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Show Notes
Choosing between a startup and an acquisition is not just a business decision, it is a vision decision.
In this popular rerun episode, Michael sits down with dental consultant and former Bank of America dental-division banker Mike Dinsio to unpack what it really takes to step into practice ownership with more clarity and fewer surprises. Drawing from thousands of dentist financial reviews, hundreds of tax returns, and 400+ transactions and startups, Mike shares what lenders look for, why loan sizes have shifted, and how doctors can better prepare before asking for funding.
The heart of the conversation is the startup-versus-acquisition decision. Mike breaks down the real pros and cons of each path, from cash flow and team dynamics to location, leases, technology, payer mix, demographics, and patient expectations. He also explains why some buyers feel misled after purchasing a practice, how to read projections with a more critical eye, and what traits help doctors succeed in either model. If you are thinking about ownership, this episode gives you practical frameworks to reduce risk and make a decision that fits your goals, personality, and long-term vision.
What You'll Learn in This Episode:
- How to decide whether a startup or acquisition fits your vision.
- What dental lenders look for before approving practice loans.
- Why startup and acquisition default rates are surprisingly similar.
- The biggest advantages and risks of buying an existing practice.
- Why startups offer control but require patience with cash flow.
- How demographics, payer mix, and community needs shape success.
- Why buyers may feel “duped” after reviewing practice projections.
- How valuation add-backs can distort your real take-home income.
- What to look for in year-over-year production consistency.
- Which personality traits tend to fit startups versus acquisitions.
- How to avoid getting buried in day-to-day “15-minute increments.”
- Simple operational levers that improve systems, case acceptance, and follow-up.
Listen now to get a clearer, more grounded path toward dental practice ownership without rushing into the wrong opportunity.
Sponsors:
Net32: Founded by a dentist, for dentists. Net32 is the leading online marketplace for dental supplies, helping dental and medical professionals save on high-quality products for over 25 years. Start saving today at: https://www.net32.com/dentalmarketer
CallRail: Call tracking + AI that turns calls into campaigns that convert, quality patients, and cost savings. Click our link to start a free trial today! https://sta.mx/vz69
Guest: Michael Dinsio
Check out Michael's Media:
Website: https://nxlevelconsultants.com/
His Podcast "Dental Unscripted": https://dentalunscripted.com/
Phone: 720-309-9551
Host: Michael Arias
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