I Didn’t Know What EBITDA Was. Here’s What I Built Anyway.
April 1, 2026
Students ask me practical questions. How do you start a business? How do you scale it? How do you raise capital? How do you spot an opportunity before anyone else does?
Those are fair questions, and I enjoy answering them. But when I reflect on what actually shaped my career — from opening my first dental practice in a strip mall in Morrisville to building multiple companies, executing a private equity exit, and eventually building a real estate portfolio worth more than I ever made in dentistry — the honest answer is that the most important lessons had almost nothing to do with tactics.
They had to do with how I was raised, what I chose to pay attention to, and whether I was willing to stay patient long enough to let things compound.
The First Model I Ever Had
I grew up watching my father work two jobs. Not two jobs in the way people casually say that. Literally two jobs. He was a chemist — he and my mother both got their PhDs from Northeastern and eventually taught at Harvard — and he worked long hours to support our family. But after those long days, he spent his evenings building our local mosque from the ground up. Fundraising. Running operations. Showing up when people needed him.
As a kid in Boston, I didn’t fully understand what I was watching. What I understood was that he treated the community work like it mattered more than anything else. He used to tell me: if you’re doing something for the right reasons, do it better than you do everything else.
That stayed with me. I didn’t connect it to business for a long time. But eventually I realized that everything he taught me about putting people first was the most valuable business education I ever received. When you learn to genuinely prioritize people — first, second, and third — everything else tends to follow.
Why Dentistry
When I was a junior at NC State studying computer engineering, my friend came to me about applying to med school. I didn’t jump at it. Instead, I did what I always do — I made a list. I spent time observing an optometrist, a dentist, and an urgent care doctor. I wrote down what mattered to me. Entrepreneurship was at the top.
What drew me to dentistry specifically was that it was one of the only fields in medicine where you could actually own and operate your own business. Every doctor I grew up seeing worked inside some large institution. My dentist had his own practice. That distinction mattered to me.
So I signed up for the dental admissions test junior year, gave myself six months to study while still finishing my engineering degree, and pivoted. People act like changing direction is some dramatic thing. For me it was just: here’s what I want, here’s the path, let’s go.
What Competitive Analysis Looks Like When You Can't Afford Consultants
Before we opened our first location in Morrisville in 2009 — right in the middle of the financial crisis, which in hindsight was either brave or insane — I wanted to understand the market. I didn’t have a research firm. I had my little brother Omar.
Omar would call dental offices around a target area pretending to be a patient. He had a list of fifteen questions. Are you open on weekends? Do you take insurance? Do you offer sedation? Do you see kids? He’d work through the whole list, hang up, and report back.
That was our competitive analysis. And it told us everything we needed to know.
What we found was that most dental offices in our area had the same blind spots: limited hours, limited services, no real focus on patient experience. So we did the opposite. We opened evenings and weekends. We trained to bring as many services in-house as possible — root canals, implants, IV sedation, orthodontics — so patients didn’t have to go somewhere else. We thought hard about what it felt like to walk into our office, sit in the chair, and leave.
We opened and immediately started seeing 400 new patients a month. To put that in context, most practices hope for 30. It wasn’t luck. It was the result of paying close attention to what was missing and filling it intentionally.
The Church Pulpit Problem
Not everything worked.
Early on, I wanted to add a concierge to the front of the office — someone who greeted patients the moment they walked in, like the experience you’d have at a high-end clinic. Great idea. Execution was a disaster.
We didn’t have the right physical space for it, so we ended up putting a church pulpit at the front of the office and seating the concierge there. Patients would walk in, see a woman sitting elevated on a pulpit, then look around for the check-in desk, then look back at the pulpit, deeply confused about what was happening.
One patient finally pulled me aside. Dr. Baky, what exactly is going on up front with the pulpit?
I shut it down. But by the third location, I designed the space correctly from the beginning — proper layout, granite countertop, someone who greets you when you walk in and makes you feel like you’re somewhere that cares about you being there. The idea wasn’t wrong. The execution just needed a better environment.
That’s the real lesson of iteration. Not every attempt works in the first location. The goal is to learn quickly enough to get it right in the next one.
The Moment I Understood What I Was Sitting On
For the first several years, I was heads-down operating. Growing locations, hiring teams, buying buildings when I could, reinvesting almost everything. I knew we were doing well. I didn’t fully understand what that meant in financial terms until a friend from dental school called me.
Are you getting private equity offers? he asked. People are bidding on dental groups right now.
I had been throwing those letters away.
I didn’t know what a multiple was. I didn’t know what EBITDA meant. I had no real framework for any of it. So I did what I always do — I went and learned. I talked to a broker. She ran the numbers. She told me our EBITDA was several million dollars annually.
I asked what that was worth. She said these were trading at around six to eight times EBITDA.
Eight times several million is life changing money.
My eyebrow went up. I said, keep talking.
What followed was a crash course in private equity, deal structure, earnouts, rollover equity, and negotiation. I walked away from the deal multiple times. That’s how you know you have something people actually want — when you can walk away and they keep coming back. We negotiated a two-year earnout when everyone said one year was the max. We structured the rollover so that doctors could own equity in the offices where they worked. We chose our buyer not based on the highest offer, but on the terms that best protected the people who had built this with us.
Own the Real Estate. Always.
One of my early mentors ran a travel agency. Built it into one of the biggest in the northeast. Then Expedia and Priceline came along and the business collapsed overnight.
What saved him wasn’t the agency. It was that he had been quietly buying real estate the entire time. Buildings in Boston in the eighties. When the ticket business died, the real estate made him tens of millions.
His advice to me was simple: own the real estate connected to your business.
So that’s what I did. Every practice we opened, we tried to own the building. That strategy looked modest in the early years. Then in 2021, my CFO sat down with me and walked through the full picture. He looked up and said, you know you have more net worth in real estate than you do in dentistry.
I didn’t believe him. We ran the numbers again. He was right.
The business generated income. The real estate generated wealth. Understanding the difference between those two things — and acting on that difference early — is one of the most important financial lessons I can pass on.
What I'd Tell Someone Starting Out
When students ask for advice, I try to give them the honest version rather than the polished one.
First: find a mentor. Not someone ten steps ahead of you — someone one step ahead. Someone who will tell you what they actually did, including what didn’t work. People who have built things generally enjoy passing that knowledge on. Let them.
Second: capture everything. I have notes on my phone from 2007 — things I observed during my associate years before I opened my first practice. Every lesson, every gap I noticed, every thing I wanted to do differently. When I finally opened, I had a roadmap. Most people skip this step and then wonder why they feel like they’re improvising.
Third: own things. Businesses, buildings, equity. The earlier you understand that income and wealth are not the same thing, the better your decisions will be.
And last: prioritize relationships over transactions, always. Money gives you freedom. Relationships give you everything else. I took 23 people — the original team that helped me build Triangle Family Dentistry and Carolina Orthodontics — on a river cruise through Europe. Just to say thank you for a decade of building something together. That wasn’t a business decision. It was the only decision that made sense to me.
That’s what the long game looks like. Not a single exit or a single investment. It’s the compounding of trust, ownership, and genuine care for the people building alongside you.
The financial results follow. They always do.
About Dr. Hesham A. Baky
Dr. Hesham A. Baky is the Founder and Chairman of AB&B Commercial Real Estate and Vantico Investments, and a co-founder of Triangle Family Dentistry and Carolina Orthodontics & Children’s Dentistry. Since launching his first practice in 2009, he has helped scale a vertically integrated platform spanning healthcare operations, commercial real estate, and private investment. Dr. Baky regularly speaks on leadership, systems-driven growth, and operator-led investment strategy.
To inquire about speaking engagements or to connect, please contact marketing@abbcre.com.
Students ask me practical questions. How do you start a business? How do you scale it? How do you raise capital? How do you spot an opportunity before anyone else does?
Those are fair questions, and I enjoy answering them. But when I reflect on what actually shaped my career — from opening my first dental practice in a strip mall in Morrisville to building multiple companies, executing a private equity exit, and eventually building a real estate portfolio worth more than I ever made in dentistry — the honest answer is that the most important lessons had almost nothing to do with tactics.
They had to do with how I was raised, what I chose to pay attention to, and whether I was willing to stay patient long enough to let things compound.
The First Model I Ever Had
I grew up watching my father work two jobs. Not two jobs in the way people casually say that. Literally two jobs. He was a chemist — he and my mother both got their PhDs from Northeastern and eventually taught at Harvard — and he worked long hours to support our family. But after those long days, he spent his evenings building our local mosque from the ground up. Fundraising. Running operations. Showing up when people needed him.
As a kid in Boston, I didn’t fully understand what I was watching. What I understood was that he treated the community work like it mattered more than anything else. He used to tell me: if you’re doing something for the right reasons, do it better than you do everything else.
That stayed with me. I didn’t connect it to business for a long time. But eventually I realized that everything he taught me about putting people first was the most valuable business education I ever received. When you learn to genuinely prioritize people — first, second, and third — everything else tends to follow.
Why Dentistry
When I was a junior at NC State studying computer engineering, my friend came to me about applying to med school. I didn’t jump at it. Instead, I did what I always do — I made a list. I spent time observing an optometrist, a dentist, and an urgent care doctor. I wrote down what mattered to me. Entrepreneurship was at the top.
What drew me to dentistry specifically was that it was one of the only fields in medicine where you could actually own and operate your own business. Every doctor I grew up seeing worked inside some large institution. My dentist had his own practice. That distinction mattered to me.
So I signed up for the dental admissions test junior year, gave myself six months to study while still finishing my engineering degree, and pivoted. People act like changing direction is some dramatic thing. For me it was just: here’s what I want, here’s the path, let’s go.
What Competitive Analysis Looks Like When You Can't Afford Consultants
Before we opened our first location in Morrisville in 2009 — right in the middle of the financial crisis, which in hindsight was either brave or insane — I wanted to understand the market. I didn’t have a research firm. I had my little brother Omar.
Omar would call dental offices around a target area pretending to be a patient. He had a list of fifteen questions. Are you open on weekends? Do you take insurance? Do you offer sedation? Do you see kids? He’d work through the whole list, hang up, and report back.
That was our competitive analysis. And it told us everything we needed to know.
What we found was that most dental offices in our area had the same blind spots: limited hours, limited services, no real focus on patient experience. So we did the opposite. We opened evenings and weekends. We trained to bring as many services in-house as possible — root canals, implants, IV sedation, orthodontics — so patients didn’t have to go somewhere else. We thought hard about what it felt like to walk into our office, sit in the chair, and leave.
We opened and immediately started seeing 400 new patients a month. To put that in context, most practices hope for 30. It wasn’t luck. It was the result of paying close attention to what was missing and filling it intentionally.
The Church Pulpit Problem
Not everything worked.
Early on, I wanted to add a concierge to the front of the office — someone who greeted patients the moment they walked in, like the experience you’d have at a high-end clinic. Great idea. Execution was a disaster.
We didn’t have the right physical space for it, so we ended up putting a church pulpit at the front of the office and seating the concierge there. Patients would walk in, see a woman sitting elevated on a pulpit, then look around for the check-in desk, then look back at the pulpit, deeply confused about what was happening.
One patient finally pulled me aside. Dr. Baky, what exactly is going on up front with the pulpit?
I shut it down. But by the third location, I designed the space correctly from the beginning — proper layout, granite countertop, someone who greets you when you walk in and makes you feel like you’re somewhere that cares about you being there. The idea wasn’t wrong. The execution just needed a better environment.
That’s the real lesson of iteration. Not every attempt works in the first location. The goal is to learn quickly enough to get it right in the next one.
The Moment I Understood What I Was Sitting On
For the first several years, I was heads-down operating. Growing locations, hiring teams, buying buildings when I could, reinvesting almost everything. I knew we were doing well. I didn’t fully understand what that meant in financial terms until a friend from dental school called me.
Are you getting private equity offers? he asked. People are bidding on dental groups right now.
I had been throwing those letters away.
I didn’t know what a multiple was. I didn’t know what EBITDA meant. I had no real framework for any of it. So I did what I always do — I went and learned. I talked to a broker. She ran the numbers. She told me our EBITDA was several million dollars annually.
I asked what that was worth. She said these were trading at around six to eight times EBITDA.
Eight times several million is life changing money.
My eyebrow went up. I said, keep talking.
What followed was a crash course in private equity, deal structure, earnouts, rollover equity, and negotiation. I walked away from the deal multiple times. That’s how you know you have something people actually want — when you can walk away and they keep coming back. We negotiated a two-year earnout when everyone said one year was the max. We structured the rollover so that doctors could own equity in the offices where they worked. We chose our buyer not based on the highest offer, but on the terms that best protected the people who had built this with us.
Own the Real Estate. Always.
One of my early mentors ran a travel agency. Built it into one of the biggest in the northeast. Then Expedia and Priceline came along and the business collapsed overnight.
What saved him wasn’t the agency. It was that he had been quietly buying real estate the entire time. Buildings in Boston in the eighties. When the ticket business died, the real estate made him tens of millions.
His advice to me was simple: own the real estate connected to your business.
So that’s what I did. Every practice we opened, we tried to own the building. That strategy looked modest in the early years. Then in 2021, my CFO sat down with me and walked through the full picture. He looked up and said, you know you have more net worth in real estate than you do in dentistry.
I didn’t believe him. We ran the numbers again. He was right.
The business generated income. The real estate generated wealth. Understanding the difference between those two things — and acting on that difference early — is one of the most important financial lessons I can pass on.
What I'd Tell Someone Starting Out
When students ask for advice, I try to give them the honest version rather than the polished one.
First: find a mentor. Not someone ten steps ahead of you — someone one step ahead. Someone who will tell you what they actually did, including what didn’t work. People who have built things generally enjoy passing that knowledge on. Let them.
Second: capture everything. I have notes on my phone from 2007 — things I observed during my associate years before I opened my first practice. Every lesson, every gap I noticed, every thing I wanted to do differently. When I finally opened, I had a roadmap. Most people skip this step and then wonder why they feel like they’re improvising.
Third: own things. Businesses, buildings, equity. The earlier you understand that income and wealth are not the same thing, the better your decisions will be.
And last: prioritize relationships over transactions, always. Money gives you freedom. Relationships give you everything else. I took 23 people — the original team that helped me build Triangle Family Dentistry and Carolina Orthodontics — on a river cruise through Europe. Just to say thank you for a decade of building something together. That wasn’t a business decision. It was the only decision that made sense to me.
That’s what the long game looks like. Not a single exit or a single investment. It’s the compounding of trust, ownership, and genuine care for the people building alongside you.
The financial results follow. They always do.
About Dr. Hesham A. Baky
Dr. Hesham A. Baky is the Founder and Chairman of AB&B Commercial Real Estate and Vantico Investments, and a co-founder of Triangle Family Dentistry and Carolina Orthodontics & Children’s Dentistry. Since launching his first practice in 2009, he has helped scale a vertically integrated platform spanning healthcare operations, commercial real estate, and private investment. Dr. Baky regularly speaks on leadership, systems-driven growth, and operator-led investment strategy.
To inquire about speaking engagements or to connect, please contact marketing@abbcre.com.
Like what you see? Share with a friend.