Dr. Ronald S. Stukalin, DDS, answers questions about the steps he followed after his postdoctoral training to start his own practice...

What to Do After Graduation Day
STARTING A PRACTICE

Dr. Ronald S. Stukalin, DDS, answers questions about the steps he followed after his postdoctoral training to start his own practice.
Ronald S. Stukalin, D.D.S, is a private practitioner in Dallas, TX, and has been a member of The American Academy of Periodontology for 14 years. He is currently the AAP New Practitioner Committee chair and received his certificate in periodontics from the University of Baylor College of Dentistry.

What was your plan after graduation?

To associate with an established periodontal practice leading towards a partnership.

What made you consider starting your own practice?

The partnership (buy-in) phase of the associateship was not heading in the right direction.

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

I had a desire to start my own practice. This was exciting and challenging. I wanted as few startup costs as possible. A recently vacated dental office was located. I planned on starting with one operatory; then paying cash to continue to expand the practice (office).

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

I talked with periodontists that I knew. They gave me valuable insight regarding practice startup. I also visited with dental supply companies to get an idea of equipment and costs associated with opening an office.

What variables influenced your decision on location?

I wanted to stay in Dallas where I was teaching part-time at the dental school. By teaching I was able to expand my potential referral sources. I searched for existing dental space within a 5-mile radius of where I wanted to practice.

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

I met with an accountant to formulate a business plan. This was presented to bank officers to secure financing. I used an accountant who had numerous dentists as clients.

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

My accountant had experience with dental startups; therefore, we had accurate figures. I also reviewed startup plans from the American Dental Association and from periodontal colleagues.

How did you obtain financing?

Initially from a bank. Then I went to family/friends to see if they wanted a good loan with an attractive rate of return. I ultimately obtained financing from my mother-in-law's employer (a physician).

What risks were involved in starting your practice?

The greatest risks were financial and the fear of failure

How did you assess and manage those risks?

By taking a small loan that was very manageable. This meant fully equipping one operatory with one employee. As the practice grew, I was able to pay cash to add more operatories, staff, equipment, etc. I also made sure my personal debt was kept to a minimum.

What is your situation now?

I merged my practice with an established practitioner in my building. He retired a few years ago. I am currently in discussion to bring in an associate.

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

By securing a loan including working capital, I was able to open the practice with less financial pressure. The loan was structured to pay interest only for the first 3 months.

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

A working wife, no children (at the time) and manageable personal debt.

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

Better than anticipated. I used conservative numbers in terms of patients, dollars generated per patient, etc. By planning carefully and conservatively, I was able to quickly control the practice and it grew proportionately.

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

Periodontists who were good friends were the most helpful. I also used the ADA manual, my accountant, and dental supply companies.

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

I'm not sure I would do anything differently. The startup practice fit my personality and goals at the time.

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

The greatest suggestion I have is to limit personal debt. By focusing on your practice and allowing it to grow, you will then have income to meet your personal goals. Don't be in a big hurry – you will be rewarded for your time and effort.

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