dental practice growth

Employees and Hiring: Does it REALLY matter?

So, how much do your employees really matter anyway?

Many dentists report that managing people and building a team is often one of the most irritating and unloved parts of running a dental business. As an owner/dentist, we dream of a creating a thriving practice full of people we love to work with while doing cases we love to do... all while making great money along the way. My partner and I often retreat to our back office “man cave” in between procedures, to escape the craziness of the day and all the estrogen floating around the practice...we work with all women (like most dentists). And, here is the PROBLEM we face as business owners: we CANNOT DO IT ALONE. Maybe some of us would like to...but we can’t. We need our staff to be our support, eyes and ears and hands and feet. You need an all star crew to make your dental business great...yes, hiring and rehiring new employees will be an “inconvenience” throughout your career. But that’s part of the deal. People relocate, change careers and move on...always commit to finding great people building a great & special work culture. Keep great people at your practice as long as possible. Turn over is inevitable, but  a great practice keeps turnover as low as possible.

There is the other great person is hard to find! And, finding 7 great people is exponentially harder (we have 7 staff members on our team). Bad chemistry, a toxic personality and bad communication and culture can KILL all the great things you’ve got going at your practice and can make your life miserable. So, back to the question: "how much do employees matter”? The answer: VERY VERY MUCH. The Key? Build your crew...and KEEP building and nurturing your it your entire career.

Here are FOUR things I’ve learned so far (during my journey), and a couple things I’ve learned from other dentists, business owners and gurus around the country.


  1. Take your time to hire the RIGHT person for the RIGHT position. Take your time, and if the right choice doesn’t present; hire a temp or make things work until you do. Find the BEST person for your practice...settling for “OK” and the easy choice will not allow you to build and amazing crew easily.

  2. People are not perfect and your business will NEVER be perfect (for long). Don’t chase perfection...and realize that life doesn’t allow perfection to exist for long. Find great people (they will not perfect people). If you get close to comfortable and all figured out in your’ll see that life is likely to throw you a curve ball and reintroduce chaos (like this week when my stellar assistant decided to move back to Ohio to be with family). A little chaos is OK, don’t be afraid of through it and keep on striving toward your goal and mission.

  3. Fire Quickly. If someone does not fit in with you mission, your culture or your crew...they need to go. I’m not saying that everyone that needs a little work should be let go immediately. But, people that don’t have the CHARACTER pieces you need them to have are NOT going to suddenly align with your mission and discover them. It’s NOT your job to change people. If they don’t like their job, don’t believe in you mission and don’t love working with your staff/patients: Fire them sooner than later - you have a responsibility to your staff and business.

  4. Always be hiring. By this I really mean - always be on the lookout for GREAT potential hires. We screen all our hygiene temps and view each of them as potential employee candidates. Network and find the best assistants out there…who is highly regarded coming out of school or an internship? Is there an all star that happens to be in a practice they are unhappy with = potential recruitment opportunity! You may not have an immediate position for them...but it’s a lot easier to constantly be searching for, and building a list of all stars then to frantically interview a couple random candidates that respond to your craigslist add when you’re in an IMMEDIATE need of a new hire. In those cases dentists often settle for what’s available and in front of them...instead of being proactive and identifying the best person for the position.

Please respond with your own stories and lessons learned!


~ Cole Brenny DDS

How to find the PERFECT PRACTICE location

I get asked a lot about practice locations and how to start the search for your new practice. The simple answer is this: your ideal location may be different than mine, BUT there are several KEY aspects of practice location that will dramatically increase the likelihood of GROWTH. That's ultimately what you're trying to determine when evaluating practice purchase/startup locations - how easily will it allow you to create growth? Because it's my belief that as young dentists buying out boomer practices - we must transform the declining or old/stable practices we acquire and transform them into growth practices in order to counter declining active patient #, sub par revenue, patients lost during the transition and non existent marketing/growth systems. 

All this said, location is one of the most important (fundamental) aspects of your new practice purchase. It affects patient type/demographic, dentistry type and ultimately your income. Think it through...

So, what should you look for and where should you begin. There are a lot of services that will help you evaluate practice locations (practice cafe, etc) but unless you are entering a STARTUP probably do not need to use one of these services. Save yourself the money and dig in a little on your own. Honestly, all the info you need can be found on zillow, google and other demographic sites. The trick is knowing what you're trying to interpret.

Here is the formula (I'll list everything you could do to maximize growth...BUT, in the end you may decide to decrease the size of your "net" you use to create growth; and sacrifice some aspects of growth in order to create a practice that better fits your dream. The goal is to create and ensure success...but more importantly to build a practice you love. 

First - Choose a location you'd love to live; a place that you can invest in the community. This should be withing a 15 - 20 minute drive time from your home; beyond that you risk burnout simply from the wasted commute time. I've spoken with handful of dentists this year that are selling their practices simply because they are NOT in the right locations and are sick of the commute. Plan to invest time - energy and marketing $ into the surrounding area/community - throw patient VIP BBQs, engage the local school and businesses. These investments will definitely be an important part of growing your dental business.

So, rural vs urban vs suburban? Truth is this - and the numbers don't lie: a quality rural location delivers less competition and more income for dentists that urban and suburban (generally). So, if you don't mind heading out state...your practice will be cheaper to purchase AND you'll have a higher production/income potential. 

Second - Look at the number of dentists in the surrounding area. Pull up google map and do a "dentist"search. How many are within 10-20 miles? How big are the practices? Are they older  (future acquisition targets)? Are they newer practices with killer reviews and great marketing ( this is a threat to your growth potential )?  Look at the demographic info for the surroundings 10 mile area (patients will usually NOT travel farther than this unless they have no other choice...again rural wins out). What type of patients do you love to work with? Does the patient demographic demand the TYPE of dentistry you love to do? Ideally you patient to dentist ratio should be around 1:2000...anything over that means the market is getting saturated, and growth could be affected. What's the household income? White collar vs blue collar? Is the area full of young families, new builds and anchored (families with stable jobs, kids in school that are less likely to move around)? To see the demographics for your target area, check out zillow demohraphics, neighborhood scout, census bureau, areavibes, point2homes.

Third - Are there schools, large businesses and industry in your target area ( check maps ) that will supply large numbers of patients? What types of insurance are common in the area (call local dentists)? Do most dentists participate with lower reimbursing PPO plans or do you have the ability to remain out of network and focus on cash patinets? 

Fourth - Getting more into the micro aspects of location a drive by of the practice location. Does it have good signage and street visibility? Is it in a high traffic area (again creating good visibility)? Good visibility is not essential to growing, but it definitely helps you cast a wider net to create growth. 

Ok! That's a good start. If you want to dig deeper or get help while buying/growing your practice - shoot me an email! Check out to learn about my one on one coaching program. I help with as little (or as much) as my clients like: getting a dentists guidance and perspective on a potential practice appraisal and growth plan to full one one one help setting up and growing their new practice. I've helped so many new practice owners avoid costly mistakes and set their practice up on a sound foundation for growth. See if it's right for you!

~ Cole Brenny DDS