Podcasts about dso

Re-releasing a DAT listener favorite! Chris Sands and Brent Saunier are on the podcast to talk about the hottest topics in the dental accounting world. Founding partners of Pro-Fi 20/20, these dental CPAs chat with Kiera about how to reduce overhead and expand the number of patients coming in, expense metrics from the hundreds of offices Pro-Fi works with, a tax rule you NEED to live by, what to stay away from financially with your business, and a ton more. Pro-Fi 20/20 is an accounting business that the Dental A-Team recommend. This episode is a goldmine of information from two fellows who know what they're talking about — especially with regard to the dental industry. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:00) Hello, Dental A Team listeners. This is Kiera. And today we are bringing you something so special. I am so excited because this is one of our most popular episodes from the archives. Whether you're hearing this for the first time or catching it again, I am so excited because it's jam packed with a ton of takeaways that you can start using right now in your practice. We have released thousands, literally thousands of episodes. And I wanted to start bringing a few of these amazing episodes back for you. So I hope you enjoy. And as always, thanks for listening and I'll catch you next time.   on the Dental A Team podcast.   speaker-0 (00:31) today I wanted to bring on two special guests. These are actually CPA in the CPA world. Believe it or not, Dental A Team actually consults this company. So we definitely love them. They went a step above most CPA companies and they really wanted to get to know the ins and outs of the dental world. So I'm super jazzed to bring them on and to just have them dive into some of the hot topics in the accounting world. ⁓ two people that I trust and recommend heavily. ⁓ I   They are one of my top three CPA firms that I refer and recommend constantly. So I'm excited to welcome Chris and Brent from Pro-Fi. How are you gentlemen today?   speaker-1 (01:06) Awesome, Kiera. Thanks so much for having us. We're excited to be with you.   speaker-0 (01:10) Yeah, absolutely. Brent, how are you doing today?   speaker-2 (01:12) I am doing great. I appreciate the invite. I'm looking forward to this 30 minutes with you.   speaker-0 (01:17) Yeah, absolutely. Well, who knows? We'll see how long this ends up going, guys. Brent, can't put a time on us. It could be dangerous zone.   speaker-1 (01:24) You're lucky he said he's doing great because we're in the heat of extended tax season, so he's kind of in the trenches. Lucky he's in a good mood.   speaker-0 (01:32) I know Tiffany has been trying to get back out to you guys to see you and Beth you heard this awesome rock star in the company She keeps saying like tiff. It's like extended tax time or it's this or it's that deadline I'm like, my gosh, you guys just have I think you're secretly adrenaline junkies of CPAs even though you don't come across that way But I think you love it cuz tax season I feel is just like adrenaline rush like trying to get to the deadline. I just can't imagine that stress like   Every quarter every year you just hit it. So props to you guys. That's not my world but super jazz to have you guys on here. ⁓ so Chris let's dive in I know there's some things so we're gonna kind of hit on overhead we're gonna talk about some taxing some Some things to be aware of i'm just so excited because this is a world I don't know and I do purposely bring really really talented and educated cpas and financial advisors onto the podcast because I'm we have a three-fold approach in our company. It's focusing on   Money and finances making sure your business is profitable you as a person and as an individual and then systems and teams top to bottom So I am big I think as a business owner. I wasn't profitable when I first started. I didn't know how to look at my numbers I didn't even know what the heck over influence. I was like googling how to figure it out So i'm just jazzing you guys are here. So Chris kind of take us away I know you had some great topics for today and i'm excited to just   Rift a little bit with you, dive into these things, things that are really tangible for our practices now, especially where you guys work with hundreds of offices across the nation. Lots of good data to be pulling out for our practices listening.   speaker-1 (03:04) Sure, well, ⁓ Kiera, I think that there's a lot of discussion around, does the DSO world seem to do a better job with overhead than the private practice world? I think a lot of private practice doctors are wondering that, they're frustrated or how do I get my overhead down? And a lot of times, I think when you focus on expenses, you tend to attract expenses. And in our world of accounting, I will often tell doctors that, ⁓   Accounting cannot make you money, it cannot generate revenue. The expenses part is the easy part for us that we can work on trying to reduce some things, but you either have a revenue problem or an expense problem. And in most cases it's actually, you creating enough revenue on your fixed expenses? And most of dentistry doesn't understand how simple that is to scale the dental business model when you look at it from a high level.   You scale a business and reduce overhead with doctor production. Okay. And so that means you need enough patients to see the practice that I worked in from my experience was 40 to 60 new patients a month per doctor, per full-time doctor. And it means you need to be reinvesting enough into marketing. And I'll talk about that, that expense or reinvestment of marketing in a minute to get those new patients. And you need to be.   monitoring the phones that get answered properly and there's conversion rate of those inbound calls to appointments scheduled. And then the real job is case acceptance. Okay, and so here I am in an accounting firm coming on your podcast and I bet you didn't think I was gonna like be talking about case acceptance.   speaker-0 (04:46) was like, wonder we didn't talk about all your time. I'm just kidding.   speaker-1 (04:49) So, know, dentistry is really the product that's being delivered. And if you're ethically diagnosing the need and creating the treatment plan, your job is to help the patient understand the urgency and necessity of fixing the problem and paying you to do that work. So your job isn't really the dentistry itself, it's case acceptance.   And your first task is to become great at case acceptance yourself as a practicing clinician. But then the real task as the owner is to be able to teach other doctors to become good at it. So I think, you know, the only the only variable overhead that the dental business model has is paying doctors a percentage of the dental collections that they create. And then you have labs and you have supplies.   associated with the dentistry that's delivered. those expenses are variable. They track with the amount of dentistry that gets done. Everything else is fixed overhead when you really think about it. Marketing is fixed and it only changes based on your choosing. Your team expenses are fixed and they only change when you hire or fire. Your rent and facility costs are fixed. Your equipment costs are fixed and only changed by your choosing. And the various required admin costs, they're all pretty much fixed. They only change by your choosing.   So if you can create more doctor generated collections with the same team and fixed expenses, your profit margin goes up, your percentage overhead, your percentage overhead to collections ratio goes down. Okay. And so I guess we see most private practice or single, should certainly say single location, solo doctor practices. We see them failing at this because they choose not to reinvest enough.   back into the business, into that marketing for new patients. They're not monitoring the phones. They're not training their team. They're not training their doctors on case acceptance. And they're too closely focused on just the clinical delivery of the dentistry. Don't get me wrong, that's required, but that's not what makes you successful or financially successful. So I can give you ⁓ some generic ranges for expenses, but the real thing is that   You know, the real way to scale a business is to generate more revenue on the same overhead. That's kind of the definition.   speaker-0 (07:20) And isn't that basically then probably the DSO model because they have lower fixed costs per se. They've figured out how to have centralized billing, centralized call center, centralized. So many things centralized that they don't need all these different things. So solo practices, if I'm understanding correctly, they've got all the costs associated, but they only have X number of revenue where when you start to add in those multiples of practices,   That's where your fixed costs, it's going, yes, of course your fixed costs will increase a bit, but I mean, I do know our fixed costs did not go up that much more when I added our second practice to it because I already have my base of fixed costs there and then we're just able to add more revenue. Is that kind of what you're saying? Am I understanding?   speaker-1 (08:01) Yeah,   I mean, you know, that, part about centralizing is, know, when you, when you do have multiple locations, I would say three or more, then you can consolidate the amount of team that's working the front desk into one location. Instead of needing three to five team members at the front desk in every office, you may only need three to five team members for all three offices. You're having one of the best things by the way, as kind of an aside, one of the best things that private practices can do as they grow is to get those phones off the front desk. You know, let.   speaker-0 (08:20) Right, right.   I agree.   speaker-1 (08:30) You know, like there needs to be, that needs to be in a totally separate admin space. But, ⁓ you know, I get asked that question a lot. Like my overhead is 65 % and how can I afford to hire another associate doctor and pay them 30 or 35 %? Well, you know, that doctor is going to create new collections. That's the point. It's not to give them your patients. It's to grow the number of patients coming in that, that you as one doctor maybe are stressed.   and you hire the next doctor and you've got to continue to invest in the marketing to keep your job as the owner is keep the chairs full, right? As long as the chairs are full, if that associate doctor is ethically diagnosing like you are, if you guys have a ⁓ clinical standard of care in your practice, if you guys talk about how you treatment plan and your treatment planning the same way, that's all required. But here's the real test. You know, how do they connect with people? How do they, how do they,   establish a relationship, establish trust and get them to move forward with that treatment. So I think dentists hate to use this word in dentistry, but the job is kind of sales. You know, if you believe in your product of dentistry to solve this need and like, again, if you diagnose decay and they don't get rid of it, you failed. I could go on a tangent on that, but the new doctor will bring new collections and you might have to hire at most, you know, an additional   speaker-0 (09:46) Yeah.   speaker-1 (09:55) Assistant or two and that would be a new fixed overhead. You would increase your fixed over it slightly But other than that the doctor covers all their costs with their their percentage pay the labs that are associated with it that the supplies are associated with it and You should net somewhere in the ballpark of 40 to 50 percent on the new collections they create and that that just adds to your profit Because all the other fixed overhead stays the same   speaker-0 (10:19) So I think there's a few things on there of like, I just, think it's a matter of realizing a lot of people bring on associates though, because they're tired, they want more free time. They don't want to be working as much. And I think it's important to clarify that if that's your model, that's totally fine. Everybody knows on the deadline team, I am not somebody who judges. I think everybody has their own personal path.   And so whatever jives with you and resonates with you. So if you're wanting to bring on an associate to have more free time, to not have to produce as much, fantastic, but realize that that overhead might not trickle down because now you're kind of replacing your cost with an associate that you're paying. And some doctors I know don't take as much pay as they would pay an associate per se, which to me, I think is a somewhat failed model. I'm really big on prepping and preparing for that associate, paying yourself as if you were an associate. So you know, these costs before you bring on an associate.   ⁓ but I really think it's important to note that because like you're saying that overhead will go down as long as the doctors are producing. And as long you're able to bring on that other doctor and have them produce, cause they should cover themselves. I definitely agree with that. ⁓ also I'm sure people are saying, yeah, but Chris, like in order to bring on another associate, I'm going to have to build out ops. That's a huge cost and expense. So I am curious, what have you guys found in Brent? You might have some answers to this Chris, you might. ⁓ but if an office is having to say, build out two more ops.   in their practice to be able to bring on an associate, how long does it usually take when you're doing build outs for that cost to be recouped and start being more profitable? Because oftentimes I do think that that gets into the problem with a lot of doctors is they're constantly building more to bring on these other doctors. So they're always adding more and more expenses. Like when do they ever break even? So what have you guys seen with build outs and different things like that of that break even point? How long should they plan for it to not be as profitable?   speaker-1 (12:09) Okay, I'm gonna give you a lot of answers on this. So number one, we use a metric called revenue per chair. So, you know, every, you   speaker-0 (12:17) What   do recommend? What do you guys recommend per chair?   speaker-1 (12:19) So yeah, everyone has a space and you have only a fixed number of spaces or operatories you can have in it. And there's only a fixed amount of time and days and hours and a number of doctors that you have. And revenue per chair capacity, we see a range between 25,000 to 40,000 per chair per month. And it does not matter when you do this. This is just, take collections and divide it by the number of chairs you have. ⁓   This does not matter how many chairs are for hygiene or how many chairs are for dentistry. That's your choice. Actually, you know, there are models where every chair can do everything and the patient never, but the 25 to 40,000 at 35,000 of revenue per chair, you're running fairly efficiently and you're going to need to be planning to expand. You're going to start to run out of space. So that's our metric first and foremost. And so if somebody tells us, well,   speaker-0 (12:53) Sure.   speaker-1 (13:09) I've got four chairs right now, but I have space for seven. I haven't built out the other three. I tell them, you don't need to build out the other three until you're approaching that $35,000 a month of revenue per chair. Question you asked, how much does it cost and when do you recoup that? So in my experience, typically it's around $25,000 per ⁓ operatory to equip it, assuming it's already plumbed. ⁓   after you just take that number and say, so let's say you were equipping a few operatories, so $50,000, you ⁓ essentially, your cost of the doctor plus the lab and supplies should max out at 50%. Okay, now they have to be producing. So until you get them, they've produced over $100,000. All right, let me do it per chair.   They need to do over $50,000 per chair for you to get your costs back. After that, you're in the money.   speaker-0 (14:09) which I think is also smart because I don't know. think dentists kind of err on two different sides. Sometimes they're too slow to actually build out. They are so cost conscious and so concerned about that build up, about the cost of the chair, about all the other things that they're missing, that that one chair is going to generate several thousands of dollars of revenue. I've had a few doctors where I'll say, sure, no problem. We'll do a deal. I will happily pay for that one chair and you pay me all.   the revenue that comes through from that chair for the next three months. That's all I ask is three months. and I know I'm going to come out way ahead of you because it will generate and it will produce, especially in high producing practices. So I think so often people are just so scared to do those build-outs because they see the cost or they do the flip side where they believe like, if we build it, they will come and they're overly aggressive and they don't have necessarily the patient base or the doctors in play to be able to accommodate that. So   I love, I need to agree. It's either cut costs or increase your revenue. Like that's really overhead.   speaker-1 (15:12) One more way to think about it is, you know, if they have patients that are having to wait so many weeks or months to schedule out to come in. if you can calculate your collections divided by the number of patients seen for any given time, for year to date or for a full year, you can get your average revenue per patient. Okay. And if you know your average revenue per patient, you know how many either new patients or how many more patients you need to fill that chair to cover the cost.   Okay. So if your average revenue per patient was, you know, $1,500 per patient, um, and the cost of that chair is 25,000, just take 25,000 divided by 1500. And that'll tell you how many patients have to be seen in that chair before you pay for that chair. Sure. You're to be in the money, you know, it's in terms of the construction. That's another basically upfront, one time fixed costs that you're going to cover. And then all the future revenue that it's going to generate. So.   Maybe if you like, think before we end this topic on overhead, I'll give you kind some of our expense metric. ⁓   speaker-0 (16:18) Sure, yeah, absolutely.   Well, hang on, before you go into expense metrics, I want to bring up one piece that I think often gets missed, because you're saying like we're in the money. But I also want to bring up something that I really love to point out, and that is return on emotion. Some people don't want to bring on an associate. Yes, like as a business model, you can be more financially successful with an associate. Yes, you can, having more chairs, more build out, more practices. ⁓ But I also want to point out there is a return on emotion. There are sometimes   Bigger headaches, they're also sometimes less headaches with bigger organizations. I personally love to consult larger practices. The pettiness, the cattiness, the smaller drama is way less in larger practices or multiple locations. So like that drastically drops down. They figured it out. They're dialed into systems. But at the same time, I think it's important for people to assess that return on emotion. You might have a dreamy life. You might be doing exactly what you want and sure you could produce more.   But if you're off work at say two or three o'clock every day and you work two or three days a week and you're shelling and seven fifty to a million in profit, not a bad lifestyle. So I think it's also important to assess like what you ultimately want and what your return on emotion is before just saying like, I'm going to build because this is the way to do it. I think if you're looking at your practices as a business model, which I personally think a lot of us should look at it that way, ⁓ just to see what you what you ultimately want, what's your end game. And that's also where I love financial advisors of   Like what is your total term? Like where do you want to get? Does it make sense to grow? Does it make sense to stay where I'm at? ⁓ I think oftentimes we, we forget that return on emotion and how that is. We always think of like return on investment, but what does that return on emotion too? So just want to put a plug of like, I think everyone's on their own path, their own journey. Definitely agree. There are lots of ways that you can be insanely profitable and having multiple practices is a great, great, great business play. And you're able to help more practices. I'm all in favor.   You're gonna have multiple locations. Make sure you're doing awesome dentistry because sure, it can be very lucrative. Just be ethical because I think that plays out long-term. So Chris, with that, what are some of the metrics you guys look at? Because I agree, I love to hear people's metrics. I think we're pretty closely aligned with you guys on metrics, which is another reason I really love working with you guys and your clients.   speaker-1 (18:32) So I think if you ⁓ were to survey the Academy of dental CPAs and all of their, what you see them put out statistically, they're gonna tell you the metric of one to 2 % for marketing. When you go and you immerse yourself in the DSO world and their conferences and get to know what they're doing, you're gonna see more of an average of six to 8 % reinvestment into marketing. DSOs have a harder time with retention. They have more patients going out the back door. Private practices.   degraded retention, but they don't often invite enough people to the party. So we don't go by the one to 2 % number. think that's an area where people try to, they're trying to keep costs down. You know, your business is the greatest asset that you own that provides the greatest return and you have the most control over. So you should be reinvesting in it more than you reinvest in the stock market or anything else. So our metric for marketing is three to 8%. Private practices, like to see at least three to five.   I mean, excuse me, in GP practices, in specialty practices, especially like orthodontics, needs to be on the higher end. Team expenses between 20 to 30%. We certainly try to keep that under 30%. Team expense does not include doctors. Okay. So that's all of your, all of your, uh, your, your entire team, including a hygienist as well, but not doctors, uh, dental supplies somewhere five to nine, five to 10 % labs.   speaker-0 (19:36) Yes, absolutely.   speaker-1 (19:58) four to 7%. So again, those dental supplies and labs really should not be greater than roughly 15 % total. Rent and facilities, five to 9%. What does that mean? So if you have a high percentage in your rent and facility costs, if your rent facility is let's say nine, 10, 11%, that means you're probably not maximizing the space and getting the collections that is possible there. Again, using that revenue per chair metric.   When you're on the lower end, if you have 4 to 5 % rent of facility, means you're running very efficiently. You're probably going to be running out of space and need to expand or potentially relocate or get another location. And then there's general administrative costs somewhere in the range of 4 to 10%, depending on the practice type and what additional folks they have.   speaker-0 (20:48) Cool.   speaker-1 (20:50) That's it on everything.   speaker-0 (20:51) No, I love it so much because I think so often people don't look at their P &Ls and they don't even know what they should be targeting for. It's just like, well, do I have money left over or do I not? And then I don't know. like all of that combined should equal about 50 % there. Is that correct? Those are 50 % and then doctor pays 30 % to give a 20 % profit margin. And then you subtract debt services from that. that kind of your guys' model? That's what I've heard. It's what I typically recommend.   speaker-1 (21:18) Roughly. mean, yeah. You know, I, the most ideal is that I think when the average doctor starts to work with us, their profit margin is in the twenties, the 20 % range. our goal is to get them into the forties. Okay. And everyone does chase this like 50 % number, but I will tell you that eventually if you have to scale again, if you have to reinvest, that's the part like you're, drive yourself nuts. Would you rather have, you know, 50 % of 1 million or do you rather have 40 % of 3 million? Right.   You know, and that's that. So it's not always just about that overhead percentage. Uh, it is about if you choose to scale and you're, you're buying, you're reinvesting some of your, your overhead percentage, you're reinvesting some of your money to buy back your time. Like you said earlier, okay. Um, whether that's on multiple doctors or not, you know, being a slave to the chair is difficult and high risk to you as a business owner. It's one of the riskiest business models there is.   speaker-0 (22:12) Right.   I think that that's such a good point.   But guys, you don't know, can, Pro-Fi is fantastic. You can reach out to them, have them help you with your PNLs. Also your current CPAs, you can get a chart of accounts and give them these percentages and say, this is where I want it to be. Help me get there, give me some information because a lot of CPAs are not dental specific and they might not know these industry standards. And I agree with you. I also think it's important to think of growth years and also profit years. Some years you are definitely massively.   reinvesting into the practice and you might not be sitting at as high of an overhead, but you're doing it with the intent. Like when I bring on new team members, when you bring on new doctors, your overhead is going to go down. It should go down because you are investing and you're growing, but you need those people. This year on Dental A Team is a growth year. I am heavily bringing on new team members. My overhead is not as great as it has been in the past years. But if I, like you said, chase that X number of overhead and never invest in that growth,   I can't get to the next level of where I wanna go. So I thought that was really, really helpful. Thank you for that, Chris. And I know now we wanna spin over to Brent. Brent's been hanging out silently over there of some tax things. And I do love that you guys ying and yang on practice metrics because that's what we're all about. And then the tax world that I'm like, here's the thing. Here's my take on taxes. I am so grateful to live in a country where I get to pay taxes to have my own business. Like I truly think that is a massive blessing of the country we live in.   With that said, I also think it's my responsibility as a business owner to be as savvy as I can on taxes and not overpay on taxes because I'm just dumb and I'm not actually looking at strategy using smart people beyond myself to do it. So Brent, I'm so jazzed. Talk to us kind of about some tax things that you've been thinking of that your clients are dealing with.   speaker-2 (24:00) Yeah, absolutely. So I remember a few early evening calls with you and you're calling and saying help.   speaker-0 (24:06) It was in December last year, like literally right before the end of the year. And I was like, Brent, I owe so much dang money in taxes. Any ideas? It's fine, guys. It's fine.   speaker-2 (24:19) One of the foundations of Pro-Fi that we built it on is education. So we are very big believers in educating our clients to understand, first and foremost, how do you even generate taxes? So the number of conversations we have with dentists that just don't have a basic understanding is really astounding to me. So we first take an approach of, you have to understand how do you generate income tax? You generate income tax by the salary or W-2 you take.   and profit. The key thing here is it does not matter if you take a dollar of that profit out of the business, you still owe tax on the profit. So here, when you're looking at your P &L, let's say a doctor has a half a million dollars of profit and they choose not to take it home and leave it in the business, they will still pay tax on half a million dollars. I had a call today, the exact conversation is like, why didn't take any of the money home?   speaker-0 (25:18) It doesn't matter. were profitable brother, sister, like rock on. Happy day for you.   speaker-2 (25:23) You know, as Chris was alluding to, if you choose to reinvest in the practice, do marketing or other items like that that are deductible, that will obviously reduce your burden. The second thing, the second biggest mistake is don't underestimate your effective tax rate. So Chris and I have, we call it, I guess the golden rule or the 40 % tax rule. And that is geared towards over-preparing a business owner when it comes time to send in those quarterly estimates.   And I'll come back to that one in a minute, but the 40 % tax rule, if you have a pen, I would write that down because that is a rule to live by. And also ask your CPA advisor, whoever they are, whether it's us or your other another CPA, ask them before you make the decisions. So I got a call yesterday from a doctor in South Carolina. He's like, hey, I want to buy a machine that's going to cost me $85,000. My equipment rep said I'd get a 40 % tax deduction.   Just about that much.   speaker-0 (26:23) That was a clever salesperson.   speaker-2 (26:26) Yeah, they all do it. We love equipping reps. No badging equipment reps. But understanding, depending upon your entity type, whether or not you will be able to deduct that in the current year is a huge thing that you have to understand. Chris and I have seen so many doctors over the years that have come to us after the fact. And I think we've done a great job of educating, hey, I bought this equipment, it's $100,000.   When we do the tax return, it's like, you're not involved deducted. They're like, why not? The equipment reps that I could. So just make call your advisor before you do it. That's the best thing you can do for yourself.   speaker-0 (27:02) Well, and I, to that point, I just say like, you should have experts on your board as a business owner, people that you genuinely trust for taxes. And like you said, ask them, ask your rep about the best products and what they're seeing of results within the patient's mouth. Cause that's where they're experts. But I'm just going to put a massive plug, like, gosh, the number of dollars I have spent personally, because I didn't ask,   If we can save anybody even a couple of grand, like you're welcome. You're welcome. Just ask, ask before you do it.   speaker-2 (27:36) Right, absolutely. Then I kind of look at what are some things that you can do to make sure you're not blindsided by that tax surprise? ⁓ One thing we do is we always recommend in your business, you have to run multiple bank accounts. And one of those bank accounts is a tax savings account. Your business should fund and pay for your personal tax bill. So think about like ⁓ grandmother's cash envelope system.   create different buckets in the business, move the money out of your OpEx account because, know, like for me, if I have 20 bucks, $20 in cash in my pocket, I'm going to spend it. But if I put it away in the bucket where it's intended, it'll be there when I need it.   speaker-1 (28:18) My bucket, right?   speaker-0 (28:19) Yes, you can just send them my way this year Chris. It's fine Brent. It's fine I'll take him but Brent I want to speak so highly to that because ⁓ It really does help. I will also put a plug of like have really good financial planners and tax planners with you because I am actually really really good at saving money for taxes What I really get frustrated with is when it comes to December and I have been saving and I have been putting that away ⁓   And then they're like, Kiera, you owe an extra X amount. And I'm like, what the heck? I've even saved this. So that's where I also think it's really pro to have really good CPAs that are that actually no tax. So I am curious. You guys tell me the truth, because I don't know how this works. I'm not a CPA, but I swear every year I get a call December 1st and it's like almost a double what I've already saved for the whole year. And I'm a saver. Like I don't spend a dime in my business.   speaker-1 (29:14) call you get all year long, Kiera.   speaker-0 (29:16) It's not well, I have a monthly call with them and we even plan for taxes, but this year my quarterly taxes It's okay guys. I'm interviewing new cpas. It's okay. my cpn doesn't listen to the podcast I don't think if so, it's great. We've had a good run for several years But like that's where I get a surprise. Is it common? Should you be getting a surprise call on december 1st? If you've got good tax people, and you've been planning and preparing and putting money aside all year long is that   speaker-1 (29:41) As you answer this question for her and I would go over safe harbor estimates, but Kiera to set you up for what Brent's going to say. What happens is somebody tells you a number and you kind of start to operate like a zombie and you're like, okay, I put that number away, put it away and you did it. And you're like, okay, I put the number where you told me, but at the same time you're trying to grow your business.   speaker-0 (30:06) To that point though Chris I'm gonna like back on this because I think I'm actually a really smart business owner But every freaking year this happens. I'm trying to fix this and hopefully someone   speaker-1 (30:15) I think it has to do with your growth.   speaker-0 (30:18) I   overestimated what my growth would be this year. So I said I was going to be double what I was last year and we're coming in at about a 70 % growth of what I was last year. So I gave my CPA a 30 % extra window to project on me and we're still coming up a hundred, I'll say a different number, but I'm coming up more than I had saved.   almost three times as much as they had saved for me. cause I get burned every single year. So I'm like a squirrel with nuts and I put away for tax savings in my company because I never know what I'm going to owe. And it scares me. So with that said, I agree with growth. If you can, if you can project where you're going to go and you're having consistent quarterly meetings with your CPA, is it common to still have a massive like uptick in December? I would ask.   speaker-1 (31:04) No, it's not.   So look, to keep it simple, like, you know, I'm kind of talking on the managerial accounting side of things and Brent's talking on the tax side of things. If you're meeting with that accountant and you look at that bottom line profit, okay, you owe 40 % of that profit, whether you took it home or not. And then if you made any estimated tax payments, you can subtract those tax payments from that 40%. Okay. ⁓ And then you can apply some deductions and maybe bring the number down.   speaker-0 (31:24) Agreed.   I'm asking for a friend hashtag myself right now I mean I get better every year around taxes because I hate the surprise and I think most people do but I also wanted to point out I'm like I think I'm pretty savvy with business I talked to a ton of CPAs like this isn't like my first day running a business So and I'm happy to hear and with that 40 % So here's another thing that I've also which maybe I'm just dumb Maybe I'm just coming around the block to this so you guys can tell me ⁓ but it's 40 % of the profit correct like   And that profit also includes my W-2 as a business owner. So I've got to like...   speaker-1 (32:10) That profit is after your W-2. Hopefully your W-2, you have normal withholdings. Sure. you're like zero or one, you can kind of pretty much say, hopefully the federal and state taxes are all withheld from that for you. Right. have to worry about it. Okay. It's the profit that's left over after your W-2 and all the other expenses of the business you have 40 % on. So Brent, tell her about what happens at the beginning of the year.   When we talk, they those first estimates. think everybody starts to like, they get glued to the estimates and they never update them.   speaker-2 (32:41) Yeah, so a couple things. So, Kiera,   speaker-0 (32:45) Call   you in December, Brent. We're going to have this conversation in year two.   speaker-2 (32:49) Maybe we should start in January for next.   speaker-0 (32:51) I like that strategy is much better. I'm like I've even I started my tax meetings in July this year guys Like this is how much I'm paranoid and I'm like they're just shelling a ton on me again And I'm like how does it happen every year? I don't I don't understand so   speaker-2 (33:05) Here's a trend I noticed over the last four years. you know, there was in 2017, there was the Tax Cuts and Jobs Act, which changed the tax code. also changed. There's also been changes to the payroll tax tables. So I would take UW2, look at your federal tax withheld and divide that by your taxable wages in box one. More than likely, it's going to be in the 10 to 12 % range.   If you were in the 40 % tax bracket, you're already 30 % short on your taxes. Let's say you pay yourself $100,000. If you're 30 % short, that's a five digit dollar. So that's where I'd first start. And that is very, very, very common. You will not see any withholding in a W-2 being over 25 % unless you manually requested that from the payroll company.   speaker-0 (33:39) Right.   speaker-2 (34:01) bonuses or automatically taxed at 25%, but your regular payroll is probably in the 10 to 12 % range. So that's one reason it's happened. What Crystal's talking about, so let's say that we prepare your return in April. So let's say your 2020 return and every accountant will do what's called a safe harbor tax estimate, which basically says your estimates will be 110 % of your prior year tax.   speaker-1 (34:30) The IRS wants you to put 10 % more than last year away, like pay them in advance. They like you to do it quarterly because collecting money once a year is a bad business model.   speaker-0 (34:40) And it's a bad business model.   speaker-2 (34:42) So like Chris said, when a client gets those estimates, and let's say they're $25,000 a quarter, they are fixed on $25,000 a quarter. So what we do is with all of our clients in June and early July, we actually run tax projections or mock tax returns the upcoming year. We pull their year to date profit, we get all their deductions and we project out if that original safe harbor estimate has changed.   Then we do it again in November and early December to make sure that you're still on track and also looking for additional ⁓ tax strategies. But to answer your question from earlier, should you be surprised with a big number? No, not if you're doing proper planning.   speaker-0 (35:30) with like a little variance, but I just want to point that out because I think so many business owners get scared of taxes and this year, don't worry guys, it's on my vision board by the age of 36. I will be a tax expert. I look at it every single night. I have no desire to be a CPA, but I really think it's important as business owners to educate yourself on taxes and like you said to plan and to save for it because otherwise it's just this always surprise bill that creates stress. For me as a business owner, I know often I just feel like   I don't dare spend money because I'm gonna get hit with this big unknown. And so I'm like this girl, I literally have four tax savings accounts in my business right now. And they're in like four different business accounts, so my CPA can't see them all. Because I'm like, you come to me every year with this huge surprise and every year it's like double what I thought you were gonna say. And like I'm grateful to be very successful in what we do. However, I don't think business owners should be surprised, especially if you have a good CPA. So I just wanted to like find out like, that normal?   I feel like I'm on the anomaly, but good to know on that.   speaker-1 (36:33) Tax surprises cause cash flow problems.   speaker-2 (36:39) So Kiera, let me quantify that one of   speaker-0 (36:41) Guys,   don't worry. Everyone on the podcast, this is a Cura therapy session. You're welcome to be attending this. So we're glad.   speaker-2 (36:48) So can there be a tax surprise? Yes. The reason the tax price might happen is if you told your CPA, hey, I'm going to be doing these improvements and they're going to be done by December 31st. If in December you tell them, well, it didn't work out and I'm not going to have all these expenses. And yes, you're going to, you're going to get a surprise because you didn't, your plan didn't follow through. The other thing is talking about the separate tax account in the business. It's,   speaker-0 (37:12) That's fair.   speaker-2 (37:18) Absolutely recommended, but the most important part is you cannot spend it on anything but your tax bill. You cannot not rob Peter to pay Paul. That is probably the biggest mistake you could make is saying, well, I'll take it now. I have eight months to put it back in.   speaker-0 (37:34) That's like that makes my heart stop. I feel so stressed for people and also for anyone who wants to know like you I wish you could see the zoom right now with me Brent and Chris You know these guys love what we're talking about because Brent is literally getting like so excited and so animated talking about this So that's just when you know people are good at what they do I get so geek I'll geek out on dentistry and systems and like how we can help you and they're jazzing about some some tax benefits here So I agree. I think that if you aren't doing that, I also like the thought of 40 %   Do you guys recommend, because I know another piece to it, which I realized this year was like charitable contributions. I'm LDS. And so having charitable contributions, 10 % is something that I was like, that was funny. We didn't prepare for that. So that's like another check that I wasn't planning. And then also like SEP and 401ks. Do you guys have anything that you recommend for that of having a tax savings fund, but also building up those other funds and those payments that you'll be making to reduce your tax bill? Yes.   but those are also pretty big expenses, depending upon how your business does every year. How do you guys manage or navigate that? Or should I just be saving more? Because again, I'm like building these funds up to this, I've got four accounts, because I stress out about it.   speaker-2 (38:44) So Chris, I'm gonna let you take that one on the cashflow. It's really cashflow planning.   speaker-1 (38:48) Yeah, a lot of questions in there.   speaker-0 (38:50) Cool, like I said, this is why I podcast guys, because I can ask my own personal questions.   speaker-1 (38:57) In terms of okay, should you be doing okay. what do you want me to start a chair charitable chair?   speaker-0 (39:03) Just   like I think that a lot of people might get quote-unquote surprised at the end of the year because not only do we have a tax bill to pay, we have charitable contributions that we're paying. We also have 7401Ks. Like there are quite a few other funds that need to be paid out again to reduce our tax bills to help us. But those are also cashflow that you need to have on hand as a business owner to be able to front that money. So I've been also thinking that could be why other people feel like it's a surprise at the end of the year, just all lumped into taxes when it is just other pieces to help reduce that tax bill for you.   speaker-1 (39:33) if   something is important to you, then it needs a separate bank account. if charitable giving is important to you, I think you should have a separate bank account so you can visually see that you've got it ready to pay. And in order to make it tax deductible, it does need to be a 501C3. can't just be any random, say, it's... Right? So ⁓ when it comes to all of the retirement accounts, mean, ⁓ 401Ks and IRAs and simple IRAs and all of that,   speaker-0 (39:51) about last year.   speaker-1 (40:02) Roth, that's like the smallest fraction. That's like the, you know, the entry level league of the tax code in terms of savings. And it's, it's really kind of the stuff that the masses can do. I certainly think it's important to save and save for retirement. think when you're a business owner and let me say this, mean, upfront, I'm a contrarian. I think when you're a business owner, you have to be a contrarian and know that not everything applies to you the same way as everyone else. Sure. I, my bias is I have a much.   stronger tendency to say, you know, spend the money in your business or put the, I should say, invest, reinvest the money in your business for growth, because it's going, there's an asset value to that, to that business. need to learn what that is and what you one day can exit it for. And it creates, gives you the most, you know, income. ⁓ If you put money into a 401k or you put money into marketing in your business, you get the same tax deduction. So that's a question. If you're looking for like year end stuff, you know,   You could put the money into the, into the retirement plan, or you could prepay some expenses for next year. ⁓ You lot of people, think don't trust their business, which is weird because it's the thing you have the most control over, but they don't trust their own business. Typically it's cause they're not really great at managing their own cashflow and having discipline. And so they're, they're hesitant to invest the money in the business. And they'd rather go roll the dice and put it in the stock market. And at the time of this podcast recording, let me tell you.   We are in a recession. It has already begun. Everything is very high. Stock market's high. Real estate is high. Your business is one of the safest places to put your money right now. It provides you an inflation hedge, okay? And it creates revenue. ⁓ And it's tax deductions. I'm a big believer in putting the money into your business or getting another business. I think Brent can talk about, know, people ask us like, what are some of the largest   speaker-0 (41:47) Right.   speaker-1 (41:56) deductions you can play in. Like what, are the bigger things you can do outside of a 401k? Tax deductions. Generally speaking, the tax code rewards you for doing things that improve our economy. And that's primarily investing in businesses, you know, adding another location, employing people and commercial real estate, commercial real estate is a big one. Again, commercial real estate's really high right now. It may not be the perfect time to be buying or building. Cause all of the costs are really high.   save that cash, even if you have to pay some taxes, save the cash for liquidity for the tough times. when this recession happens, most practice owners are going to stop investing in their business, they're to stop marketing. And you got to do the opposite. That is the time where you can do all of that at its lowest cost. that's when millionaires are really made is during recession. So I'm going on a tangent now. You got me passionate   speaker-0 (42:50) No,   I like it. I like hearing it because I like thinking of other things. think so often you said it really well of business owners want to contract. They want to not reinvest in themselves. It's like, well, like let's put it in the stock market because that's what I heard that we should do. But I really do love that mindset. And that's why I love podcasting. That's why I love talking to different people. This is why I bring you guys on here because I purposely, intentionally bring different ways of thinking out there. You've got to make your own decisions.   But I'm a big like when people are zigging, I want to zag. So right now real estate's hot. Commercial's hot. The stock market's hot. Like I literally am sitting here just thinking like, here, just sit on some cash. Like, like you said, I might have to pay more taxes on it, but sit on that cash because you know, it's going to drop. And during that time, that's when you do the exact opposite of what everyone else is doing. So I really love that advice. And I think it's wise and it's prudent. I also love what you said, Brent, of having the 40%.   A lot of people say do 30%, but agreed a lot of dentists do tip into that 40 % tax bracket. And I would much rather over prepare than under prepare. Chris, to your point, I really love also having the buckets for like we said, charitable contributions, if you're going to do ⁓ 401ks, but I really, agree with you too. I think reinvest in your business. Look to see, I do end of year spending. I look to see what I could reinvest in, what things are gonna propel us the most. I look at marketing, I look at website rebuilds, I look at.   Different softwares that are going to propel us forward different ways to make our our practice more efficient What things are really going to invest in our company and our team? To make it and then I just do fun things like, know trips places I definitely don't get much ROI on that except for emotional ROI, but I know I know this is a longer podcast guys I really hope and I also hope team members listening realize that this is not just for business owners. I think that this is also   Individual tax prepping make sure you are preparing look for ways that you can reinvest in yourself What things could you prepare for what things can you build out? Do you have separate savings accounts for different things that you're going to maybe you don't have to save for taxes But guess what maybe one day you will be a business owner So teach yourself the discipline to save now to look for reinvestment. I also think is super valuable. So I want   speaker-1 (45:05) team members, for those team members, what side hustle can you create? What side of business can you create? know, and what, what commercial or what even residential property, rental property could you create to give yourself rental income? And there are deductions that come along with that. But if all you do is just do your day to day job, whether you own a business or don't own a business, you're not going to save anything in taxes, nothing significant. got it. You got to create some value in the world out there.   speaker-0 (45:29) Agreed. say deliver the biggest and best value. So you guys teased me. So I want to wrap up our podcast with some things to not be doing. You guys have kind of like a hit list right now of some things, some tips that a lot of us might be doing that are cracking down. I know I have been privy to some of these things as well. So take us away. We'll wrap this up with just some, some of that hit list of what not to do. ⁓ and   you know, as we get in there, thank you guys for sharing all that you have. Thank you for doing a personal session with me already. So I'm excited for the hit list now.   speaker-2 (46:01) So I would say the biggest one that I've seen is the fascination that doctors have with crypto.   speaker-1 (46:01) Go ahead, Brent.   speaker-0 (46:12) Brent, it's because we're bored. We don't know what else to do with ourselves, so we're like, why not throw a little into crypto?   speaker-2 (46:17) Here's the problem. So I have about a half a dozen doctors over last six months. They called me and said, Hey, I put $200,000 into the crypto market, Bitcoin. And I'm like, really? Where did you, where did you write the check from for that investment from the practice? Here's the problem. If that practice is an S corporation and they invest that money in crypto and they hit it big, they could potentially blow up their IRS S corp election.   and the IRS will take it away from you. So if you're gonna do investments, do not write the check from your practice. You can take the money home as a distribution, then put it into crypto, but do not do it through your business.   speaker-0 (47:01) This is a moment where I just had like a, I'm like, good. I'm glad I did that at least right. even knowing. Why is that?   speaker-1 (47:03) Sorry.   So that one, I mean, that one can cause some serious damage. ⁓ But the other ones that I think nobody wants to hear when they're listening to this, and I get in all these battles on social media, Facebook groups and all that. But the two things that come up over and over and over again that everybody's kind of cheating on and they're going to get busted on is number one, paying employees and especially dentists and hygienists, paying them as 1099 contractors.   This is going to get you in trouble not only with the IRS, but with the Department of Labor. And there are some significant penalties. There is a black and white 20 question checklist that the IRS provides. You can Google that. You can find it directly on the IRS website. And it goes through a checklist of yes or no questions to determine if you qualify to be a 1099 independent contractor or if you fit the requirements of a W-2. And to simplify it,   The main thing is the element of control who controls the schedule, who tells you which patients you're seeing and when who's providing all the materials and the tools and equipment. And 99 % of the time, anyone in dentistry falls under the category of an employee. Pretty much have to be a specialist that owns their own separate practice already coming in part time in order for you to 10 99 them. And if you're 10 99ing them, you're 10 and you have to do it to their business. The other thing that doesn't work is when, you know, they're like,   Oh, I'm an individual doctor. I'll just set up an S corp and you can 1099 my escort. The IRS is not stupid. Again, they're they're looking at what are your what is your role within that that place that you're receiving the income from the revenue from. So anyway, everybody hates that. But I'm telling you, I   speaker-0 (48:58) I   don't think it's a, it's not a good place to play with fire. Um, I have a really, really, really awesome unemployment lawyer, um, and employment lawyer. He represents Uber Lyft Red Bull. He's in, um, San Francisco. If you guys need him, he's amazing. Reach out to us. Hello@TheDentalATeam.com. Um, but he told me he said, Kiera Uber and Lyft, which I personally think I'm no lawyer guys. I'm not there. Uber and Lyft to me are the epitome of 10 99 contractors.   but they are, ⁓ they're coming down, they're cracking down on it. And ⁓ I have heard that it is no longer just a small offense. It's a pretty big offense if you misclassify. To me, really, I'm a risky person, but I believe in being smart and also paying people the way they should be paid. As much as it's not fun, we transitioned our whole company and I just think play that one safe because labor laws are not something to ever mess with, in my opinion.   speaker-1 (49:51) Yep. And you know, the government has shelled out a lot of money through this pandemic and they've got to collect it and get it back. And they're going to get that back from small business owners. And, ⁓ you know, our, our dependent care systems of Medicare and social security are very fragile right now. And that's the one thing they do not want you to screw with. And so they collect that money through W2 payroll. They're going to, they're going to force more and more than everybody's W2, especially in the occupation of dentistry. Second thing is the cars. Okay. Everybody wants to run their cars through the business.   You might be allowed to run a car through your business. It depends on what type of business you're in. If you're in real estate and you're showing houses and you're driving your clients around, you can probably write your car off through your business. But in dentistry, you're going to sit across the table from an auditor and they're going to say, what does a car have to do with the business of dentistry? The IRS tax code says that your business expenses must be ordinary and necessary to the business for them to be deductible.   What does the car have to do with the business of dentistry? How is a vehicle ⁓ justified as 100 % business use as a necessary use in order to do dentistry?   speaker-0 (51:00) What if it's a wrapped vehicle that's marketing?   speaker-1 (51:03) That's different. there are very specific guidelines in the IRS tax code about what is marketing for a vehicle. must be fully wrapped. It can't just be magnets. It can't just be stickers. But it has to be significant that's used for marketing. What we find is not a lot of doctors want to wrap their test up.   speaker-0 (51:23) Because they're ticked off with the patient that Ruekinaal didn't go super well and they're cutting people off on their drive home and you don't really want your flashy business to be that car.   speaker-1 (51:31) Right. I mean, and to make it legitimate, mean, the car has to be legally registered in the business name. It has to be covered under business insurance, not your personal insurance. The loan has to be under the business name, not your personal name. And there's a, you know, most people are not doing that. They're doing, they're buying it personally. They're just making the payment out of their, out of their business. And they think that they can deduct the whole thing. And this is not true. There's even greater scrutiny if the business tries to buy, if the dental business tries to buy a vehicle.   and depreciate it, take it as 100 % use. So I know people hate to hear that, but I would just caution everyone listening, stay away from 1099 and cars in your business. But everyone's.   speaker-2 (52:12) doing   it!   speaker-0 (52:13) I heard a really great quote one day and they said Kiera everything's deductible until you get audited and I was like That's really good advice. I appreciate that. So guys, ⁓ Chris and Brent. Thank you guys for coming on the podcast Thank you for being people that I can call Brent. Thank you for being my December, you know midnight hour friend I loved last year. You said care. There's really not much we can do. Maybe we should have done this in January. So ⁓   But truly, I just appreciate you guys helping so many doctors. know you help a lot of our clients. Shout out to those clients that we mutually work together. I love working with CPA companies. I think we're a good peanut butter and jelly together. We help grow the practice, make them more profitable. You guys make sure that their books are in line. Give us the guiding stars of what levers to turn to help the practices. You take care of the taxes. So it's a really good yin and yang and   I hope all of you listening today found a lot of value. Team members, look at this for yourselves. Get the side hustle. I hope this spurred some, some topics, some conversation. Team members, can also help your practices reduce that tax bill. look for ways that you can spend end of year, just different things. So I definitely think team members have a lot of play in this as well. So Chris and Brent, thank you guys so much. It's super fun. If people want to connect with you, ⁓ maybe they're done with their CPA. Maybe they just want to find out if.   There might be another option out there. How can they connect with you? I know you guys specialize in DSOs, larger group practices, but also the solo practices as well. How can people connect if they're interested?   speaker-1 (53:40) Sure, so check us out online at our website, Profi2020.com. That's P-R-O-F-I-2-0-2-0.com. ⁓   speaker-0 (53:47) You did   that because 2020 was such a great year that you guys want to remember. ⁓   speaker-1 (53:53) That marketing plan went out the window. It was 20-20 clarity to give you clarity on your finance.   speaker-0 (53:54) No.   I   just thought I'd throw it out there. So no one will forget Pro-Fi 2020. 2020 was most memorable year guys. Don't forget it. They don't want to forget it ever.   speaker-1 (54:07) We have tons of free videos, a lot of great content on there. Check us out on our YouTube channel, all social media, know, at Profi2020. We're very easy to find. ⁓ But we're managerial accountants. It's way different than financial accountants out there. Make sure you look up that difference and know what you're asking for. ⁓ And we always do free consultations for anyone who would like it.   speaker-0 (54:29) Awesome. Well, Chris and Brent, thank you again so much, guys. Go check them out, Profi2020. Chris and Brent, they are the owners of the organization. So super grateful for you guys coming on here.   Kiera Dent (54:38) I hope you all loved today's episode as much as I did. It is crazy to think that this many episodes have been released since we started the Dental A Team Podcast. And I started looking to say, my goodness, our listeners need to be reminded of some of the things they may have learned a year ago or two years ago or five years ago, because so many things in our practices weren't relevant back then when we heard them, but they are relevant today. And I would be doing you a huge disservice if I didn't re-release some of these episodes for you to remember, to refine.   to optimize and really truly if you ever need a topic or you're like, my gosh, I wonder if the Dental A Team has anything like this, go onto our website, TheDentalATeam.com, click on our podcast tab and you can literally search any topic. So whether it's overhead or hiring or firing or team morale or engagement or case acceptance or hygiene   onboarding or whatever it is, we have so many episodes for you. And so I am going to intentionally be   re-releasing some of the top best episodes for you, pulling back some of the ones that I needed to remember, some of the things that I feel for you to really, really relearn right now and to re-remember, or if it's the first time, welcome. I'm so happy you're listening to it, but I hope you truly enjoyed today's episode. I hope that you share this with somebody. I hope that you go and implement today because we only have one day. We only get today. And so making today the best that it possibly can be. If we can help you in any way, shape or form, reach out Hello@TheDentalATeam.com.   And as always, thanks for listening and we'll catch you next time on the Dental A Team Podcast.

Do your patients feel cared for — or are you just taking care of them? In this episode, Kirk Behrendt interviews Dr. Bryan Laskin, dental author, tech entrepreneur, and patient-advocacy leader, about why dentistry is losing patient trust and what to do about it. You'll learn how private equity and spreadsheet-driven decisions can quietly degrade the patient experience, why “clarity” is the biggest lever for rebuilding trust, and how simple systems and technology can help patients feel listened to, informed, and confident. Listen to Episode 1022 of The Best Practices Show!Main Takeaways:Taking care of people is different than making people feel cared for, and patients primarily feel listened to, communicated with, and given clarity.Private equity has accelerated aggregation in dentistry, and tighter margins can increase the risk of decisions that ignore how patients experience care.Patients may still trust their own dentist, but broader trust in dentists is eroding, making transparency and clarity more important than ever.Building “care more, make more” requires systems that create connection, reinforce clarity, and build confidence to improve recall and referrals.Treatment plans are often accepted at the kitchen table, so practices need to share information that patients can review after leaving the office.Removing human variability by automating “robotic” tasks frees the team to do what humans do best: welcome, connect, and care.When evaluating technology, the first question should be how it makes people feel, because patient experience drives growth.Snippets:00:00 Huge difference between taking care of people and making people feel cared for.00:03 Bryan's background: practice ownership, CAD/CAM training, scaling a patient engagement solution, and standards work.00:05 “Care more, make more” and the clarity, confidence, connection framework.00:06 Why dentistry's recurring hygiene model attracted private equity and accelerated DSO growth.00:09 What spreadsheets miss: the patient experience and the “silent killer” of lost confidence.00:10 “Patients still trust their dentist, but patients don't trust dentists.”00:14 The biggest problem: patients are confused, and confusion destroys confidence.00:16 Transparency as the flip side of trust and why everyone “Googles” their care.00:22 New patient intake as a systems problem and how automation improves the human welcome.00:25 The pathway to trust: connection, clarity, then confidence.00:31 The technology question: “How does it make people feel?”00:32 Where to learn more: cair.net, toothapps.com, and Bryan's books.Guest Bio/Guest Resources:Dr. Bryan Laskin has spent over two decades at the intersection of healthcare, technology, and patient advocacy. As a practicing dentist, he witnessed firsthand the artificial barriers separating dental and medical care despite their profound connections. As a healthcare technology entrepreneur, he's developed innovative solutions to improve care coordination, enhance patient communication, and increase healthcare transparency.Resources mentioned:Cair (patient-facing): https://cair.net/ToothApps (practice side): https://www.toothapps.com/Brian's website: https://bryanlaskin.com/Books: The Patient First Manifesto https://bryanlaskin.com/patient-first-manifestoMore Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Dr. Jesse Defazio is a pediatric dentist and a "super associate." She has practiced in 15 offices over the last 11 years, following her husband's military career. She comes on the show to talk all about associateships and what to look for when trying to find that perfect practice. We cover some great topics including:- When does working for a DSO make sense?- Be cautious of second locations- What would the perfect office set-up look like?- Why working interviews are important- Should doctors receive a percentage of radiographs, fluoride, and prophies?- W2 vs 1099 red flagsThis is also a great episode for practice owners who want to bring on an associate and set them up for success.

This week we're joined by Ava Jordan, a junior at the University of Michigan. In her freshman year, she competed on vault in all but one meet, notching a season-best 9.85 in her very first collegiate appearance. She took things up a notch during her sophomore season, consistently competing in both the vault and bars lineups and earning her first career 9.9 score on bars at the Big Ten Championships.Now in her junior season, she's making an even bigger contribution to the Wolverines by adding beam to the mix and scoring career highs on all three events: a 9.9 on vault, 9.925 on bars, and 9.95 on beam. Ava joins us to talk about what led her to Michigan, finding consistency on the competition floor, her future goals, and more.Plus, stick around after the interview for our thoughts on Iowa State cutting its gymnastics program and some other highlights as we head into postseason.Thank you to our monthly Patreon supporters: Lee B, Cookiemaster, Happy Girl, Erica S, Semflam, Amy C, Maria L, Becca S, Cathleen R, Faith, Kerry M, Derek H, Sharon B, Randee B, MSU, Kimberly G, Robert H, Lela M, Mara L, Jenna A, Alex M,, Kelsey, Lidia, Maria P, Alicia O, Cristina K, Bethany J, Diane J, Kentiemac, Marni S, Betny T, Emily C, Cathy D, Lisa T, Libby C, Thiago, Taryn M, Dana B, Jamie S, Chuck C, Je_GL, Kaitlin, Susan P, Mallory D, LFC_Hokie, Ella, Debbie, Kay, Diane J, Julie B,, Austin K, Jane, Sarah, Amy, Stephen S, Johanna T, Alison S, Kristina T, Abigail W, Ola S, Jennifer K, Kate M, Claudia, Erin L, Sarah A, Thomas B, Kihika N, Beth C, Amy, Renee PM, Ryan V, Brandon H, Tyler, Hayley B, Ben S, Kate, Danielle, ALittleUnderRotated, Dana C, Grace, Pat G , Lexi G, Laura N, Kathy, Katie A, Ruby B,, Róisín, Megan J, Emily D, Britton, Ry Shep, Reyna G, William A, MB, Jackson G, Stella, Ulo F, Noah C, Melissa H, Alexis, William M, Trish, Susie, Leslie G, Catherine B, Karlin, Laura L, Katy S, J'nia G, Kathy M, Kathy S, Okcaro, Caroline P, JD B, Cookiecutter, Ailish D, Wil D, Caroline M, kcmojojojo, Sammy S, Fabio B, Kerry H, Ricardo A, Brandon, Leah D, Margaret G, Molly, Marco B, ClemsonTigersFan, Lisa B, DSO, Sarah M, Abigail M, Grace M, Laura A, Justin D, Paola, Kendrick C, Rich A, Ty T, Nicholas S, Becky E, Annsley M, Tere, Melody M, Stacey, Erica H, Kathy, Teressa, Angela C, Bridgett C, Ashley D, Whitney J & Amanda C!

Join dental entrepreneurs George Hariri, Matt Guarino, and Matt Ford as they break down the realities of running their national DSO, Shared Practices Group. They tackle the triumphs and tribulations of scaling a business, answer your burning questions (submit yours at bdppod.com), and delve into life's other adventures - from health and parenting to sports and politics. It's business, banter, and everything in between. Tune in and join the BDP community today!

The Delaware Symphony Orchestra's next concert, coming up next weekend, takes audiences "Across the Galaxy" with music from sci-fi and space movies.To learn more, Delaware Public Media's Martin Matheny grabbed his tricorder for a conversation with the DSO's music director, Michelle Di Russo in this week's Arts Playlist.

What does it really take to launch a dental startup while juggling motherhood, a mission-driven vision, and a learn-as-you-go leadership style? Dr. Pooja Makam opens up about building Lumina Dentistry from the ground up, all while parenting two toddlers and fighting for a patient-first approach in a world of corporate pressure.In this episode, Dr. Makam takes us behind the scenes of opening her North Carolina practice, from tackling unexpected technology meltdowns to navigating hiring heartbreaks and financial curveballs. She contrasts her corporate dentistry experience with her drive to create genuine, customizable care, revealing how she implemented efficient workflows and a “comfort menu” that attracts modern patients without hard sells. You'll hear real stories of operational fires, evolving boundaries, self-forgiveness, and the power of vetting vendors and advice. If you're dreaming of practice ownership (or simply want to survive your startup season,) you'll want to hear Dr. Makam's story!What You'll Learn in This Episode:The reality of opening a dental startup as a working parentWhat differentiates a patient-first, private practice from DSO-driven dentistryMistakes made and lessons learned in early-stage hiring and team buildingTactics for smoother workflow, cross-training, and avoiding burnoutHow to realistically test your systems before opening daySubtle ways to introduce elective services without seeming salesyMarketing and branding hacks (including how $35 can launch your logo)Navigating vendor relationships, technology snags, and construction delaysSetting healthy boundaries to protect family time and your own sanityHow to filter advice and avoid sales-driven online “mentorship”Turn up the volume for a raw, practical guide to launching and growing a dental practice on your own terms.‍Sponsors:‍CallRail: Call tracking + AI that turns calls into campaigns that convert, quality patients, and cost savings. Click our link to start a free trial today! https://sta.mx/vz69Click here for a special offer!Guest: Dr. Pooja MakamPractice Name: Lumina DentistryCheck out Pooja's Media:‍Website: https://dentist-morrisville.com/Instagram: https://www.instagram.com/luminadentistry/Facebook: https://www.facebook.com/profile.php?id=61575688889108‍Host: Michael AriasJoin my newsletter: https://thedentalmarketer.lpages.co/newsletter/‍Join this podcast's Facebook Group: The Dental Marketer Society‍Love the Podcast? Subscribe on Your Favorite App! https://lnkfi.re/TDMPod

In today's episode, Dr. Stucki sits down with financial experts Bob Spiel and Nate Williams, who push back on the idea that dental specialists should sell their practices to Dental Support Organizations (DSOs) or private equity groups. Using straightforward financial modeling, they question the belief that corporate buyers always offer the best payout, pointing out that long work-back commitments and illiquid equity can leave doctors with less overall value than a traditional private sale. They suggest that, in many cases, surgeons are essentially paying for their own buyouts with years of future work, while also giving up a significant amount of professional independence. By calling attention to the risks of share dilution and reduced control over day-to-day decisions, they encourage doctors to hold onto independent ownership of their most valuable assets. Overall, the episode serves as a practical warning about how Wall Street-driven incentives can affect both the financial health and clinical direction of the dental profession.Key Points From This Episode:We are introduced to our guests, Bob Spiel and Nate Williams.Debunking the goal and purpose of private equity (in the dentistry space).They look at the hypothesis that private equity-backed DSO groups pay more for practices than private doctors (an in-depth hypothetical scenario).Another hypothetical scenario: what it looks like when practices are sold to businessmen.Nate explains the 5-year work-back.He unpacks the rollover equity: minority non-marketable shares of an entity. What happens to shares when the ship sinks.Big cash up front and what that means for the future.Navigating misinformation as an industry. Links Mentioned in Today's Episode:Nate Williams, CPA on LinkedIn — https://www.linkedin.com/in/nate-williams-cpa-cfp Practice Financial Group — https://practicefinancialgroup.com/ Bob Spiel on LinkedIn — https://www.linkedin.com/in/bobspiel  Spiel Consulting — https://spielconsulting.com/Dentist Partner Pros — https://dentistpartnerpros.com/  Just Say NO to the DSO — https://open.spotify.com/show/2DRR7iWpDQiX1NSyaSIWzK Questions — questionsjustsaynotothedso@gmail.comEveryday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Here's the truth: most organizations are addressing case acceptance the wrong way. In this episode of "The Bryan Laskin Podcast", we unpack why clarity, not persuasion, is the real driver of treatment acceptance and how variability across providers, teams, and locations creates massive invisible revenue leaks across dental organizations. Whether you run a single practice or a multi-location DSO, the organizations that win this decade will be the ones that systematize clarity, confidence, and patient connection. I'm Dr. Bryan Laskin. I work on the infrastructure side of healthcare, building the systems that allow care to scale with connection, clarity, and confidence.

Although the foundation of the dental industry has remained consistent, there have been some meaningful changes in recent years that have shaped the dental landscape for both buyers and sellers. Christy and Charles discuss updates in the private practice and DSO arenas, from elevated practice prices, satellite location trends, interest rates, buyer and seller demand, DSO consolidation and more. This episode highlights why staying informed and keeping your goals in focus leads to smarter, more strategic business decisions.

Ready to see how much cash is hiding in your business? Get your free Financial Health Check now: coltivar.com/check Financial Intelligence Toolkit A lot of companies are profitable on paper but still run out of cash.The problem usually comes down to something most owners never measure called the cash conversion cycle. Steve explains why profit and cash flow are different, how working capital traps cash inside a business, and why growing too fast can actually make the problem worse. Once you understand how DSO, inventory, and payables affect your cash cycle, you can start pulling the right levers to get cash moving back into your business. _______________________________________Disclaimer:The views expressed here are those of the individual Coltivar Group, LLC (“Coltivar”) personnel quoted and are not the views of Coltivar or its affiliates. Certain information contained in here has been obtained from third-party sources. While taken from sources believed to be reliable, Coltivar has not independently verified such information and makes no representations about the enduring accuracy of the information or its appropriateness for a given situation.This content is provided for informational purposes only, and should not be relied upon as legal, business, investment, or tax advice. You should consult your own advisers as to those matters. References to any securities or digital assets are for illustrative purposes only, and do not constitute an investment recommendation or offer to provide investment advisory services. The Company is not registered or licensed by any governing body in any jurisdiction to give investing advice or provide investment recommendations. The Company is not affiliated with, nor does it receive compensation from, any specific security. Please see https://www.coltivar.com/privacy-policy-and-terms-of-use for additional important information.LinkedIn | YouTube coltivar.com

Join dental entrepreneurs George Hariri, Matt Guarino, and Matt Ford as they break down the realities of running their national DSO, Shared Practices Group. They tackle the triumphs and tribulations of scaling a business, answer your burning questions (submit yours at bdppod.com), and delve into life's other adventures - from health and parenting to sports and politics. It's business, banter, and everything in between. Tune in and join the BDP community today!

On this episode of MB2 Underground, Jonathan Tyroch and Joe Fox talk through what private practitioners should consider when evaluating a transition. Drawing from thousands of conversations with dentists across the country, they discuss the importance of defining your "why," understanding the differences between selling to another doctor, a traditional DSO model, or a partnership structure, and the information to prepare before entering the process.  This conversation serves as a high-level overview of MB2's upcoming Preparing to Sell webinar, which will go into greater detail on the transition process.  Link to Register for the Preparing to Sell webinar: https://hubs.la/Q045gwqk0 ------------------------------------------------------------------------  Subscribe & Listen: Spotify: https://open.spotify.com/show/69Dz26hgC9D6YqwN8JMDBV Apple Podcast: https://podcasts.apple.com/us/podcast/mb2-underground/id1747349567 ---------------------------------------------------------------------- Follow MB2 Dental on Social: MB2 Dental: mb2dental.com Instagram: instagram.com/mb2dental Facebook: facebook.com/mb2dental YouTube: youtube.com/@mb2dental LinkedIn: linkedin.com/mb2-dental

The Detroit Symphony Orchestra's Classical Roots concert comes to 90.9 FM Friday morning at 10:40. WRCJ's Cecelia Sharpe speaks with conductor Thomas Wilkins about the DSO's Classical Roots tradition and music by Black composers on concert stages everywhere...

This week's guests are sisters Morgan Price and Frankie Price.Morgan Price spent the first three seasons of her college career at Fisk University, competing for the first HBCU gymnastics team. She won six WCGNIC national titles and became the first HBCU gymnast to score a 10.0, earning the mark on uneven bars during her junior season. Now a senior at the University of Arkansas, she recently made history again as the first Razorback gymnast to score a 10.0 on vault.She is closing out her career alongside her sister, Frankie, a mainstay in Arkansas' vault and floor lineups. Frankie owns career highs of 9.9 on vault and 9.975 on floor — the latter matching the program record. As a redshirt freshman in 2023, she shared the NCAA regional floor title.The sisters join the show to discuss Morgan's historic 10.0, Frankie's return from an Achilles injury last season and their goals for the remainder of their gymnastics careers.Scoreboard episode: https://creators.spotify.com/pod/profile/all-things-gymnastics/episodes/All-Things-Scoreboard-Introducing-NCAA-Gymnastics-New-Judges-Evaluation-System-e2ts5h5/a-abo91u6Thank you to our monthly Patreon supporters: Lee B, Cookiemaster, Happy Girl, Erica S, Semflam, Amy C, Maria L, Becca S, Cathleen R, Faith, Kerry M, Derek H, Sharon B, Randee B, MSU, Kimberly G, Robert H, Lela M, Mara L, Jenna A, Alex M, Mama T, Kelsey, Lidia, Maria P, Alicia O, Cristina K, Bethany J, Diane J, Kentiemac, Marni S, Betny T, Emily C, Cathy D, Lisa T, Libby C, Thiago, Taryn M, Dana B, Jamie S, Chuck C, Je_GL, Kaitlin, Susan P, Mallory D, LFC_Hokie, Ella, Debbie, Kay, Diane J, Julie B,, Austin K, Jane, Sarah, Amy, Stephen S, Johanna T, Alison S, Kristina T, Abigail W, Ola S, Jennifer K, Kate M, Claudia, Erin L, Sarah A, Thomas B, Kihika N, Beth C, Amy, Renee PM, Ryan V, Brandon H, Tyler, Hayley B, Ben S, Kate, Landon, Danielle, ALittleUnderRotated, Dana C, Grace, Pat G , Lexi G, Laura N, Kathy, Katie A, Ruby B,, Róisín, Megan J, Emily D, Britton, Ry Shep, Reyna G, William A, MB, Jackson G, Stella, Ulo F, Noah C, Melissa H, Alexis, William M, Trish, Susie, Leslie G, Catherine B, Karlin, Laura L, Katy S, J'nia G, Kathy M, Kathy S, Okcaro, Caroline P, JD B, Cookiecutter, Ailish D, Wil D, Caroline M, kcmojojojo, Sammy S, Fabio B, Kerry H, Ricardo A, Brandon, Leah D, Margaret G, Molly, Marco B, ClemsonTigersFan, Lisa B, DSO, Sarah M, Abigail M, Grace M, Laura A, Justin D, Paola, Kendrick C, Rich A, Ty T, Nicholas S, Becky E, Annsley M, Tere, Melody M, Stacey, Erica H, Kathy, Teressa, Angela C, Bridgett C, Ashley D, Kennedy B, Whitney J & Amanda C!

Join dental entrepreneurs George Hariri, Matt Guarino, and Matt Ford as they break down the realities of running their national DSO, Shared Practices Group. They tackle the triumphs and tribulations of scaling a business, answer your burning questions (submit yours at bdppod.com), and delve into life's other adventures - from health and parenting to sports and politics. It's business, banter, and everything in between. Tune in and join the BDP community today!

Tony Seymour, President, Tate Roark, VP of Dental Enterprise & Amy Mendoza, Chief Marketing Officer of Alphaeon Patient Financing share: What is most important to patients when financing What is the #1 healthcare service patients will finance? % of patients that have delayed dental care due to cost More results & data points from survey To learn more please visit https://www.myalphaeoncredit.com/ or https://alphaeon.com/  You can also reach Tate Roark at tate.roark@alphaeon.com or find him on Linkedin at https://www.linkedin.com/in/tate-roark-51358331/ Subscribe to our channel for more episodes and stay updated on the latest DSO news, insights, and events! If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes https://apple.co/2Nejsfa and a Thumbs Up on YouTube.

Dr. Lincoln Harris, Founder and CEO of Ripe Global, shares his remarkable journey from practicing in remote Australia to revolutionizing dental education for DSOs across America. He discusses: Aviation principles & simulation technology Performance-based learning Measuring educational success & EBITDA growth To learn more visit https://www.ripeglobal.com/ You can also reach out to Dr. Roshan Parikh at roshan.parikh@ripeglobal.com , Dr. Lincoln Harris at lincoln.harris@ripeglobal.com or Kim Toovey at kim.toovey@ripeglobal.com Don't miss part two of this conversation featuring chief clinical officers sharing their real-world training results. Subscribe to our channel for more episodes and stay updated on the latest DSO news, insights, and events! If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes https://apple.co/2Nejsfa and a Thumbs Up on YouTube.      

【Podcast】「真是奢侈的煩惱」英文怎麼說？ ✦ Talk about first-world problems! 【補充學習】 ✦ humblebrag 炫耀式抱怨 ✦ Born with a silver spoon in one's mouth. 含著金湯匙出生 ✦ filthy stinking rich 非常有錢 ✦ privilege (n.) 特權 【情境對話】 D: Hey, Eleanor, I need your advice. I'm having a real crisis here! （Eleanor 我需要你的建議！有個大危機！） E: I'm listening. What's the "crisis"? （說來聽聽，是什麼「危機」？） D: So, I need a new handbag, but like, should I go with Chanel in black or Hermès in red. （我不知道要買黑色香奈兒手提包還是紅色愛馬仕。） E: Seriously? Talk about first-world problems! I can't even afford the wrapping ribbons. （蛤？你認真？這真是奢侈的煩惱耶！我連一個緞帶都買不起= =。） 加入會員，支持節目： https://ivybar.firstory.io/join 留言告訴我你對這一集的想法： Powered by Firstory Hosting

Join dental entrepreneurs George Hariri, Matt Guarino, and Matt Ford as they break down the realities of running their national DSO, Shared Practices Group. They tackle the triumphs and tribulations of scaling a business, answer your burning questions (submit yours at bdppod.com), and delve into life's other adventures - from health and parenting to sports and politics. It's business, banter, and everything in between. Tune in and join the BDP community today!

If your dental practice isn't growing, it's tempting to blame marketing, staffing, or “the economy.” But what if the real problem is leadership avoidance?  In this episode, we break down the uncomfortable truth behind scaling a dental practice: growth requires change, and change requires discomfort. If you want to increase case acceptance, improve phone conversion, reduce no-shows, build a stronger team, and create consistent profitability, you can't keep running your practice like a group chat where everyone has opinions and nobody has decision rights. We talk about why cash flow, KPIs, referrals, and profitability are lagging indicators, and how the leading indicators (cadence, training, oversight, systems, and consistent leadership) are what actually create a scalable dental organization.  This is for dentists, practice owners, and DSO-minded operators who want real practice growth, stronger culture, better execution, and a business that doesn't collapse under pressure. If you're ready to stop avoiding hard conversations and start leading like a true Dentist CEO, this episode is your wake-up call. Highlights: → You'll learn why most “people problems” in a dental office are actually leadership problems, and how oversight and training fix what software can't.  → We unpack how to tell the difference between leading indicators vs lagging indicators in your dental practice KPIs, and why profitability can hide a fragile culture.  → You'll hear why consistency matters more than charisma for dentists who want trust, retention, and execution.  → And we lay out how a real operating cadence, scorecards, communication rhythms, and clear decision rights, turns chaos into scale. To connect with Dr. Buske follow the links below -  LinkedIn Instagram Facebook Limitless Dentist Academy Join Dental Syndicate HERE Learn more about your ad choices. Visit megaphone.fm/adchoices

Private practice is getting squeezed by complexity, competition, and promises that “bigger is better.” That pressure is pushing more dentists to consider selling, scaling, or giving up control. In this episode, Kirk Behrendt talks with Dr. Christian Coachman, dentist and educator, about why celebrating independent private practice matters, why quality in dentistry isn't scalable, and what private practitioners can do to stay clinically excellent without burning out. To learn how community, support, and smart strategy can help you protect your freedom and your standards, listen to Episode 1011 of The Best Practices Show!Main TakeawaysPrivate practice protects the dentist's freedom to make key decisions that support quality and patient-first care.Motivation, attention to detail, and passion can decline when a practice is sold and clinical decisions are influenced by outside ownership.Quality in dentistry is not scalable, and it typically drops as practices grow beyond a size that can be closely managed.The temptation to scale often hits when a dentist reaches a ceiling on fees but demand continues to grow.Independent dentists can gain many advantages of large organizations by joining a real community that offers support and shared resources.The increasing demands of technology, marketing, leadership, and management are pressuring private practitioners and fueling DSO interest.Many dentists who sell are financially relieved but still want their freedom back once non-compete periods end.Snippets00:00 Intro – Protecting Independent Private Practice01:12 Why Private Practice Matters02:45 Introducing Dr. Christian Coachman04:10 Celebrating the Freedom of Ownership06:30 The Current Challenges Facing Private Dentists08:55 The Mindset Shift Required to Stay Independent11:20 Why Community and Collaboration Matter13:40 Innovation in Modern Private Practice16:05 The Future of Independent Dentistry18:30 Why Events Like The Exchange Matter20:10 Final Thoughts – Choosing Freedom Intentionally21:32 OutroGuest Bio/Guest ResourcesDr. Christian Coachman is a dentist and dental technician known internationally for his work in dental communication, treatment planning, and interdisciplinary collaboration. He is the founder of Digital Smile Design and has spent decades working inside dental practices, observing patient interactions, and teaching clinicians how to communicate more effectively with patients and teams. He lectures globally and consults with dentists seeking to improve trust, case acceptance, and long-term patient relationships.Guest resources mentioned in the episode:Digital Smile Design: https://digitalsmiledesign.comDr. Christian Coachman on Instagram: https://www.instagram.com/chriscoachmanMore Helpful Links for a Better Practice & a Better Life:The Best Practices Show:

Are you relying on the sale of your practice to fund your retirement? Before you accept an attractive offer from a DSO, it's critical to understand what those numbers really mean — and what alternatives exist.In this episode, Kirk Behrendt interviews Dr. Bob Margeas, founder of Iowa Dental Group in Des Moines, Iowa, about how he evaluated multiple DSO offers, broke down EBITDA and earn-outs, and ultimately chose a different transition strategy. They discuss adjusted EBITDA, recap risk, associate buy-ins, creative ownership structures, and why equity matters more than a headline purchase price. If you're considering selling your practice — or simply want to understand your options — listen to Episode 1010 of The Best Practices Show!Main TakeawaysEBITDA is calculated differently than a dentist's net income and often includes add-backs that significantly change a practice's valuation.Most DSOs evaluate practices on an accrual basis rather than cash basis accounting, which affects perceived profitability.Earn-outs and recapitalization payouts are tied to performance and market conditions and are not guaranteed.Selling to a DSO typically requires the dentist to stay for several years, effectively replacing future EBITDA with the sale proceeds.Structuring an associate buy-in based on trailing three-year profits can allow debt to be serviced without increasing production.Ownership equity creates long-term wealth potential that an associate-only model does not provide.Dentists who are financially independent have more flexibility and leverage when evaluating transition options.Snippets00:00 Intro03:00 The difference between a DSO and a DPO.05:00 Understanding EBITDA and common add-backs.08:00 Why DSOs prefer accrual accounting over cash basis.10:00 How earn-outs and clawbacks work.13:30 Hiring an associate based on personality and communication skills.15:00 Structuring a 20% buy-in using trailing three-year profits.17:00 Reducing clinical days while maintaining profitability.21:00 Merging practices into a holding company model.24:00 Why saving early creates flexibility at transition.30:00 “I'm just a referee” — communicating treatment without pressure.34:00 Why equity ownership is essential for long-term wealth.Guest Bio/Guest ResourcesDr. Bob Margeas is the founder of Iowa Dental Group in Des Moines, Iowa. He is a nationally recognized...

Dr. Nyree Whitley, Chief Clinical Officer at mydentist & Dr. Gordon Barfield, Senior Clinical Manager at Overjet discuss: What a clinician-first diagnostic strategy looks like The dental regulatory & clinical environment in the UK Advice for clinical leaders evaluating AI in dentistry Much more To learn more about Overjet AI you can visit https://www.overjet.com/ and book a demo or connect with Dr. Barfield on Linkedin - https://www.linkedin.com/in/gordon-barfield-dds-ms-676a9516/ To learn more about mydentist you can visit https://www.mydentist.co.uk/ or connect with Dr. Whitley on Linkedin - https://www.linkedin.com/in/nyree-whitley-2a85b85a/  Subscribe to our channel for more episodes and stay updated on the latest DSO news, insights, and events! If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes https://apple.co/2Nejsfa and a Thumbs Up on YouTube.  

Check out our new Dental AI Receptionist! It schedules better than humans: https://hubs.la/Q042tN1N0

Join dental entrepreneurs George Hariri, Matt Guarino, and Matt Ford as they break down the realities of running their national DSO, Shared Practices Group. They tackle the triumphs and tribulations of scaling a business, answer your burning questions (submit yours at bdppod.com), and delve into life's other adventures - from health and parenting to sports and politics. It's business, banter, and everything in between. Tune in and join the BDP community today!

Joining the DWD team in this podcast is LaVonne Keal a consultant and business coach with Keal Consulting. The team discusses how a dentist can prepare for the options avaialbe for partnerships and how a DSO can be an option.

Jonathan Tyroch and Joe Fox are joined by Jake Berry, Chief Development Officer, as well as Omar Jaroun, Vice President of Business Development, for a roundtable conversation on what's changing in the dental space and what dentists can expect heading into 2026. The group breaks down what they're hearing from thousands of doctors across the country, and why the DSO landscape is shifting again. The episode also discusses what's happening behind the scenes in private equity, why some DSOs are struggling, and what that could mean for dentists considering a transition. Insightful and easy to follow throughout, this episode offers a look at the current dental market and the trends shaping what partnership will look like in the years ahead. ------------------------------------------------------------------------  Subscribe & Listen: Spotify: https://open.spotify.com/show/69Dz26hgC9D6YqwN8JMDBV Apple Podcast: https://podcasts.apple.com/us/podcast/mb2-underground/id1747349567 ---------------------------------------------------------------------- Follow MB2 Dental on Social: MB2 Dental: mb2dental.com Instagram: instagram.com/mb2dental Facebook: facebook.com/mb2dental YouTube: youtube.com/@mb2dental LinkedIn: linkedin.com/mb2-dental

Casey Hiers and Jarrod Bridgeman tackle the growing influence of Dental Service Organizations (DSOs), specifically their aggressive new recruiting tactics. From signing bonuses offered directly on hygiene school campuses to the shrinking talent pool for private practices, Casey and Jarrod discuss what this means for your hiring strategy.Beyond staffing, the conversation shifts to the critical "Clinical vs. Business" divide, highlighting how even the most skilled clinicians often struggle to master the complexities of practice ownership. Casey and Jarrod explore the hidden leaks—such as poor tax management and unoptimized insurance adjustments—that cause high-production practices to leave significant income on the table.Upcoming Tour Dates: Go to our EVENTS page for infoFacebook: Four Quadrants AdvisoryInstagram: @fourquadrantsadvisoryLinkedIn: Four Quadrants Advisory

Thanks to our Partners, Pico Technology and AutelWatch Full Video EpisodeMatt answers listener emails about oscilloscope aliasing—what it is, whether all scopes can do it, and how it can trick you into diagnosing failures that aren't real. Using a “pegboard and golf tees” mental model, he explains how a digital storage oscilloscope samples voltage, stores it in memory, and then reconstructs what you see on-screen. The key takeaway: aliasing isn't magic, it's math—specifically the relationship between sample rate, timebase, and memory buffer. He also explains why some scopes (especially Snap-on) behave differently than Pico-style workflows, and how misunderstanding that screen-to-buffer relationship can create fake-looking “dropouts.”Who This Episode Is ForAnyone using a handheld/PC-based automotive DSO (Pico, Snap-on, Autel, etc.)Techs chasing intermittent cutouts, crank/cam dropouts, injector events, CAN glitchesAnyone who has ever said: “The waveform looked wrong… but the fix didn't fix it.”Key Topics CoveredWhat aliasing is (in plain language): the scope fails to accurately reconstruct the waveform you're testing.Can all oscilloscopes alias? The spicy answer is yes, they all can—especially digital scopes—depending on setup and limitations.Analog vs. digital (audio analogy): Digital sampling is like digital audio—there are “samples,” and reconstruction depends on how well you capture the real signal.The “pegboard model” for DSO operation: Up/down holes = voltage levels (vertical resolution). Left/right holes = time positions (sample points in memory). The scope measures voltage, then “plants a peg” in memory and connects the dots.Vertical resolution vs. time performance: 8-bit can look stair-steppy. 12/16-bit improves vertical accuracy. But most real-world failures come from time-domain limitations (sample rate + memory dynamics)Sample rate vs. buffer size (why scopes “fall apart”): Put too little time on screen → not enough samples to define the signal. Put too much time on screen → scope rejects/skips samples because the buffer can't hold it all. Either way: the displayed waveform can become fiction.How aliasing creates “phantom dropouts”: Gaps that look like crank sensor dropouts or reluctor issues. Can send you straight into the diagnostic swampWhy Pico changed the game: Early Pico automotive scopes stood out because they brought big memory buffers to real shop problems. Capture longer events accurately, then zoom in for detailSnap-on screen/buffer behavior is different (and people get burned): Snap-on scope often shows a “window” into a buffer (buffer bar flying across). You don't “zoom in like Pico”; you effectively set detail first, capture the event, then zoom out to find it and return to your detail level. Misunderstanding this is a common cause of “dropouts” that are really aliasing/misuseThe Big TakeawaysAliasing can make a good tech chase a bad story.The waveform on-screen is an interpretation, not a photograph.Know your scope's strengths: Some are built for speed, some for memory, some for both—but your settings decide your fate.If you're hunting an intermittent: Your success depends on matching: expected event speed, sample rate, memory depth, the scope's display/buffer behavior.Practical “In-the-Bay” TipsIf the trace shows perfectly suspicious gaps: question your timebase, question your effective sample rate, verify with a different capture strategy (less time on screen, more sample rate, different scope mode)Don't trust a dropout unless: it repeats consistently under the same conditions, and you can capture it without stretching timebase beyond what your scope can support.Learn...

In this episode of The Orthopreneurs Podcast, I sit down with Dr. Ben Samuelson—an orthodontist and co-founder of PDOA (Pediatric Dental & Orthodontic Associates)—who's quietly built a multi-practice model across Alabama that's giving OSOs a serious run for their money. We get real about the challenges of growth, retaining top-tier team members, and how building your own collaborative group of practices can unlock career advancement, culture control, and long-term freedom—without sacrificing your autonomy.Ben shares how he and his pediatric dentistry partners co-branded multiple practices under one umbrella, developed scalable systems using EOS (Entrepreneurial Operating System), and turned what used to be cookie-basket-level marketing into a patient magnet powered by smart, integrated operations. Whether you're feeling stuck at $1.5M/year or wondering how to grow while keeping your sanity, this episode is packed with honest insights and proven strategies you can actually use.Quotes“When I was by myself in my little practice... your ceiling's pretty low. Now I can give my team real growth paths and comp packages that actually reward performance.” — Dr. Ben Samuelson“You can treat more people, better, with fewer mistakes, if you build systems around your vision. That's what EOS gave us.” — Dr. Ben SamuelsonKey TakeawaysIntro (00:00)Ben's Origin Story (01:02)The Truth About Scaling (03:01)Recruiting High-Quality Team Members (04:30)Tools That Helped Build the Foundation (06:10)The Biggest Challenge: People (10:29)Covering Clinical Blind Spots (14:39).Marketing Without Cookie Baskets (16:27)Prophy-Prophy Reality Check (19:19)Secret to More Adult Starts (20:56)Additional ResourcesBen Samuelson proves that building a collaborative, multi-practice model doesn't require giving up autonomy, selling to a DSO, or losing your identity. If you've hit a wall in your private practice—or you're just ready for more—this episode is your blueprint. Whether you're curious about EOS, co-branded models, or finding your first great partner, you'll leave this conversation with clarity and confidence.Need to get in contact with Ben?Samuelsonorthodontics@gmail.com https://www.samuelsonorthodontics.com - For more information, visit: https://orthopreneurs.com/- Join our FREE Facebook group here: https://www.facebook.com/groups/

Join dental entrepreneurs George Hariri, Matt Guarino, and Matt Ford as they break down the realities of running their national DSO, Shared Practices Group. They tackle the triumphs and tribulations of scaling a business, answer your burning questions (submit yours at bdppod.com), and delve into life's other adventures - from health and parenting to sports and politics. It's business, banter, and everything in between. Tune in and join the BDP community today!

In this episode of the Group Function podcast, host Alan Mead sits down with Dr. Alex Kantor and Dr. Eric Applesies from the Just a Couple of Dentists podcast to unpack the "regular ass dentist" experience of buying, starting, running and selling dental practices! Fresh off their presentation at the 2026 Voices of Dentistry conference, the Eric and Alex (a married couple of dentists) dive into the logistics of optimizing a practice for sale, emphasizing that maximum value is built in the 18 to 24 months before a transition by tightening systems and improving hygiene "show rates." The conversation balances technical advice on EBITDA and overhead reduction with a candid—and occasionally spicy—critique of the post-COVID hygiene labor market, ultimately highlighting how dentists can prepare their businesses for a successful handoff to either a private buyer or a DSO. In their session and conversation with Alan, Dr. Alex Cantor and Dr. Eric Applesies highlighted several key levers to pull when prepping a practice for sale. Their core philosophy is that "a dollar saved is $4 to $6 earned" during a valuation. Key Optimization Strategies The 12-to-24-Month Runway: Valuations are typically based on the last 12 months of profit (EBITDA). To ensure your systems are fully "flushed out" and consistent, start implementing changes 18 to 24 months before you intend to sell. Hygiene "Show Rates": Increasing your show rate from 70% to 90% is considered "low-hanging fruit." Because hygiene has low variable costs (mostly just prophy paste and floss), nearly every dollar of a kept hygiene appointment goes directly to the bottom line, which is then multiplied during a sale. Aggressive Appointment Confirmation: Use automated texts to keep appointments top-of-mind. The "48-Hour Rule": If a patient hasn't confirmed 48 hours out, inform them they will be removed from the schedule. Follow Through: Actually remove unconfirmed patients to give your team two days to fill the spot with someone who wants to be there. Overhead Reduction (The "Spend" Side): Supplies: Move away from the "old school" model of buying through a single rep who brings donuts. Use platforms like Crazy Dental or Net 32 to treat supplies as a commodity and secure the lowest price. Labs: Look for efficiency gains through model-less workflows and digital scanning, which can reduce lab fees and turnaround times. Clinical Extraction: If you want to retire immediately after the sale, stop working clinically one year prior. This proves to a buyer (especially a DSO) that the practice's revenue is sustained by systems and associates, not just your individual production. Know Your "Game": Private Buyer: Better if you want a quick exit (6–12 months) and have a smaller practice. DSO Buyer: Better for high-revenue practices ($5M+ range), but usually requires you to stay on for several years as an associate. Some links from the show: Just A Couple of Dentists Podcast Join the Very Dental Facebook Group using one of these passwords: Timmerman, Paul, Bioclear, Hornbrook, Gary, McWethy, Papa Randy, or Lipscomb!  The Very Dental Podcast network is and will remain free to download. If you'd like to support the shows you love at Very Dental then show a little love to the people that support us! I'm a big fan of the Bioclear Method! I think you should give it a try and I've got a great offer to help you get on board! Use the exclusive Very Dental Podcast code VERYDENTAL8TON for 15% OFF your total Bioclear purchase, including Core Anterior and Posterior Four day courses, Black Triangle Certification, and all Bioclear products. Are you a practice owner who feels like the bottleneck in your own business? If you're tired of being the hardest-working person in your office, I've got something you need to hear. Dr. Paul Etchison, is hosting a virtual event that is a total game-changer. Paul is honestly one of the most brilliant minds in dental leadership today, and he's hosting the 3-Day Freedom Practice Workshop from February 19th through the 21st. He's going to show you exactly how to break through that two-million-dollar revenue ceiling while actually compressing your clinical week. It's about building a leadership team that takes ownership so you can finally step into the CEO role you deserve. Head over to DentalPracticeHeroes.com/freedom to grab your spot. And do me a favor—mention the Very Dental podcast when you sign up. It's 100% guaranteed, so you've got nothing to lose but the stress. Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code "VERYSHIP" you'll get free shipping on your order! Go save yourself some money and support the show all at the same time! The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even  their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!  

In this episode, Faraz Edalatpajouh, DDS, CEO of Clark St. Dental Partners, shares how his organization is adapting to rising costs, regulatory changes in California, and shifting payer mixes while continuing to grow. He also discusses the role of AI in dentistry, DSO challenges in a high interest rate environment, and the leadership skills needed for long term success.

Join dental entrepreneurs George Hariri, Matt Guarino, and Matt Ford as they break down the realities of running their national DSO, Shared Practices Group. They tackle the triumphs and tribulations of scaling a business, answer your burning questions (submit yours at bdppod.com), and delve into life's other adventures - from health and parenting to sports and politics. It's business, banter, and everything in between. Tune in and join the BDP community today!

30 Jan 2026. New influencer rules come into force tomorrow (January 31) and they could change how the entire advertising industry operates. Georgia Tolley has been finding out what it means for creators and brands. Plus, Big Tech earnings are in - Apple, Meta, Microsoft and Tesla give fresh signals on AI and profits. And with major expansion plans announced across DIFC, DSO and D3, CRC’s Ben Bargh and Dubai Holding Real Estate unpack what it means for Dubai’s office market.See omnystudio.com/listener for privacy information.

Kiera is joined by Dr. Paul Etchison to talk about changing the mindset of turnover = failure. This transition is part of the evolution of leadership. Both Kiera and Dr. Etchison share their own experiences in remaining true to core values, and keeping their definitions of success separate from whether a team member stuck around or not. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:00) Hello, Dental A Team listeners. This is Kiera and today is an extra special day. I have one of my faves and every time we podcast, people say, you two just seem like you love each other so much. And I really do. I've been to this man's practice. We've been friends in the industry for I don't even know how many years pre-COVID. That's a long time. And we've been on each other's podcasts a lot. He has an incredible podcast. He's an incredible human, incredible friend, incredible mentor. I got the one and only Paul Etchison on the podcast today. Welcome. How are you today, Paul?   Paul Etchison (00:28) Hey, I'm good. And I was just thinking about how you mentioned like the pre-COVID thing. You texted me a picture of when you came into my practice for two days. And it was like before COVID. And what was funny about it, and I don't know if it's funny or not, but like I looked at it and half of my team has turned over. They're all new people. So I know. ⁓   Kiera Dent (00:36) cute.   Mm-hmm.   It's real life, Paul. That's real life. It is funny and isn't because I go back and I used to   be embarrassed about that. So let's just kind of highlight on that. I used to actually be very embarrassed of like, my gosh, I don't have senior team members. And like, I hate the question. There was a hot minute. The Dental A Team felt like I was Johnny Depp in the middle of the ocean and my boat was full blown on fire. And I was like, I just hope another one shows up soon. Like I hope something comes. ⁓   And then I realized that's business ownership. Like that's real life. And yes, we built these great cultures, but you outgrow team members and team members outgrow you in life circumstances. And I'd rather be honest and real rather than perfect. And so the fact that like teams shift in a lot, mean, shoot, I used to have this vision board, Paul, you want to hear how ridiculous this was? And I took the team and I put them in the one year, the three year, the 10, and I just had this like same team follow with me. That lasted me for like six months. And I was like, rip this thing up.   Paul Etchison (01:31) Yes.   You   Kiera Dent (01:40) It's   gotten better, it's stabilized, but I think that that's real life. So thanks for talking about it.   Paul Etchison (01:44) It's hard,   yeah, I mean, we look at it and I think like the beginning of my practice career, I had very little turnover, but it was, I had to put so much into keeping that. Like it was such a hard thing to keep going. there was a lot of team members that I kept and I was able to make them happy and I was able to have it be a productive relationship and they were good at the practice. But sometimes I look back on it I'm like, man, it was just, that was a lot of energy I put into one person. I should have just moved on.   So that's how I practice now. It's different. There's a little bit more turnover and I think that's normal and that's part of business ownership. So we're okay.   Kiera Dent (02:16) What changed in your mindset for that? I have so many questions for you today. You guys, Paul and I, when we get on the podcast, it really is just like a free for all. And Paul has no clue. I have a full plan of what I'm asking you today, ⁓ but it's going to be a free for all rift of business ownership of teams. How did you change that perspective? Because I think so many people chalk that up to, I'm a failure of a boss if I've got turnover. Like I had a doctor the other day on a coaching call and she's like, Kiera,   Paul Etchison (02:19) Yeah.   Kiera Dent (02:42) What am I going to do for PR? Like I've got people turning over and how do I PR this? So anything is twofold. One, how did you get like mentally change that mindset? Cause I think it's a big mental game.   Paul Etchison (02:54) Yeah, for me, was everything that I've done in my career as far as like leadership growth and stuff, I think has always stemmed from some period of just struggle and burnout to some extent. It was like, I got to the point where I was taking everything that happened at the practice personally, every upset person at upset employees, they're bothered about something. They're they always, I mean, they're telling you how you should be doing things that not realizing that there's very complicated solutions. And sometimes there's not perfect solutions. A lot of times there's   perfect solutions. So I think what changed for me is I started looking at it from a point of my mental sanity saying I can't attribute my feelings on the happiness of all these team members anymore.   And all I need to do is just be very clear on what I want, be very consistent with the way that I treat them and hold them to that standard. But ultimately, I'm putting the ball in their court. It's up to them. And if they want to play ball, cool. If they don't, that's cool too. We can still be friends and you can go to some other office where it's more to your liking. But the biggest change for me was just realizing I can't be everything to everybody. And I did it for a long time and it was really exhausting. And I worked through that and I feel a lot better   it.   I think my team   is better for it.   Kiera Dent (04:08) Yeah, no, I don't disagree. And I'm glad you talked about that. It's been fun. think Paul, you felt like, I don't know, a big brother to me when we met and I came out to your practice and the fun things we've been able to do together and just the differences. ⁓ I think as we've grown up in the industry together, but I, I admired that because I always thought you had this amazing team. And I think to hear your version and then my version at the same time was very similar. I just realized like,   We got a killer team. Like this is an amazing company. And I think when I evolved to you're so lucky to work here, you're so like not in an egotistical way, but I think in a confidence way of like, this is a great place and we're going to attract people. I started realizing like I had confidence to make offers of what we actually wanted to pay versus what I felt like I had to chase to get people to be here. ⁓ we pivoted and I used to like chase all the time and try to be everything for everybody. And then I'm like,   Why am I doing this? Kiera, like you have built a company and a culture and a space that people love. And yes, there are changes and I will continue on forever evolve. I don't think that we're a perfectly set company, but I think that we're a pretty great, awesome place to work. And I think when I became centered, confident in me and what I was providing in the culture without having to be everything, I noticed I actually attracted a way different type of employee. I attracted somebody who wanted that same style. They, it,   It was like no more like games. think in like compensation and all this, it was more just centered. It was like, this is what we do and this is who we are and I want great people. And I also think it was very much attributed to like, got dialed in on core values. And I was like, I'm sticking to these. These are like rock solid. do not deviate from that. And if you don't fit. Fantastic. There is another opportunity, like go find your dream place and we're going to find our dream team member. And I say that in a very like confident, hopefully not egotistical. And I think you, sounds like you did a similar thing, but I.   I will say, I think you go through a space of realizing you're not a failure. It's an evolution. I think of, of leadership. It's almost like going from, I don't want to say immature. It's more like children and how's they grow. Like, I don't think a little baby is a failure for having that knowledge and that mindset. And I think some of us, are toddler baby owners. Like we've never done this before. We don't know. So we're going to have a different mindset. And then you just start to morph and evolve just like   Children grow up and they morph and evolve into these teenagers, into these college students, into like the prime of their life. To me, that also feels like a maturity of leadership as well to being confident with that.   Paul Etchison (06:42) Yeah,   I love that you point that out too, because we do, we hear a lot of complaints from our team members and then we start to, it starts to add up and then we start to really doubt.   Did we really create a great work environment? I mean, we just had an all day meeting maybe about two months ago, maybe six weeks ago,   like that. And one of the questions I asked, we use this thing called Slido. It's just in real time, you put on a PowerPoint slide and everybody can vote on their phone. There's a million like programs that do this. But I asked the whole team anonymously on a scale of one to 10, how fun is it to work at Nelson Ridge Family Dental? And I was terrified to throw that   Kiera Dent (07:03) Thank   Paul Etchison (07:19) there. I had no idea what people were going to say.   Kiera Dent (07:20) I don't blame you.   Paul Etchison (07:22) It was everybody was like eight, nine. There was like three or four sixes. Now I have 30 something team members.   So the   Kiera Dent (07:29) Yeah.   Paul Etchison (07:30) of it was very good, but it was, it was scary.   if you would have asked me what I thought it was going to   Kiera Dent (07:35) Mm-hmm. Mm-hmm.   Paul Etchison (07:37) I did not think it was going to be that good because the squeaky wheel gets the grease. This, you know, that's what we hear. That's what we focus on. And it reminds me of this one coaching client I had, cause I coached dentists as well. had a coach coaching client named Isaac and he did very similar to you.   choir practice, he really got deep into the foundational core values of this is what the practice is. And   turned over his entire team and he said, I feel like such a failure. I feel like everybody's leaving. I feel like I'm just turning everybody off. Patients are coming in and asking where everybody is. I just don't think my leadership's good. And I told him, just hang through,   Hang, you'll find your people. And then six months later, he was like, I cannot tell you how much I love my team. And so I think the message of what you and I are saying, Kiera, is that no matter   Kiera Dent (08:12) Mm-hmm. Mm-hmm.   Right.   Paul Etchison (08:22) what you want to do with what kind of vision you have for your practice, your team's out there. They are there. They are waiting for someone to take charge and just make it a big deal that that's the type of people we have at this practice.   Kiera Dent (08:26) Mm-hmm.   Paul Etchison (08:33) So if anyone's listening thinking like, have this issue at my office, get those core values out, talk to the team about it. Don't just like leave it on a document, bring it up with ⁓ a meeting and say, guys, this is what I truly want.   And sometimes apologize. I'm   I haven't been holding everyone to the highest regard or the highest standard, but I'm ready to do it and I need your help. So I love that you brought up those two points. Those are amazing things and I think everybody struggles with that.   Kiera Dent (08:55) Yeah.   I think, and I think that that's something that I feel you and I both strive to do is tell people feel like they're not alone. I think so many doctors feel like I'm the only one out there. I'm the only one who can't keep my team there. I'm the only one who has team turnover. And like, this is not the path that we were even on my radar to head, but I think it's obviously the most important path for people to hear. ⁓ I think Paul, it's the no judgment. It's the hang through it. It's, ⁓ having a guide, a mentor who's been there, done that, done that successfully. I mean, you and I can both like,   Gosh, you like grit through that and it's painful. But I also believe that while yes, painful, I feel it's an evolution of soul that you actually internally are craving. I don't believe that we rise to the call until we're ready. Like Kieran 2020, when I'm sitting on Johnny Depp like boat in the ocean, it was on fire. I was not ready for the call and the evolution that came in 2024 for me.   Like I just, wasn't ready for it, but come 2024. And I think it's a, it's a shedding, it's a shifting. It's a, like, I call it like the skin sloughing. Like it's like a snake, like you're leaving it behind. It's, I watched penguins when I was in Antarctica, like small flex there, Paul. Like the Antarctica trip was pretty rad. And we watched it. Right? We went to Antarctica. Penguins are so cute and they smell terrible. Like they're like little ketchup bottles that just squirt poop all day long. And it's disgusting.   Paul Etchison (10:11) I was just going to follow up on that. Whoa.   Kiera Dent (10:25) but they were molting when we were there and they just looked absolutely miserable. Like they sat there and they told us like, please don't touch the penguins. like, these look just, they're like, it's very painful for them. They're having to completely molt off all of these feathers. And I think that that's how I feel a lot of business owners are like, are you going through that molting process? But again, just like those penguins, just like us, I really do believe that when we're ready to be called to that higher level, one, you're not alone, two, you don't have to go through it alone.   Three, it's normal and it's part of growth, but like, there's also, you don't have to grow until you actually want to. Like, it sounds like Isaac was just ready. Like, I'm ready, I'm done. Like, I've hit my limit. I was ready, I was done. I was like, we are having a complete culture shift. Like, we're done and like, it needs to evolve. Sounds like you had it. But I also feel, and I don't know how you feel, Kieran 2020, Kieran 2024, even into 2025, leadership culture company.   keeps evolving. don't feel like I have as many of those like huge molting in 2020, huge molting in 2024, 2025. It's more of a shift in a refinement rather than a full molt. But that's, think how, at least for me, that's how I think I view leadership is.   Paul Etchison (11:37) Yeah, totally agree. It's like we go through these stages of leadership growth. And I remember for me, like leadership all the way up to COVID was like system, system, systems, consistency with team. And my team grew to like 35, 40 people and it got really unmanageable. And then when we came back from COVID from being shut down, I really wanted to try to do something different. And I wanted to keep that. ⁓   I just loved when we were shut down for COVID. I loved how it felt. It felt easy. And I said, I want that, but I don't want that craziness when we open up again. And when I did, I started to feel that same craziness. And I was going to therapy at the time. And like the therapist will tell you, just change your expectations. Don't take everything personally. And what I learned through that is there's no amount of therapy that can   broken leadership   Is that I had systems, I had consistency, but my team   had outgrown those systems. We needed more systems of leadership. So the next stage in my leadership was learning how to lead leaders and truly delegate and truly give them the autonomy to do everything. And when we did that, everything got so much better. there was parts of me that was like, I'm not the right person for this level of organization. not the right person for this size of a dental office. I'm just too anxious. I take   Kiera Dent (12:41) Mm-hmm.   Paul Etchison (12:59) too personally. And ultimately, I think it was just I   Kiera Dent (12:59) you   Paul Etchison (13:02) set up, I didn't set up my organization the proper way. So that was the next level up for me. And I think that's me shedding my skin finally once and for all to learn how to lead leaders. And who knows what's   Kiera Dent (13:14) Paul, I think that you are actually a really good example of letting go of control. How do you do that? Like,   I remember talking to you one day, this is offline, hopefully I'm not oversharing. And you're like, a lot of people say, like, what are you going to do if you retire? And I know you sold your practice to a DSO and you're like, I've never looked back. Like it was great. Um, you're like, I'm actually the person who's okay to just like sleep in and do nothing. Like I really am okay with that. Like, how did you let go of that control with your team? Um, knowing that they weren't going to do it exactly like you, like, I think people have this in theory. They try to do it, but.   Paul Etchison (13:23) No, of course not.   Kiera Dent (13:49) Like that's another molting. That's another really hard gap to go from full control. You're in charge of everything to I'm stressed out. Now I'm going to let team members take over and maybe you're, maybe you're an anomaly, maybe you're a unicorn, but how did you do it?   Paul Etchison (13:59) Yeah.   I think it's like we talked about the growth, but I think where we screw up as practice owners when we do this is we get upset that the team members are not doing exactly the way that we would do it. And there needs to be some wiggle room. There needs to be a lot of forgiveness. But ultimately, there's got to be clarity. And not enough practice owners are having the conversations with their team members. Like I always say, like, I'm coaching dentists all the time, and they're telling me about these issues they're having at their practice. And I'm saying, well, why do you think that is? And the answer is like, well, it might be this.   kind of think it's this and it's like, well, get curious, ask, ask your team. So for me, it was about telling my team what's expected and when   Kiera Dent (14:36) Mm-hmm.   Paul Etchison (14:42) didn't meet expectations, instead of like dancing around it, just going right at the   getting curious, what is going on with this? What is, why is this not happening? And then always like, you know, if you ask the right questions, the next step for any leadership, any leader is to validate their perspective.   no matter what it is and that will go so far. If you take one thing out of this podcast, do that. When your team members share something with you or if you're getting curious, asking them why things are happening, how they're feeling about something, validate their experience and watch how much they open up and they're.   open to behavior change and other options. And then that allows you the opportunity to then ask and invite participation in the solutions. What do you think we should do?   I noticed our cancellations are getting up there. Like, what are we doing about this?   What do you see happening? Getting curious. And they're saying, well, I don't know. Like, I got to ask some more   OK. And then validate their experience. I totally see how maybe you got busy with your other things and you haven't been asking your team. But we've got to ask the team and find out just so many little things.   For me, was getting out of the way, being clear with expectations. But then instead of trying to go around my leads and my leaders, my practice and go around them and deal with the other other teams myself, I let them do it and I let them fail and I help them and I support them.   And I think I know there's a lot of like team members that listen to your podcast, Kiera. I would hope if you're listening to this and you're team member, I would hope you understand how valuable you are to an owner. If you can take things, find solutions and hold your, your team members, your fellow coworkers to a certain standard, like you would be so valuable. Everyone's like, well, how can I get a raise? How can I contribute more value? I would people on my team, my leaders that do this for me, they are so valuable to me and every owner.   is just waiting for somebody to step in and fill that role. I mean, every practice could use   Kiera Dent (16:38) team members, their number one objective is to make their doctor happy.   every day, all day. That's like what my job is. That's what I want to do. That's how I want to serve. That's how I want to help out. ⁓ And I think as owners, I think it can be easy to see all the problems in your team. But I think it's what pair of sunglasses do I want to put on? Do I want to put on the one where I see like, what's wrong is just as available as what's right. Both are always available in every single scenario, every single situation. And so what are we bringing to the table and how are we looking at these different things?   How are we guiding our teams? How are we guiding our leaders? How are we showing up as leaders? How are we like, what is the filter I'm putting on every single day? Like those, those two sunglasses are right there as you walk out the door and which pair are you choosing to put on? Cause you're going to influence impact and create a team. No matter what we see what we want to see. And I believe that we create our own realities. I believe that reality is what we believe it is. And so, ⁓ I think shifting that seeing that, and I think having just a bigger plan, a bigger vision. know when I got very crystal clear of where am I headed?   What is my role? Like, this is gonna sound funny, Paul. I literally Googled like, what does a CEO do? I think doctors come out of school, like you're a doctor, like you do the dentistry, like that's what I'm supposed to do. And I remember one day I was sitting there and I'm like, what is the CEO even supposed to do? Like, I don't even know, like, like really, like where is a CEO, like dictionary, like job description, I realized, got it. It's profit, vision, and culture. Like those are really my main things. Stay out of the weeds and like go for it. And...   Paul Etchison (17:43) you   Kiera Dent (18:04) That's what I'm bred to do. Bring the great ideas, bring those different pieces. That's my job. That's my responsibility. I think dentists also have the second tier of you do dentistry too. So you are a clinician in there and then you have those pieces. But driving culture, driving a culture of accountability of fail, fail forward. like, gosh, I just read this really awesome book and they said, we measure it by outcomes, not activity.   Like just stuff like that. Like you start to become this person who wants to evolve your culture, evolve who your team is, evolve who you are as a person. And I think Paul, even in just knowing you, I think there's been an evolution of who you are as well. ⁓ I think that is just, and hopefully I've evolved too, like fingers crossed there's been an evolution and I'm not as quite, I don't know. I think we keep the best of ourselves. And then I think just evolve into our 2.0, 3.0, 4.0 levels. I guess I just asked the questions of   Paul Etchison (18:42) Absolutely.   Kiera Dent (18:58) I think you've got a fascinating story. You were full, full practice owner. You were in there. You sold out to a DSO. You're still in your practice. You still train. You, you've evolved. If you were sitting back when I met you, what would you tell that Paul of what you know today that would have made that whole experience, whether you're selling, whether you're growing, evolving. I mean, you have a very large practice. It's been real fun to watch you and your practice and everything. What would you have told that Paul?   Paul Etchison (19:27) Yeah, and this comes up a lot with my coaching clients. A lot of people ask me that. And one of the things, if we're looking at our practice, and I'm going back to the beginning, is if we want to sell our practice, if we want to cut back our days, if we want to have the most profitable practice ever, a lot of the times the strategy is identical. We're just trying to go through and create more freedom for ourselves as practice owners by empowering our team, getting them to do a lot of the responsibility.   Kiera Dent (19:48) Mm-hmm.   Paul Etchison (19:57) to be accountable for a lot of the stuff. So I think if I could go back and tell myself again, man, first of all, just stop taking everything so personal. And you come in and you look at it with these different lens of leadership and maturity and all these leadership skills. It's not just at the practice. It shows up in your relationships with your spouse, with your friends, with your kids, like all these things. Like it's all intertwined. But I would have much earlier got the leaders going in my practice because one of the things   Kiera Dent (20:16) Mm-hmm. Mm-hmm.   Paul Etchison (20:27) happen through my practice sale is I just like I mentioned I felt like it wasn't I'm not cut out for this I'm sick of being miserable I'm sick of being stressed I'm sick of taking it home and I'm sick of taking it out on people that I love and so when I sold it I said okay I'm on my three-year exit plan I'm getting out of here I'm moving on I don't know what I'm gonna do but I'm gonna move on so I said you know my associate partner Dr. Kathy she owns part of the practice too   I'm gonna pass it to her and maybe she won't be able to do it as well as me. But I need to set this up so she is just, I wanna bless her with this amazing practice that runs on its own. And in the process of setting that up with my leaders, I realized, dang, I don't know if I would have sold. And I'm still happy I sold, don't get me wrong. I'm not saying I would have, but that's what I would have tried to do early in my career. I would have went, who are the leaders? ⁓ The whole thing with like the Dan Kennedy of the who, not how. Not how do we do it, but who's gonna do this?   Kiera Dent (21:11) Mm-hmm, mm-hmm, mm-hmm.   Right.   Paul Etchison (21:25) And I would have leaned into that a lot more because I think I would have been a lot happier. I would have been able to enjoy the journey more. But at the same time, it's like we learn from our mistakes and you got to make the mistakes to learn from. So it's like, so that whole Catch-22, would I change anything? I don't think so because I wouldn't be, if I didn't have the same experience, I wouldn't be the person I am today. But man, I wish I had learned it earlier. That's for sure.   Kiera Dent (21:45) Sure.   It's fair. And I'm actually happy to hear that because I feel like this is like the DSO conundrum and like the cell. And I'm happy to hear you say that because it validates what we try to coach on to. So many doctors are like, I'm just going to sell. And I'm like, well, let's just look at this. If you sell, let's look at what your life will look like on the other side of it. Let's look to see where you are today. And really, let's get to the root of why do you want to sell? And I think, Paula, if we would have asked you that same question.   Why did you wanna sell? My hunch is it was all these problems, all these issues. It was just like, I'm sick of it. Like, let's just pass this on. Let's move on. When a great leader, a great office manager, a CEO, a CFO could have easily come in, taken over for you. You could have had the exact same scenario. You just would have owned it and had more options on the table. Like you said, it's not right, it's not wrong. But I think like for everybody listening, I think today is a good reflection of one, are you going through a molt? Like, are we molting anywhere?   ⁓ and do we, or do we need to molt? Like, is there something we need to shed, let go of identity wise? And then two, I like to do this reflection a lot. And I encourage a lot of people to do it. It sounds like Paul, you do it. Like when we're in these issues in these problems, are we stopping and pausing and asking like, what is the root? Not the symptom, the top line symptom is like, I'm so stressed. And I got this and this and this, but like, do we ever stop and pause to dig to that route and find out   what is really at the root. For me, I often have many journals that are like this, this, this, and I just like list it all out of all these things are frustrating me. But what I'm trying to do is find what is a thread? What is the piece in that that's causing the chaos because then we go fix that. And that's what I love in practices because 99 % of the time what people tell you on the top line, so coaching offices, coaching doctors, coaching teams, like Paul, you know this, I know this. What people tell you at the top is not really what's the problem.   It's the bottom layered, there's something rooted, there's something under there. These are just symptoms on the top. Same thing with patients and case acceptance, right? It's the up at the top, what they're telling you is not really what they're feeling. And all you gotta do is just dig under, find out what that root is and stress and that will go away. And so Paul, thank you for, I just am curious. I've always been curious, like, would you have done something differently? Of course we never can, like, no, we're not going to. But if I could go back and tell that younger self things, like,   Kyri, get rid of your ego, honey. Like trust your team, trust that team to do amazing, trust them to do better than you are, trust them to be better than you, trust them to make better decisions than you do, because I want to create that kind of a team and me believing that is going to ultimately turn my team into that. They have the whole study about teachers with kids and IQs and like if they believe that they have a stronger IQ without doing anything different, that child actually ends up with a higher IQ. Well, why don't we take that same principle and apply it to our teams and see what happens.   Paul Etchison (24:23) Yeah.   It's so true. And I love that you say like the reflection that you did, because I noticed this with my coaching   is that there's a lot of, there's a lot of how, how do we do this? How do we fix this? But I think anyone listening, if you just sat down in a dark room, maybe not dark room, but you're sitting down in a quiet room for 30 minutes and you reflect it, what do I really, you know, I do this with my coaching clients. We call it a practice clarity and frustration exercise. What do we, what really bothers you with the practice? What is it that really just, you know, grind your gears,   it down and it sounds simple but once you write it down you can like visually see it and start to brainstorm for solutions and you start to make this progress that not only affects the way your practice runs but the way that you're the way that you feel and I think ultimately as practice owners we need to realize that the CEO hat you mentioned what does a CEO do we need time for that and we don't have time for that when you're doing four or five days of dentistry that's why when I'm working with clients the first thing I'm gonna do with a practice owner is I'm gonna get them down to three days clinic   Kiera Dent (25:10) Mm-hmm.   Paul Etchison (25:27) And it always works. so inefficient. There's so many things we can do with scheduling and efficiency and production that we can get you down to three days clinical. But now you've got that extra day to put on that CEO hat, to reflect on the things, to write down and figure out what your plan of attack is. I mean, that's what I've got a workshop coming up in February that that's focused on that. How do we get you down to three days? And that's all I want to do in this three day workshop. We're, of course, doing these reflection activities. But I think this is over the course of my career and working   Kiera Dent (25:27) Mm-hmm.   Paul Etchison (25:57) with people, that's what I've seen moves the needle the most. We need time and we need to give the energy where it's due. And it's not, we   be 100 % clinician. It just doesn't work that way.   Kiera Dent (26:09) Yeah, no, Paul, I love that. And think that's such a fun thing. I think dentists need this. Dentists need to have their vision, have their clarity. But I think from today, the wrap is it started out with a photo, unexpectedly, of this is what we're ⁓ kicking the day off of, going from where we were to where we want to be, ⁓ looking at that, reflecting back, seeing. Because   Paul Etchison (26:23) Yeah. How do we get here?   Kiera Dent (26:34) There's a client that you and I both know. They're pretty well known ⁓ that we work with. whenever I work with, gosh, it's so many practices. I think there's like 300 employees and I'm like, gosh, I remember all their names every time. ⁓ But they talk about how sometimes the best learning is just remembering. Remembering where we've been, remembering where we're going to go, remembering things that we've learned looking there. So it's like remembering where I've been so that way I can kickstart and project into where I need to go.   using your team to get there. Your team wants to be your best asset for that. So Paul, those are kind of my wrap thoughts. I know today has just been a real fun day. Always enjoy a good podcast with you. Any last thoughts you have?   Paul Etchison (27:15) No, you know, I would just close it off with   having the listener just believe, just believe in the possibility of what's going, what is possible with your practice. ⁓ There was a point where we talked about reflection. I reflected and I said, I wrote down everything I do at the practice and I wrote down how many of these activities bring me joy and how many of them I hate. And I believe it was something like 80 % of them I hated. So that's no way to live your practice life. You spend a lot of time at work. So why not do the reflection and put the time and energy into   Kiera Dent (27:38) Mm-hmm.   Paul Etchison (27:45) Making your practice a better place to be at it's not just gonna affect you. It's gonna affect your family. It's gonna affect your team ⁓ There's big your ripples that come from this little thing So I would say sit down find a coach find a mentor read some books it is possible believe in yourself and It all starts with the planning so sit down and write down some things journal love it   Kiera Dent (28:09) Journal it up. Well, Paul, I appreciate you so much.   I ⁓ just love what you're doing for our community. I love the things that we're able to accomplish together. ⁓ And yeah, guys, check him out in Dental Practice Heroes podcast. He's got some great stuff over there as well. ⁓ Paul, so good to have you on the podcast. I think you mentioned the event in February. If people want to know more about that, how do they connect with you on that?   Paul Etchison (28:35) Yeah, go to DentalPracticeHeroes.com slash freedom. So that's where the information on the three day workshop, it's going to   awesome. And I'm doing a money back guarantee. If you don't think you liked it, if you don't like what you signed up for, I'll give you all your money back. I believe in it that much. And I know from me coaching for the past six years, I know this is what produces results. So go check that out,   more about the courses, check out the podcast. And I'm always happy to talk to any listeners if they want some help or they just want to find out what we're more about. Please just go to the website, DentalPracticeHeroes.com.   dot com.   Kiera Dent (29:06) Amazing. Paul, thank you so much for being on the podcast. For all of you listening, I hope you do take the time to reflect. I do hope you think about where you want to go and what you want with your life. And just appreciate you guys all being here. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.  

Join dental entrepreneurs George Hariri, Matt Guarino, and Matt Ford as they break down the realities of running their national DSO, Shared Practices Group. They tackle the triumphs and tribulations of scaling a business, answer your burning questions (submit yours at bdppod.com), and delve into life's other adventures - from health and parenting to sports and politics. It's business, banter, and everything in between. Tune in and join the BDP community today!

Selling your practice can look like a financial win—and still feel like a personal loss if you choose the wrong partner. In this episode, Brian Colao, one of the earliest architects of the DSO legal framework, unpacks what most dentists misunderstand about consolidation, private equity, and the true risks hiding behind "fair value" offers. With nearly three decades advising DSOs and representing more than 780 dental organizations, Brian brings rare clarity to a space filled with noise, fear, and half-truths. If you like this episode, here are more episodes we think you'll enjoy: Ep #571 - When The Practice Doesn't Need You Anymore – Dr. Dylan & Kelsey Everett Ep #550 - Every Dentist Must Master Leadership, Exit Strategies and Burnout – Dr. John Meis Check out the show notes for more information! P.S. Whenever you're ready, here are some other ways I can help fast track you to your Freedom goal (you're closer than you think): 1. Schedule a Call with My Team: If you're tired of running on the hamster wheel, and are looking for a proven blueprint to create more freedom and reduce dependency on your practice income, schedule a call with my team to learn more. 2. Get Your Dentist Retirement Survival Guide: The winds of economic change are here, and now is the time to move to higher ground. This guide gives you the steps to protect your retirement, your family, and your peace of mind. Get the 25-point checklist here. 3. Get Your Free Retirement Scorecard: Benchmark your retirement and wealth-building against hundreds of other practice professionals, and get personalized feedback on your biggest opportunities and leverage points. Click here to take the 3 minute assessment and get your scorecard.

On today's episode, Dr. Mark Costes is joined by Bill Keith and Ben Kacos for an in-depth crash course on DSOs—what they are, how they've evolved, and why every dentist should understand their growing impact on the profession. This conversation dives into the history of dental consolidation, the rise of private equity in the industry, and what those infamous EBITDA multiples really mean for your practice valuation.  The trio compares doctor-to-doctor transitions with DSO sales, laying out the pros, cons, and critical factors like tax strategy, risk mitigation, and personal goals. With real-world insights, valuation math, and clear advice on navigating offers, this is the foundational DSO knowledge every growth-minded dentist needs. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

On today's episode, Dr. Mark Costes sits down with longtime friend and respected dental entrepreneur Tiger Safarov, founder of Zen One. Tiger shares his incredible immigrant journey—from arriving in the U.S. not knowing English to building a thriving dental construction company, and later pivoting to launch a tech platform revolutionizing dental supply management.  They dive into Tiger's inspiration for Zen One, the evolution of the platform from a scrappy startup to a streamlined, AI-powered solution, and his deep commitment to supporting private dental practices in an increasingly DSO-dominated industry. With a strong emphasis on integrity, innovation, and real cost savings, Tiger explains how Zen One empowers practices to take control of their variable expenses and boost profitability without compromising on quality. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://dsn.zenone.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Rising costs don't have to automatically mean less profit. If your supply spend is sitting around 7–8%, this episode will show you how your practice can get group-level pricing and support without selling or partnering with a DSO.Jeff Cellucci of MB2 Dental introduces Carabelli Club as an option for people who want all the benefits of a group without the commitment. That means group-level pricing, vetted vendors, and a simpler way to order everything your practice needs!Topics discussed:How dentistry and the DSO space has changedWhy MB2 Dental's partnership model differs from traditional groupsThe benefits of joining a DPO like MB2 DentalWhat Carabelli Club offers practice ownersHow you can reach 5% supply spend or less“Same-store” growth and why it mattersSign up for Carabelli Club today with code HEROES26 to get 4 FREE MONTHS with your membership! https://www.carabelliclub.com/This episode was produced by Podcast Boutique https://www.podcastboutique.com SET UP A CONSULTATION WITH GARY @ LEGALLY MINE CLICK HERE  Get Free DPH Trainings,  Download the App and Join our Community!  CLICK HERETake Control of Your Practice and Your Life We help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams. Ready to build a practice that works for you? Visit www.DentalPracticeHeroes.com to learn more.

On today's episode, Dr. Mark Costes welcomes Dan Van Eps, Senior Director at Henry Schein Dental Practice Transitions, for an in-depth look at the world of dental practice sales, valuations, and the often misunderstood role of brokers. With nearly three decades of experience in the dental space—including founding a dental IT company and helping scale Carr Healthcare Realty—Dan brings a rare, well-rounded perspective to what makes practices valuable and how dentists can successfully navigate a sale.  From breaking down DSO vs. doctor-to-doctor transactions, to why a $2 million practice isn't always worth what you think, this conversation covers everything from valuation strategy, broker fees, and the critical mistakes sellers make by going it alone. Mark and Dan also discuss trends in consolidation, why the startup market is heating up again, and the real meaning behind that elusive 1% dental loan default rate. This episode is packed with practical advice and insider insights for both buyers and sellers alike. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://dentalpracticetransitions.henryschein.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast