July 19, 2019

What DSOs Look For When Purchasing Dental Practices

When it comes to selling your dental practice, don’t rule out the option to sell to a dental service organization (DSO). DSOs have gotten a negative reputation because of their seeming corporate interest, which is why it makes sense when the seller is looking to stay on with the practice but wants to release managerial responsibilities, such as in a retirement situation or anyone who is looking to maintain a work-life balance. Here’s how to make sure your practice checks all the DSO boxes.

What most DSOs do not look for:

A practice that has three or fewer operations.
A practice that collects less than $800K.
A practicing dentist who is looking to exit immediately.
Medicaid.
Inconvenient location.
If the doctor’s work is not repeatable or is hard to duplicate.

What most DSOs do look for:

A practice with at least four operations (though the more, the better).
A practice that collects a minimum of $850K, more than a million being ideal.
A practice that negotiates with PPOs.
A desirable location, mostly urban or suburban.
A practicing doctor who is looking to stay on for two or more years.
A practice with an intraoral scanner.
One dentist for every 1,800 patients.
General dentistry practices, although there are DSOs for specialty practices.

What a DSO provides assistance in:

Payroll.
Human resources.
Marketing and branding.
Practice support.
Accounting.
IT services.
Recruiting.
Capital and financing.
Tax services.
Risk management.
Ordering of supplies and equipment.
Negotiating lab costs.
Compliance.
Strategic thinking.
CE (depending on the size of the group).
Growth model (acquisition, etcetera).
Licensing.
Scheduling assistance.
All the mundane work a doctor typically doesn’t want to handle.

What’s next?

Unclear where you stand? Contact the experts at Professional Transition Strategies to see if selling to a DSO is the right move for your dental practice.

July 8, 2019

DSO Navigation Webinar: Critical Success Factors Revealed

As a business owner, it may be instinctual to want to take the sale of your practice into your own hands rather than hiring a professional. But hiring a professional dental broker to handle the sale of your practice will help you get the most out of your transaction in the long run in terms of both time and money. After all, your job during this transition is to focus on keeping the value of your practice up in order to get the most out of your sale. Here’s how.

Future plans

Whether you’re planning to put your investments toward retirement or another investment, you’ll want to ensure a smooth and lucrative transition. Take advantage of a complimentary prospectus offered by a dental broker to know the true value of your practice and which options are available.

Timing

Selling a dental practice takes approximately 150 hours, time that could be better spent maintaining a successful business. A qualified broker will already have contracts in place rather than hiring an attorney to draft documents for you, saving thousands of dollars. The broker will also save you time by already having a list of potential buyers in the area or at least an active marketing approach.

Maximum value

A qualified broker will present all possible options to you so that you can look at and compare all sides. This not only means selling to an individual, bringing on an associate or affiliating with a dental service organization (DSO), but also considering all options within each vertical. Considering various strategic approaches will help maximize the value of the transaction.

Process details

The work has only just begun after receiving a prospectus from a dental broker and presenting your practice to qualified buyers. 80% of the transaction includes the contracts, negotiations and final sale. A qualified broker guides the transition of ownership, from negotiating the sale and finding fair market value to providing the asset purchase or stock agreement and assisting with the real estate needs.

Due diligence

Having the money to purchase your practice does not mean it’s the right dentist for the job. A dental broker will go through the due diligence process to find the best match for your practice, whether that’s an individual or a group, to help you, your staff and your patients feel comfortable with the transition.

Confidentiality

Knowledge of a potential sale can hurt your business and increase your attrition rate significantly. What’s more, your staff may take the opportunity to look for employment elsewhere. Confidence is key with a professional dental broker so as to not impact the value of your practice.

Emotional baggage

Starting and putting your own sweat equity into your dental practice can be an emotional process when the time comes to move on. Strong emotional ties to your practice can make it more difficult when it comes to making business decisions, which is why hiring a broker can help make the transaction more efficient and smoother.

What’s next?

Professional Transition Strategies not only offers a free valuation at the beginning of the process with no signed contract in place, but also 30-day listing agreements where most other brokers require a yearlong contract with penalties. Contact the experts to start the seamless selling process.

May 29, 2019

You’ve Graduated from Dental School; Now What?

You’ve studied for the past eight years and now finally have that much-coveted dental degree in hand. Now what? Even if your dreams are to own your own dental practice, there are other options to consider and a few steps you might want to take first. Here, we break down some options for dental school graduates to add to their list of considerations.

Build an advisory team

Assembling a team of advisors to help guide you through every step of the process will ensure the success of your business is established from the beginning. As with any team, you’re only as strong as your weakest link, so it’s important to choose advisors who have experience in the dental industry, such as a consultant, technology advisor, real estate broker, equipment and supply representatives, certified public accountant (CPA), and attorney.

Consider location

Make sure that your lifestyle works with the location you are considering, whether in a metro or rural area. Also consider the old real estate adage of “location, location, location” also applies to your dental practice when examining a purchase. Evaluate whether you want to lease or buy, your timeframe and size requirements, as well as how much sweat equity you are willing to put in.

Acquire license

Arguably most importantly, get licensed in your desired area, if you are not already. If you are not currently licensed in the state in which you want to practice, learn the process. Do you need to take an exam? How much will it cost? Do you have the correct insurances? How long will it take?

Determine options

Purchasing a dental practice isn’t a cut-and-dry process. There are seemingly endless transition options, from buy-outs and buy-ins to associateships and affiliations, as well as options tailored specifically toward dental school graduates, such as establishing a startup or working for the military, school, or government.

What’s next?

Read more about the options for dental school graduates in the e-book “Recent Graduate,” then contact the experts at Professional Transition Strategies to get started on the right path.

April 23, 2019

Webinar: “10 Ways to Prep Your Practice for Transition”

Every so often, Professional Transition Strategies (PTS) hosts a webinar for sellers to learn more about the transition process. In April 2019, a webinar geared toward sellers detailed the steps and options when considering buying a dental practice. Here are the key takeaways.

Think about your strategy

A seller should begin with the end in mind. Think about your long-term needs, how much time is needed to implement the plan and what your ideal strategy looks like, including a buy-out, partnership or associateship, as well as whether you would consider selling to a dental service organization (DSO), private equity for extensive growth, or merger with another local practice.

Start or keep growing your practice

The biggest failure of owners is letting the practice start to decline when thinking of selling. In turn, the value of the practice drops significantly and can cause a bank to decide not to finance the acquisition. What’s more, it lowers the total options that a broker can deploy. It is worthwhile to market your practice right up until the point of transition to ensure the value won’t decline over the course of time.

Focus on core details

Other than financials, it’s important to take a wholesale look at your practice to assess what has made your practice successful. Do you provide certain treatments that set you apart? What niches do you work in? Do you serve a certain community very well? Are you engrained in the business sector? Is your management style unique in that it allows you to keep employees for a long time?

Run an equipment evaluation

Most practices are valued using a weighted system that takes into account how old the equipment is. If time allows, it may make sense to purchase upgraded equipment, use that equipment, depreciate it over five years, and achieve a much higher sales price, even though you won’t get a 100% return on your investment. Consider going digital if you haven’t already, then upgrade cone beam computed tomography, digital impressions, computer-aided design and manufacturing system, and new chairs and units.

Consider the real estate

If you don’t own the building, notify your landlord that a transition will happen. If possible, sign a new lease or an addendum that allows the lease to be assignable to a dentist who qualifies for bank financing. If you do own the building, which can be sold as an asset to help pay for retirement, start paying yourself market rent. Alternatively, consider relocating your practice to a more desirable location, which can raise your practice valuation by as much as 5%.

Clean up your books

In addition to charging yourself market rent if you own the building, if you employ your spouse, consider replacing them or at least start paying them what market value for the position would be. What’s more, don’t stop writing off items through your practice; keep track of personal travel, depreciation, etcetera.

Know your “why”

One of the biggest worries for a buyer is that they will have to compete with you over time so it’s important to be able to articulate a real and communicable reason to a buyer at least a broker so that they can tell the story for you.

Build an advisory team

Know your practice’s worth

Creating a practice prospectus that breaks down the profitability of the practice helps to understand the value of the practice and can help determine the best strategy to use, as well as give you a roadmap for what you need to do before the sale occurs, which could alter your expectations in terms of horizons. Factors such as revenue, net income, seller’s discretionary earnings and value of hard assets will all be taken into consideration.

Execute strategy

After determining which strategy to implement and how long it will take to get there, you can start getting the work done that needs to happen before the transition takes place. Now is the time to start working with an advisor to take the next steps toward implementing your strategy over the set period of time.

What’s next?

Learn more about the dental transition process in an upcoming webinar, then contact the experts at PTS to learn about the next steps.

April 3, 2019

How to Assess Fair Market Value for Your Dental Practice

Assessing the fair market value of your dental practice comes in many forms, but the methods that are most appropriate are market and earnings (capital income). Any valuation will ultimately use one of these approaches, but using a combination of approaches will form a more reliable indicator of value. Here are some factors that will contribute to the fair market value of your dental practice.

Legal definition

According to the Internal Revenue Service, fair market value is defined as the price at which a property would change hands between a willing buyer and a willing seller when the buyer is not under any compulsion to buy and the seller is not under any compulsion to sell, with both parties having reasonable knowledge of the relevant facts.

Valuation

Fair market value includes the going concern value of the practice, including dental and office equipment and furnishings, instruments and supplies, patient records, current location, and telephone numbers assigned to the practice.

Transition information

Fair market value assumes a smooth transition of ownership, including letters of introduction to all active patients and/or referring sources, the seller’s best efforts in assisting in the transfer of the practice, a noncompete agreement and all other tangible and intangible assets of the practice.

Personal worth

Fair market value does not include the accounts receivable of the practice, cash on hand, and any other bank or cash accounts, the practice owner’s personal belongings, marketable securities, real estate or vehicles, if any.

Financial, legal, and management records

Fair market value can be assessed using practice tax returns from previous years, internal bookkeeping data, personal visits from a broker and an analysis of the major management areas of practice, including all client management systems, as well as a visual analysis of the practice location and physical plant.

Sale details

Fair market value can be assessed based on whether selling to an individual or dental service organization (DSO). What’s more, the types of procedures and dentistry that the office performs affect the value.

What’s next?

Contact the experts at Professional Transition Strategies to start the process of assessing fair market value for your dental practice through a prospectus.

March 8, 2019

buy-in Archives – Page 2 of 2 – Professional Transition Strategies

One of the contributing factors and most commonly asked questions when it comes to dental practice transitions is “How long will this take?” As with any business transaction, the answers are not cut-and-dry. Here are some transition timeframes and the factors that contribute to them to help guide your decision.

Buy-out: 0–365 days

A buy-out is the quickest and most predictable transaction with the search being dependent upon marketability and location of practice. In a buy-out, the senior doctor is looking for someone to take over the entirety of their practice but can choose to stay on as a long-term associate, contributing to the transition period. Once a buyer is found, the success rate is close to 100%.

Buy-in: 1–4 years

A buy-in is essentially a short-term and defined associateship period that is approached from an owner’s time set, not employee’s. While the majority of the time is spent finding the right fit, the buy-in should occur within one year after the getting-to-know-you period. A roadmap is established upfront with all the material facts about the transition to make the process more predictable and the time horizon to be more defined.

Merger: > 2 years

The longest part of this transition is finding two clinicians who are not only compatible, but also have a similar timeframe and geographic location, both in terms of real estate. Though not always the case, in most mergers, one facility is kept while the other is relocated. However, the operational side can be as quick as a buy-in as only purchase documentation and operational agreements are required.

Affiliation: < 3 years

Similar to a merger, with an affiliation, the doctor will most likely stay on for a period of time with the buying dental service organization (DSO) or group, depending on the practice type and location. Also similar to the search process of a buy-out, the operational process for an affiliation can be even quicker even though there is more due diligence as they are familiar with the process, compared to a first-time individual buyer.

Associate: 5 years

On paper, taking on an associate is normally the fastest route as there are often a lot of prospects; however, with a one-in-five success rate, timing can be unpredictable finding the best match for your dental practice. While the search can be the quickest part at about one month, the operational part of having that person buy in can take up to a year and ultimately might not work out in the end.

Private equity investments: > 5 years

The underlying goal of this transition is to make sure the practice is big enough that a private equity group would be interested in funding it. Private equity groups are constantly searching for the right practice and can close as fast as any DSO or individual once the correct partner with a solid platform is found. However, the majority of the time is spent because the doctor would need to stay on board for at least five years since it is the business they are looking to take over.

What’s next?

Read up on the different options for dental practice transitions in the e-book “Strategies for Transition,” then contact the experts at Professional Transition Strategies to start the conversation.

December 28, 2018

associateship Archives – Page 3 of 4 – Professional Transition Strategies

While dentistry will most certainly be a lucrative career in the long run if you play your cards right, the harsh reality is that the average dental school debt is approximately $260K. Add to that an average of $220K in lost earnings plus interest, and a graduate can count on expending $570K toward dental school. Don’t be discouraged that dentistry is the number one job in America for debt; your investment is typically paid back within eight years of practice. Here are some points to consider along the way.

Buy a practice

Rather than starting as an associate or even working for a dental service organization (DSO), after graduating with a negative net worth, the fastest way to make dentistry worth it is through practice ownership, most notably in an area where there is demand. Though counterintuitive, taking on more debt will pay off.

Grow your practice

Consider the population-to-dentist ratio in your practice area, then hire consultants to grow your practice and stand out above the rest. Working with intelligent financial planners and certified public accountants (CPAs) throughout the process will keep you headed in the right direction.

Shop insurance providers

The leading cause of a lower income is the lower fees associated with PPO insurance plans. Shopping insurance providers will be financially beneficial not only as a business owner, but also to your patients.

Ask the right questions

What are my debt repayment options? Can I pay down my student debt? Can I limit my student debt? Should I repay my debt? And perhaps most importantly, will practicing dentistry make me happy?

What’s next?

Read up on other options in the e-book “Recent Graduates,” then contact the experts at Professional Transition Strategies to help guide you on the right path.

December 20, 2018

The Kids Are in College; Now What?

Becoming an empty-nester is a natural time to start thinking about your next steps, as well. While there is still tuition to be paid, a well-laid dental practice transition takes years of planning, whether that means engaging in a partnership or preparing for retirement. Here are some steps to start taking now.

Contact a broker

It takes approximately 150 hours to transition a dental practice, which is one of the many reasons to hire a professional broker. To get the most out of your sale, both financially and personally, a professional broker will help you focus on the bottom line and create an accurate appraisal of your dental practice while vetting potential buyers and removing any emotion from the transaction.

Crunch the numbers

Determine how much you need for retirement, how much debt you have left and how much you need to get out of the practice when you ultimately decide to sell it. The most important point is to plan for your transition while production is still high to ensure you gain a higher valuation. Because the most recent years’ collections are weighed heavier than past years, you’ll want to go out on a high note if a sale will take place in the next two or three years.

Know your options

With all the transition options available, you’ll want to have an understanding of your ideal transition and discuss with a broker what is currently possible and what you need to do to get to your ideal transition plan. Planning early will allow you the option to affiliate with a dental service organization (DSO), bring on a partner who will eventually buy the remaining share of the practice when you are ready to retire, or simply understand where the practice needs to be financially and strategize how to increase the value of the practice if needed.

What’s next?

Read up on sellers’ options in the e-book “Strategies for Transition,” then contact the experts at Professional Transition Strategies to get the proverbial ball rolling.

November 6, 2018

Dental Practice Transitions, by the Numbers

You’ve kept up with the “Insights” blog; you’ve taken the dental practice transition quiz. Now it’s time to learn even more about the process by way of a cheat sheet broken down by the numbers.

1,500

Number of active patients considered full capacity for a single dentist. Any more, and it may be time to consider taking on an associate or partner.

680

Credit score that is favorable to getting a better business loan.

80

Percent of goodwill that contributes toward the overall value of your practice.

150

Hours it takes to sell a dental practice, which is one of many reasons to hire a professional broker.

15

Minimum number of days patients and staff should be notified about the sale of a dental practice.

30

Percent of dental practices that will belong to a dental service organization (DSO) by 2021, as predicted by the American Dental Association.

5

Years out you should start thinking about a retirement plan.

20

Pages that make up a prospectus, broken down into different categories of interest to the buyer identifying the areas that potentially need attention.

99

Percent success rate of a buy-out, versus 60 percent for a partnership and 20 percent for an associateship.

What’s next?

Read the e-book “Strategies for Transition” to learn more about the different dental practice transition options, then contact the experts at Professional Transition Strategies to learn more.

September 25, 2018

Proven Methods to Maximize Your Dental Practice Investment ROI

Purchasing a dental practice is no easy task, but it’s only the beginning of the hard work you’ll need to do to see a return on your investment (ROI). Whether the practice is new or existing, opportunity cost should drive all your post-buying decisions. Here’s how you can ensure ROI is top of mind.

Time value

At the top of your considerations list should be the theory that a dollar in the bank today is worth more than the expectation of receiving a dollar in the future. In other words, spending and earning wisely now will only pay off in the long run.

Loan payment

Like taxes on your mortgage, interest on your loan payment can be written off as a deduction. Consider taking out a longer-term loan with lower payments to increase the cash flow of the practice, similar to taking out an insurance policy.

Tax advantages

Along the same lines, maximizing tax advantages with every decision will only pay off every year. For example: While all assets depreciate in value over time, Section 179’s Depreciation Schedule allows you to depreciate all assets up to a certain amount in the first year so that no taxes will be paid, in most cases. (Note: Associates don’t receive the same type of tax advantages as the practice owner.)

Cash flow

When purchasing an existing dental practice, cash flow should be analyzed by the income stream of the practice, the compensation necessary for the purchasing dentist, and any obligations incurred, no matter if you are looking at the loan for the actual purchase of the practice or any other working capital needed for equipment, supplies or anything else to get the practice ready for operation.

Sole proprietorship

Rather than taking the safer route of working as an associate or for a dental service organization (DSO) that will only provide a commission for the work you do, owning your own practice will only maximize the investment of your dental degree because you’ll not only receive a commission but also a profit component.

Prospectus

When working with the experts at Professional Transition Strategies (PTS), an approximate ROI equation for the purchase of the practice is included in each prospectus, which adds up the compensation of the doctor, any adjustments made for non-business-related expenses and net income distributions. The remaining amount is an approximation of the cash flow or immediate ROI available to the purchasing doctor.

What’s next?

Read up on the buying process in the e-book “Transitions: Your Next Adventure Awaits,” then contact the experts at PTS to help guide you through the process.