This document provides an overview of different career paths for dentists, including associateships, practice acquisitions, and startups. It discusses the pros and cons of each option. For associateships, it outlines responsibilities and tips for negotiating contracts. For acquisitions, it emphasizes the importance of due diligence on finances and operations. For startups, it recommends developing a business plan by determining needs and financing. The key takeaway is to thoroughly research options and get advice from mentors and professional advisors before making decisions.

1. Identifying you Career Path:
Planning Your Future
By Amber Banks, Consultant

2. Topics
• Comparing Practice Options
• Associateship Basics
• Acquisition Basics
• Start-Up Basics

3. Comparing Practice Options
Advantages and Disadvantages

4. Associateship
Pros Cons
• Immediate income • No practice ownership or “say
• No financial risk so”
• Learn from the senior doctor • Building a practice that is not
– Clinician vs. business owner yours
• Build relationship with patients • Non-compete
• Enhance hand speed • Minimal control (staff, patients,
procedures)

5. Practice Acquisition
Pros Cons
• Immediate income • Not “your” practice
• Established patient base • Overpaid team
• Staff already trained • Staff not open to “new” doctor
• Established patient & staff • High overhead
relationship • Aged equipment
• Potential loss of patients

6. Practice Start-Up
Pros Cons
• You pick your team • Lower income initially
• Determine practice philosophy • Stress of starting from scratch –
and how YOU want the practice lots of decisions to be made
to run • Getting everything established
• Build it the way you want – insurance, billing, scheduling
• Pick the location

7. Other Options
Military Corporate
• Gained experience • Fast-paced environment
• Enhance hand speed • Steady compensation
• Debt reduction • Learn practice philosophies
• Enhance experience
• Increased hand speed

8. How to decide?
• Talk with a mentor
• Personal self assessment
• Networking
• Talk with family
• Don’t just settle
• Meet with senior doctors who
have already done it!

9. Self Assessment
• Where do you see yourself after residency?
• Are you ready for practice ownership (financially and
emotionally?)
• Identify your one, five and ten year professional and personal
goals
• Do you want to practice alone or with others?
• Are you a risk taker?
• Where do you want to live?

10. Associateship Basics
Preparing for your Associateship

11. Where to Start?
Select your professional “team”
Attorney Accountant
• Review your contract • Assist with compensation
• Legal advice and guidance structure and tax
• Long-term plan considerations
• Tax planning and preparation
• Prepare you for practice
ownership

12. Know Your Long-Term Objective
• Identify what you want to accomplish in your Associateship
• How long do you want to be an Associate?
• What salary do you desire to make?
• Is it realistic and attainable?
• Is there an option for practice
ownership?

13. Know the Practice
• Space for two doctors
• Previous Associates
• Reduction to the schedule (owner)
• Booked schedule
• Enough dentistry for two doctors
• Reputation of practice
• Types of patients you will be seeing
• Medicaid
• Insurance

14. Know Your Responsibilities and
Expectations
• Requirement to grow the practice (marketing)
• Hours (weekends, after hours, ER)
• Production goals
• Management of staff

15. Understand Your Contract
First, HIRE AN ATTORNEY! Then…
• Review your contract PRIOR to signing!
• No such thing as a “standard” contract
• Non-compete & non-solicitation
• Employee vs. Independent Contractor (W2 vs. 1099)
• Expenses to be covered
• Compensation structure
• Benefits offered

16. Tax Considerations
Employee Independent Contractor
• Determined by IRS • Determined by IRS
• W-2 • 1099-MISC
• Portion of payroll taxes covered • Pay all taxes (payroll taxes too!)
by employer – Self Employed
• May be eligible for benefits • No benefits offered
• Work schedule Dr. requests • Set own schedule

17. Do’s & Don’ts
Do… Don’t…
• Ask questions! • Rush into a decision
• Visit the practice (shadow the
doctor) • Do it alone
• Spend time with the doctor • Disregard the unknowns
outside of the practice • Be afraid to ask questions
• Hire dental specific advisors
• Understand your contract and
compensation
• Take your time!

18. Acquisition Basics
Making your best clinical and financial decisions

19. Due Diligence
Focus Points:
• Clinical and financial due diligence
• Identify your needs
• Determine your financing needs
• Start your search for a practice
• Avoid making the biggest mistakes
• Interview the seller and know what questions to ask
• Negotiate with confidence

20. Investigate the Business
Clinical/Practice Financial
• “Active” patient base • Offer/purchase
• Staff – Can you get approved for financing?
• Accounts receivable • Professional valuation
• Procedure mix • Practice and building for sale
• Fee schedule – How long has it been for sale?
• Financing (internal/external) • Tax returns
• Equipment • Financial statements
• Production vs. collections • Unusual costs
• Overhead review

21. Other Areas to Consider…
• Current marketing plan
• Current lease
• How long will the seller stay on?
• Informing the patients/staff
• Role of your professional team

22. Preparing Yourself
Owner Clinician
• Employee issues/concerns • Services to be offered
(hiring/firing) • Style of patient care
• Maintaining accounting
software • Fee schedule
• Decision making • Insurance acceptance
• Hours of operation • Patient mix (ages)
• Business insurance
• Office lease Being a business owner and
clinician are very different!

23. Identify Your Needs
Start Simple. Ask yourself if these items meet your needs…
• Desired location of the practice
• Number of operatories
• Annual production you wish to achieve
• Staffing needs
• Fee for service vs. PPO vs. Medicaid
• Personal cash flow needs
• Desired compensation
• Paperless office
• Preferred hours of operation
• Does your experience/education line up with the practice for sale?
• Procedure mix
• Type of sale

24. Identify Your Needs…
Self-Assessment
5 Wants 5 Needs
1) 1)
2) 2)
3)
3)
4)
4)
5)
5)
Identify challenges to achieving your
wants. Identify challenges to achieving
your needs.

25. Identify Your Needs…
Self-Assessment
5 Deal Breakers Other Areas of Concern
1) 1)
2) 2)
3)
3)
4)
4)
5)
5)
Can any of these deal breakers be
overcome to move forward? Determine if any of the other concerns
should be discussed with the seller or
your team.

26. Determining Your Financing Needs
• Cash flow
• Working capital
• Credit score
• Co-signer
• Secondary source of income (if needed)
• Personal financial budget
• Determine any “action steps” to get you prepared for financing

27. Starting Your Speech
Who can assist? Get connected!
• Peers/colleagues/professors • Attend IDDS & IDA meetings
• State & local societies (IDA & • Become a member!
IDDS) • Read Dental Economics and
• IDDS & IDA sponsored events DentalTown
• Internet searches • Industry specific research
• Practice and commercial real
• Attend study club/local meetings
estate brokers
• Your network and team • NETWORK, NETWORK,
NETWORK!

28. Avoid Making the Biggest Mistake
• Dual representation (buyer & seller representation)
• No representation
• Non-dental specific advisors
• Rushing through a decision
• Lack of due diligence

29. How to Interview the Seller
BE CONFIDENT!!
• What are the reason(s) for selling?
• How long has the practice been for sale?
• What are post-retirement plans?
• Is the seller willing to stay on after sale?
• Are any associate doctors on payroll?
• Are the accounts receivable for sale?
• How long has the selling doctor been in practice?
• Any other challenges? (personnel, collection management, case
presentation, scheduling, marketing, competition)

30. How to Negotiate with Confidence
• Hire the right dental specific team
• Get good advice
• Be confident about the offer
• Know the practice/do your due diligence
• Self assessment
• Know what you can afford
• Talk to your mentor and other doctors who have gone through
purchasing a practice

31. Start-Up Basics
Building your Business Plan – What do I do first?

32. First Things First
• Be prepared!
• Be confident!
• Be patient!
• Be cautious!
• Be excited!

33. Be Prepared!!
• Business plan
• Credit score
• Co-signer
• Personally guarantee the debt
• Personal savings available?
• Identify secondary source of income

34. Be Confident!!
… in your business plan
… about your skill set, experience and
education
… to be a business owner and clinician
…in your marketing plan

35. Be Patient!!
… with the timeline (it could be a 12-
month process)
… in setting your goals
… in selecting your team
-professional advisors
-staffing
… in establishing your patient base
… in paying yourself

36. Be Cautious!!
… of your personal and business cash
flow budget, but stay on target!
… of who you hire on your professional
team
… of who you hire as your staff
… in sticking to your estimated time line

37. Be Excited!!
• Stay focused and excited about the
overall process!
• Talk with your family and friends
• Meet with your mentor
• And be excited about the end result!

38. What to Expect: Financing
• Cash flow and working capital needs
• Business plan
• Loan amount, interest rate, term
• Experience
• Credit scores
• Personal financial statement/budget

39. What is the Business Plan?
Think Long-Term Success! Other Purposes
• Allows you to look/plan ahead • Starting a new business
• Allocates resources • Acquiring an existing business
• Defines your vision
• Applying for a business loan
• Prepares for future
opportunities/issues
• Focuses on key points
• First impression of YOUR
business

40. Writing a Business Plan
What should be considered?

41. Purpose of the Business Plan
Clearly identify… Be descriptive!
• Purpose of the plan • Sources & application of
• Mission/vision/goals funding
• Keys to success! • Secondary source of income
• Description of the business • Education and experience
• Summary of personnel • Professional references
• Location! • Financial plan & statements
• Marketing & strategy

42. Questions?
Contact: Amber Banks, Consultant
amber@verosdental.com
317-452-4580 ext. 762
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