Independent Dentistry is Alive and Still Thriving, by Eric Swarvar

In Business by Dental Entrepreneur

I have always understood that dentists are clinicians first. Beyond that, there are
several other roles we will discuss later that must be portrayed. But no dentist has
construction manager as a common job title. Even if you are familiar with the other
roles of starting a dental practice. From securing lending to real estate negotiator,
certified public accountant, insurance credential specialist, architect, dental equipment
specialist, information technology specialist, marketer, and human resource manager.
The information contained in this book is from accumulated experiences of hundreds of
dental start-ups as seen from the professionals within the industry. I have seen
successful and mediocre start-ups with a few failures. I am removing my sales hat to
offer this guidance to give back to the industry I love. My goal is to provide a systemic
approach and limit the stress of doing a successful dental start-up.

Opening a dental practice takes sacrifice, hard work, and chutzpah. All this is needed
just to open the doors. This process takes a present, conscious mind, the willingness
to learn, lead, and trust business advisors.

It is imperative that you define your terms of success. Do not turn to social media or
your peers to seek out what this achievement looks like. A successful practice in one
part of the country is not the same for the other. I have read so many obstinate
statements of glory on social media that are implausible to apply as a standard for a
business. Set your own standards and goals.

Before you can execute any major undertaking, you should have a vision and before
you have a vision, you should have clarity for your project. A clear mind is a focused
mind. Clarity, vision, execution! Clarity, vision, execution!

To gain clarity in owning a dental practice, revisit an old question and ask a few new ones.
Why did you become a dentist? This is a question that is ambiguously subjective and
can lose its will with every passing day. Think back to when you decided to be a
dentist. Are you fulfilling your vision that you had of yourself in dental school? If not,
how have you strayed and is it for the better or worse?

What are your personal goals? What are your professional goals? Your professional
goals need to serve your personal goals. When you decide to start your own business,
goals have to be sacrificed in the short term to meet your long term ambitions.
However, the more personal goals you sacrifice, your ambitious mindset will
deteriorate. Are you willing to sacrifice finances, time, and some relationships?

If you are planning a dental start-up, don’t:
• Plan a wedding
• Plan a divorce
• Get pregnant
• Probate a will
• Build a house
• Move
• Buy a sports car
• Buy a second home
• Quit your associateship
• Pick up skydiving
• Or downhill mountain biking
• Climb Mt. Everest

In other words, do not make a decision you can’t unwind.

All goals need to be written down. If you do not write out your goals, they are just a
thought. A thought can easily become a moving target and you will compromise your
vision just to make yourself feel better. Always write down and display your objectives
and evaluate them. It is important to have daily, monthly, yearly, and BHAG (big hairy
audacious goals), generally a 10+ year goal. Review each goal with the equivalent time
set, except the BHAG; review that daily.

What is your vision for entrepreneurship?

• Be your own boss
• Control your own schedule
• Build equity in a business through time (wealth building strategy)
• Create a higher income opportunity than an associate position
• Build wealth by being a business owner
• Freedom and flexibility in ownership
• Practice freely from corporate oversight
• Become an elite clinician
• Own multiple practices
• Become a land owner, landlord, or developer
• Create high income and be complacent

Build Your Team of Advisors

Once clarity is established, it is time to build your team of trusted advisors. Trust is the
foundation of all positive relationships. This conjunction is bilateral and driven by
communication. Just like a dental practice is a business designed to generate a profit,
no one is going to take on a client if it is not a benefit to them. Fair market value for
goods and services is important, however, if you marginalize these partners down to the
dime, their incentive to work on your behalf is abated. Just like in dental work, cheap is

The financial lender is equipped to administer all relationships and assist with keeping the project on time. The lender is the conductor of the network and can introduce you to
trusted vendors.

Real estate representatives are paid by the landowner. An accomplished agent will
assist in researching a favorable location and negotiate on your behalf to get the best
rent and tenant improvement allowance (T&I).

The appropriate dental equipment company (DEC) can consult on designing the office
layout based on input from the dentist and experience from the designer. The DEC can
assist in site checks during the construction phase of the project. This is important to
ensure the mechanical, electrical, and plumbing for the dental equipment is duly
located during construction. This invaluable service should be considered in the price
of the equipment.

A quality CPA firm is familiar with the intricacies of running a dental practice as a
business and is the dentist’s closest confidant on the business side of dentistry during
their career.

A general contractor (GC) is only as good as the subcontractors they use. The
subcontractors know how a GC builds their reputation. It is not necessary to select a
GC that is specific to building dental spaces, but it is important. It is also significantly
helpful if the lender, DEC, or real estate broker is familiar with the GC you are using.
Since electronic health records (EHR) are the standard in dentistry and the dentist must
comply with HIPAA regulations, selecting a medical/dental information technology
company to partner with and manage your network is key. This is a relationship the
dentist should consider long-term. Ransomware is a real problem for small
businesses, and the appropriate maintenance and security should take place.
Human resource (HR) is generally an afterthought for most and associated with firing
an employee. However, HR should be a strategy to build and scale your practice with
the appropriate human capital. Outsourcing HR has become affordable and is
important to build the team you desire.

Butts in chairs are what drives revenue. Despite the style of practice you choose, you
need to let people know you are open for business. Collaborating with a marketing
firm that meets your needs is important. Marketing tends to get overlooked and
dismissed by many small businesses. Do not make this mistake. Having a website,
mailers, and a sign hung is not marketing. Marketing is an ongoing effort involving the
full scope of business. From production to selling goods, greeting a phone call to
dismissing the patient, soft skills should be taught and reviewed with team members to
create the type of environment you desire. These are the subtleties that build brands.
Mark Cuban said it best, “Marketing dollars do not build brands. Product satisfaction
and execution does.”

This process should be an exciting and enjoyable venture. Two weeks before opening
and the first two weeks after are always the most stressful. Do not schedule a hard
date for an open house or a ribbon cutting during this time. I can assure you the odds
are not in your favor to hit the target date. If you desire an open house or grand
opening, schedule this event 2-3 months after your soft opening. This will allow you to
work out any flaws, create a positive patient experience, and begin to create a working
relationship with your team.

To learn more, the book, The Dental Start-up is available in paperback or Kindle on Amazon.

Eric Swarvar, Dental Industry Extraordinaire
Located in Flower Mound, Texas Eric not only specializes in dental start-ups, he also assists his current client base in modernizing, updating, and adding technology to their practice for the benefit of their patients’ care.

Eric also enjoys providing mentorship for college-aged young adults and speaks annually at his alma mater’s college of business.

Founder of the 2 Hour Dental Start-up