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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.
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!
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.
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.
A Story of Three Dentists

In the past year, our firm encountered three dentists who experienced the same event - death.

Dr. A called our office, saying that he was going into the hospital for tests and needed a dentist to cover his practice, which we provided. I visited him at the hospital and his condition was so serious that he and his wife decided to sell his practice. I was given a key to the office and with the help of a dentist who was familiar with the practice's software, I was able to quickly gather all of the information required to perform an appraisal and prepare a marketing package. The next day I contacted a prospect from our database, showed the practice to him and went over the practice figures and other information he requested. After several hours of inspection and study, he made a full price offer. The following day Dr. A died. During the following week, sale contracts were distributed and reviewed and a lease for the office and financing were obtained. The sale closed ten days later with the widow receiving the full price in cash.

Dr. B was exercising when he suddenly died. Our firm had coincidentally performed an appraisal of his practice six months earlier. Upon his death, his accountant and widow contacted our firm to sell the practice. Our first step was to provide a dentist to provide continued care for patients of the practice. With a current appraisal and marketing material in hand, we contacted a prospect from our database who quickly made an offer of 94% of the appraised price. Dr. B's widow was paid in full in cash three weeks later.

Dr. C died in his office of a sudden heart attack. The family attorney commissioned us to perform an appraisal of the practice but elected to try sell the practice himself. After four months of no activity the attorney contracted us to sell the practice. The attorney failed to place a dentist in the practice to provide continuing patient care. The doors of the practice were essentially shut for four months, during which time practice value, as well as interest in the practice, had dropped precipitously. We immediately placed a locum tenens dentist in the practice to try to revive patient activity, which was minimal. Finally, five months after the owner's death, a purchaser was found. The practice sold for one third of its originally appraised value.

Dr. A and Dr. B's practice sales were as successful as if they had not suddenly died. Dr. C's outcome was much less successful.

There are several factors in post-death practice sale success. The first is the use of a locum tenens dentist to continue the practice operation. Keeping the practice active is vital in preserving value and marketability. Many patients are lost when a practice is closed or when well-meaning nearby dentists cover the practice.

Another factor for success is enlisting a professional practice broker, even though the family may already have interested prospects. Expertise and experience are critical in marketing, prospecting, qualifying, financing and selling a practice. Having prospects to immediately contact for a sale is invaluable.

However, without complete and current practice data, even the best practice broker will be ineffective. Dentists rarely assemble this information during their lifetime. The task invariably falls on a grieving spouse who does not know what to look for, where to look, or who to call. The lack of complete practice information and a professional approach to marketing the practice may easily result in losses of hundreds of thousands of dollars.

The process of gathering practice information and pre-planning the practice sale process is practically impossible for a spouse, especially when the spouse is not involved in the practice. However, the process is relatively quick and easy for a dentist. Wise dentists will make this small investment of time and effort to ensure the best practice value and success for their family, patients and staff.

A free appraisal kit can be downloaded from our website. For a printed copy, send $5.00 to ADS South, 11285 Elkins Rd. A-2, Roswell, GA 30076.

Earl M. Douglas, DDS, MBA is the founding president of American Dental Sales. He is president of Professional Practice Consultants, Ltd. and personally serves the Southeast with affiliates nationwide. He can be reached at 770-664-1982 or write to 11285 Elkins Rd, A-2, Roswell, GA 30076 or visit our website.

Earl M. Douglas, DDS, MBA, BVAL.
Published in Dental Economics, September 2003