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One Doctor Explains Why You Should Consider a Rural Dental Office for Sale

We’ve posted an interview with one doctor, Bill Dean, that we assisted with selling his dental practice. We also posted part one of an interview with the buyer, Dr. Kevin Shively, about his experience on the other side of the deal. Here, in part two, Dr. Shively discusses why he was looking for a rural dental office for sale. 

Let’s talk about the benefits of buying a rural dental office for sale. There are a lot of dentists out there that just think a city is where they need to be to have the practice they want. What would you say to people about considering smaller towns? Has it been good for you?

Oh, absolutely. I wholeheartedly support and agree going rural for opening a practice. Trying to make it in the big city, especially as someone new-ish coming out of dental school. “New-ish” being, you know, five to maybe seven years out of school.

Everybody’s business background is going to be different and, for me, being in the military, I never had to worry about the money issue. It was, “Okay, you need a crown. Let’s do a crown,” kind of thing. But trying to make it in a bigger city like Lubbock, or Odessa, Midland, somewhere like that, it’s going to be a lot harder and you’re going to have to look into participating with insurance, figuring out how to do reimbursements, things like that.

So, can you open a practice in a big city like Lubbock just on your own? Yes, you can. But it’s going to be much more difficult. I would wholeheartedly support and suggest looking into rural practices. The people need the treatment. They will come from, in some cases, hundreds of miles away to get the treatment. And at the end of the day, they know how much work went into it and they are so, so appreciative.

When you’re in the military and you have a bunch of 17 and 18-year-old kids, they don’t necessarily really understand how much work goes into things. They’ll say things like, “Yeah, I don’t know what I’m here for today. My leadership told me I had to come for an appointment today.” While they cooperate and do everything, here’s a case where you worked hours and hours on something, and they take a look at it and they’re, like, “Yeah, looks okay, I guess.”

So, you really kind of lose that love and that drive to do dentistry. Within the first week or two being in Floydada, I found that I was loving coming to work. I found that I loved getting to know and interact with my patients, and just having those moments where patients will cry because of how beautiful their teeth look again, and how they’ll fall over themselves to thank me for the work and everything that I’ve done. It really, really helped me reaffirm why I got into dentistry in the first place.

Let’s talk about your hopes for the future. We’ve talked to a lot of retiring dentists, and they have all sorts of plans of all the fun that they’re going to have. But we haven’t talked to a lot on the buying side. What are your hopes for this practice? How you see it playing out throughout your career?

I definitely want to grow the practice. Being out in the rural area, the patients … They understand there’s some procedures they can’t get around going to Lubbock for, but if they can stay in Floydada, they would appreciate it.

I want to grow the practice and ultimately start doing more procedures and make it a true … as much as possible, a true one-stop shop to be able to get everything done. That’s my hope for the future, is to grow the practice to really make it a well-rounded family dentistry practice.

Going back to rural practices, people might be worried about, “How do I market myself? How do I get more patients?” How are you getting patients to your practice?

Well, I would say rural is going to be more word of mouth. Those first few patients are going to be very leery, which mine were as well, because I’m not Dr. Dean and it’s a situation where you have to trust in yourself. You have to know that you’re doing the best for the patient and also treat them as you want to be treated. Treat them with the kindness and respect that you would love to have if you’re the one sitting in the chair. If you do that, it will come back to you a thousand-fold.

I do a little bit of marketing on Facebook. Dr. Dean, one of his main marketing ploys was, he would … There was a local restaurant in Floydada. He would frequent it, and if he noticed that one of his patients were sitting somewhere in the restaurant, when he went to pay he would also pay for that patient, as a sign of goodwill and “Thank you for your patronage with my practice.”

Because it’s such a wide area that you pull from, you’d want to have some face recognition. Word of mouth obviously would be huge.

We do have a website that we’re starting. It’s still a work in progress. But I want to, for those patients that are, let’s say, 45-50 miles away that are looking for a dentist, I’d like for them to be able to look at the website and look at what the practice looks like. And get to know our staff a little bit more, and what we can and can’t do for them, before having them make that trip out there.

There was also a transition letter that was sent out to all the active patients from the last five years. ddsmatch helped with that, but Dr. Dean and myself crafted it and then we sent it out to all the patients. So that was, I think, the biggest initial marketing plan that we had.

Looking for a Rural Dental Office for Sale? ddsmatch Can Help!

If you are considering a rural dental practice, here at ddsmatch Southwest, we have several available dental offices for sale in Texas and New Mexico, as well as across the country. Check out our listings online. Contact us today for more information— it starts with a conversation.

From the Other Side: A Doctor Discusses Buying a Dental Practice

We recently posted an interview with one doctor, Bill Dean, that we assisted with selling his dental practice. To shed light on the other side of the transaction, here is part one of an interview with the buying doctor, Kevin Shively, about working with ddsmatch Southwest, dental practice transition specialists, and his experience with buying a dental practice.

Could you please talk a little bit about your background and how you came to hear about ddsmatch?

My name is Dr. Kevin Shively. I’m originally from Louisville, Kentucky. How I came upon ddsmatch was, I was serving on active duty in the military in Germany and was contemplating my next step. I had found a job opportunity in Lubbock, Texas, that wasn’t everything that I was hoping it would be.

I had heard about ddsmatch when I was in dental school and it was a company that had interested me, and, ultimately, I knew that I was going to own my own practice one day. When I reached out to ddsmatch, they helped make that dream become a reality for me.

Can you just talk us through how the process went for you, from the time you first got in contact and how it proceeded?

Yes, absolutely. I accessed the ddsmatch website, the Contact Us portion, and put in some information, some basic information, name, things like that, email address. I was promptly called, I believe, within 48 hours by Andy. He started getting some background information on me, and trying to figure out exactly what I was looking for, and things like that. Because they don’t just help match up people wanting to buy practices, they also help find associateships and things like that. So, he was finding the best fit for me based on all those questions and everything. Going forward, we looked into some practices and went from there.

How long did the process of buying a dental practice take, from when you first started looking until you finally found a seller?

Well, it’s a little misleading, because I was dragging my feet. I had a little bit of cold feet in making such a big purchase. But all in all, I would say from the first conversation I had with Andy until the closing of the practice, no longer than about seven, eight months.

Did you look at several practices or did you find the right one early on?

Based on what my criteria were that I gave Andy, we found two that were the best fit for what I was looking for. At the time, with ddsmatch, there were several practices, but not within the Lubbock, Texas, area. And being that I had just moved halfway across the world, I wanted to stay in one place.

What were the major factors for you? What were the things that you felt were important to you in finding a match?

Well, you always have to trust your gut and your instinct on things … I toured both practices. I enjoyed and liked both practices, but I had a strong sense of one practice, which ultimately was the practice that I ended up purchasing. Once I started going through the numbers and doing the due diligence, it just further bolstered my decision to want to proceed with that practice.

Did you have any “deal-breakers” that you were looking out for?

I don’t really know if I had a whole lot of deal-breakers, this being my first time purchasing a practice. I had things that I really wanted in a practice which, going forward, if I were to do this again, they probably would have been deal-breakers. But with the practice that I ended up acquiring, it was, again, like the stars kind of aligned for me for that practice.

If someone were where you were a year ago, do you have any words of advice?

I would say it is a big step. There are a lot of unknowns, but it is a wonderful path to walk down. It is challenging work, but at the end of the day it’s extremely rewarding, and it really affirms my love for dentistry, with having patients that are extremely appreciative, and just doing what I love.

In terms of staff, do you have any thoughts on the experience of coming into a completely staffed-out and ready-to-go office? Has it been challenging?

Not so much. I learned early on in the military that a lot of change right out of the gate usually backfires on you. So, that was a lesson that I learned and implemented with this practice. I acquired all the staff from the outgoing doctor, and they were very, very hesitant and leery of the transition because change is hard for everyone. I think taking incremental steps in making changes has been very well received by the staff.

What has been your experience with the patients as they’ve come in and had a chance to meet you? What’s been your approach to making sure that you hold onto those patients?

Well, it is a small town practice. The city is only 3,000 people, but I pull from about 30 miles in any direction. Every day is a wonderful experience, in that the patients are so thankful. They are very appreciative. It’s very heartfelt. Here’s someone they don’t even know. I’m introducing myself, and the first thing out of their mouth is, “We are so glad you’re here.” And it’s such a rewarding thing to hear that.

Let’s back up a bit to the process of buying a dental practice itself. What did ddsmatch bring to the table to make the process easier for you?

As far as making the process easier, I could not have done it without ddsmatch. It’s one of those situations where you just don’t know what you don’t know, so Andy and Randy were absolutely instrumental in getting this whole thing going, as far as helping with going through the numbers, the due diligence, and they went beyond the scope of what they normally do to help.

They’re more than willing to do whatever they can to help. They’ll be the first to tell you, “Hey, this isn’t my area of expertise. Here’s my opinion, but I’m going to introduce you to so-and-so, who is the absolute expert in this.” Not only do they give you their advice, they set you up with professionals that have done this several times in the past and can guide you every step of the way. So, it couldn’t have been any easier using ddsmatch.

If someone else is in your shoes, and they’re trying to make the same similar decisions, trying to decide if they want to go with ddsmatch, what would be the selling points?

Well, my main advice with using ddsmatch is, they will guide you. They will help you in doing everything in the correct order … [If] you don’t have a strong business background, they can set you up with a CPA, with a business manager. If you’re wanting to change staff, they have connections with local dental assisting schools and hygiene colleges. If you need help going through the due diligence … It’s any and everything that you could need, they help you with. And if they can’t, they know the people that can help you with it.

Trust is a big deal. For anybody who feels like, “it’s just really hard for me to trust somebody in this situation,” what would be your thoughts for them?

The reputation of ddsmatch, in my opinion, is what can help bridge that trust gap, in that they’ve been around. There’s been, in my estimation, hundreds, if not thousands, of successful transactions and acquisitions using ddsmatch. The proof really is in the pudding, and it’s by far worked out for the vast majority of clients.

It sounds like you really felt like they had your best interests at heart.

Yes, absolutely.

With regard to the outgoing doctor, what was your timing in terms of transitioning him out and you in?

Well, mine was a little abnormal, in that I’m still in the army reserves. Uncle Sam said, you know, “You need to go to Hattiesburg, Mississippi, for 30 weeks,” right in the middle of my transition. It was a little bit of a hiccup and, admittedly, it threw the process off a little bit.

But Andy and Randy were awesome at communicating between myself and Dr. Dean, the outgoing doctor, and working out an agreement to where Dr. Dean would be an associate for me while I was serving my country. Again, it was a wrinkle in everything, but without ddsmatch I would not have been able to get the agreement in place, and get everything situated and done to allow me to go on that mission.

In conclusion, what would be the bottom line for your advice to a dentist in your situation?

The bottom line I would give anyone is, yes, purchasing and acquiring a practice can be scary, it can be a very daunting task. There will be pitfalls in areas where you can get tripped up very easily, but that happens with everything. If you buy a car, if you buy a house, things like that can occur.

ddsmatch knows where those pitfalls can occur, and they can help you navigate around them. They can help you network with other local dentists. They can help you network with people to help grow your practice, and help you to make it as smooth a transition as possible. Ultimately, ddsmatch will make your life so much easier in acquiring a practice.

Looking at buying a dental practice? Ddsmatch Has Practices for Sale

If you are considering buying a dental practice, we have several dental practices for sale in Texas and New Mexico, as well as across the country. Check out our listings online. Contact us today for more information— it starts with a conversation.

Hot Trends in Dentistry for Anyone Buying or Selling a Dental Practice

Wherever you are at in your career—whether you are looking at buying a dental practice, selling a dental practice, or somewhere in between—it’s a good idea to stay informed about dental practice and industry trends. If you are just starting out, you want your practice to be up-to-date. If you closer to the end of your career, you may want to boost the value of your practice by making it attractive to younger doctors who may be more aware of current trends. And at any time, it’s smart to see how you can improve your practice—either with tools that boost efficiencies, new technology, or ways to provide better patient care. To help out, we’re going to discuss some of the hot trends for dental offices in 2019.

3D Printers

3D printer technology is a major innovation that can have a huge impact for dentists. They can slash the time and money that you have to spend on the production of aligners, veneers, crowns, and tooth replacements. Owning your own 3D printer will allow you to manage production of these things on your own, without having to pay a third-party lab, which keeps more money in your pocket. You may need to hire someone experienced with the technology to operate the printer, but, in the long run, you may save thousands of dollars by being able to keep the production in house.

Additionally, by being able to produce items in-house, you will be measuring wait times in terms of minutes rather than days. A patient can have treatment completed in a single appointment whereas, if you rely on an outside lab, they will need to reschedule another appointment. This will be better for the patient and for your practice. It improves patient satisfaction and reduces your administrative costs.

If you are buying a dental practice, this is a great piece of equipment that you should consider acquiring.

Natural Products

More than ever, people are concerned about the materials they use, especially those they put into their mouths. Products like bamboo toothbrushes and charcoal toothpastes are becoming more popular. Consequently, practices that have integrated natural product options will attract patients for which these things are important. It’s a simple, low-cost change, and can easily be added to your existing marketing techniques. 

Even if you don’t want to fully commit to this, it’s a good idea to review the products you do have for the inclusion of unnecessary chemicals and see whether there are better options for your patients. Consider whether you can provide options that are healthier and more sustainable. 

Digital Impressions

Any dentist with experience knows the frustration of dealing with cracked and deteriorating casts. You don’t have to put up with this. Computer-aided design (CAD) and computer-aided manufacturing (CAM) software can be used to create more reliable impressions. The fact is, this is the way the industry is going, it’s simply a matter of whether you are coming along. New doctors are going to want this technology, so if you are looking to add a dental associate or considering selling a dental practice, you should consider this upgrade. It will make your practice more attractive. 

Laser Technology

Laser technology is a growing trend and for good reason. It’s a technology that has a major impact on the quality of patient care you can provide and its benefits are readily apparent to the patients. For this reason, it’s a good thing to consider if you are looking to add value before you sell a dental practice, if you are looking to expand your practice, and if you are looking for ways to add value after buying a dental practice. 

Among the many uses of laser technology, you can whiten teeth, remove tooth decay, repair enamel before filing, reshape gums, remove bacteria during root canals, and eradicate lesions. All of this makes your job easier and reduces the amount of time you have to spend on a patient. Less time in the chair also makes for more satisfied patients. Other patient benefits include less sutures, less reliance on anesthesia, reducing infections, less damage to gums for faster healing times, and less blood loss.

Group Practices

You don’t need to be told that consolidation of practices has been on the rise. However, the impending death of the individual practice has been greatly overstated. Group practices can be good for reducing costs but what makes you a good doctor may be lost in a more rigid corporate model.

That said, if you like the treatment side but hate the business end, you may want to consider selling your dental practice to a group practice. You can have a regular paycheck and lose the headache of running a business.

If you have an entrepreneurial spirit, however, you probably will still be best suited by buying a dental practice that you run on your own. 

Automated Patient Tracking and Management Software

Chances are you’ve already experienced this—getting appointment confirmation notices by text, pre-recorded follow-up calls, online portals for patients to schedule appointments and send and receive messages with your office, and using handheld tablets to complete forms. These things reduce the workload on your staff and, thereby, save you money. It also allows patients to manage their appointments and treatment on their own schedule, which is appreciated in an increasingly busy world.

ddsmatch Southwest Can Help You Know What is Best for Your Dental Practice

Here at ddsmatch Southwest, we are dental practice transition specialists and our nationwide organization has experience with hundreds of successful transitions from around the country. For ten years we have been advising doctors on how to best prepare for transition. If you are considering selling a dental practice in the next five years, we offer a free, no-obligation Practice Transition Assessment, part of which is helping identify areas of investment that will add value to your practice. Contact us today to find out how we can help you—it starts with a conversation.

Ten Steps to Buying a Dental Practice for Sale in Texas or New Mexico

This is the second in our series of articles about how to best be prepared to purchase a dental practice for sale in Texas or New Mexico. In this article, we’ll go through the major steps of a dental practice transition. While the process can seem overwhelming, once you’ve reviewed these steps, you may find it’s not as difficult as you think, especially once you’ve enlisted a team of trusted advisors.

Before we get into the details, however, we’ll briefly address the question of why to buy a dental practice for sale in Texas or New Mexico as opposed to starting a new practice. The main answer is because of the existing patient base. A successful practice that is up and running has a steady stream of patients, which means you have cash flow from day one. If you start a practice, you have to build it yourself. And if you start a practice in an area where there is already a dental practice on the market, someone else is going to buy it and you will be competing with them and their built in patient base. Depending on your career goals, you might not want to have to deal with the headaches of building a practice from the ground up, especially if you are a new doctor without an established reputation.

Step One: Put Together a Team of Trusted Advisors

As a doctor, you no doubt are a smart and capable person with a strong skill set. That said, no one person has all of the knowledge and experience to manage every detail of a dental practice transition. You need professional advisors who can help you make what is likely the most important (and complicated) decision in your career. You will need the following specialists:

  • Dental Attorney: you will need an attorney with experience in dental practice transitions. There are issues, and potential liabilities, that are unique to dental practices, so do not assume that a general practice or general business attorney will have the expertise. If they have to get up to speed, it will slow down the process, cost you more money, and you still won’t be certain that they aren’t overlooking important details. Find an attorney, with solid recommendations, that has counseled other doctors in the sale of dental practices. 
  • Dental CPA: as with the dental attorney, you need an accountant who understands the specifics of dental practice finances. You will need to rely on this accountant to understand the financial records they are reviewing in advance of making an offer and closing the deal. You need to know that they won’t misunderstand any details that may not be apparent to an accountant without dental practice experience.  
  • Dental Practice Transition Specialist: a practice transition specialist can be extremely useful for consulting on matters such as employee management and patient retention.
  • Dental Banker: dental practices are somewhat unique among business from a banking point of view. They require a lot of capital but are also very good investments for banks. A banker without experience with this type of business may not offer as favorable terms, failing to understand the particulars of dental practice valuations, where “goodwill” accounts for the bulk of the value. 

Step Two: Make an Offer with a Letter of Intent

This is your formal offer to buy a dental practice for sale. Before you make the offer, you should have reviewed the practice’s financial disclosures with your advisors and be comfortable with what is being offered. A letter of intent is non-binding, but it is a strong signal to the seller that you are serious about this deal. The letter should specify: 

  • The assets to be included in the sale
  • The assets to be excluded from the sale
  • The price offered for the practice
  • The closing date for the sale

Any item not addressed in the letter of intent should be negotiated and reduced to a written agreement before the closing date.

Step Three: Apply for a Practice Purchase Loan

Ask your dental CPA or dental practice transition specialists for recommendations to banks with professional practice lenders that have dental practice experience. You should submit applications to multiple banks so you can choose the terms that will be most favorable for your deal. The earlier you get started on this process, the better, so there is no holdup on your end in closing the deal. 

Step Four: Insurance Policies

What insurance you will need will depend in part on the other parties. If you have a landlord, they may have business liability insurance requirements you have to meet. The seller may have their own requirements, as will the bank. Generally, when you buy a dental practice for sale in Texas or New Mexico, you will likely need:  

  • Malpractice insurance
  • Life insurance
  • Disability insurance
  • General business liability insurance
  • Personal property insurance

The application processes for these may take some time, so, again, the earlier you get started, the better. Your team of advisors can also help you know what you should be looking at and may recommend some insurance companies to go to for coverage.

Step Five: Establish a Business Organization

If you haven’t already, you will need to set up a company. What kind of company you organize will vary from state to state, as local laws will govern what kinds of business organizations can operate what kinds of businesses. You’ll also want to consider how you will be personally liable for taxes or liability in lawsuits with each organization. Discuss your options with your attorney and CPA and pick the type of organization best suited for your situation. These are typically pretty easy to set up yourself and it can often be done online through the state government website. 

Step Six: Have Your Dental Attorney Review the Practice Purchase Agreement

This is the document that details the terms of the purchase. If a detail is not in this document, it is not a part of the deal and, therefore, not enforceable. Review this document closely and have your dental attorney explain its provisions, making sure you understand each part. This document should address:

  • The seller and buyer’s respective representations and warranties
  • The assets that are included in, or excluded from, the sale
  • Who will control the patient records
  • The scope of the non-compete covenant (time and geographic distance)
  • The collecting of the seller’s accounts receivable and patient credits
  • Procedure for handling any repair of defective dentistry
  • Allocation of the purchase price for tax purposes
  • Ongoing contractual obligations or liabilities
  • The firing and hiring of staff
  • The transition letter notifying patients that the practice has been sold

Step Seven: Office Space

If you are buying an existing practice, the selling dentist is either leasing the office space or owns it. You will be either taking over the lease, buying the space, or leasing it from the seller. In any of these circumstances, these are details that need to be worked out with your dental attorney and are separate from the practice purchase agreement. It is important to understand that the purchase of the practice does not include any rights to the office space. That needs to be negotiated on its own.

Whether you want to lease or buy the office space will depend on the practice, the location, and your goals for the practice. Discuss these matters with your attorney, CPA, and practice transition specialist. They can each help you understand that benefits and drawbacks of your options.

Step Eight: Sign the Documents and Take Ownership

Once all of the details are solidified and you are in agreement with the terms of the deal with the buyer, you sign the documents and submit them to your lender. Once the bank has the signed documents, they can finalize the lending process and transfer funds to the seller. When that happens, you can take ownership of the practice. 

It’s not uncommon for the sale to remain confidential to this point. Therefore, after this point, you can have a meeting with the dental office staff and start the process of taking over the practice. 

Step Nine: Send a Transition Letter to Patients

As mentioned above, a major advantage of buying a dental practice for sale is having a built-in patient base. Once the sale has closed, that is the time to let patients know that the dental practice will have a new doctor. This is the opportunity for the selling doctor—who has the trust and confidence of the patients—to endorse you as the new doctor. This letter can be drafted and agreed to before the deal closes, which may be a good idea so there is no conflict when it comes time to send the letter. Your dental practice transition specialists can provide guidance and advise as to how to compose the letter and its contents.

Step Ten: Staffing, Billing, and Licenses 

Once the deal is closed, all of the things owned and controlled by the seller’s company have to be transferred to yours. This means the seller will terminate his employees and you will hire them to your company. Utilities and other service contracts will have to be assigned and decisions made about pro rata payments, if necessary. You will need to make sure that you are in compliance with all local, state, and federal licensing and registration requirements. Again, your dental attorney and practice transition specialist can help you identify these details.

ddsmatch Has Dental Practices for Sale in Texas and New Mexico

If you are looking to buy a dental practice for sale in Texas or New Mexico, ddsmatch Southwest has several appealing options. Check out our available matches online. If you are considering transitioning your practice in the next five years, contact us today for a free, no-obligation Practice Transition Assessment and find out what we can do for you.

Prepare to Buy a Dental Practice for Sale: First Steps

At ddsmatch Southwest, we are dental practice transition specialists who focus on matching the right buyer for doctors who have placed a dental practice for sale in Texas or New Mexico. We believe that the right match is important because a successful practice transition is one where the practice continues to thrive, protecting the legacy of the selling doctor and providing the buying doctor with a solid foundation on which to build their own legacy. Because of this, we believe it is important for the buyers in the practice transitions we facilitate to be well prepared and well informed, with everything they need to have confidence in both the practice they are buying and the fairness of the transaction. 

To this end, we will be posting a short series of articles about how to best be prepared to purchase a dental practice for sale in Texas or New Mexico. In this article, we will provide a brief overview of the first steps of the dental practice transition process, from the buyers point of view, and some general principles to keep in mind. 

Assemble a Team of Advisors

After you have decided the time is right for you to buy a dental practice, and have an idea of where you would like that practice to be, you should identify and retain a small group of trusted advisors to counsel you through the process. This should include, at least, a dental CPA, a dental attorney, and a banker with experience lending for dental practice purchases. You may also want your own dental practice broker.

You may wonder why you can’t use your family member who is a respected attorney or a friend who is a CPA. While these types of contacts may be great for general purposes, you need advisors who understand the particulars of dental practices and the accounting and legal issues that are unique to your industry. You don’t want something important overlooked because your CPA didn’t recognize its significance. And you don’t want to pay an attorney’s hourly rate while they get themselves up to speed on an issue. You’ll save money and time by retaining specialists with experience.

Before you get anything but the most cursory information about a dental practice for sale, you will be required to sign a non-disclosure agreement. This agreement will protect your personal and financial information, as well as the selling doctor’s, and will protect the dental practice from staff and patient concerns if knowledge of a transition is leaked too soon. It’s a good idea to have your own dental broker or attorney to help you review and understand the agreement.

Have a Realistic Idea of What You Can Afford (and Need the Practice to Earn)

In 2018, the average dental student graduated with over $285,000 of student loan debt. When you are buying a dental practice, you have to consider both what you can afford to buy and what you are going to need to earn to cover the practice’s expenses, pay off the practice loan, keep paying on your student loans, and still have enough for your personal expenses and savings.

Depending on the practice, you may need some operating capital to keep things going in the early days after the transition. You may also need to compensate the selling dentist if you both agree it will be mutually advantageous to keep the doctor on for a period. A dental CPA and a dental practice broker can help you better understand how to look at a dental practice for sale and see its potential—or its problems. A banker with dental practice experience can also discuss with you how much you might expect to be lent for the practices you are considering.

Know the Value of the Existing Dental Practice Staff

When you are buying a dental practice, you are also getting the existing employees: hygienists, billing staff, receptions, etc. Although you will be the doctor, they are the ones that really know the patients and how the practice runs. Their institutional knowledge will be invaluable to you, both during and after the transition, to keep the operation running smoothly and help the patients feel comfortable with you, the new doctor. It is imperative to show them respect to help the transition be as smooth as possible. It’s a big change for them as well!

See It for Yourself

Every dental practice is different. You won’t really know what the practice is like until you can experience it in person. You also will want to look closely at details indicating the health of the practice: how many patients have visited the office over the past 18 months, whether the practice is appropriately staffed, patient flow, and cash flow. Those last two items, in particular, can show you whether a practice is growing, stable or shrinking. If the practice is underperforming, there may be some untapped opportunities for growth.

Look Closely at the Practice’s Financials

The asking price may not reflect the actual value. Many people tend to overvalue their assets because of their emotional attachment to them. Dentists are no different. The price of a dental dental practice for sale in Texas or New Mexico should be a reflection of its value based on sound accounting and valuation methods, not a reflection of what a doctor has put into the practice. Have your team of trusted advisors review the financial information with you to help you understand what it really says about the practice and whether its in line with what a business of its type should be doing.

Understand What Is and Isn’t Part of the Deal

If a selling doctor is asking $750,000 for a practice, you need to understand what you get for that amount. That may not include the equipment. It probably won’t include the accounts receivable. If the doctor owns the building, and you want the building as part of the deal, that can be a separate transaction and will definitely be a cost in addition to the practice sale price. If you have to purchase a lease, that will also have to be negotiated.

The selling price is a good place to start, though. If you and the selling doctor can reach an agreement on the sale price, usually negotiations on the other aspects will be smoother as both parties are motivated to complete the deal.

Be Wary of Owner Financing

Simply stated, a bank is more objective. Banks certainly have an interest in the money they lend—they want it back with a return on that investment. But this means they will perform a thorough due diligence relying on independently verifiable information. In a seller-financed deal, the seller is less likely to have a third-party valuation of the practice and asking price. They are likely looking to finance their retirement out of the sale and want to capture the interest as well as the principle. This can result in them trying to get a certain number rather than the true value of the practice. 

Consider the Value of the Seller Staying On After the Transition

It is common for the selling doctor to remain working in the practice for a period after the transition. This can be useful for helping to ease the transition for the patients, the staff, and the new doctor. It can be an attractive option for a doctor who is not ready to fully retire but wants to be rid of the business responsibilities and just focus on patient care, perhaps with reduced hours, before fully stepping away. Occasionally, however, it can indicate a seller who wants to have their cake and eat it too: sell the practice but not really have to give it up. Discuss this with your advisors. But be wary of a doctor who is proposing a period in terms of years, rather than weeks or a few months.

We Have Available Dental Practices for Sale in Texas and New Mexico

As stated, as ddsmatch Southwest, we focus on finding the right buyer for dental practices we have available for sale in Texas and New Mexico. If you are ready to make your move into practice ownership, check out our listings. If you see any your are interested in, or have any questions, please contact us— it starts with a conversation.

Should I Sell My Accounts Receivable when Selling a Dental Practice?

When selling a dental practice, there are a lot of things to consider and details to manage. Among those are how to value your practice. However, one thing that is generally not factored into the selling price is the accounts receivables. Accounts receivable are the amounts owed by patients who have been provided service but either they or their insurance (or some combination of the two) have not yet remitted payment. Accounts receivable are generally handled as a separate item as a transitioning dentist may or may not want to make them part of the deal.

Similarly, when buying a dental practice, the buyer might not want to buy the accounts receivable because they can impose an unwanted administrative burden and cost. Typically, however, it may be to the advantage of a buyer to try and get them. They are usually sold at a discounted rate (for reasons explained below) and can provide a source of operating capital from day one as opposed to borrowing additional funds from a bank.

In this article we’ll discuss the three basic options you have when and the advantages and drawbacks of each. Whether you ultimately decide to sell or not sell your accounts receivable will depend largely on the particulars of your practice and, importantly, the counsel of your financial adviser and dental practice transition specialist.

Sell the Accounts Receivable

If you include the accounts receivable when selling a dental practice, you are doing two things. First, you are releasing any claim you have on payment for work you did prior to the sale. It now belongs to the buyer. Second, you are also getting rid of the responsibility of trying to collect those outstanding payments. Under this scenario, you get to walk away with no further responsibility with regard to the accounts (except having to possibly endorse some checks over to the buyer).

As mentioned, this can be advantageous for the buyer who can use the funds as operating capital. If your buyer has reached the limit of their borrowing capacity, this can be a good way for them to make sure they have funds to keep the practice operating in those early days after the dental practice transition. If they need the accounts receivable for this reason, it may also be to your advantage to sell them, to ensure that the sale closes.

And while you will receive some compensation for the sale of the accounts, it will not reflect their full face value. This is for two reasons. First, simply stated, an agreement by a patient or insurance company to pay for your services is not the same as cash in hand. There will always be risk involved in collecting payment and this risk is reflected in the discounted rate. If you use dental accounting software, you probably know that it groups your accounts receivable into different categories, 0-30 days outstanding, 31-days days, 61-90 days, and so on. The longer the account is outstanding, the less likely you are to collect, and the more expensive it will be to do so. So a buyer may offer 85% for accounts that are due in 30 days or less, 75% for 31-60 days, 50% for 61-90 days, and so on.

The second reason, acknowledged above, is that there are costs involved with collections, costs which increase with each billing cycle. This will be discussed in more detail below.

Don’t Sell the Accounts Receivable and Have the Buyer Collect Them

If, when selling a dental practice, you and the buyer choose to not make accounts receivable part of the overall deal, you still have to have someone collect on those accounts. Basically, this can be either you or the buyer. Administratively, this is a more complicated option, but it means you get to keep the payment for the work you actually did.

Two things have to be considered. One, how the buyer will keep your accounts separate, making sure you get the funds that belong to you. The administrative staff will have to keep track of your accounts and the new doctor’s accounts separately. This will become increasingly complex for patients with ongoing treatment that you started and that the buyer is completing.

Second, when buying a dental practice, the buyer may not relish the idea of running a collection and accounting office for a retired doctor. The new doctor will be incurring the costs of collections and will rightly expect you to compensate the practice for this work out of the money being collected. Some of the expenses (in terms of either employee time or actual money spent) may include: electronic statements or paper statements, electronic claims (or in rare cases manual insurance claims), postage, labor, phone calls, secondary insurance submission, and communication time with patients or account holders. These costs can take between 5-12% of the revenue being collected, with an additional 5% convenience fee (that is, you are paying for your convenience and the practice’s inconvenience), and an uncollectable debt percentage of 3%. Therefore, you could reasonably expect about 83-85% of the money that is actually collected.

Whether this is more advantageous than simply selling the accounts receivable along with the dental practice will depend on how much you have outstanding, how long its been outstanding, and who is obligated to pay (insurance companies likely being more reliable than individual patients).

Keep the Accounts Receivable and the Responsibility for Collecting

Under this option, your only costs are your own and you get to keep everything that ultimately gets paid out, less whatever administrative costs you incur. This option is really only best in circumstances where you have a minimal amount of accounts receivable and from sources that are likely to pay.

Resources are also a factor. You may be able to do it all yourself. You may also be better off just paying your (former) administrative staff to work on the project on their own time. It is also most easily done in circumstances where the person selling a dental practice is staying on in the practice for a period of time after the dental practice transition.

Get Expert Advice on Selling a Dental Practice 

A big takeaway you should get from this article is that there are a lot of factors particular to your dental practice that will determine whether selling the accounts receivable is the smart move. For help in navigating this decision, you should rely on expert advisors with experience in dental practice transitions who can help you identify and weigh your options. 

Here are ddsmatch Southwest, we are dental practice transition specialists with experience in hundreds of successful practice transitions from across the country. We find out what your goals are for your transition and bring that experience to bear to help you meet those goals. If you are considering transitioning your practice in the next five years, we offer a free, no-obligation Practice Transition Assessment, including advice on how best to prepare your practice. It all starts with a conversation. Give us a call today and find out what we can do to help you. 

Dental Practice in Rural Areas: Better for You and Your Bottom Line

Typically, the plan for a recent dental school graduate is to practice in a suburban area around an urban city. A dental practice in a rural area is seen as less appealing. However, what young doctors are finding out is that these areas are already at or over capacity for dental practices and doctors. This means more competition for jobs and patients, lower salaries, and limited opportunity for growth. More often, practices are resorting to extended and weekend hours to try and capture more patients. Costs of living are higher. Participating in PPO plans may be necessary if the competition is doing it (especially when considering student loan debt, practice loan debt, and overhead and personal expenses).  So while the urban area may appear to offer more in terms of lifestyle, dentists practicing in these areas may not be able to enjoy those supposed benefits as they imagined they would.

Below we discuss some of the advantages of dental practices in rural areas. But don’t just take our word for it, read what a recent satisfied ddsmatch Southwest client has to say about his career in a Texas small town.

Dental Practice in Rural Areas Provide More Economic Opportunities

While high-density areas leave dentists scrambling for jobs and patients, and established dentists may have deferred retirement due to economic conditions, dentists in small towns are experiencing the opposite. Most small town dentists are doing quite well because they don’t have the same kind of competition. In fact, many rural areas are underserved, making patient demand for dental services high in comparison to urban areas. 

Dr. Bill Dean, recently used ddsmatch Southwest’s dental practice transition specialists to help him sell his practice. In a recent interview about his practice transition, he noted this benefit of small town dentistry,

“We’re a town of about 3,500 people, but we’re about 50 miles from Lubbock. It’s the nearest town, large town. And, I have a drawing area of probably 20,000 patients and coming from three or four different counties that don’t have dentists, and it’s hard for young dentists coming up to realize that they can come to a real community and have an instant practice when they start out.”

“Particularly if they’re buying a practice. There’s a ready-made client base that they can go to work from day one and be busy. They don’t have to try to develop a clientele, and they get to know their patients and the patients . . . Once they’ve won a patient over they will tell all their friends, and it just is an ongoing process of good people.”

Small Town Overhead with Urban-Level Fees

Fees charged by dental practices in rural areas are comparable to those charged in suburban and urban areas. But the overhead is much lower. A small town practice typically has its overhead expenses in the 50-55% range. Two major factors are lower wages and lower real estate or lease costs. Combined with less competition (meaning you save in your marketing costs as well), this means higher profits for your practice, and more money in your pocket. The faster you can accumulate wealth, the sooner you can retire, and the easier it will be to do on your own terms.

Dr. Dean also addresses the belief that being in a small town might make you feel isolated. To the contrary, given the realities of transit in sprawling urban areas, his access to larger city amenities wasn’t an issue, and the increased opportunities to earn and own a practice are accelerated by the built-in clientele and lower overhead:

“Lubbock is a town of about 200-and-something-thousand people, Texas Tech University is there, and they’ve got everything you could want. It’s 45 minutes away. If you’re living in Houston you may drive an hour to go eat somewhere and if you’re living in Floydada, you could be anywhere in Lubbock within an hour, and you’ve got anything you want. You got a major airport that’ll get you where you want to go, and, as I said, you’ve got an instant practice the day you open up your doors and in a large city you have to work to get people to come in. Or, go in as an associate and work for five years before you can actually become a partner.”

Student Loan Forgiveness Programs

Because many rural areas are underserved, some state agencies have established loan forgiveness programs based on the number of years a doctor practices in one of the underserved areas. So, in addition to earning more, you can also work to reduce your debt faster than otherwise, accelerating your savings. Some of the programs may require participating in Medicaid. Visit ADA.org for more information.

Small Town Life Style

Many dentists who do practice in more densely populated areas grow tired of the tough economics of urban life, the competition, and the stress. These are factors that are intrinsic to city life. We’ve discussed above how a dental practice in rural areas can increase your income. It can also greatly decrease your stress while increasing job satisfaction. 

The slower pace of life allows to you both be more flexible in your schedule and to get to know your patients better. Creating a personal bond who those to whom you provide care adds an additional dynamic to your work day that can make it more enjoyable, and less of a chore. You also will have more time to enjoy the things that make life worth living, like friends and family, and hobbies and recreation. The ability for better life balance will reduce the likelihood of burnout.

Additionally, you can enjoy the esteem of your community. A dentist is a valued member of the community, providing a valuable service. You can be seen as a respected professional whose advice is valued. Diagnosis and treatment plans are more readily accepted by patients who know and trust you. 

Dr. Dean confirms these benefits. Speaking of the doctor who bought his practice, Dr. Dean noted that he was looking specifically for 

“[s]omeone that would be a part of the community, that was more than just drilling and filling and seeing patients. And, [Dr. Shively, the buyer, has] been with a corporate firm in Lubbock for the last six months and it wasn’t a matter of getting to know the patients, it was a matter of production, and Dr. Shively didn’t like that, didn’t want that. He wanted to be a part of the community. . . .

“He said when he came out there was little league baseball playing, and he said that’s what he’s looking for, and, you know, that’s what I’ve had for the last 27 years. We’ve known for two months . . . that Dr. Shively was taking over, and that I would be leaving. And, the last two months with patients have the most humbling and rewarding of my entire career. The patients just saying, ‘we appreciate you and love you,’ and that’s what dentistry’s all about. It’s getting to know people. . . . 

“Probably half of my patients call me Dr. D., the other half call me Bill, because I go to church with them, or I’m on the school board. I’m just one of them. Particularly for these that, like the Davidsons, where I see their kids and grandkids and great grandkids, they’re really more family than they are patients. And that’s the beauty of working in a small town. When you leave the office you may see them at the grocery store, you’re going to see them at the football game, or the basketball game.”

ddsmatch Southwest Has Rural Practices Available Now

The dental practice transition specialists at ddsmatch Southwest have dental practices in rural areas in Texas and New Mexico ready for buyers. If you are looking to start your career, or are looking for a change of pace where you can own your own practice and enjoy the benefits of that ownership, take a look at our available practices

If you are considering transitioning your practice in the next five years, we offer a free, no-obligation Practice Transition Assessment during which we’ll our experience to work for you, advising on how best to build value and get ready to transition on your terms. Contact us today.

ddsmatch Has Partnered with ZipRecruiter to Find and Place Dental Associates

Increasingly, dentists have been asking us, “How do I find a dental associate? Where do I find an associate? How do I pick the right candidate?” ddsmatch listened and we have the answer. We’re pleased to announce that we’ve partnered with ZipRecruiter to leverage their proven employment solutions to expand your options, along with the continued support of our team of professionals, and the thousands of dental associateship candidates on our website.

What is ZipRecruiter and How Will it Help You?

ZipRecruiter is an online job board that allows employers to post jobs to hundreds of job boards, including to ZipRecruiter’s own job board. ZipRecruiter has the #1 rated job search app on iOS & Android. Also, in 2019, ZipRecruiter was named one of the world’s most innovative companies by Fast Company. Simply stated, ZipRecruiter is one of the smartest ways to hire. It sends employment notices to hundreds of job boards with a single submission, reaching over seven million job seekers. More than 1,000,000 companies have already used Zip Recruiter to meet their employment needs.

Among the features that sets ZipRecruiter apart are: 

  • Powerful Technology: With one click, ZipRecruiter send your job to hundreds of job sites across the web, identify the best candidates, and notify them to apply.
  • Pre-Screen Interview Questions: Add pre-screen interview questions to save time and ensure you only see the most qualified candidates.
  • Reusable Job Slots: All plans include reusable job slots, so when you’re ready to post another job, simply close the position and reuse that same slot.
  • Social Network Posting: Send your job to Facebook and Twitter, then manage, screen, and rate candidates on your Candidate Dashboard.
  • Mobile Friendly Interface: ZipRecruiter is designed for mobile so you can post a job, review candidates, and more while you’re on the go.
  • Premium Customer Support: You can call them, email, or chat live with a real customer service professional who will be happy to help you get the most out of their platform.

How Do You Get Started Finding Your Dental Associate?

Getting started is as simple as 1-2-3.

  1. Contact your ddsmatch professional
  2. We complete your custom online profile
  3. We facilitate the process

If you are in a dentist in Texas or New Mexico, contact ddsmatch Southwest for a no-obligation consultation. The cost for ZipRecruiter’s services will be determined based on your specific job posting and placement needs.

Why You Should Consider a Dental Associateship for Your Practice

A dental associate can be a highly effective way to increase production in your practice. If you have reached the maximum of what you can do on your own, find you are having to set appointments for more than three to four weeks out, and are consistently adding around 30 to 40 new patients a month, your practice may be ready for an associate. 

When it’s done right, adding another doctor can be a good investment in the future of your practice. You can improve patient care, increase the services you offer, and possibly begin the dental practice transition process, if the circumstances are right.  

How to Know if Your Practice is Ready for a Dental Associate

Bringing on another doctor requires a lot of thought, planning, and due diligence. Bringing on an associate may increase expenses and decrease profits in ways you might not predict. If you do it too soon, you might struggle to reach the point where the associate’s production is covering their expense, which can be bad for your practice. 

One rule of thumb is to look at your production numbers. If your total production is consistent at $140,000 per month (breaking down roughly to $90,000 from you, the doctor, and $50,000 from your hygienists), you are probably ready to add another doctor. Another way to look at it is by treatment room, where you want to be at a production level of about $25,000 to $30,000 per room, doctor and hygienists combined. If you are interested in adding a dental associate but aren’t quite meeting those production levels, take a look at your practice to determine what changes can be made to get you there.

Also consider your referral and case acceptance rates. A good rate for adding another doctor is around 40 to 50%. Your case acceptance rate should be at about 80%. If you are not meeting these kinds of numbers, you may have internal issues in your practice that need to be looked at before you can get those numbers up. Those issues should be resolved before you start looking to add another doctor or you can end up harming your practice.

ddsmatch Can Help You Find the Right Match for Your Practice

ddsmatch is proud to serve dentists all over the country. Our dental practice transition specialists average over 20 years of dental industry experience and have served dentists through every stage of their careers. We bring that knowledge base and depth of experience to bear for you, to help you get what you want out of your practice transition. Also, we pair our dental relationships with our searchable database to create the perfect match for dentists across the U.S.

ddsmatch has been successfully connecting the dentist’s present with their future for ten years. At ddsmatch Southwest, we focus on dental practices in Texas and New Mexico. If you are interested in adding a dental associate, or are considering transitioning your practice, contact us today for a free consultation.

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.