7 things dentists can do right now to secure their practice during the coronovirus outbreak

Posted by Brogan Baxter on Thu, Mar 19, 2020

coronovirus image from coindesk

The public health emergency that has risen from the coronavirus epidemic is unprecedented in living memory. The stock market has dropped in reaction due to the uncertainty we all share about our future. 

Right now, dental practice owners are all facing the same insecure feelings about their future and most business owners in all industries across the world feel the exact same way. It's important we listen to our public health officials for guidance while also juggling the hard decisions we will make about our businesses in the upcoming months.  

What is to your benefit, right now, as a dental practice owner, is that you run a healthcare practice. You have a more secure business model than most sectors outside the healthcare industry. 

And while there may be changes with how healthcare will be managed or administered during this public health emergency, you can rely on the readiness of your dental expertise and be able to focus and act on whatever comes next.  

To be as proactive at possible, we at Four Quadrants Advisory provide below what we feel are the most urgent financial considerations you should apply RIGHT NOW to calm the storm.

1. TALK TO YOUR STAFF ABOUT COVID-19 AND HOW IT WILL AFFECT THEM AND THEIR FAMILIES  

Take time to educate yourself and then listen to your employees’ concerns about the coronavirus. This establishes continued trust during a time of crisis. Tell them this crisis puts every business on the planet in an unthinkable position to decide how to prioritize employee concerns about health and job security. 

  • Tell your employees what guides your decision as a practice owner is, first and foremost, mandates by national public health officials and state, local, and national governments and state dental associations. Because the CDC confirms how easily transmittable COVID-19 is, as a business owner, you must respond responsibly.
  • Second, when it comes to job security, remind them you're all on the same team and must come together to support each other during this time. If that means cutting back hours, let’s make sure we know the needs of each staff person and create accommodating schedules. 
  • Again, this seems drastic, but leaders across the world are also making these hard choices. What’s important is that you emphasize you’re a work family and that you’ll get through this together. 

What about labor laws during this time? Remember, although we have 20+ years' experience as dental specific financial advisors, we aren’t labor attorneys.

If you have questions about regulations around the safety of your staff, etc. please seek that information through your attorney or the Occupational Safety and Health Administration.

2. STREAMLINE SCHEDULES, OFFER THE MOST CARE YOU CAN AND OFFER JOB SECURITY

Streamlining schedules will help you get income and your patients get the healthcare they need before mandates from the state arrive.  

  • Each state has made different recommendations on business closures. It’s important you weigh that advice with what’s best for your practice and your patients.  Is the closure notification a mandate or a recommendation?  
  • Until the state gives a mandate to close, consider staying open for limited hours to provide the most healthcare you can to your patients while ensuring staff job security so they stick with you throughout this difficult time.  

If you cut back practice and staff hours, we advise you try to consolidate days down as much as possible. Keep an open mind with scheduling during this difficult time and collaborate with your staff on shifting work hours to early morning or evening may be helpful. Whatever works for everyone.  

  • Try adding a virtual waiting room.  Post a sign on your office door telling your patients to text/call when they arrive and then sit in their cars until you are ready for them.  Call them when you are ready to see them. 
  • Discuss how to reserve specific hours for specific types of patients (i.e. elderly from 8-10am, etc.). This will help you alleviate patient concerns with getting treatment during a partial or temporary shutdown of your practice.  
  • Cutting hours is a collaborative effort. Ask your staff if there are any volunteers in the office to trade or give up hours so the schedule can meet the needs of everyone in the office.  
  • Consider cycling employees throughout the week. If you normally have 3 hygienists and only need 2, you can rotate between who has an off day and who doesn’t. 
  • Make all hourly employees clock out when they are not working.  If the office needs to close, tell your employees whatever vacation time they have can be applied during this time.  
  • If a staff person doesn’t have any vacation time, or it is all used, you may have to consider 2 things.  1) You won't be able to pay them or  2) You will only be able to pay that employee a portion of their pay (25-50%) of their normal pay. Try to offer a percentage of their pay that offers job security now and in the future.
  • If you can't make accommodations, give full-time employees preference over part-time employees and then seniority from there when drawing schedules.  
  • Prioritize work of the people in charge of collecting money for the practice. 
  • Another option that you could use is to temporarily lay off employees with the full-intention of hiring them all back.  If you lay them off, they can claim unemployment and at least be paid something.  Though this may hurt your unemployment rates moving forward, it will cost you more to have to re-hire and train all new staff.  The new Covid-19 stimulus package may be able to help present additional options. 
  • If, after talking to your staff, you sense too much insecurity, put in your mind the possibility of having to hire more staff as a result of the possibility of staff leaving because of the shutdown.  

3. CONTROL COSTS BY SEEKING CREDITOR RELIEF

Working with staff to manage hours and seeking creditor relief will account for over 50% of your overhead costs and cashflow outflows of a typical practice.  

  • We encourage you be as proactive as possible with banks, landlords and supply companies about any relief they are willing to offer on loans, accounts and payments that are owed.  
  • We are seeing many banks and supply companies that are very willing to work with you because they are in the same boat you are. 

4. ORDER 2-3 MONTHS OF SUPPLIES YOU NEED 

People all over the globe are stockpiling goods in preparation to hunker down for whatever period of time health officials advise is best to distance ourselves.

  • This means, in the future, you’ll probably face back-orders and dramatic increases in cost of supplies. Don’t waste time on this.
  • You may not need to worry about toilet paper, but we advise you order supplies you usually order within a 2-3 month time period. This way, you’ll have what you need now until new mandates arrive, and you’ll be ready to serve patients when social distancing rules decrease over time.  

5. INCREASE YOUR LINE OF CREDIT BY 50%

Many dental practice owners have lines of credit for situations like this, if not, you’ll have to be more strategic about what to do next. Making cashflow decisions about when and if you pull from a line of credit depends on how you talk to your bank.

  • Start the conversation with your banker. Tell them you'd like to receive any of the relief solutions, like lines of credit, they’re providing during the COVID-19 pandemic.  
  • Obtaining a line of credit can take a lot of time, so start now if you don’t have one.  If you do, have your banker increase the line by as much as 50% to give you more breathing room.
  • If the state mandates sustained closure of the practice, you’ll need to rely on your bank, or any avenue you get cashflow, for support.  Now is the time to leverage compassion and cooperation.    

6. STAY INFORMED OF GOVERNMENT AID

At this point during the crisis, the U.S. government is making mandates on social distancing and in the process of delivering bills, every day, that provide relief to businesses and the public.  

  • Just in the past week, we’ve watched the federal government address this crisis by making drastic, sweeping relief packages in the form of relief bills and stimulus packages to the economy.
  • A lot of these bills go through changes as each chamber of the Senate and House make compromises to meet the needs of their constituents.  

As regulations, mandates and healthcare information is released daily, we’ll be analyzing the information and providing dental specific financial advice for practice owners during the COVID-19 crisis. Sign up to receive updates.

7. PROTECT YOUR ACCOUNTS ACROSS FINANCIAL MARKETS

Both the Fed and stock market continue to act uncharacteristically from their historical behaviors.  The Fed has slashed rates everywhere and is pumping trillions of dollars back into the economy.

  • Panic has gripped investors around the world. This may be out of your control, but you can act now by protecting your financial accounts.   
  • Reach out tyour advisor to take positions that prevent further substantial erosion of your accounts and work with them in the next 2-3 months to remain vigilant and fluid with future decisions.   

Stick together, stay safe and stay focused on how to secure you, your staff and your family’s livelihoods during this time.

HOW FOUR QUADRANTS CAN HELP PRACTICE OWNERS

We at Four Quadrants Advisory understand how the COVID-19 outbreak has turned the whole world upside down.

  • We have 20+ years’ experience giving dental practice owners a peace of mind through our guidance on how to secure their business in good and bad times.  
  • We helped our clients’ endure both the 2008 recession and the ups and downs of running a dental practice. We‘re still here to help dentists endure during the era of the coronavirus crisis.  

If you’re a dental practice owner, we offer a free one-on-one strategy session about how to manage your finances during the global coronavirus crisis.

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3 WAYS YOUR ACCOUNTANT MAKES TAX DAY EVEN WORSE

Posted by Brogan Baxter on Tue, Feb 11, 2020

sad-person-with-tax-paper-and-orange-background_1200x1200-1

If your CPA doesn’t provide dental-specific accounting, by managing tax liability throughout the year, painful tax surprises will arise.

If you're a dental practice owner, tax uncertainty doesn't have to be your tax reality. Bad tax planning also means you won't save money consistently.

WHAT DO DENTAL TAX SURPRISES LOOK LIKE?  

A tax surprise is any tax refund or taxes owed over $10,000 in a given year. If this is happening to you, something is broken and your current tax advisor or accounting system is hurting your practice.  

  1. FLAWED TAX ESTIMATES 
    Most accountants calculate your current estimated taxes based on your prior year profits. This works great for the Q1 payment, but most accountants also fail to evaluate business profitability throughout the year. What happens if you have decent growth and a drop in expenses in a given year?

    In a practice that collects $1 million a year your practice's net profit can easily swing more than $100,000. This translates into a $40,000 surprise your accountant didn’t detect.

  2. INFREQUENT RECONCILIATION OF BOOKS
    Most dentists are lucky to meet with their accountant once or twice a year. And when they typically have the “tax-planning meeting” late in the year, much of the opportunity to spot and avoid tax surprises has passed. A semi-annual or quarterly reconciliation won’t cut it.

    Outdated numbers lead to a lack of monitoring. This lack of monitoring means your accountant didn’t catch the $100,000 in profit. Instead of celebrating this growth, you now have little time to put together an additional $40,000 to cover a tax surprise. 
     
  3. IDENTIFYING PROBLEMS TOO LATE 
    An unexpected increase in profit means new taxes to worry about. Your accountant didn’t identify this problem and now new problems arise. Just as you pay for the mistakes of last year, you will also have to pay the estimate for Q1 this year—the proverbial “double-whammy” of tax season.   

   
HOW DO MOST PRACTICE OWNERS DEAL WITH TAX SURPRISES?  

Many dentists deal and accept poor tax planning, but don’t realize how it keeps them from consistently saving enough money for retirement.  

  • In a desperate attempt to cover tax surprises, many owners hoard cash in advance as they prepare for the worst.  

  • Others just ride the peaks and valleys of thick and thin monthly income waves. They’ll cut THEIR OWN PAY to cover expenses or run the practice accounts thin and this is damaging to everyone. These are cashflow rollercoasters you, your employees and your family should not be subjected to. 
     

HOW CAN FOUR QUADRANTS HELP?  

At Four Quadrants Advisory, we plan to avoid tax surprises and calm tumultuous cashflow waves.   

  • No matter who you are or what you produce, your focus should be to build long-term wealth.  
  • Our goal for every client is to help them save $100,000 or more each year for retirement by stabilizing their practice income and getting in front of any major expense—like tax surprises.   

 
Interested in learning more? Book your free 30-minute strategy session

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Topics: dental accounting, dental CPA, Tax Advisory, tax time, IRS, tax surprise, tax refund

The Anatomy of Tax Surprises and How to Avoid Them

Posted by Kathy Collins on Tue, Apr 11, 2017

By Kathy Collins
CPA, Four Quadrants Advisory 

We’ve talked a lot in this space about the good, the bad and the ugly of taxes for the Dental enterprise. But then there’s the ugliest – the one many of you have experienced in one form or another and one of the most hated experiences in Dentistry – the dreaded tax surprise.

As an accounting, financial, and business advisory firm for dentists and specialists in more than 30 states, Four Quadrants defines a tax surprise as any tax refund or tax owed over $10,000 in a given year.

Everyone already knew that if you owed a decent amount of money, it was a surprise, but a big refund? It’s just as much of a mistake, but certainly easier to stomach. So if either of these are happening to you, something is broken.

Once you get the dreaded call (likely occurring between December-April 14th), your options are pretty limited. Sure, there are payment plans available from the IRS, but one way or the other you’re going to end up having to pay that full amount immediately.


The way to avoid or, at least, mitigate those tax surprises is to plan for them by managing the tax liability consistently throughout the year. And unless you have an accountant versed in the nuances of Dental practice operations, change will be needed. But trust me, it won’t be as painful as getting another bill from the IRS for five figures.

Read our guide: Dental Accounting 101

Begin this journey by asking some specific questions: Is it a ‘one-timer,’ like an expensive new piece of equipment or a sharp drop in overhead that caused the surprise? Or is it a deeper, consistent problem in your accounting systems that you need to solve by coming up with specific policies and procedures?

If it’s simply from a one-time windfall, there’s a relatively easy fix with the right help. You need better communication with your accountant to make sure they know what you have coming in and going out monthly, and can more accurately assess what your tax obligations are going to be earlier as opposed to later. We suggest a minimum of four tax projections per year to stay on top of this—and that very rarely ever happens.

yikes.jpgIf the surprise is more consistently prevalent, the relationship between you, your bookkeeper, and your CPA is in bad shape and will need to change because your current system is broken. Going forward, you need to make sure your entire tax and financial team are on the same page, with the same goal – keeping your tax situation under control on a monthly basis.

If your bookkeeping and financial analysis are more than two months behind, it’s not all that helpful for you. You need to update accurate numbers on a frequent basis. They need to lead to quarterly tax estimates that are delivered promptly each quarter, not an estimate every six months or once per year.

Ideally, an estimate that takes into consideration current practice trends, past trends, and realistic expectations for the remainder of the year should yield a much more reasonable, customized estimate.

If you’ve experienced one or more of these tax surprises in the last five years, you’re not alone. Tax surprises and poor communication are the status quo for most dentists before they come to our firm. But that doesn’t mean you have to continue to accept it for your practice. Make the changes you need to make to be sure your tax bill will be regular, predictable, and easy for you to handle.

Your sanity will thank you.

If you have struggled with tax surprises, or would like insights on how you can avoid the next one, contact us directly at (877) 720-6213 or send us an e-mail so we can determine together the best place to begin.

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Topics: dental tax, Tax Advisory, IRS, tax surprise

When is a Dental CFO a Necessity for Your Practice?

Posted by Jason Smith on Wed, Mar 1, 2017

yikes.jpgby Jason Smith
President, Founder, Four Quadrants Advisory

From the outside, it looks like your practice is doing really well. You’re making money, likely $300,000 a year or maybe even more. You’ve reinvested in the practice and grown it well, with new patients joining you regularly. To keep it going, you’ve spent on marketing, and maybe even on a practice management firm to help get the little things right, like improving patient care and internal training.

But you know better. There’s trouble behind the scenes. You’ve experienced a lot of pain. Your cash flow is tight, both for your practice and at home, and it’s keeping you up at night. Not to mention the worry that tax surprises could hurt your cash flow even more. Add in the pains of growth, like adding new staff, and it all might be getting to be too much.

Feeling these pains is a signal that you need a dental CFO for your practice. A good outsourced CFO can take your practice’s overall financial state from “a mild disaster” to “everything you could ever dream of.” Once you understand what a CFO can do for you, it’d be a mistake not to have one.

Read our guide: Dental Accounting 101

A CFO gives you flexibility and security. You’ll know your cash flow for two months ahead of time, and have the ability to deal with things like changes in payroll and emergencies. You won’t have to check your bank account daily and be surprised at what you see – or terrified that you won’t have the cash to deal with what’s coming. Your cash flow at home will finally be consistent so you can begin to build your personal accounts.

You’ll be free of the fear of tax surprises. No more $60,000 bills from the IRS that you weren’t expecting – meaning you can concentrate on growth rather than fixing holes in your budget. And with the intelligent planning a CFO gives you, you don’t have to be paralyzed by every financial decision that comes across your desk. You’ll have a team backing you, to figure out if that new procedure or equipment is really right for your practice’s specific situation today.

All of that revolutionizes your financial situation. You’ll save more for retirement – double or triple what you were before – and all of this comes without substantial changes in your lifestyle, either at work or at home. You won’t have to change the way you work, you won’t have to bring in loads of new patients. Simply fixing what’s wrong with your current finances – and trust me, there are problems in there – will totally change your situation, and your practice will start to give you what you’d always imagined.

If you’re making money but your financial situation is still awful, it’s confusing, frightening, and paralyzing. A dental CFO fixes all of that. If your practice is in a place where it’s ready for this kind of help, you can’t afford not to take it. There’s no other sustainable way to get to the next level. It’s more important than marketing, it’s more important than new equipment, it’s more important than hiring a dental practice management firm. It’s simply the best investment that you can make in your practice, your career, and your family.

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Topics: dental financial planning, dental accounting, Financial Planning, Tax Advisory

5 Common Ways Dentists Make Cash Flow Mistakes

Posted by Brogan Baxter on Wed, Feb 22, 2017

cashflowDentists aren’t usually business or financial gurus, and because of that they can run into a lot of problems when it comes to their finances. One of the main sources of these troubles is poor management of cash flow.

Read the Guide: Financial Planning for Dentists

But if you don’t know what to look for, how can you know what to fix? Here are five common hurdles dentists have to clear to get their cash flow situations in order.

Corporate and income structure

Choosing the right corporate structure and income schedule for yourself and your practice is crucial, and can help solve a lot of other cash problems. Operating as an S-corporation is most ideal, because it allows a dentist to take some income in a W-2, with taxes withheld every paycheck while remaining the business’s owner.

But an accountant might recommend a sole proprietorship to minimize tax responsibilities. This can slow your retirement savings – you can’t match as frequently on income from distributions, which is 100% of your income in a sole proprietorship. You’ll lose a lot of money from failing to look at the big picture.

Debt structuring

Dentists are naturally debt-averse, which sounds a lot better than it is. They’re likely to cut a check for a large purchase rather than financing, and when a piece of equipment costs upwards of $30,000, that could completely deplete your checking account.

It’s absolutely critical to make sure you have a baseline level of cash on hand in your accounts at all times to deal with surprise expenses, and that’s impossible if you pay for equipment and other planned expenses all at once. It may seem stressful to have debt to deal with, but it’s a lot less stressful than having a tax bill you can’t pay because of that shiny new x-ray machine.

Tax payments

The way you pay your taxes is intertwined with how your business is structured. Taxes are automatically pulled from your W-2 earnings in every paycheck, but not from money a dentist takes as a distribution. Practices that are run as sole proprietorships and as S-corps both need to make extra tax payments to cover the amount owed from distribution payments. But if 100% of your income in a sole proprietorship is coming from distributions, then 100% of your taxes need to be paid this way. And those bills can get big.

Since an S-corp allows you to be paid in W-2 income as well, that means that only a fraction of your income tax is your complete responsibility via quarterly tax payments. To an accountant, that may seem more complicated – after all, it’s two tax returns that need to be filed. But for the dentist, it ensures cash flow stability.

Quarterly tax payments fluctuate as your practice does. If you’re growing and the accountant doesn’t take that into consideration, it could mean that at year end, you haven’t paid enough taxes on your distribution income, and you could be hit with a surprise $80-100k payment. With the S-corp, with less of your taxes paid this way, even if there’s a surprise payment it won’t hurt nearly as much.

Overhead issues

An established dentist, one who’s been in charge of a practice for 8-10 years, should be running at around 55-60% overhead. In my time at Four Quadrants I’ve seen practices where the overhead level is closer to 90% or even 95%. That’s just preposterous. If your overhead is that high, something is horribly wrong with the way your practice is being run.

In a million-dollar practice, for every 1% drop in your overhead, that’s around $10,000 in savings that you can take home. Paying less improves your cash flow and puts more of your money where it should be – your bank account.

Decision-making

Think about the decisions you make in your practice. How many involve spending $30,000? Probably around one or two a year. How many involve spending $5,000? That’s probably more like one or two a month. Each one doesn’t seem big, but they add up fast – especially if you make the wrong choice.

When you make decisions about things like smaller equipment purchases, raises to employees, or fee increases, it helps to have someone on the outside to advise you. At Four Quadrants we have a “5K Rule” for our clients – if something’s going to cost you $5,000 or more, whether in your practice or in your personal life, ask us about it. We’ll look at the big picture and help you decide if it’s worth it, if now is the right time, and if there’s a strategy to help pay for it easier.

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Topics: dental tax, dental financial planning, dental accounting, Financial Planning, Tax Advisory

INFOGRAPHIC: 8 Sources of High Overhead In A Dental Practice

Posted by Mike Magan on Tue, Feb 21, 2017

Many dental practices have poor overhead, but that's not all on the dentists themselves. Practices cost a lot to start, and with dentistry becoming more and more expensive, once you get off to a bad start, it can be hard to rein overhead back in.
 
A recent Inc. article stated dentistry as a whole is one of the five most expensive types of startup companies in the United States. But if you can make it work, a dental enterprise can also become the sixth most profitable, according to Entrepreneur.
 
One major barrier to building a profitable practice and, for that matter, a dream retirement is overhead. Controlling it has gotten harder and harder thanks to the additional writeoffs with PPOs and insurance companies. We find, though, that if overhead isn’t corrected early on in the dentist’s career, they will carry that overhead with them until the end.
 
 
So let's try to de-fang the overhead monster by looking at a real-world scenario: If we find a dentist that is 37 years old and has 75% overhead. More than likely they’re going to be running 70% to 75% overhead when they’re 55. If that dentist wants to become financially free in the next 5 or 10 years, 75% overhead is devouring your ability to live in the present and keep adding to that savings for retirement.



A great overhead percentage in general dentistry should be under 60% because you'll always have to buy more equipment, reinvest in the practice, and pay for space. If the dentist is not debt free 8-10 years before retirement, they will have a very difficult saving and creating a practice that looks good for purchase. Why? Because any practice that is debt-laden is a practice that nobody else wants to buy - at least for the price you were hoping for.
 
We developed the infographic below to peer into the common causes of high overhead that virtually all dentists face. 

foursight01_FINAL2.jpg
 
If you collect at least $750,000 annually, you may be in the perfect position to take your practice to the next level. LET'S TALK TODAY! Fill out the form at the very bottom of this page or contact Casey Hiers at 765-532-5562 or via e-mail
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Topics: cash flow, overhead

3 Ways to Grow Your Dental Practice the Right Way

Posted by Brogan Baxter on Wed, Feb 8, 2017

By Brogan Baxter
Chief Operating Officer, Senior Analyst
Four Quadrants Advisory

Early on, nothing comes easy.

You have to scratch and claw for the first five new patients. Then you bend over backward to earn the next 10. the effort required to get those first 15 customers is enough to crush a person's spirit.moneytree

But you keep carrying on because Dental practices grow slowly day by day, month by month. You gain three patients and lose one; then you lose two, gain one. If you look back over a year, however, you may have 50 or even 150 new patients. “That’s no small feat,” you say. “There really is no such thing as an overnight success.”

But during periods of growth the Dentist should ask what’s fueling it - instincts such as “grow or die?” Many Dentists grow their practice just because they want more production. But why? Because you want to make more money?

Here’s a little-known fact: increasing production can actually cause you to make less money. That’s because in a rush to earn more, overhead skyrockets and you can be stuck with slightly more income and a lot more money going out the door.

Here are three ingredients we make sure our clients — brand new and longtime ones— include as part of a “smart growth” instead of “fast growth” strategy:

1. Increase your production and maintain your overhead
2. Maintain production and reduce your overhead
3. Increase your production and reduce overhead

Don't Be Afraid to Ask for Help
To grow your income, you need a good financial team on your side. You need quickly-reported numbers, you need to have a pulse on your finances and you need a quick interpretation of your situation. If a negative trend begins, you need to know so you can act fast to counteract it.

Is overhead popping up five months in a row? Know fast, so you can nip it in the bud. In fact, his applies both to your production and to your overhead. You need solid numbers on both no later than the end of next month, and the numbers need to be reconciled and analyzed by your accountant. To identify trends, compare them to the same month last year and also to the past few months of this year. That way you can see in real time what’s happening in your practice’s financials, and whether it’s a seasonal effect or something new.

Even if you grow intelligently, you can still run into issues. For example, you might get a good news/bad news call from your accountant: “Good news! You made a lot more money this year than we were expecting! The bad news is that means your tax bill ius headed into the five figures.” Without timely and frequent tax estimates, you can end up with a nasty tax surprise at the end of the year. And that will certainly put a damper on your booming business.

When managed poorly, growth will actually hurt your Dental practice and cash flow. But when you do it right, growing your practice will do nothing short of change your life.

Visit our “how we help you” page to view quick stories of how we helped ACTUAL clients. (No actors here, we knew you could tell the difference).

If you think you need a better plan than you have now, and sooner rather than later, contact us today!

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Topics: dental accounting, business of dentistry

Who's Stealing From You?  8 Ways To Protect Yourself

Posted by Brogan Baxter on Fri, Feb 3, 2017

By Brogan BaxterIs Someone Stealing From You?
Chief Operating Officer, Senior Analyst
Four Quadrants Advisory

Think of five Dentists or Specialists you know pretty well.

Three of them have been or will be victims of some form of embezzlement at some point in their career. This crime knows no bounds – unsuspecting General Dentists and Specialists, Solo Practitioners, group practices, Dentists in small towns and those practicing in urban areas are all at risk.

That means you’re at risk too. 

Dental Practices are juicy targets for fraudsters because those leading them don’t have a business degree and are so busy seeing patients the can't constantly monitor the situation sufficiently enough.

According to a 2007 study by the American Dental Association, the Dentist’s system of controls (day-end balancing, review of software audit logs, fraud found by the Dentist’s accountant, etc.) lead to the discovery a paltry 19% of the time. So that means someone discovered the remaining 81% by accident.

But the best ways to prevent theft in your dental office may seem counter-intuitive. Instead of implementing new layers of control (and therefore complexity), we recommend tightening the way you manage your office every day.

To start with, remove any opportunity to embezzle.

Simple? Yes. Effective? Absolutely!

Not only will this reduce the risk of fraud, it will also improve other areas of your practice such as cash flow and the reduction of tax surprises, while also making you more aware of your practice's financial stability. Stopping someone hell-bent on stealing from an attempt to do just that may be impossible, but catching them before they damage your livelihood is not.

What if you think someone is already stealing from you? Again, we recommend thinking counter-intuitively. Knee-jerk reactions many times just lead to a sore leg. But to be blunt: DO NOT call the police. DO NOT confront the person your think is the perpetrator.

A bad move has the potential to make your situation far worse, especially if the person you suspect isn’t the thief after all. If you waste time targeting the wrong person, that gives the actual thief time to destroy evidence.

While no one has taken advantage of our clients while we were working for them, some of our clients have come to us as victims of previous embezzlement schemes. While each case was vastly different, there was one thing that rang true in each case: the embezzlement action was always larger, wider and occurred far longer than the Dentist ever thought possible.

If you suspect a theft is taking place, the best thing you can do is preserve evidence, conduct a quiet investigation and NEVER confront the thief without backup.

There are several things that must be done to improve the outcome of a situation that is going to be messy no matter how you look at it. Prosperident, the world’s largest dental embezzlement investigation firm, reccomends taking the following steps if you suspect someone is ripping you off:

  1. Continue to act normally and avoid behaving unusually. Conduct your investigation in a way that does not disclose suspicions.

  2. The Dentist must be extremely guarded about discussing suspicions with colleagues, staff members, etc. And what about that one special, most trusted employee? Statistics show that individual is the MOST likely to be the perpetrator.

  3. Don’t fire anyone until you've gathered the evidence. The amount the employee may steal from you in the relatively short time it will take to complete an investigation pales in comparison to the cost of a wrongful termination lawsuit.

  4. Obtain professional advice. Embezzlement investigations are not a “DIY” project! You may not know what to look for and will likely need the quiet assistance of staff who might be friends of the suspect.

  5. Preserve evidence. Your company’s computers contain a cornucopia of information that will be needed to confirm the embezzlement, quantify losses, prepare an insurance claim, proceed with prosecution, etc. However, this information is volatile and can be deliberately erased or overwritten.

  6. Do not dramatically change financial protocols. Looking to make changes without being able to explain the rationale will certainly be seen through by a thief.

  7. Do not report the incident to police until you have gathered all the evidence. It serves no purpose to do this early, and may limit your options in dealing with a thief.

  8. Do not contact insurance companies. If a theft involves obtaining extra funds from insurance companies, the insurance company may have recourse against the dentist for amounts misappropriated.

As I stated earlier, the best defense against fraud is to focus on procedures that improve your practice’s financial stability. Find out what could be wrong, and put yourself on the road to fix it. Download the free Success Kit today and get started.

How does your practice stack up? Click Here to take our quick, comprehensive financial review so we can discuss this with you in more detail.

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Topics: business of dentistry, stealing, fraud

Don’t Let Tax Surprises Ruin Your Cash Flow

Posted by Four Quadrants Advisory on Wed, Aug 10, 2016

cakeby Jason Smith
President, Founder, Four Quadrants Advisory

My family knows better than to ever throw a surprise birthday party for me. I don’t like surprises and I don’t like the unexpected. I tend to arrive early to appointments, I over-prepare for most things, and I want to know what I’m getting into with everything I take on. Imagine you walked into your kitchen on a cool, winter evening after work and surprise! – your friends and family are there to greet you. Instead of a cake with candles on it, though, there’s a slightly different surprise waiting for you. A great big surprise tax bill.

You can’t put candles to this one, as much as you might like to. “Good news! Your dental practice revenues are up and overhead is steady or down. Bad news, though. We didn’t make tax adjustments along the way. Surprise!”

I’m sure most dentists don’t like surprises any more than I do, so we thought we’d share a simple technique that our clients and our CPA partners appreciate. A lot of CPAs specializing in dentistry stay on top of this, but frankly most don’t. Each fiscal quarter, we analyze a combination of revenue growth and overhead to determine which clients are likely to need tax withholding adjustments. For example, for those clients with revenue up and overhead down for the quarter by a combination of 10% on the upside, we’ll notify their CPA to make adjustments as necessary.

This has actually been an interesting barometer for the health of our clients’ practices across the board. In the third quarter of 2009, for example, we only had 15 clients that required withholding adjustments. The next year we had 28. We took this to be an indicator that we might be coming out of the deepest of the economic doldrums of 2010, particularly after looking at December numbers for most.

Read our guide: Dental Accounting 101

Our CPA partners like the added eyeballs on the P&L and appreciate having a second line of defense. This technique is one of many that make it a lot easier to save what is necessary to satisfy a well-crafted financial plan. A combination of really good analytics and communication between your advisors can keep your planning smooth. If all your advisors aren’t working together to champion great cash flow and savings, it’s tough to stay on goal.

Does this technique reduce your overall tax burden? No. Does it add anything to your retirement nest egg? Not really. Will it prevent you from clutching your chest from shock when you stumble into your “end-of-the-year Tax Surprise Party”? No doubt about it.

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Topics: dental tax, dental accounting, Tax Advisory

How Much Should Dentists Pay Themselves?

Posted by Four Quadrants Advisory on Thu, May 19, 2016

atmby Jason Smith
President, Founder, Four Quadrants Advisory

Do you wonder if you are taking too much salary, or not enough? Have you ever had to delay your paycheck a couple of weeks because cash was tight at your dental practice and you thought a large insurance deposit might drop in a few days? Are you hoarding cash because you fear an autumn tax surprise?

Rather than throw a number at a dartboard or guess at what your income should be, take a balanced approach to maintaining practice cash while still bringing a fair amount of money home for personal use. First, figure out how much overhead is necessary to fund 45 to 60 days of payables in the practice. That range will vary for each practice a little bit, based on the business model and certain trends.

Let’s say we have determined that your overhead for 45 days is approximately $100,000. That’s how much cash you want in the practice at all times – your minimum practice cash reserve. This balance will float up and down against the ideal. Remember, overhead fluctuates – so pay attention to the monthly averages on your bank statement and how they relate to your monthly overhead. Now, you can identify trends in this reserve balance, allowing you and your advisors to take action on the spot, taking distribution withdrawals in a predictable manner, putting taxes and savings in the right buckets, or adjusting salary.

Sample: Monthly Practice Cash Management

Practice Profit & Loss

Actual    September –  2011   

Actual      October –     2011   

Actual    November –  2011   

 Total Income 

 $112,447

 $105,024

 $109,574

 Officer Salary

 $22,000

 $22,000

 $22,000

 Total Expenses

 $98,814

 $92,683

 $95,320

 Net Income

 $13,633

 $12,341

 $14,254

 Overhead %

 68.31%

 67.30%

 66.91%

 +/- 2010 overhead  72.35%

 4.04%

 5.05%

 5.44%

 +/- target overhead    66.00%

 - 0.31%

 0.70%

 1.09%

 Practice Biz Checking – balance goal ($100k)  

 $85,570

 $88,419

 $104,197

 % +/- bank over prior

 - 7.7%

 3.3%

 17.8%

If your cash balance is significantly lower than what your unique practice reserve should be, here are a few options: 1) decrease your salary, 2) start strategically cutting overhead within the practice, or 3) a combination of both. Overhead changes will not happen quickly and typically, you can’t “produce your way out of it.” If your CPA utilizes a custom, dental Chart of Accounts in your bookkeeping software, you can begin a forensic examination of expenses and develop strategies to chip away at unnecessary spending.

Moreover, if you take it one step further and utilize cloud technology – allowing both you and your CPA to access bookkeeping software simultaneously in a secure environment – you can work on the overhead together, in real time. This is great because it lets you discuss all the sub-categories of your expenses and determine where to start making precision cuts – half percentage point here, another half point there.

If you know how much cash you need on hand at all times, and how much you’re paying on a regular basis, it’s simple to figure out how much money you should be taking home. And you might even be able to give yourself a raise.

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Topics: dental financial planning, Financial Planning