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MyView: What practice model is right for you?

October 05, 2015

By Walter Lamacki, D.D.S.

Dr. Lamacki
Nearly three years ago, a young dentist emailed me questioning the validity of a 2009 American Dental Association survey finding that the average dentist nets $194,000 per year, which I cited in my column "Is Dentistry Still a Good Business Decision?" He was working as an associate in two high-volume, low-fee offices and struggling financially.

I called him and we had a productive talk. I encouraged him to contact an accounting firm or practice broker specializing in dental practices. Not much later, he bought a practice and began the process of building a successful dental practice.
After a year or so, we lost contact. But recently we exchanged emails.

"Things are progressing," he wrote. "Definitely had some challenges. But overall, it was the right move to stop being an associate. For me, the most difficult thing is finding reliable and passionate staff to help. The second most challenging thing (and the staff issue would be alleviated by this) is proper compensation by insurance companies. I was surprised to see how much effort has to go into collecting a discounted fee.

"As a solo practitioner, I find myself thinking that merging and using a group practice scale would be beneficial and also provide me with more free time than I have now. But perhaps with your experience and perspective, you may have a different opinion (or perhaps agree?)."

I wrote back:  

"Nice to hear from you; welcome to the business of dental practice.

"Enthusiasm is contagious. Your passion for your profession will only rub off on your staff if you stress to them that WE are a team, and WE improve the quality of life for our patients. Value your staff as important members of the team and tell them that often; pay them to attend continuing education courses. Base their pay raises on performance and not seniority and compensate them appropriately.

"When hiring a new dental assistant, don't overlook applicants that have no or limited experience as an assistant.

"Group practice is growing, but it is still relatively new. The ADA convened a panel of dental practice experts at its last annual session on the subject (Find resources on this subject at There are distinct advantages, but do your homework; research successful group practices and join the American Academy of Dental Group Practice. Do go to Chicago Dental Society regional and branch meetings; interaction with your colleagues is invaluable.

"Forget about leisure time for now; when building a practice, you have to work harder than you've ever worked.

"There will always be problems facing you; look at them as opportunities. Problems with insurance companies are part and parcel of practicing.

"One last bit: my good friend the late past CDS President David Fulton Sr. said it all, 'Treat your patients as family and you will always sleep well.'"

This editorial, reprinted with permission, originally appeared in the July/August 2015 issue of the CDS Review, the publication of the Chicago Dental Society. Dr. Lamacki is the editor of the publication.