Expand An Existing Practice
If you’re ready expand your existing practice, use the checklist below to guide your transition and develop a plan of action. Be sure to click on each action item for a list of supporting tasks and resources.
When adding a new practice location or establishing a partnership, also consider checklists for building a practice from scratch, purchasing an existing practice, and becoming a partner.
Searching for practices for sale? Start with this checklist.
Please note: This checklist is for your informational use and not intended to replace the advice of professional advisors and specialists, including, but not limited to, attorneys and certified public accountants.
Evaluate your readiness to expand
- Have you experienced steady growth in new/active patients in the previous months or years?
- How much money are you spending and earning? Is your practice profitable enough to support additional overhead?
- How will you generate sufficient cash flow to sustain the growth of your practice?
- Are you able to staff or develop leaders who can analyze and predict the marketplace?
- Are you and/or your leaders able to delegate and trust employees to do their jobs well?
- Can your physical/organizational systems and structures handle complexities in communication and decision-making?
- Do you have an effective marketing strategy in place to address competitive pressures and attract new patients and talent?
Helpful Resources:
- The Right Time to Expand Your Dental Practice
- 6 Stages of Growth: From Solo Practice to Dental Service Organization
- Scaling Up: How a Few Companies Make It…and Why the Rest Don’t
- New Tools for Marketing: Forget the 4Ps, Embrace the 4Es
- AAO Webinar (2017) – Why Your Digital Marketing Isn’t Working
- AAO Webinar (2017) – Take Ownership of Your Internet Marketing
- AAO Webinar (2017) – Measuring Orthodontic Marketing Effectiveness
- AAO Webinar (2016) – The Social Six: Strategies and Techniques for Engaging & Growing Your Online Presence
- AAO Webinar (2015) – What’s Best: Case Acceptance Skills for the Orthodontic Practice
- AAO Webinar (2015) – CEO Mentality: Avoiding Legal Minefields
- AAO Webinar (2014) – Chief Operating Officer 101
- AAO Webinar (2013) – Overhead Management: Industry Norms and Understanding Market Segments
- AAO Webinar (2012) – Growing a Practice
Clarify your mission, vision, and core values
- Define the purpose of your organization, where you want the organization to go, and how you will go about getting there
- Integrate your mission, vision, and core values into all decisions, actions, communication, people systems and processes to shape employee behavior and commitment
Helpful Resources:
Ensure oversight of all business functions and processes within the practice
- Who is accountable (i.e., tracks progress, identifies issues) for each function (e.g., marketing, operations, human resources, etc.) and process (e.g., patient communications, employee recruitment, etc.) within your practice?
- Who oversees each line item on your balance sheet or profit and loss statement?
- Determine if you have people and/or performance gaps among business functions and processes
Determine how you will expand your practice
- How will you fund your practice expansion?
- Where will your new offices be located?
- Will you build new offices from scratch or acquire existing practices?
- Will you offer expanded clinical hours and/or a wider range of services?
- Will you add associates or partners?
Helpful Resources:
- Grow Your Business
- Building Your Practice – Stage 1: Solo Practitioner
- Practice Growth – What are Your Options?
- Why Expand Your Solo Practice?
- How to Complete a Successful Dental Practice Merger
- Financing an Office Expansion
- The DDSO: Dentist-Owned Private Group Models
- The DDSO: Equity Harvesting and Value-Added Practice Acquisition Opportunities
- The Path to Multipractice Ownership Part 2: Building
- AAO Office Design Manual
- AAO Webinar (2017) – Office Design: Creating a “Wow” Welcome!
- AAO Webinar (2016) – Mergers: A Transition Structure with Multiple Benefits
- AAO Webinar (2016) – Considerations for Orthodontic and Ortho/Pedo Partnerships
- AAO Webinar (2014) – What’s Best: Starting a Practice or Purchasing an Existing One?
- AAO Webinar (2014) – Finding the Perfect Orthodontic Practice Location
- AAO Webinar (2014) – The Psychographics of Orthodontics
- AAO Webinar (2014) – Constructing or Remodeling Your Office: Legal and Practical Issues
- AAO Webinar (2012) – Understanding Associate Agreements
- AAO Webinar (2012) – The New Marketplace and Adding a Partner
Establish relationships with industry-specific advisors and specialists
- An orthodontic/dental consultant to represent your interests and guide the implementation of your practice growth
- An attorney to review contracts and ensure legal compliance
- An accountant to assist with financial planning and tax compliance
- A lender to finance new practice locations
- A realtor and/or demographer to select new practice locations
- A contractor to build new practice locations
- An equipment specialist to purchase new equipment
Helpful Resources:
Develop a strategic plan to guide the direction of your practice growth
- Identify goals and specific actions to achieve your mission and vision
- Consider long-term goals for the next 10-25 years and break them up into a series of short-term goals for every 3-5 years
- Develop 1-2 quarterly and/or annual goals with actionable steps for the coming weeks or months
- Communicate and enforce the strategic plan on a regular basis to stay on track and establish consistency among employees, systems, decisions, and priorities
Helpful Resources:
Draft a business plan to establish a benchmark for documenting progress
- Include an executive summary, company description, market analysis, design and development plan, operations and management plan, marketing plan, financial projections, and request for funding (if necessary)
Helpful Resources:
Collect quantitative and qualitative data to predict and make decisions
- Establish key performance indicators (KPIs) to track the overall health of your practice
- Collaborate with individuals and teams to identify key performance indicators and actions toward quarterly and/or annual goals
- Invest in a practice management system that can offer a comprehensive view of your practice data across all locations
- Gather and track patient feedback through conversations, surveys, online ratings, etc.
- Track industry trends, benchmark other practices, and understand your target market
- Ensure that data is visible to all employees
Helpful Resources:
- Performance Management and KPIs
- AAO Webinar (2016) – Key Performance Indicators for Orthodontic Practices
- Measuring Practice Success: 10 KPIs Every Dentist Should Know
- Flying, Driving, and the Importance of Key Performance Indicators in Your Dental Practice
- This Successful Dentist Shares Secrets to His Thriving Practice
- Are You Sharing All the Right Information with Your Team?
Work with an accountant to monitor your cash flow and invest in practice growth
- Calculate your operating cash flow (OCG) or cash conversion cycle (CCC) to measure the amount of time it takes to convert dollars spent into dollars earned
- Determine ways to accelerate your cash flow if needed (e.g., improve processes, increase fees, reduce costs, etc.)
- Establish cash reserves to invest in future growth opportunities
Helpful Resources:
Lead, engage, and align your team with the mission, vision, and strategy
- Develop a plan to attract and retain top talent
- Lead by example and ensure your behaviors and decisions are congruent with core values
- Leverage individual strengths and delegate activities to the right employees with the right skills
- Help employees understand their role and contribution to the mission, vision, and strategy
- Host regular meetings to strengthen communication, bring focus and alignment, and solve problems quickly
- Gather ideas and feedback from employees regarding obstacles and opportunities
- Celebrate successes, give recognition, and show appreciation for employee contributions
- Provide ongoing education and coaching opportunities to stimulate employee development and loyalty
Helpful Resources:
- 4 Strategies for Attracting and Retaining Top Talent
- Drive: The Surprising Truth About What Motivates Us
- The Path to Multipractice Ownership Part 3: Leading
- Are Your Dental Team Members Receiving Enough Feedback?
- AAO Webinar (2015) – How Not to Hire the Wrong People
- AAO Webinar (2013) – The Orthodontist as Practice Leader
Maximize efficiency through economies of scale and/or scope
- Centralize management of certain practice functions and operations (e.g., human resources, marketing, patient scheduling, billing, collections, etc.)
- Duplicate best practices and standardize systems, policies, and procedures across all offices (e.g., software, reporting, records, etc.)
- Review and streamline processes to eliminate wasteful steps and obstacles
Helpful resources:
Develop a mindset for growth and continuous improvement
- Be aware of personal and organizational strengths and weaknesses
- Embrace the unknown, accept challenges, and learn from mistakes
- Be open to change, new concepts, and ideas
- Seek input and support from employees, advisors, consultants, etc.
- Create a positive work environment that values learning, teamwork, and effort
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