dental practice Archives - The Wealthy Dentist

Dental Practice Design Is Harder Than It Looks

April 18, 2018 By Jim Du Molin Leave a Comment

Machias Dental Continues Construction of New Facility

We’ve been covering the story of Dr James Sparaga, a dentist in the middle of building a spacious new facility for his practice.

The team checks out their new home
[click to enlarge]

Here are the steps the doctor has already taken:

Develop plans for a new dental facility.
Undertake a financial analysis.
Lay the foundation.
Put some walls up.
Construct the skeleton.
Raise the roof.
Watch the design firm go out of business.

The work focus is shifting from the exterior of the building to the interior (the fun part of the building!). The Sparagas had found a millwork subcontractor to build the desk, cabinets and shelving. Unfortunately, he backed out just as the job was about to start. Small-town rumors flew about the reasons why, but all that Jim and Kathy Sparaga cared about was getting their woodwork done. They ended up ordering cabinetry from both Adec and a kitchen cabinet company, hiring a shelving company, and finding a carpenter to handle the reception desk and fine finish.

The interior takes shape
[click to enlarge]

They didn’t want to skimp on the interior design, but the nearest designer was some 90 miles away. They decided to go with T.H.e. Design, thinking that a dental design company would be best equipped to verify and order wall covering, carpet, tile flooring and furniture, etc. But then, as previously mentioned, T.H.e. went out of business.

So now the search was on for an interior designer. It just so happened that the Sparagas were looking to make some adjustments to their home, so they called a residential design firm. Impressed with their service and out of sheer desperation, they asked if the design firm might be interested in a dental office project.

And what do you know? It was the design company’s slow season, and they were more than happy to take on the dental project. They have turned out to be the answer to the Sparagas’ dreams. They are re-sourcing all the needed items and improving upon the original selections.

Next it was time to select the dental equipment for the new facility. Like so many dentists, Dr. Sparaga was understandably enthusiastic about getting new toys.

But of course nothing is ever as easy as it seems… Check back next week to see what sort of snafus the doctor encounters in his search for dental equipment!

Filed Under: Dental Practices Tagged With: Construction, Dental Building, dental practice, Machias, Sparaga

Dental Dilemmas in Real Estate

April 18, 2018 By Lewis Gelmon Leave a Comment

When Buying Commercial Property, Dentists Should Think Ahead

dental lease advocate Lewis Gelmon Special Lease Feature by Lewis Gelmon

Should you lease or buy? This debate often arises from the same question that motivates people to buy a residence: “Why am I paying rent and not paying down a mortgage instead?”

The realities that drive residential property values are very different from those that create or eliminate the value of owning commercial property. Consider this: banks (being risk-averse organizations) typically won’t lend money for the purchase of commercial real estate with less than a 40% down payment. Compare that to as little as 5% for residential purchases.

The main difference is that commercial property, unlike residential property, is valued primarily on a capitalization rate of its rent-producing tenants. Despite a strong revenue stream from a building’s tenancy, there are other social, geographic, and infrastructure issues that can greatly affect a commercial property. These include:

construction of new roadways,
changes in traffic patterns,
opening of new commercial developments that shift retail markets,
access restrictions or reduced visibility to the property, and
changes in purchasing demographics.

There are three typical property ownership scenarios that dentists seem to purchase. They are:

buying into the ownership group occupying space in the same building,
purchasing an office condominium, or
purchasing a free-standing building and converting it into a dental office.

Buying into the ownership group of an office building can be problematic. Due to the split ownership, you probably won’t be able to control your investment. As a result, it will be more difficult for you to liquidate your ownership or even borrow against it.

Ownership groups of medical buildings can also be fraught with politics of the tenants. As an example, consider the dentist who became a minority owner of the building he was in. This dentist was denied dividends (and even the right to sell) because the other majority owners, who happen to be orthodontists, felt that they did not receive enough referrals from the dentist over the years.

Purchasing a dental or medical office condominium is the most risky because it is unlikely you will be able to sell the property to anyone other than a dentist or other doctor. When you are ready to sell, the volume of your potential successors is lower compared to tenants looking to lease. The outcome is that your property could be at risk of devaluation.

Purchasing a free-standing building and converting into a health care practice is the least risky route. If you buy the building in the right location, you’ll be more able to sell it to others unrelated to medicine or dentistry. Stand-alone buildings also have much greater appeal to retailers and other businesses due to visibility and parking.

If you’re truly interested in purchasing revenue-generating property, you will probably do much better owning a residential apartment, duplex, triples etc. where you receive simultaneous benefit from revenue generation and property appreciation.

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Looking for more information on the topic? You can reach Lewis Gelmon at (760) 479-9704 or lewis@lewisgelmon.com. For only $495, he will personally review your lease. Plus, get a $200 discount until October 31 just for mentioning The Wealthy Dentist. All reviews are guaranteed. If you don’t feel you have received the value, he’ll give you a full refund, no questions asked.

Lewis Gelmon is a former landlord, lease negotiator, and shopping center manager. Now a dental tenant advocate, he regularly lectures for dental groups across North America and the UK. He is the most published author on the subject of dental lease negotiations. His Good Leasing Guidelines for Dentists have been critically acclaimed by numerous dental groups. His mission is to raise awareness among dentists on the risks hidden in their office leases.

Filed Under: Dental Editorials, Dental Practices Tagged With: Dental, dental practice, dentist, dentists, Gelmon, landlord, lease, Lweis Gelmon, tenant, tenant rights

Dental Marketing: Direct Mail Marketing Seems Old-fashioned (video)

April 18, 2018 By Jim Du Molin Leave a Comment

Popular daily-deal sites such as Google Offers, Groupon and Living Social have exploded on to the Internet dental marketing scene. These sites make many dentists wonder if tried-and-true methods of marketing — like direct mail — still work for internal marketing.

Why wouldn’t they?

Dentists spend great sums of money to acquire new patients, and not continuing to market to proven buyers is truly a mistake. Regular patient mailings are one of the proven methods for dentists to stay in touch with their patients.

The Wealthy Dentist conducted a survey of dentists to find out if they regularly mail their patient base. A California dentist was quick to respond, “It’s a complete waste of time. Patients ask not to send them any more junk mail. This is not the 1970’s.”

Click on Play to see what the dentists have to say about direct mail marketing –

Are you still doing direct mail marketing? Tell us your story in our comments.

Filed Under: Dental Surveys, Dental Videos Tagged With: Dental Marketing, dental practice, dental practice management, dental survey, dentist, dentistry, dentists

Dentist Survey: How Many Hours Does an Average Dentist Work? (video)

April 18, 2018 By Jim Du Molin Leave a Comment

The Wealthy Dentist conducted a survey that asked dentists how much they work each week.

Of the dentists who responded to the survey, we found that dentists’ average work week is about 35 hours.

A dentists’ work week involves more than just treating patients, there are also dental practice management issues that have to be attended to. Dental practice management involves smart decisions about how much time to spend providing dental care.

“When I cut back to four days a week fifteen years ago, my income went up, not down!” said a California dentist.

Click on play to watch the survey video and hear the survey results –

How many hours a week do you work and how much of that is spent treating patients?

106-Dentist_Work_Week.mp4

Filed Under: Dental Videos, The Wealthy Dentist Tagged With: dental practice, dental practice management, dental surveys

Dentists Beware: The Government May Want To Tell You How To Manage Your Practice

April 18, 2018 By Jim Du Molin Leave a Comment

The North Carolina Senate recently upheld Senate Bill 655, which would require the North Carolina Board of Dental Examiners to examine all business contracts entered into by dental practices in their state.

No other state in the union has implemented such restrictions on dental practice management, or sought such inclusive authority over how dentists manage their business.

Talk about the far-reaching arm of the government!

As reported by Dr. Clifton Cameron in the Fay Observer –

“As a practicing dentist in Fayetteville, I know how this legislation will impact dentistry in North Carolina.

When my partner and I established our practice in 2008, we quickly realized dental school taught us much about clinical care, but little about running a business. And the dental industry, much like the rest of the health care industry, is changing and becoming more complex.

So like many small-business owners, we looked to outside companies to help finance the practice, manage billing, handle payroll, file insurance and execute other administrative tasks. The arrangement helped our dental practice operate so efficiently that we can charge lower rates and accept dental insurance from patients.

Instead of helping foster lower fees for patients and wider insurance acceptance, Senate Bill 655 would require dentists to personally handle all the administrative tasks of their practices.

The bill would forbid dentists from taking advantage of the types of business services that millions of small businesses use. Many dentists like me would be forced to spend less time on patient care and more time on managing the complexities of a modern dental practice.

Senate Bill 655 would give the Dental Board complete control of how dentists in North Carolina run their practices so they can keep fees charged to patients artificially high and insurance acceptance artificially low.”

The North Carolina State Board of Dental Examiners position on on Management Agreements with dental practices is as follows:

“The Board has become increasingly concerned about the expanding scope and nature of management company services and agreements, and their impact on the control of dental practices by the licensed dentists.

The bundled services offered by management companies typically involve some combination of (1) administrative management services; and (2) financial management services.

Based on its knowledge of the operations of dental practices, and after reviewing management arrangements with dental practices for almost ten (10) years, the Board has identified features of management arrangements which it has determined to be highly likely to create a situation where the ownership, management, supervision or control of a dental practice is impermissibly conveyed to an unlicensed person or organization because either separately or when bundled, those features interfere with the licensed dentists’ professional decision-making and their exercise of clinical skill, judgment and supervision in the dental practice.”

Have you read about this story? What are your thoughts about the government and a State Board of Dental Examiners dictating how you administrate your dental practice?

We look forward to hearing your thoughts on this subject.

For more on this story see: Op-ed: Legislation would restrict dentistry in the state and the North Carolina State Board of Dental Examiners position at www.ncdentalboard.org (opens in a pdf file).