CDS Member News and Articles

Professional News Articles : : ON PRACTICE MANAGEMENT by Janyce Hamilton : Home-based dental practice may be appealing alternative

Home-based dental practice may be appealing alternative

June 06, 2006

Not since the 1800s have dentists practiced their (then) “trade” out of their homes. Wasn't it the dental doc, Painless Parker, who had a horse-drawn carriage for drawing those “medicine show” crowds? By the 1950s, however, practicing away from the (then) “wife and kids” became the norm, along with tightly knotted neckties and white doctor coats.

In 2006, a dentist is just as likely to be wearing perfume, while rental leases for medical-dental office space have spiraled to unprecedented rates. Can and will the office leasing bubble burst? If not anytime soon, how can dentists (many in dire debt) be sure they do “enough dentistry”—more and more every time a lease is renegotiated—to pay the bills? Not every dentist is part of a two-income family, but leasing and mortgage expenses demand dual incomes or one high salary today. And, the squeeze feels like its threatening even “the haves.”

What's a doctor to do?

A handful of new and established dentists are going the novel, yet old-fashioned route to attempt to stem the flow of cash down the drain: practicing dentistry out of their homes.

And why are you crinkling up your nose?

It's brilliant. Your tax deductions can include half of your home's utilities (if the practice takes up the first floor of a two floor building). So can the landscaper's mowing and plowing fees. Your kids (or dog) can play in the fenced yard while your patient watches them for you out the operatory window—just kidding.

But seriously, if you can buy a house also zoned to allow a home business with signage and patient parking. . . well, that may be a sweet deal. The Chicago and suburban office space market (and residential market) seems to be climbing in dollars per square foot faster than the federal deficit.

How is a dentist supposed to earn a decent living anymore?

Sheesh.

The bright spot is that some dentists can and do operate thriving practices out of their homes. For example, one suburban dentist, who shall remain nameless, likes his set up.

First some history. Dr. X, I'll call him, practiced with a partner from dental school right out of school, and they opened a practice in a strip mall in the western suburbs. “We split after a year, and I relocated alone to a strip mall in another nearby suburb,” he said.

 After awhile, he couldn't think of a reason not to just move his practice into his home, which was centrally located in-town (a better spot than the strip mall office front). “Though my location was zoned for a home occupation, it did require city council approval and even an ordinance amendment,” he recalled.

 But all that initial effort long ago was worth it.

“I believe the biggest economic advantage is putting your money into something that appreciates, rather than just giving it to the landlord. I might be somewhat ahead on a monthly cash-flow basis over renting.”

But because it works for Dr. X, would it work for you?

His answer: “Basically (aside from the matter of convenience), it is a matter of what type of practice/image you want: a clinical/medical/formal image, or a relaxed/comfortable/informal image. I believe you can portray a professional image with either type of practice.

 “It seems that some people do not like the idea because it is not their image of a medical/dental practice, or some people like it a lot. I don't think it really matters to most people, they are more concerned about the person treating them and what they perceive that person knows. You have some people who leave the practice because they don't like the music. If you can't please everyone, you've got to please yourself. I think all of my present patients probably like the location or they would have already left the practice.

“The same probably holds true for staff and any dentist who may consider a practice location. For me it is very relaxed and convenient. But I (also) liked working in the strip mall location, and would probably be fine in a professional office building. It's more about the patients, they make the practice profitable and enjoyable, no matter where you treat them.”

Dr. X's story is just one home-based dental practice “testimonial.” To look into what is involved for yourself to set up shop at home, read on.

Home-based office resources

An American Dental Association staff member explained what is involved in opening at an alternative practice site this way: “There is no difference in setting up a home-based practice than in a regular office,” reported Joan Dietrich. The city zoning requirements should be the first and most important issue to investigate, she said.  Healthcare offices often have special requirements for parking (so many spaces required per operatory) and Americans with Disabilities Act requirements www.usdoj.gov/crt/ada (additional information on this topic is available in the Members Only section of www.ada.org.)

While this option is a good one for established dentists, with the current new dental school graduate debt, this might be most appealing. Offered the ADA's Ms. Dietrich, “One of the best resources for a new dentist is the Checklist for Starting a Practice (Illinois-specific) www.ada.org/prof/ed/careers/newdent/roadmaps/illinois.pdf”. 

There may be portable equipment available which could provide a cost savings, she said.  The ADA offers on online Dental Buying Guide www.ada.org/prof/resources/pubs/dbguide/index.asp with links to dental equipment manufacturers.

In an article entitled, “Knock the Socks Off Your Customers” at www.powerhomebiz.com, staff writer Lyve Alexis Pleshette talked about her own dentist, whose well-decorated, clean, tastefully lit, first floor dental practice of his elegant brownstone home makes for an inviting atmosphere. She writes, “Knowing that people would rather avoid visits to dental clinics, this dentist tries to overcome the challenge” and promotes his home-based dental practice.

Ms. Pleshette cautions other dentists who might think this is a way to roll out of bed and see patients with a laid-back, casual style: “Everything about your [home-based] business should shout ‘professional.' No rubber duckies on the floor or pet dogs wandering about.”

Conclusion

Many dentists feel like they are being “held hostage” financially by high office rents and 5+ year leases where the landlord has all the power.

Trying to operate your dental practice out of your residence could solve some “life problems” as well (babysitter or an adult caregiver aide can come to your house and you can keep an eye on him or her between patients). But, realistically, other problems may be introduced. For example, your Saturday early morning vegan patient who asks, quizzically: “Is that bacon I smell?”

Janyce Hamilton is a Chicagoland freelance dental writer and editor. Send suggestions for topics to be covered, or any comments on this column, to review@cds.org.

Copyright 2006, Chicago Dental Society