Less than a decade after we purchased a small, struggling dental practice in New Jersey, our practice ranks in the top 10% nationally. We are essentially a fee for service practice, with insurance adjustments less than 5%.

Although we started off with more than $400,000 in business debt, plus school and personal debt, we now have zero debt. We paid off the entire pile of debt, including school, practice, building, and personal debt.

We work four days a week, take two full weeks of vacation a year, and regularly add extra vacation days to long holiday weekends. We are able to spend time with family and friends and pursue personal interests.

While there is always someone with a bigger boat or with a practice that shows higher numbers, we reached our objectives, and have no intention of working harder or faster for further gains in production or revenue.

As somebody once said: "True wealth is having discretionary time."

Daunting Challenges

Hema graduated from dental school in 1996 and worked as an associate for several years. Peter quit a corporate job and started his own consulting firm. His main focus was to help business owners with management issues. We wanted a life with more control and more time to spend with each other.

We decided to buy an older dental practice rather than start one from scratch, because of the immediate availability of at least some patients. We evaluated and bid on several practices and finally bought a small practice in New Jersey.

The practice we bought had just around $10,000 in revenue per month, two treatment rooms and two part-time staff (one receptionist and one dental assistant.) The retiring doctor was participating in a lot of insurance plans and the practice had no hygiene program. We were in a small town with eight other dentists and Hema was the last dentist to come into town. We knew this was a practice we would have to build up over time, but the first day Hema started working, there were five patients in the door.

We realized early on that dentistry was a tough and complex business with many daunting challenges:

• Finding skilled staff was difficult. Training staff was time-consuming. Finding good hygienists was particularly difficult, as there were few hygiene school graduates in the area relative to the number of practicing dentists.

• The insurance environment was bad and getting worse.

• Patients walked in with the notion that insurance would cover "everything." This meant that collecting money was never going to be trivial.

• The cost of doing business in dentistry was very high. We noticed that dentists are drowning in debt. Given school debt, debt service on the practice, lease payments on dental equipment, and continuing education costs, this was not surprising.

• Competition in the dental profession was fierce, with dental practices literally at every street corner. Managed care practices were all around us.

After two years, the practice had grown some, but it was not making the kind of progress we had hoped for. As we looked around at other practices and talked to some of our colleagues, we realized the problems were complex and beyond the capabilities of the typical office manager in a dental office. Peter had to get involved to push the practice up to the next level.

Peter became the Business Director of the practice and took over the responsibilities in the business and management area so that Hema could concentrate on running the clinical side.

The New Office

We put together a business plan and began to tackle our problems one by one. Our first challenge was that we needed a larger space. We could not grow given the constraints of a 600 square foot office space. We identified an office building and had architects draw up plans for a new modern office with a patient consult room. Our loan was delayed and hampered by 9/11, but it eventually got approved and the contractor completed the work on time. We were excited about the new office, but now had a mountain of debt. Our work was cut out for us.

Once the office was built, we tackled the other business and management problems. As Business Director, Peter took the lead to find solutions for:

• Hiring—working out how to interview and hire good staff. Setting job expectations, performance review systems, pay scales, and bonus plans.

• Patient communications—training front desk staff on telephone skills, meeting and greeting patients, dealing with insurance issues, treatment discussion and financial arrangements.

• Accounting and collections— setting financial policy and a protocol for billing, keeping track of accounts receivables and account aging; installing systems and training staff to estimate more accurately the patient's responsibility (i.e., the portion that insurance will not pay for)

• Scheduling—reducing holes in the schedule and scheduling for efficiency.

• Marketing—identifying and implementing marketing programs that increased new patient flow.

• Technology—evaluating and upgrading technology within the practice.

• Hygiene Recall System—creating and maintaining an effective hygiene recall system.

Hema tackled problems on the clinical side. She took responsibility for:

• Training staff on clinical and verbal skills.

• Setting up systems:
  • For efficiency of dental procedures and dental treatment.
  • For efficiency of daily operations to ensure smooth patient flow.
  • To monitor inventory and control costs of dental supplies.

• Making decisions regarding acquisition of new technologies for the office.

• Taking continuing education courses to expand services available to patients.

• Taking steps to improve case acceptance.

We were constantly looking for ways to improve. We brainstormed ideas, drew upon our corporate experience, scoured management books, questioned colleagues and consulted experts. We tested a lot of ideas, and many of the ideas failed. In fact, we found that many of the methods and solutions proposed in the literature and on the seminar circuit really do not work for the average dentist.

Eventually we arrived at solutions that produced significant and sustainable growth, that were practical and easy to implement, and that fit our personalities, life goals, and value system.

At peak, we quadrupled our income. Over a 12-year period from the start of the practice, we were able to pour significant funds into retirement savings and are in position to retire today if we wanted to.

With so much study, testing and observation behind us, we now help other dentists fulfill their goals as well.

For more on our background, see the About Us page.

To discover whether your practice can become similarly successful, fill out and submit our confidential practice assessment. It's free. Request a practice assessment.