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The Value of Locum Tenens


by Earl M. Douglas, DDS, MBA, BVAL | Earl Douglas on Google Plus

Locum tenens has been around dentistry for many years, although not always known by its formal Latin name. Locum tenens literally means "hold the place down" and that is what we are doing when a dentist fills in for another dentist who is on vacation, disabled, given "time out" by the dental board, or who has died. Our physician brethren have used this concept for many years, as their practice needs are more acute than in dentistry and keeping a practice open is more critical.


In our transition practice, locum tenens has played a very important function in maintaining our clients' practice values, especially in the death or disability of a dentist. Several instances come to mind.


Several years ago, I received a call from an attorney who requested an appraisal for a practice in which a dentist had just died. I offered our services for marketing the practice and providing locum tenens services, but he declined since he thought he would save the widow money by selling the practice himself. Five months later the attorney called and requested our services in selling the practice. During the entire time since our first contact, the doors were closed and there was no one covering the practice. The sale of the practice occurred one month after we began to market the practice, but at a price that was one-third of the appraised value at the time of the owner's death. I felt we were very fortunate to have gotten that much for the practice.


At about the same time, I had just returned from a ski trip to hear that a dentist in my neighborhood was in the hospital. His wife had called our office in my absence to procure a locum tenens dentist, which request was fulfilled by my office manager. Upon hearing of his illness, I went to the hospital to visit the dentist, who had just been diagnosed with pancreatic cancer. He was heavily sedated and his wife told me she didn't know how long he had to live, but that he wasn't going back to his practice. She gave me the keys to the office, the security code, and computer passwords.


I went to his office that afternoon, and, with the help of a friend who had expertise in Dentrix and QuickBooks, we extracted all of the information I needed to appraise and market the practice. The next day was spent processing and formatting the information and arriving at a practice value. I then called prospects whom I knew to be interested in practices in the area, and scheduled a meeting to review the practice and explain the financials for the next evening.


I met the prospect on the evening of the second day after visiting the owner in the hospital, and received a full price offer. The next day, the seller died.


I then arranged for purchase contracts and financing to be put into place and two weeks later, the sale of the practice occurred and the widow was paid in full in cash.


I was quite proud of my efforts in helping the widow of a deceased dentist be paid a full price with no time, attention, or stress on her part, and to help a dentist acquire his own new practice. However, I have to give tremendous credit to the locum tenens dentist who filled in this practice from before I returned from my vacation until the closing of the sale.


The benefits of the locum tenens are profound and diverse. First, having locum tenens in place gave me bargaining strength, which I would not have had otherwise. In the first case, not having locum tenens coverage resulted in having to accept a very low price for a practice that was evaporating before our eyes. And while the price was only one-third of the original value, it was still a very fair price for what little was left of the practice.


There are other benefits of locum tenens that are not just applicable in the case of a death. One significant benefit is that if a dentist uses a locum tenens while on vacation, he or she will not make a profit in his practice while away, but the earnings from the locum tenens will generally pay the overhead for the practice, which can be a significant savings. Locum tenens will also keep up with patient emergency needs, or other treatment needs, so the owner is not faced with a mountain of patient issues to deal with when they return. Locum tenens dentists will also keep the staff working and paid in the owner's absence.


A dentist can choose from a menu of locum tenens services, from simply doing hygiene checks all the way to treating a normal schedule of the owner's patients.


I often see instances where a dentist becomes disabled or dies and his colleagues volunteer to cover the practice. There are some important items to consider before deciding on this path versus retaining a locum tenens dentist. The most important issue is that if patients are treated by a neighboring dentist in the event of a dentist who has died, patients will know that their dentist is not returning. They also know that they like and appreciate the dentist helping out in this situation and will frequently transfer into the colleague's practice. Before long, the bulk of the practice will have transferred into neighboring practices and there is nothing left to sell except for the salvage value of the dental equipment.


Another well-intentioned but costly mistake is when a dentist dies or becomes disabled, their colleagues will try to save the family money by covering the practice and trying to sell it for them. This strategy is similar to the neighboring dentists trying to do heart surgery on their colleague in order to help the family avoid the high medical costs of heart operations. Situations like this are best handled by specialists, just as general practitioners realize the need for specialized treatment when they refer out complicated ortho, endo or oral surgery.


Locum tenens is an extremely valuable tool in practice transitions when an owner cannot practice, and is also a financial aid when dentists are out of their practices for any one of a variety of reasons. Consider locum tenens the next time you're not able to be in your office.