Tip 1: Verify you have an accurate active patient count. Often the count is greatly inflated. This is less of an issue then in the past due to practice management software. If patient info has been correctly entered for all patients then the active patient count should be good. There are different opinions as to what constitutes an active patient but counting any recall patients going back eighteen months works. Doing so takes into account patients who have slipped off the radar but can be gotten back in. 

Tip 2: Has extensive dentistry already been done on most patients? If so, then most of the new production from active patients will be in hygiene. The more complete dentistry that has been done, the less ROI. If there hasn't been a lot of comprehensive dentistry done you can  convert many of the patients, if you do so on a gradient.

Tip 3: I've not seen the selling dentist staying on for a long period of time to be workable unless there is plenty of work for both dentists and the chemistry between them is right.  How long depends depends on how adequate the patient base is. The purchasing dentist usually has a heavy debt load so needs to make as much income as possible. In such situations have the selling dentist only stay on for whatever time is needed to introduce the buying dentist to patients.

Tip 5: The staff in a practice that is old school will often be set in their ways such as not collecting at time of service so any changes in office policies, whether the changes effect patients or staff, can cause upsets if not handled properly. Also old school staff are often computer illiterate, to one degree or another. Staff who have been with the dentist for a long time are usually practicing a style of dentistry that is outmoded. The time and frustration to train them is generally not worth it. However, if possible, you don't want wholesale changes in the hygiene and front desk positions, for approximately six months, as these are usually the positions the patients bond with the most.

Tip 6:  ARs can be skewed if the office has not been running day sheets, closing out month or year end reports, generating statements on a monthly basis or tracking insurance claims which, is not unusual.

Tip 7:  Dentist People Ratio of one dentist for 2000 people would be the lowest I would go. One dentist for 3000 people would be a good deal. One dentist for 4000 people would be lucrative.Rural areas can be less. 

Tip 8: The seller's insurance agreements should be reviewed.  Do not assume what you are told is accurate.

Tip 9: After purchase, do not "push" on exisitng mature patients.  Some may not want x-rays. Have your hygienist tell them before you get in the room  that  x-rays are due as it’s been a few years. If they refuse, the hygienist needs to tell you in front of the patient and document in chart. Most patients will end up getting the x-rays on their next visit having. Have hygienists use an intra-oral camera on all questionable teeth. Take a picture of the tooth, if it looks like something has changed since last visit, let the patient know the doctor might need to take x-rays.  Doctor comes in, does full exam, looks at the tooth and say, "Looks like the filling is breaking down. We need to take an X-ray to rule out any cavities or infection.  So, bottom line with older patients, don’t change anything. 

Tip 10: Have the selling doctor send out a letter using the practice's current letterhead. One letter per household. The seller personally signing each letter is also recommended and where appropriate include a personal note and use the patient's first name. A few months later the buying dentist can send out another introductory letter, brochure or pamphlet. The higher the quality the better. 

Kevin Tighe, Cambridge Dental Consultants, Senior Consultant, got bitten hard by the business and marketing bug during long summer days working at his dad's Madison Avenue ad agency. After joining Cambridge as a speaker in the mid-1990s, Kevin went on to become Cambridge’s senior consultant and eventually CEO. Cambridge Dental Consultants is a full-service dental practice management company offering customized dental office manuals. Frustrated? High overhead? Schedule a chat with Kevin at