Dentist to Population Ratio & Real Estate Myths: What Startup Dentists Need to Know
Thinking about a dental startup? If you’ve found yourself driving around town, jotting down numbers from real estate signs, or obsessing over dentist-to-population ratios, pause for a second. That’s a common first instinct—but it’s also where many dentists take their first wrong turn. And unfortunately, that one turn can cost hundreds of thousands of dollars over the life of your practice.
Let’s talk about why that approach doesn’t work—and what to do instead.
The First Mistake: Jumping Into Real Estate Too Soon
I get it. Real estate feels tangible. It feels like action. But hopping in the car before you’ve built a plan is like shaping occlusion before placing the implant.
Real estate isn’t where you start—it’s where you land, after you’ve mapped out:
Your financial plan
Your clinical philosophy
Your ideal patient profile
Your profit and lifestyle goals
Your branding and reputation vision
Opening a startup without this clarity is like mowing your lawn without lining up that first pass. One slight angle at the start, and you’re off-course for acres.
The Second Mistake: Chasing Corner Real Estate
Corner properties are the siren song of the startup world. They look prestigious. They sound like good business. But here’s the truth: corner space is built for impulse-driven businesses. Coffee shops. Chain restaurants. Not relationship-based healthcare.
You don’t need foot traffic to thrive. You need alignment—between your patient base, your services, and your systems. Some of the most profitable startup practices I’ve helped launch are tucked into quiet plazas with minimal signage.
You know what else they have in common? Smart lease negotiation and startup-specific planning. That’s how you save 50% on real estate and still come out ahead.
The Third Mistake: Calling the Number on the Sign
Let’s break this down: the agent on that sign works for the landlord. Their job is to get the best possible deal—for them. When you call that number, you’re essentially walking into a negotiation with zero leverage and a flashing “rookie” sign over your head.
I’ve seen dentists lose hundreds of thousands in these deals. Or worse—lose their space entirely years later with no backup plan. Your lease is a multi-million dollar decision. Treat it that way.
Bonus Myth: The Dentist to Population Ratio
This one might surprise you—especially since I was one of the first to publish the “2000:1” dentist-to-population benchmark in dentistry.
And yet... we’ve since proven it’s not a reliable decision-maker.
Why?
Because ratios are data points, not strategy. They don’t tell you if the patients in that area are your ideal patients. They don’t account for payer mix, growth trends, referral potential, or your goals. They’re blunt tools in a precision business.
Here’s proof:
Dr. Bryan opened with a 1604:1 ratio. Day 2? 84 patients.
Dr. Gerry had a 3000:1 ratio but served a Medicaid-heavy community that wouldn’t be ideal for most private-pay models.
The ratio doesn’t build a dream practice. Strategy does.
Here’s What to Do Instead
If you want a successful, meaningful, and profitable startup, don’t follow advice designed for the masses. Build a custom plan for your real-world goals, not just your ZIP code.
Your startup should be:
Built around your clinical vision
Located based on data-driven strategy—not just visibility
Negotiated by professionals who protect your upside
Designed to create impact and long-term stability
That’s how dentists like Bryan and Gerry hit six figures in collections within months—not by chasing the paste of cookie-cutter ratios, but by designing a path aligned with their future.
Final Takeaway
Don’t start your startup by hopping in the car. Don’t chase the corner space. Don’t obsess over the ratio. Instead, start with vision, strategy, and the right guidance.
Want to hear more? Tune into my podcast conversation with Dr. Mark Costes where we unpack these topics—and more. You can find it here.
Here’s to your future—planned wisely, led boldly.