By Rod Johnston, CMA, MBA, OMNI Practice Group
As dentists start going back to work and opening their offices, they have a lot of questions on their minds. The questions range from Human Resources related questions to questions on selling their dental practice. While I am not an HR expert, I can answer the questions on practice values and sales. Or, at least, I can give my thoughts and opinions like everyone else. Below are some questions that I have received with the answers I provided. Disclaimer – the answers I provided are my own only and are based on my opinion, the opinions of other “experts” and past history.
Question #1 – How are COVID and the mandatory shutdown going to affect the value of my practice?
Answer #1 – Good practices in good locations are going to sell for a good value in the short and long term. Practices that are in a good area with good cash flow and profitability, good patient base with great staff will sell for a price similar to that of prices pre-COVID shutdown. Buyers reps and consultants will argue that there should be a “COVID Discount” because we don’t know if patients and numbers are going to come back. I call cow-pucky on their argument. For these good practices, there is a reason they are good practices. The goodwill – location, staff, reputation, even the selling doctor is still there. Patients will need work done and the numbers will follow. I’ve spoken with several doctors in the past two days who have nice practices and they reported that their schedule is filling up into the end of June already. There is pent-up demand.
Now, for those practices performing below average of under $450,000 per year with not great margins, older equipment, and transient patient base, they may need to take a discount to sell. They probably would pre-COVID as well, but its even more firm now. The discount can be 10% to 20% depending on the practice.
Question #2 – Are Buyers still Buying Practices?
Answer #2 – In short, yes. We have been marketing our practice listings continuously throughout the shutdown. We have received a number of calls and e-mails with interest in practices. The high demand metropolitan areas are getting the most interest, but we are still getting interest in other areas as well.
Question #3 – Can Buyers get Bank Financing?
Answer #3 – As President of the National Association of Practice Brokers, I have been in contact with many banks across the country. There are some banks that provide practice financing that have completely stopped lending on practices at the moment. They reported that they will start lending again when everyone is back up and running. There are others who have been continuing to lend. Practice sales have occurred even during the shutdown.
Question #4 – Are Banks changing the way they are approving and structuring the transaction?
Answer #4 – Most of the banks have told us that they want to see 60 to 90 days of productivity after the practice has opened. They would like the production to be a minimum of 75% to 85% of pre-COVID production before they’ll approve the loan. For example, a practice producing $100,000 per month pre-COVID will be expected to produce a minimum of $75,000 per month for the two or three months after re-opening. This depends on the bank and there may be exceptions to the rule.
On deal structures, some banks are saying they are lowering their loan amounts to 75% of the production and some will remain at the pre-COVID number of 85%. If the price of the practice is above 75%, the seller will be asked to “carry-back” a portion of the loan. For example, a seller with a practice valued at 85% of collections that is being purchased by a buyer who is using Bank X which has a loan to gross collections of 75% will be asked to carry a note for the last 10% of the value of the practice over a period of time. The term or length of time of the carryback can be negotiated to some degree.
Question #5 – What are the most important things to do if I’m thinking about selling my practice in the near term?
Answer #5 – As “they” say, Cash Flow is King. You need to get your collection numbers back to near where they were pre-Covid as quickly as reasonably possible. You should also evaluate the profitability of your practice and see where you stand compared to where you should be. Ratio analysis will tell you if your payroll, supply, lab expense, etc., is too high, or where it should be. If you need help with the analysis, give Omni a call.
If you have any other questions related to selling your practice either now, or in the future, please feel free to call us anytime. We are always here to give you any guidance and advice that we can. Stay safe and be healthy.Read More
What a crazy time we are in. At least to me, this is a sober reminder that major disrupters are almost impossible to predict. I am reassured that our nation seems to be taking the situation seriously and I do firmly believe we can weather this storm. Most of you reading this are making difficult decisions about staffing, how to deal with emergencies, and how you are going to pay the rent for the next few months. I don’t envy any of you right now. There is a strong support system in this industry ready to help. Don’t hesitate to reach out. I think you will find all of us willing to go the extra mile right now to help you keep the ship afloat.
Many of you reading this are very close to transitioning your practice, some of you being on the fence. It is human nature to want to put off transitioning until after this crisis is over. You may even be getting that advice from your CPA or financial advisor. I am going to give you four reasons why you should do exactly the opposite.
One, value. We have been in a booming economy. Many of your numbers have been at all-time highs over the last couple of years. Now COVID-19 hits. How long will we be shut down? How will the economy look on the other side? Will patients pull way back on elective treatments for a couple of years like they have done in other recessions? In the present, buyers and bankers will mostly be willing to look past these next couple of months as an anomaly. Practice values will hold. For a while. That said, as someone who does Valuations and sells practices, I can assure you that in two years no one will care what your 2018 and 2019 numbers look like. In two years, what happens in 2020 and 2021 will be the new reality.
Two, market. There is a backlog of practices that are nearing the market. The people who work in the transition market have been wondering when that bubble will burst for a few years now. I for one believe this crisis will do the job. That said, many dentists pathologically suffer from procrastination by analysis. Most are going to ignore me and wait for two, three, even five years, watch the market flood, the economy falls off its current pace, and wonder why their practices are down in value and are hard to sell. The early bird gets the worm.
Three, more rules and regulations. Once this crisis is over, they are coming. They won’t be cheap, fun, or easy. You know it and I know it.
Four, time. Many of your potential buyers had their hours cut, some by 100%. They have unprecedented time right now to look at practices. Odds are you also have more free time than normal. Realistically, practice sales won’t close until this crisis is over. That said, there are months of work between deciding to put a practice on the market and a practice changing hands. When life gives you lemons…Read More
By Megan Urban, OMNI Practice Group
As many of you know, in the sale of dental practices, typically the biggest contributor in determining the purchase price is “Goodwill”. Are you aware of the aspects that make up goodwill? Of course, it includes your patients and business reputation, but it’s also based on patient retention, which is your hygiene program or Recare.
Savvy buyers understand that the repeat or retained patients are critical to on-going success. It is also important to lenders working with buyers. If you have a bulk of your patients coming in for large cases and your collections are high, that is commendable, however, a new buyer will be concerned that your patients have completed all treatment leaving them nothing to do and eliminates the chance for the buyer to meet and keep your patients.
All dentists focus on getting enough New Patients, as they should, but what happened to all the New Patients you treated over the years? Consider this example:
Let’s say you averaged 15 NPs per month for 10 years and you saw each on an average of twice per year in hygiene or Recare, you would need approximately 514 days of hygiene if you see an average of 7 per day. Some of you may see more patients in hygiene, but some may be SRP and perio patients may be coming every 3-4 months. You may work around 180-195 days per year so you would need approximately 2.75 hygienists. So that means if you retain at least 85% of those patients, you will need more and more hygiene days each year. Is this happening in your practice?
How many years have you been practicing and how many hygienists do you have? You may feel it’s impossible to fill more hygiene schedules. That tells me you may need revised scripting and a strategy for talking with your patients and educating them about their dental maintenance.
I have analyzed hundreds of practices and found that the average potential for increased collections from goodwill or patient retention is $30,000 to $150,000, depending on the size of the practice. I know it’s usually a high priority in any practice but needs a little tweaking that can bring big increases. And this doesn’t include potential increased collections from diagnosed treatment from all those periodic exams!
I encourage you to look at your own practice statistics. How many patients did you see in Recare in 2019? Run a procedure frequency report for codes 1110, 0120 and see if your numbers make sense based on your number of patients.
Do yourself a favor and increase your collections now and increase the value of your practice for the day you sell. This is my area of expertise and something I enjoy helping my clients achieve. Please contact me if you would like to further discuss and make a plan for your practice.Read More
We have been involved in practice transitions since the mid-1990s. Our company has sold over 500 practices in 10 different states. Doctors have sold their practices for numerous reasons ranging from just being tired of owning and managing a practice to severe health issues forcing them to sell. In all these years and transactions we have performed, not one doctor has come up to us after the sale and said, “I wish I wouldn’t have sold my practice so soon”, or, “I wish I still owned my practice.” In fact, most doctors whom we talk with months, or even years after a transition, say, “Selling my practice was one of the smartest decisions I made. I wish I would have sold much earlier.” So, how do you know when is a good time to sell? Here are a few things to consider:
- The Current Sales Market – Is it a buyer’s or a seller’s market? A buyer’s market is when there are a lot of practices for sale, interest rates are average-to-high and there is low-demand. Currently, as of December 2019, we are in a seller’s market. Interest rates are quite low. The economy is doing well. The demand for practices is high. The demand for practices producing over $700,000 per year is ridiculously high. We can usually sell those in 3 to 6 months. This high-demand and low-interest rates are causing an increase in practice values. In a few years, this will change – and we will probably never see these high values again in our lifetime. You want to sell your practice in a seller’s market that is this hot.
- Being Forced to Sell – There are certain things that are inevitable in life. Getting older is one of them, and that includes all the aches, pains and other health issues that go along with it. Every year, we have seen several doctors sell their practice because of back, neck, hand, or eye site issues, to name a few. We have also seen more serious health issues that forced a doctor to sell. Cancer in all its’ forms, and other diseases, can happen when you least expect it. There have been several doctors who often tell me they are ready to sell, and yet, they don’t put their practice on the market when they’re still healthy. Only when they were diagnosed with cancer did they decide to sell. One of them sold their practice and then passed away the next day. We have story after story of doctors who sold their practice expecting to enjoy retirement with their family only to report back that they or their spouse got sick, or worse yet, passed away. Enjoying retirement and life is something we should all have the opportunity to do. Selling when it’s the right time ensures us of this.
- Harvesting the Equity in Your Practice – This is one of our favorite strategies in selling a practice. And, this hot market with high practice prices makes it even a smarter decision. When you started or bought your practice, you probably took out a loan with the bank. As you’ve been practicing, you have paid your loan down and have built up your practice. The difference between the potential sales price of your practice and any debt you may have on your practice is called equity. Many doctors may have hundreds of thousands of dollars, if not millions of dollars, in equity. This equity doesn’t do anything for you. You can’t do anything with it unless you harvest the equity. You do this by selling your practice. You put the hundreds of thousands, or million dollars into the bank, invest it, or pay off your house. Whatever you’d like to do. You can then work back in the practice you just sold, or work in another practice. Or, you can even go buy a new practice, build it up and harvest even more equity. It’s a beautiful thing.
- And now for Something Completely Different – (This heading is for the Monty Python fans out there!) We all get tired of doing the same old thing, day in and day out. We are just tired of the monotony, tired of staff, tired of the patients and just ready to do something completely different. We have doctors who are ready to change course completely. We have had doctors sell and tell me they want to be a real estate agent, a barista, or they are going to run a surf shop in Hawaii. If you’ve reached that point and are tired of the same old routine, remember – Life is Short, it’s time to take action and do something different. You can always come back years later if you decide you have had a long enough break and are ready to return to practice.
- Annual Production is Decreasing – Just for fun, go back and look at your last five years of profit and loss statements or tax returns. Have your annual revenues gone down year after year after year? How’s your income – has it also gone done year after year? We frequently see this as practice owners start to get a bit tired towards the end of their careers. They slow down their production, but the overhead stays the same, so their income goes down even faster. They then decide to sell and think that the price should be based on what the practice used to do before the slide in production. It doesn’t work that way. A practice’s value is what it’s doing today, not five years ago when it was double. Using the Equity Harvesting strategy (in number 3, above) would have given these doctors hundreds of thousands of additional dollars.
We are imparting this knowledge to you not to get you to sell your practice as soon as possible. We are simply giving you some things to think about and passing on some wisdom from prior experiences of other doctors. Thinking about these five things, in addition to taking action, may provide you more time with your family if you sell a few years earlier. It may also give you more money to have a happy retirement. Look at each one of the five items above and ask yourself, “Do I want to sell your practice when I have to, or when I want to?”
Peace, out.Read More
By planning your transition carefully and working with a trusted broker in the dental practice marketplace, practice sellers can ensure each element of the process is completed smoothly. But first, it’s important to learn more on the types of dental practice transitions available for those considering a sale. In this article, the team at OMNI Practice Group explains the processes involved in several types of dental practice transitions.
Selling a portion of your practice via a partnership has its own pros and cons. One of the pros is that if you can find a partner with similar interests and philosophies as well as a set of skills that enhances your practice and you get along well, you’ve found a winner. The cons are that those types are difficult to find. The ADA states that 70% of partnerships fail. However, if done right using experts in partnerships, you can have a successful and happy partnership transition.
Walk Away Sale
A walk away sale involves the seller removing themselves and their business interests from the practice the moment the sale is completed. This could be ideal for those in the process of retiring or relocating to a new area across the country. But sellers must analyze whether they truly want to walk away from the business they helped create. To complete a walk away sale effectively, sellers must tie up all loose ends many weeks before the buyer completes their transaction. This ensures a seamless handover process and allows the buyer to immediately enter the business with a fresh start.
Sell and Work Back
This can often be very gratifying. The seller sells 100% of the practice but stays to work as an employee in the practice. The seller may cut back their hours or may keep up the pace. The seller and buyer work together, and the seller may even mentor the buyer. The seller no longer has any management responsibility or ownership. He simply does clinical dentistry. As long as the two get along, this can work out wonderfully.
Working with a dental practice transaction broker can help sellers customize the sale according to their unique requirements. Brokers are experts in managing the transition process, from organizing the timing of asset sales to implementing buy back procedures once the sale has been completed. It’s important the company the seller works with has a full understanding of their business plans before they begin the transition process, as this will help reduce potential issues as the transaction is completed.
By having a clear understanding of the available dental practice transition options, owners can ensure the right model is found for their sale process. To learn more, contact us today!