Entrepreneurship in dentistry: grow your dental business

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Jacob Puhl, CEO of the Dentist Entrepreneur Organization, says that there is much more to acquiring a dental practice than looking at its finances alone. (Image: DEO)
Jeremy Booth, DTI

By Jeremy Booth, DTI

Wed. 3. June 2020


Dentists are currently facing uncertain times owing to the ensuing financial impacts of the SARS-CoV-2 virus. But some industry commentators have predicted an even greater emphasis on oral health as a consequence of COVID-19, and some dentists may be in a position to leverage the current uncertainties in the market in order to expand their dental practices or acquire new ones. Dental Tribune International spoke with Jacob Puhl, partner and CEO of the Dentist Entrepreneur Organization (DEO), about the skills and strategies required to build a dental group from the ground up.

Mr. Puhl, thank you for speaking with us. First of all, what is the DEO, and how does it support entrepreneurship in dentistry?
The DEO is a mastermind peer-to-peer membership community of growth-minded dentist entrepreneurs working toward expanding their group dental practices. By joining the DEO, members instantly gain access to a community of like-minded dentists and dental executives who are in their position and going through the same issues they are encountering. They also gain access to a vast online resource library, an online member portal, a private Facebook group, private member event opportunities and more.

What is the current market environment for practice acquisition like, and what factors will continue to influence it?
The current financial marketplace and economy will guide the strategies of group practice owners as they face uncharted territory and uncertainty with the current COVID-19 situation.

Even with the current landscape and the COVID-19 situation, group practices still need to aim at building excellent long-term businesses

In the months to come, there may be practice acquisition and/or growth opportunities that dental groups can leverage to their advantage. Also, a downturn in the economy may be beneficial for dental groups, as they are currently struggling to find quality team members to staff their growth. Higher unemployment rates will improve the labor pool.

Even with the current landscape and the COVID-19 situation, group practices still need to aim at building excellent long-term businesses rather than purchasing a business with the intent of selling it for a quick profit. The days of investors overpaying for somewhat fragmented platforms are gone.

Many dentists speak of a gap in their dental education with regard to business knowledge. What advice does the DEO have for dentists in order for them to overcome this?
There are many ways to learn about business and leadership in the digital age. Dentist entrepreneurs can learn by reading books, listening to podcasts or having a mentor guide them, but growth really occurs with practice, and true growth occurs in relationships and through interactions with peers.

What advice does the DEO have for dentists who are considering practice acquisition?
When looking to acquire a practice, evaluating the financial aspect alone in order to determine whether it is a good addition to an expanding dental group won’t make an acquisition successful. Equally important is what’s behind the finances—the potential practice’s doctors and staff.

The DEO has also seen the benefits gained by owners of a single-location practice who decide to build a group. The economies of scale achieved by having an associate- or, at least, a partner-driven group are superior to going it alone.

What role does the owner-dentist take in such a partnership?
When the owner of an emerging group practice first makes the decision to take the next step and grow his or her business, he or she has to determine which track to take: director of clinical operations or CEO. There is no right answer. If the dentist entrepreneur likes clinical/chairside production, then he or she can be a great mentor to associates who eventually may even become partners. Or he or she can be CEO and move away from being chairside in order to focus on the business administration. The dentist entrepreneur must hire someone to complement his or her own skillset.

Owner dentists can choose to stay chairside, or take on another role, such as focusing on managing clinical operations, says Puhl. (Image: DEO)

How does this partnership intersect with existing staff at an acquired practice?
When acquiring a practice, it’s important to have a top executive team member who can work with the staff at the acquired practice so that they feel fully included in the changes that will be occurring. Furthermore, the executive leader will be able to engage the practice in resetting its values, vision and mission to align them with those of the acquiring company. The executive leader will know how to adjust and strongly align the cultures of the group and the practice being acquired.

What about building and refining leadership skills—how does that fit into the process of growing a group practice?
It’s important for dentist entrepreneurs to embrace their role as business leaders and plan the next steps needed to enable and support growth in their dental group. Many emerging group practice owners seek nuts-and-bolts business advice first, but that is dealing with matters in the wrong order.

The DEO advises new dentist entrepreneurs to follow this formula: Grow yourself, grow your team and grow your dental business—in that order. This is the three-step process that any dentist should follow in order to optimize and enable the business to grow in multiple locations. Work on yourself as a CEO and leader; work on your team in order to create the right leadership team around you to help you implement your vision; and work on your business, including strategies and tactics, learning from people at your level and above.

Lastly, what is the basic membership profile and offering at the DEO?
Members own group dental practices of a variety of sizes, but in order to be members, they must already own at least one single-location practice and have plans to expand. Depending on the number of practices that an owner has and their revenue, a membership path will be suggested for him or her.

In mastermind groups like the DEO, dentist entrepreneurs can gain a road map, growing through connection rather than going it alone. Then the prospect of growing a business does not seem as overwhelming, because the gaps resulting from a lack of education on leadership and business principles in dental school can be filled in through sharing and tapping resources. DEO members leave their egos at the door and join an open, sharing community of like-minded dentists to curate and collect best practices in order to successfully enable their group practices to grow.

Editorial note: The DEO is based in Portland, Oregon, and membership is currently only offered to dentist entrepreneurs who are based in the U.S. or Canada. The organization’s newsletter is available to nonmembers, however, and the organization hosts two annual summit events that are open to the public.

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