When owner dentists make $60,000 more per year than associates but have to work on average an extra 260 hours per year to earn it, it says a lot about margins, risk, and the changing value proposition of ownership in dentistry.
Let’s break it down.
The Math
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$5,000 more per month for owners = $60,000 more per year
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260 additional hours worked per year = about 5 extra hours per week
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$60,000 ÷ 260 hours = ~$230 per extra hour
What This Means for the Dental Industry
1. The Ownership Premium Is Shrinking
Historically, ownership meant:
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Significant income upside
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Equity growth
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Wealth creation
If the income gap narrows to $60,000 annually — and requires significantly more time and stress — the financial incentive to own becomes less compelling, especially for younger dentists graduating with heavy debt.
This partly explains why:
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More dentists are choosing associate roles
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Large DSOs are able to recruit talent more easily
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Fewer dentists are pursuing solo start-ups
2. Risk vs. Reward Is Being Recalibrated
Ownership used to clearly outperform employment.
Now the decision looks more like:
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Associate: High income, low risk, limited stress, no equity
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Owner: Slightly higher income, high risk, operational stress, long-term equity
The key variable becomes equity creation. If a practice is building enterprise value, the long-term return may justify the extra 260 hours. If not, ownership may simply become “a higher stress job with modest incremental pay.”
3. Efficiency Is the Real Differentiator
The practices that outperform are not just busier — they are better structured.
High-performing owner groups:
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Optimize hygiene capacity
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Delegate effectively
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Leverage technology (AI diagnostics, automation, digital workflows)
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Build strong associate models
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Systematize operations
If an owner has to personally work 260 extra hours to generate $60,000 more, it may indicate:
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Under-leveraged systems
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Underdeveloped leadership layers
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Margin compression from rising costs
4. This Impacts Practice Valuations
If ownership income premiums compress:
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Fewer buyers enter the market
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Seller expectations may need adjustment
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Consolidators gain leverage
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Multiples may soften for smaller practices
The industry shifts toward:
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Larger group models
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Multi-site efficiencies
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Professionalized management
The Big Question
The real question becomes:
Is the owner building an asset — or just working more hours?
If the extra 260 hours are building:
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Brand equity
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Strong teams
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Associate leadership
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Operational systems
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Long-term enterprise value
Then the $60,000 is just part of the return.
If not, ownership may need to be restructured to restore its economic advantage.
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