Dr. Wayne Aldredge answers questions about the career path he took after finishing his residency...

2005 Student Event: Scaling to New Heights in Periodontal Practice
STARTING YOUR OWN PRACTICE

Below is an interview with Dr. Wayne Aldredge.

PhotoWayne Aldredge, D.M.D., is in practice in Nutley and Hazlet, New Jersey. He completed his periodontal residency at SUNY—Stony Brook in 1999.

What is the most rewarding part of what you do everyday?

It’s easy to say “helping people”, but it’s true. We not only help our patients and referring doctors but also our staff members. The services which we provide allow for the continued use of dentitions, income to provide for our families and most importantly we help support the families of our staff members.

What was your plan after graduation?

Upon graduation, my initial plan was to purchase an existing periodontal practice from a soon-to-retire periodontist. Upon finding such a periodontist at the end of my 2nd year, spending the following year negotiating the price, writing up contracts and paying thousands of dollars on attorney and accountant fees, it fell through two days prior to graduating from my periodontal program.

As school was completed, I returned home and started a periodontal practice from scratch. While overseeing the construction of this practice, a disabled periodontist approximately 40 miles from this location put an ad in the paper looking for someone to buy his practice. To make a long story short, my classmate and I bought this existing practice.

The one thing to take out of this experience is: You must be flexible. The situation will continue to change and different opportunities will present.

What made you consider starting your own practice?

My wife and I wanted to live in a certain town in New Jersey. As no one wanted to sell their existing practice, I was left with the option of starting from scratch.

What factors affected your plan and decisions about your career and future?

I found that it was important to find a compromise between my personal, professional goals and those of my wife. Try to remember, if your spouse is not happy, you will not be either.

How did you begin the process of starting your own practice?

As with most projects, the hardest part is starting. There are a lot of unknowns when it comes to starting a practice from scratch; however, I have yet to see a “starving periodontist.” Before I started the process, I read every Dental Economics, Dental Practice Management and any other magazine or reference on starting and managing a dental practice. One thing to keep in mind, nearly everything you want to do has been done before - you do not have to re-invent the wheel. Modify what others have done to fit your particular situation.

What variables influenced your decision on location?

We were all taught in dental school practice management classes that the most important aspect of setting up a practice is: location, location, location. Although this is extremely important for general dentists, it does not hold quite as much weight for a specialist. Remember, approximately 95% of your patients will be referred to your practice from a general dentist. Therefore, you must be convenient to their patients. You must have a quality schematic of how to get to your office on the back side of your referral card or pad.

As for location, be close to major roads and the highest concentration of dentists. When choosing a space, try to remember that patients like windows.

Did you meet with an attorney, practice consultant or accountant before pursuing a loan? Why or why not? What did they do for you and why was it beneficial?

Obtaining financing was not difficult. You will find that there are plenty of financial institutions that will loan you money because historically dentists are a low risk population. I found that it is important to have a “ballpark” number of how much a build-out will cost and also what it will cost to furnish and equip an office.

How did you determine the financial requirements for starting a practice?

The quickest way to determine the “ballpark” expense is to speak with a quality dental supply company representative or to contact a colleague who has recently opened a specialty practice.

How did you obtain financing?

Financing was obtained in my situation as a mix of loans from a financing corporation, and thankfully, a low percentage loan from my parents. I pay them back and they receive a tax-deduction.

What risks were involved in starting your practice?

To me the greatest risk is financial. We all know what risks are involved, and another risk is the fear of not being successful.

What I can relate to you is that it is not hard to be successful. But it takes a lot of hard work to get there.

How did you assess and manage those risks?

You work hard.

What is your situation now?

Currently, I own one practice and am a partner in another periodontal practice. As soon as I could, I stopped working for others. There is no long-term value in it.

How did you structure the practice’s finances in the beginning to pay the bills, yourself, staff and to buy equipment, etc.?

One of the most important financial issues is to live within your means. We all know what it means, yet few of us follow this advice. Pay off your student loans as fast as you can because there is a minimal tax advantage to continually pay them off over the 10 or 20 years that you may be allowed. You will find it easier to obtain practice financing without this debt.

To answer the question: I tried to live below my means and paid everyone before I paid myself.

What financial issues or considerations came into play when planning for the future?

I have found that if you want the best equipment or a networked, digital office that you should do it initially. The reason being is that at the beginning, you will have plenty of time to learn how to use these “bells and whistles.” If you wait until you are “making money,” you will find that time is the most precious commodity.

Using real or fictitious numbers, how did the realities of your finances compare to the plan you originally outlined?

You will almost always spend more that you think. Try to budget for 15 – 20% above the estimates on nearly everything.

What resources (i.e., people publications, groups) did you find the most helpful?

By far the most important resources for starting a practice (Design, build-out, color schemes, etc.) are viewing other practitioners offices, asking questions, and working with a competent dental representative. For the most part, try to use common sense and remember that you build the office for your patients.

Given what you know now, what might you do differently?

I would have equipped all of the operatories at the beginning and networked the entire office.

What suggestions do you have for individuals considering starting their own practice?

There is nothing more rewarding than starting a practice from scratch. The entire office development is entirely up to you. I would strongly advise current residents to do the following:

How did you work out your practice insurance? Did you have your own insurance or where you insured at the different offices you were visiting?

Typically, your insurance company will insure you for all the locations at which you practice.

What was your biggest mistake as a new practitioner?

Not starting the process of buying a periodontal practice while I was a resident. This is the ideal time to start the process.

How many different offices where you performing periodontal procedures at?

I was working in three different offices; for varying days per week or month.

What is the most important thing you have learned about managing people?

All I can say is that you must be comfortable with whatever management style you prefer. Try to remember, unfortunately, you will spend more time with your staff than you will with your family members. If you are unhappy with someone and they bring the whole office down, do not hesitate to let that person go ASAP.

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