What is happening with private practice dentistry right now? Between inflation, economic pressures, insurance networks, corporate dentistry run amok, and an imminent wave of retiring dentists—we are living in strange times indeed! There are several recent trends that every practicing dentist should be aware of, including some incredible opportunities for entrepreneurially minded dentists to take advantage of. Listen to this week’s special “State of the Industry Address” to make sense of it all!
Links:
Slideshow - https://mgeonline.com/industry-2024-slideshow
Free Consultation - https://www.mgeonline.com/free-practice-analysis
The MGE New Patient Workshop - https://www.newpatients.net
DDS Clinical Training - https://www.ddsclinical.com
Wasserman Guide - https://wasserman-medical.com/shop/product/national-dental-advisory-service-2024-software-developers-version/
Roadmap to a Fee-for-Service Practice Consultation - https://mgeonline.com/roadmap/
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Questions From This Episode
Why does Jeff say private practice dentists are facing a once-in-a-lifetime buying opportunity right now?
More than a third of practicing dentists are 55 or older, with an average retirement age around 68, while the number of practicing dentists in the US actually declined in 2023 for the first time in over two decades of ADA data. At the same time, dental school enrollment isn't growing fast enough to replace that outgoing group, and MGE estimates at least 21,000 practices will come up for sale over the next five years.
Why aren't younger dentists picking up the practices that are expected to come on the market?
Practice ownership among dentists under 30 has dropped from over a quarter in 2005 to under 10 percent today, and ownership among dentists 30 to 34 has fallen from over half to the 30-something percent range. Jeff attributes this partly to dental school debt, which can run well over $500,000 at some schools once interest is included, pushing many younger doctors toward DSO employment instead of ownership.
Why does Jeff say DSOs generally aren't the competition for doctors looking to buy a practice?
DSOs typically don't target practices doing less than about $1.5 million a year, since they aren't set up to scale a small practice and the investment model doesn't tolerate that level of risk. Jeff argues there are plenty of smaller practices coming up for sale that DSOs have no interest in, and that private practitioners who know how to scale a business are better positioned to buy those.
What does Jeff mean when he says he sees a coming 'DSO bubble'?
Many large DSO-backed offices depend heavily on the energy and patient relationships built by the original owner doctor, who typically isn't required to stay past about five years post-sale. Jeff predicts that as those doctors move on, and as private-equity owners look to exit within their own five-to-seven-year investment window, a number of poorly run DSOs will lose significant value over the next five to twelve years, something he says he's already seen on a small scale with former clients buying back their own practices for a fraction of what they sold them for.
What are the main action steps Jeff recommends dentists take to prepare for this opportunity?
Build real volume through both new patient marketing and a properly staffed hygiene department, make getting out of network a genuine priority, build a practice that's profitable on routine dentistry before layering in big cases, and invest in staff training, including developing backup managers ahead of time if the goal is eventually expanding into additional locations.
Episode Transcript
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If you're a dentist in private practice and you had to pick a path to ensure maximum prosperity and success over the next five, ten, twenty years, depending on how long you're going to practice, what would that be? To that end, we just finished the MGE Owners Conference, our biggest meeting of the year for all of our alumni. At the start of that meeting, I gave a briefing to all of our clients on what's happening in the industry, how that relates to what's happening economically, and the path we see as a company for ensuring your success going forward.
That presentation was long. I can't fit all of it into a podcast, but I want to cover the bigger points, the exact same things we're telling MGE clients as to which actions you should be taking to ensure maximum success in the years ahead. I'm going to break this episode into four parts. First, what's happening in dentistry right now, because it's not just people going to the dentist for crowns, bridges, implants, or veneers, there are bigger industry trends at play that you may not be aware of. Second, what opportunities these trends are creating for privately practicing dentists, opportunities you could be taking advantage of right now, and that our clients already are. Third, the challenges you're going to run into economically, from the labor market and otherwise, that could make it harder to take advantage of those opportunities. And fourth, four or five big-picture action steps you should take going forward to secure your long-term prosperity. There are once-in-a-lifetime opportunities happening right now in the dental profession that very few people are aware of, and you should be taking advantage of them, especially if you're an entrepreneurial type of dentist.
Let's start with what's happening in dentistry. I want to focus specifically on the supply of dentists in the United States. I've included a few slides from the presentation as a download on the episode webpage, about 20 of the roughly 94 I used, and I'll call out the slide numbers as I go so you can follow along if you'd like.
The first thing I want to talk about is the number of practicing dentists in the US, slide number one. Based on ADA statistics going back to 2002, we had a decline in the number of practicing dentists in the US in 2023, the first time I can find this happening in that span. Last year, the number of practicing dentists went down. It doesn't sound like a lot of doctors, but it's the first time it's ever gone down.
Next, general demographics, slide number two. This is a breakdown of the industry by age bracket. Of the roughly 203,000 practicing dentists in 2023 (these statistics are from the American Dental Association Health Policy Institute, and I have the sourcing on each slide), about 34.7 percent, or roughly 70,000 doctors, are 55 or older. That connects to the next data point from the ADA: the average retirement age for US dentists, based on the most recent data from 2021, is 67.9, call it 68.
Here's where it gets important from a business perspective. There's a concept called the outflow, or exit rate, over a five-year window. So picture this: over 200,000 dentists, almost 35 percent of them 55 and over, with an average retirement age of about 68. For doctors under 54, the five-year outflow rate is between 2.8 and 4.1 percent, meaning if you had a hundred doctors under 54 standing in front of you, about 96 of them would still be practicing five years later. Move into the 55 to 64 bracket, and out of a hundred doctors, only 80 would still be practicing five years later. Move into 65 and over, and out of a hundred, only 45 would still be practicing, since the five-year outflow rate for that bracket is 54.5 percent.
Do you see where this starts to matter? More than a third of the profession is in that older bracket. Dr. Winteregg, one of our founders, and I were already watching this age distribution back in 2008, 2009, 2010, and this was the direction it was heading.
Now, you might think all the students coming out of dental school will just replace those ranks like they always have. Let's look at that, slide number four, which covers enrollment in CODA-approved dental schools. Total US dental school enrollment for 2022 through 2023, all four years combined, was 26,596 students, up 1.4 percent from the prior year, an increase of 368 students. First-year enrollment specifically went from 6,361 in 2021 to 2022, up to 6,513 in 2022 to 2023, an increase of about 153 students. So enrollment is growing, but not at a rate that's going to make a serious dent in the numbers we just talked about.
There could be a lot of reasons for that. Dental school has become extraordinarily expensive compared to, say, 20 years ago. I mentioned this in an episode a year or so back: for the graduating class around 2024 to 2025, NYU dental school, including loans and interest, was projected to run over $700,000. Tufts was around $550,000. Indiana University came in lowest for in-state tuition, around $350,000. That's not undergrad, just dental school. Kids are walking out with a half million dollars in debt in some cases, at a point where student loan debt is one of the few kinds you can't discharge in bankruptcy.
Slide number five is titled "Dentistry Has a Supply Problem." It graphs the net increase or decrease in practicing dentists in the US, and that line climbs steadily until around the early 2010s, then starts declining, with 2023 actually going negative, meaning fewer practicing dentists in 2023 than in 2022. You might think, well, that's just supply and demand, less of something makes it more valuable. But compare that to population growth, slide number six. US population grew by about 2 percent from 2022 to 2023, roughly 6.7 million people, from a little over 333 million to nearly 340 million. Projections put us near 360 million by 2030. Meanwhile, the number of practicing dentists actually decreased that same year.
The ADA's own projection is that the dentist-to-population ratio will stay relatively static through the mid-2020s and then increase. I'm not sure how that math works out, honestly, given tuition costs and the fact that you have to be academically strong to get into dental school in the first place. With enrollment running around 26,000 total students, I don't see the profession growing quickly enough to meaningfully shift the dentist-to-population ratio for at least the next 15 to 20 years, unless something changes with enrollment that I'm not aware of.
Here's where it gets really interesting. More than a third of the profession is 55 and older, which puts most of them on track to retire within the next 13 years or so. You'd expect younger dentists to fill those ranks, but here's a quote from the ADA Health Policy Institute, from 2021: practice ownership among dentists in private practice has been declining, dropping from 84.7 percent in 2005 to 73 percent in 2021. Out of a hundred dentists in 2005, 85 would have owned a practice. By 2021, only 73 would have.
Whose ownership is dropping, younger or older doctors? It's younger doctors. Slide number seven shows this: in 2005, over a quarter of practicing dentists under 30 owned their own practice. That number is now below 10 percent. Doctors 30 to 34 in 2005, more than half owned their own practice; that's now down into the 30-something percent range. Meanwhile, in the older brackets, 45 to 65, ownership has stayed relatively static, still around 80 to 90 percent. The drop is concentrated entirely in younger doctors.
To put real numbers on it: there are roughly 13,220 doctors under 30 in the US right now, and only about 1,256 of them own a practice, under 10 percent. Compare that to doctors 55 to 64: there are 38,427 of them, and roughly 34,622 own a practice. The bulk of practice ownership rests with doctors 45 and older.
So what does this all mean? Younger doctors aren't picking up practices, that's become a clear trend over the last 20 years. At the same time, we have a large number of doctors projected to exit the profession over the next five to twelve years. If we just look at the 55 to 64 and 65-plus brackets, we estimate here at MGE that over the next five years, between now and 2028, more than 21,500 practices will come up for sale. That's slide number 11 if you want to see the math.
Will they all sell? Will DSOs pick them up? In some cases, yes, but generally DSOs don't target practices doing less than about $1.5 million a year, because DSOs aren't set up to scale a small practice into a big one, and the investment model doesn't tolerate that kind of risk. They're buying practices in the $1.5 to $2 million range, paying a premium, adding specialists and plan participation to boost profit. So yes, some of those 21,500-plus practices will go to DSOs, but the majority won't. Some will sell to individual practitioners, some will just close. The point is, there are going to be a lot more practices available than there are buyers, since the doctors coming out of school over the next several years, statistically, aren't buying them either.
So to sum up the opportunity: the supply of dentists isn't growing fast enough to keep pace with population growth. With a large share of practices owned by doctors 55 and older, most of them projected to retire within the next dozen years, we estimate at least 21,000 practices will be for sale over the next five years. And the younger doctors who used to absorb that inventory when older doctors retired are buying far fewer practices than they used to. That's the opportunity. If these trends continue, we project a once-in-a-lifetime expansion and buying window over the next five to ten years for doctors who want to take advantage of it.
I compare it to having cash on hand in 2011 to buy rental properties after the 2008 and 2009 crash, when properties were everywhere on the market. Back then you were competing with hedge funds. Today, you might be competing with a DSO for certain practices, but I wouldn't recommend going head to head with one. There are plenty of practices DSOs have zero interest in that you could be buying instead. The one caveat: this only makes sense if you actually know how to scale a business. If you're already struggling to manage your current office, don't buy a second one, you'll just be buying yourself a bigger headache. I've seen clients buy a small satellite office doing $30,000 or $40,000 a month for a song, and a year later it's doing over $100,000 a month at a 20 to 25 percent net, run by associates, with the owner doctor barely needing to show up. One client here in Florida bought an office doing about $50,000 to $60,000 a month; it's now doing close to $300,000 a month, netting around 23 to 24 percent, and they don't have to work there, they just oversee clinical quality through associates. That's the opportunity, but only if you know how to manage a business well enough to make it work.
Now let's talk about DSOs specifically, since that's the other side of this equation. You're not really competing against them for most of this opportunity, but here are some facts. Currently 13 percent of dentists in the US are affiliated with a DSO, up from 10.4 percent in 2019. Among doctors practicing ten years or less, 23 percent work for a DSO. And in 2022, 35 percent of dental school seniors planning to go into private practice said they intended to join a DSO, up from 30 percent in 2020 and just 12 percent in 2015. It's clearly seen as a route out of student debt.
There are over 300 DSOs in the US, and 27 of the top 30 are private equity owned. Without getting too deep into what private equity is: a group of investors, often with a minimum buy-in around $25 million, pools money to buy a company, holds it for roughly five to seven years while extracting as much profit as possible, then sells it to pay everyone back with a return. That's the model. Private equity has made major inroads over the last 20 years, into storage facilities, apartments, single-family homes, and now heavily into healthcare, optometry, medical practices, veterinary practices (private equity owns a stake in PetSmart, for example), and dentistry. The general critique of the model isn't about any individual company's intentions, it's that the structural incentive is to maximize profitability and exit within a set window, not to hold and grow a practice indefinitely the way an owner-operator would.
A few opinions on how this plays out. DSOs generally don't target practices under $1.5 million a year, so if there's a smaller practice for sale nearby, that's a private practitioner opportunity, not a DSO target. The bigger issue is that DSO and private equity money has distorted the valuation model across the industry. Since I got into this business in the early 1990s, the standard dental practice valuation was simple: roughly 70 percent of the prior year's collections, with small adjustments for equipment age or condition. Now, with DSOs backed by private equity, practices are being valued on a multiple of EBITDA (earnings before interest, taxes, depreciation, and amortization, essentially a stand-in for profit). So a $4 million practice with a $1.2 million profit margin, which would have sold for about $2.8 million under the old 70 percent model, might now sell for $6 million at a five-times EBITDA multiple. That's a massive shift, and it's warped pricing expectations across the industry, leading to things like "roll-ups," where multiple practices combine to present as one larger entity in order to command a higher multiple. DSOs have generally gotten wiser to that tactic.
Personally, I believe DSOs are significantly overpaying for practices right now, to the point that I'd call it a DSO bubble. Many of our own clients, with larger offices, have been DSO acquisition targets, and I've seen the offers. My view: if someone wants to pay well above fair value for something, whether it's a car or a practice, and they know it's above value and want it anyway, there's no reason to turn the money down. But the concern is what happens three, four, five years out. Most DSO deals assume the selling doctor sticks around for about five years. A lot of these large offices, doing $6, $7, $8, $10 million a year, run on the energy and drive of that owner doctor. Once that doctor is no longer obligated to stay, and moves on, what happens to the practice? My prediction, which I gave to our clients directly: we're in the process of witnessing a DSO bubble in which many DSOs, especially those poorly run and connected to private equity, will implode and lose significant value, either due to poor management or once the original owner doctor exits or the company gets offloaded, since private equity owners want to sell within that five-to-seven-year window too. I think this plays out over the next five to twelve years. I've already seen a small-scale version of it: clients who sold practices to a DSO and then bought them back years later for around 30 cents on the dollar.
What that means for you: there's already a wave of opportunity coming from retiring doctors whose practices won't be DSO targets. On top of that, five to twelve years out, as some of these DSOs implode, there may be a second wave of opportunity, potentially even buying back your own practice if you'd sold it. It's more opportunity for the stable, privately practicing dentist. Bottom line: DSOs are not your competition here. If you're bidding against one for a specific practice, walk away, there's a smaller office out there you can scale instead, provided you know how to scale, which is exactly what we teach MGE clients to do. And there will always be a place for private practice in this country. I think a properly managed expansion into multiple practices by private dentists, especially within our client base, could actually help revitalize private practice dentistry as a whole, since a dentist-run group of offices has a fundamentally different purpose than a private-equity-run one: one wants to hold and grow for the long haul and maintain quality of care, the other needs to exit and recoup an investment. If that's your model, you can bring younger doctors into an environment where you mentor them, potentially toward future partnership, the kind of path they may have imagined when they first entered dental school, while preserving the way dentistry should be practiced.
Now, what are the challenges standing in the way, especially if you're considering this multiple-practice model? Let's start with the labor market. The narrative is that unemployment is low and it's hard to find employees. That's only half true. It is genuinely difficult right now to find hygienists and highly skilled dental assistants, and there's a reason for that. It is not difficult to find administrative staff, despite what the headline unemployment number suggests.
The US unemployment rate is currently 3.8 percent, lower than before 2020. Job openings have been declining over the past year but remain higher than pre-2020 levels. A few years ago we had roughly two open jobs for every unemployed person; now it's closer to 0.7 unemployed people per job opening, meaning there are still more jobs than people, but the gap has narrowed. Here's the number that doesn't get much attention: full-time versus part-time employment. Since March of 2023, the US has seen a net loss of about 1.35 million full-time jobs, and a net gain of about 1.9 million part-time jobs, over that same twelve-month period. Remember, unemployment counts you as employed even with just an hour of work a week. And multiple job holders, people working one full-time and one part-time job, are at their highest level in at least the past decade, based on Federal Reserve data.
What that tells me: people need work, and a lot of people are stitching together more than one job to make ends meet. If you're offering a genuinely good job at a competitive rate for administrative roles like front desk, scheduling, or treatment coordination, you should not have a hard time filling those positions, especially if you have solid training systems in place, which are critical right now. The National Federation of Independent Business backs this up too: small business hiring plans and reports of unfillable jobs have both been trending down over the past year, with inflation cited as a major factor.
Hygienists and assistants are a different story. A 2022 joint study from the ADA Health Policy Institute, the American Dental Hygienists' Association, and the American Dental Assistants Association found that about 33.7 percent of dental assistants and 31.4 percent of dental hygienists expect to retire within five years. I focus on hygienists specifically here since they always require a license, unlike assistants in many states, and finding one is generally harder. The dental hygiene workforce last year was roughly 220,000, against about 203,000 dentists, and hygiene school enrollment has only grown about 1.7 percent annually since 2018. It looks almost like we're manufacturing a hygienist shortage, since it's not a doctorate-level credential and could be scaled up relatively quickly. If any of our clients are listening and have ever considered starting a hygiene school, give us a call, we'd love to help. The general staffing target we recommend is one to one and a half hygienists per general dentist; for a four-day-a-week doctor, that's at least six days of hygiene, ideally not much more, since too many hygienists relative to one doctor actually hurts the doctor's productivity and time to sell treatment. At that ratio, a hundred dentists should support about 150 hygienists, and we're nowhere near that right now.
So on the labor front: the market has genuinely eased for administrative hiring, small businesses overall are pulling back on hiring pressure, and hygienists in particular, and to a lesser extent assistants, remain in short supply, which in my view is a largely self-inflicted shortage worth watching.
Now, general economics: inflation. Slide 18 shows CPI growth since 2003, with the Fed's roughly 2 percent year-over-year target marked. Since around 2021 to 2022, we've been running well above that target, which is why interest rates have stayed elevated; the Fed generally doesn't cut rates until inflation gets back near that target. Slide 19 breaks this down year over year since the pandemic: up 2.6 percent in March 2021 versus March 2020, up 8.5 percent in March 2022 versus March 2021, up 5 percent in March 2023 versus March 2022, and up 3.5 percent in March 2024 versus March 2023.
Here's the thing about inflation: it compounds. If I gain 10 percent of my body weight one year, then only 5 percent the next, that second 5 percent is 5 percent of my new, higher weight, not my original weight, so I still end up heavier than before, even though the growth rate slowed. Applying that same compounding to these numbers: something that cost a dollar in March 2020 cost about $1.03 in 2021, $1.11 in 2022, $1.17 in 2023, and $1.21 in 2024. That's a roughly 21 percent cumulative increase in prices since March 2020. I know some listeners will say that feels low, and in certain categories I agree it's higher. I did my own informal comparison using old Publix weekly circulars, one from December 2019 and one from a few weeks before this recording, and looking at identical items, I saw average increases in the 35 to 40 percent range on things like beer and general grocery items. That's obviously anecdotal, not an official statistic, but it's what I found.
Inflation compounds for your payroll too. Say you had a scheduling coordinator making $18 an hour in March 2020. Just to keep pace with that roughly 21 percent cumulative inflation, they'd need to be making about $21.79 an hour by March 2024, an increase of about $658 a month, or nearly $7,900 a year, per employee, just to stay even. And inflation by category varies a lot, slide 22 breaks this down: gas up 52 percent since March 2020, electricity up 31 percent, shelter up 23 percent, apparel up only 8 percent, medical care services up only 9 percent. The categories hitting practices hardest, food, gas, electricity, shelter, are running well above that 21 percent average.
And here's the payoff data point, from the ADA Health Policy Institute: average net income for general dentists (not specialists) was $186,620 in 2019, and $186,780 in 2022, an increase of only $160 over three years. Costs, whether payroll, insurance, lab fees, or general overhead, have been quietly eating almost all of the gains.
Which brings us to fees. One of the core traits of an agile small business is the ability to adjust pricing in response to market conditions. If you can't raise your fees, you're stuck. Two problems tend to show up here. First, most new clients' baseline fee schedules aren't even at the 40th percentile for their area when we first meet them. Using something like the Wasserman Guide, which breaks down fees by CDT code and zip code, if the 40th percentile fee for a crown in your area is $1,100, that means 40 percent of doctors nearby charge that or less, and 60 percent charge more. We generally recommend clients target the 60th percentile or a bit higher for their full fee. Doctors tend to set fees once, based on whatever the prior owner charged or general local norms, and then rarely adjust for inflation, so eight or ten years later their fees have quietly fallen way behind. If you haven't revisited your fee schedule in a while, that's worth doing now; the Wasserman Guide's developer version runs about $600 and is worth it for the updatable, downloadable fee data.
The second problem: if you're heavily in network, you can't actually raise your fees. Typical PPO write-offs run around 50 percent on diagnostic and preventive procedures and around 40 percent on basic and major procedures, depending on your specific mix. In an inflationary environment, staying that deep in network while unable to adjust pricing is a genuinely dangerous way to run a business long term. That's why we've been pushing clients hard toward getting out of network, which is exactly what Sabri and I covered in detail a couple of episodes ago, walking through the bucket system we use to sequence which plans to drop and when.
One thing Sabri mentioned in that episode that I think is worth repeating here: for practices that are heavily embedded in PPOs and anxious about dropping them, one option, once you've confirmed it's workable legally in your state, is to raise your out-of-network fees for basic and major dentistry, but leave your hygiene fees where they are. Most patients don't notice or mind paying a bit more for a filling, but they notice immediately if a cleaning that used to be fully covered suddenly comes with a copay. I've seen this work well for a client running a satellite practice this way; it nets close to 25 percent and keeps things stable while still giving the practice room to raise the fees that matter most. I may do a full episode on this model specifically.
So the underlying data points here: inflation has run hot, and if you can't adjust your fees while stuck in a low-reimbursement, heavily in-network position, you're steadily losing ground on your ability to stay competitive, attract talent, and keep pace with rising costs. To put yourself in a position to succeed, you need the ability to affect your fees as quickly as possible.
Zooming out: prevailing industry conditions point to a once-in-a-career growth opportunity in acquiring practices over the next five to ten years. DSOs generally aren't your competition for this. You do need to know how to scale a business to make it work. It's also a chance to help keep ownership of dentistry in the hands of private practitioners, which matters to me personally. On the challenge side, labor market pressure is concentrated in hygienists and assistants rather than administrative staff, and the bigger overall threat is inflation combined with an inability to adjust your fees, which directly affects your ability to attract and retain good talent.
So here's what we're recommending to our clients right now, in broad strokes, since the specifics vary by practice. First, make sure your primary practice is stable and growing, since it's the launchpad for everything else. That starts with volume: take new patient marketing seriously, and take your hygiene department just as seriously, since living off new patients alone while neglecting hygiene retention is a losing strategy long term. If you're bringing in even 25 new patients a month, 300 a year, after ten years you should have about 12 days of hygiene a week in your practice, the equivalent of three full-time hygienists working four days a week. If you're only running three or four days of hygiene after that kind of new patient volume, patients are coming in the front door and leaving out the back, and that's a significant waste.
Second, make getting out of network a real priority. Every one of our MGE Power clients is working with their power client manager to get out of network as quickly as it makes sense for their practice.
Third, don't build your practice's profitability around big cases. A lot of our clients, and dentists generally, are doing more advanced procedures than ever, full-mouth reconstructions, All-on-4s, All-on-X cases, which is genuinely incredible compared to where the field was even 20 years ago. We actually have a sister organization, DDS Clinical, with courses on full-mouth reconstruction and implant placement if you want to build those skills. But your practice should already be profitable on ordinary, bread-and-butter dentistry before you ever add big cases on top. If your practice nets a solid profit doing routine dentistry, and then you layer big cases on top of that, you become significantly more profitable and can do more for your patients. If you're depending on the occasional $27,000 case while letting routine $3,000 to $5,000 treatment plans walk out the door unclosed, that's backwards.
Fourth, invest in staff training, and this has two parts. One is more structural: a lot of people entering the workforce now, particularly younger hires, simply haven't been taught basic professional skills that used to come from part-time jobs or general schooling, how to address a patient properly, how to write a professional letter or email, and so on. It's not a matter of aptitude or willingness, they just haven't been exposed to it yet, so practices need real training systems in place to build those skills before expecting someone to perform at a professional level. Anecdotally, I've also heard from longer-tenured dentists hiring newer graduates that some of them lack confidence in certain basic clinical procedures, possibly tied to disrupted clinical training during 2020 and after, which is more a mentorship gap than a continuing-education gap.
The other training piece is specific to running additional locations. What actually makes a satellite office work is personnel, specifically having a good doctor and, just as importantly, good management on-site, since a satellite office shouldn't depend on the owner doctor personally being there to function. In the MGE Power program, doctors train as an executive over roughly 76 days and 600 hours, and we recommend training a manager alongside them for just as long. If you're planning to expand into additional locations, we recommend keeping a couple of manager trainees developing at all times, so when the next opportunity comes up, you already have someone ready to run it, rather than scrambling to find management for a new location on short notice. That investment tends to pay off even in your existing practice, since better-trained management makes any location more productive.
So that's the state of the profession as we see it right now, and the general framework we're recommending. I have the charts and slides available as a download if you'd like to follow along with any of the specific numbers, along with links to the New Patient Workshop, DDS Clinical, the Wasserman Guide, and the Roadmap to a Fee for Service Practice consultation, all on the episode webpage.
To sum it up: you're at a genuinely once-in-a-lifetime fork in the road as a dentist in the United States right now, with a real opportunity over the next five to ten years to build something substantial. MGE clients are actively taking advantage of it, and honestly, at this point it's almost harder not to. You do need to know how to scale a business, and if you want help with that, that's what we're here for. You can reach us at (800) 640-1140 or find us online at mgeonline.com.
I hope this gives you a clearer picture of what's happening in the profession and the opportunity in front of you. Have a great week, and I'll see you next episode.