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  03.31.05 Issue #160


The Promised Land: The Perfect Practice Site

Scott McDonald

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Most professionals have a wish list of qualities they most want in a place where they put a practice. We have looked at several thousand practice sites and have learned that sometimes these qualities are good and some that sound good, may actually not be so good.

No Competition

It is great to be the only dentist to serve a community. Knowing that your nearest competitor is many miles away may be comforting. Unfortunately, it may also be a danger signal. For most practice settings, the ideal ratio of general dentists-to-population is between 1,100-1,300 population-to-dentists. If the doctor is considering opening a scratch practice, we put the threshold at about 1,400+. Of course income, education, population density, and employment will all be mitigating factors.

We sometimes see figures of 2,500:1. Obviously, this can be a very good opportunity for someone. But we often see factors that make this less desirable than it looks. As an example, locations with extreme poverty, crime, or unemployment will be difficult for a practice unless these factors are well understood.

Lots of Rich People

We are not talking about people who are prosperous. We mean the top 5% of the income level of the Country. These are “The Rich.” Some dentists have the mistaken idea that to locate near the very wealthy, whether in Scarborough, NY or Beverly Hills, CA will mean higher income. This is wrong for two simple reasons:

  1. The Rich move around a great deal. Most have more than one home and tend to maintain a schedule that makes recall appointments a nightmare.

  2. The Rich can be cheaper, more frustrating, and “flakier” than the average person. They are accustomed to getting their way. While they can afford more, it does not mean they will spend their money on dentistry.

Based upon our observations of how income affects dental behavior, the top 6% to 25% income level population are more stable, better referrers, and more profitable.

Gimme BIG Growth

Setting up practice in a growing area, particularly for a scratch practice, is always going to be easier than in one that is stable or in decline. The problem is that there are many other professionals also setting up practice in the same place, often at the same time. Gilbert and Scottsdale, AZ and Las Vegas, NV are famous for their huge growth. We also do many reports for dentists thinking about setting up in the same neighborhoods. And it is only logical that if we are examining the same location, there are many more doctors who have not sought our help doing the same thing.

Rather than run to the first big “mega-growth” location, we recommend looking for regions that have positive growth as well as other positive demographic characteristics.

Demographers look at “new resident growth” in two ways:

  1. New Immigrants (not necessarily just foreign immigrants but out of state move-ins as well)

  2. Migrants (those moving from one part of a region to another)

Each will have different commitments to dental practices. Each pose opportunities and risks.

But what about sites, particularly in the Northeast and Midwest, that are having a net loss in population? Actually, the shifting of populations creates opportunities for new dentists in areas that might otherwise be considered poor, as well as ways to target underserved-but-desirable residents who are NOT moving. We can help evaluate these “diamonds in the rough.”

Out of the Box” Locations

Experience has proven again and again that there are marvelous opportunities for new office sites (including satellite locations) throughout the U.S. You don’t have to move to the city d’ jour in the news that is “HOT! HOT! HOT!” to be successful. We have spent nearly twenty years examining neighborhoods in all 50 states and we can speak with confidence that there is potential out there, often where it is least expected.

Scott McDonald is the former Marketing Manager for the California Dental Association, national lecturer and author and provides demographic marketing and site analysis recommendations for The McKenzie Company. For more information email or visit our website

The McKenzie Company Upcoming Events
Date Location Sponsor Speaker
Mar. 31-Apr. 2 Las Vegas, NV Dental Town Gathering Sally McKenzie & Exhibit
Apr. 1 Walnut Creek, CA Contra Costa Dental Society Sally McKenzie
Apr. 9 Portland, OR Oregon Dental Association Sally McKenzie & Exhibit
Apr. 15 Destin, FL Excellence in Dentistry Sally McKenzie & Exhibit
Apr. 21 Nashville, TN American Academy of Cosmetic Dentistry Sally McKenzie & Exhibit

For more information, email
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