a meeting is hosted by a strong membership-based association like the Hinman Dental Society and attracts more than 20,000 professionals to their meetings, there are numerous opportunities for networking.

Students should attend as many events as possible, including their dental school’s reunion, if held during the meeting. Hinman offers a Student Orientation that will

www.dentalentrepreneur.com

allow them to learn more about the meeting, socialize with students from other schools and meet some of the leaders within Hinman. There will be many opportunities to talk with colleagues and learn from one another.

• Social Events. Most dental meetings host several signature social events, as well as alumni receptions for the various dental school alumni in their regions.

Hinman is known for its Dentist Reception and Auxiliary Reception, both of which students are invited to attend. There’s also a Keynote Session and other exhibit hall events that provide free entertainment and the opportunity to meet others like you, as well as those who can be mentors to you. If you are married, there also are social events designed for spouses that allow them to have fun as well while you are taking courses or visiting the exhibit hall.

Clearly, meetings like the Hinman offer a great value to students and emerging dentists. At no charge, a student can check out the meeting and take advantage of many of its resources. And, when you become a practicing dentist, joining an association like Hinman can provide you with the tools you need to be successful. In addition to fulfilling your continuing education requirements, you can shop and purchase needed products and equipment in the exhibit hall, and reconnect with colleagues and friends at various events and receptions.

While there are other CE opportunities out there, they don’t provide the value that a dental meeting provides. They also don’t expose you to a 100-year legacy of excellence and continuing education expertise that is unmatched in the profession. ■

Dr. Richard Weinman is a practicing dentist in Atlanta and a long-time member of the Hinman Dental Society, currently serving as the PR Committee Chairman. He also is a member of the ADA, Georgia Dental Association and Academy of General Dentistry. Dr. Weinman is a graduate of the Medical College of Georgia School of Dentistry.

www.dentalentrepreneur.com

Dr. Hinman’s Legacy: A Meeting Strictly for Educational Purposes Born in 1870, Thomas P. Hinman graduated from Southern Dental College in Atlanta with his Doctor of Dental Surgery degree in 1891. The following year, he joined the faculty of his alma mater and became Professor of Oral Surgery. Dr. Hinman held high offices in many professional organizations including the appointment by President Woodrow Wilson as the U.S. Delegate and Honorary Chairman of Section VIII of the Fourth International Congress of Dentists in London. This nomination was considered one of the highest tributes in the dental world.

During his career, Dr. Hinman often spoke and attended numerous dental clinics and conferences. During that time, he recognized a need in the South for a progressive clinic that would provide the latest developments in dentistry. His legacy is the meeting he began “strictly for serious-minded educational purposes.” Dr. Hinman believed strongly in the individual’s contribution to dentistry and required attendees to return to their state dental society and present what they had learned in a formal program.

The first classes for the Atlanta Midwinter Clinic, later renamed the Hinman Dental Meeting, were initially limited to 120 dentists who received instruction from three lecturing clinicians. In 1926, the meeting expanded to 200 attendees, and dentists from across the country clamored for the restricted invitations. Under his direction, the Clinic was known for its progressive methods for education, including live surgical demonstrations and “modern” x-ray slides.

Dr. Hinman served as General Chairman of the Clinic until 1931 when he died and the meeting was canceled that year and renamed in his honor. The meeting continued to thrive even after Dr. Hinman’s untimely death. In the 1940s, attendance was expanded beyond invitation-only, and exhibits were introduced in 1942 with 14 booths appearing in the ballroom of the Biltmore Hotel in Atlanta.

Many of the traditions he established from the start are still observed at the annual meeting today. For instance, Dr. Hinman required that teaching clinicians were to be met at the train station and escorted to their reserved hotel room. They were to be accompanied by a committee member at all time, unless they preferred to be alone. Today, all featured clinicians and special lecturers are hosted by a member of the Hinman Dental Society and extended the same southern hospitality that Dr. Hinman provided a century ago.

Dental Entrepreneur Fall 2011 35

Dental Trade Shows American Dental Association October 10–13, 2011 Las Vegas, NV

Chicago Mid Winter Meeting February 23–25, 2012 Chicago, IL

Holiday Dental Conference November 4–5, 2011 Charlotte, NC

Hinman Dental Meeting March 22–24, 2012 Atlanta, GA

Greater NY Dental Meeting November 25–30, 2011 New York, NY

California Dental Association – Spring Session May 3–5, 2012 Anaheim, CA

Yankee Dental Congress January 28–30, 2012 Boston, MA

Index of Advertisers ADS Transition Specialists……………………………………………………………................................ 13 ADS South……………………………………………………………………........................................... 17 ADCPA ………………………………………………………………..………............................... Back Cover Air Force…………………………………………………………………….............................................. 19 Aspen Dental............................................................................................................................... 23 The Artist Evolution LLC.................................................................................................................. 9 Henry Schein (PPT)..................................................................................................Inside back cover Hinman ....................................................................................................................................... 7 Lightspeed.................................................................................................................................. 31 MacPractice................................................................................................................................ 15 Oxyfresh..................................................................................................................................... 27 Paragon...................................................................................................................................... 29 Patterson Dental Supply..........................................................................Inside front cover and page 1 Patterson Advantage.................................................................................................................... 21 Sirona........................................................................................................................................ 25

36 Fall 2011 Dental Entrepreneur

www.dentalentrepreneur.com

It’s the Journey Are you fully prepared for your professional journey?

Do you know what it takes to build professional and personal wealth? Hire an associate?

Bring on a partner? Plan an exit strategy? Sell a practice? It takes expert guidance from a team of people who have your best interests in mind.

Henry Schein Professional Practice Transitions (HSPPT) is the nationwide team you want on your side when you decide to pursue your professional goals. HSPPT provides a full range of transition services and will support you from graduation to retirement with practical advice and customized strategies that will ensure your financial success.

• Appraisals • Practice Sales and Purchases • Associateships, Partnerships and Mergers • Retirement Planning • Business Structure Consulting

Follow Henry Schein Practice Transitions at facebook.com/henryscheinpracticetransitions

1-800-730-8883 Henry Schein Financial Services is not a bank, does not represent itself as such, and does not conduct banking activities. © 2011 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.

or e-mail: ppt@henryschein.com www.henryschein.com/ppt

ADCPA_OneSheet_Three_Layout 1 8/12/11 1:07 PM Page 1

Looking to get a jump start on practice success?

Let the Academy of Dental CPAs help!

Does your CPA really know your practice? Can he or she tell you:

✓ ❐

✓ ❐ ✓ ❐ ✓ ❐

If your hygiene department is being productive and how much money you’re leaving on the table if it isn’t?

How your wages compare to other dentists?

How your fees and procedures mix compares to other dentists?

What the “best practices” are doing that you’re not?

✓ ❐

When you should NOT use the New or Used Equipment Purchase IRS Section 179 depreciation write-off?

✓ ❐

How you can pay for your practice, put your kids through college and protect your spouse in the event you die or become disabled?

✓ ❐

How you can start long-term financial planning NOW so you can prepare for your future and the future of your practice?

If your CPA can’t answer the questions above, contact an ADCPA member firm today! We will guide you through a consultative process that is designed to identify what -- and whom -- is most important to you. Once we identify your goals, we will implement a planning strategy that will help you achieve your long term goals -- both personal and professional. By selecting an ADCPA member firm, you will have access to an entire network of CPAs who are dedicated solely to the business of dentistry. Our CPAs work with over 8,000 dentists nationwide and have only one goal in mind -- improving YOUR quality of life. Our plan will include both your personal and professional financial management planning and oversight along with assertive and proactive tax planning that will ensure your financial success for years to come. After all, we think your personal and professional success is worth jump starting.

Find the ADCPA member nearest you at adcpa.org

The mission of the ADCPA is to enhance its members' expertise through the sharing of knowledge and resources to provide progressive consulting, accounting and tax services to dental professionals.

ACADEMY OF DENTAL CPAS

The Academy of Dental CPA’s (ADCPA) is a national association of accounting firms that specialize in delivering creative solutions that meet the unique needs of the dental profession.

For more information, please call 800-331-8525