What if you open your doors and the phone doesn't ring? For most associates thinking about opening a dental practice, that's the fear underneath all the others.
It makes sense. You spent years learning dentistry, and almost none of that time went into the business side of a practice. Stacey Peters, Director of the Startup MBA at Ideal Practices, put it plainly on a recent episode of The Startup Dentist Podcast: most associates don't have experience with this part, and they often don't know where to start.
She and Stephen Trutter, CEO of Ideal Practices, walked through what to focus on once the big decisions are made and construction is underway. Here's what stood out.
The tile can wait
Stephen recently saw a doctor ask a Facebook group whether the high-end tile in their reception area should carry through into the operatories. His verdict on the episode: "tile doesn't matter." Make the office nice, but the question that deserves your energy is how the practice becomes profitable.
Stacey added the patient's side. Nobody leaves a dental office raving about the reception colors. They talk about whether the experience felt different and whether someone listened to them.
Culture and systems happen either way
Stacey's first point is a mindset shift, from associate to owner and from coworker to employer. Then she said something every future owner should hear: "culture is going to happen whether you plan it or not. Systems are going to create themselves, whether you plan them or not."
That's why the work starts with leadership and the patient experience you want, before any standard operating procedure gets written. Once you know the result you're after, every system has a goal.
Hiring starts earlier than you think
Stacey recommends placing hiring ads at least 8 weeks out, sometimes 8 to 10 weeks depending on the area, so you aren't hiring out of panic. A good ad reflects your vision so clearly that it can attract someone who wasn't even looking for a job.
Experience is where it gets interesting. A team with some experience is easier to start with, but Stacey, who has worked in dentistry for 30-plus years, warned that "someone with a lot of experience often comes with a lot of bad habits." She has heard "this is the way we've always done it" about a practice that turned out to be insurance fraud.
Her sweet spot for a startup's first hires is 1 to 5 years of experience: enough foundation to contribute, and still open to doing things your way. Stephen added a warning of his own: a newer dentist can get overrun by someone with decades of experience. It's your practice, and the team needs to run it your way.
Insurance credentialing can't wait
Insurance comes next because of a clock you don't control. Stacey explained that carriers reserve the right to take up to 90 days to credential you, so the process has to start early enough to finish by opening day.
Before you apply anywhere, decide where you want to end up. If your long-term goal is to be fee for service, Stacey suggests starting with no more than 5 carriers, chosen from the plans local employers actually offer and the fee schedules that make sense.
Build systems around anything that touches a patient or your money
The systems list can feel endless, so Stacey offered a simple filter: "anything that touches a patient or touches your money." Walk through a patient's whole visit, from the first phone call to the final follow-up, and you'll see every system you need.
Then practice them. A phone script that looks good on paper can sound wrong out loud. Stacey has also watched doctors plan to collect payment up front, then rethink the whole financial policy once real patients started calling.
Stephen added one more rule. You need to know every one of these processes yourself, so the practice doesn't stall the day a key team member leaves.
Your first 100 patients are on you
This was the hardest truth in the conversation. Opening with an empty schedule and waiting for a Google ad to make the phone ring is a scary position to be in. Stephen said the most successful startups he's seen "know that the first 100 patients are on them."
That means building a list of people who will be your first patients, from community and business connections to friends, family, and colleagues. It also means getting the timing right. Wait too long and you open to silence. Market too early, hit a construction delay, and you're rescheduling people who have never met you, which Stephen called "the kiss of death" for a new practice.
Rehearse before the first patient walks in
Once you have your certificate of occupancy, the temptation is to start seeing patients right away. Stephen and Stacey both push back. The next 2 weeks belong to training on your software, phones, and equipment, followed by a full dress rehearsal with a friend or family member as a mock patient.
Skip that, they warned, and you risk losing your team. Their standard is simple: "We want the first patient to never know that they were your patient."
Action over perfection
Stephen closed with a note for perfectionists: "Your world is measured in millimeters." A startup isn't, and obsessing over the perfect post or the perfect system usually ends in no decision at all. You can adjust a phone script later, but you can't get back the time spent waiting.
Stephen and Stacey go deeper on every one of these steps, including what the last 60 and 30 days before opening look like, in the full episode.
Listen to the full episode
