The Real Conversation Around Practice Financing

Let’s talk about money.

Not in a scary way. In a strategic way.

On a recent episode of Hey Docs!, Jill Allen sat down with Steve Steinbrunner from Provide, powered by Fifth Third Bank, to unpack what orthodontists actually need to understand about financing today. Whether you’re planning a startup, purchasing real estate, or acquiring an existing practice, the rules have shifted and so has the opportunity.

This wasn’t just a conversation about loans. It was about positioning.

The Banking Landscape Has Evolved

Financing a practice is not just about getting approved. It is about understanding what lenders are looking for, what they are willing to support, and how to walk into the conversation prepared.

Steve shared insight into how banks evaluate:

• Startups
• Acquisitions
• Refinancing
• Commercial real estate purchases

The takeaway is simple. The more proactive and educated you are, the stronger your position becomes. Lenders want to see clarity, liquidity, and a doctor who understands their numbers, not just their brackets.

Commercial Real Estate Is a Bigger Conversation

One of the biggest shifts we are seeing with startups is the increased interest in owning commercial real estate from day one.

Historically, most healthcare startups leased space. It required less upfront capital and felt like the safer route. Today’s orthodontists are thinking more entrepreneurially. With guidance from sophisticated advisors and access to creative financing structures, ownership is becoming part of the early stage strategy conversation.

That does not mean it is right for everyone. It means it deserves thoughtful evaluation.

SBA Loans and Creative Structures

Steve also walked through the rise in SBA utilization for healthcare professionals. Recent changes have made SBA loans more flexible and accessible, allowing doctors to:

• Enter real estate ownership with less cash upfront
• Preserve liquidity
• Structure repayment in a way that supports practice growth

The key theme is liquidity.

Overpaying student loans at the expense of cash reserves can actually hurt your ability to secure financing. Strategic financial planning will always outperform emotional financial decisions.

What About Practices With Declining Revenue?

Not every acquisition target is thriving. Some practices show declining revenue on paper. That does not automatically make them a bad investment.

Steve explained how lenders like Provide evaluate:

• Community brand presence
• Goodwill
• Facility value
• Forward looking potential

In some cases, these opportunities are underwritten similarly to startups, focusing on future trajectory rather than historical decline. That is where strategic vision and a strong advisory team become critical.

What Lenders Are Really Looking For

If you are preparing for ownership, here are a few realities:

• Maintain liquidity
• Protect your credit score
• Avoid overextending personally before you are ready
• Build your advisory team early

Most importantly, start conversations sooner than you think you need to.

Financing is not a transaction. It is a partnership. The strongest outcomes happen when doctors treat lenders as strategic collaborators, not last minute paperwork processors.

The Bigger Picture

This episode was not just about getting a loan approved.

It was about thinking long term.
It was about aligning financing decisions with your growth strategy.
It was about building a practice and a future intentionally.

If you are considering a startup, acquisition, or commercial real estate purchase, this conversation is worth your time.

Because the goal is not just ownership.

It is sustainable, strategic growth.