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What Buyers Overlook: How a Dental Practice’s Culture Impacts Your Success

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Beyond the Numbers: Why Culture Matters More Than You Think

When buyers evaluate a dental practice, they usually focus on collections, overhead, active patients, and equipment. These are essential indicators of value—but they don’t tell the whole story.

What’s often overlooked?

  •  The culture of the practice.

Culture isn’t something you’ll find in a P&L statement, but it can directly impact:

  • Staff retention

  • Patient satisfaction

  • Your leadership experience

  • Long-term growth

The truth is, culture can be the reason a practice thrives—or the reason it falls apart after a transition.

What Do We Mean by “Culture”?

In a dental office, culture refers to the personality of the practice. It’s shaped by:

  • How the staff interacts with each other

  • How the doctor communicates with patients

  • The pace and style of appointments

  • Office traditions, systems, and even jokes

  • The unspoken “way things are done here”

You may be buying charts and chairs—but you’re inheriting a team, a tone, and a rhythm.

Signs of a Healthy Practice Culture

Before making an offer, look for these signs of a positive, stable culture:

  • Low staff turnover: Long-tenured employees often mean strong relationships and trust.

  • Clear roles and responsibilities: Do team members know what’s expected of them?

  • Respectful communication: Between the doctor, staff, and patients.

  • Staff engagement: Are people just punching a clock—or do they care?

  • A well-run morning huddle or team meeting: It shows systems are in place.

  • Positive patient feedback: Online reviews and word-of-mouth matter.

You’ll feel the culture the moment you walk in—trust your instincts.

What Happens When Culture is Ignored?

Even when the numbers look great, buyers who don’t consider culture risk:

  • Losing staff quickly after closing

  • Disrupting patient experience and satisfaction

  • Clashing with the team’s way of working

  • Feeling isolated or unwelcome as a leader

  • Struggling to implement change

You may inherit a high-producing practice—but if the culture breaks down, so will performance.

How to Assess Culture During Due Diligence

1. Talk to the Seller About Leadership Style

How hands-on are they? Do they micromanage or delegate? This affects what the staff is used to.

2. Ask How Conflict Is Handled

Do problems get addressed directly, or are they swept under the rug?

3. Observe Interactions Quietly

Are staff members friendly to one another? Does the front desk greet patients by name? These small moments tell you a lot.

4. Inquire About Staff Tenure and Roles

A long-tenured hygienist or front desk manager can be your greatest asset—or your biggest challenge if not handled with care.

5. Ask the Seller What the Team Values Most

Flexibility? Autonomy? Structure? These clues help you lead effectively post-close.

Can You Change the Culture After You Buy?

Yes—but with patience.

Culture doesn’t shift overnight, especially if staff have been together for years. Instead of trying to overhaul everything, consider:

  • Listening first: Conduct one-on-one meetings with each team member.

  • Preserving what works: Keep systems that are functional. Change comes later.

  • Making staff part of the process: Invite their input before implementing new tools or policies.

  • Communicating clearly: Share your philosophy and vision—don’t leave them guessing.

  • Introducing gradual improvements: Avoid overwhelming people with sweeping changes.

Remember, you’re not just becoming the owner—you’re becoming the leader.

Final Thoughts: Culture Can’t Be Quantified—But It Can Make or Break You

Before you buy a practice, take time to understand the people behind the numbers. You’re not just purchasing revenue—you’re stepping into a community.

A good cultural fit creates smoother transitions, higher retention, and long-term growth.

A bad fit? It can drain your energy, frustrate your staff, and stall your momentum.

  • As you evaluate practices, ask yourself: “Can I see myself thriving here?”

If the answer is yes, the numbers may be the easy part.

Need Help Finding the Right Fit?

At American Practice Consultants, we help buyers look beyond the spreadsheets. We guide you through not only financial due diligence—but also the interpersonal factors that shape long-term success.

📞 Contact us today to start your journey toward practice ownership—with clarity, confidence, and culture in mind.

Beyond the Numbers: What Buyers Should Ask the Seller During Due Diligence

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Why the Numbers Only Tell Half the Story

When buying a dental practice, reviewing financial reports, production data, and patient counts is essential. But the numbers alone don’t paint the full picture.

What you ask the seller directly during due diligence can reveal critical insights into the practice’s operations, culture, challenges, and growth potential—things no spreadsheet will show you.

  • The right questions can help you avoid surprises, build trust with the seller, and start your ownership journey with clarity and confidence.

In this post, we’ll outline the top questions buyers should ask the seller during due diligence—plus tips for how to ask them in a way that builds rapport and supports a smooth transition.

“Why Are You Selling Now?”

This simple question opens the door to a bigger conversation. Is the seller:

  • Ready to retire?

  • Burned out?

  • Moving away?

  • Concerned about upcoming changes?

Their answer can offer important context—and sometimes, opportunities. For example, if they’ve been coasting toward retirement, there may be room for operational or marketing improvements.

“What Procedures Do You Refer Out—and Why?”

Understanding what’s being referred out can reveal untapped revenue potential.

Ask:

  • Do you refer out endo, extractions, implants, perio surgery, or ortho?

  • Is it due to skill preference, time constraints, or equipment limitations?

If you’re comfortable with those procedures (or plan to bring in a specialist), this can signal significant room to grow production post-sale.

“Tell Me About Your Team.”

Staff dynamics are a huge part of what you’re buying. Ask:

  • Who are the key team members?

  • How long have they been with the practice?

  • Are there any upcoming retirements or staffing concerns?

  • What roles are essential to day-to-day operations?

Also inquire about compensation, bonuses, and overall team culture. A stable, experienced staff can make your transition much easier.

“How Do You Handle Recall and Hygiene Scheduling?”

The strength of the recall system often reflects long-term patient retention and production stability.

Ask:

  • Is hygiene fully booked weeks out, or are there open slots?

  • Do you have a formal recall system or automation in place?

  • How often do patients return for cleanings?

  • How far out do you schedule preventive visits?

This gives you insight into how well the practice supports recurring revenue and patient loyalty.

“What Marketing Efforts Are You Currently Using?”

Many retiring sellers scale back or eliminate marketing. That’s not always a bad thing—it can mean room to grow.

Ask:

  • Do you do any online or offline marketing?

  • Do you track where new patients come from?

  • Is there a website or social media presence?

  • Are you getting referrals from other providers?

If the practice has grown organically or by reputation alone, even a small marketing effort could yield big results under your ownership.

“What’s Your Approach to Treatment Planning and Case Acceptance?”

Clinical philosophy matters. Understanding how the seller recommends treatment can help you assess patient expectations and communication norms.

Ask:

  • Are you more conservative or comprehensive with treatment planning?

  • Do you use intraoral cameras or other patient education tools?

  • How do you present larger cases?

This will help you plan how to maintain trust with existing patients—or shift communication strategies over time.

“Are There Any Known Equipment or Facility Issues?”

This isn’t just about age of equipment—it’s about function and future costs.

Ask:

  • What equipment is leased, and what’s owned?

  • Are there any maintenance issues or needed replacements?

  • How old are the major systems (e.g., compressor, vacuum, sensors)?

A good seller will be honest. Catching this early helps you budget wisely and may support negotiations.

“What Would You Improve If You Were Staying?”

This is one of the most revealing questions you can ask. Sellers often know where the practice could improve—but didn’t want to invest the time or money themselves.

You might hear:

  • “I’d upgrade the technology.”

  • “I’d extend hours or offer more payment options.”

  • “I’d update the website and start doing social media.”

These insights can become part of your growth plan post-sale.

“What Should I Expect in My First 90 Days?”

This gives the seller a chance to coach you a bit and set realistic expectations.

Ask:

  • How quickly do you expect patients and staff to adjust?

  • What’s the best way to introduce myself to patients?

  • Are there any quirks or “unwritten rules” I should know about?

A seller who wants a smooth transition will be happy to offer this perspective.

Ask Questions That Build a Foundation

During due diligence, don’t be afraid to ask more than just what’s on paper. Smart, respectful questions show the seller that you’re serious—and they help you walk into your new role prepared.

  • After all, you’re not just buying numbers—you’re stepping into a leadership role. Understanding the story behind the stats helps you lead with confidence.

Ready to Start Your Due Diligence Journey?

At American Practice Consultants, we help dental buyers navigate every step of the process—from asking the right questions to interpreting the answers.

Contact us today for a confidential buyer consultation and start your transition with clarity.

Due Diligence 101: What Every Dental Practice Buyer Needs to Review Before Closing

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Why Due Diligence Matters

So, you’ve found a dental practice that seems like a perfect fit—great location, solid collections, loyal patients. The numbers look promising, and the seller seems trustworthy.

Now it’s time for due diligence—the phase where you verify everything you’ve been told before finalizing the purchase.

  • Think of due diligence as your opportunity to “look under the hood” and confirm that the practice is everything it appears to be.

In this post, we’ll walk you through the key areas every buyer should review so you can move forward with confidence—and avoid surprises after closing.

Financial Statements and Tax Returns

Start by requesting the past 3 years of:

  • Profit & Loss Statements

  • Tax Returns (Federal)

  • Production and Collection Reports

Look for:

  • Trends in revenue and expenses

  • Consistency between tax returns and internal reports

  • Profitability after adjusting for seller’s perks (owner add-backs)

Pro Tip: Have a dental CPA help you interpret the numbers—especially to calculate adjusted EBITDA or cash flow.

Patient Base and Production Mix

You’re not just buying numbers—you’re buying patient relationships.

Review:

  • Number of active patients (typically defined as those seen in the last 12–24 months)

  • New patient flow

  • Procedure codes and production by type (restorative, hygiene, specialty, etc.)

  • Treatment referred out (growth opportunity!)

Ask: Is this a recall-driven practice or one dependent on new patient flow?

Hygiene Program and Recall System

The hygiene department is often the lifeblood of a general dental practice.

Request data on:

  • Hygiene production as a % of total production

  • Recall scheduling systems

  • Frequency of continuing care visits

Strong hygiene = stable recurring revenue.

Fee Schedules and Insurance Participation

Review the practice’s:

  • UCR fees (Usual, Customary, and Reasonable)

  • PPO participation and reimbursement rates

  • In-network plans and potential credentialing needs

Compare fees to regional benchmarks.

Ask if there are opportunities to drop low-paying plans post-sale.

Staffing and Payroll

A great team can make or break your first year of ownership.

Request:

  • Staff roster with roles, hours, and length of employment

  • Compensation and benefits

  • Employment agreements or contracts

  • Any known issues with morale or turnover

Be sure to factor salaries and benefits into your cash flow projections.

Lease, Real Estate, and Equipment

If the practice is in a leased space:

  • Review the current lease agreement

  • Check for assignment clauses or landlord approval requirements

  • Understand rent escalations and renewal options

If the real estate is for sale:

  • Get an independent appraisal

  • Consider whether owning or leasing makes more sense

Also inspect:

  • Equipment age and condition

  • Digital vs. analog systems

  • Technology you may want to upgrade

Legal and Compliance Review

Have your attorney review:

  • Corporate structure and ownership

  • Licensure and permits

  • HIPAA compliance and record keeping

  • Any pending legal issues, claims, or audits

It’s rare—but not unheard of—for legal or compliance concerns to surface during diligence. Better to uncover them now.

Watch for Red Flags

Be alert to signs of concern, such as:

  • Drastic year-over-year revenue drops

  • Incomplete patient records

  • Over-reliance on high-production procedures

  • High staff turnover

  • Unusually low net income despite high collections

These don’t always mean a deal-breaker—but they require deeper investigation.

Do the Work Now, Avoid Regret Later

Due diligence isn’t the most exciting part of buying a practice—but it is one of the most important. It’s your chance to validate the opportunity, reduce your risk, and plan your transition with eyes wide open.

The more thorough your review, the smoother your ownership journey will be.

Need Help Navigating the Due Diligence Process?

At American Practice Consultants, we specialize in helping buyers assess practices from every angle—financial, operational, and clinical. Let us help you make a confident decision.

Contact us today to schedule a confidential buyer consultation.

You’re the New Boss — Now What? How to Retain Staff and Build Trust After Buying a Dental Practice

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Patients Aren’t the Only Ones You’re Inheriting

When you buy a dental practice, you’re not just acquiring patients and equipment — you’re stepping into a team dynamic that already exists.

The front desk knows the patients by name.

The assistants understand the doctor’s clinical rhythm.

The hygienists are the heartbeat of the recall system.

These staff members are key to your success — and their decision to stay or leave can shape the trajectory of your ownership.

In this post, we’ll explore how to retain the existing team during your first 3–6 months of ownership, reduce staff anxiety, and build a healthy, high-performing office culture from Day One.

Why Staff Retention Should Be a Top Priority

During a transition, the biggest risk isn’t losing patients — it’s losing staff.

If staff members leave, you may face:

  • Disruption to patient experience

  • Slower onboarding and productivity

  • A drop in revenue and patient trust

  • A stressful start to your ownership journey

On the flip side, retaining staff leads to:

✅ Smoother transitions

✅ Higher patient retention

✅ Built-in operational knowledge

✅ Increased morale and performance

Start with Thoughtful Communication

One of the best ways to earn staff trust is to lead with transparency and empathy. After the sale is finalized (or close to it), schedule a staff meeting to introduce yourself and share your intentions.

What to Cover in Your First Meeting:

  • Acknowledge their loyalty to the practice

  • Share your appreciation for their work and commitment

  • Outline what’s not changing right away (keep systems steady at first)

  • Share your long-term goals and how they can grow with the practice

Avoid making sweeping changes in the first 30–90 days — stability is the name of the game.

Offer Incentives for Staff to Stay Through the Transition

Even if staff members like you, they may be unsure about staying. Offering transition incentives can give them financial and emotional motivation to stick around through the handoff.

💡 Retention Incentive Ideas:

Incentive

How It Works

Retention Bonus

Offer a bonus (e.g., $1,000–$2,000) to team members who remain with the practice for 90 or 180 days after the sale.

Welcome Gift or Note

A small gesture (like a handwritten card or gift card) shows appreciation and personalizes the transition.

One-on-One Time

Meet with each staff member individually to hear their concerns, goals, and feedback.

Job Security Agreement

Consider a short-term employment contract or formal letter of intent to stay with consistent pay and benefits.

Continuing Education (CE) Support

Offer to fund one CE course for each team member in the first 6 months to show investment in their growth.

Tip: Put any bonus or incentive structure in writing so expectations are clear.

Respect the Culture Before You Reinvent It

Every practice has its own workflow, rituals, and quirks. As the new owner, you may have your own ideas about how things should run — and that’s okay — but:

Culture change works best when it’s gradual and collaborative.

Start by observing:

  • How the team interacts

  • What systems are working

  • Where there’s tension or opportunity

Then invite feedback before making changes. This builds trust and helps staff feel heard — not steamrolled.

Encourage Open Dialogue and Feedback

Transitions can make staff feel insecure, even if nothing major is changing. Create space for honest conversation by:

  • Holding weekly or bi-weekly huddles

  • Inviting anonymous feedback

  • Asking, “What’s one thing I can do to support you right now?”

When staff feel seen and safe, they’re far more likely to stay — and to help your vision succeed.

Celebrate Small Wins Together

Even something as simple as:

  • Treating the team to lunch on your first Friday

  • Celebrating patient growth milestones

  • Shouting out great teamwork in morning huddles

…can go a long way toward building camaraderie and showing your appreciation.

Conclusion: You’re Not Just Taking Over a Practice — You’re Leading a Team

Buying a dental practice is a business decision, but succeeding as the new owner means becoming a trusted leader. By focusing on staff retention and morale from Day One, you set the tone for your practice culture, patient satisfaction, and long-term success.

When the team stays — and thrives — so does the practice.

Looking for Practices With Strong Teams and Growth Potential?

At American Practice Consultants, we help buyers find not just the right numbers — but the right people. We specialize in practices with strong, loyal teams and offer transition support strategies to help you hit the ground running.

📞 Contact us today for a confidential buyer consultation.

Thinking About Practice Ownership? Here’s What Dental Students Should Be Doing Now

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It’s Not Too Early to Start

If you’re in dental school—or just starting out as an associate—you might think owning a practice is years away. And you’re probably right. But here’s the truth most new dentists miss:

The most successful owners are the ones who start preparing long before they’re ready to buy.

You don’t need to know exactly when or where you’ll buy a practice, but by making a few smart moves now, you’ll dramatically improve your options when the time comes.

In this post, we’ll explore what dental students and early-career associates should be doing 3–5 years before ownership—so you’re not just ready, but confident, when the opportunity arrives.

Get Clear on Your Long-Term Vision

Practice ownership isn’t a one-size-fits-all goal. Start thinking about:

  • 🏙️ Where you want to live and work

  • 👥 Who you want to serve (families? high-end patients? underserved populations?)

  • 💼 How you want to practice (solo? group? partnership?)

  • 🛠️ What kind of practice culture, clinical philosophy, and technology matter to you

The clearer your vision, the easier it will be to recognize the right opportunity when it appears.

Pay Attention to the Business Side of Dentistry

Dental school is focused on clinical skills—but if you want to own a practice, you’ll need to understand:

  • Profit and loss statements

  • Overhead and collections

  • Staff management

  • Patient acquisition and retention

  • Insurance and fee structures

How to get started now:

  • Shadow or talk to private practice owners

  • Ask questions about how the office runs—not just the procedures

  • Read business books or listen to dental ownership podcasts

Keep Your Finances (and Credit) in Order

When you’re ready to buy, lenders will want to see:

  • A solid credit score

  • A history of responsible debt repayment

  • Reasonable savings for a down payment or emergency cushion

Pro tip: Start tracking your income and expenses now. Even a basic budget will help you build good financial habits that make borrowing easier later.

Choose Associate Roles That Build Ownership Skills

Not all associate positions are equal. As you enter the workforce, seek roles that offer:

  • Exposure to different procedures

  • Clear metrics (so you understand production and collections)

  • Mentorship from an owner who is willing to explain the why behind their decisions

  • A possible path to ownership (some associateships lead to partnerships or buyouts)

Every job is a chance to learn what you do and don’t want in your future practice.

Start Building Your Support Team

Practice ownership isn’t something you do alone. Start building relationships with professionals who specialize in dentistry:

  • Dental CPAs

  • Practice brokers

  • Commercial lenders

  • Practice consultants

  • Attorneys familiar with dental transactions

These experts will guide you through everything from financing to contracts to valuation when the time comes.

Stay Curious About Practices for Sale

Even if you’re not ready to buy, it helps to:

  • Look at practice listings

  • Review sample valuations

  • Ask brokers questions

  • Learn what different price ranges get you in different markets

This builds your market knowledge and gets you comfortable with the buying process.

Ownership Starts Before You’re Ready

You don’t need to know everything today—but if you start laying the groundwork now, you’ll be positioned to own the right practice in the right way, at the right time.

Ownership isn’t about perfection—it’s about preparation. And you’re already on the right path.

Thinking Ahead? Let’s Talk.

At American Practice Consultants, we work with future buyers at every stage—even if ownership is still a few years away. We’ll help you plan your path, understand the market, and be ready when the time is right.

📞 Contact us today to schedule a confidential buyer consultation, even if you’re still in school.

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