Which Path to Practice Ownership: Buy, Join, or Start?
Every path to practice ownership brings unique opportunities and challenges. Get the clarity you need to take your next step with confidence.
Getting Started
BUILDING YOUR ADVISORY TEAM
Whether you plan to buy a practice, start one from scratch, or become a partner in a practice, several principles apply across every stage of your career. Foremost is building a trusted advisory team with extensive experience working with dentists.
This expert team should include, at a minimum:
Lawyer
Accountant
Banker
Financial/investment advisor
Insurance advisor
You will likely want to expand your network to include:
Commercial real estate agent
Leasing specialist
Equipment supplier—designer
General contractor
Practice appraiser
EXPERT TIP:
Create an Advisory Team Contact Card and list your accountant, lawyer, insurance, and other advisors with direct phone numbers and emails.
Building a Solid Foundation
No matter what your path, it is critical to plan your finances carefully, understand your personal comfort level with debt, and align major decisions with your long-term goals. At a minimum:
Protect your income and future with life and disability insurance, which are essential when financing or managing a practice.
Always have a lawyer review any lease, purchase agreement, or associate contract before signing.
Continue investing in your skills and professional growth, such as a mini-MBA program for dentists and eventually a Certified Health Executive (CHE) designation.
Buying an Established Practice
If you place high value on an existing patient base and are comfortable taking on financial risk for a proven asset, buying an established practice could be a great fit.
Why Consider It
Provides an immediate patient base, equipment, and staff.
Offers the highest earnings potential and is typically more profitable than a startup.
Allows you to purchase existing cash flow and an established business.
Helps when qualifying for financing or a mortgage due to proven income history.
Potential to deliver strong long-term financial growth.
What To Watch Out For
High debt levels and rising interest rates can create significant financial strain.
Overpaying is a risk if appraisals or financials are overly optimistic (due diligence is essential).
Lease issues such as demolition or relocation clauses, or short remaining terms, can reduce resale value.
You must be prepared to maintain the seller's production levels, especially for advanced procedures.
What To Do Now/Next
Most lenders require life insurance coverage to secure financing for a practice, so it's wise to get it in place early.
Work with your accountant to review true cash flow and test your comfort with the debt load.
Consider incorporating, which can provide tax benefits and may help manage practice debt.
Join an Existing Practice
Joining an existing practice as a partner or part-owner can be an attractive middle ground for dentists who want the benefits of ownership without taking on the full risk of starting or buying a practice alone. However, it also comes with unique financial and interpersonal challenges that require careful planning.
Why Consider It
Partial ownership allows you to share operating costs and risk.
Potential for higher and more stable income vs. working solely as an associate.
Offers built-in peer collaboration and continuity when someone is away.
Can serve as a stepping stone toward full ownership.
What To Watch Out For
Partnerships can be strained by personality conflicts, workload imbalances, and unclear expectations.
Minority ownership (less than 50%) can limit control and make it difficult to exit or sell your share.
All partners typically share liability (financial, legal, and professional) even if one causes the issue.
Buying ownership in stages increases legal and accounting costs over time.
What To Do Now/Next
Engage a lawyer and accountant experienced in dental partnerships to review structure, valuation, and leases.
Ensure a detailed shareholders' agreement defines roles, responsibilities, and exit terms.
Protect yourself and your partner(s) with life, disability, key person, and buy-sell insurance.
Starting Your Own Practice
STARTING YOUR OWN PRACTICE
If you’re passionate about creating a unique brand and have tolerance for administrative work, people management, and initial financial risk, starting your practice from scratch offers the ultimate control to build your vision from the ground up.
Why Consider It
Gives you complete control over philosophy, operations, and patient experience.
Allows you to design the office and choose your preferred technology.
Lets you hire and train staff who fit your desired culture.
Can be less than costly than buying an existing practice.
Builds goodwill and brand equity from the ground up.
What To Watch Out For
Begins with no patient base, requiring strong marketing and community engagement.
Expect slower growth and possible losses in the first 12 to 24 months.
Demands a hands-on, entrepreneurship mindset and willingness to manage operations.
Lease terms and location choices are critical to long-term success.
What To Do Now/Next
Create a realistic, conservative business plan with five-year projections.
Seek dental-specific expertise for lease negotiation and financing.
Begin marketing and outreach well before opening to build community awareness.
Maintain an emergency reserve to buffer early cash flow fluctuations.
Webinar: Should You Buy, Join or Start a Dental Practice?
Watch this expert panel discussion and discover how to:
- Evaluate financial impacts of practice models to guide ownership decisions.
- Understand key legal requirements such as partnership agreements, employment contracts, and liability protection.
- Select financing strategies that optimize returns while managing risk.
- Need CE credits? Watch here, take a quiz, and download your certificate of attendance.
Already know which path you're on?
Book your complimentary consultation today and let's work together to ensure you're on the right track.
Learn
Leading the Next Generation of Entrepreneurial Dentistry: Dr. Aisling Whitaker
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The information contained here is of a general nature only and should not be considered as personal investment, tax, legal or financial advice. For specific advice about your situation, please consult with your financial advisor.