Spouses Face the Challenge on Establishing Two New Practices Simultaneously
by Drs. Margot Kusienski and Jeff Eby
Have you and your significant other ever considered walking away from stable jobs to open two separate practices from scratch?
My husband Jeff and I were both working at established practices when we began to realize that we did not have a future. We began to casually explore the possibility of Jeff purchasing a general dentistry practice, but nothing seemed right. We decided to analyze Census 2000 and the ADA demographic report of the area (Lancaster County) in which my husband was raised. We were searching for a change in lifestyle; we wanted to focus on a future that was conducive to family life.
After careful analysis, we determined areas in the county that were in need of general dentists. As an endodontist, I used the AAE membership directory to determine the number of endodontists in the county. Once we decided on an area, we began a site search with the help of a real estate broker. We were not in a financial position to buy, so leasing was the only option.
After several months of looking at sites, we resorted to driving around the area in hopes of spotting space for lease. We got lucky! We both found space for lease with the square footage that we desired.
We discovered that it was necessary to learn how to write a business plan so that we could be considered for a business loan. With our combined student loan debt exceeding $300,000, securing a loan was a challenge, especially since we were about to not have secure employment. We completed our business plans and had them reviewed by an accountant. We began shopping around for loans, keeping in mind that we did not have any collateral and could not afford to make payments until our doors were open for business. We were approved by a dental lender who would allow us to repay the loan once we opened the doors of our practices. As does everything, the deferment in payment came with a cost. The interest rate was similar to a credit card finance charge, and we had to act as personal guarantors for each other.
We had our attorney begin negotiations with our prospective landlords and consulted a floor plan designer from the local dental supply company that had come highly recommended. Each of us had a clear vision for his and her office design, making it easy to work with the designer. Once the plans were completed, we interviewed contractors for the build out. We desired quality workmanship, a time schedule and a fair estimate. In order for the contractor to give an accurate bid, it was important to select materials (wall covering, counter top material, ceiling tile, etc.) to be used in the build out of the practice.
We attended the Greater New York Dental Meeting so that we could choose dental equipment. Once the equipment was chosen, the floor plans could be finalized. We had a lease, a dental supply company, floor plans, financing and a contractor; all the while our employers did not know our impending plans. The contractor had given us a 10- to 12-week time frame to complete the build out, and we were ready to begin.
As the construction began, we were working full time and supervising the build out. It was imperative for us to visit the building sites at least a couple times a week and meet with the contractor to review progress of the projects. We then began to choose colors, flooring etc. It was time consuming, so we decided to utilize the skill of an interior decorator to help us coordinate the various materials and reduce our running to and from supply stores. We had to make timely decisions; otherwise the project could be delayed. Hence, we made decisions at times even when we may not have been confident.
As the construction progressed, we realized that we needed to subcontract people to install our phone/computer lines, audio systems and security systems. We also were researching various dental software packages. The dental software was expensive and confusing, and none was perfect.
Sixty days before we planned to leave our jobs, we informed our employers of the impending changes in their practices. We were both blessed with understanding and supportive employers who were happy for our growth. It was easier once our employers knew that we were planning to leave in the near future.
Progress on the construction of the offices continued briskly, and many decisions needed to be made on a daily basis. As construction neared completion, we began to tie up loose ends with our previous employers. Cases were completed, and we stopped seeing new patients.
The final week of construction was extremely hectic. The contractor was working hard to finish the project at the same time that the dental supply company was installing cabinetry, operatory equipment and other large dental equipment. It seemed as though every way we turned, we had someone asking us where or how we wanted something placed or installed.
Finally, it was time to open our doors…