Building Your Dental Practice From Scratch: Lessons From Dr. Kayla Klingensmith's Journey

In the competitive world of dentistry, making the decision between buying an existing practice or starting one from scratch is a pivotal moment in a dentist's career. On a recent episode of Dentist to De Novo, host Jonathan Miller sat down with Dr. Kayla Klingensmith to discuss her experience with creating a practice from the ground up. As a young dentist who spent years in associate positions adapting to the styles and preferences of other practitioners, Dr. Klingensmith found herself at a crossroads when considering practice ownership. Her journey offers valuable insights for other dental professionals considering a similar path.

This blog post explores Dr. Klingensmith's decision-making process, the challenges she faced, the myths she debunked, and the wisdom she gained while building her dental practice from scratch.

Lesson 1: Trust Your Inner Voice  

For many dentists, purchasing an existing practice seems like the responsible choice. The allure of inheriting an established patient base and immediate cash flow is understandably attractive. Dr. Klingensmith initially followed this conventional wisdom, interviewing at practices for sale and meeting with dentists looking to transition. However, something wasn't clicking during these meetings. She described feeling uncomfortable and sensing that these existing practices weren't aligned with her vision.

After years of working as an associate, Dr. Klingensmith had grown tired of adapting herself to fit into other dentists' molds. She referred to this as "chameleoning" herself—morphing into whatever type of dentist each practice needed her to be. This compromise of her professional identity had reached a breaking point. With nine years of experience under her belt, she knew what she wanted in a practice and was no longer willing to compromise those ideals by inheriting someone else's systems and philosophies.

The decision to start from scratch wasn't made lightly. Dr. Klingensmith reached out to every dentist she knew who had built a practice from nothing, asking pointed questions about financial struggles, spousal support, and savings requirements. One piece of advice stuck with her from a colleague named Darren Lou: "Figure out who you want to listen to and just listen to that one person." This simple yet profound guidance would become a cornerstone of her startup journey, helping her navigate the overwhelming amount of conflicting information that comes with such a significant undertaking.

Lesson 2: Beat Decision Paralysis  

One of the biggest challenges Dr. Klingensmith faced was decision paralysis. As the daughter of two engineers, she joked that she had inherited an "analysis prior to paralysis" mentality, making decisive action difficult. This analytical approach can be both a blessing and a curse when starting a practice, as there are countless decisions to make—from selecting contractors and equipment to designing the space and choosing financial partners.

The financial aspect of starting a practice was particularly stressful for Dr. Klingensmith. She had attended seminars where horror stories about practitioners running out of money or facing endless change orders left her concerned about budget management. Another worry came from hearing that the biggest holdup in construction projects is often the dentist themselves, not contractors or suppliers. This insight made her keenly aware that her own decision-making speed could impact timelines and ultimately, costs.

Jonathan Miller, the podcast host and Dr. Klingensmith's coach through the process, helped her overcome this decision paralysis by encouraging immediate action when she was already leaning toward a particular choice. When Dr. Klingensmith expressed a preference for a specific contractor or bank, Miller would push her to commit rather than spending additional weeks deliberating. This approach saved valuable time and mental energy, allowing her to focus on the next steps rather than second-guessing previous decisions.

Lesson 3: Question Industry Assumptions  

During her research phase, Dr. Klingensmith encountered a common belief that dental practices require specialized dental architects and contractors who exclusively work on dental offices. This notion, often perpetuated in online forums and discussion groups, suggests that only industry-specific professionals can properly execute a dental office build-out. Her experience challenged this assumption.

Instead of limiting herself to dental-specific construction teams, Dr. Klingensmith chose a contractor who had recently completed a periodontist's office in the same building. While they weren't exclusively dental contractors, they understood the basic requirements. She also leveraged the expertise of Henry Schein, a dental supply company, utilizing their knowledge and connections to fill any gaps in the construction team's dental-specific experience. This approach saved her money without compromising quality.

An unexpected revelation during construction came when Dr. Klingensmith realized she had more flexibility than anticipated. When watching outlets being installed, she was surprised to learn she could request additional electrical points without major complications. The contractor reminded her, "This is your building," a simple statement that shifted her perspective on the project. She had been concerned that once construction began, changes would be impossible or prohibitively expensive, but discovered there was actually considerable flexibility during the build-out process.

Lesson 4: Find One Trusted Guide  

Perhaps the most valuable lesson from Dr. Klingensmith's experience was the importance of having a single trusted advisor to guide the process. Initially, she resisted hiring a coach, believing her network of dentist friends who had already completed startups would provide sufficient guidance. However, she quickly discovered limitations to this approach:

• Friends were often busy with their own practices and took time to respond

• Their advice was based on experiences from years ago, in a different economic climate

• Market conditions, costs, and best practices had changed significantly

• Different advisors gave conflicting information, creating confusion

When she finally decided to work with a coach, she found that having one person to coordinate the process, organize information, and keep her on track was invaluable. The coach acted as a "tiebreaker" when she received conflicting advice, helped her prioritize decisions, and guided her on when to focus on specific aspects of the project.

Jonathan Miller likened the practice-building process to wedding planning, where there are countless decisions to make and timelines to follow. Having someone to say "focus on this now, that can wait" helped Dr. Klingensmith avoid becoming overwhelmed by the sheer volume of tasks. Her coach also understood the holistic view of the project, recognizing how decisions in one area might impact timelines in another, something individual vendors or advisors might not appreciate.

The timing element proved particularly crucial. Dr. Klingensmith learned that certain steps had to happen in a specific sequence, and some tasks couldn't be completed until specific milestones were reached. For example, she couldn't register certain things with the state until the practice was open for business, or begin credentialing with insurance companies until other elements were in place. Having a guide who understood these dependencies saved her from wasted effort and frustration.

Taking Action: Your Path to Practice Ownership  

If Dr. Klingensmith could offer one piece of advice to dentists considering practice ownership, it would be to recognize that each journey is unique. While you can learn from others' experiences, you cannot simply copy someone else's path to success. Your circumstances, market conditions, personal preferences, and professional strengths will create a unique situation that requires individualized decisions.

She also acknowledges that there may be an "inkling" inside you pointing toward the right decision. For Dr. Klingensmith, the desire to start from scratch was present early on, but she initially pushed it aside to pursue what seemed like the more responsible option of buying an existing practice. In retrospect, she believes she might have started her practice a year earlier had she listened to that inner voice sooner rather than following conventional wisdom.

The value of finding one trusted advisor cannot be overstated. While gathering different perspectives has merit, having a trusted guide to help filter that information and keep you focused on the next important step is essential. This doesn't mean ignoring all other input, but rather having someone help you navigate the sea of conflicting advice that inevitably comes with such a significant professional undertaking.

Your Practice, Your Vision  

Dr. Kayla Klingensmith's journey from associate to practice owner highlights the importance of creating a professional environment that aligns with your vision and values. After years of adapting to others' expectations, her declaration—"I want to do it the way I want to do it"—became the driving force behind her successful startup.

If you're considering a similar path, remember that timing is everything. Use the pre-opening months wisely to set up systems correctly, make thoughtful decisions, and prepare for success. Don't rush critical choices, but also avoid analysis paralysis by committing when your instincts point you in a clear direction.

Most importantly, find guidance you trust. Whether through a professional coach, mentor, or experienced colleague, having someone to navigate the process with you can make the difference between a stressful ordeal and a challenging but rewarding journey.

The dental practice you build should reflect your professional identity and values—not someone else's. As Dr. Klingensmith discovered, there's no substitute for creating something that truly feels like yours from the ground up. While the path may have more obstacles, the destination—a practice that genuinely embodies your vision for patient care—is worth every challenge along the way.

Connect with Jonathan Miller:

Website: De Novo DDS

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