Orthotown June 2019 - 10

personal practice life where decisions needed to be made, what was
done and how it all worked out. It wasn't that I was unhappy-I
just like to take on a challenge, achieve it and move on to the next.
I have a strange feeling many of us are similar in this regard.
Let me tackle some of the many decision points one needs to
make as we proceed on the business cycle curve. Over the years,
the recurring themes in my personal life-and I'm sure in many
of yours-involve:
* Locations and build-outs.
* Attorneys and accountants.
* Practice consultants or coaches.
* Financial advisers.
(Taking on associates, ultimate transitions, or sales and real
estate are also sizable decision points in a practice career, but I'll
address those at a later date.)

Locations and build-outs
Locations and build-outs are some of the first decisions to make
after choosing whether to buy an existing practice or go alone
with a fresh start. The decision to purchase a practice is much
different these days, because keeping an existing practice growing
and functioning is difficult, much less starting one from scratch.
From what I hear and can attest to, "small practices" rarely
have enough cash flow to support the owner, let alone an owner
and purchaser. For that reason, if you move in the direction of
purchase, it needs to be done with the same type of due diligence
paid to purchasing any other type of business.
Ask yourself: "If I were to purchase this business for cash, could
I pay the going rate for an orthodontist and make a decent return on
my invested cash?" If so, go for it. If not, keep thinking or move on.
If the decision is made to build out a practice in a select location,
build for the future-but not for another associate in the same
location. Rarely can one justify two highly paid professionals in the
same building. It's been my observation that there are just too many
dental chairs. It's much more cost-effective to hire more assistants,
paraprofessionals like hygienists or other licensed practitioners.
Also, the reason McDonald's started serving breakfast and lunch
was because it made their real estate more profitable. Think in these
terms-not more associates working fewer hours.

Attorneys and accountants
I'm always disturbed when professionals say they're going to ask
their accountant or attorney for advice. I don't dispute that they
are valuable partners in your journey, but they're hired to put your
ideas and decisions into legal frameworks. Definitely look for their
suggestions and ideas, but do not defer to theirs only. Endless hours

10

JUNE 2019 // orthotown.com

of wasted time and money are spent if you expect them to arrive at
your business decisions, business plans and entrepreneurial ideas.
You need to have your own vision; they help to put it on paper.

Consultants and coaches
If you're on your way to growth and success, now is about
the time when HR issues and difficulty developing processes and
procedures are becoming apparent.
Unless you're extremely talented, have the time and are willing
to spend hours upon hours training one-on-one with your new
staff, prepare to hire a consultant if for no other reason than to be
the enforcer for you. In my practice career, almost every 7-10 years
the need for a consultant became obvious. If not for consultants, I
wouldn't have practiced with an office manager and a new-patient
coordinator, employed same-day starts or hired a professional relations
coordinator. In other words, doing things the "same old way" was
identified and a new paradigm was introduced into the practice.
As you can see from that list of attainments, there are many trends
and milestones to reach in a growing practice.
Each consultant has his or her own special talent and specialty.
Ask about their strengths and weaknesses on the Orthotown message
boards-plus, there are ample examples of them published in
Orthotown magazine. One bit of advice: You can't change your inner
personality or tendency. Just like a spouse who tries to change his or
her partner is doomed to fail, so too can an overpriced consultant
fail to gain results if your inner feelings and the consultants don't
line up. If you have misgivings, it's best to move on.

Financial advisers
This is the big one.
There is no shortage of financial advisers who are willing
to take a piece of you for a fee. Let me assure you, there are no
simple, untested and proven ways to get rich quick. The practice
of orthodontics allows you to get rich slowly. It doesn't matter
what you invest in as much as investing itself. "Pay yourself first"
should be your motto. Spend less than you earn and save as much
as you can. Stick with it and don't chase the next big thing. The
best financial adviser has a fiduciary relationship with you and at
best keeps you from making emotional decisions.
I've run out of family members to share stories and anecdotes
about. My wife, Nancy, the calming influence in my life, has allowed
me to pursue my dreams, stay on track and, by the way, raise three
wonderful children whose individual lives I have previously shared.
I hope that you can relate to their life experiences and add them
to yours. (BTW, this was written on Mother's Day!) ■


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Orthotown June 2019

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