change

Now or Never

Dentistry, Lifestyle

First off, my sincerest apologies for neglecting to write frequently on this forum. Whether it was business or simply being uninspired, I am sorry for not having made any posts here in a while. As I am practically a week away from my 45th birthday, I felt an inclination to write a bit about updates in my life. Probably the most grandeur of which, is the news that – as of two weeks ago – I gave notice to my dental office that I am leaving. In September of this year (2024), it would have been 10 years working at this office. I have written before on this very blog about why I chose to be an associate versus an owner for so long; however, I have recently come to the realization that there really is a finite amount of time for me to create any kind of lasting legacy for myself. The two original owners of my group cashed out to a private equity (PE) company several years ago. Surprisingly, since then, things have been steady and, dare I say it, slightly improved from how the original owners would run things. The PE company introduced a 401k retirement plan and a generous continuing education allowance that I never really had offered to me before. They addressed some staffing issues, which ultimately made the office busier i.e. more productive. The PE even had the budget to address some of the cosmetic shortcomings within the office, and had a legal team that can handle disputes with the property manager and owner of the aged building we reside within. I know what you’re thinking….so why leave, right?

“There is no passion to be found playing small – in settling for a life that is less than the one you are capable of living.”

~ Nelson Mandela

Before I address that question, I should say that over the years I have been presented with and declined more than a hand-full of offers to join other groups or start my own venture. In every case, the build-out costs were too exorbitant, or the barrier of entry was too cumbersome for me to consider it viably. I would entertain (even be excited about) the idea of it for several weeks or months, and then ultimately talk myself out of it for being too risky of an endeavor. Each time regressing back to the comforts and stability of my existing associate position.

Perhaps the biggest reason my brain convinced me of is that, the associate position afforded me a comfortable living wage along with ample time with my family. I am blessed with how much time I have with my boys; to go watch them play tennis tournaments, to pick them up from school, to readily take vacations together. There are moments and memories that I am grateful we were able to create because of how cushy my work schedule is/was.

I do not think it would be wise for me to start from scratch. Maybe as a new or recent graduate, sure. I am literally 10 years out of residency training, and I absolutely do not think I have the time/energy/patience to start a new practice from scratch. Real estate costs have increased, supplies are more expensive, staffing have new hire minimum wages, and build-outs of dental offices have historically been ridiculous hard to afford.

So in February of this year, when I casually responded to an Indeed job post in search of a pediatric dentist in the Las Vegas area – I had no idea what would quickly transpire. I first spoke with a recruiter for the group, and informed him right off the top that I was not interested in making a lateral move in my career; that the only position I would entertain should have an equity component included into it. He asked for a little time to take my demands back to the owners of the office(s) and explore whether that was doable. Later that night, the owner texts me to arrange a dinner with his partner, himself, and an operations director within the company.

Come to find out, this group has 9 existing (general) dental offices, and think the future growth is in building up their orthodontic and pediatric components of the practices. The owners seem extremely affable and down-to-earth, and want someone that seems like they’ll work hard to increase the pediatric dentistry presence within the community. They’ve experimented with pediatric dentistry for about a year in one of their locations, but want a (eventual) partner that is a good fit for their team.

This opportunity checks a lot of boxes for me. They have already established themselves and clearly know how to grow a brand and create offices. After a six-month dating period, there is buy-in potential for me to be a partner and have some equity on the table. It has an unique opportunity for me to be a ‘pediatric director’ and eventually oversee the operations of offices versus simply being a workhorse and doing the dentistry one patient at a time (which, don’t get me wrong, I still very much love to do).

This happened so dizzyingly fast. I had a lawyer review the contract, and although quite expensive, offers some peace of mind that my interests are guarded against in the fine print of things. I gave my notice to the group, and plan to serve out a contractual 90 days while they find a new provider to replace me in the practice. Probably the last – and certainly the hardest – task left is breaking it to the staff I have worked with all these years. My existing office crew is filled with quirky, captivating, hard-working women that make going into the office every day so enjoyable for me. When it comes time to break the news, I am sure I will have to fight back tears because of how attached I feel to all of them.

In any case, thank you for taking the time to read this. I think, the older I get, I come to realize that I have lived so much of my life in a bubble of comfort and stability. And, although scary and at times asininely uncomfortable, I think leaving my comfort zone and taking on some (calculated) risks standing to give me some rewards and accomplishments in life that will leave a legacy for myself. Anyone else taken similar risks? I would love to hear about them! Thanks again!

Conquering Change

Dentistry, Lifestyle

Recently, I was made aware that the office I have gainfully been employed at for the past seven years was going to be sold to a larger, private-equity company. One of two owners called me to break the news about the transition, and nonchalantly tried to reassure me that not much should change about the terms of my employment other then who signs my paycheck.

I have never been one to embrace change well. I would almost go so far as to say I fear it.

I see day-to-day change take place in front of me constantly, and I struggle to accept even that. My kids getting older is a prime example. Google Photos reminds me of this day ‘7 years ago’ and I am an emotional wreck. Why do they have to grow up so freaking fast?

Listen, I know, it is a part of life and we cannot control it. Without a doubt, my best days are when I manage to block out the seemingly infinite “what if’s” scenarios that float around in my head. When I somehow silence all that noise that occupies my mental space, my days are much more peaceful and happier.

Years ago, I read a book called “Who Moved My Cheese” by (Patrick) Spencer Johnson. From what I remember, it was a quick enough read with a very simple message. Life moves on, and so should we. “The quicker you let go of old cheese, the sooner you find new cheese.” The author devotes the book to trying to embrace change in work and throughout our lives.

I have worked for enough large DSO’s (Dental Support Organization’s) to know they are not run the same as smaller, privately-owned offices. In an attempt to streamline operations and cut costs (and maximize profits), something’s gotta give – it may impact the quality of dental materials, the staff, the schedule – it could touch on every aspect of the practice.

As a mere associate, I am not privy to the terms of the sale and transition of ownership. Only time will tell what changes will come. The way I see it, at best, my office stays as-is and nothing changes. At worst – the autonomy I have enjoyed in picking out my own materials and setting my own schedule starts to disappear. What would be utterly devastating is if my beloved staff get spooked and decide to quit.

This is the second office now that has been sold out from underneath me. Because I have been just an employee, as the practice changes hands – even though I worked hard to build it up, because I have no equity stake – I reap none of the benefits of its successes throughout this sale taking place. The two original owners (not much older then I am currently) have now paved a pathway for retirement for themselves; and I am but a commodity being sold along with the chairs and other equipment.

On the flip side, I have been compensated well over the years and had I invested more wisely (thanks a lot Celsius Network), I might also in my own right have been on a path towards financial independence. Plus, over the last seven years I have not been burdened by administrative hassles of running this practice – and when the A/C fails, addressing staffing issues, dealing with payroll matters – none of that has really weighed on my shoulders.

“Change happens when the pain of holding on becomes greater than the fear of letting go.”

― Spencer Johnson, Who Moved My Cheese?

How my staff will respond to the new owners, how my pay will be affected, how my patient schedule may change – all of these are unknowns that occupy my mental bandwidth these days. Mixed in with regrets about not building up equity all these years and reaping zero ownership benefits. And do not get me started on the massive financial setback I have incurred with the atrocious investing missteps on the Celsius ordeal.

Lately though, when I am not caught in a moment of self-doubt and insecurity, I am convinced that – however horrendous these last several months may have been – I am more open to taking on the challenges of practice ownership, I am a wiser/more cautious investor, and I am, for the most part, optimistic about what the future has in store for me. I am even finding ways to enjoy my kids getting older and the fun activities I can do with them now versus seven years ago.

Hope you handle change better than I do. Every day I feel I have to convince myself there is light at the end of the tunnel. Thank you for taking the time to read my post today! Please feel free to share with me your own stories of taking on change in your life!