ADAPT Blog

If you own a practice, you’ll eventually need an exit strategy. And it’s wise to start thinking about your preferences long before you think you’ll need to sell. After all, sometimes life happens and forces you to act sooner. 

It can feel daunting to think about walking away from the practice you’ve spent decades building. How will your patients be cared for? What about your loyal staff? 

And what about YOU? What will you do during your retirement?

Relax. You have options — probably more than you realize! Retirement doesn’t always have to look like a 100% sale in which you hand over the keys and never look back. Today, many doctors are approaching their retirement as a years-long transition period during which they can do more of what they love — and leave behind the things they don’t prefer. That can take a lot of forms, including practicing part-time, teaching/mentoring, helping underserved populations, or making a fresh start in an entirely new-to-you practice. Your options are limited only by your imagination!

I recently joined Kelly Tanner on the Dental Handoff podcast. We spent a lot of time discussing why it’s so important to cultivate the type of practice that staff will WANT to stay in. 

After all, dentistry is about relationships. And if you want to build long-term relationships with your staff, you need to be the type of leader that inspires respect. 

So how can you “own the operatory” in a way that makes your practice a great place to work?

Kelly and I discussed this at length, including:

• Learning to “read the room,” or understand the non-verbal cues your staff (and patients!) are sending 
• Why great leaders should keep an open mind and encourage staff to share their ideas
• How to nurture the staff development that is vital to a strong, stable practice
• Ways to create an atmosphere where team members will strive to improve the practice — together

We also talked about how important it is to choose the right staff for your practice, whether you’re hiring an associate or auxiliary or looking for your successor. When you find someone who “meshes” with the staff and practice, you increase the likelihood of long-term satisfaction for all involved — doctors, staff, and patients. 

But success isn’t guaranteed when you find the right person; rather, you should also lay out an integration plan that will help the entire practice through the transition. A good integration plan will ensure that everyone is prepared so that the new team member feels confident treating patients from their very first day.  

Whew! Give yourself a great big pat on the back. The last four years have been TOUGH!

You may have passed your national boards and your requirements are almost complete. You feel as prepared as possible for your licensure exams — maybe you have even already passed them already!

Before you jump on that flight to the Caribbean, take some steps to ensure you are prepared for the next step in your career. For most new graduates, that will be some sort of clinical position, usually as an associate.

So how can you make that transition from student to professional as seamless as possible?

Step 1: Continue to improve your hand skills and speed

Many recent grads worry, “How am I going to increase my speed and justify my salary? Especially since I had to hand off all my patients to other students who need the requirements.”

Maybe you’ve found a practice that looks great on paper: the location, the salary, the number of operatories. 

How do you know it’s the practice where you can become the dentist you’ve always dreamed of being?

I hear of too many cases where dentists jump at the first associateship they’re offered, simply because the salary sounded right — then six, nine, or twelve months later they realize it’s just not a great fit. Maybe they’re working too many hours, or they’re doing nothing but prophys when they thought they would be learning implants.  

So how can you avoid this fate?

When you’re evaluating a practice, slow down and take the time to determine if it’s the right one for you. After all, you worked hard to get through undergrad and dental school. It’s worth a little extra effort now to make sure you’re choosing the right practice for your next step. 

I recently spoke with Rolando Mia of Empowered Dentistry about exactly this topic. Listen to our episode of the Dental Voice podcast or read on for some of the advice I shared. 

The last three years have been unlike anything you could have ever prepared for. From mandatory shut-downs to PPE shortages to the Great Resignation, your practice has weathered it all. Congratulations on making it through!

But now that things may have settled a bit, have you thought about how your practice is really doing?  

The end of the year is a great time to catch your breath and reflect on where your business is and where you want it to go. 

Let’s look at how to go about a comprehensive dental practice business review. 

As the Great Resignation reaches dentistry, it may exacerbate existing access-to-care problems — possibly leading to declining oral health, more dental emergencies, and even an increase in heart disease and other serious health problems. 

A July report by the ADA’s Health Policy Institute found that 74% of private practice dentists say that it is currently “extremely challenging” to recruit qualified dental hygienists, and another 19% say it is “very challenging.” Similarly, 84% of dentists say it is extremely or very challenging to recruit dental assistants. We recently looked at ways that practice owners can retain their knowledgeable staff who have built relationships with patients. 

However, dentistry is also seeing another side of the Great Resignation: many older dentists are accelerating their retirement plans.

At ADA Practice Transitions, we’re seeing another trend: young dentists are embracing the opportunity to step into established practices and take proactive steps to retain hardworking staff. In many cases, these dentists can tap into programs, such as the National Health Service Corps, that forgive student loans for dentists providing care in underserved communities. 

Dental school graduates know the pain of student loans all too well. The American Dental Education Association estimates that 2021 graduates were saddled with an average of $301,583 in loans. 

However, don’t let your dental school loans deter you from building the career you’ve always dreamed of! 

Whether you’re looking for that first associateship or striving for practice ownership, there are ways to pay off your loans on someone else’s dime. The federal government, states, and even local municipalities have created a host of programs that can ease the burden. Refinancing can help, too — as can a bit of creativity. 

Read on for some possible ways to cut your dental debt. 

Check the Public Service Loan Forgiveness Program

The U.S. Department of Education Public Service Loan Forgiveness Program is accepting applications through October 31, 2022 — so if you haven’t checked your own eligibility, take a minute to do so now! Even if you can only get $10-20K in forgiveness, it is worth taking the time to fill out the paperwork.

The Great Resignation has reached dentistry — especially as hygienists choose not to return to the profession. In fact, a study co-authored by the American Dental Hygienists’ Association and the American Dental Association found that the COVID-19 pandemic has resulted in a contraction of about 3.75% of all hygienists, representing a loss of approximately 7,500 hygienists nationwide. 

The result is a scramble for qualified staff. The ADA’s Health Policy Institute reported that as of July, 74% of private practice dentists say that it is now “extremely challenging” to recruit qualified dental hygienists, and another 19% say it is “very challenging.” Similarly, 84% of dentists say it is extremely or very challenging to recruit dental assistants. 

That’s why it’s essential that owner dentists take steps to retain their most valuable resource: long-tenured, knowledgeable staff who have built trust with patients. 

Why hygienists are leaving the workforce

When dental practices closed at the start of the COVID-19 pandemic, many staff were sent home. Even as practices began reopening, many of the 98% of practicing dental hygienists who are female found themselves juggling childcare challenges. Dental work has no “remote” option, and dental schedules inherently lack the flexibility to pivot when a child has to stay home unexpectedly due to a COVID exposure. 

As a result, many hygienists began to exit the profession entirely. An August 2021 study found that 74% of hygienists not working had left the profession for voluntary reasons. Of those, 37% say they decided to retire.  

Some of the remaining hygienists are leveraging the shortage to find jobs closer to home or negotiate for greater flexibility, higher pay, or better benefits. As of June 2022, 79.9% of practice owners had raised pay for their dental hygienists within the past year — with 18.1% reporting increasing wages by 10% or more.

If you’re a few years out from retirement, now is the time to start preparing your practice for an eventual sale. Taking the time to thoroughly prepare will streamline the transition for everyone, helping improve patient and staff retention. Careful preparation may even result in a higher valuation, as your practice will appear well cared-for and more organized.

And if the unexpected should happen and you’re forced to sell sooner than planned, you won’t be starting completely cold. 

Too often, people retire and then wonder, “Now what?” For years, work has shaped their days, months, and years. They plan vacations when things will be slow or schedule family events around their practice’s needs. 

When they retire, they have nothing but time — and no meaningful way to fill that time. Sometimes this can lead to depression or frustration.

So how do you avoid this trap?

Here are some ways to start cultivating your retirement lifestyle before you stop working.

(See also: How to Sell Now and Retire Later) 

Think — and talk — about your interests

Think about the things you enjoy doing, in every realm of your life. Travel, golf, woodworking, painting, spending time with your family. Is there a cause you wholeheartedly support that you wish you could spend more time with? Or maybe you’ve always dreamed of visiting every single national park. 

Talk to your spouse and family. What do they want to do with retirement? Your partner may remind you that you absolutely loved your annual summer trips to the lake, before life got too busy. Maybe it’s time to take another visit. You may even think about living there a few months of the year once you retire!