Special Section for New Dentists: Why ‘Wait and See’ Is the Most Expensive Strategy for Today’s Asso by Brian Hanks, MBA, CFP

by Brian Hanks, MBA, CFP

You graduated with $365,000 in student debt. You’re grinding through an associateship, watching DSOs snap up practices in your market, and telling yourself you’ll get serious about ownership when the time is right. Maybe when rates drop. Maybe when you feel more ready. Maybe when your loans feel more manageable.

A few months ago, I posted a version of this argument on the Dentaltown message boards, and the discussion that followed was some of the best pushback I’ve gotten anywhere. Townies raised the things that deserve to be raised: What about mentorship? What about the associate who isn’t clinically ready? What about the paths to ownership that aren’t a straight acquisition? This is the final version of that argument, sharpened by that conversation.

The core of it hasn’t changed. Here’s what I’ve learned from helping about 1,500 dentists buy practices across 49 states: Waiting is not a neutral decision. Every month you delay, you’re making a choice, and it’s costing you more than you think.


The anxiety is real. The math is more real.
Between DSO consolidation, interest rates, and the psychological weight of six-figure debt, buying a practice feels like a massive risk. I get it. But complicated is not the same as unfavorable.

The true average income difference between an associate and a practice owner is almost exactly $150,000 per year once the practice is stabilized. Over five years of waiting, that’s $750,000 in forgone earnings, before you count the equity you’re building for someone else the entire time. The “safe” choice has a very real price tag, and it compounds every year you tell yourself next year. (Fig. 1)

Fig. 1

Meanwhile, the window is more favorable than the mood suggests. Seller expectations that inflated through 2021–2023 are softening in many markets, and sellers who were holding out for top-dollar corporate offers are quietly becoming more flexible. Lending remains remarkably accessible: Dental practice loans are among the safest in banking, and lenders who understand dentistry routinely offer 100% acquisition financing to qualified buyers. And as more associates hit their three- to five-year mark, competition for quality practices will only rise.


What the Townies got right about preparedness
The strongest thread in the board discussion was essentially this: Fine, waiting costs money, but so does buying before you’re clinically or financially ready. Fair. So let’s define what prepared actually means, because it’s less than the anxious version in your head and more than nothing.

Clinically: You need enough speed and confidence to produce at a level that services a loan and pays your household. For most associates, that arrives within a year or two of practicing, not five or 10. When I informally polled a group of dentists who bought practices straight out of school, every single one told me the same thing: “I wish I would have just worked for a year.” Not a decade. A year.

Financially: Liquid funds equal to the lesser of 10% of the purchase price or $50,000, and a clean payment history. That’s the real bar. Your student loan balance matters far less than you fear, because banks underwrite the cash flow of the practice, not the size of your education debt.

On the business side: Here’s the reframe I’d offer those who said, “I’m not ready to manage people.” You already manage people. If you work chairside with an assistant, you’re managing a person. If a front desk builds your schedule, you’re managing a person. Ownership doesn’t introduce management to your life; it gives you authority over the management you were already doing. What you genuinely can’t prepare for in advance is the feeling of ownership itself, because some things are teachable and some are only learnable. There is no mannequin to practice on for running a business. The only thing that fully gets you ready for ownership is being an owner.


The shortcut nobody budgets for: Mentorship
Several commenters raised mentorship, and they’re right that it’s the most undervalued asset in a transition. The learning curve of ownership exists, but it is not a curve you have to climb alone, and the associates who move fastest almost always have three kinds of people around them.

The first is an owner who’ll open the books. Most practice owners are surprisingly willing to talk shop with a serious associate: What they’d do differently, what the overhead really looks like, what surprised them. One honest lunch hour with an owner could teach more than a weekend CE course on practice management. The second is the seller. In a well-structured transition, the selling dentist is the best mentor you’ll ever have, because nobody else on earth knows those patients, that team, and that operatory’s quirks. Negotiate transition support into the deal on purpose and not as an afterthought. The third is a deal team that has done this hundreds of times: a dental-specific accountant, a dental-specific attorney, and a lender who knows the industry. Their job is to make sure your first acquisition benefits from everyone else’s 500th.

If you have none of those three today, that’s not a reason to wait five years. It’s a reason to intentionally build your network of people who can help you.


The different paths, honestly compared
The board discussion also pushed on something I should have said plainly the first time: A straight practice acquisition isn’t the only door, and the doors aren’t equal.

Acquisition remains the most proven path with the shortest return on investment. Day-One cash flow, an existing patient base, a team in place, and financing that banks compete to provide. It’s the path where the “I-make-owner-money” math kicks in fastest.

Startups trade that Day-One cash flow for total control. For the right dentist in the right market, they work, but the earnings gap that acquisition closes in Year One, a startup may not close until Year Three or Four. If you choose that path, choose it with open eyes about what the slower ramp costs.

Partnerships and buy-ins can be the least risky path to ownership as long as one crucial detail is true: The new owner actually has the control in the business they’re looking for. I believe there are only three true ownership percentages in dentistry: zero, 50, and 100. If you’re being offered 49% ownership, you have an associate job with profit sharing. You can be outvoted on when to buy the new CBCT, on whether to drop an insurance plan, on everything that matters, indefinitely. Minority ownership can make financial sense in specific structures, but walk in knowing that a minority stake buys you economics, not control, and control is most of what ownership is for.

And staying an associate is a legitimate path too. Ownership is not a moral imperative, and there is nothing less noble about a career built deliberately at the chair. But make it a decision, not a drift. The associates who struggle most aren’t the ones who chose associateship on purpose; they’re the ones who waited so long for the feeling of readiness that the waiting accidentally became the career.


Before you fall in love: The two-question lemon test
For those moving toward a purchase, here’s the 10-minute screen I teach before anyone spends a dollar on due diligence.

1. Does the dentist actually want to live there?
Location is the one variable you cannot fix after closing. You can upgrade equipment, improve systems, and rebrand, but you can’t move the practice. Do you and your family genuinely want to build a life in that community? A dentist who is embedded in the place they serve builds a different kind of practice than one who’s already planning an exit.

2. How much did the practice collect last year?
Collections are the most honest number in any practice’s financials: not production, not EBITDA, but what actually came in. That single figure tells you how desirable patients find this practice, how well-trained the staff is compared to other offices, whether the asking price is defensible, what debt service you can carry, and whether the practice is trending up or declining. Ask for three years, not one. And if a seller hesitates to share it, that’s data too.

If either answer gives you pause, that’s not automatically a reason to walk away. It’s a reason to ask harder questions before you go further.


The real risk isn’t buying. It’s waiting too long.
The perfect time to buy a dental practice is a myth. The right time is when you’re prepared: a year or two of clinical speed, a modest cash cushion, mentors around the deal, and a clear-eyed view of what you’re buying. Preparation is achievable this year. The perfect feeling only comes after you take action, never before.

Stop asking whether you can afford the purchase price. Start asking whether the practice can afford you: your time, your energy, and your future.

The Conversation Continues
This article was shaped by a discussion on the Dentaltown message boards. Click here to read the original thread and join the conversation.

Brian Hanks, MBA, CFP, is a dental accountant and founder of Dental Buyer Advocates, where he works exclusively on the buyer’s side of practice transitions. He is the author of How to Buy a Dental Practice, now in its fifth edition, and host of the Practice Purchased Podcast.