#1: The Build-Up Weekly

Dear friends and colleagues,

Welcome to the first ever Build-Up Weekly, where we’ll be delivering weekly insights and inspiration for dentists on every stage of the private practice journey!

I hope you’ve all had a great week!

Three years ago I started writing a weekly newsletter, attempting to help our community of dentists navigate the rapid developments and challenges of spring 2020, including practice closures, loans and grants, finding the right air purifier, and toilet paper shortages.

We kept at it, week after week. I tried to include content that was relevant to dentists at every stage of private practice, but after 143 weekly newsletters, it was still a “practice sales” newsletter.

Today, that is changing. Welcome to The Build-Up Weekly.

The plan is to have something for everyone - where by ‘everyone’, I mean dentists in or contemplating private practice.

Each edition (in your inbox every Friday) will have four sections:

• In 🚀 The Acquisition 🚀 we discuss issues related to, you guessed it, buying a practice!

• In 🪴 Growth Stage 🪴, we’ll be sharing practical tactics and meaningful tips for success at any stage of private practice.

• In 💸 The Transition 💸, the focus will be on issues surrounding the sale of a dental practice.

• Finally, in 💡Weekly Inspiration💡, our goal will be to live up to the name of the newsletter - we’re here to build each other up.

Sometimes I’ll be sharing links to articles that others have written, sometimes I’ll be sharing stuff that I’ve written, and sometimes we’ll have videos or other fun items.

I hope that you all enjoy this new format.

My goal is to build up this newsletter to include as many dentists as possible. To that end, I would be honored if you would share this newsletter with your friends and colleagues.

In order to thank you for your referrals, I’ve set up a little program:

• 3 Referrals = Personal Shout Out in the Newsletter

• 5 Referrals = $5 Starbucks Gift Card

• 35 Referrals = Yeti Tumbler

Here is a link that makes it easy to refer.

And with that, let’s dive in!

Types of Leases: Pros and Cons

This week on ‘The Acquisition’, I thought it would be good idea to talk about leases! For many dentists, buying their first practice is also the first time they sign a commercial lease.

Let’s look at three of the most common types of leases that tenants can enter into with commercial landlords.

Gross Lease: The the tenant pays a fixed amount of rent each month, and the landlord covers all of the property expenses, such as property taxes, insurance, maintenance, and repairs.

• Pro: You know what you owe.

• Con: Higher upfront rates.

Modified Gross Lease: A hybrid between a gross and triple net lease. The tenant pays a fixed amount of rent each month and splits some of the associated property costs related to their unit with the landlord.

• Pro: Split risk with landlord.

• Con: Harder to budget.

Triple Net (NNN) Lease: Where the tenant is responsible for paying the property expenses, such as taxes, insurance, maintenance, and repairs, in addition to the monthly rent.

• Pro: Lower monthly rent.

• Con: Potentially more volatile expenses can lead to cash flow issues.

Important additional considerations:

A NNN lease may be more cost effective with a newer construction building, whereas a gross lease may be more cost effective for an older building that needs more (and more expensive) maintenance and upkeep.

On a related note, however, consider the landlord’s incentives. If they can pass expenses on to the tenant (with NNN or modified gross), they may be more inclined to keep up the building. If they are receiving the same amount regardless (a gross lease), they may be less inclined to keep up the building.

Ready to dive deeper? Investopedia has great articles on gross leases, modified gross leases, and triple net leases.

As always, speak with a professional before engaging in lease negotiations. And understand that each of these lease types can work well – a practice that’s a great fit may not have the perfect lease type, but it can still be the right choice for you.

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Refocusing on Reactivation

This week on ‘Growth Stage’, I wanted to discuss reactivation (the systems we use to ensure that our patients are returning to the practice for regular care).

The best way, of course, to keep patients active and engaged is to ensure that they don’t leave without their next appointment scheduled.

However, the last few years have been wonky (to say the least). In many practices that I’ve analysed recently, patients have been slipping through the cracks.

We don’t want that!

So how do we focus on reactivation? The first step is to go to your practice management software. This is also a great time to clean up your active and inactive patients.

Dentrix: Check out this article on The Forgotten Patients and run this report to see the patients overdue for continuing care. Also check for patients who may have never been seen for hygiene or entered into a continuing care program.

Eaglesoft: Check out this article titled How Truthful is Your Data (relevant quote: “However, Eaglesoft calculates this percentage based on the number of active patients Eaglesoft thinks you have, not how many you truly have.”). Then run these reports to see how many patients have not been seen during a specific date range.

OpenDental: Here are instructions for running a reactivation report in OpenDental.

Once you know where to find past due patients, it’s time to get to work getting them back in the practice. Here are a few more tips for reactivation:

Responsibility: You either need one person who is responsible for reactivation (and has time set aside to make phone calls, send text messages, email, etc.), or you need a specific schedule with multiple team members to ensure that reactivation is actually being worked on.

Reporting: However you set up the responsibility, reporting is crucial. Get weekly numbers of past due patients, contacted patients, reappointed patients, lost patients, and patients who haven’t responded.

Cadence: Set up a regular cadence to ensure that patients who fall through the cracks are being reached out to.

Reactivation should be an ongoing project, but it’s easy to let it fall by the wayside. If this is you (or if you’re unsure whether or not your front office is handling reactivation consistently), then it’s time to get back to it!

Systems and Selling

This week on ‘The Transition’, I wanted to highlight something that came to mind as I wrote about the reactivation system above.

Maintaining systems (like regular reactivation) gets more important the closer you are to considering a sale. 

Unfortunately, this is often the opposite of what happens.

Why is maintaining systems so important?

1. Systems allows the practice to continue running smoothly when we are distracted or taking more time for ourselves. As a practical matter, this is often true of the doctors we work with who are considering a sale. They’ve paid off the house, the kids are through college, and they are feeling ready to slow down. If your mind is elsewhere, systems keep the ball rolling.

2. Systems increase revenue and profitability. No matter how you slice it, if everyone knows what their job is and all aspects of the practice are covered, then your profit will go up. This not only means more take home income for you, but it also means a higher practice value.

3. Systems make it easier for an incoming buyer to continue to take great care of your practice and benefit from the practice you’ve worked so hard to build.

So if you’re considering a sale, review your systems. Consider bringing in a consultant to keep an eye on things and keep everyone motivated as you approach retirement.

There are exciting times ahead, but don’t get so distracted that you lose focus on the business that you are planning to sell.

And if you’re considering a sale, get connected with your local Integrity Practice Sales agent here.

My goal for The Build-Up Weekly is not only to provide great information to dentists at every stage of the private practice journey, but also - as the name suggests - to build each other up.

This week, I wanted to share a quote from the American novelist and essayist Annie Dillard about writing. I think it’s broadly applicable, no matter what our projects are. It’s about giving it all and giving it now. Here’s the quote:

If and when you have something to give - be it a complement to a team member or family member, a good idea to attract new patients, something you want to write or play or sing or dance, or a newsletter you want to assemble - whatever it may be, consider giving it all and giving it now.

And with that, I hope you enjoyed our first edition of The Build-Up Weekly!

Please consider using the link below to share our newsletter. 🙂 

With best wishes to you and your families,

Trevor Kimball

p.s. feel free to respond to this email! I’d love your feedback and suggestions.