Benefits of a Small-Town vs. Big-Town Practice

In Business by Dental Entrepreneur

There’s plenty to be said of the benefits of living and practicing in a big city or Metropolitan area. Proximity to upscale dining, Cultural Activities and Shopping Malls are at the top of the list when I speak with a young dentist seeking to purchase a practice. Easily, nine out of ten are seeking a practice no further than a thirty-minute drive from a large city.

While practicing in a large city does have benefits, there are drawbacks. There is more competition, much more. New dentists in Urban areas often offer extended hours including Saturdays just to be competitive. The cost of living is expensive, as is practice overhead. A young dentist will feel pressure to participate in PPO plans as they know their competition participates. Student loans, a practice loan, practice overhead expenses and personal expenses will not likely allow a new practice owner the flexibility to opt out of PPO plan participation.

A young buyer could potentially get away with opting out of PPO participation IF he or she were to purchase a well-established Fee for Service practice. It would require the buyer to cultivate and maintain a wonderful relationship with the seller. In addition to singing the buyer’s praises in the letter to the patients announcing the sale of the practice, the seller and team would need to promote the buyer and assure patients they are in good hands. If at all possible the entire team should be hired by the buyer and no major changes in policy should be made for 6 months. This scenario can work if the buyer maintains a good relationship with the seller. Keep this in mind when making an offer and during negotiations.

Rural dentists tend to have less stress and more quality time with family and friends. There’s less worry about overhead and whether the schedule if booked. These patients do not miss an appointment unless there’s a true emergency. Rural or small town practices have 50% overhead, on average. Practicing in a Small town or rural area will afford a young dentist the freedom to work normal hours. There are no “expectations” of evening or weekend hours and no pressure, unless it’s self-imposed, to participate in discounted insurance plans. Fees are typically comparable to urban fees.

Dentists practicing in small towns and rural areas will find they are held in high esteem and treated with much respect. Their diagnosis and treatment plans are rarely questioned as patients are more trusting and take their dentists’ word as gold. If a patient chooses not to have recommended treatment, it will likely be for one of two reasons, fear or financing. Offering a third party financing option can be helpful with the latter.

New dentists who choose to practice in rural or under-served areas may qualify for full or partial student loan repayment. Dependent on federal and state policies for fulfillment. Some states require participation in Medicaid, some do not. Visit for details and resources for loan repayment programs.

As previously stated, there are tremendous benefits to living, working and raising a family in a small town. I have yet to hear a small town or rural dentist say they regret their choice. You will know the people who teach and coach your children. You will know the parents and likely the grandparents of your child’s friends, as they will be your friends, neighbors and your patients.

Rural dentist that want to spend a weekend in the city to enjoy fine dining, visit art galleries and museums or shop at a large mall can afford it. As, one benefit of practicing in a small town is having more financial security than city dentists who are competing for patients and have higher overhead. Most small towns and rural areas have only one dentist if any. Consider practicing where you’re truly needed.

Remember this about dentists who choose to practice in a small town or rural area, they:

  • Choose their own hours
  • Have more disposable income
  • Enjoy less stress
  • Are treated with great respect
  • Are appreciated
  • Diagnosis and treatment plans are not questioned
  • Spend more time with family and friends

Small towns and rural areas are in great need of dentists!

Mary Fisher-Day grew up in a small town in South Carolina and now resides in Charlotte, NC. Her career in dentistry has spanned more than 30 years; she has worked as an assistant, scheduling and financial coordinator, and office manager. Early in her career, she moved often. Although it was tough at the time, moving often did have one benefit; Mary saw the effects management style has on practice culture, employee satisfaction, Patient satisfaction, loyalty and ultimately, Practice Success.

Realizing a desire to expand her career, Mary continued her education with the study of business management. Coupled with knowledge of the inner workings of a dental practice, she was ready to begin the next phase of her career. A conversation with a friend lead to a meeting and offer to work with a large dental practice management and transition group. When the company made the decision to focus solely on transitions, Mary founded The Dental Business™.

Mary and her Associates work with dental teams, customizing their programs and addressing any urgent issues immediately. Mary’s goal is to have their clients see results very quickly. Teams are coached and armed with systems, tools, resources and strategies to reach practice goals.

Mary’s ultimate goal is to see the team enjoy going to work each day, have patients that happily refer others and prosper in their successful practice.