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Well, I have to ask… why?

“I would much rather work 16 hours a day for myself, than 8 hours a day working for someone else”

— Every entrepreneur out there

Well, alrighty! You have an idea, an idea that is putting stars in your eyes and painting a pretty good picture to you. The future is looking pretty amazing isn’t it.

You have decided to become a practice owner. You are going to buy or build a dental practice, become the boss, the owner, the one in command. Your name in lights, work when you want, how you want, right?! Friends you met in dental school are becoming owners, and boasting about how great it is. I get it. Trust me. Working for yourself is pretty great. But, I want to ask one question. Give it some thought, some real thought. Ready?!

Why?

Yep, why do you want to be the owner? I mean, right now you are probably an associate, working a steady schedule. You might not have the exact schedule you want, but you are busy when you show up. You come in, see patients, head home. And, yes I will take a wild leap, that you are making a making a pretty decent living. Maybe 30-40% of production? Shoot, maybe more. But wait, you are making that, coming in and going home, with little to no stress. No weight on your shoulders. No burden of stress wondering where all your patients are, how you are going to pay your team, figuring out the best marketing ideas, etc. (The list could go on). Why trade that it in?

Entrepreneurship is tough. Most small businesses (which your practice will be) fail within the first few years. According to CB Insights over 29% fail because they run out of money, 23% because they don’t have the right team and 17% because they didn’t create a solid business model.

Not including the fact that (drum roll here), you proably want to open a practice because you want to be a dentist, right? I mean, I think I have heard that more times than I care to know! But, sorry, owning a practice, means you are now a Business Owner! You don’t just get to be a dentist!

Asking WHY, isn’t just for dentists. I mean, any person considering working for themselves should ask this question. Because in all honesty, it is easier to go get a job. However, I won’t deny that working for yourself is pretty amazing, and there is something about earning your way on something you built. As a small business owner of an ecommerce business, and retail store, I know all to well the stress, worry and sleepless nights that being an entrepreneur can lead to, but I also know the reward and what it feels like to see success.

So let me give you some sound advice, from one business owner to another.

Ask yourself why. Write it down. Go for a long walk, breath the fresh air and really figure out why opening your own practice is important. Will it positively or negatively impact your life? In fact, what do you want in your life. I mean, if you want to be able to travel all the time, being an owner might not be the right path. Take sometime, don’t listen to the people who have become owners, and don’t listen to the people who haven’t. This is where you have to listen to yourself.

If you jump into ownership, congratulations! Buckle up and get ready for a wild ride. Grab some leadership books, hire a business coach, and get going!

Candy, it’s job security for dentistry!

We had a bowl of candy at the front desk in our dental office! Yes, you read that right! A bowl of actual candy – not sugar free, not the tooth shaped suckers sold by dental companies. Nope this was sugar filled, sticky, hard candy.

And it was amazing!

If you’re a dentist you are probably raising your eyebrows in shock or shaking your head in disagreement, trust me even the dentist I worked with gave me a hard time about it.

After all, dentistry is about taking care of teeth, right? And sugar is the evil root of all dental issues. Why would we want to encourage patients to wreak havoc on their enamel! Kind of disgraceful huh?

Patients loved it though, it was always a conversation starter, put a smile on their face, for a moment eased their anxiety about being at the dentist. One time a very nervous patient called and a crown she had on #30 had come off! When asked what happened she admitted to eating caramels and it just came happened. So, like a good office manager, I ran to the local corner store and bought her a bag of sweets. When she arrived for her appointment, we gave her the bag of candy and told her that it was for after her appointment!

She started laughing and was taken by surprise. She also relaxed and was more at ease. How many dentists are handing out candy right?

Now, by no means am I saying that this is what you should do. If you don’t want candy in the office, no big deal (what about a soda machine)?! Joking!

See it’s not about the candy. Remember the woman with the missing crown? We gave her the caramels? It was a few weeks later and she sent us a great thank you card and mentioned the caramels and that she liked that little touch (also promised she was watching what she was eating). Over the next couple months, that patient referred quite a few new patients to the office, which is always what we want. And everyone of those patients mentioned the bag of caramel.

We became memorable to people. Our action of giving candy or having it at the front desk, made our office stand out to people. Because (drumroll) we were different! Our culture was one of fun, ease, comfort. We did other things like full on decorations for each holiday, had a resident elf that hung around the office, offered coffee or tea in the lobby and genuinely treated everyone like family.

The culture of your office is what will allow you to stand apart and be noticed. You don’t want to blend in, get lost in the fact that you do crowns or teeth whitening like every other dental office. You need to find ways to be different and that doesn’t always mean offering different services. It can mean instead, having televisions in each room, or lavender scented towels for after their appointment. It can be sending birthday, anniversary, or thank you cards to each patient. It can be having patient appreciation days, shoot have donuts every Monday.

The reality is you have to do something to rise above the rest, or else you will be fighting against the competition based on services, and well most dental offices all offer the same thing.

The Business of Dentistry

“There is cash in the bank, so I must be okay”

~ Said the Business Owner Who Wonders Where Their Money Went

There is no doubt that dental students are smart! They don’t just hand out dental licenses to anyone, right?! Dentists are skilled in science, artistic abilities and are taught that perfection is in the details. Most dentists have the goal of practice ownership, but with the lack of business education, they are not prepared for the challenges that lie ahead.

Every dentist I have ever worked with said the same thing, they “just want to do dentistry.” They believe that if they find that amazing office manager to run the business side of things, then they will just get to be the dentist in back. Which I don’t blame them for wanting. After all, they have devoted most of the last decade to learning dentistry and they want to build on their skills and well, practice what they went to school for.

This is where the disconnect happens. They don’t see their practice as a business, or themselves as business owners. They don’t understand that at the end of the day they are ultimately responsible for everything that happens in the business and that they are responsible for running the business.

Own your business!

Ok, be honest. How many CE classes do you take? Do you see the a class on veneers and just jump at the opportunity? There is nothing wrong with this, and to grow your skills is very important. But, not being able to do the perfect Class II composite isn’t going to kill your business. What will cause a lot of harm and potential financial loss is not having done the business “stuff” before, and not getting the guidance needed to be successful at it. Lack of team moral, poor scheduling, payroll concerns, marketing headaches, unfocused culture of the practice will lead to a loss of patients, revenue and create some sleepless nights.

I remember this one office I was asked to visit. Now, it was beautiful, updated, and comfortable. Great views of the mountains. The dentist, highly skilled, personable, and motivated. He had multiple hygienists, patients coming in, and really it seemed like it was working. Yet, his schedule was constantly falling apart. The recall report had never been worked. The 30/60/90 day report was scary. There were no analytics to even begin to see the health of the practice. The poor dentist was eager, but was struggling with how to motivate his team, and get people to work with him to be successful. It was a near recipe for disaster on his investment.

This is a classic case of not knowing business. For those of us who have ventured out on our own for the first time, we don’t know much. However, this is your business, and you need to learn it. Find CE courses to take on business, read books, find pod casts to listen to. Get a mentor. 

Begin thinking like a business owner, because those days of just doing dentistry are over!

Suggestion: Hire a consultant!

Any great team, has a coach. Even that super successful dentist down the street, most likely has worked or is working with a consultant or a coach. Hiring one can teach you about the importance of systems, what analytics to review to understand the health of your practice. They can give you verbal skills to help improve communication between the team and yourself, give guidance on treatment presentation and more. Basically, a great consultant can guide you to practice success. Let’s not reinvent anything here, lets just get right to the stuff that works! 

A consultant is an investment for sure, so make sure to take time to find one that is right for you. The most important things to know are how they will work with your team, how often they will meet with you, when they will be in your office. Do you just meet via a Skype call? Do they offer trainings? How are results monitored?

You will also want to know what kind of consulting they do. For example, I prefer assisting dentists in purchasing or building their office, and getting it set up correctly. I help with developing systems, hiring staff, leadership development and work in the office for a period of months. Other consultants might come in once a month, and help with leadership and marketing. Others might just give you a binder full of ideas and send you on your way. Take time and find one that you feel you can build a relationship with.

There is so much that goes into a successful dental practice. Changes in regulations, leadership, marketing and more, can be overwhelming. You don’t have do it all on your own, but you do need to know what is happening  and how to make decisions that can positively impact your business. 

I bought a practice, now what?

One way that dentists become owners, is by buying an already established dental practice. This can prove to be a very successful endeavor, or it can completely fall apart. I have seen what happens when there are bad transitions, and patients end up running for the hills and the dentist who thought they would have a full schedule from day one, ends up standing in an outdated office, wondering what happened.

On the other hand, I have seen offices transferred to a new dentist with an almost seamless transition. Business just carried on as usual. So, what is the difference, and how can you not lose your a** through this process?

Below is a list of items you will want to look at, but before you do that I would also suggest hiring a business consultant (who specializes in dentistry) or a transition consultant. Do not just rely on what the broker says, or if you meet with the selling dentist, do not listen to what they say. By working with someone who is looking at all the things you haven’t had to look at before – 30/60/90 day reports, profit and loss statements, and help navigate what a dated practice to really cost you, the risk on your investment can go down.

#1 What does the office look like on the inside? Unfortunately, most offices are for sale because the owner dentist wants to retire. Depending on his business philosophy, he might not have updated recently or at all since he first opened his practice. Will you have to replace the flooring? Nothing like stained blue carpet in the hygiene rooms to scare a patient away! That pink wallpaper, might need to go. As exciting as remodels are, they cost money and unless that was figured into the purchase price, you might have to live with the chipped counters, and mustard yellow bathroom fixtures for awhile.

#2 Meet the staff. Are they friendly, are they welcoming. How long have they been there. On one hand, having staff that has been there for a long period of time can help, because patients know them. On the other hand, which we will discuss a little later on in another post, is they can stay stuck in how things were done, and not want to move forward. But initially, do you think that you’d be able to work with them? Or do they give you a cold shoulder right away?

#3 Where is the office located? Are you buying a building, or just the business? Is the building rundown, who are the neighbors? What is parking like? These are things that if you were building an office, you want to consider before making a move.

#4 Reports! If you can, look at the accounts receivable (A/R) report. What are collections like? What does the schedule look like on a daily basis, is it full or are there lots of holes? There was a practice that was purchased, and when we looked at the 30/60/90 day report found tens of thousands of dollars that had never been collected and was way past the 90 day mark. That is not just money that you will get, that is a headache waiting to happen. These might not be able to collected on, especially if there are outstanding dental claims to insurance – they have a time limit to be processed! Beware of A/R!

#5 Check that equipment! There are so many advancements in dentistry these days, and a big one are the cool toys (equipment) that are coming out. New curing lights, digital x-rays, cordless drills are just a few, and not the most expensive. Now, we can agree that excellent diagnostic equipment can be the answer to helping patients to understand their treatment needs. Want to offer same day crowns? Although a great benefit to patients, it will hit you in the pocket book for sure. So, really look at what is currently I office. I can remember walking into a treatment room and seeing what had to of been one of the very first curing lights ever made. And the year was now 2018. My heart hurt for the new dentist that was so excited about his practice, but clearly had no idea on just what the cost of updating was going to be.

#6 How helpful will the selling doctor be in the transition? Many times the retiring dentists has owned the practice for many years, and because of the relationship driven nature of dentistry, will know his patients like family. So, having him leave abruptly can be a shock to many. Is the dentist willing to stay on a few days a month for a period of time? Can you put a picture of yourself and family a the counter, as a slow introduction? What about sending out a letter to patients, giving them a heads up of this great change? In a nutshell, you want the dentist to pass the torch and be your advocate. Trust me, when the dentist leaves suddenly or is ousted, patients will run for the hills.

#7 Lastly, do not just look at the number of patients in the database, because that does not mean much. I met a dentist who was telling me he was buying a practice that had 4000 patients in it, but I new that the schedule was rarely full. So where were those patients? You need to know active at least in the last 2 years, this will give you a better idea of the number of patients you actually have the potential to see.

Regardless if you buy your build, there’s going to be a lot that has to go into it. Developing a brand culture, advertising, team building, equipment updates and more will add up quickly. Do your due diligence, this is a business investment, get some guidance!

A Crown is a Crown

“People don’t buy what you do; they buy why you do it. And what you do simply proves what you believe.”

This I think is the hard truth to face for many entrepreneurs. Honestly, when was the last time anyone had a new idea? It’s not like people are inventing airplanes, or the first espresso machine or we are seeing first denim pants being created. In the past there were revolutionary ideas, people could create a product and then sell it and they were the only ones doing that. There was no real competition!

Perhaps you had to get people to change their way of thinking, like going from a horse and cart to an automobile. But once people realized the convenience, look at where we are now. Business today (for the most part) is just people re-creating ideas. And the ones who succeed, who really stand out from the crowd, are the ones who know exactly who they are marketing to and use the culture of their business to stand apart.

They have a very clear direction and they know their ideal customer, client or patient. They aren’t trying to market to everyone, they are trying to market to a very specific person or a group of people.

This is especially important for businesses to understand. Let’s look at dentistry, because that’s what I love. You open a dental practice, I guarantee that nothing you are doing is different then the office down the street. You’re probably doing crowns, maybe same day, composite fillings, teeth whitening, a little bit of Endo. So, really you’re not doing anything differently. You are doing dentistry.

So why should they come to you? You can’t just go out there and say hey I’m a dentist come see me. Because there’s probably dozens if not hundreds of other dentists in the same city. People have their choice, it’s nothing new. It’s not like you’re moving into a town and you’re the only one, and if you are good for you. But for the majority of dentists, opening a practice, you are instantly going to have competition.

This is where knowing the vision and mission of your business is key, but most importantly who you are marketing to and what is the culture of your business, is going to set you apart. Why should people choose you? How will you make them feel? What do you stand for? Those are the things that people will look for to differentiate you from someone else. 

Location, location, location!

“Just because you build it, doesn’t mean they will come” – Business Owners Wondering Where Their Customers Are

When we decide to start a business, be it opening a dental practice, a retail store or some other brick and mortar space, the idea of business can make us turn a blind eye to some important items. One of them being the location we choose.

You see, starting a business venture can be one of the most exciting times of your life. The possibilities of the future, excitement of the unknown is what allows business owners that initial burst of enthusiasm. We find the extra hours to work on an idea, don’t mind running on a few hours of sleep, and high doses of caffeine, all to see our dream a reality.

Keep in mind though. That the excitement we are experiencing, can also mean we overlook key items. We justify settling, we opt to just make things work, because for most of us patience isn’t a virtue!

Location is the biggest one we will settle on. Many times this is because real estate is sometimes limited in the area we want to be, so when something comes up with perhaps the right square footage, we leap.

First hand experience here. My retail space was only going to be 1000 sq. ft. No more, no less. To me, if it was that size it would be manageable and comfortable. That size is also not the easiest to find. So when I found one, although there were some reservations of doubt happening, I figured it would be okay. I was stuck on the size.

It didn’t have the best parking, and visibility from the road was okay, but wouldn’t catch the eye of most. Yet, because the size was where I wanted it (and I desperately wanted to start my business) those weren’t going to be huge issues. I would just advertise more (which costs more money) and well, most of the other tenants had just moved out, so parking was good (another red flag)!

When looking at location, you need to focus on the things you can’t change, and how they will impact your business. The layout and design of your new space, can be built out to nearly exactly what you want. You can choose the colors, change the flooring, put your office wherever you want. Just like making changes in your home, you can make the interior look just like your vision. This is what architects and contractors are for. Trust me, any space can be recreated.

It’s the physical location, parking, signage, upkeep of the commercial space that you won’t have control over. Funny, these are also the items that can help promote your business or detract from it.

Below are my 10 key items I look at when viewing a commercial space.

1. Visibility. How visible is your office from the road. Will people see your sign? How will they know you are there? Is the building hidden behind trees, is the front facing the road? If you were a potential patient, would looking at the building tell you the practice was there? How visible the office is can drastically help with advertising, and reduce that budget. It costs money to get those new patients, and will be like that throughout the life of your business. Why not have a highly visible office, and let the sign on the building do some of the work for you?

2. Style. What kind of structure is this? A stand alone building, or an office in a multi story building? Will you be in a strip mall, at an intersection? A stand alone building is great, however you have no foot traffic. An office building can be great because you will have instant people to attract as new patients, however, visibility might be low, other dentists could move in (a clause you would want added to a contract), and parking might be an issue. A strip mall might see higher levels of turnover in other businesses, but foot traffic and visibility are usually really high. Parking may or may not be a concern.

3. Parking. What other tenants are in the building. How many spaces are there. How many employees are you anticipating having? There was plenty of parking near my retail store, until a hair salon opened and then well, parking became a problem. If your patients can’t park, how can they get to their appointments?

4. Utilities. This is one that is easily overlooked, and there is no standard. Do you have control over your own thermostat? Are utilizes metered individually or on a single meter and then divided? What are CAM or maintenance dues each month?

5. Signage. If you’re in a strip mall or free standing building, you most likely can have a huge sign that attracts people. A monument or pillar sign might up also, listing all the tenants in the building. Office buildings will typically be more strict, and may not offer any signage at all. There was a local building that had 3 dentists in it. The building was beautiful, plenty of parking, good area. But not one sign. No one new what was in there. The newest dentist was struggling, because he wasn’t prepared to advertise, and didn’t have a patient base , so could rely on word of mouth (which yes is great, but does take time). Needless to say, he was moonlighting for the Public Health Service to earn a living.

6. Other Tenants. This is actually really important, because how busy they are or how many employees they have could be an asset to you. Some dentists like being in a building with other dentists, I don’t get this at all. I’ve been in building where there are 5 general dentists offices all in a row! Talk about taking money out of your own pocket. My suggestion, find businesses that have people coming back frequently (good for marketing). Like a chiropractor office, beauty salon, law office.

7. Days on the market. This is HUGE! If a space has been on the market for over a year, I would say no. There is a reason then, it might not be noticeable at first, but there is a reason. Obviously the space isn’t in high demand. Or perhaps the landlord is difficult to work with. If it’s been sitting, I would step back for a minute. In addition, just because a commercial space has been listed for a long time, does not mean they will negotiate. You won’t get a screaming deal.

8. Upkeep. Do not just assume! What will the landlord be taking care of? Do they wash the windows each season (nothing ruins the view worse than dingy windows!), do they plant flowers in the spring, do they have a house keeping service to clean the common areas? If there is a public bathroom that you intend on using for your patients, is someone cleaning it at night? No question is dumb, ask them all!

9. Visit more than once. Do not make a decision from a single 20 minute visit. Go by at different times of the day. If you go by at night when the other building tenants, have left, you might miss out on the punk rock music from the salon next door or the smell of pizza coming from the local eatery that comes through the vents. Different days, at different times. That’s my opinion. Surprises can difficult to deal with.

10. Get an agent. Yes, you can scour the internet and look at a ton of listings yourself, or find a real-estate agent that specializes in commercial leases. They can help with negotiations (which we talk about in another blog), find properties that might interest you and keep you updated as new locations are coming available. They are usually a wealth of knowledge and can help make the process a little smoother.

Listen, I get it. You want to start that business now! It is the right time, or at least it feels like it to you. But, a bad location choice can do some major damage in terms of how fast you grow and how much money you will need to throw at advertising or even if you are in business after that first year.

My expert advice, look at the things you can’t change. If any red flags pop up, stop. Think about it. Will it increase your advertising budget? Will it deter people? Ask friends to drive by and give you their initial thoughts. Think about it from a patients eye.