r/Dentistry • u/Regular-Ambition-902 • 1d ago
Dental Professional Is ownership worth it if taking insurance
Seems counterintuitive since you have to play by their rules when the ownership is all about control and calling your own shots.
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u/aarrtee 1d ago
i bought a practice... worked with insurance... developed relationships with patients.
when Delta/aetna/cigna failed to keep up their fees with the cost of running a practice, i dropped em, one at a time in 2025 and early 2026
Delta was the last...
We wrote letters... we sent emails. We explained that we would fight for our patients to get their fees somewhat covered by their insurance company. We are now 100% fee for service. We lost some patients... most were folks who have healthy mouths and get 2 hyg visits a year and one restoration every few years. Vast majority of our patients stayed. And of those that left... a few came back after they went to another office that participated but for some reason did not impress them.
The business has grown. I am selling it at the end of this year to my junior associate. I have an agreement to go from four days a week to three in 2027. He as agreed to me only working 10 months of the year. I will not work in January or February.
Going south.
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u/mskmslmsct00l 1d ago
The financial illteracy of this generation needs to be addressed.
You don't own an office to call your own shots. Yes you have more control over the day to day but the reason you own is to acquire an asset.
Staying in associateship is like renting for life because you don't want to mow the lawn or pay for household repairs. That's fine but understand that you're paying for the homeowner's mortgage and all of their expenses which includes lawn maintenance and repairs while they take a little extra on top to turn a profit.
And at the end of your lease you will get a security deposit back and nothing else. Meanwhile when the owner sells their home they will make 6-7 figures to fund their retirement.
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u/Mission-Knee1572 1d ago
Wow. Open your mind. I opened my office so i could primarily call my own shots. We all do things for our own reasons.
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u/Regular-Ambition-902 1d ago
Except a practice can tank in value whereas a house maintains its intrinsic value.
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u/JacksonWest99 1d ago
Yea but you are in the driver seat. You control the asset more than you control the value of your home.
There are not many millionaires who were lifetime associates. A dental practice owner who is not a millionaire at the end of it all is a failure.
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u/Ready_Scratch_1902 21h ago
home values can tank 50%. you haven't been around long enough . in some states the value of a house can stay sideways for years.
dental offices produce cash. how you invest that cash is what will make you rich.
sure a dental office can be sold at peak earnings for a multiple etc. but thats the paradox- why not keep it and continue to harvest investable cash? esp if a doc likes working.
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u/mskmslmsct00l 1d ago
Literally any investment can tank. Including homes which can see their short term value plummet based on market forces.
Go on Zillow and look at the number of houses on the market right now they have recently reduced price. I saw one that went from $800k down $95k to $705k all because no one is buying homes in this market.
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u/Regular-Ambition-902 1d ago edited 1d ago
I really don’t think a practice and a house are a fair comparison. They are both assets but characteristically different.
A practice value is dependent chiefly on the dentist and the team and secondarily on the local market. A home value is completely independent of the owner but entirely dependent on the local factors like the supply and demand.
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u/kimjongswoooon 1d ago
I largely disagree. I bought into a practice 25 years ago which was doing $1.3M. In 8 years, I took it to $2M. Then the Great Recession hit and demographics in our area shifted dramatically. A lot of other things occurred in that time; I shifted from dentistry as my main income source to real estate, we invested less and less into technology in the office, etc but our numbers dropped year after year. We now do $600k being open 3 days a week and are trying to sell.
The number 1 reason people pass on the practice isn’t annual income or quality of the office. It’s demographics. The area has a lot to say about how a practice does.
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u/gunnergolfer22 1d ago
If you need a practice sale to fund your retirement that's pretty sad. I'm an associate (who rents an apartment) and if I keep saving at my current rate assuming no increase in pay over time, I'd conservatively have 60-70 million by the time I'm 65
Also, the vast majority of physicians are employees. Are they all screwed?
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u/DrNewGuy 1d ago
Please elaborate on the math that gets you 60-70million in a 40 year career without a bump in pay
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u/gunnergolfer22 1d ago
I conservatively am able to invest 13-14k a month into the market. 10% return. 35 years. I already have 500k invested after a couple years working
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u/joshwantstobelieve 1d ago
Is the practice where you work at accepting all insurances? What is production and collection like? How many active patients?
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u/gunnergolfer22 1d ago
Idk. But we accept a lot. Umbrella plans, Delta, VA patients. Very poor area so hard to get case acceptance on bigger things. I collect on avg 100-110k a month on 4 days. Idk how many active pts
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u/dentalnerd-55 1d ago
For perspective, with 2.5% annual inflation, $60 million in 40 years would have purchasing power equivalent to approximately $23 million today.
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u/gradbear 1d ago
Not sure why you’re getting downvoted. Math checks out. Nice work.
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u/funkytownpants 20h ago
If you’re old enough to know what happens in life, that’s outrageously silly math
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u/gradbear 1d ago
Yes, like you said. You call the shots. You can choose to not take insurance. Don’t forget building equity and tax benefits.
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u/DentalAttorney 1d ago
Yes, for most dentists I think it is worth it, though it depends on how you define worth. From a financial standpoint it is unequivocally worth it. Take the same $600k of production as an associate versus as an owner. Over a career, ownership will mean millions of dollars of difference in take home for that same 600k of production, and that is before counting the hygiene production you now capture and the practice you can sell at the end. If you own the real estate too, you may have a second asset to sell.
I would also push back on the idea that associateship is more flexible or secure. In most cases you are working at the owner’s will or on a short notice termination clause. If the owner sells to a DSO, turns out to be a bad owner, or just wakes up one day upset, you could be out and looking for a new job. With ownership, you decide which insurance plans you take, if any.
If insurance is a big deal to you, and no judgment I get it can be a real pain, look at fee for service practices. They are rarer, but they absolutely exist, and they can be some of the most lucrative. They come with their own challenges, of course, but those owners figured out a solution to the issue. I am a dental transition attorney, so I see acquisitions of all shapes and sizes, and I am always happy to talk through the nuance of each one. Best of luck either way. I think for most of the profession, ownership is the right path.
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u/Wide_Wheel_2226 1d ago
I think you go all in or all out. If you go to be mostly INN then you need to bill for everything.
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u/WhoDoYouKnowHereB 1d ago
You are forgetting that as the owner, even if you “play by their rules”, you are likely making meaningfully more money and you control quite literally all other aspects of the practice. Unless you are getting absolutely reamed on fees, which you should know before purchasing, this is really not as deal-breaking as you make it out to be.