Doctor Demographics

I write about where to put a practice, the market conditions that are influencing the places where dentistry works best, and the trends that are helping or inhibiting practice.

Blog By:
Mike Green

Transcript 

From Chairside to CEO: Scaling Your Practice

Welcome to The Perfect Place to Put a Practice! I’m your host, Mike Green, from Doctor Demographics. Today, we’re tackling a topic that’s on the minds of many ambitious doctors out there: making the transition from full-time clinician to full-time business owner. If you’re a dentist, veterinarian, or optometrist who’s dreaming of expanding to multiple locations, stepping back from the daily grind of patient care, and hiring associate doctors to handle the clinical side, this episode is tailored just for you. We’ll break down the why, the how, the benefits, and the pitfalls—so grab a notebook, because we’re about to get practical.

Okay, welcome to all of you good people, and we want to thank you for listening and supporting the podcast for our now over 300 episodes. Also, for those of you in the dental world, if you haven’t gotten my book titled “Dental Marketing Mastery” yet, it is available in both softcover and Kindle versions now on Amazon. We’ve received a lot of great feedback from it, and I know that it will be helpful for you in your marketing efforts moving forward.

Alright, let's dive into today’s topic. Transitioning from being the hands-on doctor in the chair to the strategist running a multi-location empire isn’t just a career shift—it’s a mindset change. Many doctors start out loving the clinical work, but as their practice grows, they realize they can’t do it all. You might be seeing more patients than ever, but your schedule is packed, burnout is creeping in, and you’re thinking, “There has to be a better way.” That’s where scaling comes in: opening additional locations, hiring associates to take over the clinical duties, and focusing your energy on the business side—strategy, operations, and growth.

First, let’s talk about why this transition matters. According to data from the American Dental Association, about 13% of U.S. dentists were affiliated with Dental Service Organizations (DSOs) in 2022, up from 10.4% in 2019. That’s a clear trend toward group practices and multi-location models. But it’s not just dentists—veterinarians and optometrists are seeing similar shifts, with corporate consolidations and private equity driving the move to larger operations. Why? Because solo practices are tough to sustain long-term. The ADA also notes that 75% of dentists still work in single-location setups, with 35% being true solos. But for those who expand, the rewards can be huge: higher revenue, better work-life balance, and a practice that runs without you glued to the chair every day.

Let me share a quick story from a client—let’s call him Dr. Alex, a veterinarian in Texas. He started with one clinic, doing everything from exams to surgeries. But after a few years, he was exhausted. We worked together on a growth plan, and he opened a second location, hired two associates, and shifted to overseeing operations. Within two years, his revenue doubled, and he finally had time for family vacations. It wasn’t easy, but it transformed his life and business.

Section 1: The Benefits of Making the Leap

So, what are the upsides of transitioning to full-time business owner? Let’s break it down.

First, increased production and revenue. When you hire associate doctors, you’re essentially multiplying your capacity. Associates can handle the day-to-day clinical work, freeing you up to focus on high-level decisions. Data from dental consulting firms shows that practices with associates often see 20-30% higher production because you can serve more patients without overworking yourself. For vets, this means more wellness visits and surgeries; for optometrists, more exams and fittings.

Second, reduced burnout and better work-life balance. As the owner, you’re no longer the only one on call for emergencies. Shared workloads mean less stress. The American Dental Association reports that dentists in multi-doctor practices experience lower burnout rates, and the same holds for other fields. Plus, associates bring fresh energy and ideas, improving the overall patient experience—think shorter wait times and more specialized services.

Third, smoother succession planning. If you’re eyeing retirement, having associates in place makes your practice more valuable and easier to sell. Buyers love turnkey operations with trained staff. And mentorship opportunities? Huge. You can guide younger doctors, building a legacy while they handle the heavy lifting.

Finally, scalability. Multi-location practices tap into new markets. If your first site is maxed out, a second one in a growing area can capture untapped patients. Just remember, as one study warns, expanding can double fixed expenses, so plan carefully.

Section 2: The Challenges You’ll Face

Of course, this transition isn’t all smooth sailing. Let’s be real about the hurdles.

One big challenge is financial. Opening a second location means higher overhead—rent, equipment, staffing. If you’re not producing enough at your original site, you could strain cash flow. Aim to hire an associate when your schedule is consistently booked 4-6 weeks out, as metrics from firms like Aprio suggest.

Staff retention and management is another. In multi-location setups, coordinating teams across sites is tough. You might deal with EHR migrations, inconsistent patient data, or communication breakdowns. Plus, in today’s workforce shortage—McKinsey reports ongoing physician shortages—finding reliable associates isn’t easy. Scope-of-practice laws vary by state, adding regulatory headaches.

Then there’s the emotional side. Letting go of clinical work can feel like losing your identity. Many doctors struggle with delegation, micromanaging instead of leading. And marketing? It gets more complex with multiple sites—you need unified strategies to avoid confusing patients.

Take another client example: Dr. Sarah, an optometrist in Florida. She expanded to two locations but hit roadblocks with staff turnover after a hurricane disrupted operations. We helped her rebuild with better disaster plans and incentives, and now she’s thriving. The key? Preparation.

Section 3: Actionable Tips for a Successful Transition

Ready to make the move? Here are some step-by-step tips based on what’s worked for my clients.

First, assess your readiness. Look at your metrics: Are you at 80-90% capacity? Do you have 6-12 months of reserves? Use tools like the Tax Foundation or Census data to scout new locations—focus on growing populations with underserved healthcare needs.

Second, hire smart. When bringing on associates, prioritize fit over just skills. Offer competitive benefits—data from Reddit threads shows associates value 401(k) matches, PTO, and health coverage. Start with a trial period or non-compete clauses to protect your investment.

Third, build systems. Invest in unified software for scheduling, billing, and communication across locations. Delegate early—hire an office manager if needed. As Harvard Business Review advises, learn business language: focus on outcomes like ROI and patient retention, not just clinical metrics.

Fourth, cultivate leadership skills. Transitioning means shifting from clinician to CEO. Work on emotional intelligence, conflict resolution, and team building. Network with mentors or join groups like the Veterinary Practice Management Association.

Fifth, market strategically. Use multi-location marketing to build brand consistency—think shared websites and social media. And don’t forget incentives like loan forgiveness in underserved areas to attract talent.

Finally, plan for innovation. Embrace telehealth or new services to differentiate. Remember, growth is ongoing—keep learning.

Conclusion

And that’s a wrap for today’s episode of The Perfect Place to Put a Practice. Transitioning from clinician to full-time business owner is a game-changer, opening doors to multi-location success, financial freedom, and a legacy that lasts. But it takes planning, the right hires, and a shift in mindset. If you’re feeling the pull to scale, start small—assess your practice today.