ADAPT Blog

I was recently on the Best Practices Show podcast with Kirk Behrendt. We had a great conversation about how to avoid unwanted surprises during the dental practice transition process. Listen in to our conversation or read on for some key points.

What to do before the letter of intent

The best way to avoid surprises is to do your homework.

Dr. Albert has expensive tastes. He always has the latest gadgets, eats at the best restaurants, and drives a shiny new car.

So when it came time to buy a practice, Dr. Albert sought out the best practice money could buy. He borrowed the maximum amount his bank would lend to buy a beautifully outfitted 8-op practice with brand-new, top-of-the-line equipment. Located in a fashionable district of a major city, the seller had built a great reputation by treating many celebrities, including actors and TV personalities.  

A year in, Dr. Albert felt like he was failing miserably. The seller had built the practice on highly complex procedures. With his three years of experience, Dr. Albert had the desire to perform these procedures, yet lacked the education and speed that come with decades of experience. Also, since he had never managed a staff before, he ended up micromanaging his auxiliaries who were used to more autonomy. Two of them quit to take positions with his biggest competitor while a third demanded a significant raise.   

A long-time associate had stayed with the practice, but she was busy with her own patients and did not want to add any more. To keep up, Dr. Albert felt he needed a second associate, but he couldn’t find someone with the right skills willing to work part time. He rarely took days off. Even when the practice was closed, he was busy preparing for his next patients or trying to solve staffing issues. 

His patients — who were also used to the very best in life — weren’t happy. Appointments constantly ran late and took longer than they had under the seller. When the long-term hygienists left, several patients followed and left negative reviews online. And he noticed that referrals were down.

Dentistry offers so many possible career paths. You can practice nearly anywhere, in offices of all sizes and configurations. Do a little bit of everything or master a specialty. Work with toddlers or senior citizens. Choose public health, the military, research, academia, organized dentistry — the possibilities are truly endless.

No matter your path after dental school, I’ve landed on five things that dentists need for a successful, satisfying career.

Whether retirement is imminent or still just a dream, if you are a practice owner, it’s time to begin thinking about how you’ll eventually transition your practice. After all, sometimes life happens and you must accelerate your plans — which is much easier if you have thought about your desires in the first place!

Ultimately, your practice is worth what someone will pay for it and, most often, what a bank will underwrite a loan for. You know how great your practice is, but how do you get other dentists to see and understand how fabulous it really is? In many cases, the best place to begin is by looking at your practice through a buyer’s eyes. You want to identify, and then highlight,  what might inspire them to make an offer. 

Keep in mind that all buyers want the same thing: a financially sound practice where they can do the type of dentistry that excites them and keeps them engaged. No matter where you are in your timeline, you can start taking some steps to prepare yourself and your practice to shine for an eventual sale.

Every day, I talk to practice owners looking for a new dentist to join their practice. These owners are universally focused on finding the person who will take good care of their patients.

But beyond that, their requests vary — a lot. Some want a confident, independent dentist who can take on every aspect of general dentistry without any oversight. Others are enthusiastic about mentoring an early-career dentist to watch them grow. Some want a personable, chatty colleague to discuss cases with, while others want someone who can work solo so the practice can expand hours.

When owners join ADA Practice Transitions (ADAPT) to find a buyer or associate, they fill out a detailed profile about their goals, expectations, and needs. We ask what they’ve learned from prior hires and what they hope to find. 

We recently analyzed that data to see which attributes stand out. While answers were all over the place, several key themes emerged. 

Dr. Gabe Holdwick has learned he would rather be from a place rather than just live in a place. The difference may seem subtle, but it makes for a more satisfying career and lifestyle.

Dr. Holdwick grew up in Harbor Beach, Michigan, a town of 1,700 people perched on the shores of Lake Huron. His family has lived in town for five generations, over 175 years. 

He knew that dentistry would give him options to take his career anywhere — but he also hoped to return to Harbor Beach to enjoy the lifestyle and practice “geographic arbitrage.”

Ask Dr. Kala Foster about the advantages of working in a small-town dental practice, and she rattles off a long list: doing dentistry her way, appreciative patients, great work-life balance, a fantastic place to raise a family, and all the benefits of practice ownership. 

Dr. Foster lives in Gaylord, Michigan, the center of what is known as Michigan’s “Vacationland” lake region. With 3,600 residents, Gaylord is the “big town” in the area, drawing vacationers from all over the state while serving as the region’s economic hub. 

After living in metropolitan Detroit, Dr. Foster moved to Gaylord three years ago. Since then, she has built a great life in her new home. 

“We can do ‘vacation stuff’ in the evenings. Boating, snowmobiling, everything’s right here,” she says. “I always have 3-day weekends.” 

In this week's profile of rural dentists building amazing careers, Dr. Sara Stuefen shows us how she enjoys the best of both worlds: a rural practice and an urban lifestyle.

As a member of the ADA’s New Dentist Committee, Dr. Stuefen often spoke to dental students who assume they need to practice in an urban area to live the type of life they want. But she’s quick to point out, “When you graduate, you don’t know what practice style is right for you until you try. There are so many great opportunities in small towns, and you can afford to have the latest technology!”

She also dispels a common misconception: “Rural doesn’t have to mean four hours to the nearest Target. Besides, you can order everything online these days.”

After graduating from the University of Iowa, Dr. Stuefen wanted to work in a small town where she could know her patients and make a difference. “I know I flourish in a smaller environment,” she says. “I like feeling connected to my patients and being able to rely on myself.”

However, her engineer husband needed to be in a more urban area to find a job. (This was a decade before the COVID-19 pandemic forced many businesses to realize how many jobs can actually be done from home.)

So they compromised: Dr. Stuefen bought a practice in Vinton, Iowa (population 4,900) and the couple moved to Cedar Rapids (with 132,000 people), just 40 minutes away.

It’s turned out to be the perfect fit for all their needs.

Dr. Jenna Hatfield never thought she would end up back in the small town where she grew up. After all, Norfolk, Nebraska has just 24,000 people. However, after dental school in Lincoln, Nebraska (population 283,000), Dr. Hatfield and her husband realized that Lincoln didn’t feel like the right place to raise a family. 

By chance, Dr. Hatfield heard that her childhood dentist in Norfolk was trying to figure out his exit strategy. The timing was perfect: she came in as his associate, then bought out the practice two years ago. 

Today, she’s built an ideal life in Norfolk. She does the type of dentistry she loves, makes a difference in her community, and has the flexibility to care for her family and children. 

“I never thought I’d end up back in Norfolk, but it just felt right,” she says.

Most dental practice buyers want the same thing: a financially sound practice where they can do the type of dentistry that excites them and keeps them engaged.

However, as they go through the process of considering potential practices, I see many would-be buyers turn down practices that could be a great fit. 

Often, it comes down to a single factor: location. Many buyers assume that they can only have the lifestyle and practice they want in a big urban center or its immediate suburbs. The reality is different, however. While they may find a great practice in a city, it can come with costs: a higher price tag, tougher competition, more expensive housing, and a more hectic lifestyle.  

Over the past several months, we’ve been speaking with some very successful dentists, including several on the ADA’s New Dentist Committee. Each of these dentists has built a satisfying, lucrative career — beyond the big city. Each has also attained a comfortable work-life balance. They practice dentistry the way they want to while living a lifestyle with plenty of time for family, community, travel, and other interests.