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2009 Student Event: Starting a Practice

Dr. Richard Nejat answers questions about his experiences starting a practice.

Photo of Dr. Nejat Dr. Nejat is in practice in New York. He completed his periodontal residency at SUNY at Stony Brook in 2000.

What was your plan after graduation?

I wanted to go into private practice and teach one day a week.

What made you consider starting your own practice?

Growth potential and ability to control your financial destination. I don’t like to rely on others to “get you patients.”

What factors affected your plan and decisions about your career and future?

In my last year of post-grad training one of my fellow residents (who graduated a year earlier) was working for a periodontist who wanted to sell his practice. He could not manage to start another practice from scratch and take over this practice full time. Consequently, I had an opportunity to take go into a partnership with this classmate.

How did you begin the process of starting your own practice?

I first chose a location. Then I looked for space to rent. Then I visited dentists in the area to build relationships. I learned about a lot of the backend details through trial and error.

What variables influenced your decision on location?

Family and relationships with other dentists

Did you meet with an attorney, practice consultant or accountant before pursuing a loan? Why or why not?

I choose to rent space until I had an opportunity to buy a practice. During the past 7 yrs I have dealt with lawyers and practice consultants. I learned a lot each time I met with these individuals. But every time I had to deal with a lawyer or a consultant, the deal never went through. The one time I dealt directly with the owner, everything went smoothly without any outside help. I think in all the prior meetings I learned how to value a practice and find what I was looking for. I also learned about what the seller was going through.

How did you determine the financial requirements?

I made a business plan and a profit-and-analysis spreadsheet to see what I needed to do to make things work for me.

What risks were involved in starting your practice and how did you assess and manage those risks?

Minimal risk - I kept costs down. You just need to spend lots of time in growing and managing your practice

How did you structure the practice’s finances in the beginning to pay the bills, yourself, staff and to buy equipment, etc.?

I kept 2-3 months of overhead/costs in the bank and took out in a check everything else. Also I worked for other practices for a few years to help pay the bills until the practice was more profitable

Using real or fictitious numbers, how did the realities of your finances compare to the plan you originally outlined?

It was much harder than I thought but it just takes time.

What resources (i.e., people, publications, groups) did you find the most helpful?

Business partner and brothers (are physicians).

What is the most useful advice you can offer to someone who is considering starting a practice?

Make a plan and stay with it (and it's okay to change things as you go). Just don’t give up.

What do you like most about being a periodontist?

Long-term relationships with my patients - being able to maintain patients after treatment is rendered.