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Message from my mentor

Message from my mentor:
One of the greatest influences in my professional experience was way back in the day, in the early 1990’s. At that time my 3 children were young, under the ages of 7, and my mental state was mostly a blur. My husband and I had purchased a dental practice in Raleigh/Durham, North Carolina which began the journey of discovery regarding dental practice management methods.

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From Dentist to Small-Business Owner: Tips and Options


You learn how to fill cavities and keep teeth clean and healthy in dentistry school. What you don’t learn is how to raise capital and manage business debt.

“That can make life after dentistry school challenging,” says Genaro Romo, who started his career in Chicago in the 1990s. He quickly realized that being a successful dentist meant being a successful small-business owner.

“We were trained to be dentists,” Romo tells NerdWallet. But “you need to know how to run a business.”

Choose your path: group practice or solo

After graduating from school, dentists essentially have three options. One is to join a practice as an associate and “work your way up,” Romo says. That’s what he did, and it was a successful strategy. He eventually struck out on his own, setting up his own practice; today, he has a 20-person office in Chicago.

There are two other major options:

  1. Build your practice from scratch. This can be exciting, but it’s expensive. A dentist launching a startup practice typically requests a loan in the range of $350,000 to $500,000, says Gavin Shea, a senior director of sales and marketing at Wells Fargo, where he’s worked with hundreds of dentists.

    Between 50% and 60% of the funds goes toward building out an office, which usually involves big investments related to specialized plumbing and electrical needs, he tells NerdWallet.The basic dentistry workspace is called an operatory. A fully equipped setup, which includes cabinetry, dental chair, lighting and digital X-ray equipment, can cost “anywhere from $25,000 to $50,000 for each operatory,” Shea says.

    The startup route can also be tricky; Romo notes the importance of having a clear business plan. Overspending based on a fuzzy growth strategy is a common mistake, he says, though he adds: “Make sure you have room for growth.”

    Some dentists are overly cautious with investment only to find that, as their business grows, “you have nowhere to go,” Romo says. “They maximize their space and they have to start over in a new location.”

    And just as with buying a home, location is key, Romo says. “You really need to do research,” he says. The key question: “Is there a need for a dentist in that location?”

  2. Buy an existing practice. Acquiring an existing practice, such as one owned by a dentist who’s about to retire, is a common route taken by new dentists. As with buying a house, it’s important to accurately appraise the value of the practice.It’s easy to make a mistake. For example, Romo says, “You could be buying an office that may not be as busy and the equipment is very outdated.”

    “Most independently owned dental practices will sell [for] between $500,000 and $750,000,” Shea says. A dentist requesting a loan usually also factors in “some short-term working capital to cover the first few months of ownership.”

Choose your financing: bank vs. alternative lender

While Wells Fargo declined to disclose interest rates related to dentistry practice financing, the financing it offers includes SBA-guaranteed loans, which typically carry low interest rates. An SBA loan is usually based on the current prime rate plus an additional markup rate, known as the spread, of 2.25% to 2.75%. At the current prime rate of 3.25%, a typical loan would charge 5.5% to 6% interest.

Bear in mind that the SBA has strict requirements and the application process can take months. But a traditional bank is not your only option; alternative lenders tout the speed of their application and approval processes, which may range from a few hours to a few days.

Some alternative lenders now also offer financing specifically for new dentists. However, interest rates are higher than those offered by banks. Check out the different small-business loans options on the NerdWallet Best Business Loans page.

At DealStruck, for example, a borrower could get a three- to four-year term loan to finance dental equipment at interest rates ranging from 12% to 18%, says Steve Freshour, the lender’s director of credit.

“These are fully amortizing term loans,” he says. “A standard 4% origination fee would be charged and netted from the loan proceeds.”

When making financial plans for a dental practice, “Everybody’s situation is different,” Romo says. But, he stresses, “You have to remember you’re investing in your practice.

“If you’re investing in technology, it builds stronger patient relationships,” he says. “It’s not a luxury. If everything works out, it’s probably paying for itself.”

Get help from the experts

Whether you start a brand-new dental practice or buy an existing business, Romo offers two key tips:

Find a financial advisor who specializes in dental practices

Some professionals specialize in giving dentists financing advice for starting or expanding a practice. “There are CPAs who specialize in dental offices,” Romo says. “There are dentists who also have accounting degrees” or other kinds of training that qualify them to offer guidance.

And the best way to find an advisor is through professional organizations of dentists. Which leads to tip No. 2:

Join professional associations

Romo urges new dentists to reach out to other dentists from the beginning. He did so by joining the Illinois Dental Society and the American Dental Association, and was so impressed with the ADA’s work that he became one of the organization’s spokespeople.

The ADA’s Center for Professional Success website offers information and tips for dentists, including a calculator for managing business debt. The California Dental Association has a practice support page with information and tips related to the business side of a dental practice.

Some dental associations also have relationships with banks. The ADA, for example, works with Wells Fargo, which has a practice finance page dedicated to serving the financing needs of dentists, optometrists, doctors and veterinarians. It offers information on key aspects of starting and growing a dental practice, including opening a new location and buying new equipment.

Source article: From Dentist to Small-Business Owner: Tips and Options 


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The importance of Cloud-Based Technology in your Modern Practice

Cloud Technology in your Modern Practice

The modern practice is a long way away from the old dental practices serving up massive paper files, heavy metal dental equipment, and impossibly hard to reach on the phone. The reason for deploying cloud-based technology services may vary from practice to practice, but the fact of the matter is, cloud computing is going to take on an even more important role (whatever it may be) in your practice in the near future.

According to a research conducted by In-Stat, the healthcare industry is expected to spend more than one billion dollars in public cloud computing services by the end of the year. What drives this spending? The need to remain mobile and to increase deployment of electronic health records are what differentiates the modern practice from your practice of the olden ages.

Is it time for your practice?

Chances are you’re already using the cloud in other aspects of your life. Whether it’s to send a simple email, online banking, or checking your Facebook account, you’re already in the cloud. The question is, are you ready to move your dental practice and dental lab with all of your secure patient information into this ever-lucent cloud?

Dental practices can benefit from cloud computing by using services that offer specialized management software to connect laboratories with their dentist clients. This makes them better equipped for more proper dental information exchanges. Sometimes this is highly necessary when transporting large, sensitive files.

In addition, you can’t compete with the convenience in the cloud. Information is instantly accessible anytime, anywhere, from any computer with sufficient bandwidth. No need to continue to be concerned with software compatibility, processing speed, or data storage capacity. If your practice is spread across multiple locations or your laboratory isn’t in the same building all the more reason it’s time for your practice to switch into the cloud instead of trying to compile everything into a single database and losing access each time.

The extra time and not to mention financial costs associated with your existing practice management system is not necessarily conducive to your modern practice. Think for a second about all of the hassles a typical dental office experiences with their IT people and client/server practice management system.

While many offices hire an IT professional to keep their computers and network running, there’s a constant need for upgrading the hardware and software. Cloud applications have the ability to remove any hassles, i.e. hardware glitches, data backup, server issues, and the need for upgrades. When you’ve freed up more time and budget on timely tasks dealing with your software equipment you’ll be surprised how much more time you have to spend on other matters that really will make a difference in your clinic.

Integration and Implementation

With cloud-based technologies, practices provide better patient services and gain financial control once again. Although each practice uses their own health records and financial systems, it’s still possible to impose a standard system with cloud-solutions. Since the cloud technology is scalable you can start out small and can scale as the practice takes off with relative ease and flexibility.

The data integration is hosted on your own computing platform making the integration easily scalable and with little capital investment. Many dental cloud platforms have built in imaging software allowing you to integrate with intra oral cameras and phosphor plate imaging systems as well.

To conclude, the cloud is ever so important today and will continue to play an important impact in the modern dental practice. When collaborating and exchanging 3D or 2D imaging data between laboratories and practices, or ensuring your practice’s management system is all on the same page, it’s essential the communication is accessible through the cloud.


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Reputational Management


If you find that you have some negative malicious reviews online what can you do? Actually it is easier to tell you what not to do.

Don’t Sue: As reported in the ADA News Dr. Yvonne Wong decided to file suit when she received a negative review on Yelp which she thought was false and unfair. The result Dr. Wong lost the suit, she has no legal recourse and to make it worse, much worse, she was ordered to pay over $80,000 in defendant’s legal fees.

Don’t Preempt: There are services that sell dentists and physicians contracts and patient forms that supposedly will prevent patients from posting negative online comments. These are of dubious legality and for at least one dentist who tried to use them it was an unmitigated disaster. Stacey Makhnevich a NY dentist has been sued by a patient for trying to enforce an agreement preventing patients from posting negative online comments. This set off a firestorm of online news and universal condemnation from the general public. None of it is good news for Dr. Makhenvich who it seems has been forced out of the profession by the bad publicity and legal complications.

Don’t Panic: As professionals our reputation is precious and we never want to see anything negative said about us. The conventional thinking is that negative comments need to be removed at all costs. On the other hand recent research indicates that a negative online review is not always bad. In the right situation it demonstrates that the reviews are legit, not just reviews from staff and family. Some negative seems to have a “blemishing effect” that actually makes the positive reviews more persuasive.

The only thing you can actually do is to overwhelm negative reviews with positive ones. However even with this tactic dentists face obstacles. For example if you appeal to your happy patients to write good reviews and several of them do some review sites choose to consider a flurry of new reviews to be somehow illegitimate and they will “filter” them out.

Reputational Management

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Prioritize Vendor Training for ROI

software ROI
Training from your software vendor is a crucial step to successful use and ROI on software investments. In my experience, many practices, especially small ones, think that they can read the manual and self-train and get the benefits of their software. However, many times dissatisfaction with software is actually a lack of training. Many practices don’t use all the relevant features, or use them wrongly, and therefore spend much more time and effort on tasks than needed.

When selecting software, asking around is a common method to figure out if software will work for you. Talking to other users, checking references and finding out about the user experience is valuable.  However, dentists need to recognize that few dental practices prioritize vendor training and make the most of it. Further, at any particular software vendor, there may be several trainers and there may have been changes/upgrades in software. Furthermore, practices that use a software may have purchased the wrong software or not allowed enough time for their own training.

In addition, training from a vendor is the first step in a two-way relationship. Establishing the importance of the software in daily work is necessary both internally to the practice and to create a channel of communication with the vendor. Ideally, a practice has selected the best software for their needs, and will use that software for years to come. To build a strong, ongoing relationship, practices need to treat vendor training as a mechanism for setting up communication channels, providing feedback and important information. The trainer often becomes the go-to person, the key link in the communication chain for practices to understand upgrades, communicate unique needs and problems, and receive important information from the vendor.

Using your software fully demands deep knowledge, and trainers can provide personalized information about the nuances and features. Communicate with the vendor and trainer; don’t suffer in silence, and don’t expect the vendor to read your mind.

In small and large practices, the organization must value the training and be committed—even if that is hard to do. Treat training as an obligation and an opportunity that you have paid for.

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