Ask a room of dentists what they learned about profit and loss at university and watch the silence. They can talk you through a molar endo blindfolded. Ask them how to price a treatment plan, hire an associate or read a set of accounts, and most will admit nobody ever taught them. That gap does not close on its own. It follows people into practice ownership and quietly costs them for years.
Dr Alex Marques has felt both sides of it. He is an oral and maxillofacial surgeon with a PhD from King's College London, and he now runs RIT Premium Dental Care across six practices in Rio de Janeiro, Lisbon, London, Liverpool, Birmingham and Chesham. Three countries, two continents. None of that scale came from anything he was taught in dental school. As he puts it, dental school makes clinicians, not entrepreneurs. The clinical training is world class. The business training simply is not there.
That is not a complaint. It is a diagnosis. The moment you own a practice you are no longer only a dentist. You are an employer, a marketer, a negotiator and the person who signs off the rent. The degree that made you excellent in the surgery did not prepare you for a single one of those roles. Nobody hands you that curriculum. You have to go and build it yourself.
The business degree nobody gave you
So where does it come from? Alex is blunt about it: the business is your own responsibility, and you have to treat learning it as seriously as you treated learning to operate. For him that meant an MBA, postgraduate study, mentors, books, podcasts, conferences and a lot of deliberate networking. He does not present any of it as optional reading. It is the second education that ownership demands, and the sooner you start it the less it costs you in mistakes.
His sharpest line on this is one every owner should sit with. If you want to become a businessman, spend time with businesspeople. You do not learn commercial instinct in a room full of clinicians talking about clinical things. You learn it by being around people who think in terms of margin, risk and growth, and letting the way they see problems rub off on you. The company you keep is a syllabus.
There is a warning folded into that too. Alex is clear that there is no overnight success, and nothing replaces time, experience and hard work. The books and the podcasts accelerate you. They do not skip the queue. Anyone selling a shortcut to a thriving practice is selling something Alex has never seen exist. You compress the timeline by learning faster, not by learning less.
Start before you think you need to
The trap is waiting. Most owners only reach for business knowledge once something is already going wrong: cash is tight, a key associate walks, the numbers stop adding up. By then you are learning under pressure, which is the most expensive classroom there is. The owners who fare best treat the commercial side as a discipline from day one, not a fire to fight later.
If you want a place to begin that is written for exactly this reader, The $2 Dentist covers the ground dental school skips: the mindset shift from clinician to owner, and the systems that let a practice run without you carrying every decision on your own back. Think of it as one more voice in the room full of businesspeople Alex talks about.
None of this asks you to care less about dentistry. It asks you to accept that being brilliant with your hands and being sound with a business are two separate skills, and only one of them was on your timetable. The clinicians who thrive as owners are the ones who go and get the other one on purpose.
Alex talks through the whole of his journey, from a single clinic in Rio to six across Europe, in the full episode of Between Patients. It is on YouTube, and it is worth an hour of your evening if you own a chair or plan to.
Host, Between Patients
Host of Between Patients and the fourth generation in a dental family. I sit down with private practice owners for the conversation we usually only have once the door is closed — no script, full editorial control, a real record of how they think, decide, and rebuild.
