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 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.
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 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 first element to consider when appraising a practice is the purpose of the appraisal. The primary reason for most appraisals I prepare is to set a price for sale purposes. Judging from the results of actual sales, these valuations are accurate and workable, as the great majority of practices sell at the appraised price and the purchasers are invariably successful. One note of caution here is that practice values are invariably for a 100% undivided interest and no inference can be drawn for the value of partial interests. In other words, if a practice is appraised at $600,000, one cannot deduce that a 50% share is worth $300,000, since there is a discounting process that must be factored. A minority discount due to lack of control and a lack of marketability must be applied when an interest lacks control, which a is the case in a 50% or less interest.

The second reason I see for practice appraisals, and I hope you don't fall into this category, is for division of property in divorce. Since there is usually an adversarial atmosphere to divorce appraisals, the results produced by both sides are usually rather far apart. Many times experts are engaged who have never conducted a dental practice appraisal and have no knowledge of the dental market. The chief economist for a college, while intellectually superior, may have absolutely no working knowledge of the practice marketplace and end up applying formulas that result in outrageously high or low values. Too many times, this approach to partisan valuation only results in high litigation costs before the court finally arrives at a reasonable and realistic value. When approached by an attorney for divorce appraisal work, I tell them that they will get the same result whether he or she retains me as if the opposing counsel had retained me. It is critical to retain independence in the appraisal process, particularly in this area.

A third reason for an appraisal is in cases where a practice is being displaced by a governmental agency, known as imminent domain. When your building is being torn down to make room for a MARTA station as was the case some years ago, or to make room for a new high-rise, as is currently happening in Atlanta, values must be established for the loss of value as a result of displacement.

Another appraisal purpose is that of financial planning. For this purpose, the appraisal must provide much more information than just the price. While the price is important, the project must also develop further information such as estimated time to a sale, how to minimize taxes, and the practice's capacity for the seller to work in the practice part-time after the sale, to name a few. A number of dentists have come into my office and said, 'I just don't know what I'm going to do!' My typical reply is, 'I know what you're going to do, you're going to sell your practice. The real question is how and when.' For larger practices, having the data to make this decision as precisely as possible will have significant impact in the overall planning outcome.

One growing segment of appraisal demand is that of determining practice value and knowledge of all financial aspects of the practice for informational and preparedness purposes. Lately, a number of dentists have commissioned appraisals as a form of life insurance for their practices. They have seen colleagues unexpectedly pass away and watch these practices dwindle in value until they are eventually sold for pennies on the dollar, if they are sold at all. These clients seek our services for several reasons. First, they know when a seller unexpectedly dies, the surviving spouse never knows what to look for, where to look, or who to call. They realize that this burden places tremendous stress on a survivor, who is stressed enough from the loss of a spouse.

These clients realize that, even though the process of gathering everything needed for an appraisal and sale is a tedious process, it is infinitely easier for them to accomplish than for a survivor who doesn't know where to start.

When I have everything in hand that I need to appraise and sell a practice and can put a substitute dentist in place in the event of a death or disability, I generally can sell the practice at its fair market value and do so quickly and in a cash sale. When it takes months to gather the information, there are generally large discounts in what a practice will sell for, if it can be sold at all.

Another side benefit of this appraisal is that owners learn a great deal about the financial management of their practice. In performing a practice appraisal we learn a great deal about the strengths and weaknesses of a practice. In one case, we even showed a dentist that his landlord had a lien on his practice, which the dentist was not aware of. In another case, a dentist had the preparation appraisal performed and six months later, he suddenly died in a work out session. Knowing the practice, having a current appraisal, and having everything in hand to market the practice greatly expedited the process. I knew of several interested parties, called them, and within fifteen days, the practice sold for 95% of the appraised value, in cash.

All things considered, it would be the rare practice owner who would not benefit from having an appraisal of his or her practice. The information gained can have instant value, as in the case of a death, or ongoing value, as in the case of financial planning. One caveat for dentists is that a qualified appraiser should be chosen for any appraisal assignment. Just having been in the business for a number of years is not a sufficient qualification. While a qualified appraiser will have experience and knowledge of the dental practice market, they also must have education, training and experience in the appraisal field, and should be a member of a professional appraisal organization.

Every dentist should have a current appraisal for his or her practice. It's just very cheap insurance and an invaluable management resource.

Earl M. Douglas, DDS, MBA, BVAL.
Published in Doctor of Dentistry, December 2006