As I talk to dentists preparing for career transitions, some are simply taking the next step on their long-planned path. But others are facing an unplanned change after “life happened” and made them rethink their priorities and goals.
Sometimes it’s a positive reason, like wanting to spend more time with grandchildren or pursue a non-dentistry passion. Other times, a health issue (whether their own or a family member’s) forces a shift. Maybe an elderly parent needs full-time care. Or they’re navigating a divorce or major life change. Sometimes it’s simply burnout.
It’s human nature to panic when facing change, and all too easy to get paralyzed by fear and stress. But that can lead to snap decisions that may cause regret.
Luckily, dentistry gives you so many options. You just need to explore them methodically and evaluate all the information. Consider asking a trusted colleague for their opinion. And of course, talk to your family – after all, they know you best!
Let’s explore what happened with two dentists to whom “life happened.”
Dr. Arthur: Ignoring a looming problem
Dr. Arthur’s practice thrived on complex, intricate cosmetic procedures. He built a great reputation among local practitioners and was booked out for months. He had enough business to bring in an associate or partner but preferred working solo. After all, no one else could meet his exacting standards.
In his early forties, he began experiencing numbness in his right hand – his dominant hand. It got worse on days when he performed longer procedures. Sometimes he took anti-inflammatories and iced it, but mostly, he just shrugged it off.
After four or five years of this, his condition deteriorated rapidly. He could no longer hold a pen without pain, let alone a handpiece – and of course, he refused to compromise his treatment standards. A hand surgeon diagnosed him with advanced carpel tunnel. “You’re beyond braces or steroids – you need surgery, rest, and rehab,” the surgeon said.
Dr. Arthur panicked and canceled his entire treatment slate for the next three months. Then another three months. The surgery did not restore the precise control he needed to treat patients, and he was forced to retire early.
By that point, his practice had been closed for months, with zero production – which greatly affected his valuation. After more than a year of searching, he finally found a buyer interested in the equipment who was willing to re-build the patient pool and referral network from scratch. But the price was less than a quarter of what the practice had been valued at just three years prior.
How to avoid this: Build a plan before you need it
Every dentist should regularly think about their long-term needs and options. Make it one of your annual activities – perhaps at year end, or as you file your taxes.
Ask yourself: what if I had to sell right now? What if my spouse got an amazing job offer three states away? What if an elderly parent needed me back home? What if I was suddenly injured and unable to work?
Then think about what it would take to sell your practice. Does it have “curb appeal,” or could it use some TLC? Simple cosmetic maintenance – recovered chairs, a fresh coat of paint, or a deep cleaning – is easier when you stay on top of it and can keep your practice show-worthy. Longer-term improvements, like new technology, can also be attractive to buyers. And you might as well enjoy them for a few years before you sell!
Be sure to also review your fee schedule, collection policies, and payer mix as part of this process. This will ensure your practice is in the best possible financial shape.
All these actions become especially important if you have “warning signs” of looming problems. In Dr. Arthur’s case, those early aches and pains might have motivated him to bring on an associate or partner – someone who could learn the business while he cut his own hours. When the problems grew worse, he could have reduced his role to consulting-only or sold the practice to someone already established in the community. That would have ensured continuity of care for patients while protecting the value of the practice – avoiding a fire sale.
Dr. Francine: no way out of burn out
Dr. Francine followed a very traditional career path. She worked in two different associateships before starting her small-town solo practice. Over thirty years, she built her 4-operatory practice into a thriving, well-respected business. She was one of only two dentists in town, and her patients and staff were loyal. She was busy four days a week and didn’t have space or desire for an associate.
But the COVID pandemic gave her time to think. She wasn’t getting any younger and felt like she was missing time with her young grandchildren. And the long days bent over a chair had begun to take a toll on her back.
When Dr. Francine re-opened her office after the state-mandated closure ended, she realized her heart wasn’t in it anymore. She never re-opened more than two days a week and began referring patients to the other dentist in town. As soon as she reached Medicare eligibility this spring, she closed her doors for good. Her long-time staff scrambled to find jobs. Patients had to endure long waits for the town’s remaining dentist or make a 90-minute round trip to the next county.
How to avoid this: Consider your options
We have heard from many Dr. Francines recently. They hate to leave their patients in a lurch, but they are simply DONE with clinical dentistry.
Before you close your doors, though, investigate all your options.
With this path, you find the perfect dentist to buy your practice – someone with a similar philosophy of care who will care for your patients for years to come. They’re serious about ownership, but not quite ready to buy. (Maybe they need to get their finances in order.) You hand over all the clinical work but stick around for a couple of years as a mentor. This can take many forms: you could come in a day or two a week to discuss cases or offer hands-on help, or you might just offer guidance on running a successful business. Many younger dentists crave this type of mentorship, so this can be a win for both sides!
Dr. Francine could have used this path to stop doing clinical dentistry while still offering a wealth of advice to her eventual buyer. Meanwhile, she would still own the practice and draw a small salary (and benefits), but with a set end date. She could introduce her patients to the new dentist, conveying her confidence in their skills and assuring patients they would be cared for.
This would also avoid the all-too-common mistake of cutting production, which affects the ultimate sale price. The incoming buyer can maintain production – and has an incentive to build their own sweat equity.
Remember, there is life after clinical dentistry! When faced with a change, avoid the temptation to panic, close your doors, and accept less for your practice. Instead, take a deep breath. Think about your goals and talk to trusted colleagues and family. Then build a plan that will carry you to the next step.