Continuity of patient care is a top priority when a dental practice is sold

Originally published in Dispatch November/December 2016

Make a plan to deal with ongoing patient care and retreatment.

As the demographics of our profession change and the business modes of practice evolve, a growing number of dentists are moving toward retirement; many dentists in mid-career are choosing to change their practice environments.

Patients can feel anxious when a new dentist takes over a practice. They may feel abandoned by their previous dentist. This feeling is commonly reported when the sale of a dental practice is a surprise to patients. In some cases, patients are not notified that changes are coming and there is no transition period during which the selling dentist remains with the practice as an associate.

When selling or buying a practice you should consider a number of issues related to the completion of treatment plans and retreatment, if necessary. The continuity of patient care must always be a top priority.

Develop a plan to resolve potential problems that may arise during and after the transfer of practice ownership. This way it is more likely that patients will stay with the practice, and the investment made by the purchaser (in paying the goodwill portion of the purchase price) will be realized. As well, patients are less likely to make a complaint to the College or start a legal action against the dentist as a result of feeling betrayed by the circumstances of the sale. Taking steps early can help prevent problems in the future.

Prior to the sale, review the ongoing treatment needs of individual patients and identify those who are part-way through a treatment plan. Establish a plan of completion for these patients, with financial arrangements that do not cause them unnecessary hardship.

The purchasing dentist may have a more limited scope of practice or different areas of expertise than the selling dentist. If the completion of treatment will require a referral to a general dentist or dental specialist outside the practice, consider who will make the referral, and how the financial arrangements will be affected.

Make a plan for ongoing patient care and retreatment of failed treatment. Include the plan as part of the agreement of purchase and sale. Consider a transition period in which both dentists work at the practice, and patients have the opportunity to get to know the new dentist. Ideally the selling dentist will complete treatment and take care of retreatment. This will have the added benefit of making patients feel a continuing connection, and increase the chances that they will continue as patients of the practice.

Identify patients who may have made special financial arrangements with the selling dentist, for example a payment plan or assigning dental benefits. The purchasing dentist could either agree to continue those arrangements, or notify patients in advance of any change in office financial policy that will affect them.

Discuss whether the purchasing dentist will want to perform and charge for a comprehensive dental examination. If patients who have been part of a practice for many years are charged a much higher fee than they are accustomed to paying for their first examination with their new dentist, it is important that they understand the difference between this and their usual recall examination.

If retreatment is required for work that was performed relatively recently by the selling dentist or the patient requires remedial treatment for an ongoing issue, inform the patient of the treatment that is required. Present the situation to the patient in a way that does not criticize the dentist who did the treatment. All dentists, regardless of their expertise, will have outcomes from time to time that were not anticipated and the purchasing dentist may not be aware of circumstances that may have contributed to the failure of the patient’s treatment.

Patients may appreciate an attempt by the purchasing dentist to consult with the selling dentist about any concerns that arise (even after the transition period) with respect to the care that the previous treating dentist has provided. If the selling dentist is no longer working in the practice, any release of personal health information will require the patient’s consent.

Consider ways to smoothly introduce any change in dental treatment philosophy; discussing changes in treatment plans with patients will help avoid misunderstandings that could result in complaints to the College. Simply presenting patients with a different treatment philosophy may lead them to an unfavourable conclusion about the new dentist or the previous dentist’s quality of care, even though both dentists’ philosophies may have merit. Both parties may wish to discuss their respective treatment philosophies at an early stage in the negotiations of the sale. This kind of discussion may help determine if a practice is the right dental practice for a prospective dentist to purchase.

The College recommends that any dentist involved in the sale or a purchase of a practice get legal advice and not execute any written agreement without consulting with a lawyer.