The Business of Dentistry

Attention graduates! Dental school is over, and now real life begins.

Years of study have helped prepare you to diagnose and treat clinical problems, relieve pain, and develop skills that expand your scope of practice. These are essential if you wish to deliver top quality dental care to your patients. Now you have decisions to make, dentistry to enjoy and potential challenges to consider and overcome. Hopefully this article will highlight some of the key issues that young dentists need to understand in the early stages of their careers.

The landscape for dentistry continues to change from solo practice to group practice to multiple clinics under corporate ownership. Consequently, there are great challenges new dentists must face upon graduation including a decision on your chosen career path and how to achieve that. Few dentists launch their careers by setting up and operating a new practice. This is not a criticism, it reflects a simple reality - dental school training leaves little time for lectures on practice management. 

If you are intending to operate a new practice, it’s important to understand a few key facts:

• Dentistry offers us the opportunity to help and care for our patients, providing a valuable service. However, a dental practice, like any other business, needs to be financially viable and to make a profit - without profit, a business does not survive.

• A dental practice operates by means of contracts and agreements. The terms contained in these documents dictate all the obligations of the parties involved.

• Outside of when you are seeing patients and performing dental procedures, you are both a clinician and a business person.

There are other challenges you will face as a new dentist in your life outside of work. Some of these are challenges faced by graduates in general, such as debt and lifestyle changes. There are also more specific challenges you will face as a new dentist in practice, including the following two:

• Money – Piled on top of student debt, a dentist who chooses to purchase an existing practice or to open a new office could spend one million dollars or more in the first year of operation. The numbers can be scary. Here’s an action plan:

  • Meet with an experienced accountant to set up a detailed financial plan, with a budget that includes capital, interest and operating expenses for the first 12 months.

  • With the plan in hand, meet with your bank manager to discuss financing. Do some homework and learn about current interest rates on commercial loans, and find out and compare what different banks can offer. Dentists are low-risk, highly desirable clients for banks – use this to your advantage.

  • Learn from your accountant about running your business - setting up a payroll, remitting taxes and managing the logistics of cash flow and expenses.

• Staff – There is enormous value in hiring and retaining outstanding staff. 

  • Patients take comfort in seeing familiar faces when visiting the dentist, and keeping your staff happy will build the practice. 

  • Take time interviewing, check references carefully and most of all pay your staff more than the going rate – it’s an investment with a valuable return. 

  • Remember to have contracts signed for all staff.

Since not all dentists wish to take the leap into private practice after graduation, the good news is that today there are several working options to consider: becoming an associate, either with a principal dentist or in a corporate practice; working in public health clinics or in remote service areas; or, possibly, returning to school for specialty training. 

If you choose to become an associate, be aware that handshake deals are finished – this is business, and it must be operated in a business-like way. Do not enter into any working relationship with another dentist without a written agreement – for which you will need legal advice. This is for your protection.

Everyday practice carries a heavier workload than you may have experienced in school, and it takes time to adjust to such pressure. Be aware of and plan to manage the many obstacles in your path to professional success. It also takes time to adjust to the pace. Set appointments initially with enough of a buffer to allow you to do the best work you can and without being rushed. Better to treat six patients carefully than 12 patients hastily – rushing leads to mistakes, re-treatment and unhappy outcomes. 

Perhaps most important, involve your life partner in every step of this process. You will be astonished how often a non-dentist can provide a fresh perspective and discover issues and solutions that never occurred to you.

Finally, be confident in yourself. Dentistry is a worthy, honorable profession that with your commitment will provide lifelong rewards.