In a time of economic volatility, dentists face a crucial choice: stay with the masses at the mercy of the changing economic tides or proactively chart a course to higher ground.
The warning signs are clear. According to the ADA Health Policy Institute, confidence among dentists is at a historic low: only 45.8% feel optimistic about their practice’s outlook, and just 34.9% feel confident about the dental sector as a whole.1
We’re not in the economy of a decade ago. Rising interest rates, inflation and volatility are the new normal. Traditional strategies—401(k)s, public markets, DSO buyouts—aren’t delivering the security they once promised.
Welcome to the great retirement reset
I’ve seen the same pattern play out again and again: a lifetime of high income, yet little true wealth. A profitable practice, yet no plan for what comes after. A long career, followed by an uncertain exit. The result? Vulnerability at the very moment when freedom should be within grasp.
The good news is it’s not too late to build your financial ark. This checklist offers a new roadmap for those who want to preserve freedom, protect capital, and retire on their terms.
1. Manage your burn rate (the high-income paradox)
Behind the façade of success, for many practitioners lies what I call the high-income paradox—the perplexing reality that as income grows, life often becomes more complex, not less complex.
High income does not equal high net worth. Many dentists live on financial autopilot, spending in lockstep with what they earn. The lifestyle creep is subtle, but relentless. It often leaves little margin for investment, much less for true financial resilience.
If you want to thrive in post-clinical life, you must break this pattern. Create a wide margin between what you earn and what you keep. Invest that margin in cash-flowing, inflation-resistant assets. This is where freedom begins.
2. Reduce and eliminate bad debt
In boom times, debt can accelerate growth. But in downturns, it’s a trap. As interest rates rise and capital tightens, debt becomes a liability, especially variable-rate debt that’s outside your control.
Avoid using debt to fund lifestyle expansion. Instead, prioritize eliminating risky liabilities and strengthening your balance sheet. Debt should be a strategic tool, not a trap.
3. Maintain liquidity ("dry powder")
Liquidity gives you options. It buys you time. In a downturn, it can create opportunities others aren’t prepared to seize.
Short-term cash equivalents (Treasury Bills, high-yield savings accounts, money market funds) are currently paying the highest returns seen in years. Having “dry powder” available not only protects you from being a forced seller, it positions you to capitalize on deeply discounted opportunities.
Warren Buffet is sitting on record amounts of cash.2 Beware the “fear of missing out” sold by slick investment sponsors at this stage of the market cycle.
4. Invest in real, tangible assets
The wealthiest families don’t chase trends—they own assets. Real estate. Land. Precious metals. Basic commodities. Hard infrastructure. These are inflation-resistant, durable stores of value that can weather economic storms and grow steadily over time.
Wall Street may sell the illusion of wealth, but it can’t create or control tangible assets. Real assets exist outside the financial engineering of central banks and government policy. You can’t print more farmland. You can’t artificially manufacture more gold.
When you own income-producing property, you no longer rely on market whims or quarterly earnings calls. You're anchored in something real, something you can touch, improve, and direct. Financial freedom doesn’t come from what you earn. It comes from what you own.
5. Strengthen business resiliency
Now is not the time to overextend your practice. Focus on margin, not expansion. Strengthen your systems. Build cash reserves. Consider how your practice can retain patients even in recessionary periods.
Innovative models such as membership plans and bundled services are helping forward-thinking dentists keep their chairs full, even when patients are cutting back.
Also, be cautious of overreliance on credit lines, HELOCs, or variable-rate financing. In a contractionary market, those can be reduced, or called, without warning.
6. Preserve your business equity
If you’re counting on a practice sale to fund your retirement, you must protect that equity with foresight. Exit assumptions built on linear growth models may not hold true in a volatile economy. Deferred compensation or earnouts tied to future performance may never materialize.
Plan your exit as though the market could dry up tomorrow. Structure deals to minimize future dependency, and ensure you retain access to capital on your terms.
Here’s an example of a young doctor I advised recently, who was contemplating a partnership with a DSO. In his early 40s, with two thriving pediatric practices and a young family, he wanted to "leverage his assets." Growth is enticing, but losing control to partners with misaligned goals, especially in a volatile market cycle, would risk everything he had built. My advice? Keep the driver’s seat. Control equals freedom.
7. Create a personal emergency plan
Think like an entrepreneur preparing for disruption. What if your accounts were frozen tomorrow? What if a cyberattack delayed access to your funds?
Have backup plans—physical cash, precious metals, trusted advisors, and essential documents. Consider the creation of a "black book'' with critical contacts, instructions, and passwords that are shared with your spouse or key family members. Build a real-world contingency plan, just like you would for your practice operations. Prepare now. When the storm hits, you’ll be glad you did.
8. Invest in relational capital
In uncertain times, your relationships are your most valuable asset. The strength of your inner circle, what I call “your five,” can determine how well you weather a crisis.
Surround yourself with like-minded peers, mentors, and strategic partners who share your values and vision. Whether in real estate, private lending, or entrepreneurial ventures, your network becomes your safety net, and often your opportunity engine.
9. Follow the quiet moves of the wealthy
The truly wealthy quietly shift their portfolios. Central banks are buying gold. Family offices are acquiring hard assets. Dentists can and should do the same. Diversify into real assets. Create redundancy and options in your wealth strategies.
Retirement isn’t an age, it’s a strategy
The dentists who will thrive in this next economic chapter aren’t the ones with the most credentials or highest production. They’re the ones who took control, prepared early, and understood that financial independence isn’t found in a portfolio; it’s built through ownership, stewardship, and sovereignty.
Those who build their financial ark now won’t just survive the economic storm, they’ll lead others through it.
Editor's note: This article appeared in the June 2025 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.
References
1. Economic outlook and emerging issues in dentistry. American Dental Association Health Policy Institute. 2025. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/q12025_hpi_economic_outlook_dentistry_slides.pdf
2. Langley K. Warren Buffett defends his growing cash pile. Wall Street Journal. February 22, 2025. https://www.wsj.com/finance/investing/warren-buffett-berkshire-hathaway-letter-2025-9c4530f8?utm_source=chatgpt.com
