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Growing with the End in Mind: Strategies for Growing Your Practice

By: Gavin Shea

As a mid-career doctor, you may have 15 or 20 years of patient care, staff management and office supervision behind you. Not only is this a significant accomplishment, but can look ahead and decide how you want to approach the remainder of your career. How can you maximize the value and profitability of your practice during the second half of your professional life so you are well situated for a successful retirement?

Here are some helpful strategies for growing your practice mid-career:

Update your technology and equipment

The needs and circumstances of your practice have likely evolved since you first made the decision to purchase your current equipment. For example, it may not have made economic sense when you were starting your practice to create high-efficiency treatment centers enabling you to treat more patients each day ? but now that your schedule is overbooked, it might be logical to do exactly that.

In fact, incorporating updated equipment to increase efficiencies and treat more patients can be an effective way to grow an established practice. Some newer technologies can enable you to offer advanced treatments that you previously referred out to specialists, allowing you to capture those fees. Updating your equipment can also bring real value to your practice as you add tangible assets, as well as perceived value since you can now promote state-of-the-art treatments.

But don't make the mistake of replacing all of your equipment with one major investment, expecting to see an immediate boost in practice growth. It may take years to recoup the amount of your technology investment through an increase in traffic flow and fees. Instead, consider creating a technology investment plan that sets aside funds on a regular basis for well-planned equipment purchases. To initiate a technology investment plan:

  • Keep abreast of new technology developments through periodic meetings with your equipment supplier, and ask for referrals to dentists who have purchased the equipment so you can learn about their experiences.
  • Prioritize the technologies you wish to incorporate over the next few years, including software and hardware systems, digital equipment and tools, and utility systems that power your practice.
  • Set aside funds every month -- for example, 5% of net profits -- for future equipment purchases. That way, you can be ready to take advantage of new advancements that can benefit your patients and practice.
  • Actively market your new technology investments to your patients so they are aware of the advanced processes and services you now offer.

Most important of all, remember that the key benefit of any purchase of advanced technology should be a higher level of care for your patients achieved through improved outcomes, less pain, greater convenience, and more efficient service.

Add an associate to your team

Another strategy for expanding your treatment portfolio and growing your practice mid-career may be to add an associate to your team. The right associate can enable you to increase your capacity to treat patients while simultaneously mentoring the newer dentist towards a future transition into partnership or ownership of the practice. However, be aware that training an associate can take a considerable investment of time and resources.

So how do you know when the timing is right to add an associate? Here are some indicators to watch for:

  • You are regularly booked out at least four weeks
  • New patients are turning down appointments because you can't see them soon enough
  • You are losing patients to a competitor across town with a broader service offering

To calculate whether your practice is well positioned to support a new associate, try using this common rule of thumb :

Your practice may be able to support a new associate if it has ...

  • A minimum of 2,000 active patients,
  • Hygiene booked four to six weeks ahead, and
  • The financial ability to subsidize six to 12 months of associate salary.

Build an additional operatory

Mid-career doctors who have been practicing in the same facility for many years may find the size of their space is limiting their potential for production. As you grow your patient base, staff and services over your professional life, it only makes sense that you may also need to grow your space in order to meet demand and maximize productivity.

Of course, expanding your facility to satisfy your full potential for production can be a considerable financial and logistical undertaking. In fact, dentists who seek to improve their workspaces may be surprised by the magnitude of the project to which they've committed themselves and their checkbooks.

Adding an operatory to your practice may increase your bottom line. That's because the additional space can allow for the treatment of emergency patients who may have previously been referred to another dentist. Emergency procedures may equal or offset the loss of revenue from those patients who cancel their appointments or are no-shows.

The bottom line when it comes to growing your practice is that no matter where you are in your dental career, it's never too late to further develop your practice to better serve your patients and ultimately position yourself for a successful and profitable retirement.

About the Author

Gavin Shea is the National Director, Healthcare for Wells Fargo Practice Finance. With more than 17 years of banking experience with an emphasis in practice lending, he leads sales and marketing strategy development and implementation throughout the national footprint. His industry background offers practitioners a unique perspective as they approach some of the most important decisions in their professional lives. With more than 30 years of practice lending experience, Wells Fargo Practice Finance specializes in helping healthcare professionals acquire, start and expand their practices with various financing options and a signature Practice Success Program. Contact: gavin.m.shea@wellsfargo.com or 844-626-4317

View all articles by Gavin Shea


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The views expressed in the articles are those of the authors alone. They may or may not reflect the views or opinions of Wells Fargo.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

ADA® is a registered trademark of the American Dental Association. ADA Member Advantage is a service mark of the American Dental Association. ADA Member Advantage is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association.

All financing is subject to credit approval.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

All financing is subject to credit approval.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

All financing is subject to credit approval.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

All financing is subject to credit approval.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

All financing is subject to credit approval.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

All financing is subject to credit approval.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

All financing is subject to credit approval.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

All financing is subject to credit approval.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

All financing is subject to credit approval.

Wells Fargo Practice Finance is the only practice and commercial real estate lender recommended for members of the American Dental Association.

ADA® is a registered trademark of the American Dental Association. ADA Member Advantage is a service mark of the American Dental Association. ADA Member Advantage is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association.

All financing is subject to credit approval.

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