Dental Practice Reporter

By Dr. Suzanne Ebert

In my work, I talk to dentists from across the country who are preparing for career transitions. Some are retiring and taking the next step on their long-planned path, but others face outside forces that make them rethink their priorities and goals.

The reasons can be positive, like spending more time with loved ones or pursuing other passions. Other times, it is a significant life change such as health issues, divorce, or burnout.

It can be too easy to get overwhelmed by fear and stress, but that can often lead to rash decisions that cause regret. It’s human nature and all too easy to panic when facing change.

Luckily, the dental industry has many options. You need to explore the choices methodically and evaluate all the information. The first step, consider asking a trusted colleague or family member for their opinion. They know you best and can be an objective listener.

Here are two tales of what happens when “life happened” to two dentists without transition plans.

Ignoring the problem

Dr. Arthur’s dental practice thrived on complex, intricate cosmetic procedures. His stellar reputation among local practitioners resulted in patients waiting months to book an appointment. He had enough business to bring in an associate or partner but preferred working solo. He felt no one could meet his exacting standards.

In his early forties, he began to experience numbness in his dominant hand. It was worse on days when he performed more prolonged procedures. He tried anti-inflammatories and icing it, but mostly, he ignored it.

After four or five years of this, his condition deteriorated rapidly. He could no longer hold a handpiece, and a hand surgeon diagnosed him with advanced carpal tunnel.

Dr. Arthur panicked and canceled his entire treatment slate for the next three months. His surgery did not restore the precise control he needed to treat patients, and he was forced into early retirement.

At this point, Dr. Arthur’s practice had been closed for months, which significantly affected his valuation. After more than a year of searching, he finally found a buyer interested in the equipment and rebuilding the patient pool and referral network from scratch. But the price was less than a quarter of what the practice had been valued at just three years prior.

Have a plan before you need it

Every dentist should regularly think about their long-term needs and options. It would be best if you made it an annual activity as you would file your taxes.

Ask yourself: What if I had to sell right now? What if I needed to move away? What if an elderly family member needed me back home? What if I was suddenly injured and unable to work?

Next, contemplate what it would take to sell your practice. Does it have “curb appeal,” or could it use simple cosmetic maintenance, like new furniture, a touch-up of paint, or a spring cleaning. It is always easier when you stay on top of it. Longer-term improvements, like new technology, can also be attractive to buyers. And you should enjoy the latest items for a few years before you sell.

Review your fee schedule, collection policies, and payer mix as part of this process. This will ensure your practice is in the best possible financial shape. Having your finances in order is key to making a sale for what your practice is worth.

These steps become especially important if you have warning signs. In Dr. Arthur’s case, those early aches and pains might have motivated him to bring on an associate or partner who could learn the business while cutting his hours. When the problems grew worse, he could have reduced his role to consulting or sold the practice to someone already established in the community. That would have ensured continuity of care for patients while protecting the value of the practice.

Burn out

Dr. Francine’s career followed a very traditional path. She worked in two different associateships before starting her small-town solo practice. For over thirty years, she built her 4-operatory practice into a thriving, well-respected business. There was only one other dentist in town, and her patients and staff were loyal. She was busy four days a week and didn’t have space or desire for an associate.

Then the COVID pandemic gave her time to think. She wasn’t getting any younger, and she reflected on her life. The long days bent over a chair had begun to take a toll on her back. She felt like she was missing time with her young grandchildren.

After the state-mandated closure ended, she re-opened her office but realized her heart wasn’t in it anymore. She never re-opened more than two days a week and referred patients to the other dentist in town. Once she reached Medicare eligibility this spring, she closed her doors for good. Her decision hurt her loyal longtime employees and patients. Her staff had to scramble to find jobs. Patients had to endure long waits for the town’s remaining dentist or make a 90-minute round trip to the next county.

Examine your options

There are many Dr. Francines out there looking at their lives during the pandemic. They hate to leave their patients in a lurch, but they are simply burnt out with clinical dentistry.

Investigate all your options before closing your doors. There is a Mentorship-to-Ownership path that can be ideal for this type of situation. Find someone with a similar philosophy of care to buy your business who will care for your patients for years to come. Many talented young dentists out there are eager to own their own dental practice but not quite ready to buy. This can take many forms: you could come in a day or two a week to discuss cases or offer hands-on help, or you might just provide guidance on running a successful business. Many younger dentists crave this type of mentorship, so this can be a win for both sides.

Dr. Francine could have used a path like this to stop doing clinical dentistry while still offering a wealth of advice to her eventual buyer. She would still own the practice and draw a small salary and benefits, but with a set end date. She could introduce her patients to the new dentist, assuring them about the quality of care.

This would also avoid the all-too-common mistake of cutting production, which affects the ultimate sale price. The incoming buyer can maintain patients and is incentivized to build their own sweat equity.

When faced with a challenge, take a deep breath. Think about your goals and talk to those you trust. Then develop a plan that will carry you to the next step. There is life after clinical dentistry.

Dr. Ebert built a successful dental practice from scratch. After selling her practice, she became the dental director of a Federally Qualified Health Center where she provided high quality care to underserved populations. She joined ADA Practice Transitions as the ADA Advisor to provide real and tangible benefits to dentists as well as helping to address access to care issues across the country. She is currently ADAPT’s VP of Dental Practice & Relationship Management.