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Orthodontic Practice Lease Considerations – Part 2

We previously discussed some of the issues regarding an office lease that need to be considered when buying an orthodontic practice and the selling doctor owns the office. In this article, we will discuss lease issues to be considered when the office is leased from a third party.

The first item to consider is when you can contact the landlord about lease terms once you purchase the practice. Quite often, the selling orthodontist wants the sale of the practice to remain confidential as long as possible. The seller may not want the landlord to know that he/she is selling the practice until many of the other sale and financing terms are agreed to by the buyer and seller. Thus, the buyer’s conversations with the landlord may not begin until later in the negotiation process.

Just like when the selling orthodontist owns the real estate, the lease terms must be considered. The buyer generally has to get at least a 5 year lease term, inclusive of renewal options, in order for a bank to provide financing for the transaction (the bank wants assurance that the buyer will have an office to treat patients and earn income for a reasonable amount of time in order to repay the purchase loan). The landlord generally prefers a longer lease term, and the buyer has to consider how long he/she plans to stay in the office and whether another office or location in the city is better for the practice. If the buyer’s plans are to relocate the practice soon, he/she should try to negotiate a shorter initial lease term with options to extend the lease for one year periods (to satisfy the lender’s requirement).

The lease rate also needs to be considered as we have seen some instances where the seller has been in a tenant in the office for a number of years without a rate increase, or without a formal lease agreement, and has a very good relationship with the landlord. When the seller is no longer the tenant, the landlord may see this as an opportunity to increase the rental rate to fair market rates, which has an impact on the practice’s profitability. Similar to when the seller owns the office and the fair market lease rates should be considered when the practice valuation is prepared, if it is fairly certain that the lease rate will be increased in the future, the practice valuation should take this into account and the buyer should be made aware of this early in the process.

Finally, one of the biggest issues we often face is the landlord’s reluctance to release the selling orthodontist from personal liability related to the lease (particularly when the lease is assigned to the buyer). The individual doctor often personally guarantees that his/her professional corporation will pay the lease.  The selling doctor usually has been a tenant in the building for a number of years, is financially well established, and may have a great relationship with the landlord. With the sale of the practice, the buyer will be required to personally guarantee the lease payments, but the buyer usually doesn’t have substantial personal assets as does the seller. More than likely, the buyer has minimal liquid assets, a lot of student debt, and very little or no experience running a practice. Understandably, this makes the landlord nervous and the landlord may refuse to release the selling doctor from his/her personal guarantee of the lease. This is an issue for the seller, which may require additional negotiations with the Landlord as to how long the seller will remain a guarantor.

There are many items to consider when selling and transitioning an orthodontic practice, and the lease agreement is just one of those items. However, the lease can often turn in to a multi-faceted negotiation process that can take longer than the parties anticipate.

Orthodontic Practice Lease Considerations – Part 1

Whenever dealing with a practice sale or transition, the buying and selling orthodontists have a lot to consider throughout the process, such as purchase price, length of the doctors working together before and after the sale, staffing issues, etc. However, we often see that one of the most important issues takes a back seat in the transition negotiations – the office lease! Whether the office is owned by the selling doctor or by an unrelated third party, we have seen numerous transactions be delayed due to lease issues not being resolved timely.

In the case where the selling doctor owns the real estate, the selling doctor often does not know what the fair market rental rate of the property is. The selling orthodontist often sets the lease rate he/she pays to himself/herself based on tax considerations or mortgage payments, which may be significantly higher or lower than fair market rental rates. We often have sellers tell us during the valuation process or transition negotiations that the rental rate should be $XX per square without really knowing the market, getting advice from a real estate expert, or understanding if this is a gross or net lease rate (“gross” meaning that the landlord pays most or all expenses, such as real estate taxes, insurances, maintenance, and “net” meaning that the tenant pays such expenses). The buyer, often inexperienced in these types of transactions, is generally advised to get the opinion of a local real estate expert to help evaluate the lease rate. The problems arise when the buyer’s expert says the rental rate should be significantly lower than the seller’s expectations. After much more time and research by the seller, it may be discovered that the rental rate he/she can receive from an actual tenant is much less than what he/she initially thought would be paid (or, often worse, if the seller realizes that the lease rate should be increased, which, if requested by the seller, creates other trust issues for the buyer). This situation can create a stumbling block in the transition negotiations and delay the closing of the transition.

The seller doctor, acting as the landlord of the property, has to understand that most buyers will do some research on what the fair market rental rate should be for similar spaces in the area. So, ultimately, the seller has to be reasonable and agree to lease the office at (or very close to) fair market rental rates. Otherwise, it may mean that the seller has to go through negotiations with multiple buyers to either: (1) find the buyer willing to pay a higher than reasonable rental rate, or (2) eventually understand that qualified buyers demand a reasonable rental rate and the rent must be set at market rates. Unfortunately, the latter often occurs after one or more qualified buyers have walked away.

Our advice to selling orthodontists that own the real estate is to do some research on the fair market rental rate for their office spaces when they first begin to consider selling their practices. The sooner these rates are established and supported by actual market research, the smoother and quicker the transition negotiations will go. It also helps in the valuation of the practice because the practice’s value is largely dependent on the income/profit accruing to the owner. If the income/profit used in the valuation is not correct (due to incorrect lease rates), the buyers may also challenge the valuation.

In our next blog post, we will review lease issues that can arise when the office is owned by a third party rather than the selling orthodontist.

Sure Bet: Learning Opportunity in Las Vegas

We’re traveling to the upcoming topsFest meeting. The 2013 topsOrtho Users’ Meeting is being held at the Green Valley Ranch, located just 15 minutes from the Vegas strip. Lectures were created with all topsOrtho users in mind, from beginner to advanced, for doctors as well as administrative and clinical staff. This is the perfect opportunity to gain continuing education credits and mingle with other topsSoftware users.

There will be a wide variety of speakers featured, presenting on a diverse array of topics. This year’s meeting includes many top doctors and consultants including Char Eash, Jackie Shoemaker, Joyce Matlack, Dr. Mark Sanchez (along with many others) and the amazing topsOrtho team. Chris Bentson is also honored to speak at this year’s topsFest event. He is scheduled to present on Friday, February 1st at 9:15am on the topic of Today’s Orthodontic Marketplace.

Chris’ presentation is broken into two portions. Part one will primary discuss the current economic state and market conditions of the orthodontic community. A detailed breakdown of an orthodontic practice expense statement and its benchmarks will be offered to attendees. The data gathered from Bentson Clark & Copple’s 2012 Annual Resident Survey will be featured in order to provide a general understanding of how their choices will affect the future of the profession. Part two of the presentation is focused on the top eight trends in practice growth. Examples will be provided of social media, aligner technology, corporatization of dentistry, fee structure, referral trends, abbreviated treatment times, purchasing a competitor’s practice and starting an orthodontic satellite office.

 

Be A Lifetime Learner

Last weekend, Doug Copple and I (Chris Bentson) attended a study club meeting held in Atlanta, GA.  The meeting was a two-day affair hosted by a nationally-known orthodontic consultant which brought together about 30 practices. This year’s meeting revolved around the theme of marketing.

To get the meeting started, a tour was arranged of a local fast-growing orthodontic office that is currently incorporating a number of very new, fresh ideas.  Next, a list of topics to be discussed during the event was created by the meeting’s attendees via an open discussion forum. Overall, the meeting was focused and solely centered on discussing ideas to raise the level of performance and service in each practice represented.

All in all, it was an enormously educational experience for all attendees, including myself. I came away with several key thoughts. Foremost, in order to run a successful enterprise you must commit to becoming a lifetime learner. The orthodontic marketplace is continually changing (the meeting discussed consumer and competition changes). Keeping up with these shifts require effort to study and learn how to adapt one’s business. I was also reminded that practice ownership takes a great deal of work and determination. We all can learn by sharing ideas, taking the risk to ask questions and be open about one’s successes and failures.

Every orthodontist was an exceptional student during his or her formative years. We all know that practicing doctors commit to the standard requirements for continuing education. However, not all continue with a genuine thirst for knowledge and desire for new ideas. If you feel stale, stuck in a rut, upset about the condition of your practice; pause for a moment. Ask yourself if you’re really still learning about running your business and considering new clinical ideas. The practices we see that are vibrant, growing and thriving are being operated by “lifelong learners” who are continually trying new ideas to achieve growth and excellence in all areas of practice life.

Big Shift in Patient Demographics: Does it Matter to You?

In December 2012, the United States Census Bureau released its long-term demographic projections. It revealed a fundamental shift in the US population among various ethnicity groups. The released projections included the following findings:

  • By 2043, the non-Hispanic White population will no longer make up the majority of Americans.
  • Intermarriage for first- and second-generation Hispanics and Asians is on the rise, causing a blur in racial and ethnic lines and increasing the number of individuals who identify themselves as multiracial.
  • Children of immigrants are the fastest-growing demographic group.
  • Moving forward, the United States will become the first major post-industrial society in the world where minorities will be the majority.
  • Among children, the point when minorities become the majority is expected to arrive much sooner, in 2019.

What are the implications for orthodontic practice owners? It likely depends on how much longer you plan to practice. If you are at the beginning of your orthodontic practice career or envision working for 30 more years, the implications of the minority friendliness of your practice, your market strategic and target marketing will be significant.

In 2012, for the first time, racial and ethnic minorities became a majority of babies under age one for the first time in United States history. Ten years from now, this group will be the majority of children in braces.

Perhaps it’s time to step back and ask, “How minority friendly is my practice?” That is a good starting point to begin thinking about and planning for the changing patient demographic that could be your practice’s reality in ten years.

Bentson Clark & Copple’s Resident Survey

We spend a lot of time and effort working with today’s orthodontic residents. We visit their residency programs, attend events solely catered towards the resident community and participate in resident-only webinars and presentation opportunities. We spend numerous hours speaking with them as they search for an orthodontic practice to purchase and/or employment opportunities. We are focused on actively working with and providing as much information as possible to them to help them make educated decisions about their future. This group of young professionals will ultimately shape the future of the orthodontic industry.

As part of our commitment to providing relevant, accurate and useful data to the orthodontic community, each year Bentson Clark & Copple conducts a nationwide survey of all current orthodontic residents for the purpose of collecting, compiling and analyzing information regarding today’s orthodontic resident population.

As in our previous surveys, we ask a variety of questions regarding residents’ anticipated plans after completing their residency program. The survey also inquires about income expectations, geographic locations, total educational debt, and preference of whether they would seek an employment relationship or equity opportunity upon graduation.

We have published a brief sampling of the 2012 Annual Orthodontic Resident Survey’s results in the 4th Quarter edition of the Bentson Clark reSource. We have, in addition, compiled the full results of this year’s survey in booklet form featuring our commentary and a comparison of this year’s data to that of the previous two years. This publication will be available for purchased within the next few weeks. Please check our website and blog for additional information and purchase information.

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