Practice Sales

What Is My Practice Worth?

By Megan Urban, Practice Transition Consultant

Have you ever said something like this? “In the 90’s I was producing over $1.5M. Five years ago I was producing $900,000. My practice must be worth at least $1.0M and this area has huge potential.” Value is not based on “long ago past” numbers nor “potential” numbers. Buyers don’t pay for what you did over 3 years ago nor potential. They have to put in the work for the “potential”, so they don’t pay you for that and most banks and appraisers look at the last 3 years.

First of all, production is not nearly as important as collections. In some offices, the two numbers might be pretty similar, but in many, there is a huge variance due to large insurance write-offs, any in-office discount plan, and uncollected production. Next, how much of your collections are you taking home?

Let’s talk about what your practice may be worth, potential action items, and who should assist you to value and sell your practice. It is one of the most important decisions in your life that impacts your income.

Gather your team of trusted advisors. Now is not the time to listen to friends and family that aren’t familiar with the dental industry and do not have many years of experience. You will want a reputable transition consultant (broker) and dental-specific CPA and attorney. Your transition consultant will have a list of dental-specific CPAs and attorneys that do much of the work in your area. The CPA will help you to maximize any retirement plan you have, reduce taxes, and pay off the debt in a way that makes sense for your specific situation. The attorney will ensure all sale agreements, non-compete, and re-do treatment is correct, as well as any work back or carry back documents.

To help with a simple and successful transition, ensure your financials or books are clean. Work with your CPA to ensure personal expenses are not being run through the practice. Know what your actual take-home is out of your collections. If collections are high but all expenses are high too, the value won’t be as high as you’d like.

Take a look at your AR and try to collect as much as possible and do any necessary write-offs. AR can be purchased by the buyer and the over 60 or 90 days old is not worth much unless you can show the patients are keeping up with monthly payment plans.

Most dentists don’t think they have many credit balances, but there are sometimes surprises here. Some credit balances may be correct and you need to do your due diligence to refund the money or better yet, finish treatment. Check that the credits are not an error. EOBs are difficult to read and an insurance adjustment may need to be modified or corrected. Credit balances are often adjusted directly off the purchase price.

So, how much is your practice worth? Your transition consultant will complete a full valuation and prospectus and then together you can set the price. If collections and/or income have been declining, that’s fine if you’re happy, just understand that buyers don’t pay for “old days numbers” and “potential”.

The Business Side of Dentistry – Theft and Embezzlement

By Kevin Brady, Practice Transition Advisor

Experts estimate that more than 40 percent of dentists are embezzled with an average loss of $50,000. But, because the embezzlers often steal small amounts of money over many years, the thief is never noticed. The US chamber of commerce estimated that 75 percent of employees steal from their workplace and that most do so repeatedly.

A majority of people, if given an opportunity, will take advantage of a situation to steal from their employer on the following frequency:

-3 percent will steal daily

-7 percent will steal weekly

-20 percent will steal 4-12 times a year

-70 percent will steal 1-2 times a year

-4 in 10 doctors experience theft in some form from the practice. 1 in 4 dental practices experience monetary theft from their practice.

The significant types of theft in dental practices are:

-Time

-Office supplies

-Dental supplies

-Goods and services in Kind

-Money

All types of theft can hurt the bottom line of the practice. The Monetary thief, in most cases, has the most negative effect on the practice bottom line. Most dentists find it hard to believe that their handpicked, trusted, longer-term staff would steal from the practice.

Here is an unfortunate, and real-life, example. A dentist had a highly successful practice with five employees. One was a long-term office manager who came to work early and left late every day. She managed all the financial transactions daily along with the insurance and statement billing. The office manager took an extended vacation. While she was gone, the office sent out statements and received numerous calls from patients that their statement was incorrect and that either their insurance had paid the bill, or they paid on the day of service by check or credit card. The doctor had the staff investigate all the disputes and found out that the office manager had embezzled more than one hundred thousand dollars over the years. He was devasted and could not believe that the long-term, most trusted employee had done this to him.

Methods that have been used by staff to steal from the practice:

• Zero Charge- Patient comes in for services, and the office staff member posts a zero-balance charge and pockets the money. At the end of the day, the computer collections balance to the deposit slip. No one notices.
• Falsify Deposit Slip– Employee brings the doctor a deposit slip to sign for the day matching all the collections taken in for the day but then takes out all the cash from the deposit bag or envelope and changes the deposit slip when depositing the money.
• Multiple Adjustments to Accounts- Courtesy discounts like cash discounts or senior discounts are used. Employee charges the full amount to the patients and keeps the cash discounts and pockets it.
• Fictitious Vendor- Employee sets up a fake business with an account and has doctor sign supply order checks for supplies. The employee deposits these checks into an account and keeps the money.

Internal Controls

Make sure that even your closest friend in the dental practice is being watched. Here are some suggested internal controls to help prevent thief and embezzlement:

• Segregation of Duties– Make sure one person does not control all cash flow processes.
• Daily Audit Trail– Review daily transactions to catch zero balance postings.
• Rotate Duties– This will help to reduce the chance for embezzlement.
• Verify the End-day Report to Deposit Slip– Ensure that you see the end-of-day report and it balances with cash deposits. The doctor should be responsible for depositing funds in the bank.
• Review Bank Statement– Take time to review the statements monthly.
• Require Vacations– All employees must take vacation days that they have earned.
• Performance Plans– If the practice meets specific goals and the practice is increasing its revenue, give incentives to employees in monetary form.
• Background Checks- Make sure you follow through on background checks before hiring new employees.
• Verify References- Check all references.

Having internal controls will help protect the practice and staff that are honest and want to do a good job. It will also help everyone stay focused on their tasks and goals at hand and take away the opportunity for someone to embezzle. You don’t want to have good employees turn into liabilities.

Omni Practice Group has been helping dentists for over 15 years developing plans for dentists to transition their practice. Our goal is to help you find the right buyer and make a smooth transition of your practice when the time is right. Contact us today for a free no-obligation consultation with one of our Practice Transition Advisors.

Selling Real Estate with Your Dental Practice

Megan Urban, Transition Advisor at Omni Practice Group, gives some advice for anyone who is unsure if they should sell their real estate along with their dental practice.

When You Should Think About Selling Your Practice

There are many reasons why dental practices are put up for sale.  Some of the more common reasons actually have little to do with the practice’s general performance.  For example, many practice owners discover that they need to sell for health reasons or personal concerns, such as divorce or partnership issues.  While a business downturn might prompt many dentists to sell, economic drivers are not the only issue.  Owners may want and need to sell, but often it isn’t always that simple.

Many dentists are looking to retire but are unpleasantly surprised to learn that they simply can’t afford to do so.  Still yet, many dentists don’t truly want to retire or sell, but instead, they just want more freedom in their lives.  The day-to-day responsibilities of owning and operating a practice can take their toll.  Many dentists are looking to make a change and would love to be free of this burden.  This class of owner has already “checked out” mentally, and this can have profound negative consequences for their businesses.

When a dentist wants out but discovers that he or she simply can’t afford to sell or retire, it will come as no surprise that there is usually an accompanying drop off in enthusiasm.  Ultimately, the vast majority of practice owners will start to lose focus.  Often, we find that they stop investing the capital necessary to continue the growth of the business, which can trigger other events, such as the loss of key staff members and/or customers.  The failure of the practice to maintain its footing and competitive advantage can lead to a more aggressive posture by existing competitors or even encourage a new competitor to move into the market.

In time, the practice owner may come face-to-face with the harsh realization that they have no choice but to sell if they are to salvage any of the practice’s value.  The best way for a practice owner to safeguard against this situation is to sell when his or her practice is doing well, as this helps to ensure an optimal price. 

Working with a practice broker, even years before one is interested in selling, is one of the single smartest moves any business owner can make.  The time to think about selling your practice is now, as no dentist knows what life or the market will bring.

To help figure out where to start, register for one of our upcoming webinars or contact us today – phone: 877-866-6053 or email: info@omni-pg.com.

Transition Announcement and Patient and Team Retention

By Megan Urban, Practice Transition Advisor

In my experience, sellers get concerned with the “correct” time to tell their team about the transition. We recommend informing them when all documents or some are signed and there is no doubt the sale will go through. It may be 2 weeks or 2 days before closing, it depends, and your transition advisor will assist you.

If you tell your team too early, they may become stressed, confused, and unsure of their future, so they may panic and find another job and possibly tell patients. None of this is good!  Your team and patients are important to the goodwill of your practice.

When you do announce the new buyer, remind the team that they love their teammates and patients and that isn’t changing. Explain a bit about the new dentist and schedule time for them to meet. Help them feel confident that the transition will be great, and the new dentist will need their assistance for everyone to be successful.

A letter to patients is typically sent from the seller with the buyer’s approval. Depending on both the buyer and seller and the unique area, a newspaper ad can be placed, and an open house can be scheduled. Your transition advisor will provide ideas and examples to help you choose the best method for announcing the transition.

Patients may be unsure of the new buyer, so consider not making any abrupt changes, such as incomplete treatment and payment options. You can’t underdiagnose or discourage ideal treatment but be aware of a way to communicate based upon the previous owner to retain as many patients as possible and still bring in your processes and protocols.

The new team will be concerned about the new buyer’s expectations so consider not changing much in the practice for a while, so they have a chance to transition and become comfortable. Provide information they won’t know such as how to schedule and what instruments you need for each procedure. Help everyone to be successful in their position.

Remember to remind your team often that everything is ok. Consider having one-on-one meetings with each new team member and ask specific questions. “What keeps you coming here every day? What’s one thing you would change in the practice if you could? Can I count on you to bring questions and concerns to me rather than involve the entire team?”

Transitions can be stressful. Work with your transition advisor that has many experiences and ideas to share to help everyone be successful.