Episode 180 – The Changing Landscape of Dental Careers

This episode of The Productive Dentist podcast showcases the ever-evolving landscape of dental careers, and host Dr. Bruce B. Baird takes us on a journey through time – from the early days of informal practice transitions to the present-day era of complex retirement decisions.

Dr. Baird reflects on the legacy of his grandfather, Dr. Harry Lampa, and shares how the concept of selling dental practices has transformed over the years. In the 1950s it was as simple as passing patients along to a friend, but in the 1970s and 80s, practice value became a key consideration to set the stage for the changes we see today.

Dr. Baird also highlights the shift in the mindset of newer generations of dentists who are not looking to work relentlessly anymore but want to balance their professional and personal lives. He discusses how this change has significant implications for how dental practices are bought and sold, and the rise of Dental Service Organizations (DSOs).

As you listen to this episode, think of the following questions:

• What are the goals and strategies you’ve set to proactively plan out your dental career?
• Dentistry is no longer one-size-fits-all, so which path aligns best with your professional and personal aspirations?
• What are you doing to continuously improve, and stay on top of industry trends?

EPISODE TRANSCRIPT

Regan 0:00
Hi, Doctor. Regan Robertson, CCO of Productive Dentist Academy here and I have a question for you. Are you finding it hard to get your team aligned to your vision, but you know, you deserve growth just like everybody else? That’s why we’ve created the PDA productivity workshop. For nearly 20 years PDA workshops have helped dentists just like you align their teams, get control of scheduling, and create productive practices that they love walking into every day. Just imagine how you will feel when you know your schedule is productive, your systems are humming, and your team is aligned to your vision. It’s simple, but it’s not necessarily easy. We can help, visit productivedentist.com/workshop that’s productivedentist.com/workshop to secure your seats now.

Dr. Bruce Baird 0:47
Things are changing now where Doc’s are not wanting to work four and a half or five days they want to make good money, but they’re not. They’re not so obsessed with, you know, blow in and out. You know, making a million dollars a year and that’s not to say that there are guys out there that don’t want to do that. I’m just saying it’s just a little bit of a change. Hello everyone. This is Dr. Bruce B. Baird and you’re listening to the Productive Dentist podcast in this podcast. I will give you everything that I’ve learned over the last 40 years in dentistry working with 1000s of dentists. I’ll tell you it’s not that my way is the only way, it’s just one that has worked extremely well for me and I’d love to share that with you so you too can enjoy the choices and lifestyle the productivity allows, more time for things you love, increased pay, better team relationships, and lowered stress. Let’s get into it with this week’s episode of the Productive Dentist Podcast.

Hi, this is Dr. Bruce Baird with Productive Dentist podcast, again answering questions from our listeners and one, one person sent, one of my friends over in Fort Worth asked the question, ‘Can you explain the changing landscape of dental careers? You know, the, some people are doing things at midlife, some are waiting to the end of their career, what are you seeing Bruce, as you know, as you continue to work with dentists across the country?” And that’s an interesting question. You know, when I first got into dentistry, let’s go back before that. My grandfather, as many of you know, Harry Lampa, you didn’t know him, but he was my grandfather, there was a dentist in New York City and was best buds with Babe Ruth but back in the day back in the 50s, and 60s, when a dentist sold their practice, they didn’t sell it, they just asked a friend down the street, if you would mind taking over my patients for me and you would send your patients a letter and say, “You’re gonna go see Dr. Wilson now or whoever.” You just hung up the shingle and, and that changed in the mid 70s, you started to see practices that were creating value and in the 80s and 90s, where you would sell your practice to another dentist, for anywhere from 65 to 85% of your previous year’s collections and we would see that, you know, it depends on the kind of practice you have, if you had new equipment and you had nice facility and you might get closer to 85% of your previous 12 months and there were other formulas to there were a lot of other formulas, I’m just using a generality when I say 65 to 85, because that’s what would fall if you had old equipment, and old, old stuff, then your practice might go for, you know, 65% or even lower, that’s just a range and then we get to this time in the 2000s and what I’ve noticed is the Gen-Z and the Gen-X they they have a different little bit different philosophy. They’re wanting almost to retire in practice, they want to work, but they also want their life. You go back to the baby boomers like myself, we just worked really hard and, you know, learned in the school of hard knocks but I will tell you that many of our new Doc’s that are coming through PDA now are really they’re already planning their life. I mean, they’re not just letting work plan their life for them. You know, which is what happens to a lot of people. You know, I can tell you that I did not take more than one week off for the first 35 years and practice, you know, except when I was in the military, I was able to take two weeks off or three weeks off, because of just the structure and the way, the way I was way I was doing things. So, you know, but things are changing now where Doc’s are not wanting to work four and a half or five days, they want to make good money, but they’re not. They’re not so obsessed with, you know, blow in and out, you know, making a million dollars a year and that’s not to say that there are guys out there that don’t want to do that. I’m just saying it’s just a little bit of a change and so this when I look at DSOs, and I look at the sale of dental practices, I was totally flipped out. When I heard that the average dentist selling to a DSO was 41 years old and I was just like, “You gotta be kidding me. Why on earth would you sell your practice of 41 years old?” But then as I researched, as I got to understand better what goes on in a DSO and what, what kind of, you know what kind of salaries that someone could make, but with the sale of their business, maybe not their entire business, but maybe in a joint venture type arrangement, they can get a significant chat that offsets their entire, offsets their entire debt load, and still allows them to work and make money and do it in a different way. Whereas a lot of the dentists that are 55, or 60, now it’s time they want to sell, but they’re thinking to themselves, “Yeah, but I’m not gonna make enough money on this sale, I’ve got to work longer, I’ve got to work harder.” So you really have to step back and say, when do you start planning for your career, and the end of your career, when you start planning today, is what I would say start planning now for that and the reason being, if you’re looking at something in the future, and you’ve got your sights set on it, then you’ll at least know when you get there, if you don’t know where you’re headed and then they have the old adage that any road will get you there, because you’re just going to end up where, where you end up and I don’t, I don’t like that I never liked that feeling, that’s why I started doing two days a week it was a game for me, I wanted to go from four and a half days to four, then from four days to three and a half and I came up with a formula that if I increase my production per hour, by $250 per hour, my own personal production, that that would allow me to take a half day off and that’s exactly what I did and four and a half turn to four and then the four turn to three and a half and man, I was really enjoying it and the three and a half turn to three and eventually it turned to two. So that two days a week, I was still able to produce more dentistry than I did when I started but it gave me the freedom to be able to do that.

So when we look at the careers of dentists today, we have a lot of dentists that are just going straight to work in a DSO environment through the research that David Porritt and Dr. David Porritt, who is the CEO of Lampa Dental Group, who is really close friend of mine, he did his thesis for his doctorate on job satisfaction of a dentist in a DSO, what he found was that 72% of the people that are in those DSOs across the country really would rather be doing something else and to me that’s that’s not real good statistic. When, when you’d rather do something else but it’s I think a lot of those are young dentists that have come right out of dental school that still have the thought in their mind that I’d love to open up my own practice. I’d like to start my own business. Great. Do I think it’s possible to do it? Absolutely. There’s no question about it. I don’t care, DSOs are going to entail about 70% of all dentists when we look at that in the next in the next seven years, seven years from now. So we’re looking at a date, let’s just call it let’s just call it 2030. So 2030 70% dentists are going to be working for DSOs but guess what? 30% aren’t. 30% will be fee for service driven, high quality, high tech, high touch, those are still going to be around and I tell young dentists. I tell people I love young dentists, I just have always have and now I love old dentists too, because I’m an old dentist. So it’s kind of having fun getting the whole gamut. But I will tell you that yes out of the 72% of people that aren’t happy. They have the opportunity Now to get some experience, I went in the military for four years. Now they’re in a DSO environment, and they learn to do things and they always I will tell them set aside 8% of your payroll, you know, set aside 8%, and use that proceeds, learn, learn, learn, learn, that’s what you want to do. You want to make sure that your skill set is going to be ready when you decide to maybe open up your own practice or when your still skill set gets better and better and better. Guess what, you move up within the DSO environment that you’re working in it. So it’s still about individual responsibility, it’s still about, I want to be the best dentist I can possibly be period and that’s something that I’ve always felt, you know, if I told my team, “Hey, if I’m not better this year than I was last year, it’s time to tell me, you know, because I want to improve every single year as as being a dentist and I still want to do that I’m not practicing with my hands anymore.” But I’m still learning about a lot of the new printing technology and the new all on for stuff that we’re doing. Why because I still have an interest in it. I’m still very, very interested in those things. So and I want to be able to help dentists kind of make those right decisions. Now, if I’m towards the end of my career, and I haven’t prepared, you know, this landscape, I haven’t prepared for my retirement, I was expecting to sell my practice and now you have these DSOs are coming out and saying you have to work another five years, that’s tough for some guys, they I really didn’t plan on that there are some out there that will allow you to work three years. I actually believe it’s, it’s a transition for you anyway. So that’s not a bad thing and right now, how do I increase my production? How, if before I sell to a practice, before I sell to a DSO, I’m 58 or 62, or whatever, set aside three to four years to focus on growing your business, growing your EBITA growing your profits, by doing that, it’s going to increase your multiple, it’s going to increase the amount of revenue you’re going to get for your practice and it can help you shore up your needs for retirement and it can be done in a very short period of time, I’m telling you, we were working with Doc’s that, within six months to nine months, they’ve already doubled their practice value. Now, what does that mean, if you double your practice value, and you get a 5x? One, you got a 5x but if you double your practice value, you just got a 10x even though it was a five. So if any of that makes sense but it’s something that’s we’re going to see in the future and we have a lot of older dogs, but we also have younger dogs that come to PDA. So I hope this has been an interesting topic. You know, there’s no real right answer for what to do mid career or at the end of the career. I just know that my preference would be start to retire in practice for 15 years, like I did. I had time to do all the things I wanted to do and spend time with kids and grandkids and enjoy life. Because the older you get what you start realizing is you’re not going to be around forever and you start realizing that, hey, none of my buddies that have passed would have said I wish I would have worked another 10 years, you know, they just don’t say that. So, anyway, God bless you guys. Hope you have a great week and I’ll talk to you next week.

Thank you for joining me for this episode of the Productive Dentist Podcast. If you found this episode helpful, make sure you subscribe, pass it along to a friend. Give us a like on iTunes and Spotify or drop me an email at podcast@productivedentist.com don’t forget to check out other podcasts from the Productive Dentist Academy of productivedentistpodcast.com Join me again next week for another episode of the Productive Dentist Podcast