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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.
A Story of Three Dentists
In the past year, our firm encountered three dentists who experienced the same event - death.
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.
Measuring Practice Value

In my last column we discussed the concepts of price and value. We defined price as the consideration (cash, note, barter, etc.) paid to acquire an asset and value as the benefit (cash flow, enjoyment, etc.) received by the buyer of the asset.

The importance of value to the buyer of a dental practice is emphasized, since value is the buyer's actual take-home income. Our objective now is to learn how to recognize and measure value in practices.

To this end, let's examine two actual practices.

Table 1 Practice A Practice B
Gross collections
$654,643 $472,803
Practice price
$425,000 $289,000
Price as a percent of gross
65% 61%
Buyer net income after all expenses and debt service $121,910 $129,353
Buyer net as percentage of gross collections 19% 27%
Most buyers would agree that Practice B is more desirable because the price is lower, the net income is higher, the price is a lower percentage of gross, and the percentage net is higher. Before deciding though, let's look at these two practices more closely.
Table 2 Practice A Practice B
Hygiene collection
$170,879 $104,017
Seller (as post-sale associate to buyer) $363,327 $0
Buyer produced collections
$120,437 $368,786
Buyer net income after all expenses and debt service $121,910 $129,353
Buyer net as a percentage of personal production 101% 35%

We have just introduced an important new statistic - buyer net as a percentage of personal production. This percentage, along with the net income dollar amount, is the most important measure of practice value.

Buyers who overlook this essential statistic will likely prefer Practice B. Buyers examining this statistic will likely prefer Practice A with a 101% net as a percentage of personal production compared to 35% for Practice B.

Additionally, Practice A's first year accrued equity of $74,692 plus the buyer's income of $121,910 yields a total benefit of $196,602 or 163% of personal production. Practice B's comparable first year equity of $51,105 and buyer's income of $129,353 yields a total benefit of $180,458, which is 49% of personal production. Simply put, Practice B's buyer will earn only one-third the value (income and equity) for a given amount of production as will Practice A's buyer.

One reason for these differences is practice overhead efficiency. Practice A's three-year average adjusted overhead expenses are 43% of gross compared to 54% for Practice B. Practice A's 11% higher efficiency results in a $72,000 higher net income for its owner compared to an equal amount of work produced in Practice B.

The most impactful difference, however, is due to surplus earnings from income generated by hygienists and the seller working as a post-sale associate. Practice A's income from these sources is $534,206. After paying seller and hygienist salaries of $198,116, Practice A has surplus earnings of $336,090 which pays the annual debt service of $116,263, with an additional $219,827 to apply to expenses. Practice B's hygiene collections of $104,017, less hygiene salaries of $46,140, leaves surplus earnings of $57,877, which covers 73% of the $79,549 debt service with nothing left over for overhead.

The dramatic contrast of these actual practice opportunities underscores the importance of understanding and applying the statistic of buyer net as a percentage of personal production to measure practice value - an essential understanding for making well-informed practice purchase decisions.

Earl M. Douglas, DDS, MBA, BVAL.
Published in Dental Economics, March 1999