Found a Practice? Don’t Overlook These 5 Must-Ask Questions

An illustration of a group dental practice

When you are searching for a new practice, whether as an associate or buyer, how do you decide where you can be the most successful?

What do you do when multiple options look about the same on paper?

There are several obvious things to look at, such as a livable salary, clinically sound practices, and adequate physical space. But what about some of the less obvious things that can make or break a situation? (See Building Your Dental Dream Home for what a practice with “good bones” looks like.)

Ask yourself these five key questions to decide whether a practice is one where you can grow, contribute and thrive.

1. Can I improve efficiency within the schedule?

The ability to improve efficiency can allow you better work/life balance while you add to the bottom line. No matter what is most important to you, everyone benefits from being more productive in the same amount of time.

As part of the interview/evaluation process, ask to see the current schedule. Look at how much time is allotted for different procedures and see where you might add value. For example:

  • Your experience may make you faster than the current schedule accounts for
  • You bring new skills that are a more valuable use of the operatory’s time
  • You may see opportunities to add to the bottom line by doing multiple procedures during the allotted time (think quadrants as opposed to single-tooth dentistry)

Don’t forget that if an otherwise-perfect practice has fewer operatories than you think you need, optimizing the schedule can help fill that gap. Plus, with COVID’s more extensive cleaning and PPE protocols, it can be more efficient – and cost effective – to work out of a single operatory rather than constantly switching rooms.

2. Are the office policies established (and followed)?

Buyers are always encouraged to take a deep dive into the practice’s operations and policies, but associates should also do their due diligence on how well the practice is run. After all, they will be tied to those policies for their foreseeable future. (Check out some sample questions.)

There is more to a well-run practice than simply how much is collected each month. For example:

  • Does the office have employee and policy manuals that clearly document office functions?
  • Are team member roles well defined? (i.e., how will you work with a dental assistant?)
  • Are Key Performance Indicators (KPIs) tracked frequently?

Understanding how the office runs may uncover other opportunities for you to add value, especially if you have relevant experience – just be aware that it may take some time to make big changes in current policies, particularly if the staff enjoys a more ‘fluid’ environment.

And if the office is well run, it can be the ideal place to learn the ins and outs of the business of dentistry. Be on the lookout for what works well and what could use a little ‘beefing up’ – the more invested you are in the practice’s success, the more likely you will be happy with your choice.

3. What is the average wait time for treatment?

One of the biggest challenges entering a practice can be having sufficient patients to keep everyone busy. If the owner is selling and retiring, this is relatively simple because typically you will retain at least 70% of the current patients. But if the owner is expanding, make sure to have a conversation about how patients will be recruited and allocated.

This goes beyond patient counts. Rather, the average wait time for treatment may be a better indicator of the practice’s true demand for services. In general, if treatment wait time is less than four weeks, the practice is already adequately staffed and the owner should commit to reducing their own hours if bringing in a new full-time dentist.

If the average wait is more than four weeks, there should be plenty of work to go around – but again, both dentists need to discuss how to allocate existing patients and whether (and how) they will recruit new patients. The conversation needs to include how easily the current owner will ‘give up’ existing patients and how the staff and owner will encourage the patients to give the new doctor a try.

In the easiest scenario, the current wait time is more than eight weeks and the practice is losing patients due to inadequate coverage, meaning there should be no issue with finding enough patients for multiple full-time doctors.

See: What Went Wrong: The Practice Wasn't Ready for an Associate

4. When was the fee schedule last updated?

Ideally, a practice should review its fees annually. Doing so helps keep fees in line with the local market and avoids big price increases that deter patients.

But it’s especially important for an owner to update fees before bringing on a new dentist. Patients are always going to be more accepting of increases from their trusted, long-term dentist. If fees go up right after a new dentist joins, either as an associate or an owner, that dentist may be seen as “greedy.” This can be especially hard if a buyer comes in, finds that fees haven’t been updated in years, and must quickly make changes.

The ADA Survey of Dental Fees (free to members) can help you see how the practice lines up with other local practices.

5. How can we work together to ensure success?

Most importantly, be proactive in building a plan for your own success. During the interview process, ask how you can work together to integrate you and your philosophy into the current office culture. Asking this question shows that you are invested in the success of the relationship and the practice.

If you want a mentoring relationship, be sure to discuss what that looks like. For example, you may ask for two short daily meetings: one first thing in the morning to prepare for the day’s cases and another to review the day and plan for the next. If you want to learn the practice management side of dentistry, say so – and ask to be involved.

If you are buying a practice outright, discuss how the current owner can help with patient retention and staff relations. The seller typically wants to ensure the practice’s success, and an open discussion about how to best support each other can go a long way towards achieving this goal.

Either way, work together to build an integration plan that ensures nothing falls through the cracks. (See: No Surprises: How to Prepare for a Smooth Practice Transition and download our free sample Integration Plan.

Download Integration Plan

No matter what, take a critical look at potential practices before jumping on board. Make sure that the practice fits your goals and feels like a place where you can be successful. You will be spending a lot of time there, so it’s worth investing the time to find the right fit.