Buy or Build, That is the Question

This could go down as the biggest decision that a dentist has to make, and there are plenty of arguments for either choice. Do you buy an existing dental practice? Or do you build out a brand new one?

Regardless of which decision you make, do the research for both options. Dentists who bought an established practice, will tell you that it is the only way to go, while dentists who enjoy brand new equipment, will tell you there is nothing better.

This will be the first and biggest decision you make on your practice ownership journey.


There are some real positives to this. You get a patient base, probably staff that patients already know and trust. There is equipment and supplies, that you can change out or add to as time goes on. Basically, you have a functioning dental practice. Meaning, you will have revenue coming in, so the risk of the investment might seem lower.

Of course, you will need to do a valuation, look at equipment, take a glance at the schedule, look at the location, signage, get some ideas on what advertising is going to be. Create a plan for transition, so the old dentist can hand the torch over with his/her blessing. After all, you are buying a patient base, you want to keep them happy so they don’t all run away.

Depending on the age of the practice, updating equipment and furniture might be a must. Are you buying the first curing lights ever made with this deal? How much is a new pano? Are you going to be okay having to tape together hoses for awhile? Since most dental practices aren’t updated that often, and the cost of an established practice is just about as much as building a new one, are you okay maybe not having new equipment for awhile?

Although there are times that having established staff is great, I would say I hear about the headaches more than anything. Are they going to want to do things the way they have always done them? Do you want to fight the battle they might put up? Most long term employees look at the practice as their own, so it could you against them in making changes. As a new business owner, are you up for that challenge?


You get a practice set up just how you want. You get to build a team from scratch who is aligned with you vision, choose the colors, have all the new gadgets and toys. Being able to offer the latest and greatest, might appeal to a younger patient, so although you won’t have a beginning patient base, you aren’t worried.

Make sure to find a good location, budget for advertising, working capital to get started. Find an equipment company that can help with the buildout, and build a good relationship with your banker and CPA.

Build it just how you want it, but don’t overbuild. After all, you won’t have a full schedule right away. So watch where you tie up your funds!

If this is something you are investing in for the long term, building a practice so that it is designed just how you want it, might be the better option. Yes, you will have to do more leg work to get those patients in the door, but long term you will be more comfortable in your space.


When deciding what to do, hire a consultant or project manager (like myself), that can assist in providing a critical eye on either decision. They can help with transition and working with staff in an already working office. Or be the right hand person on the new office job site.

Whichever way you choose to go, remember it is going to be a lot of work. There is no right choice here, it is just right for you. You are going to have headaches and stress with either option, but what is more exciting to you? What challenge are you most willing to take on? Don’t rush this process, and take time to look at offices that currently for sale, what they offer and compare them to what it would look like building a new one!

Good luck!

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