How Was I Ready to Start a Start-Up Dental Practice While Still in Dental School?
“Big Things, Have Small Beginnings.” — David in Prometheus
There are many dentists who are practice owners. There are fewer who took the leap of faith to start a practice from scratch as opposed to purchasing a well-oiled machine in an existing practice. Smaller is the group still, who found early financial success in their start-up. A typical start-up practice may take 1 to 2 years for the owner to draw a profit. Even smaller is the group who began this journey before even having a DDS behind their name.
That makes my story a bit unique. Because that was me.
During my 2nd year of dental school – My logo was designed, practice name selected, social media pages established, and web domains secured.
During my 3rd year of dental school – My comprehensive business plan and marketing plans were completed and I had a massive spreadsheet of potential locations for my practice.
During my 4th year of dental school – I had cornered the area I would be practicing, compiled and price shopped my full list of equipment and supplies, applied for Start-up Loans at the banks, been pre-approved for the loan, and won my class’s ‘Operative Dentistry Award’ along the way.
Upon graduating I settled into a wonderful associate job for about a year’s time (after quitting my first job after only 3 days). That period of time was the gap between graduating and seeing my first patient. I did not OPEN my start-up while in school, though I STARTED my START-UP process while still in dental school. Specifically referring to the things I just listed off a few moments ago.
It took about a year to actually see my first patient from the time I got out of school.
Which is not unusual for a start-up, especially when you need to go through the construction and build out process. The process takes time. It’s my belief, that if this is your ultimate goal, the earlier you start the better.
I graduated in the class of 2016 from the University of Michigan and saw my first patient in my practice in 2017.
I went through that process with no architect, no big companies behind me, and a contractor with zero dental experience. No financial backing from family letting me borrow money, no dad, uncle, or cousin, who was already a dentist. I also did it without taking on a large practice loan.
I was able to keep the amount I spent on the practice loan under $90,000. That makes my story a bit unique as well – especially when some dentists will spend more than that just on their cabinetry!
When the start-up opened – I was profitable the first month and the practice was self-sustaining from that point forward. Tapping into my working capital funds never even became necessary, though I did have it as a comfortable cushion in the company account — just in case. I slowly transitioned out of my associate job and full-time into my practice. My first year full-time in my practice, my income was already in what’s estimated to be the top 5% of all dentists. All while doing zero molar endos, zero implants, zero implant restorations, zero orthodontics, and zero impacted 3rds. Those procedures simply weren’t in my skillset as a new grad. I needed a business model where I could do well — just with the basics.
There’s a lot that goes into running and operating the business on a daily basis — but let’s not start there. Let’s start at the START — which was dental school. A question I’m often asked is: How did I prepare myself to confidently, successfully, and with no hesitation accomplish the items I just outlined above? That is really the topic of the article.
Let’s get into it
Preparation Step 1: Voracious Reading
I was an insatiable learner during dental school when it came to preparing for success in my future career. You’d typically see me in the back of the lecture hall reading a book on business, entrepreneurship, self-help, or marketing. Books have always been there for me when seeking solutions. If you click here, you will see a list of some of the books I have found most helpful along my journey.
Preparation Step 2: I Built a Team of Interns.
At a certain point, the amount of information I was attempting to compile became too much for me to handle on my own. I was attempting to compile comprehensive knowledge to start, own, and operate a dental practice. And dental school itself provided zero education on these topics. I inevitably assembled a team. I sent out an email blast to the pre-dental club and recruited a team of three interns to work under me when I was a dental student. This helped massively with my time management.
I would set goals for the week and they would report back. For example, I may say, “Okay team, this week we need to learn all about Accounts Receivable and the role in a dental office. I want you three to spend the week researching the topic and then report back to me with your findings.”
The team would then spend a week researching the topic, report back to me, and I would curate the information into something structured and useful. By the end of dental school, I had a massive binder full of information and had also personally written a ~65 page manual that I used to guide myself on the business of dentistry. The information came largely from my team of interns.
Preparation Step 3: Structured Learning Opportunities
I also sought out structured learning opportunities in two forms. I knew this is something that my peers were likely not doing. My belief was essentially, the more extra things I do that OTHER people are not doing, the more likely I will set myself apart after graduation in terms of success.
The first thing I was doing was taking dental business CE. Real CE. Not just free podcasts. I spent several thousand dollars on CE. I paid for it with student loans and money I generated from pre-dental coaching and book sales (I wrote a book that was ranked #1 it its category for 4 straight years on Amazon).
After spending thousands on CE, I realized there was still so much I did not know. This was a BIG motivational factor behind why I decided to create my own CE course which I legitimately believe is the most comprehensive practice ownership CE course a young dentist or dental student can take. Shameless plug — because my CE program is really good.
The second thing I was doing was skipping select dental school classes to attend business school classes. Assuming I knew I was likely to get an A in the dental class regardless, I would skip the class and run over to the campus business school and sit in on lectures. I was able to attend wonderful lectures led by some of the best business faculty in the state, and also able to sit in on talks from CEOs and leaders from high profile companies like Starbucks and Twitter. Much better than hearing about the Kreb’s Cycle for the 4th time.
Preparation Step 4: Interviewing Dentists
‘Gemba’ is a word in the Japanese vocabulary that is often found in their business texts. The word simply means “the real place where the work is done.” The premise is that you can do all of the research in the world you want, but to truly understand how something works – you need to immerse yourself in the environment. You need to go to the Gemba.
Looking back, I would have done this by taking a job as a dental assistant during dental school. I believe that is one of the absolute most advantageous things you can do for yourself as a dental student. Find one or a few dentists to work for during dental school.
While I didn’t work as a dental assistant, what I did do was interview dentists while visiting and touring their practices. I toured the lab, the sterilization centers, I picked apart the operatories and mingled with the staff. I asked the dentists every question I could think of according to a guided rubric I created. I went through their financial numbers. I saw what worked and what did not work. I observed the work flow clinically and the patient flow in these offices. I compiled and condensed all of the information into something I could utilize and make sense of.
Again, I utilized my intern team. “Team, I need to interview 3 dentists next month — I need you to cold call offices all week and bring me a list of the ones who say yes.”
Preparation Step 5: Leverage My Strengths
You need to know what your strengths are and you need to practice identifying them. There are things I was good at, that I was able to leverage into success. You may not be good at these same things. There are probably things you’re at that I’m terrible at. This isn’t limited to innate or trained skills – it also extends to resources. For example — maybe you have a well-off parent who can give you seed money. Boom – you don’t need to worry about financing. Leverage that strength. Maybe you went into the ortho clinic every spring break or summer break, instead of going home or on vacation, and got a better grasp of how to handle cases — that could be an advantage you could leverage.
My advantages were unyielding work ethic, exceptional bread and butter dentistry (I won the Operative Dentistry Aware), and ability to market (marketing and branding was something I always enjoyed researching). I leveraged those skills into opening a start-up practice that had and continues to have more new patients each month than I know what to do with; under a business model that requires no additional clinical skills beyond what I learned in dental school.
There are things that make you unique. Qualities you have that make you exceptional. Identify these things within you, and put them into action.
Kaizen — let’s get a little bit better, every day.
Are you an employee dentist who does not own a practice yet? Not sure where to start? Let’s work together! Check out the most comprehensive Practice Ownership CE available. Included is the full course, toolkit, templates, 1-on-1 help from me, and a supportive peer-mentorship group.
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