If you are an associate weighing practice ownership, the internet has already lied to you twice. One side of social media tells you it is effortless, just buy in a rural area and you will be fine. The other side is a pile-on of doctors tearing each other's cases apart and warning you off the whole idea. Neither picture is real, and neither helps you decide.
This is part of our Where Are They Now series, where we sit back down with doctors a few years after they opened their own practices to find out how it really went, no highlight reel. So here is dental practice ownership without the filter, from someone seven years past the starting line. Dr. Ben came to dentistry after running a commercial construction company, so he knew what building a business from scratch actually costs in stress and surprises. He still says the first year of his dental startup humbled him. That honesty is exactly what makes his story useful before you open, rather than after.
On his dress rehearsal day, the run-through every new practice does before opening, a patient showed up a week early and asked to be seen. Dr. Ben's team took her right then and closed a $10,000 case on what he calls day zero. An incredible high.
Then there were days the office was completely empty. Zero patients. And as he puts it, that is just how it went for months. Great collections one week, a silent phone the next, the two of you looking at each other wondering what to do today.
That whiplash is not a sign you did something wrong. It is the texture of a brand-new practice finding its feet. Knowing it is coming, while you are still an associate, is what keeps it from rattling you when it arrives.
Here is the line worth tattooing somewhere before you sign a lease: your first hundred patients are on you, not on an agency. Dr. Ben was surprised by how long external marketing took to ramp, roughly 90 to 120 days before campaigns produced a predictable flow.
The reason is simple. A cold lead who finds you in a search will check your Google reviews, which a new practice does not have yet. So the patients who made him profitable in those early months were warm. They came from him showing up in the community, meeting people in public, and inviting them in.
This is the part Dr. Ben wants associates to really hear, because it is where most of them get caught off guard. In those first months, you are not only the dentist, you are the practice's first and best marketer, and the responsibility for a full schedule sits squarely with you. No agency, no new front desk hire, and no software is going to care about filling those chairs the way you do.
So he did the work himself. He knocked on doors, met his future patients face to face, and built the warm relationships that paid campaigns cannot manufacture in 90 days. The doctors who open strong are the ones who plan that legwork before construction ends, instead of refreshing a Facebook group every 90 days asking which ad agency to blame. The ones who struggle are usually waiting for someone else to do the part that was always theirs to do.
Dr. Ben is the kind of person who could have tried to DIY a startup. He had built a business before. He chose not to, and his analogy for why is the best in the episode: he wanted bumpers in the bowling alley. He still had to throw the ball and make every decision, but he wanted experienced people on the sides keeping him out of the gutter, telling him when something was too expensive and when it was too cheap.
He had also seen the alternative. Some consultants, he said, sell a turnkey package where you essentially get someone else's practice. The kind where you could scroll Instagram and go, I know exactly where that came from. He did not want a boilerplate. He wanted a practice that, when you walked in, was unmistakably his. The associates who avoid the most expensive mistakes are usually the ones who, like him, decided early they did not want to buy someone else's problems or learn every specialty the hard way.
Today Dr. Ben produces over $2.2 million a year and works 168 days, which is ten weeks off. He has more than 900 five-star reviews. He is expanding into a larger space, and his patients' new commute will be about 60 feet, because it is on the same floor.
The part that should land hardest for an associate: three DSOs opened within a half mile of him, some spending more than $1.5 million on glitzy build-outs with chandeliers. He is still thriving. As he says, you cannot replace the personal care of a private practice. Private practice ownership is not spreadsheet-based dentistry, it is human-based dentistry, and high-value patients are increasingly hunting for exactly that.
One more thing he wants you to hear before you take advice from a stranger on the internet. Good general advice is often terrible specific advice. His comparison: it is like taking dating advice from the guy who married his high school girlfriend. It worked for him once, and that tells you almost nothing about your situation. The way Dr. Ben was coached was wildly different from how the next client was coached, because they were two different people on two different paths.
His closing message is the one to sit with. Bet on yourself. There is real risk in a startup, but when you put the right people around you, the risk drops significantly and the reward does not. The associates who look back in seven years grateful they leapt are the ones who saw the honest version early, prepared for the hard parts, and refused to build alone.
Hear Dr. Ben walk through the whole journey, highs, empty rooms, and all, in the full Where Are They Now episode. https://open.spotify.com/episode/466z0XGmPtqXNicEBQEaQv?si=1hv8DsFAS9qR0JaE1H6gNQ