The succession plan that has been commonplace in oral surgery for the past number of decades is changing and evolving, according to this DSO executive.
Younger surgeons and dentists are becoming less interested in owning their own practice, which is causing surgeons thinking about retirement to spend more time recruiting. On top of differing priorities than previous generations, many new graduates cannot financially afford to purchase a practice due to mountains of student debt.
Brian Lawson, senior vice president of business development at MAX Surgical Specialty Management, recently connected with Becker’s to talk about the new era of succession planning in oral surgery.
Based in Hackensack, N.J., MAX is an oral surgery MSO that supports practices and surgeons across five states in the Northeast.
Note: Responses were lightly edited for clarity and length.
Question: What are some of the most common moments when an oral surgeon realizes that they didn’t think about their succession plan early enough?
Brian Lawson: It’s something we see a lot more often these days, and I think the driving force behind it is really due to the evolution of the industry in general. What this industry used to look like 20 or 30 years ago is obviously different than what it is today. There used to be kind of a typical path, you had your practice and you ran it for two or three decades. When you were ready to retire, you found a young associate, you handed off the practice to them, you stepped back and you rode off into the sunset. The profession has changed a lot in the last 10 years, and I think that’s driven by both the expectations for owner surgeons in terms of what they’re looking for in succession, and then also from prospective associates what they’re looking for. The takeaway is that the path that used to be very typical is not so typical anymore.
Q: What changes have happened in the past few years that have caused this dynamic shift, from both sides of the equation?
BL: The younger surgeons coming out of residency or fellowship have different priorities than surgeons had 20 or 30 years ago. They’re coming out with a lot more student debt, and so they often don’t really even have the financial ability to go get another loan to purchase a practice. That makes it just much more unrealistic to find someone to come in and step in. Secondly, I think younger surgeons are a little bit more attracted to opportunities where they can go in, work, see patients, get a paycheck and then clock out at night. When you’re the owner of a practice, you really don’t have that luxury in a true private practice. It’s much more of a 24/7 type of job that isn’t as appealing to young surgeons, as that may have been before. That’s making it a little bit more difficult to find someone to just come in and take the baton.
On the experienced surgeon side, it’s just much more difficult these days to recruit surgeons. They cost a lot more than they used to, and the expense is always significantly more than private practice surgeon owners anticipate. In addition, it takes a lot more time and effort to even get noticed in a sea of several other practices, DSOs, hospitals and health systems. When you’re a solo practice, it can be tough to stand out, and tough to beat out larger organizations that have full-time recruiting departments.
Q: Where does a DSO or partnership platform like MAX show up for their surgeons and help them along through that process when they do need help with succession planning?
BL: First, we really spend some time with the existing surgeon owner to understand what they’re looking for. They built their practice with a vision, and they care a lot about what the legacy is going to be in the future. Really trying to understand what they value, what the culture of the practice is, and what’s that pitch to an associate? Once we kind of have a pretty clear vision of what we’re looking to bring on board, then our surgeon recruiting team goes to work. From MAX’s perspective, we focus exclusively on oral and maxillofacial surgery and we focus exclusively on the Northeast region, so we’re not spread too thin like maybe some other DSOs are. We have built really strong, deep relationships with the top Northeast residency programs, and that just helps us have a lot more success in the recruiting landscape. We’re not just trying to fill the spots we have right now, but also trying to look ahead two or three years and start building those relationships now, and that’s a big piece of joining the right organization as well.
You wouldn’t tell your partner two weeks from when you were going to retire. It’s something you build on, and think through over the course of a few years. That’s the culture we built at MAX, so when someone joins, we typically get a few years of a heads up that they are looking to retire at this point in the future. Let’s start putting this plan together, and so we can do that collaboratively to not just find a body, but find the right person who fits the practice, fits the community and fits the culture. When you put that type of thought into it you typically have better results.
At the Becker's 5th Annual Future of Dentistry Roundtable, taking place September 14-15 in Chicago, dental leaders and executives will gain insights into emerging technologies, practice growth strategies and the evolving landscape of dental care delivery, with a focus on innovation, patient experience and operational excellence. Apply for complimentary registration now.