Squat or buy? The honest comparison, including the part your bank cares about

I build squats. I have built three. So you would expect me to tell you that buying an existing practice is the inferior option.

I am not going to, because for a lot of dentists it is the right answer, and I would rather you made a good decision than a flattering one.

Here is the comparison, honestly.

What buying actually gives you

Revenue on day one. This is the whole argument, and it is a strong one. You walk in and there is a patient list, a diary, a team and a set of accounts. You are not building demand, you are inheriting it.

Easier finance. A lender looking at three years of accounts will typically fund 80% to 90% of the purchase price. You are usually putting in 10% to 15%, which on an average practice is somewhere around £80,000 to £120,000.

A shorter runway to a salary. You can pay yourself much sooner, which matters enormously if you have a mortgage and a family and no appetite for eighteen lean months.

What buying actually costs you

You inherit everything. The equipment someone else chose, the staff contracts someone else wrote, the lease someone else negotiated, the software someone else bought, the patients someone else trained to expect a certain price and a certain style. Some of that is an asset. Some of it is a problem you have paid for.

You pay for goodwill. A significant chunk of the purchase price is not equipment or fit-out. It is the value of a patient list that may or may not stay when the familiar face behind it leaves.

Change is slower and more expensive than starting fresh. Every dentist I know who bought a practice and wanted to reposition it privately spent two years and a lot of goodwill doing it.

What building actually gives you

Total control. Location, layout, treatment mix, pricing, brand, team, culture, systems. Nothing to unpick. The practice is designed around the business you actually want, not the one someone else built in 2011.

No goodwill payment. Every pound goes into an asset you own rather than into someone else's exit.

A cleaner asset at the end. This is the part people miss. A practice designed from day one to be associate led, with clean systems and a proper lease, is a far more saleable business than one that depends on the owner being in the surgery. I sold my third build. That was possible because of decisions made in week two, not week two hundred.

What building actually costs you

Time and no income. Six to eight months is typical from decision to open, and profitability generally takes two to three years. That is a long time to fund yourself.

Harder finance. This is the decisive point for most people. For a squat, banks will often lend no more than around 50% of the cost, because there is no trading history to underwrite. A £350,000 build can therefore need £150,000 or more of your own money, against £80,000 to £120,000 for buying.

Risk. There is no patient list. If your site is wrong, no amount of good dentistry fixes it. Location analysis on a squat is not a nice to have, it is the whole thing.

The decision, framed properly

Ask yourself three questions.

How much cash do you actually have, and how long can you go without drawing a salary? If the answer is "not much" and "not long", buy. This is not a failure of ambition, it is arithmetic.

Do you want to change how dentistry is delivered, or do you want to own a dental business? Both are legitimate. If you have a strong clinical vision that does not match anything currently available near you, building is the only way to get it. If you want to own and improve a going concern, buying is faster and safer.

Are you building a job or an asset? If you intend to be in the surgery five days a week forever, buying an established practice with a full diary is a very sensible way to do that. If you intend to build something that eventually runs without you and sells, the design decisions you make on a squat matter more than anything you can retrofit.

My actual position

I build squats because I am not a dentist. I was never going to be in the surgery, so the practice had to be designed from the first day to run without a principal in the chair. That is a much easier thing to design in than to add later.

If you are clinical, you have a genuine choice that I never had. Make it on the numbers rather than on the romance of it, in either direction.

Start by finding out what a build would actually cost you. If that number is comfortably fundable, you have a real decision to make. If it is not, you have just saved yourself six months of daydreaming.