Professional Transition Strategies (PTS), a company that facilitates dental practice purchases and mergers & acquisitions, today announced it was included in Inc. Magazine’s annual Inc. 5000 list for the fourth consecutive year. PTS ranks #1487 with a three-year revenue growth of 317%.
“Receiving recognition from a distinguished program like the Inc. 5000 for the fourth year in a row validates the effort and expertise our team brings to the table for dental entrepreneurs as they navigate the industry’s consolidation wave. I’m so proud to have this team represent and grow our company,” said Kyle Francis, president and founder of PTS.
The 2023 honorees represent companies that have driven rapid revenue growth despite facing hurdles like inflationary pressure and the rising costs of capital.
“Running a business has only gotten harder since the end of the pandemic,” says Inc. editor-in-chief Scott Omelianuk. “To make the Inc. 5000—with the fast growth that requires—is truly an accomplishment. Inc. is thrilled to honor the companies that are building our future.”
Here’s a dilemma that’s not uncommon in dental practices with two or more owners: What happens when one of the owners is ready to retire and the other wants to keep working? In the past, choices were limited, and the owners either had to sell the practice or bring in an associate (or multiple associates) to buy in so the doctor who wanted to retire could take the value of their share and leave.
The flaw in the associateship model is that associate arrangements fail far more often than they succeed – up to 80% dissolve because the owner’s expectations and priorities are out of sync with the associate’s, their business styles are incompatible, they can’t agree on a practice transition timeline or they’re a mismatch philosophically on other vital business issues.
Luckily, dentists who are practicing now have more options than selling outright or bringing in associates. Here’s a closer look at some of the options practice owners have today, including partnerships through dental service organizations (DSOs), followed by advice for practice owners who are trying to reconcile mismatched retirement time horizons.
Today’s Practice Transition Options
Practice owners have many more choices when it comes to practice transitions today than they did in years past, particularly since the number of groups and DSOs is growing rapidly. That translates into opportunities for doctors to gain more value when selling their part of a practice and/or a chance to roll equity into the practice or DSO to generate investment income after they retire.
For doctors who plan to keep working after a co-owner retires, options for practice transition include arrangements where they can benefit from an equity roll into the practice or DSO too while also gaining support from the purchasing group. Support can include assistance with managing the business, help with clinician or manager recruiting, etc., to keep the practice going strong. Transition options include:
Merger to form a group practice: In this scenario, multiple practice owners merge together to create a single group, which makes individual exits less disruptive because there are more doctors to share the workload. It helps maintain stability among the different practice locations and can even make the new group of practices more attractive if they choose to sell to a group or DSO at a later date. This can be a great option that yields excellent results, but its success hinges on all owners agreeing on a post-merger business strategy.
Joint venture or group buyout: This transition strategy involves a group purchase of the whole practice or a portion from the current owners, enabling the doctor who wants to retire to leave while the doctor who wants to continue working to keep practicing until they’re ready to step away.
Equity roll: An equity roll transition can take a number of forms that enable practice owners to sell all or part of the practice to a DSO. After the sale, the doctors can invest all or part of the cash from the transaction into the DSO’s holding company as an investment – regardless if they’re the doc staying on or the one retiring.
The right fit for practice owners will depend on their personal preferences and plans, business goals and risk tolerance. But given the high failure rate of associateships, it’s great to have more options.
The University of Washington is the most recent university to tap doctors in the Aspen Dental network to serve as adjunct faculty and mentoring clinicians in its clinical externship rotation for the fall 2023 semester. These clinicians join 12 other Aspen Dental practice owners that serve as preceptors and adjunct faculty in clinical externship programs at other top universities including the University of California, Los Angeles, and the University of Michigan.
Aspen Dental first joined the University of California, Los Angeles’s, externship program in 2018, when they piloted their program. A select group of dental students had the opportunity to complete a two-week community rotation.
Today, students in their fourth year complete at least six weeks of rotations at six different practice models, with Aspen Dental representing the dental support organization model. Connections within the program introduced Aspen Dental to the University of Michigan’s program, where students are completing similar rotations, and later this fall, University of Washington students will have the same opportunity.
“The vision of the ongoing collaboration with university externship programs is to inspire students to develop the skills clinically and socially for continued professional growth, which we are champions of day in and day out,” said Dr. Arwinder Judge, Chief Clinical Officer at Aspen Dental. “Dental students on the precipice of their professional careers are gaining real-world experience to determine what path is best for them, while potentially matching with an immediate post-graduate opportunity within an organization that will support them through their journey as a new doctor.”
Externship programs enable dental students at these universities to gain hands-on experiences in various dental practice models while completing their clinical rotations at Aspen Dental office locations. Students develop valuable skills necessary for professional growth and to learn patient engagement, practice management and team-based care delivery, while also increasing access to dental care for vulnerable populations through sustainable community service.
“The externship program allows dental students to learn more about different dental models firsthand before entering the workforce,” said Rachel Greene, Clinical Assistant Professor, Restorative Dentistry at the University of Washington. “This experience empowers them to choose a career that is best suited for them while also giving back to the community.”
“There is no substitute for hands-on experience,” said Bill Piskorowski, Associate Dean of Community-based clinical education UCLA. “This program prepares our students to deliver person-centered care in an integrated health care delivery system. We have started to see a shift in the industry with historically non-traditional practice opportunities becoming traditional.”
To date, 52 dental students have participated in rotations in an Aspen Dental practice. The class of 2024 is expected to include 60 students on rotation at Aspen Dental branded offices from all three participating universities.
“Aspen Dental is committed to continuing education for students and working professionals alike to ensure the best quality care for patients,” said Dr. Tawfiq Alkilani, Aspen Dental practice owner and preceptor. “It’s been very rewarding to be able to work with young dentists to build their skills through this program while also allowing them to get an understanding of and work with people in different dentistry models.”
Congratulations! Take a moment to acknowledge your accomplishments and give yourself a well-deserved pat on the back. The past four years have undoubtedly been challenging.
You’ve likely successfully cleared your national boards and fulfilled most of your requirements. Perhaps you’ve even already passed your licensure exams. Now, as you approach the completion of this phase, it’s crucial to ensure you’re fully prepared for the next step in your career. For most recent graduates, that entails securing a clinical position, often as an associate.
So, what can you do to make the transition from student to professional as smooth as possible?
Step 1: Continue to improve your hand skills and speed
Many recent grads worry, “How am I going to increase my speed and justify my salary? Especially since I had to hand off all my patients to other students who need the requirements.”
It’s common for graduates to lack the clinical experience to act quickly. After all, you’re used to the much slower pace of your school’s clinic. Never fear, though: you will build speed — and confidence — with increased situational exposure.
The very best way to do this is to practice, practice, practice! Use this time between exams and your first associateship to continue to work on your clinical speed and confidence. Doing so will help set you apart from other new grads in the job market. (It will also give you a great answer when a potential employer asks, “What have you been doing to improve your skills?”)
Even if you have already transferred all or most of your clinical patients to an underclassman, there are things you can do to work on your clinical speed and competence.
Heartland Dental announce the recipients of the 2023 Heartland Dental Hygiene Scholarship, a prestigious for recipients awards package totaling $18,000. The scholarship was established with the aim of assisting future dental hygienists in Florida in their journey to provide exceptional care and positive patient experiences.
As one of the nation’s largest dental support organizations, Heartland Dental recognizes the vital role that hygienists play in delivering outstanding patient care. With the projected 9% increase of dental hygienist job openings from 2021 to 2031, Heartland Dental is fully aware of the growing demand for these healthcare professionals. This understanding led to the launch of the scholarship program in Florida in 2022.
Cathy Telles, campus recruiting manager for Heartland Dental, expressed the organization’s unwavering commitment to investing in the future of dental hygienists:
“At Heartland Dental, we’re committed to investing in the future of dental hygienists. These incredible professionals are deeply rooted in our communities, and those who choose this career have the chance to change people’s lives forever. In recognition of our appreciation for these important individuals, we are thrilled to award the 2023 Heartland Dental Hygiene Scholarships as a way to support hygienists and provide them the chance to continue their education, develop leadership skills, and become mentors within their community.”
SGA Dental Partners (SGA), a Thurston Group portfolio company and premier dental service organization, is pleased to announce it has recently partnered with its 100th location and is expanding its footprint across the Southeast. SGA experienced unprecedented growth in 2022 with the addition of 28 acquisitions and 55 total practices.
In 2023, SGA has completed 13 new acquisitions, adding 15 locations and 19 new doctors in the company. Looking ahead, SGA will continue to expand its presence in the region through partnerships with best-in-class clinicians.
“I am very proud of the growth we experienced in 2022 and we are poised for another tremendous year in 2023. Although the centennial mark is a notable accomplishment, we are bringing the same level of hunger and humility to build this organization today as we did five years ago. That is what I am most proud of, we are not wavering in our commitment to improve the lives of our patients, partners, and team,” said chief executive officer, Jordan DiNola.
SGA’s growth strategy focuses on partnering with high-performing clinicians and developing an operating system that cultivates true clinical autonomy for its providers. This core belief has resulted in a large degree of internal referrals from existing SGA partners.
This is a strategy that SGA believes will allow the organization to continue to outperform peers and contribute to continued expansion across the Southeast. Throughout this period of exponential growth, SGA’s commitment to preserving the unique identity and culture of its partner locations has remained a cornerstone of their success.
“We work diligently to support our partners and team members throughout the Southeast, and believe that strengthening local brands, local doctors, and local culture is at the core of who we are as SGA,” said chief development officer, Dr. Zack Bentley.
Patrick J. Haynes III, chairman and CEO of Thurston Group added, “SGA continues to operate as a best-in-class dental service organization, outperforming peers as an industry leader. They have continued to attract the highest quality partners across multiple dental specialties, and we are excited to continue the success in 2023 with a focus on general practitioner and periodontal specialty partnerships.”
With 13 periodontal locations and multiple other specialty locations, SGA is creating a comprehensive network of care. They have established a network which is built on strong relationships between general practitioners and specialists, providing the best care to patients throughout the Southeast.
For more information on SGA Dental Partners and its partnership opportunities, visit www.sgadental.com.
Dental student debt has reached unprecedented levels in recent years. As new dentists adapt to the healthcare world, many of them will choose jobs that pay off their loans and alleviate debt. This often results in more dentists opting for corporate roles over starting their own private practice, adding even more strain to an already fragile healthcare system where more than 100 million people in the U.S. face barriers to accessing care.
Medical student debt has lasting repercussions on communities across the country, and that gap will only continue to grow as student debt increases and incoming doctors struggle to provide local care in favor of corporate careers.
The Student Debt Crisis
According to the American Dental Education Association (ADEA), the average debt for graduating dental students in 2022 was $293,900, a 434 percent raise from an average debt of $55,000 in 1990. This amount has the ability to jeopardize a new doctor’s ability to choose their own career path. Reports show that the majority of in-debt dentists choose to work at corporate offices rather than start their own practice to secure a consistent income and pay off their loans.
Condensed healthcare systems created by market consolidation and rising costs have created healthcare deserts all over the United States. Many of these healthcare deserts can be attributed to medical students choosing corporate roles over private practices due to the debt they acquire. Students with large amounts of debt can be discouraged from practicing in rural or low-income areas that may offer lower salaries or fewer employment opportunities. This pushes up-and-coming dentists to reside in condensed markets which means fewer dental offices in smaller, more rural areas.
As of 2021, 80 percent of counties in the U.S. lack proper access to the healthcare services they need to maintain health. Healthcare deserts force patients to drive upwards of 30 minutes to reach healthcare facilities where there are not enough staff to treat them. For example, of the 67 counties in the state of Florida, only one has enough dentists to treat all patients. This disparity forces patients to live without essential care that can improve their quality of life. Those without access to dental care often deal with preventable ailments that keep kids out of school and adults out of work.
Espire Dental, a fast-growing, elite, cosmetic and multi-specialty group practice, founded by dentists, is pleased to announce the acquisition of Anderson Family Dental in Colorado Springs, CO.
Founded in 2018 and headquartered in Denver, Colorado, Espire is turning the dental industry upside down with its mission to radically elevate the dental experience for both patients and team members.
Its growing footprint of 27 practices are located throughout Colorado, California, Oklahoma, and Wyoming. The addition of this new dental practice strengthens Espire’s positioning in southern Colorado, expanding excellent dental care and cosmetic dentistry options to patients in Colorado Springs.
Tim Hill, CEO of Espire Dental, shares the cultural philosophy between Espire and Anderson Family Dental. “Anderson Family Dental has a rich history of providing exceptional dental care to patients in Colorado Springs. Espire is thrilled to continue that family tradition and help take it to the next level. We are proud to be the solution for premier, private-practice dentists who would not typically join a DSO group and are honored that Dr. Anderson chose us to be his partner.”
Anderson Family Dental has been providing unmatched patient care in the Colorado Springs community for 57 years. Dr. Erick Anderson said, “Finding a partner that would appreciate the history of our family practice was important to me. When I met the leadership team at Espire, I knew that they would be a great fit for our team and patients.”
Espire provides its practices with best-in-class support including practice operations, clinical training, HR, marketing, and accounting. This allows Espire’s dentists to focus on patient care, relationships and leading their valued team members. “We’re proud of our unique culture and the way it seamlessly integrates with our outstanding support systems. Espire differentiates itself by providing business support to our practices while fostering hospitality-like experiences, which elevates the patient care and provider experience that dental practices should expect from their partner,” said Hill.
Espire is actively seeking dental practices that share a commitment to elevated patient experience, high-quality clinical care and employee fulfillment.
One of the best parts of being a dental practice broker is that I’m given a unique line of sight into new trends in the industry. Something that we’ve been noticing at Professional Transition Strategies (PTS) is that the average age of dental entrepreneurs selling their practice is getting significantly younger.
In fact, most doctors we worked with before the pandemic ranged from 55 to 58 years old, as many of them were gearing up for retirement. Now, the average age of a dentist selling their practice with us is down to 44 years old. And we suspect this is a phenomenon happening all around the country.
So, what’s causing this huge drop in age?
There are a couple factors at play, but it comes down to two major components: the industry’s consolidation wave and the fallout from the pandemic. The sweeping consolidation happening across the industry is highlighting new opportunities for dentists – and many are taking advantage of them. Coming out of the pandemic, many businesses and industries reshuffled their operations which lends itself to changes in dentistry.
Here’s a closer look at why younger dental practice owners are choosing to sell their practice sooner rather than later.
Consolidation Gives Way to Equity Arbitrage Opportunities
As dentistry is undergoing industry consolidation, it’s given rise to many new financial opportunities for dentists, which contributes to this trend. Private equity backed dental service organizations (DSOs) provide an alternative to traditional partnerships. In the past, many dental entrepreneurs on their path toward retirement would bring in an associate to take over after they stepped away; however, associateships have an extremely low success rate, making them an undesirable route for many.
Dental practices must beef up their teams’ awareness of spear-phishing attacks, currently accounting for 91% of data breaches. Your team members must understand the threat landscape and know that hackers are trying to infiltrate the practice. Dental practices face many threats. Attacks and phishing attempts continually evolve and become more sophisticated.
As a dental practice leader, you can mitigate these attempts through a security and privacy awareness training program. eLearning is a good option here. Unlike in-classroom meetups, internet-based classes are delivered on-demand and as needed. Using online platforms also expand your training and reinforcement options such as threat simulations. Third-party phishing simulations, for example, provide various scenarios that mimic real-world attacks and attempts. Doing so matters because research shows that businesses that set up simulated phishing attempts once a month have 27% fewer employees falling victim to such attacks.
In any care setting, those numbers are too high. Because dental practices have valuable patient information in their systems, dental practices are rife for an attack. That said, let me provide some best practices you need to know to get the most out of your security awareness and HIPAA training.
What to Consider When Preparing
You may have options depending on your simulation solution. In addition to email phishing, consider sending SmiShes (phishing to employees via text messaging). Or try voicemail phishing, known as Vishing.
Then, there is USB Baiting, done by seeding bogus, infected USB drives around the workspace or parking lot that can communicate back if plugged into a computer. Employing optional simulations reduces a practice’s susceptibility to phishing attacks. In addition, it allows you to change training techniques to give employees a more comprehensive range of threats they should look out for.