The 5 Stages of Dentistry According to Dr. Abernathy

No matter what stage of your career you're in, it's never too late to find growth.

At 40 years of age, I decided I would retire from dentistry in 15 years with $6,000,000 in assets and be debt free.

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I had just read Bob Buford’s book “Half Time.” In it, he tells how his son dies a few days before joining him in running his very successful business. It traces his thoughts and grief as he tries to make sense of life. His conclusion was that he had spent the first part of his life trying to be successful. He felt he needed to spend the last stage of his life trying to do something significant. He referred to this point of transition as half time — kind of like a football game where you go into the locker room with the first half over and having to reassess your strategy for the second half.

I came away from that book with a renewed purpose and a new plan to make my dreams come true. The trouble was that I didn’t know anything other than dentistry. I had to make dentistry fun and profitable for the next 15 years. During that time, I sold partnerships for fractional ownership of my practice to three doctors, grew the practice an average of 15 percent a year, lowered my overhead to the 50 percent range, added nine hygienists, a commercial lab, one more location, started Summit with my partner Max Gotcher, and eliminated all of my debt. I have tried to add significance to every day of my life since that turning point. It is this sense of purpose and significance that continues to drive me today in my sixties.

There are five stages of a dental practice, and no matter what stage you’re in, there is always hope to find the renewed sense of purpose that keeps me going.

1. We all start day one with no money and we’ll call this the Survival Stage of dentistry. We will do whatever it takes to make a living: We are real short on experience and long on persistence. We start out doing whatever it takes. Dr. Gordon Christensen says that, “Our diplomas are just learner’s permits. We are just barely, not dangerous.” The great thing at this point of our careers is that we don’t know what we don’t know. We are pretty clueless about the business of dentistry. We are just looking for a chance to get into the game.

2. The next stage is the Growth Stage. This is the most exciting time for most of us. We start practicing as a dentist, get an apartment or home, get married, and even start a family. We are gradually increasing our clinical, business, and financial skills, usually by trial and error. Everything is looking up. At almost every turn, we run into something that is a challenge. The trouble with growth is that it ends far too quickly for most of us. Very few of us are able to keep adding challenges, clinical skills, and sustain growth in our practices. Without continued growth and profitability, we are doomed to languish in mediocrity. Note: This is the time you want to consider an associateship, or no later than the beginning of a Plateau stage.

3. The next stage is the Profit Plateau Stage. You could find that you hit several different plateaus during your career. Slow down, plateau, and then you market more, add a procedure or even another provider, grow a little, and then hit another plateau. It is kind of like failing. You really only fail the last time you stop trying. As long as you fail forward and keep getting up after a challenge knocks you down, you have not failed. You may currently struggle with some challenge, but it will not make you fail.

4. Patient numbers drop, production barely covers expenses, staff turnover is high, and the inevitable slowdown into the Leisure Stage begins. The name leisure probably doesn’t do it justice. It is more of a decay of attention and profitability — a time when stress is the constant and profit is elusive. You begin to think of patients as the problem. You arrive late, never really are fully engaged during the day, leave early, and try to occupy your life with something other than dentistry.

5. It is at this point that we hit the Sellout Stage: the very worst time to try to sell a practice or bring in an associate or partner. Your systems are in shambles, there is little or no profit, and not even enough energy to lead the practice. You will receive the least amount of money for your practice and have little or no time left to act on an investment strategy to help it grow. At the time in your life when you need money the most, and should be able to cut back, you find yourself back at the Survival Stage. This is a vicious circle that captures way too many of the dentists I encounter. Great opportunity, plenty of time, but a complete failure to follow through. You become a thermometer instead of a thermostat. You sense what’s going on around you, but you never control your environment. A young doctor should never buy a practice in its lowest stage, unless it is a fire sale.

Not a pretty story and not the path that you want to take. That is why you are reading this. As a new graduate, you will be looking for a practice with the goal of a career-long Growth Stage with huge financial gains, less stress and a renewed enthusiasm for life.

It is this sense of purpose and significance that I hope to give you as you read this book. This book will change your life if you will just act, and act today.