“The most important thing in evaluating businesses is figuring out how big the moat is around the business… I want to know how big the castle is on the inside and then I want to know how big the moat is around it.”
— Warren Buffett
What no one tells you until it’s too late
Most dentists never think about the moat around their business. They think about the next patient, the next procedure, the next piece of equipment. They focus on the castle—but ignore whether it’s truly protected.
What does a moat mean in dentistry? It means systems that protect your goodwill. Contracts that secure your associate relationships. A team that doesn’t fall apart without you. Patients who stay because of the brand, not just the person.
But that’s not what most dentists build. They build a lifestyle. A comfort zone. And over time, it becomes a trap.
This article is not about clinical excellence. It’s not about marketing tactics. It’s about personal responsibility—the brutal kind. The kind that asks: What have you built? And is it defensible? Because if it’s not, what you think is an asset may actually be a liability.
Let me show you what that looks like in real life.
The 54-year-old dentist who waited too long
He’s a great clinician. One of the best in town. Decades of experience. Patients love him. Staff respects him. Comfortable 4-day workweeks. Predictable flow. Solid income.
But now he’s 54 and he’s thinking about the next phase: How do I retire? How do I exit?
A few years ago, he relocated his two-chair practice into a new space. Built it out with care. Classy reception area. Spacious waiting room. But the operatory count? Still two. He even carved out space for a private consult room—with a desk, a monitor, and velvet chairs. It looked good. It felt good. But it didn’t produce good.
One of the chairs was operated by his associate. Bread-and-butter dentistry. The other by him, focused on what he enjoyed most: clear aligner therapy and implants. Invisalign alone made up 30% of his production.
Hygiene? One day per week. That’s right—one day.
There was no hygiene program. No evening hours. No growth strategy. Just comfort. And a vague hope that his associate—whom he brought on a few years earlier when he was unwell—might one day buy the practice. There was just one problem. Actually, several.
The illusion of the exit plan (and the trap he didn’t see)
The “exit plan” was simple: Do more Invisalign. Take home more cash. Maybe—just maybe—the associate will buy the practice one day.
But dig a little deeper, and you find a house of cards. There were no restrictive covenants. No non-solicitation clauses. No share purchase plan. No contract. Just a handshake.
Why? Because years ago, when his health took a turn, he was desperate to bring someone in. He found someone he liked. She was kind to patients. She did good work. She showed up on time. And in his words: “She’s the best I’ve had. The others were a disaster.”
She got paid well. No management duties. No financial stress. No responsibility. And over the last four years, she quietly became the backbone of the practice. New patients? She sees them. Old patients? Many transitioned to her chair. Office drama? He shields her from it.
And she’s happy. Why wouldn’t she be? No risk. No investment. No ownership headaches. She gets the upside—without putting any skin in the game.
Now here’s the kicker: He admits that if she left, half the practice would go with her. That’s not a business. That’s a gamble. And she has no interest—none whatsoever—in buying the practice. Why would she? She already has everything she wants.
And that’s when the insomnia started. The anxiety. The realization that what he built isn’t worth what he thought it was.
He feels stuck. But he’s not stuck because of her. He’s stuck because he built a practice that was never defensible to begin with.
What buyers see (and why they walk away)
Let’s talk about reality—what buyers actually see when they look at a practice like this.
They don’t see the years of hard work. They don’t see your “good name” in the community. They don’t care about your upgraded waiting room, your fancy espresso machine, or how much you love doing Invisalign.
They look at one thing: risk. And here’s what they see:
• No hygiene program. That means no recurring revenue stream. No automatic reactivation. No base to feed treatment.
• No signed associate agreements. The minute the deal closes, the associate could leave and take half the patients.
• No production depth. The seller’s production is dependent on clear aligner cases—which most general dentists aren’t comfortable taking over.
• No systems. Everything runs on legacy knowledge, not structure.
To them, this isn’t a million-dollar practice. It’s a minefield.
Production will sink the moment they walk in. Retention will collapse. They’ll have to rebuild trust with a patient base they didn’t create—and they’ll do it with no hygiene engine, no referrals, no loyalty, and no backup. No sophisticated buyer touches that.
You might feel like it’s worth seven figures. But unless it’s structured like a business, it’s just a high-paying job—one that disappears the moment you disappear.
And here’s the brutal part: You can’t fix this by begging the associate to sign a contract now. That’s wishful thinking. Backdating agreements doesn’t work. It won’t hold up. And it won’t undo the fact that the associate has been allowed to build her own power base—under your roof.
This is where most dentists panic. But panic won’t help. And denial definitely won’t.
This is where personal responsibility enters the conversation. This is where you stop waiting for a buyer, a miracle, or a kind gesture—and you start taking full control of what you’ve built.
The turning point: Thick face, black heart
This is the moment most dentists avoid. It’s uncomfortable. It’s humbling. It forces you to admit that the thing you poured decades into… may not be what you thought it was. But this is also the moment where everything can change—if you’re willing to think differently.
There’s an old warrior philosophy called Thick Face, Black Heart. It means exactly what it sounds like:
• Thick Face is the ability to endure criticism, judgment, discomfort, and pushback without flinching.
• Black Heart is the resolve to do what must be done—not what makes you feel good, or keeps everyone happy, but what actually works.
This isn’t about becoming cold. It’s about becoming clear. Clear about what you want. What you’ve built. What needs to change. And here’s the truth: This dentist doesn’t need a miracle. He doesn’t need a saviour. He needs a plan—and the courage to follow it.
It’s not too late. But it will require stepping out of the comfort zone he spent years building. Because the only thing worse than facing a hard truth now… is avoiding it and waking up five years later with zero options left.
The rebuild plan:
What taking control actually looks like
Let’s be clear: this isn’t theory. This is execution. This is what happens when a dentist stops hoping and starts acting like a business owner.
Step 1: Expand the engine room
Start with capacity. Right now, there are only two chairs. One for the associate. One for the principal.
The consult room? It’s wasted square footage. Convert it. Add a third operatory. You don’t need a velvet chair and a big monitor to close cases. You need credibility, pre-framing, and systematized communication before the patient even shows up.
That extra chair? It can generate $500K a year. That’s not an expense. That’s a growth lever.
Step 2: Build a real hygiene program
One hygiene day per week is malpractice—from a business standpoint. This isn’t just about cleanings. Hygiene is the retention engine, the reactivation system, and the diagnostic foundation that feeds every chair in the office.
• Hire a full-time hygienist immediately.
• Within 6 months, add a second to meet demand.
• Implement automatic re-care systems.
• Reactivate dormant patients from the last 2–3 years.
Don’t overcomplicate this. The patients are already there. They’re just not being served.
Step 3: Expand access, kill excuses
Want more new patients without throwing money at marketing? Expand your hours. Offer evenings. Offer Saturdays. Capture working families. Beat the competitor who locks up at 4 p.m.
This isn’t about burning out—it’s about optimizing. Build a rotating schedule. Bring in team members who want flexible hours. Adapt.
Step 4: Reinforce the moat
You’ve been invisible for too long. Time to rebuild your visibility and authority—on purpose.
• Start a simple monthly newsletter. Not spam—real updates from the principal dentist to the patient base.
• Run internal referral campaigns.
• Re-engage your community. Sponsor a local event. Show up where your patients live.
• Most importantly: Reintroduce yourself to every patient who’s been seeing your associate for the past four years.
This is how you protect goodwill—and start transferring trust back to the business, not just individuals.
Step 5: Fix the people problem
This is non-negotiable.
• Hire a new associate with proper contracts: restrictive covenants, non-solicits, and performance metrics.
• Begin phasing out the legacy associate. Do it cleanly. Respectfully. Professionally.
She may be “amazing,” but if she owns half your goodwill without owning a single share of your business, you’re not in control. And here’s the hard truth: You can’t rebuild a defensible asset with someone who holds all the leverage.
Step 6: Build systems that run the practice (so you don’t have to)
Everything—everything—must run on documented systems.
• Scheduling
• Case presentation
• Financial discussions
• Hygiene recall
• Marketing
• Team training
• New patient intake
People don’t scale. Systems do. Your practice should run without you—and it can, if you build the machine properly.
Related: The high price of free dental consultations (and how to stop paying it)
Step 7: Shift from dentist to business owner
Here’s where it all clicks. Stop thinking like a producer. Start thinking like an asset builder. Whether you decide to sell—or scale and collect cheques while mentoring associates—you’ll finally have options. That’s what true wealth is: optionality.
The timeline and transformation: What this dentist has now
Here’s the part no one talks about. This didn’t happen overnight. It wasn’t easy. But it was doable—because he finally decided to act like an owner, not just a clinician.
Over 18 months, this is what changed:
• A third operatory up and running, producing half a million in annual revenue.
• A full hygiene program humming, feeding both restorative chairs and reactivating dormant patients.
• Extended hours brought in new patient flow—without increasing ad spend.
• Community referrals surged because people could actually see the dentist again.
• Systems replaced chaos. Metrics replaced guesswork. Delegation and leverage replaced microman-
agement.
• A new associate onboarded with the right agree-
ments.
• The legacy associate? Phased out, professionally and cleanly—before she could pull patients away.
And the practice? No longer a fragile machine built on relationships and good luck. Now it’s a system. A defensible, scalable business.
Today, this dentist has something he didn’t have before: options. He can sell for $1.5M+ to the right buyer, on his terms. Or he can stay in the game 1–2 days a week doing the dentistry he actually loves. Mentor young and ambitious associates working in his practice. Manage an associate-run practice from a distance—by the numbers. Collect checks. Sleep well. He’s not trapped. He’s not guessing. He’s in control.
And it all started with a decision to stop tolerating the comfort zone—and start leading like an owner.
About the author:
Dr. Galia Anderson graduated from the University of Toronto’s Faculty of Dentistry and built a successful private practice in Vancouver, British Columbia, where she served patients for 15 years. Today, as the founder of Dental Business Experts, Dr. Anderson is committed to empowering dentists to achieve substantial growth in their practices. Schedule a no-obligation strategy call with Dr. Anderson to get started: www.yourdbexperts.com/call
