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WWW.THENEWDENTIST.NET2 FALL 2009

Dear Readers,

On the Discovery Channel, the popular show MythBusters routinely debunks various myths and urban legends – everything from exploring if cigarette

lighters really do pack the power of a dynamite stick to determining if sonic booms are capable of shattering glass. The hosts use modern science to separate reality from fiction. By definition, a myth is a belief that has little or no basis in fact. But that simple description doesn’t begin to explain the power that myths have over our decisions.

Take the myth that the majority of dentists buy or build their first practice when they are five to 10 years into their careers. This myth influ-ences the decisions of hundreds, if not thousands, of companies in the dental industry. Many of you will be stunned to learn that longstanding myth is completely false. In fact, the majority of dentists – 52% to be exact – securing loans for startup practices either from scratch or new purchases are in the first FIVE years of prac-tice. Dentists early in their careers are not the small, silent, and insignificant minority that many misguided companies think you are.

Speaking of myths, if you’re building your first practice, don’t succumb to the myth that you have to spend a fortune and incur huge debt to create a beautiful space. I sat down and talked with Dr. Jarom Lamoreaux of Colorado recently about his experience and the lessons he learned on his first startup practice. You can read more on page 18.

Another myth that many dentists, both those new to practice and those well into their careers, believe is that patients will speak up if they have a concern or problem with the doctor or the practice. That too could not be further from the truth. As David Clow explains in the excerpt from his book A Few Words from the Chair; A Patient Speaks to Dentists (P12), dentists and patients may see each other regularly, but they rarely develop the kinds of rela-tionships that enable them to work effectively as a team to accomplish desired results.

David is a patient who felt so strongly about his experiences in the dental chair and the opportunity that dentists have to make profound and positive changes in people’s lives through dentistry, that he felt compelled to pen his experiences and perspectives. This book is a must read for every dental team.

Also in this issue, I am pleased to introduce Dr. Joshua Austin who will be a regular contributor both in the magazine and at his New Dentist Clinical Buzz/Blog at www.thenewdentist.net/clinicalblog.php. Dr. Austin is a new dentist practicing in Texas. He’ll be sharing clinical perspectives and candid insights about his personal experiences and chal-lenges as a new dentist.

I hope you enjoy this issue of The New Dentist™. In addition to the information you find here, there is a wealth of material at www.thenewdentist.net to help you dispel any number of myths that you encounter throughout your career.

Fondly,

Sally McKenzie, Publisher

FROM THE PUBLISHER’S DESK

F A L L 2 0 0 9

PUBLISHER Sally McKenzie [email protected]

DESIGN AND PRODUCTIONPicante Creative picantecreative.com

MANAGING EDITOR Tess Fyalka [email protected]

CONSULTING EDITORS Tom Snyder, DMD MBA Jim Stehman, DMD Keith W. Dickey, BS, DDS, MBA, SIU, School of Dental Medicine

SALES AND MARKETING For display advertising information contact [email protected] or visit our digital media book at www.thenewdentist.net/mediabook.htm

The New Dentist™ Magazine is published quarterly by The McKenzie Company (3252 Holiday Court, Suite 110, La Jolla, CA 92037) on a controlled/complimentary basis to dentists in the first 5 years of practice in the United States. Single copies may be purchased for $5.00 U.S., $8.00 international (prepaid US dollars only).

Copyright ©2009 The McKenzie Company. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical without permission in writing from the publisher. Authorization to photocopy items for internal or personal use is granted by The McKenzie Company for libraries and other users registered with the Copyright Clearance Center.

Disclaimer – The New Dentist™ does not verify any claims or other information appearing in any of the advertisements contained in the publication and cannot take responsibility for any losses or other damages incurred by readers’ reliance on such content. The New Dentist™ cannot be held responsible for the safekeeping or return of solicited or unsolicited articles, manuscripts, photographs, illustrations, or other materials. The opinions, beliefs and viewpoints expressed by the various authors and contributors in this magazine or on the companion website, www.thenewdentist.net, do not necessarily reflect the opinions, beliefs, and viewpoints of The New Dentist™ Magazine or The McKenzie Company.

Contact Us - Questions, comments, and letters to the editor should be sent to [email protected]. For advertising information contact [email protected] or visit our website at www.thenewdentist.net to download a media kit.

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TABLE OF CONTENTS FALL 2009

D E P A R T M E N T S

F E A T U R E S

2 Publisher’s Desk

16 The Buzz | Hire Me. Please!

22 The Not-So Simple Human | Your Strengths are Also Your Weaknesses

New Practice, Old TechnologyBy Lorne Lavine, DMD

What do you replace first?

Steer Clear of Bad HabitsBy Josh Austin, DMD

Avoid the clinical compromise.

Students: What’s on Your Mind?

A Few Words from the ChairPatient and book author David Clow has some advice for dentists.

5 Lessons for Start-up SurvivalBy Sally McKenzie, Publisher

Avoid the start-up pitfalls that nearly sank this doctor.

Becoming a Successful AssociateBy Tom Snyder, DMD, MBA

10 steps to make the most of your opportunity.

Debt DrivenBy Ralph Sardell, Ph.D.

The psychological toll of ‘owing.’

Financing Options for Your Practice PurchaseBy Keith Merklin and Jim Baum

You can still obtain funds to purchase a practice.

6

10

11

12

18

20

24

616

28

24

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For the new dentist who is graduating, there

are plenty of options for starting your new

practice. Many will choose to associate

with an established dentist to “learn the

ropes.” Others may pursue an opportunity

to purchase a practice from a retiring dentist. In both of

these situations, though, the new dentist is often left with

the challenge of bringing the practice into the 21st century,

at least from a technology standpoint. While some of the

newest technology like cone beam and CAD-CAM are very

exciting, the truth of the matter is that many new dentists

are already saddled with significant debt from their educa-

tion, and these types of purchases are often not in the

budget. The purpose of this article is to examine where a

new dentist should start, with a focus on getting the most

bang for the buck.

Practice ManageMent SoftwareI continue to be amazed at the number of practices that are

not using modern practice management software to run the

practice. The practice management software is far and away

the most critical decision that a practice owner can make.

This is the “glue” that holds everything together, and all the

other decisions, like computers and image software (more

on this shortly), will be tied into the practice management

software decision.

The choices that face the dentist are almost over-

whelming. Recent consolidations have reduced the “major

players” in this area. The “Big Four,” as they are often

referred to in online forums like Dentaltown and the IDF,

consist of Dentrix, Eaglesoft, PracticeWorks, and Softdent.

Combined, these four programs account for at least 80% of

the market by my estimation.

However, there are certainly many smaller companies

that have been around a long time and continue to produce

excellent products. One program that I highly recommend

for new dentists is Open Dental (www.open-dent.com). Not

only is this a great program, but there are no upfront costs.

You pay $149/month for the software, service, and support

(it drops down to $99/month after the first year)…that’s it.

The trick, however, is to find the program that best meets

your specific needs. As different systems are compared,

you will see how certain features are handled better on one

program than another, while another feature is better on a

different program. When comparing products, there are a

few things I recommend that you keep in mind:

1. You must involve your staff in this decision. As most

dentists know, the staff are the ones who interact daily with the

software. Many dentists have admitted to me that they barely

know how to turn the computers on, let alone understand a

Where to Start?

New Practice, Old Technology —

By Lorne Lavine , DMD

CONTINUED ON PAGE 8 >>

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complex dental program. It is your staff that will be handling

all of the administrative functions that the software handles.

If they find the program difficult to use, it will be disastrous

to your practice. Many dentists are fortunate enough to have

an office manager who has experience with dental software;

someone like this can be an invaluable resource for deter-

mining the advantages of a particular program.

2. Every program has numerous bells and whistles, but

most dentists end up using only a very small portion of these

“features.” There are certain areas of practice management

programs that almost all offices use. These include but are not

limited to patient registration, scheduling, treatment planning,

insurance estimation and processing, recall patient manage-

ment, and reports of practice parameters, such as production

and collections. Every dentist and every practice is unique. It’s

essential that you make a list of what’s important to you and

compare every program you evaluate using your list.

One method that I have found effective is to take either

an existing patient or create an imaginary patient and see

how the software tracks this patient. In other words, create

the patient record, schedule them, create a treatment plan,

post treatment to their account, create an insurance form,

re-schedule the patient, etc. In this case, you can compare

“apples-to-apples” when evaluating how software handles

this. Keep in mind that you should see how well the software

can adapt to how you prefer to see and treat patients. Poorly

designed software will force you to change how you practice

and process patients and you should avoid this at all costs.

coMPuterS in the oPSMany older or outdated practices will not have computers

in the operatories, and I think this is one of the biggest

“no-brainer” decisions you can make when upgrading the

practice’s technology. Computer prices continue to drop and

for around $1000, you can have a very powerful computer

that will run all modern dental software for three-to-four

years. If the practice plans to add digital x-rays at some point

in the future, computers in the ops are mandatory to both

take and view these images.

Many practices find that they are more efficient if they

decentralize the practice…remove some of the duties of the

front desk and have those duties completed in other areas of

the practice. For example, there’s no reason that hygienists

cannot schedule their recall patients for their next visit while

they are still in the chair and many hygienists I work with are

also comfortable collecting payment and/or printing walkout

statements. You’ll also need computers in the ops for functions

such as charting, treatment planning, and patient education.

MarketingAs any good practice management consultant will tell you, in

tough economic times, it’s critical that dentists market their

services both internally and externally. The good news for new

dentists is that this can often be done effectively even if you

have limited funds. In the last issue of The New Dentist™, I

talked about software like Demandforce that can help get the

practice better Google rankings, and software like that runs

under $300/month. New dentists will find that creating a

website and marketing it can be done with even limited funds.

There are numerous social media systems, such as Facebook

and Twitter, which don’t cost a penny but can still be used to

effectively market a practice.

As new dentists start to upgrade the older practices they

are acquiring, they need to be smart about how they spend

their limited funds. By investing in the proper infrastructure

first as well as cost-effective marketing, the practice can

be allowed to flourish and eventually have funds for other

high-tech purchases.

Lorne Lavine, DMD is the Founder and Presi-dent of Dental Technology Consultants. Dr. Lavine holds two prestigious certifications, the A+ Certified Technician designation and the Network+ Certified Professional. These desig-nations demonstrate proficiency in computer repair, operating systems, network design and

installation. Dental Technology Consultants provide dentists a full range of services relating to the implementation of technol-ogy. Dr. Lavine can be reached at [email protected] or at 866.204.3398.

Technologycontinued from page 6

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Editor’s Note: “The New Dentist™” magazine is pleased to introduce Dr. Josh Austin. Dr. Austin is a 2006 graduate of the

University of Texas Health Science Center San Antonio Dental School. After working as an associate for two years, Dr. Austin

opened his own practice this fall. As a regular columnist for “The New Dentist™” magazine and Clinical Director of the New

Dentist Clinical Buzz/Blog, Dr. Austin hopes to help new and young dentists to feel connected and learn from each other. “There

are so many voices out there trying to tell new dentists what to do and how to do things that many get lost. I am just an average

new dentist experiencing the same challenges as thousands of others. I hope that I can offer some new dentists a pearl here and

there that might help them get through their day.” BY JOsh AUsTIN, DMD

Steer Clear ofBad Habits

situation. On Friday afternoons, I am back in the dental school

ivory tower where every occlusal amalgam gets rubber dam

isolation to the contralateral canine. During the week, I am in

private practice where sometimes even root canals are done

without a rubber dam. Staying true to the fundamentals taught

to us in dental school has made me a better dentist.

This is not to say that I am telling the dental world to do

things exactly as they were taught in dental school, to quote

college football analyst Lee Corso “Not so fast, my friend.”

In some regards, dental school educators are traditionalists

entrenched in aging technology, methods, and materials. There

is a happy medium between being progressive and forward

thinking but also being rooted in some of the fundamentals we

learned during our education.

My plea to the new dentist is simple. We all understand

the pressures of being a new dentist. As time goes on, and

you find yourself more comfortable in your practice situa-

tion, keep an open mind. Don’t forget about your operative

instructor who was a stickler for a rubber dam. Think about

that pros faculty who would ask you to smooth your margins

more. Keep those voices in the back of your head. They are the

voices that will guide you when you are lost or uncertain.

Dr. Austin can be reached at [email protected] or

www.thenewdentist.net/clinicalblog.php.

A bout eight weeks ago, like many of you, I

received my copy of The New Dentist™ maga-

zine. I had read the publication before, but it

seemed that there was something different this

time around. As I flipped through the pages, I noticed a new

publisher had taken over the publication, Sally McKenzie. The

McKenzie name is certainly familiar to those

in the dental profession.

By this time, I had been writing my New

Dentist Blog for around eight months. I saw

some similarities in the audience that Sally and

I are trying to reach. I decided to contact her

in an effort to combine resources and provide

new dentists with clinical and non-clinical

information both online and in print. That’s

the process that led me to The New Dentist™ magazine and

website (www.thenewdentist.net).

I look forward to being able to offer some clinical insights

to other new dentists. As I have stated in my Clinical Buzz/

Blog at www.thenewdentist.net/clinicalblog.php, I am just

an average new dentist working through the same troubles

many of you are. New dentists are in a unique position in

dentistry. Dental student debt is currently at the highest level

in history. Because of this, many graduating dental students

feel pressured to begin producing at high levels very quickly.

Unfortunately, this oftentimes leads to compromising the prin-

ciples and values new dentists learned in dental school. From

a clinical perspective, this can mean abandoning the rubber

dam and performing procedures that the new dentist doesn’t

feel completely comfortable with.

There is no magic bullet to fix the average new dentist’s

situation. As time proceeds and production increases, this

pressure can subside. However, at that point, the bad habits

adopted during those earlier years may already be ingrained.

I have seen this happen to colleagues and even experienced it

myself. As a part-time faculty member, I see both sides of the

Josh Austin, DMD

WWW.THENEWDENTIST.NET 11 FALL 2009

DENTAL STUDENTS: What’s on Your Mind?

These days, Michael Babston, president of the senior class at University of Alabama School of Dentistry, is focused on Part II of the National Board Exam and passing the CITA exam in February. He is very happy to be pursuing a career in dentistry. “I look forward to implementing the skills and techniques I have acquired over the past four years to start a successful lifestyle as a practicing doctor.” But he acknowledges that he is worried about the future as well. “My chief concern is how quickly I will be able to repay loans I used to finance dental school. The economic recession is not a concern of mine; I strongly believe dentistry will survive, even thrive, in times of economic hardship. This is primarily because I believe there is/will be a relative shortage of dentists in the south due to the number of retiring ‘baby boomer’ dentists.” In the near-term, Michael is applying for a residency in Oral & Maxillofacial Surgery. After that, he plans to practice in central Alabama.

Dental students, tell us what’s on your mind. Email Managing Editor Tess Fyalka at [email protected]. We want to hear from you.


people like me, typical dental patients, are the most impor-

tant people in your professional life. When you and I don’t

communicate, we’re both missing out.

With me, you have a chance to practice health care at a

higher level, and for greater rewards, than you might ever have

imagined. Speaking practically, you need more effective patient

recruitment and better retention. You need to spend less time

and money in areas that don’t produce for you, and more

where they deliver a return, so you need to invest as effectively

as you possibly can at marketing, and more delivering paid

services. Speaking at a higher level, you need the satisfaction of

knowing that the work of your hands is making a difference,

and that what you sow today is reaped in better lives for the

people you treat. You want to enjoy the hours of your labor

and you want to look back with deep satisfaction over what

you accomplished. You want the respect of your professional

community. You want to be appreciated by your patients while

Editor’s Note: A Few Words from the Chair by David Clow, the first book written for dental professionals and students by a patient, offers a new perspective on the opportunities and challenges facing dental practices.

An excerpt from A Few Words from the Chair:

Not long ago, I had a chance to

give one of the best dentists in the

country some comments about the

ways in which he was marketing

his services. This dentist owns one

of the most prestigious and lucra-

tive practices in the United States.

It’s not unusual for patients to

fly halfway around the world to

see him for a six-figure course of

treatment, so his concern wasn’t

gaining more work or increasing

his income. He wanted qualitative

improvement. Although he had a beautiful office in a great

location, dedicated staff and the finest equipment, he recog-

nized that something was missing.

We visited together for over two hours, and he used

part of the time to give me the talk he gives to prospective

patients. He showed me slides of his beautiful clinic. He told

me about his fastidious sterilization procedures and the puri-

fied water at every station. He took well-deserved satisfaction

in the before-and-after shots of his work. His craftsmanship

was breathtaking. Some cases started with severe damage.

All of them ended beautifully. I felt deep admiration for his

passion and his skill as he delved into the finer points of

porcelain veneers. He makes his own, and he’s an artist.

As he wrapped up his presentation, he looked to me with

pride and waited for my feedback. He was right: something

was indeed missing. “Doctor ___,” I told him, “With all due

respect, I don’t care about anything you just said.”

He wasn’t pleased.

Here’s the problem: dentists and patients have extended

interactions, but hardly any conversations. I assume the ones

like this one with my dentist acquaintance are quite rare.

That’s too bad for us all, because I need your expertise, and

you need to understand me better as well. Someone like you

could be the most important health-care practitioner I know;

A Few Words from the Chair


On behalf of McKenzie Management, David Clow consults with dental professionals on practice culture, case acceptance, and patient expectations. He can be reached at davidclow@ mckenziemgmt.com.

Mr. Clow is also a writer/consultant for Fortune 100 companies. His book, A Few Words from the Chair, is the first book written by a patient for dental professionals and students. It can be purchased at www.thenewdentist.net.

THE STRENGTH TO HEAL while gaining experience and a renewed sense of pride.

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A Few Words from the Chaircontinued from page 12

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you’re here and missed when you retire. For all that, you

need me.

What about me? Speaking practically, I need excellent

health. I need pain-free, sound, strong teeth that permit me

to eat the healthiest diet. I need to know the best mental well-

being and the best physical fitness and the deepest emotional

satisfaction a person can know. I need a trusted independent

healthcare practitioner who delivers front-line prevention

before my problems become serious, and even more—at a

higher level—a chance to fulfill hopes and to find happiness

of which I scarcely dare to dream. I need love, respect, joy

and satisfaction in my life.

For all that, I need you.

Pretty ambitious, I know, and a lot for people to ask

of each other. Does it surprise you that I should expect

dentists to talk in these terms? It shouldn’t. Your goals

are the same as mine, and we can help each other to

make them all real. For either of us, getting less than

everything we hope for is foolish. Looking for less, and

settling for too little, has had tragic consequences for

every dentist and every patient in the nation. This unmet

potential isn’t a matter just of your income and my teeth.

It underlies billions of dollars in poorly invested health-

care spending, millions of serious illnesses, and countless

lives endured, but never truly fulfilled, by people who

know neither how healthy they can be, nor the transfor-

mative possibilities of a smile.

I believe there is a great crisis in health care in the United

States, and a great opportunity in prevention, and thus an

essential contribution for dentists to make. I believe you are

artists and healers with unique capabilities to do it. I believe

there is a great deal we do not know about each other, and

that it serves us both to talk.

The GapWhat an opportunity patients have! Dentistry offers people

so much they want and need. Why don’t people get it? What

would permit someone to have this resource available and

fail to use it? What would cause them to misunderstand it so

thoroughly that they fear it more than they fear the conse-

quences of not collaborating with a dentist?

There are gaps here, and like the gaps you work on in

your practice, they’re problems. The obvious one is between

us, between dentist and patient. There’s another between

what I really need and what I think I need. Yet another

divides what you think you do and what I think you do. And

there’s a serious one between the value most dentists have

and the value they feel they can discuss. Until these gaps

are bridged, you and I will continue denying each other the

benefit of a collaboration that could make both of our lives

better. And the potential worth to you and to me of those

miracles I mentioned will go unfulfilled.

Somehow dentistry isn’t where it belongs. Despite its

credibility being beyond any doubt, a tidal wave of attention

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“I hired McKenzie Management to help me with my practice

year one into a scratch start. I would definitely do it again.

McKenzie Management helped me increase efficiency and

productivity and helped to implement successful systems.

I had a gut feeling I could benefit from a practice consultant,

but I was reluctant to hire one for my practice. I thought a

business degree and corporate experience was all I needed

for success. I’m glad I went with my instinct and called

McKenzie Management. I had heard they were the best, and

now I know it. My investment in McKenzie not only paid for

itself by the second month, the systems put in place

continue to pay dividends. I can recommend

them without hesitation.

I am happy to speak to any dentist about

McKenzie Management.”

- Dr. Frank Clayton • Suwanee, GA


“I recently graduated from dental school

in Nevada. I moved to California and have

a California dental license, but I cannot

find a job. I am looking for a position either

part-time or full-time as an employee or

associate. I have searched for a job in

virtually every California city for almost

two months. I’ve looked at CareerBuilder.

com, Craigslist, The Dental Trader, and

other websites, but I can’t find anything.

At this point, I’ll work as a hygienist if I

have to, can you help?”

• Newly graduated DMD

Dear New Dentist,

Thank you for reaching out to The Buzz. Please do not give

up hope even though this has been a very frustrating start

to what will become a very rewarding career. What you and

thousands of graduates from the class of 2009 are facing is

the aftermath of a horrible economic downturn. Yes, there is

hope on the horizon. But dental practice revenues have been

down in recent months, so the need to bring on an associate

dentist is not as high as it was before the recession. However,

this is temporary. So what can you do to take charge of your

destiny? Plenty, read on.

“Please do not give up hope even though this has been a very frustrating start to what will become a very rewarding career. “

Inside Dentistry, Dentaltown, or Dental Products Report

to purchase mailing list addresses of dentists in the zip

codes where you would be willing to work. You can also

request the names and addresses of general dentists that

THEBuzz Struggles and Challenges Facing Today’s New Dentists

Can you help Nevada DMD? Visit the Buzz/Blog at www.thenewdentist.net and click on the Management Buzz/Blog. Want to read more answers to questions from dentists like you? Visit The New Dentist Buzz/Blog at www.thenewdentist.net.

First, register and check out www.dentalopportunities.

com. Next, if you are a member of the California Dental

Association, contact them and ask if they can help you link

up with any member dentists seeking associates.

Prepare your resume. Include your experience, educa-

tion, honors, awards, and references. Also include a photo of

yourself. Your resume should look very professional. Prepare

a well-written cover letter. Next provide several copies of

your resume and cover letter to the local dental supply

company representatives, including Henry Schein, Patterson

Dental, and others. Ask them to give these to clients that they

believe are considering retiring, trying to cut back, or looking

for an associate.

The most aggressive technique is to contact some

of the dental trade magazines such as Dental Economics,

graduated between 1974 - 1984. Those dentists would be

approximately age 55 to 65. You would then mail to them

your cover letter, resume, and contact information. You

also might offer to work for them FREE for 2 days so they

can observe your skills. It’s something to consider to set

yourself apart and prove that you are worth far more than

just a passing consideration.

I hope that is enough to get you started. Best of luck to

you and let The Buzz know how this works out.

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5 Lessons for Start-up SURVIVALDr. Jarom Lamoreaux, 31, received his DMD from University of Nevada Las Vegas School

of Dental Medicine and his MBA, he jokes, from the “School of Hard Knocks.” He readily

acknowledges that earning the second “degree” was much more costly and not nearly as

much fun as dental school. He can look back on the experience now with a little levity, but the

first couple of years out of school were rough. In fact, at times, the struggles were so great

he seriously questioned his decision to go into dentistry.

On a whim, Jarom and his wife, Kelly, who is also a

dentist, went to work for a company in Arizona,

but they quickly realized their hard work was

paying off nicely for the company, but doing little for them.

The couple wanted to build their own practice. They chose

an area in Colorado where they believed the market was

better for new dentists. Colorado may be known for its

spectacular mountain views, but, for the Lamoreauxs, it is

here that they walked through some very deep professional

valleys. They also learned their share of serious life-lessons.

LESSoN #1 – ASK LoTS oF QUESTIoNS, AND THEN ASK MoRE QUESTIoNS

Armed with an undergraduate degree in small business and

entrepreneurship as well as considerable research that he

and his wife did on their own time, Dr. Lamoreaux believed

he knew enough to build his new practice on his own. “I

had been planning on opening a dental office for years. In

undergraduate school, when I was majoring in business,

I always geared it toward dental business, such as writing

a business plan for starting a dental office. Even in dental

school, I was reading business books, accounting books,

and other dental business stuff. I researched as much as I

could, but even that wasn’t enough. The problem was that I

didn’t ask enough questions, and I trusted too much. There’s

just so much to look out for.”

His headaches began when he overspent significantly

on equipment and tenant improvements on the space he was

leasing. Additionally, as a first time owner, Dr. Lamoreaux

says that he also made mistakes in how he handled the lease

agreement. “We just let people take advantage of us.”

LESSoN #2 – BIG FIRM = BIG MoNEy

Dr. Lamoreaux chose a large, expensive architectural

firm, but he wound up with an architect who had never

designed a dental office before. “We kept having these

project meetings with the contractors, engineers, and

architect. I felt really important, but I didn’t realize

how much I was being charged for those meetings. The

architect for our first office kept trying to ‘sex up’ the

place. Those were his actual words. All of his little accent

items increased the cost per square foot to build out, thus

increasing my monthly fixed costs.”

At last, the office was built, and Jarom and Kelly were

ready to put the frustrations aside, chalk the negative

experience up to “lessons learned” and move on. In January

2008, the doors opened and the couple had $55,000 in

working capital, within five weeks it was nearly gone.

LESSoN #3 – BE VERy SELECTIVE IN HIRING STAFF

Dr. Lamoreaux discovered that the office manager he and

his wife hired, someone who came across as truly excellent,

was incompetent. “We found out that she never submitted

By SALLy MCKENzIE, publishEr


Drs. Jarom and Kelly Lamoreaux

a single claim to insurance. We hired people to do jobs, but

we didn’t hold them accountable, and that got us into big

trouble.” He urges dentists not to hire an employee for a job

that the dentist does not understand him/herself. In other

words, dentists should be at least somewhat familiar with

every system in the practice. “Get with a practice consultant

who fully understands the business of dentistry – but not

just any practice consultant, a reputable one with a solid

track record and references. Learn how the business systems

are supposed to work. Otherwise, the employees can tell

you anything, and you’ll believe it because you don’t know

otherwise,” warns Dr. Lamoreaux.

The couple was facing exorbitant lease costs and high fixed

costs. Overhead was swallowing them, and Dr. Lamoreaux

found himself regretting his decision to become a dentist. “We

were under so much stress to produce and that’s just not good

when you spend your days knowing that you have to produce

this much just to break even.” Thankfully, the couple were well-

received in the community and together were able to average

about 80 new patients a month in the practice.

Nearly two years later, Dr. Lamoreaux says their practice

is doing well and they’ve since built a satellite office, which he

says, with the benefit of lessons learned, cost less than half the

price of the first and fixed costs are thousands of dollars lower

in the second office. The second time he went with a very small

architecture firm that cost less than half the price of the large

company. “My architect did a great job.” And, most importantly,

the second architect had dental office design experience. “Any

architect can design something beautiful. But it takes a true

master to create something beautiful and within budget.”

Dr. Lamoreaux realized in building the second office,

which was a completely different experience from the first,

that the frustration, anxiety, and expense could be signifi-

cantly reduced, if not eliminated. “Now I want to help

other dentists avoid that. My goal is to get the message out

– I’m tired of people taking advantage of dentists,” says Dr.

Lamoreaux. And to help other dentists through the process

he started simplifiedstartups.com; the site is a testament to

what Jarom and Kelly went through, and a roadmap for how

to avoid the same traps that they fell into.

The site provides information on managing overhead

from the very beginning, creating the business model that

will work for your practice, developing and defending a

realistic but conservative budget, as well as other essential

information. Currently, Dr. Lamoreaux is creating a step-by-

step plan for new dentists to walk them through the process

and guide them away from the many minefields that threaten

the viability of any start-up practice. For more information,

visit his website at www.simplifiedstartups.com.

LESSoN #4 – BUSINESS MoDEL FIRST

In talking to his friends, colleagues, and other dentists that

he tries to help, Dr. Lamoreaux finds that dentists usually

make a mistake of building an office and then trying to

figure out what type of business model they want to imple-

ment. “The opposite should be true. Office design should be

a reflection of the type of business model you want to run. A

master architect understands these differences and helps you

design accordingly.”

LESSoN #5 - CAVEAT EMPToR

“So many dentists say, ‘That won’t happen to me. I’ll make

smart choices and not overspend.’ If you don’t have experi-

ence and know what a fair price/deal is, how can you know

if you haven’t just overspent? Additionally, most of the advice

out there is garbage. People mix business models together

and talk about things they have no expertise in. But in the

end, we found a way to reduce our fixed costs on our second

practice by $7,314.41 a month, and the second practice is

just as beautiful.”

Want to learn more about Simpli-fied Startups? Contact Jarom Lamoreaux at (719) 488-5981 or [email protected]

Many of you are now considering becoming an

associate. Some of you will be on a “partner

track,” others may consider purchasing the

practice of your new employer in a few years.

Below are 10 steps that you should consider

taking to ensure you will have a productive and

successful relationship with your employer.

• TOM sNYDEr DMD, MBA

THE TOP 10 STEPS To Becoming a SUCCESSFUL Associate


1. Reactivate Patients

Busy practices that may be the right fit for you to join

usually have a patient retention problem. We recommend

that a patient reactivation program be implemented to coin-

cide with your joining the practice. This allows the practice

to reactivate patients that have not been seen on a regular

basis in hygiene. This is often the case in practices that have

more than enough patients; however, there is not enough

capacity for one doctor to handle the entire patient base.

Your joining the practice is the perfect opportunity to solve

that problem.

When patients are reactivated, we recommend that

they be scheduled for a hygiene appointment with the asso-

ciate. The hygiene appointment is probably the most non-

threatening appointment in the dental practice, making it

the ideal way for you, the associate, to get to know several

of the patients. It also allows patients an opportunity to

get to know you, and hopefully you will form a long-term

dentist/patient bond with all of them!

That being said, we do not recommend that you always

see the patient as a hygiene patient. Rather, once you’ve

completed their reactivation recare appointment, future

recare appointments should be scheduled with the practice’s

hygienists. We also suggest that your employer schedule you

for no more than four reactivation patients a day so that you

have time to perform other clinical procedures. The number

of scheduled hygiene reactivation patients per day is directly

related to the number of patients that can be reactivated.

2. Determine your Clinical Supply Requirements

For those of you who are graduating this year or are

completing your residency program, your first real job

in a private practice may hold some surprises for you.

Therefore, it’s important that you sit down with your

employer and head assistant to determine what clinical

supplies you may need that may not be readily available

in the practice. Rather than join a practice and be unable

to perform at the level you feel you’re capable of because

you do not have specific supplies, instruments, or burs,

for that matter, discuss what you need up front. If your

employer does not agree with your requests, now is the

time to discuss it before you begin treating patients.

3. Determine Realistic Time Units

Many associates are scheduled with the identical time units

as their employer. This is totally unrealistic, particularly if

you are a recent graduate. Therefore, you should carefully

review your time unit allocations. If you are uncomfortable

with them, add more units. You do not want to keep your

patients waiting unnecessarily because you’ve underesti-

mated your time requirements.

4. “over-the-Shoulder” Training

As new practitioners, you need to continue your clinical

learning process. We recommend that “over-the-shoulder”


Dr. Thomas L. Snyder is Managing Partner of The Snyder Group, LLC, a nationwide practice transition and financial management consulting firm. With more than 75

years of experience in the field, The Sny-der Group provides a full range of services for new dentists considering purchasing a practice, practice valuation services, associate/partner agreements, practice transition matters, and retirement plan-ning. They can be reached directly at 1.800.988.5674. [email protected], www.Snydergroup.net

[email protected]

“After the Practice Start Up training,

I feel better and more confident about opening

my dental practice. For anybody thinking

about opening his/her own dental office,

this training is a must. I received a

tremendous increase of knowledge

about dental management.

Now I know the game plan!!!”

• 2 Days, one-on-one training.

• Preferred time 3 to 18 months prior to opening.

• 6 months of follow up support after the training

or once you are in your new practice.

• Training location - La Jolla, CA or Your City.

• Training and Support Materials.

• 16 hours of AGD CE Credits. View course curriculum at www.mckenziemgmt.com/cons-startup.htm

Practice Start Up Program

Mention this ad and receive a 5 hour DVD Set:

Realizing The Practice’s True Potential by Sally McKenzie (with your enrollment)

training be implemented in the

practice, if not on a weekly basis,

at least on a bi-weekly basis. By

serving as the “dental assistant” for

more complicated or clinical proce-

dures that you are unfamiliar with,

you, as the associate, will learn from

your employer and gain confidence

and experience to perform them

yourself one day.

5. Assess your Strengths

and Weaknesses

As a recent graduate, obviously,

there are certain clinical procedures

you are more adept at performing.

We recommend that you analyze

your employer’s production report

to determine those services that

are being referred to area special-

ists. Usually, at the top of this list is

endodontics. So, if you’ve had limited

experience in endo, we suggest that

your employer enroll you in an endo

clinical program. There are a multi-

tude of clinical programs available

encompassing all facets of dentistry.

The important thing is to be realistic

in your clinical self-assessment and

make sure that what you learn can

contribute to the practice’s growth as

well as your own.


FALL 2009WWW.THENEWDENTIST.NET22

you had what it took to make it through dental school.

You’re goal oriented, perfectionistic, focused, and driven

– all essential to surviving the academic rigor of your chosen

career. But those same qualities that served you so well as a

student, may be your Achilles heel as a professional.

As the dentist, the success or failure of your practice falls

primarily on your shoulders. It’s essential that you have a very

clear understanding of your temperament or personality type

as it is often referred. It will have a profound and powerful

impact on your ability to build and maintain an effective staff,

attract and keep patients, achieve production and collection

goals, and manage stress throughout your career.

Dentistry requires certain characteristics to be successful

such as being a good communicator, excellent listening skills,

warmth and compassion for your patients and employees,

creating a motivating environment for staff, not being too

autocratic or too lax, a willingness to experiment and take

risks, forward thinking, organized, patient, able to reprimand

or fire people when necessary, and the ability to make deci-

sions just to name a few.

It’s fair to say that few newer dentists bring all of those to

the table from day one. But what is essential to your success is

a willingness to understand your temperament type, improve

your shortcomings, and hire staff whose temperaments are

not the same as yours but complement yours.

Perhaps you went into dentistry because you loved the

sciences? You had the skills and the discipline, but then you

got into the patient side of it and realized that dealing with

people all day is utterly exhausting. It’s entirely possible that

you are an introvert, and forcing yourself to be extroverted all

day drains your energy. Introverted dentists can also have low

case acceptance and generally do not have flourishing prac-

tices because they struggle to communicate with patients and

staff and often come across as uncaring or aloof. While the

natural tendency is to hire people that are like you, the dental

practice needs a good mix of strengths and different person-

alities. Extroverts, for example, are often better at communi-

cating with people.

You may be a “thinking type” person. Thinking types are

“bottom-line” people who “call it as they see it.” As a result,

they can hurt a person’s feelings but are totally unaware they

have done so. They are able to step back from a situation,

analyze it for what it is, and apply an impersonal solution.

Thinking types can come across as heartless, insensitive, and

very uncaring because they naturally see all the flaws in situa-

tions and are very critical. Thinking types are usually moti-

vated by a desire to achieve goals. They also feel it is more

important to tell the truth than be tactful.

While you may be more “thinking” in nature, your

staff may be more “feeling,” as dental auxiliaries often are.

Feeling types like harmony and will work very hard to make

this happen. They need plenty of feedback and praise from

employers. They consider it important to be tactful as well

as truthful. They dislike telling people unpleasant things

and will procrastinate doing so. They have an inner desire

to please everybody. They can come across to others as weak

because they are too emotional.

Thinking type dentists can unwittingly alienate their

entire team if they are not aware of how they come across

when they come out “shooting” over something they don’t

like or are not happy with. They will fire off nasty comments

and accusations before gathering all of the necessary informa-

tion leaving even the tougher staff bristling in anger and the

feeling staff ready to quit on the spot.

Feeling type dentists can experience serious financial

difficulty if they are afraid to give patients “bad news.”

They may be inclined to minimize treatment – recom-

mending a filling when a crown would be a better long-

Your Strengths Are Also Your Weaknesses

THE NOT-SO Simple Human


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As we watched the financial systems collapse over

the last 12 months, many of us have been struck

by the sheer greed of those involved. Wall Street

risk takers abused the system yet stood in line

for their share of the federal bailout, as many of us watched

in disbelief and suffered the consequences of their actions. I

don’t need to tell you that should you make such catastrophic

financial decisions in your life, there will be no federal bailout

monies to save you. You, doctor, are essentially on your own.

Manage your debt well and you’ll reap the benefits many

times over. Manage it poorly and you’ll pay an even greater

price. But successfully handling debt involves far more than

simply making financial payments in a timely manner. It is

a reflection of how you will handle virtually every aspect of

your future success … or failure. Read on.

Starting out in business, many young dentists enter

the profession with sizeable school debt and then must

take on additional financial liability in one form or another.

As financial debt grows, so too does “emotional debt” and

both must be managed for their risk implications. If you

fail to manage your financial debt, you can develop a bad

credit rating. If you fail to manage your emotional debt,

you can stress out in your 20s, deny the stress, get married,

have children, acquire a mortgage, and rationalize that

you are stressing for a good cause: the family. Eventually,

as you approach your 40s, burnout, a sudden illness, or a

diagnosis of impending heart disease will give you pause

about the feasibility of out-running your debt. While there

is always risk when you accept any kind of debt, working

excessively to stay ahead of the bank or partner can destroy

more than your credit rating; namely, your personal health,

family harmony, and your self image.

For the new dentist, defaulting financially will consume

few aggressive entrepreneurs, but what causes the most

damage to many young professionals is the stress of managing

their emotional debt by focusing on the financial debt. Yet

how you manage your emotional or financial debt is a func-

The Psychological Toll of ‘Owing’

tion of how successfully you managed

your “personal investment” decisions while

growing up.

From a historical perspective, look over your

life and you will gain some insight into how you handled

various forms of “debt,” financial or emotional, in the past.

This tells you a lot about how you will handle debt in the

future. Did you try out for a team and accept the investment

of hard work or did you pass on the tough training? Did you

take the Advanced Placement courses and accept the chal-

lenge or did you feel they required too much effort? Did you

ask out the girl/boy of your dreams or were you too afraid to

put in the effort to impress her/him? Do you accumulate debt

on your credit cards, pay them off regularly, or do you just

make the minimum payments? Your personality and ability to

manage emotional and financial debt manifests in the history

of your lifestyle and your personality and temperament deter-

mines your capacity to handle debt in the future.

Debt Driven

Ralph Sardell, Ph.D, Clinical Psychologist, is in private practice in La Jolla, California. He works exclusively with business executives and dentists. As the Business Coach for McKenzie Management, he works with his clients on personal issues that affect business profitability. He can be reached at 858-454-2828 or [email protected]. Call for a free consultation.

BY rALPh sArDELL, Ph.D


iMPact of choiceSAs you start out in the business of dentistry, you have choices.

You can build a new practice and accept 100% risk. You can

work for someone, hone your skills, and work for a salary or

percentage. You can buy in as a partner. Or you can borrow

a lump sum, purchase an existing practice, and go it alone,

or any combination of these. Each option carries its own

emotional issues, in particular the isolation you can experi-

ence when you become financially responsible for not only

yourself, but for others, i.e. family, mort-

gages, partners, and building your 401K.

While all of the business options are viable,

the ultimate/best choice is to make a decision

based on your personality and history for

managing your emotions and your money.

How risk averse or success driven are you?

It is not unusual for many dentists to

become overwhelmed by their sense of obli-

gation, not only to their families, but to staff,

patients, and most of all their partners or

competitive colleagues. This sense of social

obligation is instinctive and biological. Their

sense of pride demands that they succeed.

However, many young dentists find themselves driven to

satisfy the expectations of others, while often being driven to

surpass their traditional expectations of themselves. This is

unnatural and sows the seeds for an eventual burnout.

Logic and reaSoning not enoughIt is a psychological fact that emotion will always overcome

reason, and, for that reason, understanding which emotions

guide or drive you is important. Fear will always trump logic.

Your logic may be perfectly sound and sound perfect to you

when you listen to yourself. But in all likelihood, your logic

will lead you to an outcome that is very typical of what you

experienced in the past. Do not be fooled by the sheepskin

on your wall. The temptation or pressure to increase produc-

tion can be overwhelming, but you will fail at this leap of

faith if you are not accustomed to driving yourself for 10 or

15 years without a safety net. Yes, without a safety net, and

that’s the point.

When you were a child and you drove yourself to

incredible feats of academic superiority, mom and dad were

there to take care of all the essentials. Today, as a young

entrepreneurial professional, there is no safety net only

Debt Drivencontinued from page 24

increasing expectations as your family and

financial obligations grow. It is important

to appreciate that the fact that fearful

emotions incapacitate reason and logic is

actually a good thing from an evolutionary

standpoint. We make emotional deter-

minations quickly and instinctively; this

capacity saved our lives on the Serengeti.

Listening to one’s logic can be nothing but

a 10, 20, or 25-year fantasy that we are

surviving and winning, when we are, in

fact, dying slowly from misinformation.

Yes, reasoning and thinking got you through organic

chemistry, and hand-eye coordination and working in small

spaces got you through dental school; but logic and reasoning

will not help you when it comes to managing staff, selling

treatment plans to patients, raising children, nurturing a

marriage, and managing debt. Managing your financial risk

requires a bit more awareness of your emotional disposition

and a bit more honesty. While your academic temperament

determined your standing in graduate school, your emotional

temperament will determine your ability to survive the busi-

ness of dentistry, and my message is that it would be wise to

accept the facts and reality of your personal history and make

your financial debt decisions accordingly.

what can You truLY handLe?If you were a fearful adolescent, then calm your fears by

accepting a more conservative entrepreneurial path so that

you can learn to manage your money, your emotions, and

make good business sense. If you are accustomed to finan-

cial and emotional risk then push forward with your full

potential and take large steps in that direction knowing

Many young dentists find themselves

driven to satisfy the expectations

of others.

From the Chaircontinued from page 14

that the outcome is basically certain based on your past

behavior. And, if you are somewhere in-between, then

trust your feelings as to what kind of risk would be

prudent. Taking big chances can be healthy and fun when

you are coming into the business without any emotional

negativity. If you carry emotionally negative baggage,

taking smaller steps can be healthy and fun as well. Your

past successes will materialize again, just as your tendency

for failure will materialize.

In the end, it is your emotions and your fear of

risk that controls the whole picture. If you have spent

your life visualizing your success, you will eventu-

ally be successful, but at what price? Taking on debt is

not about dollars and cents. It is about the danger of

unbalancing the equilibrium of your daily emotionally

comfortable routine in an effort to materialize a fantasy

of yourself that you are familiar with but may not be

practical in the long-run.

and money has flowed past

the health care professionals

whose services might deliver

the greatest return of all. I’m

not saying dentists are going

broke, or that there are too

many of you. Nevertheless,

I’m struck again and again

by the absence from both

the patient side and the

professional side of a big,

factual, splendid declaration

of the dental profession’s real

purposes and real signifi-

cance, a statement so simple

and truthful that nobody

can deny it or get it wrong.

I was surprised

recently when I opened

a best-selling anthology

about healers and healing.

It contained contribu-

tions by M.D.s and Ph.D.s,

counselors, several different

kinds of mainstream and

alternative providers, but

none—none—by dentists.

Not a word. How is that

possible? Were the editors

suggesting that you don’t

have a place among such

company, that you aren’t

“healers,” while metaphy-

sicians are? Is the dental

profession suggesting that?

Maybe the editors were

asking, “What do dentists

have to do with the health

care crisis in America?” I’d

hate to think that dentists

are asking it too.

There’s that gap again

between the need and the

solution. Frankly, I don’t

care who’s responsible for

it, but one way or another,

it needs to be bridged.

Whatever is standing in our

way needs to be over-

come by us both, together,

because our goals here are

the same and our effective

collaboration is essential.

What an opportunity

you have! Great dentists

perform wonders for their

patients. Many of you hesi-

tate to believe that, it seems,

but I know you understand

what I’m saying. I’ve spoken

with dentists who were so

moved by the effects of their

own work they were almost

reluctant to talk about it.

They didn’t want to seem

full of themselves, or unpro-

fessional, I guess. From

their modest perspective,

they just fixed a problem.

But the patient who rose

from that chair, even after

a brief course of treatment,

was a different person, with

a different outlook on life,

with new hopes and possi-

bilities, with courage and

hope they’d never felt. That

patient had been looking for

that smile, or that relief from

inexplicable pain, or the

simple ability to eat comfort-

ably, for their whole lives,

and they found it in a matter

of hours, in a place that once

made them afraid, with a

person they once avoided.

Miraculous, I’d say.

It’s a humbling thing,

I guess, to be told that you

have miracles waiting to

happen in your fingers,

but please, don’t argue

with me about this. I’m not

flattering you, and I’m not

exaggerating. It’s simply

true. I need you to believe it

every day. Your training and

technology have never been

better. My understanding

of what great dentistry can

do for me has never been

greater. We’ve never needed

each other more, nor ever

have we been able to do

so much practical good

for one another. So if the

billions of dollars patients

are spending in pursuit

of miracles aren’t going at

least in part to every dentist

in the nation, we’re both

squandering an opportunity.

What an opportunity

we have! I want our collabo-

ration to reach that level

where my highest hopes

meet with the best of your

abilities. That’s why it‘s

important for me to be as

candid with you as I was

with him. For your good and

my own, I need you to think

again about who dentists are,

about what you do and why

you do it. And I need to offer

you some thoughts from the

person in your chair.

5M’s of a Successful PracticeFREE Download

www.thenewdentist.net/5M



While today’s economic environment is

certainly challenging, there are still a

number of financing options available

for dentists transitioning to ownership.

Whether you’re purchasing an existing dental practice or

starting up a practice in a lease space, you most likely need

financing that gives you maximum flexibility and resources

to meet your immediate needs and ensure long-term

success. But prior to starting the loan process, you’ll want

to know the financing options available to you and the

answers to questions you’ll get from the lender.

Loan options are based on the type of project you

pursue. If you are purchasing a practice or starting a

practice in a lease space, your loan is considered Practice

Financing and can be structured as either a conventional

practice loan or Small Business Administration (SBA) loan.

conventionaL Practice LoanS A conventional practice loan is typically financed over

five-to-10 years, and can range from variable and fixed-rate

loan packages with standard repayment terms and possible

down payment requirements, to customized fixed-rate

loans with up to 100% financing and flexible terms.

Conventional practice term loans are often used for

practice acquisitions and start-ups in lease spaces. These

offer a number of advantages to new business borrowers:

• Lowerfeesandlesspaperwork.

• Flexibleandcustomizedrepaymentplans.

• Upto100%financingoptionsavailable.

• Quickturnaround.

• Lendersmayacceptthebusinessandbusinessassets

as collateral rather than personal property and

personal assets.

But conventional loans have their disadvantages as well,

particularly if you’re not working with a specialty lender.

• Conventionalloansthroughalocalorregionalbank

can require a larger down payment.

• Loanscanbebasedonexistingassetsratherthan

future performance, making it difficult for new busi-

ness start-ups to obtain financing.

• Theremaybelimitedcreativerepaymentoptionsfor

borrowers with special circumstances.

SBa Practice LoanSSBA Practice loans are term loans obtained through a bank

or commercial lending institution and guaranteed by the

Small Business Administration.

SBA practice loans are typically financed over seven to 10

years, with SBA lenders offering 85% to 90% financing. The

loan typically commands a 2% to 4% SBA guaranty fee and

other closing costs, most of which can be financed into the

loan. However, as part of the 2009 Economic Stimulus Package

for Your Practice Purchase

FINANCING OPTIONS


BY KEITh MErKLIN AND JIM BAUM

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Studio: 510.749.0054 Fax: 866.646.9477 Email: [email protected]

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Ready to Own a Practice? Unsure Where to Start?

• Custom financing to meet your needs• Planning tools to manage your progress• Practice expertise to support your success

Let Matsco guide you from plan to success!

Contact us today for your complimentary practice transitions newsletter: www.matsco.com/DQ209TND

Matsco is the only practice lender selected especially for ADA® members and endorsed by ADA Business Resources.

ADA® is a registered trademark of the American Dental Association. ADA Business ResourcesSM is a service mark of the American Dental Association. ADA Business Resources is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association.

©2009 Wells Fargo Bank N.A. All rights reserved. Matsco is a registered trademark of Wells Fargo Bank N.A.

All practice financing is subject to credit approval.

If you have immediate financing needs, call your Financing Officer at 888.937.2321

T:8.125 in

T:10.875 in


signed by President Barack Obama, many of these fees have

been temporarily reduced or even eliminated for certain loan

programs, making SBA financing even more attractive.

SBA practice loans offer some key advantages over

conventional practice loans:

• Alowervariablerateoption.

• Noprepaymentpenalties.

• Moreflexiblecreditunderwriting

guidelines.

But SBA practice loans also have their

limitations:

• SBAloansalmostalwaysrequireat

least a 10% down payment.

• Theloanfeesandclosingcosts

traditionally range from 2-4%

depending on the size of the loan.

However, due to the 2009 Economic

Stimulus Plan, many of these fees have

been temporarily waived.

• Theloanprogrammayrequirepersonal

assets and property as collateral.

• Theloanstypicallyrequiremore

paperwork.

Be PrePared for Lender QueStionSTo ensure the loan process goes well, be

prepared to answer these five basic questions

that all lenders ask potential borrowers:

How much money will you need? The

lender needs to know the precise amount of funding that

you need for your project, which means you’ll need to do

your homework in advance by obtaining estimates for your

practice purchase or start-up.

How will you use the money you will borrow? For a

practice acquisition, be prepared to provide the negotiated

purchase price plus the working capital needed. For start-up

or expansion projects, lenders will be looking for detailed costs

for the project with a specific amount for working capital,

equipment, construction costs, as well as a contingency fee.

How will you pay back your lender? Provide a busi-

ness plan with a detailed pro forma that shows your monthly

cash flow and ability to make payments to the bank.

When can you start to make payments on your loan?

You may want to request a graduated payment plan where

the size of your payment gradually increases over time as

your business becomes established and grows. Be sure you’re

provided with a specific timetable showing exactly when and

how much you will be paying month-by-month.

What will you do if you experience a revenue or

income shortfall? It’s critical to be prepared with

an alternative plan. This could either be cutting

expenses, working outside your practice,

or tapping into working capital, lines of

credit, or personal savings.

advantageS of uSing a SPeciaLized Lender

Using a specialized health care lender

for your practice acquisition, start-up, or

expansion saves you both time and money.

Unlike most local banks, a specialized

lender can combine your practice, equip-

ment or property purchases into one loan

package, providing a streamlined process

with one credit application, one set of fees

and one closing. A specialized lender can

also provide a broader range of loan options,

from short-term fixed rate loans to low

variable rate mortgages. Many specialized

lenders also use a consultative approach and

can provide additional resources to help

make the process easier.

Even in a tight economic environment

like we’re experiencing today, you can still

obtain the funds you need to make the transition to new

practice ownership. With a little homework and prepara-

tion, you’ll be well on your way to obtaining the funds that

will help get your dental practice off the ground!

Want to learn more? Visit www.matsco.com/

dentalstrategies to read the full article on “Financing

Options for Practice and Real Estate Purchases.”

Even in a tight economic

environment like we’re experiencing today, you can still obtain the funds you need to make

the transition to new practice

ownership.

Financing Optionscontinued from page 28

Keith Merklin has been a commercial lending officer for 10 years and is currently Director of Commercial Real Estate Financing for Matsco. He can be reached at 510.450.3230 or [email protected].

Jim Baum, Mid-Atlantic Regional Manager for Matsco, helps den-tists nationwide finance their practice acquisitions and start-up projects. Jim also speaks at seminars and dental schools through-out the year. He can be reached at: 800.897.2208 or [email protected].


Top 10 Steps for Associatecontinued from page 21

9. Request an Experienced Assistant

Chances are that you have not had the opportunity to

spend many hours with a chair side dental assistant in

dental school or sometimes in a residency program. It

is critical for you to work with an experienced assistant,

particularly during the first three-to-six months of your

employment. You can learn a great deal from an expe-

rienced assistant. Learning clinical routines, instrument

transfer, as well as practice record keeping protocol are

all important to your success.

10. Marketing, Marketing, Marketing

It goes without saying that if you join a busy practice, you

may believe there will always be an infinite supply of patients.

We often find that the new associate fails to engage in any

meaningful marketing activities. To avoid this problem, get

involved in activities that can generate new patient refer-

rals. Whether it’s coaching sports teams, joining community

service clubs, or participating in church and civic activities,

these opportunities place you in a position to meet many new

people who may become future patients as well as increase

your profile in the community.

In summary, there are many practical tasks you can

accomplish, particularly in the early stages of your employ-

ment. There is usually extra down time for you to follow

these ten steps, so become a proactive participant and the

outcome will be a successful associateship!

6. Schedule Weekly Meetings

It is important for the employer to serve as your “mentor,”

particularly during the first six-to-12-months of your affili-

ation. This frequent communication can prevent problems

from occurring, particularly in the early phase of your

employment. These meetings should be scheduled for one

hour and the topics of discussion should include treatment

planning, case presentations, challenging cases, and sched-

uling problems.

7. Schedule Monthly Meetings

Monthly meetings should be held to review the business

aspects of the practice. You should review your production

reports, collection reports, accounts receivable reports (if

applicable) as well as other reports that may be relevant. The

employer gets the opportunity here to begin coaching you

in developing analytical skills that are needed to become a

successful manager.

8. Get to Know your Practice’s Software Program

We recommend that you become familiar with various

features so that you are able to run specific management

reports, understand scheduling, etc. Developing this skill

becomes more important if you assume ownership or

become a partner. This allows you to become more involved

in the overall management process of the practice. For

example, running a detailed production report shows you

how you are spending your time in various clinical areas.

Running an incomplete dentistry report may give you

insight into how successful you have been with your case

presentation skills.

Now at The New Dentist Website!Visit Our Library of Downloadable

Articles Now!www.thenewdentist.net/library


The difference between “I think”

and “I know”

1.877.777.6151 | [email protected]

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Magazine

Strengths and Weaknessescontinued from page 22

term solution. But they cannot say “No” to staff who

request raises, bonuses, and other special perks that

send overhead skyward.

It is essential that you understand not only your

own temperament type but your staff’s as well. Moreover,

certain personality types are not suited for some dental

office positions. In other words, Emily may be great with

people and absolutely horrible at collecting payments.

Placing staff in positions that they are not suited for can

result in high accounts receivable, holes in the schedule,

poor patient retention, ineffective recall systems, poor

case acceptance, and low hygiene production, to name

just a few.

Understanding your temperament type and the types

of your employees is crucial for practice success. One of

the best books on the subject is Please Understand Me,

by David Keirsey. Making the effort to better understand

yourself, as well as those you work with, will save you

and your team many wasted hours dealing with conflict,

anger, and reduced productivity in the years to come.

$15 savings applies to all ADA products. Use priority code 78930ND to receive savings. Offer expires 12/31/09. May not be combined with any other offers, discounts or promotions.

Gain indispensable resources for helping you build a thriving and professional dental practice. Order now to SAVE $15 on orders of $75 or more.

Learn proven methods for developing and

expanding your practice. Gather tips for ensuring

practice transitions go smoothly. And implement

tools and suggestions for working efficiently

with third-party payers and complying with

regulatory standards.

Visit adacatalog.org or call 800.947.4746

for the tools you need to succeed.

Order now and SAVE $15 on orders of $75 or more.Includes all ADA products. Use priority code 78930ND.

Profit From theBusiness Expertiseof the ADA

#1 web site for New Dentists

www.thenewdentist.net

TM

[email protected]

Dr. Josh Austin • Clinical DirectorGraduate 2006 and Practice Owner

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