ADS South ADS South
 
ADS South Newsletters
May, 2008 "Just who are we, anyway?" and "What if something happens to your partner?"
 
Other Articles of interest.
The Need for an Appraisal - They're Not Just for Sales
Appraisals are obviously needed for purposes of establishing practice value at the time of a sale. However, there are many other benefits to be gained by commissioning an appraisal in advance of a sale. Read what one dentist says about the many ways an appraisal benefitted him and his practice, even when he was not considering a sale.
For Sale by Owner ... or by Broker
I saw an advertisement in a state journal for the sale of a practice. The ad contained the capital letters "NO BROKERS", which was to me an irresistible invitation to reply.
Price and Value - A Lesson for the New Practice Buyer
I remember sitting in class in dental school back when the earth was cooling, thinking, "If I ever get out of here, I'm never coming back." Well, eventually I did get out of there and realized afterwards the incredible knowledge and skills I had somehow acquired. I also realized how ill-prepared I was to face the many financial decisions that were not based on my extensive knowledge of enamel rods or biochemistry.
How to appraise a dental practice
I am often asked 'How do you appraise a dental practice' and 'What percent do you use to get the price?'. If the process were that simple, we wouldn't need experts in practice appraisals, just a calculator that can multiply two numbers.
How Is Business?
I have been hearing from more and more dentists that things are slowing down in their practice as the economy continues to unravel. Dentists who were booked for four weeks in advance are now only booked for two weeks or less. Patients are seeking more “needs” based treatment than “wants” based treatment. Cosmetic dentistry is waning as more patients are presenting for the most basic treatment.
The Value of Locum Tenens
Locum tenens has been around dentistry for many years, although not always known by its formal Latin name. Locum tenens literally means “hold the place down” and that is what we are doing when a dentist fills in for another dentist who is on vacation, disabled, given “time out” by the dental board, or who has died. Our physician brethren have used this concept for many years, as their practice needs are more acute than in dentistry and keeping a practice open is more critical.
I'm Losing Money On My Associate!
Recently I structured an Equity Development Plan, our safer alternative to partnerships, for a practice owner and an associate dentist. I assumed that they were happy and doing well until I received a call from the owner that the associate was making too much money and that the owner was losing money. Apparently, while still less than six months into the relationship, the associate was producing $50,000 per month and increasing.
Women and Practice Transitions
The emergence of women in dentistry has been a slow but steady phenomenon that has challenged many of us to examine our preconceptions and stereotypes of how women practice. Besides the many effects women are having on the clinical side of the profession, women are also impacting the management and transitioning of dental practices.
The Value of a Practice Appraisal
As I consider the topic of the value of a dental practice appraisal, I think of all of the instances in my twenty four year’s experience of why people have had their practices appraised and what good it has actually done for them.
The real cost of slowing down!
I don't know how many times I have heard a dentist tell me how he plans on cutting back and slowing down and he gets closer to retirement. On one occasion in which I had listed a practice for sale, the seller told me of his plans to cut his schedule back by one day per week to work on his golf game. I had never thoroughly analyzed the effect of a cutback before but decided to take a very close look at what the exact effects of such a cut back would be.
A Successful Alternative to Partnerships
My former article discussed the pitfalls of partnerships and buy-ins which include loss of control, loss of marketability, and loss of value. These are consequences of converting a real tangible practice into intangible undivided interests.
Minority Partnership Pitfalls
One of the most popular practice transition strategies is the buy-in. The interests may be any size - 10%, 49%, 50 % or more. Sometimes it involves selling progressive interests and other times it involves selling a remaining interest by a retiring shareholder.
A Story of Three Dentists
In the past year, our firm encountered three dentists who experienced the same event - death.
Measuring Practice Value
The importance of value to the buyer of a dental practice is emphasized, since value is the buyer’s actual take-home income. This article explains how to recognize and measure value in practices.
Value or Price - Choose Wisely
All to frequently buyers zero in on price as the primary practice purchase issue, while ignoring the issue of value. However, buyers stand to benefit much more by receiving high value than by paying a low price, since the primary practice value actually is the net income the buyer takes home from the purchased practice.
The Importance of Associate Contracts

The best business dealings are when you deal with someone whose word and handshake are all you need ... and then you put it in writing! Written contracts between owners and associates are critical. Too often, dentists tell associates to come and work for them to see how things work out. Later, if things mesh, they get together and work out a contract. Too many times, however, later never comes and contracts don't materialize. This lack of a contract is the source of several critical problems.

First, both parties tend to create their own set of understandings and expectations ... and these understandings rarely coincide. As time goes on, friction mounts when these contradictory goals collide, and they then tend to occur more frequently. This results in a very unpleasant practice for everyone involved - i.e., dentists, staff, and patients.

One critical element of a contract is a "covenant-not-to-compete/nonsolicitation agreement." For example, let's say an associate has worked in a practice for five years without such an agreement. During these five years of "seeing how things work out," the associate has, in effect, freely acquired the goodwill of the patients he or she has treated.

Now, suppose the owner wants to sell his "$900,000" practice. The owner's production is $500,000 and the associate's production is $400,000. When the owner has a practice valuation, the value is placed at his or her production level of $500,000. Despite the owner's strongest assertions otherwise, the buyer, the buyer's accountant and attorney, and the lender will not support paying the seller for goodwill that actually belongs to the associate. In fact, the associate can leave with his or her patients and establish a new practice or associateship nearby. The bottom line is that buyers will not pay a seller for goodwill that the associate owns and the buyer does not expect to receive.

At this point, the seller will want to negotiate a covenant-not-to-compete and a nonsolicitation agreement with the associate. That owner will quickly discover that unless enhancements are offered - i.e., money - the associate will not be willing to make such concessions. The owner can terminate the associate, but the associate still can take the patients he or she has treated.

The owner has no leverage after the fact. In our example, the loss of $400,000 of goodwill translates into a loss of $250,000 in the sale price. This is the price the owner paid for not having a written agreement.

Many problems can arise between owners and associates, and when they have not been anticipated and be much more difficult. One party will invariably have a stronger bargaining position, and one will be more vulnerable after time has passed and individual investments in time, energy, and money have been made.

Another important issue is the status of the associate, whether that associate is an employee or independent contractor. Frequently, owners will designate the associate as a contractor to avoid paying employer withholding taxes. The caution here is to ensure that the associate actually meets the criteria for a contractor. Does the associate provide his or her own dental equipment, instruments, supplies, auxiliary staff, and does the associate set his or her own schedule and work without any supervision? In such a case, the associate might possibly, but not necessarily, pass the contractor tests.

If these conditions are not met, the Internal Revenue Service may judge the contractor to be an employee. In this case, the owner may expect to pay the IRS for all past withholding and payroll taxes, with possible additional penalties and interest. If an associate has been working for a year or more, this can become very expensive.

If the associate is incorporated, an owner may more safely consider contracting with the associate?s corporation, and the associate?s corporation will pay his or her salary and withholding taxes. If the associate is not incorporated, it is safer to regard that individual as an employee and withhold taxes and pay the payroll taxes due. These taxes amount to about 3 percent of the associate?s gross production, so reducing the associate?s commission by 3 percent would have the same financial effect as if the associate were a contractor who paid his or her own taxes. This avoids the huge financial risk the owner would face if the IRS disallowed a contractor status.

When is the best time to plant an acorn? Now! The same applies to a contract with your associate. The benefits are enormous and the cost is negligible. Talk to your consultant or attorney today!

Earl M. Douglas, DDS, MBA, BVAL.
Published in Dental Economics, March 2006