Everything Dental Blog – January 2017

Dentists perform many duties, wear many hats and are responsible for just about everything that happens in the dental office. Being a dentist and small business owner is not easy work. It is one of

the toughest professions, both mentally and physically.

Much has been written about the clinical, business and leadership challenges dentist deal with on a daily basis but little has been written about their psyche. Dentists have clinical, financial and operational oversight at the office and a myriad of personal and family obligations at home.

For almost a decade, dentists have been bombarded with rising costs, regulatory mandates and a changing landscape. The proliferation of dental insurance and the competition from regional and national dental groups has changed the way dental care is marketed and delivered. Compound that with the urgency and cost to digitize the work place and it’s no wonder why the independent, solo dentists feel overwhelmed. It also explains why private equity and venture capital money is in vogue with the dental groups.

Below are several generalizations or characterizations about the psyche of some of the most accomplished dentists I know. Many of these people are mentors of mine and have taught me from their experiences and their mistakes. I am a better, husband, dad and business partner because of the wisdom they have shared with me. .


The Perfectionist – Stifled by the pursuit of clinical perfection instead of clinical excellence, these dentists fall short operationally. These dentists represent some of the best clinicians I know but many of them wish they made more money.

Living the Dream – Enjoying the benefits of a practice that is relevant to the community it serves and operates efficiently. These practices have an infrastructure and organizational structure. They run on time, emphasize prevention and have a strong re-care program. These dentists have an exit strategy in place (associate or partner) and have fully funded their retirement.

Burnt out and looking for relief – These dentists are frustrated and overwhelmed. Due to a lack of systems and delegation, these dentists are buried with management and administrative tasks. They are unhappy and feel overburdened because they have failed to build a competent team that executes and manages the day to day business. Other contributors to the burnout syndrome are control issues and financial pressure.

Highly competent entrepreneur – These dentists are driven and goal oriented. They have excellent clinical skills but are focused on the business side of dentistry. They operate with intensity and purpose. These entrepreneurs hold themselves and their employees accountable. Often times, they’ll drift away from wet handed dentistry because the operation and opportunity requires it.

Unwilling and unmotivated – These dentists refuse to adapt or invest in their business. In time, the facility gets outdated, the patient base shrinks, the staff turns over and the dentist fails to adequately fund their retirement. Many of these dentists still love their patients and dentistry but are not a fan of technology or change.

Conspiracy TheoristThese dentists believe they are at the mercy of high priced dental manufacturers, greedy insurance companies and intrusive government mandates. They don’t like change and are skeptical about the message and the messenger.

Dynamic and determined – Most young dentists are bright, energetic and focused on making a good future for themselves. They get their intel on the web and in dental discussion groups sponsored by firms that use SEM (search engine marketing) to attract them. Unfortunately and unintentionally, they build their media presence (especially social media), with sites and favorites created from their interests and likes. In essence, they are limiting their exposure because of web preferences. Overtime, these dynamos seek strategic relationship and alternative viewpoints expanding their bandwidth.

The reluctant performer – These dentists are the consummate procrastinators. They have good practices and good teams but won’t take the initiative or make the investment to make them great. These dentists are reluctant to add that operatory, hire that second hygienist, take on that associate or hire the consultant. In most cases their inaction is more of an emotional barrier than a financial one. They don’t want to add another layer of work or have to adjust to change. Eventually, they act and wonder why they waited so long!

The progressive senior dentistMany 50+ year old progressive dentists are hard workers and still enjoy dentistry. They embrace technology and love the benefits of digital imaging, CadCam and digital impression scanners. These dental pros are at peace with their stature and place in the dental community. They are done with their children’s college tuitions and own their home(s) in full or have a manageable mortgage. These doctors are focused on travel, leisure and their retirement planning.


Obviously, we can’t put dentists in a box. Most dentists fall into more than one of these characterizations and we all have a little bit of each of them in us. Dentists are as diverse as any other group. They are highly educated, logical and evidence based professionals. Unfortunately, doctors are operating in a rapidly changing marketplace with a great deal of uncertainty. The polarization in our politics and the pressures of operating a small business have created a sense of isolation and doubt.


This is not a case study

If you were to take a deep dive of my 149 clients, the statistics would speak volumes about the marketplace. I have 95 entities [actual clients that I bill] and 149 facilities that I serve. I manage one hospital account (with a residency program) and 15 associated community health center facilities. That leaves 38 offices that are part of a group practice (2 or more facilities with the same ownership).

Currently, one of my clients who has two offices is in the process of buying a third. I have five other clients that are either buying or building their second office (in progress) and three more clients are looking to buy a second office this year. By year end, based on these transactions, over 48% of my clients will be affiliated with a group of some kind. This is quite significant and speaks volumes about the future of our industry!

Over the next few years we will continue to experience a consolidation in the dental sector. These destabilizing events (mergers, acquisitions and web based commerce) will continue to challenge the status quo and will reshape the way dental commerce operates.

Going forward, we must operate deliberately and with purpose. We must invest in technology and business applications that enhance operations and efficiency. All of us must improve our messaging, marketing and branding efforts. Dentists must focus on the millennials. They are going to get married and have families. All healthcare providers must focus on customer care and the customer experience. Happy customers post reviews which impact organic SEO which impacts patient referrals and new patient inquiries. In the era of mobile apps – reviews matter!

Things are moving quickly but they are stabilizing at the same time. The trends are clear now so we can plan ahead and meet our objectives. The hyper speed of these changes are not news anymore. We must accept the speed in which change is occurring and act with purpose before we fall too far behind. Inaction, procrastination and failure to engage will result in a competitive disadvantage and lost opportunity.


Regardless of your psyche, we are in an incredible industry that serves the general public. Modern dentistry is predictable, affordable and can be life changing. It is also in a state of flux and we must pay attention to trends. Whether you are buying, selling or growing, the business requires your due diligence and resources. Let’s celebrate the opportunities and learn how to prosper in the new dental economy.