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Transition Tale: How an Unexpected Ultimatum Led One Dentist to Fulfillment

Posted by Bree Simmers on 4/16/20 4:45 PM
Bree Simmers

Emily_Ishkanian_GraduationEmily Ishkanian, former chair of the ADA New Dentist Committee, joined a practice that turned out to be the wrong fit for her long-term goals. She shared her experience with ADA Practice Transitions. Read on for her story and 5 lessons for other dentists.

ADAPT: When you were in dental school, what did you imagine your dental career would look like?

Dr. Ishkanian: My great grandfathers were dentists and both owned their own practices. So, when I decided dentistry was my path, ownership was always a part of that dream: dental school, transition as an associate, and then purchase to practice general dentistry.


ADAPT: Describe your first job out of dental school. Did you discuss eventual ownership? What was your plan?

Dr. Iskhanian: In my final months of dental school, my mentor connected me with a dentist who had been in practice for over 30 years. He was looking for an associate and had expressed a desire to transition his practice within five years. At the time, I thought, “Could I have fallen into a better opportunity?” But hindsight is always 20/20 and looking back there were definitely things I would have done differently.

Coming out of dental school and finding a job isn’t always easy. Many employers want experience, but with looming student debt and other financial obligations, new graduates are desperate for a job.

Excited at this opportunity, I sat down with the owner during my interview. He again expressed his desire to transition the practice within the next five years. He wanted to sell the practice to someone who had gotten to know his patients and was willing to allow him to continue to practice dentistry as an associate one or two days a week as he desired. At the time, I expressed that I was looking for a mentor and someone willing to share their knowledge of the business side of dentistry in order to eventually venture into practice ownership. We both seemed to agree.

ADAPT: What went well at that first job? What did you like?

Dr. Ishkanian: I liked that I had the freedom to practice the way I wanted. I appreciated that I didn’t have someone micromanaging me. But as a new dentist, I yearned for learning opportunities that I had to seek outside of the practice.

ADAPT: What didn’t you like?

Dr. Ishkanian: As a new graduate, I began soaking up whatever knowledge I could. This was my opportunity to learn about ownership and dentistry with an expert. However, that opportunity never came. While I regularly brought up wanting to learn about the business aspect or discuss transitioning the practice, the owner always said he wasn’t ready, stressing that it was HIS practice and he would make all the decisions. So patiently, I waited. Three years turned to five and in a blink, I was an associate for nine years, staying because ownership was the proverbial dangling carrot.

I operated under the false pretense that our friendly agreement was my end game and his. My hope was that I would eventually own the practice after putting in my time. I just had to be patient long enough and endure the poor working relationship, lack of mentorship, and management challenges of the practice. After all, I had given nine years of my professional life to this practice and had trusted the owner’s goodwill.

ADAPT: How did the relationship with the practice owner change over time?

Dr. Ishkanian: Over time, my relationship with the practice owner went sour. He made it clear that he wouldn’t be mentoring me in the business aspects of dentistry, nor would he begin to prime staff and patients for a future transition. Eventually, it became a job that I endured rather than loved.

ADAPT: How did the practice evolve while you were there?

Dr. Ishkanian: The practice grew significantly while I was there. I was able to compare my schedule and production with the previous associate’s and knew that my contributions were benefiting the practice and ultimately the owner. I made contacts that increased my patient pool and brought new patients to the practice.

ADAPT: How did the relationship end? What happened?

Dr. Ishkanian: On a day I practiced alone, just as I was finishing treating patients and working to close down the office for the week, I received a call from the owner. He said, “I might have some good news for you. On my desk is an envelope with two documents:

1) a first right of refusal to purchase my practice and

2) the lease of my building.

And also, I have someone that wants to buy the practice and close soon, so if you don’t want to purchase, you are terminated in 30 days.”

I drove home with his envelope feeling shocked, angry, and betrayed. Why had he not chosen to negotiate with me alongside this potential buyer? Why weren’t we having these conversations in person? Why wasn’t I provided any of the financial documentation needed to value the practice?

The owner gave me two business days to make a major career decision that required an $800k monetary investment and a lease with an unspecified term. I was not able to do any due diligence and review historical financials to substantiate the purchase. Frankly, I was upset that his offer wasn’t genuine, which would have meant having a conversation with me while negotiating with the other party.

ADAPT: Where are you now? How is it different?

Emily_IshkanianDr. Ishkanian: I had been working one to two days a week for another dentist, a friend from dental school. He had been asking me to join their team for the last few years and I had never taken the leap.

Fortunately, I was already comfortable with the existing team, the office flow, the software, the systems. The office is beautiful and up to date and there are plenty of patients for two dentists to treat. Most importantly, I not only respect the owner, but I enjoy our time together as colleagues. He is a few years ahead and is always willing to show me new techniques or skills, something I highly value. For the first time, I really love practicing dentistry.

ADAPT: What’s next for your career?

Dr. Ishkanian: After ten years as an associate and dedicating a significant amount of time and energy to organized dentistry, I made the decision that at this time, ownership is not my priority. My husband and I welcomed our first child last December and I’m enjoying being a mom. I love the flexibility dentistry offers, and we are exploring working part time.

Thinking back on my ten years practicing dentistry, I thought that ownership would have been part of my story, but life leads you down different paths. I work on not being disappointed and upset at how things transpired and focus on the gifts that I have been given as a result of the outcome. I am debt free and have the schedule flexibility to spend time with my family.

ADAPT: What lessons would you share with other dentists?

Dr. Ishkanian:

  1. Use an unbiased third party like ADAPT to facilitate a transition.
  2. Get an initial practice valuation.
  3. Set a specific date in the contract when you will discuss the transition.
  4. Give the opportunity time to accomplish your goals – but if that doesn’t happen, move on and don’t get stuck!!! You didn’t go into dentistry and spend time, money, and energy for it to be just a job. Make sure, whatever your path, that you still love it because it fulfills you and allows you to grow and reach your aspirations.
  5. It’s ok for the dream to change over time.


Check out other posts in our Transition Tales & Truths series.

Ready to start your own dental practice transition? When you work with ADA Practice Transitions, you get a dedicated ADA Advisor who will help you think through your goals and find the practice where you can thrive. Start your profile today.

Topics: transition tales


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