By: Nicole M. Jane, DDS, MS
 Life in residency is good! You made it through dental school, interviews, and the match, and now you’re on your way to the ultimate goal of being an orthodontist. Now—aside from all the duties of residency—it’s time to start focusing on where, and how, you wish to practice.
I, having experienced life as a dentist in the U.S. Navy, decided I was ready to take on my own practice after graduation. This was the easy part. The hard part was finding a practice that fit my needs and lifestyle. I suggest that you ask yourself the two following questions about what type of practice fits you:
- Where do I want to practice?
Do you like the conveniences of a big city where everything is within an arm’s reach? Do you like a small town with outdoor activities? Each practice type has a different type of personality. A larger city may mean that your neighboring orthodontist is across the street and that you may have more competition than your rural peers. It may also mean that you will have a larger patient pool as well. A rural community practitioner may not face the same competition, but the number of patients available will also be small—perhaps requiring satellite offices. In my opinion, the best place to practice is where you’ll be happiest and where your lifestyle needs are met.
- What type of practice fits me?
This, in my opinion, is the harder question to answer. And, if you do find a practice that you believe will fit you, after working there for a few months, you may decide that you are wrong! However, if a practice isn’t working out, you can always change in the future. This is where you really need to answer a few questions: Are you looking for an associateship, partnership, or solo practice? Do you want to start as an associate with the ability to take on an ownership position? What sort of techniques work best for you, and will the practice support them?
These two questions will start you off in the right direction. Once you have answered them and found a practice that looks like it may work, multiple other questions need to be addressed. A practice that is for sale needs a good valuation, such as one that Bentson Clark provides. This valuation looks at the number of active patients, contracts receivable, condition of the building and equipment, and a host of other items. The current staff should also be evaluated. Does the staff provide an office atmosphere that you like? Will changes in staff need to be made? (Expect changes once you own the practice, as this is a very common occurrence.) When you believe that you have found a practice that fits you, make sure everything is put in writing and have good advisors review the agreements before starting to work in the practice.
I would like to briefly recount my story to you regarding my finding a practice. I wanted to live where I could have an active lifestyle outdoors, snow skiing and being on the water. I knew that I preferred a good relationship with my patients and wanted to practice in a smaller sized community. Being from Michigan, I wanted a practice on one of the Great Lakes, in a rural or suburban community, and preferably “up North.” I had two practices that I was interested in fall through. The first was because the orthodontist changed his mind about having a partner; the second because the terms weren’t agreeable between the senior doctor and myself. I was not finding other practices in the state that fit my needs, so I looked west and found a practice in South Lake Tahoe, California.
I signed a buy-out agreement, wherein I would completely own one hundred percent of the practice immediately, and the senior doctor was signed as an independent contractor for a one year transition period. I liked this option because it gave me complete control over how the practice was run. The senior doctor and I had a similar treatment philosophy that made the transition smooth between the patients and me, but we ran the practice very differently. This led to staff changes; I kept two of his team members and hired four of my own. The transition of the team members worked out well for me, as they truly understood my philosophy. I was also fortunate to have the AAO Annual Session within driving distance, and was able to take the team to learn from the speakers and other practices.
Buying an existing practice worked out well for me, as I was able to start treating patients from day one. The practice however had been declining as is often the case when a doctor is near his retiring years, so I needed to build it quickly! I had lunch with my referring dentists, asked patients to refer their friends to me, and got involved with community events even though many required minimal donations in order to be named as a sponsor. I found a local marketing firm that produced high-quality ads for the newspaper. I became involved in as many study clubs as I could in order to continuously see referring dentists and touch base with them regarding referrals. I got to know what my dentists expected from treatment and how much communication each desired. I worked many late nights, but they have paid off!
My advice for finding a practice? Start early—start now! Align yourself with good, trusted advisors (Bentson Clark is a good place to start since they have a team of advisors including a practicing orthodontist, an accountant, and an attorney.) Find opportunities through the AAO’s matching service, your orthodontic supply company representatives, and word of mouth. Ask instructors and other residents for advice. I wish each of you the best of luck in the future!
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