Dale E. Wagman, D.D.S. has been a PARAGON Dental transition Consultant since 2007.  He owned and operated a large dental practice for almost 30 years.  He has authored numerous dental management articles, as well as a best-selling textbook on the history and self-management of Dental PPOs.  He lives with his wife in Northwestern Michigan.  He can be reached at 517-375-3740

Career Suicide – The Easy Way


It’s easy to kill a practice.  You can over-treatment plan.  You can over-charge.  You can insist on treatments patients don’t want.  You can refuse to honor insurances. You can have an unpleasant chairside manor.  You can mistreat staff.  The list goes on.

Unfortunately, you can kill an entire career even more easily–often before you ever get one started–by making one critical mistake.

Almost every month, transition consultants will typically get a call from a young dentist who is working on killing his or hers.  They tell the consultant that they have been an associate for the last three or more years and have increased their speed and knowledge exponentially since graduation.  They will mention the hours of continuing education they have had.  They will expound on their skills and ability to perform a vast array of dental procedures.  They may discuss their financial situation and credit possibilities.  Some may even claim to be pre-qualified by some bank for a purchase.

Naturally, the consultant is thinking, “This is a client I can help.”  Then, the young dentist drops the inevitable bombshell.  “Oh by the way,” they will say.  “The practice I am looking for must be located within 30 minutes from the intersection of Fifth and Main Street.”  Bam!  One sentence and this young dentist may have just destroyed their entire career potential.  They may have doomed themselves to mediocracy by eliminating a potential opportunity that may have rocket propelled their financial viability for years.  They may have become one more among the many waiting for success to find them.

Realistically, the average dentist has between 30-40 years to practice.  During that time, they have to pay off student loans, pay off practice debt, raise a family, pay off a home, build equity in a practice that they can sell later, save up some extra money for retirement and maybe, if they are lucky, actually live a little–by traveling or perhaps by buying a toy or two.  Moreover, they have to do all that while paying taxes, fighting competition, resisting corporate challenges, acquiescing to staffing realities and surviving continual pressure from insurance companies and other third parties.  Let’s face it!  They really can’t afford to waste time, and they certainly can’t afford to trap their future by building artificial geographic walls around their potential.

Sure, the urge to live a normal life is strong after dental school.  You want to have a home and settle down.  You want to have some kids and get a nice family started.  You want to start staking out some territory.  You want to stick your chest out and start letting the world know you are finally free – no longer a prisoner of academia and ready for the world.  And, of course, if you have a spouse, he or she will want to see you do all of that too—and probably much more.  However, you have to be realistic.  It could take years for even a mediocre opportunity to become available in any pre-defined location almost anywhere in the country.  Finding a good one could take even longer.  Just simply settling on something because you are tired of waiting could be a huge, life-defining mistake.

Let’s look at just one example.  According to data available at the time of this writing, the population-to-dentist ratio in one very desirable Midwestern county, in which many young dentists want to live and practice, is approximately 844-to-1.  An 844-patient practice is just a two-day per week practice to a new dentist who can see only eight patients a day.  It is not even a two-day practice to a dentist who can see just 10 patients a day.  The irony here is that just two counties away—a little over an hour drive—the population to dentist ratio is approximately 2557-to-1.

How many patients can you see in a day?  Probably many more than 10, right?  How long are you willing to wait for a practice that has only the bare-minimum number of potential patients?  At that pace, how long will it take you to pay off all your debt and put together a decent retirement plan?  If 844-to-1 is the mathematical norm for a particular area, how long will it take to find a practice that has twice that many patients–a full week of patients, say?  And, more importantly, with how many other dentists will you be competing, just to get a shot at buying it?  Essentially, you could find yourself standing in line to buy half a practice and unless you are very skilled at building practices, you will end up with half a career.

The key to business success is flexibility.  It is also the key to career success.  When good opportunities–ones that will provide sufficient revenue to reach all of your goals–become available, you need to be able to react quickly and take advantage of them.  You often can’t afford to wait until you sell a house. You can’t afford to wait until your kids matriculate from one school to another.  You can’t afford to wait–period!  Opportunity knocks very softly sometimes, and it doesn’t always knock on the door you want it to.

The old adage, “Money won’t come to you, you have to go to it,” is very true.  Don’t limit your success by limiting your geography.