Selling a Dental Practice

Asset Allocation and “How to Sell My Dental Practice?”

If you’ve ever gotten into the weeds of the question of “how to sell my dental practice?” you’ve probably heard talk about allocation. There are different ideas about how to handle allocation and sometimes people disagree. This might make it seem complicated. But it’s not, really. There is a fairly simple rule to follow and, if you work with your dental practice transition specialist and your dental accountant, you should be able to negotiate an allocation that will work for both the seller and the buyer. But first, what is allocation?

Allocation of Assets

Simply put, the allocation of assets is the process of assigning a dollar value to each asset being transferred in the sale of a dental practice (excluding the building, if that is part of the sale). These assets include all of the tangible items of personal property included in the sale and the big intangible that usually accounts for the bulk of the value of a dental practice: the goodwill. We’ll get to why this distinction is important below.

Generally when you put a dental practice for sale, you aren’t selling the business entity (e.g., your LLC or S-Corp), you are selling what the business owns.  That is, you don’t sell your shares of the corporation, you sell off all of the corporation’s assets, including your furniture, equipment, patient records, supplies, your trademark and logos, etc. All of these items are specifically identifiable and can be quantified in value. That is, your equipment is worth what you paid for it, less depreciation over time. How much could you sell your used equipment for? That would be the value its allocated. As far as the intangible of goodwill, the value there is harder to determine and is more fluid.

The Simple Rule for Allocation

The simple rule for allocation of assets is that you determine the value of the practice (for more information on this topic, see our recent post on methods of valuation for dental practices, “How Much is My Dental Practice for Sale Worth?”), negotiate an agreement between the buyer and seller on the value of each category of tangible assets (e.g., the furniture and equipment is worth $150,000, the supplies are worth $10,000, etc.), and whatever remains after that is allocated for goodwill. It’s a fairly simple arithmetic problem, once all parties are on the same page.

For instance, if you are buying a practice for $1,000,000, and the tangible assets are valued at $200,000, the goodwill is then allocated $800,000, or 80% of the purchase price. Some will say that good will should always equal a certain percentage, or fall within a certain range, such as 75-80%. That’s really the tail wagging the dog. There is no rule for how much should be allocated to goodwill. Rather, goodwill tends to fall within that range as dental practices are valuated.

Why Allocation Matters

As you are wondering “how to sell my dental practice?” you might think this sounds like a lot of trouble to go through. Why not just negotiate the overall value of the practice with the buyer and leave it at that? In a word: taxes.

For the seller, tangible assets are taxed at the ordinary rate, whereas the intangibles are taxed at the more favorable capital gains rate. This is why it’s so advantageous to have a high percentage of the purchase price allocated as intangible goodwill. The tangibles have to be allocated at a fair market value. Fair market value is essentially what the buyer and seller agree upon, but has to be within a reasonable range. The rest can then reasonably be called intangible.

If you are a buyer, you want to be able to gain back the maximum amount of the purchase price over as short of a period as you can, by expensing, depreciating, and amortizing the assets. Some of the tangible assets, certain pieces of furniture and equipment, for instance, can be depreciated over five to seven years. The goodwill, however, will take longer to depreciate, 15 years.

How to Sell My Dental Practice and Get the Most Out of It

To maximize the value of the sale of your dental practice, you need to be careful with your allocations to reduce the amount that the IRS will take of your proceeds. This is why it’s so important to have a qualified team of professionals, with knowledge and experience specific to dental practice transitions, to advise you throughout the process. At ddsmatch Southwest, as expert dental transition specialists, we recommend that in addition to a transition specialist, you have dental attorney and a dental accountant who will understand the legal and taxation pitfalls and how to avoid them. We also recommend that you use a Certified Business Valuator to evaluate every aspect of your practice to get it ready to put on the market. At ddsmatch, we partner with Blue & Co., for dental valuation consulting and dental accounting.

If you are considering a Texas dental transition or New Mexico dental transition in the next five years, contact us for a free, no-obligation Practice Transition Assessment. We will discuss the current local dental practice transition marketplace, establish best transition options for your practice, and advise on potential practice investments to increase value. Contact us today and find out how we can help you meet your dental transition goals.

Why Do I have to Sign a Non-Compete When I Sell My Dental Practice?

If you are transitioning your dental practice with the intent to retire from dentistry, you might ask yourself, “if I don’t intend to work as a dentist, why would I sign non-compete agreement when I sell my dental practice?” It may seem unnecessary to you. To the buyer doctor, however, this document is extremely important. In this post, we’ll discuss a little about what these agreements are and why they matter.

Before we get started, however, please understand that the issues surrounding these agreements are legal matters and you need a qualified attorney to counsel you regarding the reasonableness and enforceability of non-competes in your state. This post is for general informational purposes only and should not be relied on for legal advice.

What is a Non-Compete Agreement?

A non-compete agreement is a contract in which one party agrees to not compete with another party in their area of business within a defined geographical area and for a certain length of time. A non-compete agreement may include non-solicitation provisions which prohibits one party from soliciting customers away from another party.

In dentistry, these agreements come up in three basic scenarios:

  1. When Hiring an Dental Associate: the dental associate will likely be asked to sign a non-compete agreement that covers the period after the associate leaves the practice. It would protect the practice by prohibiting the former dental associate from competing directly with the practice or using information from patient files to lure patients away.
  2. When Entering into a Dental Partnership: similar to the dental associate scenario, the agreement covers the period after a partner leaves, to protect the practice.
  3. When Selling a Dental Practice: Again, the agreement is to protect the practice. But, here, the doctor being protected is the buyer—the new doctor. The agreement prohibits the seller from practicing within a certain area for a certain length of time, thereby increasing the chance that the practice’s existing patient base remains with the practice, even after the departure of the long-time owner.

In most states, these agreements are enforceable (California is one notable exception). This means that, especially with regard to dental associates or when you decide “it’s time to sell my dental practice,” a non-compete agreement will likely be a non-negotiable part of the deal. And, in fairness, they are a good idea for whichever doctor is left in the dental practice.

For the buyer of a dental practice, it’s important to be assured that the selling doctor is not going to pocket the money, open a practice across the street, and take all of the patients with them. Also, if the selling doctor is going into retirement, that’s uncharted territory for the seller. What if after a few months or a year or so the seller decides they don’t really like being retired? The buyer wants a guarantee that they will have time to establish themselves in the practice and earn the trust of the patients and staff before having to compete with the seller.

Reasonableness of the Terms

A key to the enforceability of the agreements is whether the terms are reasonable. What does that mean? Well, it depends. It depends on the state law governing the agreement and it depends on the location of the practice. Again, you will need a qualified local attorney to advise you on these issues.

There are two main points on which the agreement must be reasonable: the scope of the geographical area being restricted and how long the restriction will be in place. For the length of time, two to three years is a common duration, although it may be up to five. For the geographical area, it will largely depend on where your practice is located. For instance, in a dense metropolitan area, such as New York City, the area may be small, defined in city blocks. However, in rural Texas, a dental practice for sale might be the only one in a 50-mile radius.

One guide to determining a reasonable geographic area is, before you think “it’s time to sell my dental practice,” consider where your patients live. The area that you draw patients from can be quantified as the area in which about 80% of your patients live. That way you capture the bulk of your patients without chasing the outliers that might make the area too broad and, therefore, unenforceable.

A word on the enforceability of unreasonable restrictions. Some employers or buyers of dental practices might purposefully try and see what they can get away with in terms of overly broad restrictions. This is a bad practice for both parties as it relates to the agreement. Overly broad terms may have the effect of invalidating other parts of the contract which are related—so if you are the one asking for the non-compete, don’t push your luck by asking for too much. If you are the party being restricted, sometimes courts will take the approach that you knew what you were getting into when you signed. Don’t take the risk. Plus, do you really want to be contractually obligated to a party that is trying to get something from you unfairly? In that situation, it’s probably better to walk away.

Other Considerations for the Terms of the Non-Compete Agreement

  • What circumstances will negate the agreement? If the practice ceases operations, is sold to another dentist, or moves location, you should consider how these factors will impact the agreement. For instance, if the practice closes, maybe the agreement should no longer be enforceable. If the practice moves, it should probably depend on where it moves, and how far that is from the original location (e.g., whether it changes the geographical area from which the practice draws the majority of its patients). If the practice is sold, there will likely be a non-compete between the parties to that sale. That would be a situation you’d want to discuss with your attorney.
  • Does it cover going to work for an existing competing dentist? This is mostly applicable to former dental associates or partners, although it could arise in the sale of a dental practice. Even if the change in employment is not advertised and no one is stealing patients, it’s still possible, especially in a small town, that people will learn of the change and that could draw patients away. This is something you should consider and discuss with your attorney and dental practice transition specialist. If you are dealing with a partner or employee leaving the practice, they may be leaving because they are unhappy in the practice, a factor to be carefully considered.
  • Are staff covered by the non-compete agreement? Do you want to prohibit the other party’s ability to hire your staff away from you? Will you state laws allow you to do anything about it proactively?
  • If partners are splitting a practice, how do you divide the resources? Who keeps the patients? Who gets the referral sources? These factors must be decided before you can move forward with any further restrictive agreements.

You Need a Trustworthy Specialist when it’s Time to “Sell My Dental Practice

At ddsmatch Southwest, we are expert dental transition specialists who draw on the experience of hundreds of dental practice transitions from across the country to assist and advise our clients with their dental practice transitions in Texas and New Mexico. One of our satisfied clients said one thing he especially appreciated about the dental transition specialist that handled the sale of his dental practice was that  

“Your issues were his issues . . . the thing that was amazing with me was that I absolutely knew nothing, but absolutely had an amazing experience, and that’s because Andy took good care of me. . . . He’s a good guy. He looks out for his clientele.”

You can read more about that client’s experience on our Dental Transitions Blog.

Whether you think “it’s time to sell my Texas dental practice” or whether you think that time is still a few years down the road, it’s not too early to find out what ddsmatch can do to help you meet your dental transition goals. Contact us today for a free, no-obligation consultation.

What Will Dentist Practice Appraisals Show about Your Overhead Costs?

One of the major factors that affects value in dental practice appraisals is overhead. Overhead is a term that represents the ongoing costs of operating a business. These are expenses you incur regardless of how many patients you see or how much you charge in fees. These include rent, employee wages and benefits, lab costs, materials, and so on. Simply stated, overhead is everything that isn’t money in your pocket.

Overhead is important for three related reasons. First, it tells you how much it costs to run your practice. Second, it shows the profitability of your business. For instance, if your overhead costs are 65%, which according to some researchers is about average for general dental practices, this means that for every dollar you collect, $.65 pays your overhead and you get to keep $.35. And, third, when you start to look at overhead by category, it shows you where you might trim some fat to make your practice more profitable.

Some overhead expenses are fixed, such as rent, meaning they don’t change from month to month. Some are variable, such as costs for certain materials or lab costs, which will vary depending on your patient treatments. And some are semi-variable, like utilities, where you may have a fixed base charge with additional costs that depend on usage.

While it’s important to look at your overhead costs as a whole, the real work is done by looking at each category, line by line. There are national averages which can be a rule of thumb on where you should be with each category, but these are just general guidelines. If you are over the average on rent but under on employee costs, it may balance out, as an example. But national averages can also be problematic. For instance, as noted above, the national average for total overhead may be as high as 75%, but 60% is really where most practices should be. Below, we’ll discuss a few categories where you can start to examine overhead, especially if you are considering putting your dental practice in Texas for sale or are considering dental practice appraisals.

Employee Costs

Number of Staff Members

If you are like most doctors, this is your biggest expense. The target here is for employee costs to be about 25% of your intake, and that should include not only wages and salaries, but also any benefits, bonuses, and any other compensation. If you are above that range it likely means one of two things: you either have too many employees, or you are paying them too much.

Over-hiring is a common problem. If your staff is busy and balls are being dropped, the easy solution is to hire another person. But you have to carefully consider whether you really need another employee, or if your present staff just needs more direction or training. Hiring additional staff doesn’t typically solve the problem, and in most cases, it just creates a new one in the form of higher overhead. If you’ve already made this mistake, you are faced with a tough decision. Eliminating staff is one of the most difficult aspects of running a business, but, at the end of the day, you need to have a dental practice that is running as efficiently as possible.

Managing Staff Members

If your office isn’t running smoothly, it may be because you haven’t been as effective in your role as CEO of your dental practice as you need to be. Being a good doctor doesn’t necessarily mean you are also a good manager. But that doesn’t mean you can’t learn how to better support your employees.

If employees are not clear on their job descriptions and responsibilities, if they lack the vision to see where they fit into the whole of the operation, or if they are not as efficient or productive as they could be, more often than not, it’s a matter of training, supervision, and support. Having specifically delineated job descriptions, written policies, and clear instructions on office procedures can go a long way toward making sure everything is being done properly and on time. Employees benefit from performance measurements and frequent feedback, and your business will benefit in turn from the increased efficiency, which will be reflected in dental practice appraisals.

So, before you hire another person, look at, for instance, how patients are moving through your office. How long do they spend at the front desk? It shouldn’t take more than 10 minutes to check a patient in and out. If your offices sees 20 patients a day, that’s 200 minutes of time at the front desk. If there are 480 minutes in a work day, you shouldn’t need more than one person at the desk. If your front desk person can’t keep that time in line with where it should be, even with additional training and support, then what you need is a replacement, not additional labor.

Employee Compensation

There is a notion that employees should get some kind of pay increase each year. This is wonderful  if your practice is increasing collections each year. However, if your practice is stagnant or declining, you simply cannot afford yearly raises. Remember that every dollar of increased overhead is a dollar by which you decrease profits. If you can give raises and maintain 60% overhead, then it is fair to compensate your employees for the efficiency they bring to your practice.

If giving raises will take your employee overhead costs above the 25% target, then you should consider making raises dependent upon the practice’s performance. While stagnation or declining profits is not likely the fault of one employee, it’s unlikely, under these circumstances, that your employees are operating at peak efficiency. And if they know that they’ll get a raise each year regardless of performance, they will lack incentive to improve. Here is where performance standards can carry real weight— instituting a policy where raises must be earned on the basis of what an employee brings to the business.

Patient Recall

One of the many factors potential buyers of dental practices want assessed in dental practice appraisals is patient recall. Returning patients indicate that your monthly and annual collections are something that can be replicated in the future. When a young doctor buys a dental practice, they want future success, not past ones.

Unfortunately, many doctors don’t prioritize a patient recall system. If you haven’t already, you should set up procedures for your patient coordinator to contact past-due patients and schedule appointments, with a goal for making a certain number of calls and appointments each day. Recall patients bring in revenue you would not have otherwise collected, increasing profitability and reducing overall overhead.

Raising Fees

Many dentists resist raising fees because they think that higher costs for patients might drive those patients to other practices. The fact is, consumers expect prices to rise over time. If you regularly review your fees and make incremental increases, keeping in line with the market value of your services, it won’t surprise or upset most patients. The problem is waiting too long. Then you have to make bigger increases, which are harder for patients to accept.  Also, if you have an eye toward selling your dental practice in Texas, a potential buyer may be wary of a practice that has too low of fees. If the buyer wants to bring fees in line with market value, they don’t want to be the one to do it, as a change in ownership coupled with higher prices may increase patient attrition.

Other Important Overhead Categories for Dental Practice Appraisals

The other overhead costs you can count on for any dental practice will be rent, utilities, lab costs, materials, equipment, marketing, and accounting. There are industry standards for how much of your overhead should be allocated to these categories. For instance, rent should be about 6-7%, materials and lab costs should be about 6% each, marketing should be about 2-3% of your overall overhead costs, and account should be about 1-2%. Before you put your dental practice for sale, you may want to consider having a business valuator look at your practice and review where your costs can be reduced. When a potential buyer reviews a dental practice appraisal, they’ll be most interested in a dental practice that falls within these industry standard ranges.

But, remember, these are averages. If you are high in one category, making that reduction can bring you within the overall ideal range, then discrepancies in other categories will appear less problematic. Once you know where your costs are and make the necessary adjustments, keep an eye on each overhead category every month to watch for waste, inefficiency, or other ways your costs may be unnecessarily high.

At ddsmatch Southwest, we are uniquely experienced in helping clients who are selling a dental practice to achieve their profitability and lifestyle goals. We are expert dental practice transition specialists, and will help you identify a buyer with a strong skill set and personality match that will carry on the practice and legacy you have worked so hard to build. We ensure that every detail is covered, help you avoid common mistakes, and ensure no step is overlooked.  Plus, your confidentiality is always guaranteed. Contact us today for a free, no-obligation Practice Transition Assessment and find out how we can help you get the most for your practice.

How Much is My Dental Practice for Sale Worth?

When it comes to valuing a dental practice for sale, there are a lot of different methods and theories. In all honesty, there are so many variable factors that there is no one formula where you plug in numbers on one end and get an objectively correct answer out the other. But there are a couple of rules of thumb that can give you a good idea of a ballpark range. Realistically, you’ll need to work closely with your accountant, your dental practice broker, and, ideally, a certified valuation analyst (here at ddsmatch Southwest, we partner with Blue & Co. for our client’s valuation needs).

The two most common methods for valuing a dental practice dental practice for sale are to use a multiple of collections or a formula relying on your earnings before interest, tax, depreciation, and amortization (EBITDA). We’ll discuss each in turn and then discuss why these numbers will only tell part of the story.

Multiple of Collections

The multiples of collections method is fairly simple, until its not. The simple part is that it’s just a multiplication equation. You take your total collections (or gross revenue from the practice) and multiply it by a percentage. This, however, is where it gets less clear: what percentage do you use? Historically, the average answer has been about 67%, although you will also hear this should be 70-80% of the average of your last three years collections. Another way to consider this approach is the price to gross revenue. That is, what will the buyer be willing to pay for each dollar of collections? $.67, $.70, $.75, or $.80?

Our use of the word “historically” should be telling. This method of valuation is become less common as the business side of the dental industry changes (more on this in the next section). However, before you get too excited about the simplicity of this method, consider the following hypothetical: if you have a practice will $1m in collections, using a multiple of collections method, the practice could be valued reasonably within the $670,000-$800,000 range, depending on other variables. The problem here is you are only looking at one number, the total collections. You don’t have any information yet about overhead and other costs. This hypothetical dental practice for sale could actually be worth much less.

EBITDA

The earnings before interest, tax, depreciation, and amortization (EBITDA) is becoming increasingly popular as the business side of the dental industry has experienced a shift towards a greater number of group practices being driven by entrepreneurial dentists and outside investors. With group practices being more and more focused on investor returns, there is a shift to an investor perspective of owning and operating dental practices. Typically, investors consider the actual debt-free cash flow, rather than gross collections, as the most reliable indicator of the likelihood of a return on their investment. The EBITDA method can be considered a price to earnings method. The question here is how much is the buyer willing to pay for each dollar of free-and-clear net earnings?

This method is trickier because determining your debt-free earnings is not as simple. Also, the range for the multiplier for EBITDA is much wider (you can see anywhere between two and 18 as the correct multiplier) and more variable by practice type. For a solo practice, a reasonable multiplier might be three-to-four times. For a multi-doctor practice, in might be four-to-five times. For a multi-location practice, it might be five-to-six times. And for a group practice with infrastructure and scalability, it could be six times and up from there.

When we apply the EBITDA method to our above hypothetical, you can see both the difference and the advantage of this method. If a dental practice for sale has $1m in collections and 60% overhead (which is about average for a dental practice), its EBITDA is $400,000. But, what if a practice has an above average amount of overhead? If a practice has $1m in collections but 75% overhead (if, say, the practice has more employees than it needs or the doctor pays themselves a hefty salary), the EBITDA is only $250,000. The multiplier of collections would place both practices at the same value, however, the second practice is clearly worth less than the first.

The Rest of the Story

There are two major factors that are not accounted for in either of these models. First, as mentioned previously, there are all kinds of variables that impact value outside of the information used in either of these valuation methods, including:

  • Location
  • Product mix
  • Payer mix
  • Fee schedules
  • Referral rates
  • New patient acquisition
  • Fixed assets
  • Whether office is leased or owned
  • Cosmetic appearance of the office
  • How modern or well-maintained is the equipment
  • Availability of financing and current interest rates
  • Transition plan (whether seller will stay on for a period)
  • Community goodwill and how well that will translate to the buyer

All of these things will impact the value that both the buyer and seller will place on the dental practice for sale. Which brings us to the second factor: market value. At the end of the day, a practice is worth whatever it can bring from an open market. All of the valuation methods are simply ways to try and reach an agreed upon range from which negotiations can start.

We Work for You to Get What You Want for Your Dental Practice for Sale

Here at ddsmatch Southwest, our goal is to help you meet your dental practice transition goals and get a deal that you think is fair. As part of our Trusted Transition Process, we work with you by discussing the current local dental practice transition marketplace, help establish the best transition options for your practice, and suggest improvements and investment options that will result in a real return in the sale. Contact us today for a free, no-obligation Practice Transition Assessment.

Using a DSO When Selling a Dental Office

In the world of dental practice transitions, there is a lot of talk these days about the increasing role of corporate dentistry. If you are wondering whether you should consider these options as you put your dental office for sale, it’s important to understand what these options are, what they aren’t, and how they are different.

Dental Service Organizations

Dental service organizations (DSOs) are management companies which own and run multiple practices. Examples include Heartland, with over 800 locations across 36 states, and Aspen Dental Management, with more than 650 locations. A DSO will have their own methods, meaning they’ll have a management organization, fee schedule, staffing requirements, and other business tools that they’ll want to impose on your office. Uniformity is part of the key to success, replicating the functioning of one office across many. If they have a good model, theoretically, a DSO can smoothly run a practice from a business standpoint and not get in the way of providing quality care.

If you sell to a DSO, you become an employee. This can be a good option for a dentist looking at retirement, but not quite ready to give up the game. You can still provide treatment for your patients, receive a salary and benefits, but not have to deal with as much of the business or administrative side of things that takes up your time after office hours. If you are looking to cut back hours or responsibilities, this can be a good option.

If your concern is getting the most money out of your practice, a DSO can similarly be a good choice. A DSO will have deeper pockets and easier access to more financing than a private buyer. And, given that a DSO typically has a long term goal of expansion into additional markets, seeing the gains from their economies of scale, they may be willing to outbid private sellers.

The downside may be your legacy and possibly losing the goodwill of your patients and community. You’ve worked all of your career to build a successful business. If you use a dental practice broker, such as ddsmatch Southwest, when you put your dental office for sale, we use our expertise to help identify a buyer with a strong skill set and personality match that will carry on the practice and legacy you have worked so hard to build.

While a DSO is staffed with real people, who care about the treatment they provide, their doctors are merely employees with a limited ability to respond outside of the corporation’s practices and policies. How much this is an issue is a personal determination that will vary from practice to practice. If you want to consider offers from DSOs, you are still well-advised to retain a dental practice broker as the issues that arise in the sale to a private buyer are mostly the same as the ones involved in selling to a DSO.

Private Equity Groups

By contrast, private equity groups typically don’t buy practices, they invest in them. Private equity groups are investment management companies that provide financial backing, as an investment tool, in either startups or operating business. A private equity firm generally doesn’t have an interest in being involved in day-to-day operations. Rather, they are looking for a return on an investment.

A common mistake people make when thinking about private equity investments is believing that the investor is looking for a return from the practice’s existing cash flow: that the investment is given in return for a percentage of the current earnings. If that were the case, private equity investing would not be a good investment tool. Why would you need an investor if you already are making enough profit? Private equity investors are not satisfied with your practice’s status quo. Rather, the investor sees an opportunity for growth and wants you to expand your practice with their equity.

Therefore, rather than selling your practice, you are, in effect, becoming a manager of the private equity group’s investment. Their investment gives them leverage over you to expand your practice. If you are looking to expand, this can be a good way to do it, rather than financing through a bank and increasing your debt load. You can greatly increase the value of your practice, the return on which you will reap when it does come time to sell. If you aren’t interested in becoming a business manager over a group of practices, then private equity investing is not a good way to go.

Currently, there is a merging of DSOs and private equity, with investors seeing DSOs as a field ready for harvest. In March 2018, Heartland Dental announced that a private equity firm had acquired a 58% stake in the company, in which it was valued at $2.8 billion. Other private equity groups have made investments in DSOs, but the jury is still out on whether Heartland Dental will be “a kind of Walgreens for the dentistry business” or whether the company is overvalued and overleveraged.

Is it a Good Idea to Sell to a DSO?

Again, this comes down to some very personal choices that must be carefully considered when you put your dental office for sale. While the ADA put the number of doctors working in DSOs at about 7.4% in 2017, it noted that for younger doctors (ages 21-34), that number jumped to 16.3%.  Doctors are leaving dental school with unprecedented amounts of student loan debt, which can make banks worry about financing for the purchase of a practice, especially when the doctor is lacking hand speed and production capabilities that only come with time and practice. The bank wants to make sure it gets its return, too. Young doctors are finding a safe bet is to join an existing practice to gain that experience, and DSOs can give them that time while offering a potential to build equity in the practice.

On the other hand, DSOs have gotten themselves into trouble with practices that indicate they may be more concerned about their bottom line than responsible treatment and ethical practices. Earlier this decade, a U.S. Senate investigation determined that some DSOs were providing unnecessary treatment to children to collect more from Medicaid. Also, early last year Benevis LLC, which operates Kool Smiles clinics in several states, settled with the U.S. Department of Justice and paid a fine of $23.9 million plus interest for submitting false Medicaid claims.

ddsmatch Southwest Can Help You Get What You Want When You Put Your Dental Office for Sale

At ddsmatch Southwest, we take the experience of hundreds of successful dental practice transitions from all across the country and put it to work for you. As seen here, there are a lot of tough questions about how to get to where you want to be when you put your dental office for sale. We can help you review your options, look at the benefits and drawbacks of each, and offer unbiased advice about what choice is most likely to get you to your goal. Our definition of a successful deal is not just one where papers are signed and money changes hands. It’s one where the parties walk away happy, feeling like they got a good deal. Contact us today and find out what we can do for you.

Are You Thinking About Selling Your Dental Practice?

If you aren’t thinking about selling your dental practice, you should be. We’re not saying you should sell it now. Rather, you should be thinking about when that day does come and what you can do now to be better positioned to maximize your practice’s value. Here, we’ll discuss some things that you can do to start preparing, no matter where you are at in your career.

Start Planning Early

We all hope to be able to retire on our own schedule, but life often has other plans in mind for us. Should you become ill or injured, should you fall prey to a repetitive motion disorder, you may find the time to sell your dental practice arriving sooner than you think. And while we are not advocating you should assume the worst, the fact is that dentists who are compelled to sell their practice on a short timeline (less than one year) are more likely to get less than the actual value of their practice.

Conventional wisdom puts planning for a dental practice sale at a minimum of between two to four years. Here at ddsmatch Southwest, we say that if you think you are five years or less out from retirement, it’s a good time to have your practice evaluated by an outside consultant who can advise you on any changes or upgrades that will bring you a return in the sale. For doctors in that five year range, we offer a free, no-obligation Practice Transition Assessment.

Starting early has a couple of benefits. First, you need to realistically consider how long the transition will take. It’s not just about doing a bit of spit-and-polish, signing papers, and handing over the keys. Depending on your practice and the buyer, you may want (or need) to stay on for a period to help the buyer transition into the practice. If you’re counting the days until you can spend your days on the golf course, keep this in mind.

Also, some of the upgrades you may need to make for your practice to be reasonably attractive to a buyer may take time to implement (if you have issues with your patient base) or to make profitable (if you need to upgrade equipment or software). If your upgrades are expensive, or require a learning curve, you need sufficient time before they stop costing you money and start earning you money.

Don’t Mentally Retire Before You Actually Retire

The closer those last days or weeks or months get, the more tempting it may be to start easing into retirement. Don’t. When the buyer’s bank assesses the value of your practice, they aren’t going to rely on numbers that are five or ten years old. They want to know what the practice is earning right now and in the recent past—one to three years. If you’ve started cutting your hours, referring more work out, cancelling insurance plans, reducing the number of patients, or doing less marketing, you run the risk of devaluing your practice.

Know What Gives Your Practice its Value

This can be summed up in three simple words: active patient records. A nice clean office with up-to-date and well-maintained equipment and a pleasant, professional staff are all great things to have. But, in and of themselves, they have little value without a strong and growing patient base. Most importantly, you need to be able to show a steady stream of work for the 18 months prior to your valuation.

When you sell a dental practice, what you are really selling is you active patient records. This, along with your brand (the practice’s reputation and goodwill in your community) account for 75% or more of your practice’s value. These “intangibles” are by far your most valuable assets. Their value is increased when paired with an efficient business. If you have high overhead costs, you’ll get less than a comparable practice with a better cash flow. The buyer is going to look for a practice that can provide a reasonable income to cover their living expenses after servicing the debt of buying the dental practice. So, a strong active patient base plus good cash flow yields a better sale price.

Some other considerations on increasing cash flow and building value include:

  1. Raising Fees. Too frequently, older doctors are reluctant to raise their fees. Given that profitability is a major driver of a dental practice’s value, you must avoid making this error. Raising your fees each year may be the best way to guarantee increases in collections and profitability, which benefit you both immediately (more income that you get to keep in the practice) and at the time of sale (higher market value). Also, your buyer is going to want to have fees that are in line with the current market but not have to immediately raises fees after the transition, possibly driving away patients.
  2. Overhead. Keep a careful eye on all of your costs. Create a budget each year with specific amounts allocated for each overhead category. Be sure you are aware of current industry standards to make sure you aren’t overpaying for lab or supply costs. If your practice isn’t growing, you cannot afford to give annual cost of living raises. If this is the case, you may instead consider bonuses that are tied to increased collections. The lower your overhead, the greater your profitability, and, therefore, the higher your market value will be.
  3. Keep marketing. Just because you are retiring doesn’t mean your practice is going stop running. It might surprise you to learn how often doctors approaching retirement will cut back on marketing efforts or stop them altogether. As discussed above, the lending bank wants to know how your practice is performing right now and in the more recent past. You need your numbers to be on a consistent upward trend. A dip at the end will be a red flag that the practice has a problem. Also, make sure that you are keeping up with modern marketing trends. Your first efforts should be on referrals. But you should also update your website, invest in online marketing tools (search engine optimization, or SEO, to make sure you show up in online searches), and get patient reviews on Facebook and Google and post them on your own website.
  4. Update your office and technology. If you are closer to retirement (under two years) you can make cosmetic improvements to your office. First impressions matter (and ongoing impressions matter to your patients). If you have more time, you should consider your equipment and technology. Your buyer will likely be young and more familiar with the latest technology. However, you will need time with new tech to learn and become proficient. Once you do, however, it can bring you a return by increasing your patient flow and your treatment acceptance rates. These, in turn, will be reflected in your books as increases in profitability.

 

 

Think About the Impact of a Transition Plan on the Practice

When selling a dental practice, it’s common for the seller to stay on for a period of time. If your buyer is not already working in your practice (such as an associate or partner), this means the practice will have to support an additional doctor. You need to consider how that will impact cash flow and any existing practice debt, and whether you have sufficient revenue to support another doctor. The bank will certainly consider this when determining whether its willing to finance the purchase. These details need to be carefully considered but may be hard to predict, as what the buyer wants will impact how long you need to stay on, if at all.

ddsmatch Southwest Can Help You Sell Your Dental Practice

At ddsmatch Southwest, we bring the experience of hundreds of successful dental practice transitions, of all types and from across the country, and put it to work for you. We use that experience to help you identify a buyer with a strong skill set and personality match that will carry on the practice and legacy you have worked so hard to build. We ensure that every detail is covered, help you avoid common mistakes, and ensure no step is overlooked.  Plus, your confidentiality is always guaranteed. Contact us today and find out how we can help you meet your practice transition goals.

Build Value Before Putting Your Dental Office for Sale

There are typically two phases a dentist goes through when thinking about the value of their own dental practice. The first comes early, when a dentist is concerned with take home income—that is, “How much can I earn right now?”  The second comes later, when the doctor begins to think about transitioning the practice. Then the doctor is concerned with “What is my practice worth?” The fact is, however, many things that determine what the practice is worth are built in early in a doctor’s career. Here are some important things to consider early on that will pay off when you are ready to put your dental office for sale.

Your Value is in Your Brand

“Brand” is a hot buzzword right now, as social media influencers are concerned about their personal brands. This sort of talk can be annoying. But remember what a brand actually is. It began as a mark to identify livestock (and, later, goods in commercial markets) to denote ownership and deter theft. Presently, the term has broadened to encompass an overall experience of a customer that distinguishes an organization or product from its competitors. For a dentist, it can be your own name, but it’s really about the good name your practice has, and your reputation among your patients, and in the community.

A strong brand is important for a dental practice for the purpose of attracting and keeping patients. Without it, it’s unlikely a practice will have a strong patient base. And while you may look at your practice and see deep patient files, lots of new patients each month, high referral and case acceptance rates, and a full appointment book scheduled out for several weeks, what you really have to offer when you put your dental office for sale, is a strong brand. That is what the buyer is paying money for.

This is important to consider early in your practice because you want a strong brand that is not explicitly tied to your name. If you open an office as John Doe, DDS, built a solid reputation of goodwill in the community, and are known as a provider of excellent care and quality service, what will happen when John Doe is no longer part of the practice? Patients will find a new dentist (studies have shown that up to 40% of patients will leave under these circumstances). Buyers know this and may not be willing to pay as much for a practice that is too explicitly bound up with a single dentist’s identity.

While you want to be known as a good dentist, it’s more important for the life of your practice to survive some inevitable patient attrition after the practice transition. This can be easy to address early in one’s career, when one’s name is less well known. However, even for established dentists, rebranding to a more general practice name that leverages existing affinities in the community is not a risky move and can get your more when you transition your practice.  For instance, in Farmington, Utah, a historic hotel built from stone was refurbished and operated as “Rock Hotel Dentistry” to build on existing goodwill in the town’s pioneer heritage. Consider local affinities you can leverage in building your own brand.

Be Properly Organized as a Business

In a large corporation, each department has a head. In a small business, too often the owner tries to do it all. The fact is, as a practicing dentist, you can’t. You simply don’t have the time. This is why it’s important to have a solid organization with clear lines of responsibility and a consistent monitoring program, or else you’ll find details being overlooked and balls being dropped.

How you organize may be unique to your circumstance. However, you need to have structures organized for every aspect of your clinical care, operations, accounting, marketing, and personnel. You, of course, remain CEO and are ultimately responsible for everything. But this doesn’t mean that you can’t leverage your staff’s skills or outsource things such as marketing and accounting.

On the point of accounting, it’s more important than ever to have a solid set of well-organized and detailed financial records. Buyers are not content with a simple report of production and collections. They now want to review earnings before interest, taxes, depreciation and amortization (EBITDA), gross margins, assets, the lease agreement, and patient base. As with every aspect of your organization, the more prepared you are (and the sooner you start), the more likely you are to get what your practice is worth when your put your dental office for sale.

Once you have a smoothly running operation, it’s important to regularly review each part to see where you can refine processes and update your business systems. In part, you want buyers to be impressed with your efficiency and organization. But, importantly, this can translate into higher profits for your and a more quantifiable increase in value for buyers. In a study by Deloitte, businesses that use state-of-the-art business and human resource systems can average cost savings of 22% per employee. That kind of cost savings can be passed along through the practice transition, making your practice more valuable.

On the same point, up-to-date systems for re-care and reactivation will ease the transition for the new dentist, an attractive selling point. You can do the same with automated systems for submitted claims and receiving payments from insurance providers. For more one this, read our recent article about how back-office automation can build value for your practice.

Leave Profits in the Business

A common practice among small business owners is to pay the employees, pay the bills, and take the rest home. This might seem like a good idea in the short term, however, what it’s really doing is obscuring how profitable your practice is for potential buyers.

A better practice is to pay yourself a salary just as you would an associate, typically about 30% of collectable production. This makes your take home pay a predictable recurring expense, with the remainder of your practice’s net income as profit. Your numbers will be more clear and concise, with the value of the practice more easily ascertained—the profitability will be easily quantified in your financial records, how you need it to be when it’s time to show them to potential buyers.

Also, this method makes a clearer distinction between you, personally, and your practice as a business organization. This is important because, first, you don’t want to have a murky and confusing set of books to open to potential buyers. But, more importantly, the protections that come from limited liability are lost when the owners commingle business and personal funds and expenses.

ddsmatch Southwest Can Help You Prepare Your Dental Office for Sale

If you are considering transitioning your practice in the next five years, ddsmatch Southwest offers a free, no-obligation Practice Transition Assessment. During this assessment, we find out your goals for your practice transition and offer professional, experienced advice on how to best prepare to sell your dental practice, including potential investments or improvements to increase value. We never advise a doctor to change for the sake of change, but only where we see areas that will add value in a sale.

Contact us today and arrange for your free Practice Transition Assessment.

Plan To Sell a Dental Practice?

The short answer is, much sooner than you probably think. The long answer is that it depends. Because of the variables involved, no two dental practice transitions are alike. However, a good rule of thumb is that you want to start actively planning for selling a dental practice around ten years before you think you want to retire. Below, we’ll discuss some of the variables and break the timeline down a little bit to give you a better idea of what you should think about doing and when.

Variables Impacting Transition Timelines

Dentist Take-Home Pay

While dentists regularly show up on the list of highest paying jobs in the U.S., you probably don’t need us to tell you that how this actually translates into money in your own pocket can vary widely. For instance, the latest numbers from the Bureau of Labor Statistics report the median salary for a dentist is $158,000. That number will go up and down in real life depending on where you practice and what kind of work you do (oral surgeons and orthodontists have markedly higher median salaries at $208,000 and up, while general dentists come in slightly lower, at just over $151,000).

Also, consider in a private practice how your collections vary from year to year. And, like most small businesses, your earnings ebb and flow with the larger economic well being of your community (consider the frequency with which you are asked to negotiate on fees with patients who may be experiencing financial difficulties).

If your potential buyers are fresh out of dental school, you need to consider that the costs of education, and subsequent debt load, is rising. The class of 2018 reported an average student loan debt of $251,869 (public universities) and $236,133 (private universities). When combined with the financing to purchase your practice, this is a significant amount of debt for a new dentist to have to manage. They’ll need to carefully consider what they need to realistically earn to stay afloat and whether the practice they are looking to buy has a record of consistent collections.

Location of the Practice

This is, at its most basic level, a consideration of small towns and rural areas versus urban and suburban markets. Urban centers have more people and, therefore, more potential buyers. In an urban area, once a qualified buyer is located, a dental practice transition close in six to twelve weeks after the practice is valued. In a rural area, it can sometimes take two to three years before a qualified buyer is even located. This is not even considering the economic health of your community: whether its a growing city, a shrinking town, an area that has lost major job providers, etc. The stronger your local economy, the faster you’ll probably be able to sell. However, you can have problems at the other end of the spectrum as well. A highly successful practice that is worth a high sale price may be out of reach to most buyers.

When the Dentist Thinks They Will Retire

According to a 2010 ADA survey, dentists under 40 years of age reported that they anticipated retiring at the average age of 61. Dentists over 40, however, reported that they anticipated retiring at the age of 67. A possible reason for the change is the more experience a dentist has, the more they realize what is involved in retiring and what has to be done to get ready when selling a dental practice. For this reason, the idea of planning your transition ten years out might seem like too much, but, when you are inside that process, you’ll understand.

Planning for Selling a Dental Practice

No matter how far off you think you are from retirement, thinking about the recommendations below will never hurt. And even if you inside ten, or five, or two years from transitioning your dental practice, there are things you can do to prepare that will add value and help you get the best price you can get.

Ten Years (or More) from Dental Practice Transition

This is a good time to consider your equipment and office technology. Replacing equipment and making high-tech upgrades can be costly. If you are closer to retirement, these costs may not be worthwhile for you. This is because, first, you need time to be able to pay off the equipment. Second, you need time to become proficient on the new equipment or software before you and your staff become more efficient in a way that is reflected in your earnings.

Costly equipment and technological upgrades only build value once you own the equipment outright and its earning you more money. If you don’t have the time for this kind of investment, you shouldn’t do it, as it can eat away at your bottom line in the short term. If you do have the time, it’s a good idea to bring your office up-to-date.

Five to Ten Years from Dental Practice Transition

First, you should plan on reducing your specialty procedures, making your practice as mainstream as you are able to by about five years out from your practice transition. Second, you should consider whether the improved efficiency from your equipment and tech upgrades allows you to keep more things in-house—are there things you referred out that you now have time and equipment to keep (e.g. making crowns)? Keeping more production in-house allows you to keep that money in-house as well.

Additionally, you should look at each aspect of your office and consider where your processes and procedures could be refined or made more efficient. If you haven’t done so already, it’s imperative that you switch to a digital record system, taking your office paperless. No young dentist is going to find an old fashioned filing system appealing. Rather, it will look like an old relic (which it is) that they have to deal with (which they won’t want to do).

This is also a good time to bring in a dental practice consultant to review your practice and give advice on how it could be improved and additional adjustments that could impact valuation before you try and sell your dental practice. Here at ddsmatch Southwest, we offer a free, no-obligation Practice Transition Assessment aimed at dentists who are five years out from transition. In our assessment, we look at your local market, suggest physical and image improvements, advise on potential investments to increase value, review present and future staffing integration, and help you establish the best transition options for your practice.

Two to Five Years from Dental Practice Transition

Here you want to look at your fees and determine where you can raise them. A good place to be is within the 80th percentile in your market for comparable procedures and services. Consider ways to increase your patient base or services. However, again, avoid adding specialty procedures. At this point, you don’t realistically have the time to be properly trained and gain the experience to be competitive.

You should also review your staff salaries and consider whether they are both fair for your local job market, and whether they adequately reflect each staff member’s qualifications and abilities. If your staff salaries are too low, you risk losing good employees. Staff turnover this late in the game can signal problems in the practice to potential buyers and can negatively impact patient retention (after all, patients interact more with staff than with you). Conversely, if your salaries are too high, that will reflect lost value in your practice. Experienced and reliable staff who feel valued are most likely to stay through transition, which will be an important selling point for buyers.

At this point, you should no longer consider expensive equipment or extensive remodeling. Instead, your focus should be on cosmetic improvements, like flooring and paint. Look closely at your office, and solicit input from your staff, for wear and tear that can be easily—and inexpensively—repaired. Your goal here is to make a good first impression on your buyer with a well-tended office.

Less than Two Years from Dental Practice Transition

If you haven’t already, now is the time to retain a dental transition expert. Whomever you get should be experienced, with a solid track record of successful transitions and happy clients. A good transition broker can help you put together the team you need (business valuator, lawyer) and make the final preparations for selling a dental practice.

Put ddsmatch Southwest’s Experience to Work for You

Here at ddsmatch Southwest, we bring the experience of hundreds of successful transitions from all across the country, in all kinds of markets, and put it to work for you. The proof of this are in the testimonials from our many satisfied clients. Your goals are our goals. Contact us today and find out how we can help you meet your practice transition goals.

Will New Equipment Help You Sell Your Dental Practice?

Any time you’ve been to a dental conference, you’ve seen all of the equipment being exhibited. The sales reps can spin a great line about how much faster and more efficient you’ll be by upgrading to what they have to offer. Also, these conferences frequently have presentations on new procedures and the latest technology, methods and tools that can improve the profitability of your practice.

While a young dentist can afford to take a long term view of investments in new technology, given that they have time to recoup the investment, for an older dentist, with an eye toward transitioning their practice, this might not be the case. The question is whether the investment will add value before you sell your dental practice or whether you’ll just eat the cost.

As the pace at which technology is improving keeps getting faster and faster, it’s harder than ever to know when is the right time to upgrade your equipment. After all, you don’t want to invest in something only to have it quickly become obsolete. And while it’s imprudent to get infatuated with every new technological improvement, it can be essential for your practice to stay up to date on new developments in your field and understanding what will impact your practice for the better.

Sticking too closely to what you know, what you’ve always done, will keep you in the past. This could cost you patients. Sometimes it best to stick with what’s worked, but sometimes you have to change. The trick is how to know when.

Even the best equipment will wear down. It’s imperative to keep an eye on how each piece is functioning and know when it’s time for a replacement. If you keep the following thoughts in mind as you assess your equipment, it can help you determine the right time to invest in upgraded equipment.

  1. What is the true cost? There are two costs to consider for every piece of equipment. The first is the sticker price—how much does it sell for. Second, what will it actually cost you? Here is where you factor in the cost of financing (how much will you ultimately pay when interest is included), fees for any training you’ll need, the cost of installation, and any other related costs to getting the equipment, getting it installed, getting yourself familiar with its functionality, and having access to technical support, or related accessories or supplies. All of that added together is the true cost.
  2. What will I earn from it? Once you know the true cost, consider how the equipment will impact your practice. Will it make you faster? Will your practice be more efficient? Will you be able to perform any new procedures or keep diagnostics in your office instead of sending the patient’s money somewhere else? You can use the answers to these questions to project whether the equipment will increase your collections either in the form of added services or ability to see more patients. Then, take that projection and compare it to the true cost of the equipment to figure out how fast the equipment will pay for itself. It may be sooner than you think. It also may not.
  3. What could I do that I couldn’t do before? This is fairly straightforward: if the equipment allows you to perform procedures you couldn’t before, then, instead of referring them to other doctors, you keep that revenue for yourself. Also consider whether the new procedures are an opportunity to grow your practice, either through attracting new patients or by bringing in an associate (younger dentists will look for offices with newer equipment, with which they will be more familiar).
  4. Is it cheaper to fix the old equipment or buy new equipment? If you have equipment that is frequently breaking down, even if the repair costs seem low, they add up over time. Also consider whether the malfunctions are impacting your ability to see patients or perform procedures—that is, whether your old equipment is costing you money. Look over your books to add up what you’ve already sunk into the old equipment and track when you have to reschedule patients. Take those numbers and compare them to the true cost of new equipment.

Equipment Upgrades Should Be Driven By Financial Rationality

If you’ve considered all of these factors but are still undecided, here are a few other considerations about new equipment and whether it’ll be good for your practice. As above, these points are all about whether the new equipment will earn you money or cost you money. If you think you will be transitioning your practice in the next five years, you also have to consider whether you can recoup the cost before you sell your dental practice, or make up the difference in the sale. For those considerations, you may want to consult a business valuator or dental broker.

  • Will it make me more efficient? Generally speaking, new equipment is faster and easier to use than old equipment. This means you can do more, with more ease, in less time. While you may have a learning curve, newer equipment is also typically easier to use once you adjust to it. Plus it’ll be more likely to be easily integrated into your other software systems, which may save your staff time.
  • Will it make me able to do more things? The more things that you can keep in office, whether its procedures or diagnostics, whether it’s digital radiography or a machine to make crowns, the more you do yourself, the more you earn.
  • Will it bring in new patients? This can work in two ways. Some patients, as consumers, are attracted to new technology, making your upgrades a selling point. Also, if there are patients who need certain specific procedures or tests, new equipment open up that market to you.
  • Will it enable me to provide better care to my patients? You want to provide your patients with the best care that you can. Your patients want this too. And they sense when you are making an effort to do that. It can help with patient retention and building goodwill for your practice.  This area also includes improvements that directly impact your own comfort and quality of life at work, or that make your own work more enjoyable, as these factors also improve the patient experience.

To be sure, not all equipment upgrades are equal. Some of these questions will be tougher to answer than others, but going through this exercise can help you make the choice that will be the best for your practice and your patients, which will translate into higher earnings for you.

Get a Practice Transition Assessment Before You Sell Your Dental Practice

If you are considering transitioning your practice in the next five years, ddsmatch Southwest offers a free, no-obligation Practice Transition Assessment. During this assessment, we find out your goals for your practice transition and offer professional, experienced advice on how to best prepare to sell your dental practice, including potential investments to increase value and physical and image improvements. We never advise a doctor to upgrade simply for the sake of upgrading, but only if the cost of that upgrade will have a related increase in the value of the practice when sold.

Contact us today and arrange for your free Practice Transition Assessment.

Why Consider a Dental Service Org?

The career path for a dentist can seem fairly predictable. You graduate from dental school, maybe work as an associate for a while, but, ultimately, you open or buy your own office as a sole practitioner. Maybe you partner with other dentists to share administrative costs, but you essentially run your own business. That’s long been the goal. And when it’s time to retire, you’ll put your dental office for sale to another sole practitioner.

Increasingly, however, dental offices for sale are being bought by DSOs (dental service organizations). So, rather than sell to another, younger doctor, you may find yourself fielding offers from a corporate buyer. While some doctors may not relish the idea of the practice they’ve built by hand (and their patients) being consumed by what they perceive as a faceless entity, the fact is that DSOs are both increasingly common and meeting needs for both patients and doctors that aren’t provided by the traditional sole practitioner model.

What a DSO Does

A DSO is, in essence, a management system. Typically, they are organized for the benefit of investors who see buying dental practices as a good investment, but they can also be used by doctors who want to merge several practices together to operate as a single entity.

Traditionally, a sole practitioner manages every aspect of their practice, from treatment to cleaning the bathrooms. However, with growing interest from investors, a more structured business model is necessary in order to manage multiple practices. A DSO wants to ensure consistency of quality and service across all of its offices, therefore, it cannot simply rely on the on-site staff to make sure it’s done according to the right standard.

The Benefits of DSOs for Doctors

First, some doctors simply prefer to let someone else handle the business side while they put their focus on treatment. A DSO provides a qualified and knowledgeable business office to take care of the administrative matters, allowing doctors to put their time into seeing patients and not having a competing burden on their time.

Second, as an aging dentist nears retirement, they may consider bringing on an associate who will eventually buy the practice. If, however, the doctor does not have enough patients to support an associate, this will not be possible. Also, young dentists are increasingly saddled with large amounts of student loan debt and are looking for associateships before going out on their own. A DSO can solve both problems.

By selling a dental practice to a DSO, the older doctor is able to transition the practice—it can be an outright sale or the doctor can continue to work in the practice, depending on the doctor’s goals. And, by spreading costs across several locations, the DSO can afford to bring on an associate, perhaps working at more than one local office.

The younger dentist then has the option of remaining with the DSO for their career or, when the time is right, to branch out on their own with the requisite experience. Additionally, for younger dentists who were trained on more modern equipment, working in a DSO may be an easier transition into their career, as they will be more likely to have up-to-date technology than an office where a doctor has been practicing for decades.

The Benefits of DSOs for Patients

DSOs can benefit patients in a couple of ways, some more directly than others. DSOs are more likely to be a modern facility with generalists and specialists in a single office, making it easier and more appealing to get necessary care. Also, DSO offices are more likely to be open later in the afternoon or evening and on weekends, which can be critical for patients who lack flexibility in their schedules.

DSOs are also more likely to use a variety of marketing techniques, allowing them to reach more patients. And, DSOs typically make their services available through wider networks and have attractive treatment financing options. This means that people who haven’t been to a dentist for a long time may be enticed to get care, even if they previously believed it was unavailable or unaffordable. In this way, DSOs can benefit an underserved patient base.

DSOs Have Strength Through Scaling

The current trend with dental insurance companies is to either maintain or reduce their schedules of fee allowances. While your costs are going up, they payout in effectively reduced either way, it’s just a matter of by how much. A DSO with several offices will have leverage that a sole practitioner doesn’t to negotiate more favorable payouts.

Also, instead of having 20 dentists absorbing costs individually, DSOs get the benefit of purchasing in bulk, more widespread marketing, and can offer better benefits packages to employees. Some are even creating their own continuing education programs and are able to bring in well-known presenters for workshops and seminars.

Why Consider a DSO When You Put Your Dental Office for Sale

The current trend in the dental industry appears to be tracking that of the larger medical industry. MSOs (medical service organizations) have been acquiring hospitals and practices for some time, changing how medicine is practiced. Currently, hospitals own many medical practices and most physicians work for hospitals. As with most changes, there is some good and some bad. Be certain, however, the trend will continue whether you like it or not. Depending on who you ask, there are projections that DSOs will own about 30% of practices in the next 10 years, possibly growing to 50% in the decade after than.

For a dentist looking at transitioning their practice, however, this can be very good news. When you put your dental office for sale, there are a lot of things to think about, but a big one is how much can you sell for. DSOs will have the deepest pockets and, with a long term strategy, may be willing to outbid other fair offers.

In addition, though, many doctors may want to turn over the business end to someone else and spend their last year or two or more focused solely on patient care. A DSO can be a good option as you will be able to ease into retirement without having to worry about things like:

  • Bookkeeping and payroll
  • Personnel issues
  • Marketing
  • Collections and billing
  • IT concerns
  • Anything else that isn’t clinical

While laws governing corporate ownership of dental offices vary from state to state, one constant is that clinical decisions remain the doctor’s responsibility, including the ability to plan and recommend treatment, and patient records are owned by the doctor. (We acknowledge that there are rumors to the contrary, an issue beyond the scope of this article. Any DSO that is meddling in patient care should be reported to the state board of dentistry.)

ddsmatch Southwest Can Help Find the Right Buyer for Your Dental Practice

While getting a fair price for your practice is a big concern, we here at ddsmatch Southwest know its not your only concern. DSOs can be a good fit for some practice transitions, but not for everyone. Your goals are our goals. We will take the time to learn what you are looking for in a buyer—or help you figure it out if you’re not sure—so you can go into the next phase of life knowing that your practice is in good hands.

Contact us today for a free, no-obligation Practice Transition Assessment and find out how we can help you.