New Practice

When we initially think about breaking away and starting our own practice, the thought can be quite overwhelming and scary.

We don't know where to start and we don't know what to do. Everyone you talk to has different advice

, such as:

When we finally get our practice up and running, the situation becomes even more challenging. The enthusiasm of beginning something new is replaced with anxiety and stress.

Every day we try something new, whether we read about it in an article or hear it from a colleague. We spend money on lunch meetings, advertising, marketing, design, and other business needs, but it seems as though none of these things work.

In $499 New Patient Solutions for Dentists, Order TODAY! we believe in doing things right from the start. Although this program is designed for all practitioners, it is extremely helpful for new or young practices.

Simply follow all the steps in the program to setup your practice, and you will quickly move into a position to achieve your goals. When you use this program regularly, within months you will have the benefit of accomplishing what otherwise would take years to develop.

How to Use This Program

You may think you should wait until you have enough patients to start using the analyzing tools in this program, but the truth is the exact opposite. Since you may not be very busy at this point, you have an advantage over other doctors who lack the time to spend on improvements.

You should begin running the "Office Performance Test" with your first patient. Remember, this is the time to gear for success. You want to detect any problems before you have even started making money or establishing a patient base.

Everything you have read, as well as what you will see later in different sections of the program will apply to your practice too. Do not classify yourself as "not being at that point yet."

You want to master the program by the time you start seeing your first patients; once you do, you will realize how your new image can accelerate your practice’s growth. A patient recommendation by word of mouth goes a long way.

Image Is Everything

The biggest challenge for most new or young practices is dealing with the image issue. We are probably talking about young dentists who lack self confidence in themselves and/or their clinical skills. Staff members and patients alike can easily sense these doubts and insecurities.

When you walk into such an office you can almost smell the newness, like you would a brand new car. One way or another, every patient who comes in finds out that the doctor has just started or that the practice is new. This often leads to some automatic assumptions that are not always positive.

As you first begin building your practice, your role in creating a positive image is extremely important. The rule is to avoid anything that gives your patients of the impression that you lack experience, are a new dentist/office, or are unreliable.

To look at this issue in even more depth, let’s go over some important areas, as well as some very common mistakes made by young practices.

This is one question that really puts us in a dilemma when we are thinking about starting our own practice. It is probably an area you have researched a lot, so I am only going to discuss the issues that are commonly overlooked when making this decision.

Let's quickly review the advantages and disadvantages of each option:

New practice

Existing practice

Advantages

Easier to find
Easier to setup 'your way'
Costs less
Enough time to build the practice and learn new systems at the same time
Ability to train your own staff
Smaller debt to start with
Patients are coming for you not someone else
Equipment is new
Furniture and tenant improvements are new

Immediate income
A system is already in place
Staff is already trained
No need for heavy marketing
Can use the experiences of the existing staff or selling doctor
Insurances are already activated

Disadvantages

No income to start with
Insurances take a while to be activated
No routine is setup for the office

The system in place may be deficient
Bad habits of the staff are difficult to change
Patients are not used to the new doctor and his approach
Office equipment, furniture and dental instruments may be worn/outdated
Immediate large debt is assumed from the beginning

When you are ready to make your decision, the most important question you should answer is the following:

"How much more do I have to make in an existing practice to pay for the difference in cost of purchasing a practice as opposed to starting from scratch?"

Look at the example about my (hypothetical) practice I have rounded the numbers for easier illustration:

How much more do I have to produce in the existing practice to be able to pay off this difference in Five years?

As you can see the difference in the investment is $350,000, which means an additional $70,000 annual payment for five years. If we take a five year loan with an average interest rate of 8%, the total extra payment after five years is going to be $420,000, out of which $70,000 is interest (or $14,000 per year in interest accrual).

In this case I am going to assume that after five years, the new practice will have reached the production level of the existing practice. Let's calculate now:

If in the existing practice you make $330,000 more in annual production, you will have an extra net income of around $110,000 (overhead of 66%), which after taxes leaves you with around $70,000 to pay off your loan (as you know, the principal of the loan is not immediately deductible).

In other words, approximately $300,000 of your annual production will go toward paying off the existing practice loan! This means that even if you make an average of $300,000 more in the existing practice in the first five years you are not taking anything more home because this is the cost of paying off the difference. Also, remember that you have done $300,000 more worth of dental work each year, which is a lot of work!

Although we used ballpark numbers in the above example, below you can see a more accurate calculation based on some average assumptions. You can rewrite the table with your own data to calculate your own scenario. Just remember these two important factors:

1. Don't forget to count the amount of extra work you will be doing in the existing office to produce the assumed additional income.

2. Take into consideration the fact that there is a higher chance of success with existing practices.

Starting from scratch or buying an existing practice? Check our financial comparison table
	New Practice (Estimated)	Existing practice (Assumed fixed for easier calculation)
1st year collection	$100,000	$500,000
2nd year collection	$200,000	$500,000
3rd year collection	$300,000	$500,000
4th year collection	$400,000	$500,000
5th year collection	$500,000	$500,000
Total collection for 5 years	$1,500,000	$2,500,000
Total net income (65% overhead)	$520,000	$875,000
Total debt (primary investment)	$150,000	$500,000
Total debt paid after 5 years (8% interest)	$186,000	$600,000
Amount remaining after payment of debt (actual net income)	$334,000	$275,000
Numbers are kept simple and rounded for better understanding.
As you can see in this scenario the doctor who chooses to start his/her practice from scratch will make more money, and will ultimately do less dental work. We often confuse the production number with actual income, forgetting to deduct the costs from it. Obviously you have to be able to meet the production levels assumed for the new practice, but I am sure you consider these figures rather feasible.

This calculation method gives you a guide to closely compare the financial advantages of each option, and will assist you in making a better decision.

Are you setting up your practice to be open only a few days a week?

This decision is one of the most common mistakes made by a lot of new dentists and is often done so because it seems to make sense. You don't yet have enough patients to dedicate all your time to, which in turn gives you more time to develop your new practice. You also have to work somewhere else to pay the cost of the new practice. So, it makes sense to start off working only few days a week, then add days as you build up the practice, right?

Wrong!

I have no objection to the fact that you can't spend all your working hours in your new office. However, not being available a few days of the week will hinder your progress significantly, especially when your staff must tell patients, "Because we are a new office, the doctor is only in on Mondays and Wednesdays!" Scheduling conflicts are common, particularly with patients who work full-time or who live out of the area.

Remember, we are supposed to create an image of being a reliable practice; how can you be considered reliable if you are not even there half the time? How will you be considered a confident practitioner when people think you are not confident enough to take on a full patient load?

The solution is not to quit all your other jobs and work full time in an empty office. What we suggest is this:

Try to be available in your new office every day, for at least part of the day, only a few hours will do. What you want to do is give your staff members, who communicate with all potential and existing patients, a chance to tell them that you are in your office everyday. Now, if you are not there at the exact hour patients want, your staff should tell them, "Oh, I’m sorry, I don't have any openings (appointments) available at that time. How about 2 PM instead?” They should avoid saying things like, "The doctor is only here on Tuesdays and Thursdays," or "The doctor is only here after 2 PM…"

The objective is to give people the impression that your practice is already up and running full-time, and is a place where the doctor is busy enough to show up every day.

You should be able to arrange your schedule so that you are in your office around half a day, every day. This is equivalent to working 2.5 days a week, which is the amount of time most new dentists allocate to their new offices anyways. By spreading this time throughout the entire week you'll enjoy many benefits, including the following:

You can check on your staff every day.
You won't lose emergency patients who are unable to wait for the specific day you are in the office.
You won't lose walk-in patients (especially if you are located in a shopping center).
Most importantly, you are essentially devoting a full-time schedule to your new practice, which is imperative to your success.

I always encourage any dentist who wants to take on part-time associates. it allows you to not only gain more exposure to different doctors’ management styles, but to enjoy flexibility; both are valuable assets in starting your own practice.

Don't Advertise the Fact That You Are New!

I am personally opposed to promotional ideas such as "Grand Opening" or "New Office Opening," etc. I believe that marketing dentistry is not like advertising a restaurant. It is not just about convenience, and it is not about experiencing something new and different. When a new restaurant opens people are curious to check it out; this is not the case with dentistry. People looking for a doctor want to find a someone who is reliable, compassionate, experienced, and who uses the latest in dental technology.

Therefore, advertising the fact that you are new and inexperienced does not help you!

So, forget the "extra exposure" you think you'll get by using "Grand Openings" and so on. Do your advertisements but leave out the fact that you are a new practice! Talk about your up-to-date technology, or your experience in different fields of dentistry, or how you emphasize patient comfort. Avoid even mentioning the fact that you are new.

When patients call or visit your office, you and your staff should be very careful not to bring up the "newness" of your practice in your conversations.

Even worse, do not use the fact that you just started as an excuse for not providing a service you are supposed to! For example:

"We just started here so we don't have our x-ray machines yet!"
"This is our first month here so we are still waiting for our new whitening system."
"We just opened last month so I'm not sure how to give you accurate directions from there!"

Look like you belong where you are. You are comfortable, confident, and seemingly well established. Act as though you have had the office for years, not days! Remember, it is all about your image. If in a conversation or any other circumstance you absolutely have to tell a patient that you are new, the term "new location" would be your best choice of words.

Dealing With the New Staff

This is a very difficult area for any new practitioner, let alone one who is starting his own practice. One mistake often made is hiring the first person that comes through the door. Another common error is talking to the new/potential staff about how you don't know what to do and need an experienced staff member to help you run the practice.

As you have seen and will see in other sections of $499 New Patient Solutions for Dentists, Order TODAY! , it is imperative you convey a good image to your staff. Regardless of what they are supposed to say to your patients, if your personnel do not trust you their lack of confidence will show, whether it's directly or indirectly apparent.

So, the first group you need to create a good impression for your staff. They must have 100% confidence in your clinical skills, your ethical values, and in your ability to be successful. The worst thing you can do is share your weaknesses with your staff, looking for sympathy or help from them.

It is vital that you have the upper hand. After reviewing the $499 New Patient Solutions for Dentists, Order TODAY! material you will know enough to carry on with the confidence of an experienced professional. You need to be the one who establishes the practice and should be the one who tells everyone what to do.

Visible nervousness is another problem that can be very harmful to your image. When we start a business it is natural to get stressed out, but listen carefully to this:

An important tool in managing your staff is holding on to your authority. What I mean is that you should be predictable and consistent when it comes to setting up your systems and formulating practice policies.

Often we see something new in an article or listen to advice from a friend, then rush out to implement a new policy in our office. We tell our staff that we want to do this new thing from now on. A few days later when that new policy doesn't work the way we expected, we come up with another one. Or we just don't enforce it, until finally everyone forgets that we implemented it in the first place.

By repeating this cycle we are telling our staff that we are inexperienced and inconsistent. We are teaching them that they don't have to really take what we tell them seriously, because there is a good chance that we will change our mind very soon. They will think that we are not determined to enforce new policies, and that they can simply ignore them and do things the way they like. Your orders will be taken lightly, because they know tomorrow there will be a new one to follow!

You now have a system that you can implement, one that has been proven to work by successful practitioners who started out right where you are now. Practitioners who started right where you are now. Therefore you too can be consistent. You can be reliable and in control, which is crucial for the long-term success of your practice. The trick is not to panic at any time and to stick to the plan.

How many staff members do you need?

It is true that in the beginning you may not need to have more than one person, but your decision goes back to the image issue. Although you don't have much work to give your staff to do, nothing is worse than a patient calling an office and getting the machine because your only staff member is at lunch, just when you desperately need that patient’s business. Or when a patient comes to your office for a procedure and you are alone in the back with no assistants, or when your front office comes back to help you, and of course, has to leave you whenever the phone rings!

I know you want to be careful with your expenses, but your main goal should be to create a great image. Do you have enough staff members to make your office look like an established practice, or do you look like a practice on the verge of bankruptcy?

Before you start your practice, you need to create a business plan regarding your goal and the resources you are going to use while moving towards that goal. Financial planning is a crucial part of this. You basically want to know, for example, that your goal is to break even in six months and you are planning to increase your production to half of your cost by the end of the third month.

It is always best to plan based on the worst-case scenario. If you end up doing better, good for you. But if for any reason you are unable to perform the way you expected, at least you are prepared. As a general rule, I don't think any dental office should take more than a year to at least break even. I did it in three months! Nevertheless, plan on the worst-case scenario.

If you are not moving towards your goal with a steady increase in your production, then you need to take a good look at how you are running your business. Panicking is not going to do the job. Have confidence in yourself, but respond to the practice performance indicators in a timely manner.

Another common mistake among practitioners starting a new business is that they spend too much time with their patients, as if they have nothing else to do. They think, "This way my patient is really going to be impressed and will like me and refer me other patients".

As you know, I am an aggressive advocate of spending time with patients as a marketing tool. But at the same time, image is everything. If you look like you have nothing else to do, the damage to your image will outweigh the benefits!

So, you need to find a suitable balance. Spend time with your patients, yet act as if two other patients are waiting for you! Never be misleading or less than truthful. However, "hanging around" your patients or going back and forth into the room just because you have the extra time does not look good.

In other sections of the software you will find a great deal of information on how to market your practice and how to control overhead, etc. The rules apply to all practitioners, whether you are a new practice or an established multimillion-dollar operation. Follow the recommendations and guidelines and stick to them; you will soon see the results.

New Practices and New Dentists

How to Use This Program

Image Is Everything

Are you setting up your practice to be open only a few days a week?

Don't Advertise the Fact That You Are New!

Dealing With the New Staff