Podcasts about dso

In this episode, Mohamed welcomes back Dr. Kevin Harland, a recent graduate from the OU College of Dentistry, for a candid conversation about the realities of life just two years out of dental school. Dr. Harland shares a powerful personal story about his daughter's health journey, which profoundly reshaped his perspective on his career and life. He then offers invaluable advice for fourth-year dental students, covering everything from tackling board exams and the importance of gaining hands-on clinical experience to the nuances of treatment planning and material selection. Dr. Harland also discusses the benefits of joining a professional study club and shares what motivates him daily as he navigates the challenges and rewards of his growing career. A New Perspective: Dr. Harland opens up about his daughter's recent major surgery and recovery, a life-altering experience that helped him prioritize his family and find a deeper meaning in his work. Board Exam Tips: For fourth-year students, Dr. Harland advises using question banks like Bootcamp for the INBDE and getting comfortable with plastic teeth for the clinical boards, emphasizing that these exams don't define your career. Fourth-Year Focus: He recommends that fourth-year students should start thinking seriously about their desired work environment by shadowing in various practices (DSO, private practice, public health). Clinically, the focus should be on getting comfortable with the handpiece and experimenting with different materials and techniques in the safe environment of the dental school. Clinical Growth: Dr. Harland's biggest areas of growth have been in the efficiency and confidence of his handpiece skills and in the complexities of treatment planning, especially when dealing with difficult cases. Navigating Difficult Conversations: He emphasizes the importance of under-promising and over-delivering, and having honest conversations with patients about the possibility of different treatment outcomes. The Value of Community: Dr. Harland shares his positive experience with a local study club, highlighting the camaraderie and the invaluable access to a collective mind of experienced clinicians. Materials Matter: He discusses his material selection for partial and full crowns, weighing the pros and cons of materials like EMAX, Tetric CAD, and Zirconia based on the clinical situation. Daily Motivation: Dr. Harland finds motivation in providing for his family, the satisfaction of creating excellent restorations, and the positive feedback from patients who recognize his care and dedication. Join the Very Dental Facebook group using the password "Timmerman," Hornbrook" or "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! -- 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 “VERYDENTAL10” you'll get another 10% off 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!    

This episode features Rob Odell, Owner of wpDuo, who shares how dental and DSO leaders can streamline patient acquisition, reduce lead leakage, and build long-term competitive advantages through better systems and strategic thinking.

On today's episode, Dr. Mark Costes is joined live from the Thrive Live event in Las Vegas by Brian Colao, a true authority on DSOs, mergers and acquisitions, and dental law. He shares his unparalleled insights on the current state of the DSO market, explaining how economic uncertainty, stalled private equity deals, and rising costs have created the most unpredictable environment in recent memory.   Brian breaks down why so many transactions are being abandoned, how multiples have changed since the white-hot years of 2021, and what smart dental entrepreneurs can do to position themselves for success despite the turbulence. From DSO formation strategy to picking the right partner, this is a masterclass in understanding what really matters in today's dental consolidation landscape. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://www.dykema.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Gary Bird breaks down the six biggest dental growth myths that are stopping your practice from reaching its potential. 1. “There's not enough new patients in my market.” 2. “Patients only care about insurance.” 3. “Patients can afford tx, but don't prioritize it.” 4. “Marketing doesn't work in my area.” 5. “My team can't handle growth.” 6. “I didn't convert the new patient because they were a shopper.”Connect with our Host, Gary Bird, Here ⤵️SMC: https://smcnational.com/Personal: https://thegarybird.comWant to Master The Business Side of Dental and get free resources?Visit ➡️ https://smcnational.com/dsoacademy*85% of DSO Academy students would recommend it to a friend!➖➖➖➖Dental Marketing Goat, the go-to podcast for dentists who want to grow faster, market smarter and build practices that thrive in today's competitive landscape. Hosted by Gary Bird, the Dental Marketing Goat himself and founder of SMC National - recently named Best Dental Marketing Agency by over 60,000 dental professionals. Each episode unpacks the real strategies, marketing frameworks and operational shifts that high-performing practices use to attract more patients and increase production. Whether you're a solo practitioner or scaling a DSO, you'll learn how to align your marketing, team and systems to drive predictable growth.➡️Want to see how SMC can help you grow?

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, Gary Bird shares essential strategies on how to avoid the summer slump in dental practices. Learn proven dental growth tips, including how to analyze production dips, optimize phone processes, increase patient referrals, and leverage admin training days to boost summer production. Gary also covers how aligner days and strategic dental marketing can help fill schedules and drive new patients during slow months. Summer slowdowns are common in dentistry, but with the right dental practice management strategies, you can maintain growth and profitability. Discover how to plan ahead, prevent revenue dips, and turn the summer season into a growth opportunity for your dental practice. Watch now to learn actionable steps to keep your dental office thriving year-round.Connect with our Host, Gary Bird, Here ⤵️SMC: https://smcnational.com/Personal: https://thegarybird.comWant to Master The Business Side of Dental and get free resources?Visit ➡️ https://smcnational.com/dsoacademy*85% of DSO Academy students would recommend it to a friend!➖➖➖➖Dental Marketing Goat, the go-to podcast for dentists who want to grow faster, market smarter and build practices that thrive in today's competitive landscape. Hosted by Gary Bird, the Dental Marketing Goat himself and founder of SMC National - recently named Best Dental Marketing Agency by over 60,000 dental professionals. Each episode unpacks the real strategies, marketing frameworks and operational shifts that high-performing practices use to attract more patients and increase production. Whether you're a solo practitioner or scaling a DSO, you'll learn how to align your marketing, team and systems to drive predictable growth.➡️Want to see how SMC can help you grow?

We hear that “consistency is key” in a lot of areas of our lives, and dental growth is no exception. But what's difficult is strategizing for consistent growth. In this episode of The Dental Economist Show, host Mike Huffaker sits down with Mick Janness, CEO and Co-Founder of Oakpoint, to explore how his team grew a single practice to over 40 locations through strategic hub-and-spoke specialty care models. Through the conversation, they unpack practical insights on everything from revenue cycle management to maintaining clinical autonomy in a growing organization. Focusing on fundamental execution and patient experience is what takes businesses to the finish line of success, allowing them to find the key in the first place. If you want to grow more, without settling for less, this is the episode for you!

Discover how Dr. Phi Pham rapidly scaled his dental startup by focusing on patient-first care, same-day emergency dentistry, and disciplined team performance. In this episode, we explore the proven strategies behind his 95% phone conversion rate, 600% marketing ROI, and explosive new patient growth. Learn actionable insights on dental practice marketing, case acceptance, and financing that can help any dentist grow faster and smarter.Connect with our Guests Here ⤵️Dr. Phi PhamChief Dentist and Founder of Southern Smiles - RosharonWebsite: https://southernsmilestx.com/Want to Master The Business Side of Dental and get free resources?Visit ➡️ https://smcnational.com/dsoacademy*85% of DSO Academy students would recommend it to a friend!➖➖➖➖Dental Marketing Goat, the go-to podcast for dentists who want to grow faster, market smarter and build practices that thrive in today's competitive landscape. Hosted by Gary Bird, the Dental Marketing Goat himself and founder of SMC National - recently named Best Dental Marketing Agency by over 60,000 dental professionals. Each episode unpacks the real strategies, marketing frameworks and operational shifts that high-performing practices use to attract more patients and increase production. Whether you're a solo practitioner or scaling a DSO, you'll learn how to align your marketing, team and systems to drive predictable growth.➡️Want to see how SMC can help you grow?

Dive deep into the heart of dental excellence with our exclusive interview featuring Steve Craig, a multi-award-winning leader and Solmetex's Director of Special Markets. In this powerhouse episode, Steve unveils the secrets to building high-performing dental teams and revolutionizing your practice with cutting-edge dental water solutions.Discover how to transform your leadership approach, cultivate a culture of growth, and navigate the ever-evolving dental landscape. Steve's 20+ years of DSO and dental industry expertise shines as he shares invaluable insights on team development, practice optimization, and the critical role of water purity in modern dentistry.Learn why water is the #1 instrument in your practice and how Solmetex's comprehensive solutions can elevate your patient care and protect your practice's legacy. Steve's passion for making the complex simple will inspire you to unlock your team's full potential and create a thriving, patient-centric environment. Don't miss this opportunity to gain actionable strategies and ignite your practice's growth!Join us as we explore the future of dental leadership and water innovation with Steve Craig.Connect with Steve Craig or Solmetex:linkedin.com/in/stevecraig20www.solacmetex.comWe a-DOOR-e our listeners! Find out more about The Mint Door:

Kiera and Dana perform a practice autopsy mashup. In this episode, they specifically take a look at multi-location practices, and how to make all of them profitable instead of just one or two. Topics discussed include overhead, associates, marketing, and more. 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 such a special day. I have the one and only Dynamite Dana. I think that that's what we're sticking with. I think it's better than the other nickname that we came up with. But Dana, if you guys know her, you love her. She's been in a consultant with us for years. Dana, welcome to the show today. How are you?   Dana (00:17) Yeah, good morning. Thanks for having me. I'm excited. I don't get much like podcast time with you. It's usually with him. So it's a fun morning for me.   Kiera Dent (00:26) I   know Dana's a rock star. ⁓ I, yes, I can sell a little podcast and yes, that's fun to do, but it's more fun to have someone on here. So I sent Dana a message and I had it like in the afternoon. And then I was like, Ooh, my schedule changed and moved it to like first thing in the morning. So Dana, thanks for being easy to accommodate. but I think that that's you. You're just always there, always willing to help and offices love you for that. So   Dana (00:43) Yeah.   Kiera Dent (00:51) We have a fun topic, you guys. I love a good office autopsy. So Dana and are gonna kind of mash a couple practices together and dig into some practice profitability trends that we're seeing on an office autopsy. You ready for that today, Dana? Because I love these. Anything more than a good profitability story and how to get there, that's what it's about. And I think that that's what so many practices struggle with. They don't understand how to get profitable. They know that it's there. They know that it can be an illusion.   Dana (01:03) Yeah, this is exciting.   Kiera Dent (01:18) They know that it can be a reality for some. so Dana, I feel like some of the practices we've been dealing with lately, it's like actually making it turn into a reality rather than just as hope and a wish. So take it away. I know you've been working on this. I've been working on this. Let's have some fun today.   Dana (01:31) Yeah, it's been really fun the past couple weeks. I've been like able to just do a lot of numbers crunching a lot of future projections a lot of like hey what effort is it gonna take to like get things where we want them to be and it's really fun to give owners like the possibilities of What they currently have or where they want to be and so it's just been really really interesting the last couple weeks getting to do that and getting   Kiera Dent (01:43) you   Dana (02:02) offices to see like where they want to put their energy where they may need to put their energy and so it's just been numbers aren't you know I'm learning to love numbers more and more ⁓   Kiera Dent (02:14) Yes, did you hear that? Dana, did   you start out that way? Let's just let's just help listeners feel like is this a normal thing?   Dana (02:22) No, I mean, I am a systems girl through and through. And so, you know, I know how important the numbers are. And of course, like those are pieces I look at. But really, really being able to manipulate the numbers, to be able to project things, that is something that I've really had to dig into more and more. And it's been fun for sure.   Kiera Dent (02:45) Yeah, and I love the reason I highlight that is because for myself for Dana numbers were not something natural for some people it is just wired into you but I think for 90 % of human beings out there they would feel very similar to how you and I feel and so I just want to highlight that it's totally normal not to understand numbers but it is also normal to figure out how to use numbers and when you do it actually feels like like life becomes so much easier it's like   my gosh, there was an HOV lane this whole time. And I had no clue that there was like a fast pass, fast lane over there that if I would just learn my numbers and dig into it, I would honestly be able to do things a lot better. And so I think like, that's what makes me so excited Dana is this is where we also help practices. Like let's use the numbers to manipulate and actually do less work, more profitability and more ease. So kudos to you for digging in kudos for you, like admitting that systems are your gem, which I think it's easy, right? But to me, I'm like,   systems are only as valuable and only as important as the numbers are reflecting. Like, yes, we should put them in, but I'm like, if we're just putting systems in place, but we're not moving the dial, what does it matter? ⁓ You're going to be struggling. You're going to have financial stress. You're going to be like not happy. Use the numbers to figure out which system's broken and then go to work there. It becomes so much easier and less effort for sure.   Dana (04:02) Yeah, yeah, it's pretty magical to see. So yeah.   Kiera Dent (04:05) Right. All right.   So we have a couple of practices. We've got some that are multi locations. We've got some that are solo locations. And I think we should dig into some of these multi locations because multi locations I feel are like interesting families. And what I usually notice in multi locations, ⁓ oftentimes, depending upon the practice, these offices actually like one or two or three are super profitable. And then the other two are like sucking the practices dry.   And it's so interesting because we think like, let's get so many, which if your plan is like a DSO rollup or it's legacy, or you want to just expand your reach and you want to help more people, all those things are great and fine. but I think like figuring out how do I make my other locations profitable? Or if you're in a single location, I think a lot of these tactics will apply to you. So let's kind of dig into these multi-location places, Dana. ⁓ cause I think it's funny, like we've seen some offices where it's not funny. It's unfortunate that like two are doing so good. And so they expand and they open up more.   And then these other two are not doing so well. they're like two are profitable and two are not. So then we're not profitable all the way around and we're working our guts out. So let's talk about like, how do you fix that problem? And I think for solo practices, if you're in this boat, these things can apply to you too, if you're not as profitable, because I've also seen in solo practices where they've maybe added like a Medi Spa to it and maybe, and that's two technically different businesses under one roof.   If the spa is not doing well, like I just talked to someone the other day, their spa is sucking them dry, but the dental practice is doing well, but they think the practice needs help when it's like, no, no, no, the practice is fine. The Medi spa is the problem. Or if practices have multi locations, but it's all under one umbrella, they have no clue which practice is actually the problem practice. And I think that that's something we also see is they don't actually separate them out. So they're like, we don't even know which practice. So let's dive into it, Dana. You've been working with a couple like this. Let's kind of dig into some of your, your tips and tricks.   Dana (05:56) Yeah, and that's honestly exactly what we did in the beginning is, hey, let's separate and let's look at numbers individually for each practice so we can see.   Kiera Dent (05:57) you   Dana (06:06) as a whole, are we doing? Yes. But where are we profitable and where aren't we so that we know, like you said, how we can hone in and target our efforts on the ones that need a little bit more of a boost or show a little bit more of opportunity. And so once we figured that out, then it really is looking at fixed costs for individual practices. It's looking at overhead expenses and then it is really projecting out what does it take to get it to where we want to be.   So what do we actually need? And in this instance, it was really cool to be able to even dive a little bit deeper as far as, okay, well, if we take the doctor, if we take the provider away from the profit that's like...   Kiera Dent (06:51) Mm-hmm. Mm-hmm. ⁓   Dana (06:51) the practice is profitable and he's working in one of the other practices like what does that also cost the practice that is booming and so it's it was really fun to just map that out have them see that also too every time he's pulled to one of these other practices there is a cost to the   larger location. And so just getting them to see that it just helps him   make a better decision as far as   how much time that he is spending there versus associates and then getting the associates to help grow external practices. And it just, think gave him just a clearer picture. ⁓ And then we also looked at, okay, well, you know, considering investing in some marketing for these. So what does it take for how many new patients do we really need to get to that number? And then we kind of mapped it out and okay, well, what does the marketing spend look like for one year, for two years, for three years to get   there so then they had a timeline to ⁓ just be able to make decisions on.   Kiera Dent (07:57) Mm   hmm. Yeah. No, Dana, you brought up so many good points. And I think like, let's drill down into this a little bit, because you like, these are the things where numbers become so fun, because now it's just a plus b equals c. But if we do a plus b plus c, that's going to equal d. If we take a minus b, add c, what does that equal? ⁓ And so that's really where it's like looking at this. And so I think for a lot of providers, especially our powerhouse providers that started the practice made these profits.   practices and then open multiples, there can be this thought process of, well, I have to be in the practice all the time. Otherwise, the practice doesn't make money. And I think that is one way to live. But let's also like, choose our own adventure books. Like, let's go back in time, like we could have at the end of that chapter, it says, okay, option one is you're going to actually continue working like this, and you are going to be the provider in four locations. Or we can have you be where we powerhouse you.   in one or two or maybe all four, but it's a very sustainable schedule for you. And we work to build up the associates and the hygiene department and we make it to where all of them are flourishing with or without you. And to me, I like to choose option B, you can choose option A if you want, but that's like a sure shot to burnout. And I think so many multi-practice owners actually do this, like I'm gonna go to all the practices because I'm the strong producer, I'm the strong provider, I need to get these things going and you can.   but it's like for how long and is there another path? So drilling it down, Dana, I think let's talk about like, how can they do this other path with ease? Like what are some of the tactical things that we've seen with practices you're working with, with other practices that we've worked with in the past? Like what are some of these like tactical pieces? how can we, because I think that illusion is so strong that I have to be the producer, I have to be the one who hits the numbers. What else can we do and how long is that timeline realistically?   Dana (09:47) Yeah, I think the first and foremost is if you aren't going to be the provider in in the other practices It's really building strong associates really making sure that you're finding the right fit for Whether it's the main office whether it's one of the extension offices whatever it is that that associate really is the right fit and That you are calibrating really well and you are bringing in strong associates who want to grow these practices with you and alongside you because I get you can't be in every   practice you can but like you said it sure is a way to be exhausted and burnt out and start to just not love owning all of these practices.   Kiera Dent (10:28) Mm-hmm. And like, let's so as you said that it makes me think about like when you buy a practice I remember I was working with this this potential client We were looking at the metrics of this practice and they realized that like 70 % of the production of this practice was actually being done By procedures that this dentist didn't do so was like, well good luck buying that practice You only can do 30 % of this production. So yes, they may have produced like 1.5 or 1.9 like whatever it is   but slash 70 % of that because you won't be able to produce that unless you bring an associate in. And so I think when you talked about like, are the monthly costs of this practice? What does it actually take us to run? Let's do our second location. Well, you're so used to your practice right now because you're probably doing these expanded procedures. You're probably doing these higher ones. And most of the time, what I see is doctors are like, well, I'm just going to hire someone who can do bread and butter dentistry as my associate. So then I can just do these big surgeries. Well, if that's the case, we need to figure out.   Practice number two or practice number three, A, what are the actual full costs of that practice and what do we need to produce? B, can we produce that on bread and butter or do we need to bring in your specialty? If we need to bring your specialty in or if we're going to pull you out of current option A, like where you currently are with an associate, how much of the dentistry is actually being done by your specialty services? And do you need to hire an associate that can do some of those specialty services as well? This is where the numbers become so paramount because it's like, we produced   1.5 or we produce two or we produce three. Now we're going to open our next location. But like Dana said, like bringing on an associate, it's not just a good fit. It's also making sure that they have the procedure makeup mix that can offset your production loss when you're gone. Or you get very strategic of, okay, when I am in practice A, I'm only doing these high end ones. So I'm producing this amount. They're, they're funneling these exams to me. You also have to be careful because if your associate doesn't do these high end procedures,   they're not going to look for in exams. So that's when you calibrate your associates, you calibrate your hygiene team to look for it. And when you get to multi offices, this is where Zoom and virtual meetings become paramount because you get all associates together and we all start looking for it. So we actually become referring partners to one another within the practices. And we also get our hygiene team and or AI to make sure that all the, of us are diagnosing the same level. So these are the things where I'm like, this actually can make your   multi-practice ownership way easier if you get these good foundations in place. And like you said, Dana, you find an associate who's like just as good, if not better, if you need them to be, but looking at the numbers because just because your practice is producing 2 million, 2.5, 3 million, wherever you are before you open your second location, maybe it's 1.5, look to see how much of that is done by your higher end services because typically an associate coming out of school   or a newer associate who's bread and butter dentistry is usually producing like five to 6,000 a day. Well, look at what you're producing. And if we brought someone in, can they produce that? Or if straight out of school, they're producing like 2,500. So you might need to scale up or have multi associates. But I think also being strategic when you open these practices of what do my doctors on the low end need to produce? Because I know they're going to produce lower at the beginning. How can I calibrate them and work with them every single month, every single week?   How can we take x-rays and make sure from the get-go these associates are doing really well? And also how can my hygiene team make sure that they're all calibrated to be doing the exams that we want? I think like those things might feel hard, but choose your heart in the scenario of I'd rather do that and know what I actually have to produce rather than just thinking we're gonna like stamp and repeat when you might be the higher producer. Dana, that was a lot of thoughts. What are your thoughts on that?   Dana (14:08) No, I love that and you're exactly right. think looking at the service mix, knowing how much of your production comes from those things because then it's like how important is it to find that and what exactly am I looking for in an associate? you know, we talk about avatars a fair amount and it's just like that is what points you into building those pieces and honing in for exactly what you need to be successful.   Kiera Dent (14:34) Mm-hmm, and I'm really big also on like how can we scrap the cost down at the beginning? Because gosh like I don't have children Dana you have four and so I think Question mark you you probably speak to this better than I can obviously you can't because you've gone through it But my hunch is when you have a baby, it's really hard and then as they get older You're like shoot. Let's have another baby and maybe you've forgotten how hard baby is when they're a baby Is this true or false? I just tell me how it is like   baby grows up and then you have the next baby like did you maybe forget how hard it was to have a brand new newborn and you're like tell me about that like how is that parenting   Dana (15:08) yeah.   Well, yeah, for sure.   Your mind plays tricks on you and makes you think that it's going to be super simple. And yeah, it's just like each phase, right? You kind of forget how you look back, right? And you see the beautiful things, right? You see the things that were fun. You see how much they smelled so good and how little they were, you know, all those pieces. And yeah, you do remember or you do remember the highlights and you tend to forget like the long exhaust   you know, nights that can sometimes come with a little tiny human. So yeah.   Kiera Dent (15:43) Yeah.   And I think that's about practice ownership too. So when you look at it, you have forgotten when you go to buy your second location, the scrap and the hard and all the things you did to build that thing to be successful. Like literally we forget, I forget, I mean, I was talking to Shelby and I'm like, I remember paying Tiffany on straight Venmo. Why she continued to work with me. I don't know my Venmo account. there's a max that you can send every single week, month.   And I'm like, Tiff, I hit my limit. Like, I'll have to send it to you when it resets in like three days. How on earth the Tiffany keep working with me is question number one I have. And number two, like, that's not even something that I even like remotely think about in today's world. Like, things are so set up, but you forget all of that. And so I think when we buy practice number two or practice number three, and we're looking at these costs, let's not go for the bougie luxury of exactly what we have. Let's figure out what are the things that are going to make it consistent. Same software, same exams, same like   a operatory setup if possible, because those things actually make you move quicker and then your practices become standardized. So when you go from location to location, it's much easier. But those are gonna be some of the things that also keep the costs lower. So we don't have to produce as much with you in there and still have it be profitable because you can have a practice that's only producing say 70,000 or 80,000 without you there at a 50 % overhead.   and still shelling out to you 20 to 30 % profit, depending upon how you're paying your associates. And that's still a great practice. It does not have to be producing the numbers if you keep your costs within reason. And so I think also being careful that if you're not there and we don't need all these, like we don't need all the marketing for the second location. We don't need all the implant supplies. Like if that's not a part in our associates not going to do it, then make sure that we're not incurring that cost. Because what that does is I think that this is where we then get into the struggle.   of the profitability of the multi-practices that then fluctuates because we're standardizing, but we're also trying to make all of them the exact same when maybe that's unnecessary. So I think that's one, but then you also talked about marketing because every new location has a different makeup. They're going to have a different makeup of patients. And just because it worked in one area for your marketing does not mean it works in another area. So Dana, let's do a little dig. We have a hypothetical for, for practice location, two practices are profitable. The other two aren't.   What are some of the steps or things that we should look for to get these other two profitable? Because we kind of talked about like before you buy a practice or if you're already in it, like here's some things to do or looking for these different associates, but like, shoot, I'm already in it. I've got two that are great, two that are bleeding. What do I do on these bleeding ones to make them healthy?   Dana (18:22) Yeah. And I think it's multi-practice, single practice, whatever it is, it's knowing who you're trying to attract and where are they? And so it, you know,   If you're a pediatric practice, Well, who are the parents that we're targeting? Who are the moms that we're targeting? Where are they in the community? How can we get involved in the things that they're involved in? Whether it is even online Facebook groups or whatever it is. But I think it starts with knowing exactly who you want to walk through your door and where you find them around the location of the practice.   Kiera Dent (18:56) Mm-hmm. And that's going to help because also pay attention because certain areas will attract different parents. Like there's different demographics. There's different socioeconomics. Like, so just because you're trying to attract the Lululemon mom for one practice, you might be attracting the Walmart Target mom at another location. Both moms are amazing. Both children will be great, but you've got to do like the Lululemon mom.   has very different marketing tactics and what you're going to do and what your giveaways might be in that practice or whatever you strive to do, how you're going to involve in the community. I'm going to be at the Pilates. I'm going to be at the juicer places. I'm going to be at like Elixir. Like that's what I'm doing for my Lululemon mom. I'm going to be like, they're probably at charter schools more than they're at public schools. That's going to be a different mom. And then my moms who are the target Walmart moms, I'm going to be at like the community centers. I'm going to be at the rec centers. I'm going to be at the YMCA. I'm going to be at   The I don't know like the moose lot like whatever those ones are where lots of kids go you guys I don't have kids so clearly I'm not great at this but like that's why I'm not a pediatric dentist either ⁓ But you look at it those moms are gonna be different The moms who are about Walmart are going to want someone who is cost of like so you might throw membership plans in there because they're more for that the lululemon mom's probably going to want more of like the Nutrition and what can I do and what's the highest quality? They're not going for like your lowest like   like give me a deal, but your Walmart and your Target mom probably is. And so again, there's nothing wrong with either mom, but your marketing strategies will probably need to change. So when you're looking at that profit margin or the bleeding practices, is our marketing working and do we need to change it up? Agreed. Do we have enough new patients for that? I also think I'd be looking at my costs. Like do, our staffing right? Cause some of these bleeding practices don't have enough patients that we might need to scale back our team.   at those locations to where maybe we're working two or three days. Like that's a bummer, but we're going to hire more part-time employees rather than full-time employees until we can build up to that. And these are decisions that I just want to highlight. CEOs, this is why we get paid what we get paid because our job is to make these hard decisions. Our job is to say like, we don't have the space for this. So we tell the team, you don't just have to go like whack, like, all right, we're out. It's like, Hey, we've got two months that we can do this and I need to get this patient up to this amount. This is our BAM. This is what we have to produce.   And if we don't, we're going to need to cut back to three days. Like it's just a black and white conversation, but your job as a CEO is to make sure you're not bleeding money and you get those practices profitable. It's also, what can we do? Can I, can I go in and mentor that associate doctor? Can they come and watch me? Can we assist each other? So that way they see how I'm doing these procedures and I can help them get more confident in it. Like what needs to happen to get that production number up? What, what do I need to do for my assisting team there?   So again, it's not, and I think for these multi-practice owners, I think one of my biggest tips is you are not the solution. Pretend you are a puppeteer behind the screen. How do you get all these practices profitable without you being the one? Dana, what are your thoughts about that? Cause that's how I feel, but I'm curious how you feel.   Dana (22:03) Mm-hmm. No, I agree with you completely and I think that when they have the numbers when they look at those pieces when they can say, okay If I bring in an associate and they produce at this amount it will take me let's say While use pediatric as an example, they produce 300 an hour right or 300 per patient per new patient that comes in and then you can say okay Well, if we do it at that if we do it at the 450 level if we do it closer to the 700 per patient or per hour then   Kiera Dent (22:20) Mm-hmm.   Dana (22:31) it lets you see how quickly you can grow, how quickly you can get to the production that you need to cover your expenses, those pieces. And so I just think that you're 100 % right. And knowing the numbers to be able to make those decisions and make those critical cuts or those critical ⁓ avenues for success, it just truly, truly helps.   Kiera Dent (22:55) And it all comes back to the numbers. And I think when you know your BAM, like a true BAM, we're talking bare ace minimum, we're not going again. It's, it's like, think back to when you started the practice, that's bare ace minimum. Like, what do I need to do to scrap it down? We're talking top ramen versus filet mignon. We'll get to the filets, but we need to start here, grow up to it. Again, choose your heart. For me, it's way harder to be not profitable and cash flowing negatively rather than not hiring as much or cutting my supplies down or   limiting what we're doing or changing my hours up until I can get it there. Now, Dana, let's go into a weird one because a lot of times owners think like, especially like solo practice owners, that if my practice isn't profitable, I'm going to scale it down to like two or three days and then I'm going to go moonlight at another practice. This is like a very hot debate that I have within myself. like, what are your thoughts about that? I have very strong opinions about this, but I'm super curious because   That can seem like a plausible idea, right? Like, let's go work somewhere else. Let's bring in the money to cover this one while I build it up. Give me some thoughts on that if your one practice isn't doing as well.   Dana (24:01) Yeah. And you know, I can understand the notion of like wanting to do that, because it's like, I'm trying to stop the bleeding, or I'm trying to at least reduce the stress or reduce the feeling of this isn't growing fast enough, or it isn't as successful as they want. But then what you're doing is you're really limiting the potential, you're limiting the potential of the location that you already   have right to then go where you don't have unlimited potential. And so I just feel like to plug the energy and put the effort and put the focus on the practice versus I can understand the want to go find something that is steady and stable when this feels so uncertain or we don't know. But I do feel like you you put your energy and your focus on it and it will   be more profitable than if we went somewhere else where it's capped for sure.   Kiera Dent (24:57) Mm   hmm. It's fun debate that I really love and I love the perspectives and I think there's no right answer. You've got to figure out what's right for you. But I am very similar to Dana in the sense of I feel when you have an out of a second practice that you moonlight at, ⁓ it doesn't force you to innovate in your space. It's kind of like a bandaid where it's like, okay, yeah, yeah, this can bleed kind of like a second location or a third location that's not as profitable and your first and second ones are just covering up the pain of it.   ⁓ to where you're like all right we'll just go and we'll find money in another place versus like no if you have to sit in this place you will figure it out because there's no other option like the boats have been burned we have to figure out what we're going to do and we have to make this work and so that's kind of where i'm like sure i see it but i also think there has to be a date that's in stone of we will end by this time and i know i have to have it profitable   Same thing with your bleeding practices. I think when you put dates on it of like by this date, it has to be profitable and you have to have the self integrity within yourself that you will actually own that that you will work towards that because otherwise you said Dana like it's unlimited potential within your practice. It's also like you're limiting yourself by going to another location and I feel like if another location is easier for you, maybe being a practice owner is not right for you. And I say that with love and respect, like know thyself and be free.   ⁓ because I feel like, when you burn the boat to innovate, find it. Shelby and I were talking the other day and we like throughout this goal and Shelby's like, Kiera, I don't even know how we're going to do that. We've never done that before. And I said, I don't know either. We're going to figure it out. Like that's just how you have to operate. Like, I don't know. And so whether it's, need a coach or you need someone to guide you like Dana, like sometimes we're in the thick of it. I have coaches. I can't see. I call Liz all the time. I'm like, Liz.   I need your perspective because I don't know and I'm in it and I need you to be a bird's eye view for me of like, where do I need to navigate through this? Because the option is to go through it. It's not to like jump off board. ⁓ but maybe you need a coach. Maybe you need to like look at the numbers and figure it out. Maybe you need to realize I'm not the solution for it. And if I'm not the solution, then what are my solutions in the, in the coloring box or in my toolbox? Like I think when you remove yourself and you say, because it's not sustainable.   Four practices, one doctor and trying to be the profit producer for all of them. Like that's a hard ask even for a short amount of time. Sure, you can do it, but it's not sustainable. Like you will burn out. And I see these doctors coming in like crisp fried, like ready to give up everything. They have nothing left. They're becoming numb. They're becoming like detached from family members. They don't even get excited for things that used to make them excited because they're literally burnt to a crisp. So it's not a sustainable model. So why are we doing it?   cause we think it's easier. like we think moonlighting is easier versus like, no, let's fix the problem. Let's have a date in stone and let's move on. So Dana, I freaking love these conversations because it helps me see like one, you've got to know your numbers. The numbers will tell you what to do or not to do. Two, I think you've got to be really confident in making the decisions. Three, let's set some dates in stone and make sure that we're actually committed to figuring out the problems by this date. We're not pumping more money into it. ⁓ honestly, like   If I was looking and I had practices that weren't profitable, I think the only areas I would spend money are possibly marketing, possibly, but there's so much free marketing that you can do. So let's not throw money there if we're actually losing money. I would spend money on a great consultant, someone who's been there, done it and done it successfully to move you there because sometimes when we're in the thick of our problems, we can't get out of it. So that is another cost that, but again, I talked to a doctor there on cashflow row right now is what I call it. And I said, all right.   You have two choices. You're either going to rise up or you're going to rise out. Like you take your, like choose your heart. And to me, I'd rather like pay the money and commit and make the decisions and like follow through or turn it over. Like you're in cashflow row. There's no other option for you. So you've got to execute. ⁓ and really, truly like those are the main things that I would spend money on. And then I would look to see how can I cut my expenses and what do I actually have to do and produce to take the stress off to become profitable or at least not losing money.   That's like my only focus for that time and I don't let anything else distract me. It's very hard to put those blinders on, but I think that's also where an accountability coach, a consultant. Yes, I will toot our own horn. Dental A Team is really, really good at this. We do not let you steer away from it. I know you want to talk about marketing and I know you want to talk about like, but we need these supplies. No, that's a distraction from what's really going on. We need to get profitable and that's production, collections and overhead reduction. Like that's all you need to do during those moments.   So let's figure it out and let's find the way and put those blinders on and commit that we will always be profitable. Dana, I'm off my soapbox. Any last thoughts you've got? Because I clearly am passionate about this.   Dana (29:42) No, I love seeing the passion and you know, it just bleeds through in everything you do and and that's the passion that we have for our clients. And so when we see them in these situations and it's like, let's dig in together. Let's figure it out and put in the work.   Kiera Dent (29:55) Yeah, Dana, brilliant. love that you have clients like this. love that I have clients like these are the puzzles we love to help you with. So whether you're a solo practitioner or you're a multi owner practitioner or you're thinking multi ownership, whatever it is, like I really do think having a coach hopefully before you get to this spot, if you're already in the spot, rock on, we can still help you. So I think like whether you're in it now, like get the help, like throw up the life raft right now before it's too late. I really, it,   It stresses me out when clients come in and they're on cashflow row. It's like, it's okay. And it's okay. And it doesn't mean you're a failure. It doesn't mean you weren't a bad, like you're a bad business owner or I should have seen this coming. No, you're a business owner. Like this is real life, but like, let's get the help before it gets to be like, really like the water's already up to our neck. Like let's get it. Whereas maybe at like our chest and we're feeling the pressure mount a little bit, but there's still a little bit of breathing room rather than when it's like up to our chin. That becomes a lot harder, but still doable.   ⁓ Or like hey, let's be proactive kind of like I mean couples therapy I'm like, let's be proactive and do this before we need the divorce help like let's let's try and save the practices before so if we can help you I love to do practice growth calls with you like no pressure complementary to you We'll just look at the gaps in your practice give you a ton of value if it works for you and we're a great fit Awesome, we'd love to help you If not, you're gonna walk away from that of some awesome tips in value because I want you to see your blind spots And I want you to see the solutions ⁓   regardless. So reach out Hello@TheDentalATeam.com or book a call. Dana, love podcasting with you. Thanks for coming on early today. Thanks for being a great consultant. Thanks for loving our clients and just having that passion for their success. So fun to podcast with you today. Of course, and for all of you listening, thanks for listening. I'll catch you next time on the Dental A Team Podcast.   Dana (31:32) Thanks for having me.  

One of the traits that separate great dentists from good Dentists are their abilities to communicate with patients and to lead a cohesive, happy dental team. Today, Art visits with Jonathan Bonanno who is an Industrial Organizational Psychologist and whose work involves helping dentists to communicate with their patients and also involves the importance of understanding employees needs, providing a psychologically safe and positive work environment. Art and Jonathan discuss what steps a Dentist can take to improve team cohesiveness and efficiency, why calling your team a “family” might not be the best way to refer to them, and how to determine if the “vibe” in your dental office and with your team is off, and how to fix it. Jonathan also explains how to create and promote a positive team culture and why it is important to recognize achievements. Finally, Jonathan describes several different leadership styles and why there are good, or not so good such as autocratic and democratic leadership, Laissez-Faire leadership, and then two good leadership styles which are Transformational where we inspire and motivate and Servant leadership where we serve the needs of others. About the GuestsJonathan BonannoIndustrial Organizational PsychologistJonathan Bonanno is a trailblazing organizational development executive, founder of ZIA, and the visionary behind The Chief Psycho. With a career rooted in psychology, leadership, and talent optimization, Jonathan has redefined what it means to create safe, high-performing cultures—especially in dentistry and healthcare. Known for his bold, no-BS approach and commitment to authenticity, Jonathan supports teams and leaders in unlocking their full potential, integrating psychodynamic insight with practical strategy. Whether he's coaching a DSO, leading a workshop, or hosting his podcast, Jonathan shows up with zeal, heart, and an unapologetic drive to disrupt the norm.About the Host Art Wiederman, CPA Director of Dental Practices Art specializes in serving dental practices. He oversees a variety of services including accounting, tax compliance and planning, financial planning, retirement planning, and financial practice management consulting. Art's expertise is not only in taxation issues for dentists, but also in his knowledge of dental practice metrics and benchmarks. Art has the ability to look at a dentist's statements and identify profit holes in their practice.

In this episode, Gary Bird breaks down how one dentist skyrocketed from $219K to $456K in production in just 12 months. Discover proven dental growth strategies including building for expansion, improving dental case acceptance, scaling with associates, and tripling the dental marketing budget. Gary explains why mastering dental sales, patient financing, and adopting a true growth mindset are essential for practice growth. Learn how focusing on future dental practice growth instead of short-term profit can dramatically increase production. These dental practice management tips will help dentists grow faster and smarter. Connect with our Host, Gary Bird, Here ⤵️SMC: https://smcnational.com/Personal: https://thegarybird.comWant to Master The Business Side of Dental and get free resources?Visit ➡️ https://smcnational.com/dsoacademy*85% of DSO Academy students would recommend it to a friend!➖➖➖➖Dental Marketing Goat, the go-to podcast for dentists who want to grow faster, market smarter and build practices that thrive in today's competitive landscape. Hosted by Gary Bird, the Dental Marketing Goat himself and founder of SMC National - recently named Best Dental Marketing Agency by over 60,000 dental professionals. Each episode unpacks the real strategies, marketing frameworks and operational shifts that high-performing practices use to attract more patients and increase production. Whether you're a solo practitioner or scaling a DSO, you'll learn how to align your marketing, team and systems to drive predictable growth.➡️Want to see how SMC can help you grow?

In this episode returning guest Gary Salman, CEO of Black Talon Security, and special guest Evelyn Lahiji, COO of Children's Dental FunZone discuss the current state of cybersecurity. Join us as we learn more about Evelyn and Children's Dental FunZone and their partnership with Black Talon. The duo discuss: The difference between IT and cybersecurity The importance of training & education Current real-world examples of cyber incidents Introduction to the EAGLEi dashboard for cybersecurity management To learn more about Children's Dental FunZone you can visit https://www.childrensdentalfunzone.com/ You can contact Evelyn Lahiji at evelyn@cdfzone.com If you would like to learn more about Black Talon Security and how you can protect your dental group practice or DSO you can visit https://www.blacktalonsecurity.com/ or schedule a consult at https://www.blacktalonsecurity.com/demo-black-talon-security

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!

Enjoying the Ride: On TourThe Deadcast season finale hits shows at 3 legendary venues, exploring Dick Latvala's transformative experience at Red Rocks ‘79, Hollie Rose's tour journal, the wonders of the Alpine Valley parking lot, & when Shakedown Street got its name.Guests: David Lemieux, Jay Kerley, Hollie Rose, Rebecca Adams, Bill Lemke, Phil Garfinkel, Jim Jonze, Tom Ryan, Art Moss, Lisa Hitchcock, David Van Divier, Scott Bauer, Julie Dock, Mobile SteeleSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Why have dozens of DSOs collapsed? What's the impact on the dental industry? And how can you protect yourself, even if you never plan to sell? Tune in to learn what's really happening in the DSO market, and what YOU should look for if you're considering a DSO!Topics discussed in this episode:Why so many DSOs are failingWhat investors look for in DSOs today3 characteristics of an ideal partnerRisks of the DSO business modelBenefits of partnering with a DSO_________________________________****To learn more about MB2 and get a free valuation for your practice:  Text "MB2" to (312)910-2603****Text us your feedback! (please note: we cannot respond through this channel))Join our Online Mastermind Community with All the Training, Systems, and Plug and Play Protocols for you and your team. https://www.dentalpracticeheroes.com/DPHcoaching Use the same marketing company as Dr. Etch!Get your free demo with Relevance Marketing by Clicking HereTake Control of Your Practice and Your Life I help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams. Join the DPH Hero Collective and get the tools, training, and support you need to transform your practice: Team and Doctor Training for every aspect of Practice Management Comprehensive Training: Boost profit, efficiency, and team engagement. Live Q&A Sessions: Get personalized help when you need it most. Supportive Community: Connect with practice owners on the same journey. Editable Systems & Protocols: Standardize your operations effortlessly. Ready to build a practice that works for you? Visit www.DentalPracticeHeroes.com to learn more.

Crushed by debt and considering a DSO just to stay afloat? Before you make a move that could define your entire career, listen to this. In this episode, Jeff Blumberg lays out what every new or soon-to-graduate dentist must know about breaking free from the associate trap and building a real future in dentistry. The window of opportunity is wide open—but only if you know where to look.    The MGE Power Program - https://www.mgeonline.com/power-program  DDS Success - https://ddssuccess.com/  Jeff's Email – Jeffb@mgeonline.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!

What do dentists need to increase profitability in their business and create time freedom? Jake Conway, founder of Custom Practice Analytics, is back for an in-depth conversation on future-proofing businesses in an era of uncertainty. We dig into the financial stressors facing dentists and entrepreneurs today and how knee-jerk decisions often compound the problem. Jake shares his battle-tested approach to key performance metrics, and also tackles one of the most misunderstood decisions practice owners face: whether to scale or sell.  If you like this episode, here are more episodes we think you'll enjoy: Ep #526 - Brannon Moncrief – Dental Practice Transitions – DSO Trends, Seller Options and Best Practices Ep #525 - Dr. Victoria Peterson – Investment Grade Practice – The Business Principles Every Dentist Needs to Succeed Ep #522 - Dr. Mauricio Dardano – An Inside Look At a Dentistry Consolidator – The Success of MB2 Dental 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'd like to replace your active practice income with passive investment income within 2-3 years, and you have at least 1M in available capital (can include residential/practice equity or practice sale), then schedule a call with my team. If it looks like there is a mutual fit, you'll have the opportunity to attend one of our upcoming member events as a guest. 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.

90.9 WRCJ's Peter Whorf speaks with DSO music director Jader Bignamini about the orchestra's final concerts this season, including beloved concertos, hidden gems and thrilling tone poems...

In the latest episode of The Dental Economist Show, host Mike Huffaker welcomes Priyanki Amroliwala, Senior Manager of Talent Acquisition at Forty Two North Dental, to explore what's really going on in dental hiring. From the shortage of talent in rural areas to the growing importance of lifestyle and culture for today's dental professionals, Priyanki unpacks the challenges and opportunities that dental leaders face. She shares how dental support organizations (DSOs) can adapt quickly, the power of listening to what candidates want, and why the best recruitment strategy starts with understanding people, essential for any Dental Business leader today. Tune in for practical insights into building a practice culture that attracts and keeps top talent, without breaking the bank. If you want to navigate the shifting landscape of dental hiring and build a team that lasts, this is the episode for you!

In this episode, Brannon Moncrief returns to the podcast to unpack what's really happening in the DSO market—from tightening deal structures and smarter buyers to the harsh reality that not every recap delivers. With over two decades in the game and 13 years leading McLaren & Associates, Brannon shares what makes a practice desirable in 2025 and why some of the biggest players in the space are hitting walls. Whether you're a mid-career doc holding high EBITDA or just building toward scale, Brannon breaks down how private equity thinks, how deal terms have shifted, and how to avoid being locked into a losing outcome. EPISODE RESOURCES https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Send us a textWelcome to the AstroGuy Podcast, your monthly guide to the night sky! In this episode, we're taking a deep dive into the top astronomical events in June 2025, including planetary alignments, lunar features, space exploration updates, and deep sky objects you won't want to miss.Whether you're using a telescope, binoculars, or just your eyes, there's plenty to see in the night sky this June!If you enjoy the episode, please subscribe, comment, and share, and leave a review on your favorite podcast platform. Carpe Noctem!Links:Feel free to buy us a cup of coffee or two! We really appreciate it! https://tinyurl.com/AstroGuyCoffeeOur Facebook group page: https://www.facebook.com/groups/astroguypodCranford TV-35: https://www.cranfordnj.org/tv-35Clark TV-36: https://www.ourclark.com/194/Clark-News---Our-Clark-MediaThe June 2025 Episode Guide: https://tinyurl.com/AGGuideJune25  The Full Episode Guide of DSO's sorted by Catalog Name: http://tinyurl.com/AGFullGuideOur “Astronomy Basics” episode: https://youtu.be/MtUkLVneNYsCharles Messier episode: https://youtu.be/3JvAEj29OBo?si=P7E2wCvIP9ZN00ZFWilliam Herschel episode: https://youtu.be/1sCFTQf03Wk?si=nkc4_SaeR61Z5BOpAffiliate LinksHigh Point Scientific: https://www.highpointscientific.com/?rfsn=7714880.bb6129Amazon: https://amzn.to/4gFQmOGAudio Credits: Spring Flowers by Keys of Moon Evening Improvisation by Spheriá Adrift Among Infinite Stars by Scott Buckleywww.scottbuckley.com.au Relaxing Chill MusicARNOR by Alex-Productionshttps://onsound.eu/ Music promoted by https://www.chosic.com/free-music/all/Creative Commons CC BY 4.0https://creativecommons.org/licenses/... Demon Lion Monster Growl Roar by Manim8https://freesound.org/s/469123/License: Creative Commons 0

Don't be shy, send me a message!Thomas Felix Creighton talks about Britishness in the 1950s, drawing on both academic sources, and family diaries, letters, and recollections. This episode covers family experiences of the Second World War, births in the baby boom, and life in Britain and the Empire in the new Elizabethan Age.Books recommended include:Postwar: A History of Europe Since 1945, by Tony Judt, which was previously reviewed on the Youtube channel @BritishCulture (007's Retirement Reading, Part 4)Austerity Britain, 1945-1951, by David Kynaston, and Family Britain, 1951-1957 by the same authorLooking for Trouble: SAS to Gulf Command - The Autobiography, by General Sir Peter Edgar de la Cour de la Billière, KCB, KBE, DSO, MC.Thomas also talks about the following Youtube videos, which give some imagery to what is here described: A Colonial Childhood │ 3 Generations of Brits in CyprusCyprus Under British Rule｜With Cinéfilm from the 1950s & video from todayA Frontline Soldier's Last Letter Home - Italy, 1943WWII: A Letter From a Frontline Soldier in Italy, September 1943A Teacher in the Raj: My Great-Grandfather, F.E. CreightonIf you have memories or family stories to share, please do get in touch:Message me anytime on Instagram, @FlemingNeverDies, or e-mail: AlbionNeverDies@gmail.comCheck out my https://www.youtube.com/britishcultureCheck out my Red Bubble shopSubscribe to my newsletter for update e-mails, random postcards, and stickers: https://youtube.us9.list-manage.com/subscribe?u=b3afdae99897eebbf8ca022c8&id=5165536616Support the show

What's really happening in the dental industry—and what does it mean for your practice? In this special deep-dive episode of Dental Business RX, Jeff Blumberg breaks down the biggest trends shaping dentistry today, including an aging workforce, declining practice ownership, DSO expansion, and a looming dentist shortage. Whether you're a new grad or a seasoned pro, this episode lays out the coming changes and what you can do right now to stay ahead of the curve.  Slideshow & DSO Summit - https://www.mgeonline.com/episode-193-downloads-form-page/  Free Fees & Plans Analysis - https://www.mgeonline.com/fees-and-plans 

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 Deadcast cruises down the eastern seaboard, including stops in Hartford, Hampton, Philadelphia, and Landover, featuring touring tips, another police chase, & a visit to the White House.Guests: David Lemieux, Sam Cutler, Dennis Alpert, Tyler Roy-Hart, David Leopold, John Leopold, Rebecca Adams, Brian Schiff, Gary Lambert, Chris Goodspace, Winslow Colwell, Scott Jones, Chad EylerSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Fred Heppner of Arizona Transitions is back for part 2 of his chat with Kiera! Life comes at you fast, and sometimes, it comes in the form of a surprise. Kiera and Fred talk about creating an exit strategy today for your departure from dentistry, as well as what the economics look like for moving on from a practice. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript Kiera Dent (00:01) Hello, Dental A Team listeners. This is Kiera and I am so excited for you to have part two of me and Fred Heppner going through associates, DSOs, how to really grow this. You guys, we had such an incredible first half of this episode. It was so long and so much information that I wanted to break it into two parts. So here's part two. I hope you enjoy. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.   Kiera Dent (00:24) should people be talking   when they're in their 20s 30s or is it something we're like start to think about it I know Ryan and I from Dentist advisors we we talk shop about this quite often of like there I mean there are studies that show that when you retire you actually start to atrophy in life and ⁓ there isn't as much of a purpose and so we talk often of like how can we continue that   mental stamina, the things that are going to fulfill us, whether it's working or something else of philanthropy, like whatever is going to keep you going as a human, whether you're working in the chair or you're not, I think is important. So that's I was curious of like, really probably connecting with you three to five years before we think we might retire, but with the caveat of, hey, if something were to happen to me, what would kind of be my exit strategy? your like death list like I do, like if I die, this is what's going to happen. It's creepy, but it's awesome.   Fred Heppner (01:15) No, it's, it's creepy and it is awesome. And at the same time, it's a really good conversation to have because if we're three to five years out, then one of the first things to do is say, okay, so what's going to happen if you're not here? And that carries on to the discussion we had earlier. So once the discussion about, what do want to do when you, when you retire or you stop practicing dentistry, then the questions start coming up. What about the economics?   Kiera Dent (01:27) Mm-hmm.   Fred Heppner (01:44) So in any... Yep, absolutely.   Kiera Dent (01:44) I was just going to say, like, is it sell? Is it DSO? it? And also, I mean, this   to me also, I think might exponentially accelerate some people's plans because the DSOs are hot and it's like 10x EBITDA. That might accelerate your retirement or your sell because you're on a wave right now that who knows if in the next 20, 30, 40 years we'll be there. Fred, I'm super curious, like, how is this whole DSO model maybe shifting it for transitions? Or is it? I'm curious.   Fred Heppner (02:13) It is, it's shifted quite a bit, but what it's shifted is a real desire for dentists to be able to sell their businesses and release the management responsibility and to have somebody else take that over. 15, 20. Yeah. I just want to do, I just want to do dentistry. I don't want to manage a business. I don't want to manage people. Um, I don't want to run the company. I want to be able to practice my trade. Well,   Kiera Dent (02:22) you   The dream for every business owner. ⁓   Exactly.   Fred Heppner (02:43) I can tell you that in the last 15, 20 years, it's certainly exploded in dentistry and not in a bad way. And here's why. Dentists graduating from dental school today need a place to work. The banks that loan money to dentists to buy dental practices are looking for dentists that have a couple years experience in dentistry. They have a production track record. The banks can see what it is that the dentist can do. Chair aside.   a good credit score and some liquidity, usually 8 to 10 % of the purchase price of the business that they're looking at in cash. So one of the things to consider is graduating dentists should be able to make the minimum payments on their debt, on their student loans, on what debt they have, and begin to put money away as quickly as possible to gain some liquidity. So as we look at the equation of   what DSOs are doing, they're providing them with a place to work. Because as dentists come out, I mean, the majority of dental practices that I work with, maybe you can echo this or discuss it, are just single dentist practices. Right, they don't have a, somebody called it a plus one at some point time, and I thought, okay, that's decent. So you have the dentistry, but there's the ability to bring somebody on maybe one or two days a week. Well, that doesn't,   Kiera Dent (03:44) Mm-hmm.   Totally same.   Mm-hmm.   Fred Heppner (04:09) That doesn't feed a hungry young dentist coming out of dental school who really has a lot of debt and wants to begin to work and develop a way to reduce that debt. They're looking for four days a week, five. They might have a quality of life thing where they just want to work three tens and be off Friday, Saturday, Sunday, Monday. That's okay. But the point is, is that most private practices don't have the capacity to be able to bring on a full-time dentist and feed them right away and keep them very busy. The DSOs, corporate dentistry,   Kiera Dent (04:19) Right.   Fred Heppner (04:39) have offices that can provide that place. So essentially, if a dentist comes out of school and begins to work, they may very well work for one of the corporate DSOs, which gives them experience. It gives them the ability to work five days a week. It gives them the ability to practice in what I call civilian dentistry out of dental school. And it gives them the opportunity to be able to see what it's really like. I can tell you, Kiera, that 15, I think 15 years ago,   Kiera Dent (04:57) Mm-hmm.   Fred Heppner (05:08) the most popular phone call I would get on my phone line was, hey, we just got 50 million from a private equity firm. We're starting a DSO, but we're different. And we want to buy practices from you because we heard you're good. And I just tell them, great, thanks very much. Get in line, register on my website. And when an opportunity comes up, I will email to you like I do everybody else the opportunity. Because most of my clients call and say, I...   Kiera Dent (05:17) you   Fred Heppner (05:34) Hard no to a DSO. I'm a private practitioner. I've got a legacy practice and I want to sell to another private dentist Okay, so that was the most popular second most popular call was I'm sick of working for a company find me a practice to buy Now it's shifted More so do I hear I'm sick of working for somebody else find me a private practice to buy I'm ready to go The the DSO calls have filtered off of it and I don't know that that's a global   Kiera Dent (05:48) Mm-hmm. ⁓   Mm-hmm.   Fred Heppner (06:03) representation of the DSOs starting to slow their buying and really focus on the profitability of the offices they have to really maintain the profitability due to higher interest rates. Maybe they're slowing down their buying. Who knows? The interesting thing about it is that it's somewhat of a closed loop in DSO work. You really can't get into and find out exactly what everybody is doing unless you're member of their organizations, which is fine. And I respect that.   Kiera Dent (06:12) Yeah.   Fred Heppner (06:32) private information, but it begs the question. And ultimately, if a dentist is looking to buy their own practice, eventually they're going to need those one to two years experience, liquidity, good credit score, in order for them to go to one of the commercial banks and say, I want to buy a practice and let me get a practice to buy and then we'll put it together. Okay? So I can tell you that private practice is alive and well.   Kiera Dent (06:55) Mm-hmm.   Fred Heppner (07:02) very bullish on the individual dentist who's out there still practicing and doing quite well. I can also tell you that those kinds of doctor to doctor transitions are extremely successful. The idea is some people who look at a transition like that would think, my gosh, the dentist leaves, all the patients will leave. They'll go somewhere else, they'll go to other practices. Well, if that was true, let's carry that forward. If that was true,   Kiera Dent (07:14) Mm-hmm.   No.   Fred Heppner (07:28) then that would mean that the loans that the dentist used to buy the practice would go in default, would they not? Because if all the patients left, there would be no revenue and they'd have to fold up camp and see you later, right? The default rate on dental practice loans still over the last 15, 20 years and even recently is 40 basis points. 100 basis points is 1%. 40 basis points is four tenths of 1%. So if you follow the math,   Kiera Dent (07:33) Mm-hmm.   Mm-hmm.   Fred Heppner (07:58) The default rate is less than half of 1 % on the billions of dollars that are loaned by banks for dentists to buy practices. They don't fail. Okay.   Kiera Dent (08:08) Totally. They don't and they're such a   good investment. I think that that's why so many people like, that's why I think DSOs are buying up practices. ⁓ And I think that that's where so many private practice owners now, I would say I've watched where it used to be legacy practices and there's still legacy practice doctors who do not want to sell to a DSO. Like when they're there, they want to sell doctor to doctor, they want to bring in an associate, they want to bring in partners. I think   By default, dentistry tends to be a more humanistic, ⁓ very relationship model ⁓ versus I still think though, right now DSOs, you're right. I don't think people are getting as many calls. ⁓ But what I will say is my doctors are probably getting 20 to 30 emails every month from a DSO interested in buying their practice. So they are getting it as private practice owners. And so I think that that's where, ⁓ like I said, some people within the last eight years bought a practice as a private practice.   the DSOs, they were profitable. were within the metrics that the DSO wanted. And it just made sense. was like, I'm going to get 10x EBITDA on this. My EBITDA is great. No private party is going to pay me what this DSO is going to pay me. And while yes, I'd love it to maintain a legacy practice, I'm in my 30s and I could basically have retirement today. mean, there's more risk selling out because they have a lot of it in their stocks and there's a whole ⁓ game around that.   I think that that's where maybe some of the younger generation might be looking at transitions sooner than I think the more senior population of dentistry is. think that they're starting to be the shift and that's where I'm very curious of like, maybe conversations need to be had sooner. Maybe because DSOs are aggressive on the emails to the dentist. Like it is wild and they are sexy offers to them that are not always true. And that creeps me out too, because they're hearing a number. Like I had a doctor and he had a DSO.   Fred Heppner (09:49) Yep. Yep.   Kiera Dent (10:04) come to him and they said, Hey, we're going to give you 5 million. And he's like, here, it seems like a great deal. And I said, yeah, but you're going to do 5 million next year just in your own production. So that's actually a bad deal because you're already going to make that without selling to them and having to work for them for the next five to 10 years or like three to five is usually what their requirement is. So again, I think that this is where it's like, how do we cut through that noise to know when I do transition? Because I think people are getting asked to transition from private practice.   sooner. You're right, they go work at the DSO, they go to some of those bigger corporate practices to get the experience, then they go buy their private practice, and then it really is, or they do a startup. And then it's pretty aggressive because I think Wall Street's pretty hot right now and private equity is very, very luring, but they do have to hit certain requirements to join DSOs.   Fred Heppner (10:53) Yeah. There are tons of verticals that people are getting into, the private equity is getting into, you're right. There's a ton of money at it. You know, I would tell you that the devil is in the details. It may very well be that there are transitions that occur where a DSO or a corporation acquires the assets of a private practice and the dentist stays and works back in the office. And that transition works swimmingly well for the dentist who sells for the DSO.   Kiera Dent (11:02) Mm-hmm.   Fred Heppner (11:21) And ultimately everything works out fine. There are others that don't and they're, they're out there. And I think what you mentioned earlier is, you know, I could get 5 million from my practice. Well, why would you, you will be able to make that in, your earnings in 2.3 years, whatever it might be, whatever the math pencils that be. But if you think about it, if it, if 10 times EBITDA is their offering price, what are, what are the details? How much cash at closing?   Kiera Dent (11:38) Right.   Mm-hmm.   Fred Heppner (11:49) Is there a work back or a work back arrangement where you will be paid to be the dentist? And what is your compensation? What are the benefits that you would receive? And what is the term of that work back arrangement? You're right. It's creeping up now more into five years. 15, 20 years ago, was maybe, you know, stay on one or two years and we're good. There's a claw back. There's a hold back provision that holds back part of the purchase price. And the dentist has to meet the   Kiera Dent (12:04) Mm-hmm.   Yeah.   Fred Heppner (12:17) has to meet certain metrics from the trailing 12 months to be able to get that back. Well, let's pretend. Let's pretend that the DSO comes in and sets up the practice and nothing changes and the business continues to grow and develop because there's more marketing promotion and advertising. There's better cost control. There's just better stuff going on and that works. Well, what if it doesn't? What if all of a sudden the company comes in and says, we're changing these policies?   You were Delta Dental Premier, we're jumping into PPOs because we've got really good reimbursement rates on these 12 PPO contracts. Well, if that reimbursement rate drops from fee for service, does that hinder the doctor to be able to generate the income necessary for that hold back to be acquired in the next two to three years? And then there's equity. You mentioned that they offer a stock in the company to be able to ultimately participate in a   Kiera Dent (13:09) Mm-hmm.   Fred Heppner (13:15) recapitalization should that happen? Well, it'd be really interesting. You're going to love this one. I know you're going to love this one. So for any of your listeners, any of your A-Team clients, if they get approached by a DSO and they look at it and they think it's really, really good, have somebody look at it. What you will hear typically is you really don't need an advisor. You don't need an attorney. We've got all the contracts ready to go. You can come.   Kiera Dent (13:35) Mm-hmm.   Lies. Lies.   Fred Heppner (13:44) Exactly. You can just take all of this and we'll be good. Well, trust but verify. And ultimately a good team would be able to review these. I would be glad to review. I review paperwork all the time from dentists that are looking to transition. And if there's an equity piece in that offer, I turn around and contact the DSO on behalf of the client. And I say, we'd like to see your financials.   Kiera Dent (14:08) Absolutely.   Fred Heppner (14:11) What do you mean? Well, you're asking my client to acquire stock in your company in lieu of cash at closing. yeah, that's part of the deal. I need to see your financials. I need to advise my client on whether or not you have a healthy company and whether or not my client's going to be at risk by taking stock in your company. Well, nobody's ever asked us that. Well, I am. And doesn't it make sense? We've just provided to you tax returns, profit and loss statements, but sing along if you know the words, balance sheets, W-2, production reports, everything on the business.   Kiera Dent (14:21) Yeah.   things.   Mm-hmm.   Fred Heppner (14:39) And yet you're not willing to provide the other. Just provide the other. Show us that your business is solvent. Show it that it is something that my client would like to receive in stock. So, mon bro.   Kiera Dent (14:50) And there's strategy   for tax around that too. there are benefits to having stock rather than all the cash at closing for your total dollar amount when you want to retire, but only if that stock actually is valuable.   Fred Heppner (15:05) Pays back. Correct. Good. And that   is so brilliant. You see, you're good looking, you're smart, and that's a rare combination today. So, so, but think about it. You just mentioned something that people really don't think. If, if I have a practice and they give me 1.5 million chopped up into the ways that we've mentioned, and I have $200,000 worth of equity in the company, what if that $200,000 is half of 1 %? Well, when they recapitalize, I get half of 1 % of what proceeds, right?   Kiera Dent (15:09) Thank you.   Mm-hmm.   I love it. It's such a...   Fred Heppner (15:35) So map it out. Yeah, map it out. mean, can   you sell your practice twice? sometimes yes, sometimes no.   Kiera Dent (15:43) And there's so many sticky pieces around it. And that's where I feel like it's just a, think this is where people get leery to do it. However, I think like there are some, you said, that go really, really well, but agreed. And when I look at this people like Kiera, like I thought about that doctor and I was like, so sweet. You're going to five mil. That's your 10 X. You're going to produce 5 million. Your overhead right now is sitting at a 50 % overhead. So right now you're taking 2.5. Let's say you do get a $5 million check.   you give me 10 taxes, it's barely over your 2.5, which you're already going to get next year. So like, yes, next year, you still have to pay taxes because you're at a 50 % overhead. So you will still get a small amount more of cash to you. But there's a lot of strategy that goes into that 2.5, pending upon what you need when you invest that, like for every million, it's about like on average, if it's in the stock market, about 35,000 right now is like a very, very, very loose number to like estimate your financial future. But I'm like,   you throw 2.5 into the stock market right now, we'll high five, you're making about 100K a year. Like that's just to me, those are the things that I feel you need to be really smart about to make sure that your practices are assets and not liabilities and something that really will provide the retirement for the work you've put in rather than it just feeling good in the moment, but not really giving the life you want.   Fred Heppner (16:59) You know, excellent point. And what you also said earlier, just in passing was, what dentists could buy my practice. can't sell to a private dentist. I've got to sell to a DSO. ⁓ surprise, surprise. That's a myth. There are dentists who would, I can tell you right now, if you could give me your client's number, I'll buy her practice. Well, yeah, well, I mean, that's gonna, that's gonna pencil. So the, the point that I would make is know that   Kiera Dent (17:12) It is a myth.   Right? I know, me too. I'm like, actually, actually I would.   Fred Heppner (17:29) Dentists that are out there who are looking to buy really profitable practices and can meet the production goals. So there's an important aspect there. Your client's doing two and a half million in profit, five million in productivity on her own. If a person coming in to buy that won't be able to quite meet those production numbers, they may hire the client back for a year or two. The bank may want them to make sure that there's some kind of arrangement where they have some help.   But if a bank is looking at a practice that has that kind of liquidity and profitability, they'll gladly loan the money to the dentist if other measures are there because they know it's going to be paid back. So I want to dispel the myth that big practices with large productivity and big profitability are excluded from private practitioners being able to buy them. It's not true. Is it? Yeah.   Kiera Dent (18:10) Mm-hmm.   I agree. They get nervous because of the debt,   but I have somebody that I know that just bought into a $2.5 million is how much they had to bring to the table. Plus they have their student loan debt, plus they have their house debt and they were able to do it to buy into a practice. so I'm like, I think let's not assume that that's the only route. think figure out what you want and there is a buyer based on the outcome you want. I think Fred, I want to switch gears because I want to ask some questions about associates.   because I think we've kind of gone through like private practice. There's so many things like make sure you're taken care of, make sure you know where you're going. But now I want to switch gears because I think this is something I get asked all the time. And so selfishly again, welcome to curious therapy with Fred. I want to know all the pieces. This is my podcast that you get to be a part of. No, it's for all of you. ⁓ we get asked often, how do you set up a great associate buy-in? So like, how do I buy these people and how do I tether them in? I think one of the greatest, I would say   Fred Heppner (19:06) I'm listening.   Kiera Dent (19:19) stressors and like blind spots in practices and the thing that can really hurt a practice is when they have an associate that associate leaving. ⁓ And so they want to like golden handcuff these associates, but they want it to be good for both parties. What are some of those associate transitions to retain associates to get them in as partners? Is it a good idea? Is it not a good idea? And I think like we can wrap on this because I, I'm super curious of like what you recommend to help with that transition.   Fred Heppner (19:45) The   capacity for the business volume has to be there. You've got to have, not only are you working, but there's this phantom practice out there that you can't get to as the provider. And you need somebody to be able to get to that. So bringing on an associate to get to that phantom practice immediately creates incremental income, which is, to the owner of the business, very liquid.   Kiera Dent (20:03) Mm-hmm.   Fred Heppner (20:07) The cost associated with treating extra people during the course of the day is the associate's compensation and variable cost supplies in lab. And if you're ⁓ providing can-to-can technology and your lab costs are very low, but you're producing crowns in a day, for example, and using that kind of technology, then the cost associated with treating every incremental patient and creating that revenue is very low.   we're suggesting that the team in place can handle the extra work. We don't have to hire an extra assistant or hire an extra administrative person. So given those things.   ⁓ One of the best transition plans, in my opinion, is one that has time built into it. The associate has to develop some traction. They have to generate some productivity. They have to show that they can produce the numbers. But more importantly, the outcomes are good. The treatment outcomes are successful. The patients are adapting to them. The team connects with them. This is a good relationship. As an aside, really quick, when you mention relationship business in dentistry,   I think DSOs traditionally are a transactional business. They're really focusing on the transaction, right? Private practice focuses on the relationship. Not to say that corporate dentistry doesn't focus on relationships. They're focused more so on the transactions. I might get ridiculed for that statement, but that's what I see. And that's my opinion.   Kiera Dent (21:19) I would agree.   Sure,   sure.   Fred Heppner (21:36) So back to the associate, need the associate to develop some traction. And essentially that traction comes from being in the office, seeing patients, working with the team, and ultimately getting feedback along the way. And I think that's a one to two year cycle. Will you know as a practitioner and owner of the business within the first one or two months, if the associate is working two or three days a week or four days a week, will you know, do they get along with the patients? Do they get along with the team? Yes. Will you know about treatment outcomes?   Kiera Dent (21:40) Mm-hmm.   Fred Heppner (22:05) To some degree, yes. So early on, you'll know if this is cut bait, this is not going to work. Or yes, this person's fitting in great, primarily because they were vetted. So quick, quick retract back to how do you hire them? Go through a long process of vetting. Don't just take the first one that appears. Get to know them, make sure they're going to integrate well. I see a lot of associate plans.   work real well when the dentist knows the dentist owner knows the associate coming on board from some past experience. Great example is the dentist associate grew up in town, did an internship kind of in the office as a sterilization tech, kind of worked in the office, found out that dentistry was their passion, went to college for undergrad, went to dental school for dental degree and came back to the town to work for that dentist. Right. Okay, good. So somebody you know, ⁓   Kiera Dent (22:38) Mm-hmm.   Totally.   Fred Heppner (23:00) son of doctor, owner's best friend. So there's history there. You know, the quality of the individual. Okay. So once traction is developed during the part of that associate agreement, there's some discussion about ownership and building an understanding of how the practice works so that when time comes to be a partner and buy in, there's already some traction. There's already some traction so that if the person elects to buy the seller out,   in a couple years, then they can switch roles. But there has to be some traction. One of the things that's really perilous is thinking about jumping into a practice and being a partner right away. If you want to practice and you do two million a year, hygiene does 500, you do 1.5. I'm going to come in and I want to be a partner of yours today because I've heard how great your practice is. And you have the physical plant capacity, you have the patient capacity, and I can step right in.   If I pay you half of the value of your practice today to buy in, we can split up the medicine and supplies and drugs. can split up the equipment. We can split up the office equipment. ⁓ we can split up all the operatories, but how do we sort out the patients? Because come Monday morning, say we close tomorrow, Friday, come Monday morning, I need to have in my schedule, the ability to generate half of the revenue in the business so that I can pay myself and I can pay.   to having bought in. that make sense? And that doesn't really happen easily when somebody just freshly wants to buy in as a partner. So fast forwarding to partnerships, which I hope we get a chance to talk a little bit about today, that associate has to be in that process, in that business for a period of time. And that traction needs to get up so that they've got productivity under their belt. And again, going back to what we talked about about banks,   Kiera Dent (24:32) Mm-hmm. Mm-hmm.   I agree.   Fred Heppner (24:59) they wanna see that that productivity is there, that they'll be able to generate it because they wanna make sure that they get the loan paid for. And a really good associate agreement has, in my opinion, good restrictive covenants, not to compete, not to solicit patients or staff. ⁓ In some states, that's not allowed. The FTC voted that associate agreements or employment agreements should not have restrictive covenants, but there's no legislation yet that has actually mandated that.   Kiera Dent (25:05) Totally.   Fred Heppner (25:26) So keep in mind that it's probably not appropriate to think that you'll be able to limit somebody's ability to work. Now for them to essentially buy your practice, for example, and you as a, agreement have a restrictive covenant that you will agree to that's different because somebody paid you good and valuable consideration money for you not to compete against them because they bought your business in an employment agreement. It's a little different.   Kiera Dent (25:49) Mm-hmm.   Great.   Fred Heppner (25:56) So if a dentist comes and works for another dentist who owns the business, and after a couple of months, it's just not gonna work out, they're not gonna have enough connection with the patient base to solicit patients or solicit staff or the team. They won't. So would it matter if there was a restrictive covenant in that initial agreement? Probably not.   because after a couple months, if they've alienated patients and alienated staff and they're not very good at dentistry, you want them out of there anyway, forget about the restrictive covenant, they could go work for somebody else close by. It's probably the same thing that'll happen.   Kiera Dent (26:36) I think it's really wise because I think so many offices hire an associate, but they're so scared to move them along in two months. I think that was wise advice you listed. It is so much easier to move them on in two months than it is to keep them for six months, eight months, 10 months, and then realize their dentistry or their team connection or their patient connections not there. so ⁓ it's, it's be very intentional within those first 90 days and make sure that this will be a long-term fit. ⁓ You can see it in two months.   Fred Heppner (27:01) So how does this,   you can, I'm sure you can. How does this sound? For the first six months of an associate agreement, maybe you don't have quite a good background, deep background about that individual, but you feel that they would be good in the practice. They come recommended by their instructors at university, at dental school. was highly, someone was highly recommended. How about a single page,   six month agreement that says you come to work for me, I will pay you this. And if you want to go, you can go. If I feel you need to go, I'm going to release you. It's an at will agreement, no restrictive covenants, nothing in it that locks anybody down. Because again, what I mentioned earlier is how much traction can you generate really in one or two, three, four months, because you'll know after four or five months that this is somebody really want to lock in at six months, develop a really strong, well-written attorney reviewed.   employment agreement that has restrictive covenants that has specific on how to redo cases in case they need to be done at the end of the employment agreement. Right. What do you think? I mean, does that give that give the opportunity?   Kiera Dent (28:08) Sure.   I think,   I mean, I like it. think that the devil's advocate in me would say, I'm not sure that the ⁓   millennial Gen Z generation coming through would say yes to six months. I think that they're looking for more security. They're looking for more guarantees. They come in with a lot more debt and a lot more risk that I am really curious. As a business, I think it's freaking brilliant. As on the other side, I'm curious, would you be able to get candidates that would want to come or is it too risky of an offer?   Fred Heppner (28:43) You mean,   yeah, do you mean the associate dentist coming on board is thinking more about themselves rather than the practice?   Kiera Dent (28:52) I think with the associate offers that are given currently, ⁓ I think agreed. It does show that they're thinking about it, but I also feel for a practice making sure that they're competitive with offers. I don't love having to be ⁓ like with hygienists. I don't want to have to go chase them, but you have to at least be competitive with other people in the market. So I think I agree with you. I just feel for practices making sure that maybe   Fred Heppner (29:05) ⁓   I understand what you're saying.   Kiera Dent (29:19) you are so competitive with other people and offer. So you do get the candidates, but you can have some of these ideas within like that I think would make you even maybe more attractive. So maybe it's a year that we're offering, but like, Hey, in the first six months, there's no restriction. There's no nothing. We add that in in six months. So that way you are competitive with other people. Cause I think associates, they need that security and I'm watching more and more come through. I mean, they're walking out with one mil plus 2 million in debt. Like, so I think that   I think to be competitive with others, might need to be a possibly. This is my hallucination that could possibly just make sure you're competitive.   Fred Heppner (29:53) Well, well, no, you're   so you're right on you're in a you're in another section of what the employment agreement might look like called compensation and benefits. I'm looking at just the period of time that you would be that a dentist would be employed in the practice to determine if it's a right fit for them and if it's a right fit for the practice and if it's a right fit for the patients and the team. Compensation can say exactly what you were saying. Now,   Kiera Dent (30:16) Right.   Fred Heppner (30:22) Unfortunately, it isn't the responsibility of the practice to provide for somebody who is unproven in their debt or to satisfy their lifestyle requirements. Yes, they're competing with other organizations that are offering salary, health insurance, vision, life insurance policies, all of those benefits that come along with big corporations. However,   It's a private practice. And the sooner I think that dentists who are coming on as associates know the intricacies and the difficulties of running a business and also the rewards that come with it, they would understand better how those arrangements are made. And I've seen compensation programs set up where it's the greater of over two weeks, a compensation per day or a percentage of a certain amount over a certain amount of productivity. So you can meet those requirements. can kind of meet.   Kiera Dent (31:15) Mm-hmm.   Fred Heppner (31:16) Kind of need halfway in between.   Kiera Dent (31:18) Yeah, and I think that that's where I was saying of I feel like making sure that you're meeting in the middle. I love the idea of being able to protect like, you're right, like not being stuck in this with someone who's not working out and getting stuck, I think is actually something that happens all the time with associates. ⁓ And so I think like, Fred, it was such a fun like,   chat about us. I agree, we need to chat more partnerships because now it's like, okay, we've got these associates, we've got some ideas on it. We've heard about figuring out where we want to go and how we're going to be able to get there and needing to think about our future life and how when we need to transition, you said the three to five years, I think looking for like, what do need to do to be able to buy a practice? If I want to buy a practice, what do need to get? Then we talked about like the DSO offers coming for private practices, and how to assess that through Fred.   And then we moved into associates. So Fred, like that was such a like smorgasbord of topics, which I love. And I think definitely reconnecting because I think there's the next step is like, how do we bring in these associates for partners if we want them? How can we build a legacy practice? That's not necessarily just the DSO. So I'd love to get you back on the podcast and chat partnerships and like alternative transitions beyond, but gosh, Fred, such a fun podcast today.   Fred Heppner (32:10) It was fun.   I am   happy to do it anytime. I appreciate what you do for dentistry. So I'll absolutely support you and be glad to do it.   Kiera Dent (32:36) Thank you. Well, Fred, as we wrap up today, were there any last thoughts you had to give to the listeners? And of course, ArizonaTransitions.com, ArizonaTransitions.gmail. If you're looking to transition or associates or what do I do or hey, Fred, I just need help. But any last thoughts you have as we wrap up today?   Fred Heppner (32:52) Yeah, I think   I tell you a funny quip that I think resonates with most people that I talk to. Dentists are excellent at curing dental disease, at diagnosing conditions and recommending treatments and working with patients to get them well. And, ⁓ coming into an event like purchasing a practice or selling a practice where they've never done it before. They don't have the experience or the education.   going in to understand what to do. I would encourage them to get advice and guidance from a great team. ⁓ I have a deal with my dentist. Mike Smith is brilliant. He has a practice called the biting edge here in Phoenix and he's brilliant. And he and I have an agreement. I don't do my own dentistry.   And he doesn't do his own practice transition stuff or practice management stuff. He relies on me to do that because they're in the middle. meet. So I want him to cure my dental conditions and make sure I'm in the optimum dental health that I could be. And I'm to make sure that I provide the services to him so that if he's looking to acquire a practice or merge an office into his, or figure out how the next plan would be for his practice growth or his transition, that he's going to sit down with me because he understands that that's my expertise and he.   he benefits from.   Kiera Dent (34:15) Yeah, I love that. That's such a good way to look at it. Let's sit in our lanes. Let's do what we're really good at and not try to be a one-stop shop. I think that that's brilliant, Fred. And I feel like for all those looking for the transitions for what do we do? How can I do it? Reach out, Fred. I think you're a wealth of knowledge. You've been in it for a long time and just truly so grateful to have you on the podcast today.   Fred Heppner (34:36) It's my pleasure. Absolutely. Have a great day. Talk to you soon. Bye here.   Kiera Dent (34:39) Awesome. Thank you. And thank you,   Fred. Thank you, all of you. And for all of you listening, thanks for listening. And I'll catch you next time on the Dental A Team Podcast.  

The Bulletproof Dental Podcast Episode 396 HOSTS: Dr. Peter Boulden and Dr. Craig Spodak GUEST: Clifton Cameron, Lightwave Dental DESCRIPTION Clifton Cameron, Chief Dental Officer of LightWave, discusses the dental service organization (DSO) landscape, covering industry challenges like labor inflation, financial strategies, and market consolidation. The conversation explores how dentists should evaluate partnerships, the impact of consumerism on practices, challenges facing solo practitioners, and the importance of strong leadership in navigating the evolving dental industry TAKEAWAYS LightWave is America's only Dental Leadership Organization (DLO). Labor inflation has significantly impacted the dental industry. Dentistry is resilient and can withstand economic fluctuations. The importance of understanding earn-outs and financial risks in DSO agreements. Stability in the market is becoming increasingly important for investors. The majority of dental practices are still solo practitioners. Financial strategies must adapt to current economic conditions. Consolidation in dentistry is ongoing, with a significant percentage of practices under DSO contracts. The need for camaraderie among dental professionals is crucial. Consumerism is reshaping patient expectations in dentistry. Dentists must adapt to changing market dynamics to remain relevant. Investing in leadership and technology is vital for growth. The dental industry is seeing a trend towards consolidation. CHAPTERS 00:00 Introduction to LightWave and Leadership 05:00 The Current State of DSOs 10:01 Understanding Earn-Outs and Financial Risks 14:58 Navigating Labor Inflation and Financial Strategies 20:07 The Future of Dentistry and Market Resilience 25:00 Consolidation in Dentistry: Current Trends and Insights 32:06 The Rise of Startups and DSOs 36:19 Consumerism and the Future of Dental Practices 40:19 The Value of Dental Practices in Transition 44:25 Two Paths for Dentists: Business Owner vs. Employee 53:39 The Future of DSO Consolidation REFERENCES Bulletproof Summit Bulletproof Mastermind  

In today's Part 1 episode, Dr. Mark Costes catches up with longtime friend and powerhouse entrepreneur Dr. Kyle Hale. Kyle opens up about life after selling his DSO, why he took a step back, and how he spent his sabbatical reconnecting with family and rediscovering his passion for racing. He shares his reflections on the stress of clinical dentistry, how his wife Callie's burnout influenced their business decisions, and what it took to prepare their group of practices for a smooth and successful exit.  The conversation also dives into the challenges and lessons learned from scaling quickly, the importance of systems, and how stepping away opened doors to new ventures like the Airway Dentist. This is part one of an inspiring conversation about transition, purpose, and designing a life by intention. EPISODE RESOURCES https://theairwaydentists.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Kiera is joined by Fred Heppner of Arizona Transitions to talk through dental practice transitions. Their conversation includes when you should start thinking about your transition, what the economic outcomes will be any way you go, what a private indemnity group is (and how it can help), and more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcrpt Kiera Dent (00:01) Hello, Dental A Team listeners. This is Kiera. And today I am so excited to welcome an incredible guest to our podcast, Fred Heppner. He's with Arizona Transitions. And honestly, I feel like right now in today's world, dentists need more than ever guidance and direction of like, what do we do? How do I transition my practice? What am I looking at for retirement? Do I go the DSO route? Do I do the legacy practice route? I just feel like there's so much confusion. And so trying to cut through that noise,   Fred is incredible. We met him and I just said, you know what? He's incredible. And so he said for him, it's whether a person is buying a dental practice or putting a dental practice up for sale, Fred truly can help you successfully navigate through that transition. He deals with complete transitions of dental offices and also practices securing a partner or an associate, which that is such a hard thing. Like, how do we do this? There's a million ways to slice and dice that pie because he's worked with so many different aspects of the dental industry. His experience allows him   to ensure that all parties are satisfied with the transition. So I'm super jazzed. Fred, welcome to the show today. How are you?   Fred Heppner (01:02) I'm   doing great. Thank you, Kiera. I gotta meet this guy. Who is this guy, Fred?   Kiera Dent (01:06) Well,   here he is, if I'm not mistaken. But truly, I'm so honored to have you on the podcast. When our team met you, they were like, Kiera, he's got to get on the podcast. And so just truly excited because like I said, this is a zone that I get excited to geek out on because we deal with it in consulting all the time. Our clients are constantly asking us like, what should we do? They want to bring on partners, they want to bring on associates, they want a retention model. ⁓ They want to know like,   I feel like your dental practice can be your greatest asset or your greatest burden, depending upon how you set it up. And so really being able to just dive in with you. And like I said, I think there's so much noise right now. The dentists are like, it's almost like ostrich in the sand. Like, I just don't want to even think about it. I'm going to put my head in the sand. I'm not going to pay attention. But the reality is like, let's educate, let's learn. Let's bring experts in like yourself. So that way dentists can feel more confident making the decision. I don't think it has to be scary. I don't think it's be daunting. We just need to be educated and.   Fred Heppner (01:41) Yeah, I agree.   No.   Kiera Dent (02:05) and hear wisdom and then do what feels right. So Fred, that was my intro, but anything else you want to add of how you got here or, mean, I'm just excited to riff with you today.   Fred Heppner (02:14) I appreciate the opportunity and I can tell you even from what you just said back in, back in 1983, when I started in the business of dentistry, the interesting thing was I didn't hear very often, Hey, what's your transition plan? Because oftentimes dentists were really just going to build a practice and then that was going to be their retirement and they would sell their practice and retire. Financial planners were, were non-existent to a large degree. And it was early on that I heard somebody and it really resonated with me.   They asked a young dentist who had just taken ownership or started a practice, when are you going to hang up your hand piece? And the dentist kind of, I just got started. What do mean? When am going to hang it up? I got, you know, I got 20, 30 years here. No, no, no. The moment you take ownership of a business, you want to consider what your transition plan out would be early on so that it doesn't spring it on.   Kiera Dent (02:51) Mm-hmm.   Mm-hmm.   Fred Heppner (03:09) We may   talk here later on about, what happens if you're not there? What happens if there's an injury or disability or illness and you can't practice dentistry? Now what? And let's consider talking about that maybe later on. So early in the game, it's appropriate to have some kind of idea of some kind of transition plan. Transition plan doesn't mean I have to value my business. I have to procure a buyer act to make sure that financially qualified. I have to get a contract. I have to get a lease. That's not a transition plan. In simple, think.   Kiera Dent (03:21) Yeah.   Fred Heppner (03:38) The transition plan is what do you want to do when you sell your practice, when you move on from dentistry? And you know, as well as I do, you have clients who have been in dentistry and practice for 25, 30, 35, 40 years. And if they stopped doing something that they've been doing for three decades, what are they going to do with their time? And that's, that's really high on the scale of importance in a transition plan, because ultimately they're going to sit back and say,   Kiera Dent (03:53) Mm hmm. Yeah.   Fred Heppner (04:08) I don't know that I want to be home. I don't know that my spouse wants me to be home all day. And you have to think about these things. So it's much more than I have a practice to sell. I've got a purchase price. I have to figure out how I'm going to sell everything and my staff and my patients and so on. It's more than that. So I think in the initial phases of somebody considering what's my transition plan that can pull their head out of the sand and look at a spot and say, what do I really want to do if I   Kiera Dent (04:12) Totally.   Fred Heppner (04:37) If I don't do this, what will I do? And then feels a whole bunch of other questions into the play. Number one, how much am I going to make from selling my practice? What are the economic outcomes? How much in proceeds will I have after all the fees associated with selling the business and the taxes associated with paying for the proceeds? Now, what have I got left? What is that? What does that number look like? Well, I have no idea. Well, I need to find out. That's why I have a business.   Kiera Dent (05:05) Mm-hmm.   Gosh, Fred, I am so grateful you brought this up because honestly, feel like so I don't know my financial advisor teases me all the time. He's incredible. And he's like, Kiera, you are the person that has every exit strategy. You're like, all right, so what's going to happen if this happens or what happens? And I love to play this game with my husband. I'm like, okay, so if there was a fire in our house in this location, how are we going to get out? Or if we had this, because I feel like when you have almost that North star, especially in your life of   Okay, this is how much I want when I wanna retire. This is when I wanna retire. This is like you said, if I want to, what am I gonna do when this doesn't, like when I'm no longer doing dentistry? Because you're right, I actually, ⁓ working at Midwestern ⁓ University in Arizona, I know a lot of dental students and I know a lot of dentists now. And ⁓ I've been gone from Midwestern for about now, about nine years. And ⁓ in those nine years, which does not seem that long, it's not even been a decade, ⁓   Fred Heppner (05:50) Mm-hmm.   Kiera Dent (06:05) There have been students who have gotten a disability. There have been students who have gotten cancer and can no longer practice dentistry. There are students that have already sold to DSOs. And I'm like, their life looks so different. The student I'm thinking about who ended up getting pretty sick and had to leave, thank goodness he had his ⁓ insurance on him, his disability insurance. But like when I met him,   there was no way that we ever would have thought like four or five years into practice. I went and saw him in his practice and now like he's not doing dentistry anymore. And so I think Fred, it's one of those things where I help him pray every dentist who's listening gets to work until they're 80, 90, however long they want to go that they get to practice their craft. but I think what you're talking about of let's think of what would I do if I couldn't do this anymore, whether by choice or whether by life, ⁓ and then be able to make decisions because I feel like   When you stair step it back, you're able to actually navigate today way more confidently than if you don't have a plan. And I think that gives you more security than anything else. ⁓   Fred Heppner (07:08) Amen. And if your practice   is stable, strong, producing a good profit and you are able to not only retire debt, but start to put away for your own retirement, you are much more in a direction of control also. So retirement may not be a year or a number. It sometimes is an event because injury, disability, illness, sudden death have no discrimination. It can happen to anybody.   And if there isn't a plan in place for that, which I would recommend dentists look into, ⁓ if they don't have them in their community, forming private indemnity groups, disability coverage groups, where if a group of 16, 17 dentists that per oculi are in the same community and know each other and respect each other would agree that if anything were to happen, the group would get activated and it would cover the practice a day at a time on rotation for all the membership.   until the practitioner returns from the injury or disability or the practice is sold because the dentist is incapacitated and can't come back. As a side note, I want to mention to you that I do this for six different groups here in the Valley in Phoenix where I live. And there are anywhere from about 12 to 22 dentists in each of those groups.   So if you're listeners or if anybody in the A team wants to know more about forming groups, I'm happy to pay it forward, provide it for you. It's important. It's really something that dentists, we're invincible. Nothing's going to happen to us, especially when they're 30 years old and they just graduated from Midwestern and they bought their first practice and they're fired up. And it's like, they are looking at nothing other than growth, development, coaching. They're not even thinking if something were to happen to them. So.   Kiera Dent (08:38) Mm-hmm.   hope. Right?   Mm-hmm.   Fred Heppner (08:57) Just as an aside,   let's you and I make sure that we talk more. And for any dentists who want to develop those kinds of groups, it is invaluable. And there are tons of stories that I could impart to you and impart to anybody who's willing to listen about dentists that have a mishap. ⁓ Jim Jorgensen here in Phoenix ⁓ owns Squaw Peak Dental for years. He was in Vegas with his wife, Terry, midnight. They were up in the hotel room and he flatlined. He had a massive heart attack.   Kiera Dent (09:15) Mm-hmm. Yep. Mm-hmm.   Fred Heppner (09:28) She kept him going until the paramedics arrived. He survived. We activated the group. We covered his practice for three months. He came back, continued to practice. A year later, he sold it. So he couldn't have done that. He would have lost that asset and lost the value that that asset has on the open market if that group hadn't been in place. So.   Kiera Dent (09:39) incredible.   Thank   I will. love that. And thank you for sharing that. And that's something I didn't even know existed. And I, I don't, I'm just very pro. Like, I remember when I was filling out our trust and I had to write my will and I was not very old, still like in my thirties, it was really weird. And it made me feel icky. And when you said the phrase earlier of like death, disability, illness, that has no discrimination. It hit me in my core of you're right. Like we do feel like we're invincible, but the reality is those three are hanging   out at any moment and we have no idea when they're going to strike us or our family or someone that we know. As icky as that is. And so I feel like it's like, let's just get, let's get prepared. Like when I had to figure out what's going to happen to me, if I ever am incapacitated and I called my brother, who's my power of attorney. I said, okay, this is what I want. Are you willing to do it? But now I don't like if it happens great. Like he knows, I know there's a plan in place and as much as I would hate for it to happen, there is a plan that's like, and I feel   Gosh, maybe I'm just a selfish egotistical human over here. It does give me a lot of empowerment to know that I know if something were to happen to me, things are good. And I will also say my whole team hates it, but I have an entire death plan of if Kiera Dent dies, I haven't made it so sweet that they want to kill me off. So like, that's my, that's my caveat. Like, let's not make it that good. But there's an entire plan because I realized...   If I don't have this plan in place, if things aren't able to be transferred quickly to people that I trust and that people need to execute on, this company would die and we would not be able to serve all the people that we have. And so as, as weird and as eerie as it is, I feel like Fred, there's so much empowerment that can happen because it's no longer scary. Just like getting an operations manual, just like getting all your systems in your practice in case someone leaves. I feel like it's the same thing for your business in your life. So Fred, like that's a great tip. And I think people should reach out and definitely connect with you.   Fred Heppner (11:42) maybe   for another future podcast. Coming to an A-Team podcast near you,   Kiera Dent (11:44) Like,   I mean, hey, I'm here for it.   Fred Heppner (11:50) I don't know.   It's really important. People take it for granted. And it's interesting because the people that are in the groups that I have and sponsor just sitting back and say to themselves, why wouldn't anybody not be involved in this type of group? So good for future.   Kiera Dent (12:05) That's helpful. Okay. All right. And Fred, just like, mean,   we'll, share it at the end too, but if people are interested, how do they connect with you? We'll just put it in the middle too. So people have the info and then of course we're going to continue on.   Fred Heppner (12:16) ArizonaTransitions.com is my website. ArizonaTransitions@gmail.com is my email. Best way to reach you.   Kiera Dent (12:23) And I'm sure people are   questioning, you work only in Arizona or do you work outside of Arizona just to clear that up for our listeners? Okay.   Fred Heppner (12:29) Good. Time for a little backstory. So   back in 1983, when I started in dentistry, I was a, I was a business coach, similar to how you operate and develop business systems and coaching and training for dentists and their teams to grow and essentially develop profitable and enjoyable practices. I did that for about 20 years. And then about 22 years ago, I really saw a void in Phoenix where I live. moved here in 1995.   of the transition space. just didn't see dental practice transitions being done with integrity, in my opinion. They could have been, but I saw some of the aftermath because dentists would call me and say, hey, I just bought this practice. Can you help me? It's a mess. So I would go in and assist them. Well, slowly but surely, I saw an opportunity to be able to jump into the transitions realm. So I jumped deep into ⁓ classroom study and book work on how to do business evaluations correctly.   Kiera Dent (13:04) Mm-hmm.   Fred Heppner (13:26) the International Society of Business Analysts was my education forum. ⁓ Casey Conrad, who is brilliant, he taught me how to do business valuations correctly. And by the way, he writes the curriculum for the organizations that provide accreditation to people who want to be a business analyst. So I'm learning from the guy who teaches everybody. And then I started studying large contract negotiations.   Kiera Dent (13:45) Mm-hmm. Amazing.   Fred Heppner (13:52) As I developed that understanding and saw that there were things that I could contribute to, I jumped into that realm and became more of ⁓ a transition specialist here in the greater Phoenix area. Well, along the way, I came upon a group called American Dental Sales, which is a large cooperative of 40 dental practice transition specialists, 23 different companies. They cover all 50 states and they had a void in Arizona that they needed to fill. So they approached me and said, we'd like you to come on board.   ⁓ I then met a guy named Hi Smith, who really was one of the preeminent dental practice brokers in the country. ⁓ He was in Naples, Florida. He had a place in Oregon, so he kind of commuted periodically. But Hi was very, very well regarded and still is. He's retired now. Hi was the transition specialist for the Pride Institute, a very well regarded practice management company out of California. And for 35 years.   Kiera Dent (14:44) Mm-hmm.   Fred Heppner (14:50) They referred all the business nationwide to High to develop any kind of transition plan or valuation or partnership or associate ship or practice sale. Well, he was a member of ADS and he actually, I want to say he took me under his wing to some degree because we just became very good friends and he became a really significant mentor of mine.   I fell ill and said, I'm not gonna be able to do this any longer, so you're gonna take over my book of business. and by the way, you're also gonna start doing seminars for the Pride Institute. And I'm gonna introduce you to the people over there so that when they need help, like I've been giving them for the last 30 years, you'll take over. So as a result, we were doing seminars all around the country. So four to five times a year, we'd be in Denver, Boston, Seattle, Orlando, Dallas, Chicago, Philadelphia, you name it.   Kiera Dent (15:30) Mm-hmm.   Fred Heppner (15:43) So people that would come to those meetings were Pride disciples, clients, and they would ask me to help them with their transition. So that became more of a establishing services for dentists that are outside of Arizona, not necessarily creating a footprint in each of those territories. The Pride Institute was purchased by Spear Practice Solutions about 10 or 12 years ago.   Kiera Dent (16:08) Mm-hmm.   Fred Heppner (16:09) So I got dragged kicking and screaming over to Spear and developed a really good relationship with the track practice growth partners at Spear and also Amy Morgan, who was the CEO at Pride out still with Spear. So that's the backstory to tell you that I've done transitions in 26 different States. And it's very easy for me to help provide consultation and guidance for transitions really anywhere.   Kiera Dent (16:12) Thank   Mm-hmm. Mm-hmm.   Awesome.   Fred Heppner (16:39) Florida, as an example, Florida requires a person to be a commercial real estate broker to broker business assets. So I have colleagues in Florida that I refer to. And with my affiliation with ADS, I have boots on the ground in pretty much every territory that if I don't think I can provide value to the client, I simply connect it with the people in my group and everything gets worked right.   Kiera Dent (17:04) That's awesome.   That's amazing. And it's such a fun story.   mean, I think our our paths have crossed on probably several levels. One of my business coaches is former pride. And as soon as you said that, I was like, Oh, my gosh, I bet we both know Liz. I'm sure we and all the different pieces. But I love that because I figured Arizona transitions might some of the listeners might feel like you can't help them and assist them. So I really wanted to clear that up that it's all across the nation in different areas. So all right, Fred, let's dive into like walk us through I know you've got some   Fred Heppner (17:11) Yeah, chances are.   yeah, ⁓ yeah, absolutely.   Kiera Dent (17:36) points.   I know you've got some things of like, what is the transition plan? Like how do doctors get to that level? What do they need to do if they're transitioning? Now again, this doesn't mean you're selling. Right now, I think there's a lot of options to sell, but also like prepping in case life, one of those three mysterious, hopefully never coming to you, like orbs is how feel. I feel like they're like floating around and hopefully they never strike. But what do we do? What are kind of the steps? What are some of the things you have for that?   Fred Heppner (17:56) Yeah, yeah.   Well,   I think the first step in any kind of relationship that I build with a client, it would be a true consultation. And in that sense, it's tell me what your ideal retirement plan or transition plan would look like. You've worked your practice for a number of years. At some point in time, you're going to decide that you will retire from the practice of dentistry. What do you want to do? What does that look like?   What would you be involved with? I'll give you a quick example. Jerry Cox, who's a dentist in Old Scottsdale here in Phoenix, called me and said, I'd like you to help me sell my practice. And I said, I'd be honored, thank you. So I went and saw him and we put together the plan and I asked him the question, what do you want to do? What do you want to do after you retire from practice? says, well, I like to do sculpture. And I said, really, Fred?   Kiera Dent (18:56) you   Fred Heppner (18:57) What have you done? kind of work have you done? He says, well, let me show you. He showed me pictures of the statue of Heather Farr. Heather Farr was an amateur golfer 25, 30 years ago or so, who played at ASU, who was an enormous success, played on the LPGA tour, and ultimately ⁓ developed breast cancer and died. Heather's statue ⁓ was sitting at Karsten Golf Course down near ASU, which they've now plowed.   Kiera Dent (19:20) Wow.   Fred Heppner (19:27) and also at Greyhawk Golf Club. And Jerry sculpted that statue. And I got goosebumps right now. Anyway, so as an example, Jerry has a studio at his house. He said, as soon as I sell, I'm doing that. So the point is in the transition planning phase, know what you want to do. Know what you will occupy your time. If it's turn.   Kiera Dent (19:33) Wow. Yeah.   So Fred, I'm gonna just like ask questions right here because, and   I'm gonna talk for myself. So guys, like this is my own therapy session. So thank you for being a part and a fly on the wall. Like sometimes we don't know. ⁓ So like I feel I'm very much, I know I wanna retire. I know I want more free time, ⁓ but I literally sit here and this, it's like, know how you think about like how time truly never ends. And if you think about like too hard, it actually creeps you out. Like that's kinda how I feel about like retiring of like,   Well, I know I don't want to keep working this hard. Like I don't want to be putting in as many hours, but I still love the impact. I still love the legacy, but I don't quite know what that looks like. And I feel like a lot of times people in their thirties, in their twenties, in their forties, I think as you get later on in life, you probably have more of that clear picture. But what about for those that are very fresh, like that truly maybe some people do, maybe I'm, maybe I'm the only one on my own planet. I don't think I am, but like, what do you do if you don't know what you want to do?   Fred Heppner (20:46) You're not alone. So good. part of the time, what did Chelsea, what did Kelsey Grammer say? I'm listening. So the, the, the idea is that there are portions of people that don't know. There are some that are very clear on what they want to do and there's some that are kind of, well, I'm not sure. My, my recommendation would be, think about it. Then don't answer right now, but think about it because I want you to know what you will be doing when.   Kiera Dent (20:48) Thank you. Thanks for my therapy today, Fred. I appreciate it. Thank you.   Hahaha ⁓   Fred Heppner (21:16) you stop doing this and it may change over time. It may kind of morph into, my God, I didn't know that I really enjoyed painting. Okay. Then, then that's maybe what you might do because as you retire from the proceeds of your sale of your business, you'll, you'll build out a studio in your home or in the Casita or wherever it is. So it, it's okay that you may not know. It's okay that a person may not know what they want to do, but it's important to start thinking about it.   Kiera Dent (21:26) Mm-hmm.   Fred Heppner (21:47) And then we can kind of move into the rest of the, ⁓ the rest of the questions, which I would say, is it a year that you'd like to finish working? Some dentists may want to finish when they're 55. Some may want to work until they're 65. Some may want to finish working when they're 50 or it might be a number. My investment portfolio has to be at $10 million liquid, not including asset hard assets like home.   vacation home, cars, anything like that, boats, whatever, ⁓ but that the liquid assets have a certain number because then I know through my financial planner, because he did a wealth timeline, another side note, right, Kiera? ⁓ He said that if you keep doing what you're doing and you retire at this age and you pull in social security and you have this mandatory required distributions from your portfolio,   Kiera Dent (22:16) Mm-hmm.   Right? Exactly.   Fred Heppner (22:41) you'll be able to have this much money when you're 99. So, and that's just a mathematical spreadsheet that most good financial planners have. And I highly recommend it for anybody who's in business, who's developing a portfolio for retirement. So it may not be, I don't know yet. Okay, good. Well think about it and know that I may circle back during our relationship and ask you, have you given much thought? Do know what you're going to do?   Kiera Dent (22:45) Mm-hmm.   Fred Heppner (23:09) Early on, is it important? Not as much as when it's a three to five year window. When it's a three to five year window from retirement, then we want to talk more significantly about it. Because that will be a good...   Kiera Dent (23:23) got it because that's what I was curious I was like should people be talking   when they're in their 20s 30s or is it something we're like start to think about it I know Ryan and I from Dentist advisors we we talk shop about this quite often of like there I mean there are studies that show that when you retire you actually start to atrophy in life and ⁓ there isn't as much of a purpose and so we talk often of like how can we continue that   mental stamina, the things that are going to fulfill us, whether it's working or something else of philanthropy, like whatever is going to keep you going as a human, whether you're working in the chair or you're not, I think is important. So that's I was curious of like, really probably connecting with you three to five years before we think we might retire, but with the caveat of, hey, if something were to happen to me, what would kind of be my exit strategy? your like death list like I do, like if I die, this is what's going to happen. It's creepy, but it's awesome.   Fred Heppner (24:15) No, it's, it's creepy and it is awesome. And at the same time, it's a really good conversation to have because if we're three to five years out, then one of the first things to do is say, okay, so what's going to happen if you're not here? And that carries on to the discussion we had earlier.   Kiera Dent (24:28) Mm-hmm.   The Dental A Team (24:31) Awesome. Thank you. And thank you, Fred. Thank you, all of you. And for all of you listening, thanks for listening. And 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!

In the DSO world, as in life, financial disappointment can jeopardize growth, making a strategic and realistic approach to profit-making crucial to secure financial health for your business. And yet, many struggle with the concept. In the latest episode of The Dental Economist Show, host Mike Huffaker welcomes Mike White, Principal at Clifton Larson Allen, to explore why proper financial fundamentals are crucial for practice growth, how to position your group for successful transactions, and key strategies for maximizing practice value. This conversation offers deep insight into the hidden financial leaks plaguing many DSOs today, tried and tested methods to unlock hidden profit and the importance of realism and acceptance in it all, reminding us that it pays (literally) to have your financial house in order!

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 Deadcast makes a beeline for the northeast, focusing on shows from legendary venues in the Manhattan and Boston areas included on the new Enjoying the Ride box, including ESP experiments, weed smuggling, free jazz titans, multiple police chases, and more.Guests: David Lemieux, Ron Rakow, Sam Cutler, Richie Pechner, Allan Arkush, Ned Lagin, Gary Lambert, Blair Jackson, Stanley Krippner, Rebecca Adams, Johnny Dwork, John Scher, Michael Simmons, Tyler Roy-Hart, Henry K, Howie Levine, Kenny Schiff, Debbie RondeauSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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, Dustin Burleson sits down with the powerhouse leadership team behind Rock Dental Brands to answer one of the most pressing questions in modern dentistry and orthodontics: How do I avoid choosing the wrong DSO?You'll hear directly from CEO Kristi Casey, Chief Development Officer Spencer Lunghino, and Co-Founder Dr. Mark Dake as they share a transparent look into the origins, philosophy, and strategic direction of Rock Dental Brands. Together, they bust myths around private equity, clinical autonomy, and growth timelines—and reveal what doctors should really be asking before joining a DSO.If you're a dentist, orthodontist, or specialist considering your next move, this episode is a must-listen. What You'll Learn:The real story behind private equity in dentistry—where the money comes from and how it worksWhy not all DSOs (or equity structures) are created equalHow Rock Dental Brands evolved from a doctor-led support model to a nationally respected DSOThe biggest myths around clinical autonomy, ownership, and growthWhy Rock's equity model is designed to treat doctors fairly—and how that differs from joint venturesHow to reverse-engineer a smart partnership decision using Charlie Munger's “invert and avoid” philosophyWhat questions to ask during DSO due diligence (and how to avoid future regret) Key Quotes:“We were built to be proud of the work we're doing 50 years from now." —Dr. Mark Dake“You're not giving up control of your practice. You're gaining part of 110 practices.” —Kristi Casey Connect with Our Guests:Spencer Lunghino – spencer.lunghino@rockdentalbrands.comrockdentalbrands.com Resources Mentioned:GreyFinch Practice Management SoftwareDentiCon by Planet DDSVistria Group – Private equity partner of Rock Dental Brands Subscribe & Review:If you enjoyed this episode, please leave a review and subscribe to The Burleson Box on Apple Podcasts, Spotify, or wherever you listen. Your support helps us bring powerful conversations like this to more listeners in healthcare leadership. ***The Burleson Box is brought to you by Stax Payments:Save Big on Transaction Fees: Boost Your Bottom Line with Stax Payments.Did you know that your practice can start saving thousands of dollars on your monthly processing costs with our preferred payments partner, Stax? Simplify your practice operations and provide a quality patient experience. Healthcare practices like yours need a way to accept payments simply and securely. That's where Stax comes in.Stax helps you manage your entire payments experience from within one platform. You can safely accept touch-free payments in-person, online, or over the phone, securely store and manage patient information with layered security and Level 1 PCI compliance.
Take advantage of a simpler, more transparent way to process your payments with competitive flat-rate pricing, provided exclusively through Stax. No additional fees or contracts required!Power your practice and get paid faster with simple, safe and secure payment solutions. Have questions? Schedule time to speak with a dedicated payment consultant to learn more.Click Below to Lear More Today:StaxPayments.com/burleson-seminars*** Go Premium: Members get early access, ad-free episodes, hand-edited transcripts, exclusive study guides, special edition books each quarter, powerpoint and keynote presentations and two tickets to Dustin Burleson's Annual Leadership Retreat.http://www.theburlesonbox.com/sign-up Stay Up to Date: Sign up for The Burleson Report, our weekly newsletter that is delivered each Sunday with timeless insight for life and private practice. Sign up here:http://www.theburlesonreport.com Follow Dustin Burleson, DDS, MBA at:http://www.burlesonseminars.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!

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 today's Part 2 episode of Dr. Mark Costes' interview with Matt Mulcock, CFP, managing partner at Dentist Advisors, they break down the evolving financial landscape for dentists. They discuss the rise of private equity and DSOs, how practice valuations have shifted from collections-based to EBITDA multiples, and the critical decision-making process when considering a sale.   Matt also emphasizes the importance of financial organization, understanding incentive structures in wealth management, and assembling a “personal board of directors” to navigate major career and investment decisions. If you've ever wondered whether selling to a DSO is the right move or how to maximize your long-term financial health, this episode is packed with insights to help you make informed, strategic choices. EPISODE RESOURCES https://dentistadvisors.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

The Deadcast's tour of Enjoying the Ride trucks all the way to the East Bay, exploring beloved venues including the Greek Theater & Kaiser Auditorium, with tales of the Hog Farm's Skeleton Crew & vintage field recordings from Oakland Coliseum Arena's parking lot. Guests: David Lemieux, Ron Rakow, Kevin Schmevin, Mark Pinkus, Blair Jackson, Steve Silberman, Rebecca Adams, David Gans, Johnny Dwork, Tyler Roy-Hart, Steven Bernstein, Robert Nyberg, Chad KroegerSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

On this episode of the Dentist Money Show, Kyle Francis, founder of Professional Transition Strategies joins Matt to break down the evolving landscape of dental practice transitions. He emphasizes the importance of education, preparation, and strategic decision-making. They talk about some of the common misconceptions about DSOs and highlight the benefits of joint ventures. Tune in to hear insights on how to maximize your practice's value and better understand the consolidation trends in the dental industry. Check out our Dental Practice Valuation Calculator to get an estimate of your practice's worth. Use this easy tool if you're considering selling your dental practice, merging with a DSO, or planning your financial future! Book a free consultation with a CFP® advisor who only works with dentists. Get an objective financial assessment and learn how Dentist Advisors can help you live your rich life.

On today's episode, Dr. Mark Costes sits down with dental attorney Matthew Odgers, founder of Odgers Law Group, to break down the legal essentials every dentist needs to know. Whether you're buying, selling, or entering a partnership, Matthew shares expert insights on avoiding costly mistakes, negotiating lease agreements, and structuring airtight contracts.  They also discuss the importance of due diligence when purchasing a practice, navigating lease challenges, and why well-defined partnership agreements are crucial for long-term success. Plus, they dive into the pros and cons of selling to a private buyer versus a DSO.  EPISODE RESOURCES https://odgerslawgroup.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

In this episode, Dr. Tehaum Saood shares his journey as a new dentist, discussing the challenges and experiences he faced transitioning from dental school to practice. He emphasizes the importance of finding the right job, seeking mentorship, and being intentional about career choices. Dr. Tehaum also provides practical advice for new graduates on job searching, interviewing, and navigating the early stages of their careers in dentistry.Dr. Tehaum's page: https://www.instagram.com/onemissiondmd/Engage with the podcast on Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/dentaldownloadpodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Haley's Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/dr.haley.dds⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Keywordsdentistry, dental school, career advice, mentorship, job search, Aspen Dental, new dentist, dental practice, professional growth, dental education, DSO, dental support organization jobs, DSO jobs, reality of dentist, dentist life, associate dentist

Kiera talks about the numerous shifts on the horizon in dentistry, what your practice can do to embrace the changes, and how Dental A-Team can help. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:01) Hello, Dental A Team listeners. This is Kiera and I am so excited to have you on the podcast today. I hope today is just an incredible day for you. And I hope you remember you are in the greatest industry possible. And today I'm really excited because I feel like there's some opportunities to discuss and challenges that I think offices are gonna be facing in the next five to 10 years. I wanted to pop on and just say like, hey, dentistry is changing fast. And my question is, are you and your practice gonna be ready to seize the opportunity or?   Honestly, are you going to be struggling and hanging out in the back? I think that there will be a lot of shifts. I think we've seen a lot of shifts in dentistry. And so really just popping on to help you look for different things for technology, patient experience, different things within the practice, and really be able to help you guys prepare and get your practice there. Do you guys know Dental A Team? We are here to serve. We are here to help you and your practice have the best experience. I truly do believe that running a dental practice that's profitable and successful does not need to be hard. It does not have to be crazy.   and it can actually be fun and we can get doctors and team members aligned to be able to work in tandem together. And so that's why we're here today. I'm super excited because honestly, staying ahead of these trends is going to help you have long-term practice success. I've really been watching in the offices that we consult, the ones that are adapting and early adapters to technology, I think are going to be in the forefront. And so really just looking at where you are in the life cycle of your practice, looking to see where you want to be in the next five to 10 years.   and not making decisions to sell or to go to a DSO or to stay in a legacy practice out of necessity, but actually out of choice. So number one, I think that AI is coming in. AI is coming in pretty popular. There's a lot of different things. So we're having it in diagnostics. So like Pearl and Overjet, they're able to help co-diagnose with you. There's 3D printing that's coming in. I know offices are using AI and creating bots. We have an office.   where they've created an actual 24 hour a day bot for their practice. And I really think right now is a time for you to be learning. So whether it's 3D printing within your practice, automating our patient communication, looking into AI like this practice where they have a bot, using chat GPT for other things, utilizing AI, think helping practices with case acceptance. We've talked with Pearl, I've had Pearl on the podcast before, but what's crazy cool about that is offices are utilizing it.   actually you're seeing like a 30 to 50 % increase in case acceptance just by using this AI assisted technology. And I prefer Pearl over Overjet. Honestly, I think that there's no wrong choice on it. But the reality is like, I think you've got to get these things in motion. You've got to start looking for them. Otherwise, I really am concerned for you as a practice that you will accidentally become outdated. So really making sure that you are, you're working through this, that you are adding these things in because I think   AI is going to rapidly take off. And if you're not prepared, I think you will be outdated. So that's opportunity number one. So I'd say get involved in some sort of AI, whatever it is, even if you just start dabbling in chat GPT every single day, whatever it is, but really starting to utilize that. Opportunity number two. Now these are the opportunities that I see in the next five to 10 years. I think they're hitting this now. But number two is going to be like looking at membership plans, fee-per-service.   looking at some of those things. Now I'm not here to say drop insurance plans. I've actually been, think a consultant who's been pretty adamant about hanging onto insurance plans for as long as you can, pending upon what you want to do for marketing. If you're an incredible marketer, rock on, you might not need it. But insurance is just going to be something where I feel over time, it's going to get a little bit funkier. I don't think you're going to see a huge increase in insurance funds. I could be totally off on this. I'm not stamping my like everything that I am, but I think like, let's pay attention to it and let's see.   costs are rising in dentistry, but insurance plans are not paying a lot. And so could we start to shift our patient base? Could we start to retain our patients and actually build this fee for service model in? Now you've got to be super careful and I'm going to put like huge asterisks and exclamation points and pieces around it because if you do not transition out of insurances correctly and have a plan and a process and a patient experience in place, you will get like, I've seen it be so bad for practices. So really I think like,   One, if you don't have an in-house membership plan, let's get that started. I'm very pro these. It allows you to have options in the future. It allows you to have different marketing strategies. I think a lot of people are just looking at benefits at a different way now. And I think it just helps you to not be as dependent upon insurance in the future. Then number two is assess your insurance plans. And let's see, are there maybe any insurance plans that we could drop that aren't really going to hurt your production? You really got to do this strategically. Otherwise it will burn you in the booty.   and I do not want you to be at that practice. I've had too many of those offices, so let's make sure you're not there. And then make sure that we're like really getting people sticky to our practice. I think this will be a really, really, really big change for people. And then also it's something where even as fee for service patients, if you can get them on membership plans, I can speak for myself. Being on a membership plan, I actually came in for my two cleanings as opposed to a fee for service patient who often will only come in one time.   So I think it's just another way for you to have more patient flow, more opportunities to diagnose by having that membership plan. I have a practice where they were, this is me as a patient, I was going to them and they had a membership program. The doctor left, branched off, opened up their own practice and they don't have a membership program. And I was like, well, sweet, maybe I'll just go to you once a year. This is as a consultant. I know I need to go in twice a year. I know I have amazing teeth, but I don't need to go twice a year. Like honestly, if I only go once a year, my teeth are probably fine.   but if they had put me on a membership plan, there are other opportunities. For example, you could offer me a night guard, you could do whitening on me, you could do fluoride treatments on me, but because they're not putting into place a membership plan, odds are I probably won't be going back. So look to see how can we actually get our patients to be retained in our practice, not dependent upon insurance. So when we start to trickle that down, we start to convert more and more of our patient base. And what I will say is a lot of practices have transitioned say,   30 % of their patient base over to a membership plan. They start practicing on this, they start getting used to it. So when they want to drop insurance plans, they have a solution that's been really ingrained into their practice. The team's really good. I'm obsessed with companies like Dental Menu. I think that they do a great job for membership programs. I think that they've got a great one built. BoomCloud Clear. So you can just take a look to see who you like the most for it. And then I'm really obsessed with Moola. Moola, I think is a great credit card processor for you.   that actually helps you with your membership programs in-house so you can actually save on your credit card fees. I'm really pro them. Any of these companies that I'm recommending today, be sure to tell them, Denali team, you heard it on the podcast because they actually have a referral pricing for you. So that's what I negotiate. We don't do hardly any affiliates within our company. I just negotiate the lowest fees for you. but really I think looking to see, I think it's an opportunity for you with insurance plans and the economy to start adding in a membership.   Opportunity number three for you is looking into, tell the dentistry I don't think like hot, hot, but I do think virtual consult and online payments. So how can we make things easier for people? So can we get a virtual consultation? Can we start to have, I know there's like, we've had other people on our podcast before where they do virtual, like your smile, what is it? Your virtual smile consult. And what you can do is you can actually do treatment planning. You can have new patients meet you.   You can have videos on your website where it's like, hey, I'm the doctor. They can actually ask questions to the doctor. I have seen a lot of this with bigger cases come into pretty strong effect. Also, if you're wanting to do say consultations where maybe we're doing bigger treatment plans or even like full mouth cosmetic, there's a lot of those that I think are out there to help virtually. I have a doctor and they do a lot of what's called hybrid. So all on X cases and there's a software they can literally use and show the patient their new smile sitting in the chair.   So I think whether you're having patients virtually meet you or if you're using that technology within the chair to help present your cases better, having online options, so online scheduling, online payments, those types of things I really think we need to get more into the virtual world. I think dentistry is a smidgey dated. So I would strongly recommend for you on this to see how can you actually add these pieces into your practice because I do think these are going to like enhance you and just be something patients are expecting. Right now patients are expecting online.   patient scheduling, they're looking for online payments. They're looking for, mean, think about it. If I want to have a consult, my husband and I, we've done IVF. I've talked about it a couple of times on the podcast. I did a virtual consultation with my IVF doctor in another state and we went and we went, now, if you know IVF, IVF's around a 20 to $25,000 process per cycle. And so thinking about that in comparison to dentistry, they literally did virtual consults with me so I could be out of state, I could fly in.   I didn't have to actually be there. And so looking to see, that's what modern medicine is doing. What things could we actually do in dentistry that might be able to help us out as well? So I really think looking for that, that's where I mentioned Moolah, they're great for online, your smile, your virtual, gosh, I'm like botching it. I think it's your smile virtual consult, virtual smile consult. Look it up, that one I'm not as strong on. But just see how can we incorporate some of these items within our practice.   And I would really say that when you do this, you're able to get those high case acceptance. You're able to have more patient acceptance. Think about it. We're paying bills online at night. We are also scheduling appointments. I am constantly on my phone in the middle of the day, at night, on the weekends, moving appointments around, looking to see. And I think if we're not offering that for our patients, we're actually gonna get left behind because patients might accidentally leave you to go to a practice that's actually more up to date. So definitely.   Let's get into how can we become more virtual online. I think it's a huge, huge, huge opportunity for practices. Like I said, I think those are the top three opportunities right now. So we've got AI, membership programs, and then getting more virtual. So virtual consults, virtual like having more available online options. And then I think two of the big challenges in the next five to 10 years, which I think we're seeing it, which I think tie into the opportunities are,   We know it's expensive to run a dental practice. And I think dentistry has had this like nice run for quite a few years, decades where they've been able to stay in a very profitable margin. Hence why DSOs have entered the playing field. And so I think with inflation, higher payroll, supply costs, I think that there's some things in there to pay attention. And number one is you've got to know your number. So I'm really pro overhead calculators, looking at it, having your team involved with you, making sure that all of you are on the same page.   Those are gonna be some really good ways for you guys to stay on top of it, not falling out behind the scenes and figuring it out. Then utilizing buying group things. So for example, Synergy is a great buying group. You buy from your own preferred vendor, but you just get a discount on your supplies. Why not do things like that? How can we actually look to see, can we hire hygienists in and then have a base plus commission? and I were on the podcast.   a couple of weeks ago talking about how we can incentivize hygienists and not have to have as high of payroll, but really looking to see what are the ways that we can do this, looking to see how we can increase our fees, doing a 5 % fee increase, negotiating with insurances or possibly dropping some of those lower paying ones. What are some of these pieces? And what I will say is When you watch your numbers and you analyze your overhead, I promise you, you will be more profitable. So right now we're like, gosh, it's so expensive, which I'm not here to say it's not.   But there's offices out there that are running at a 35% overhead. So that means there's 65% profit margin for them. So looking at that and knowing that there's practices that are able to do that, that means once we know it's possible, then we can look for how you can do it in your practice as well. Now I understand that there's different areas. California is expensive. Hawaii is expensive. Like I hear you, but that doesn't mean that it's impossible. And I think being a wise steward over your numbers is actually something that I really would implore you to do.   to make sure that as costs rise, you know what you're actually spending money on. So you can actually make better decisions. look to see, can we hire this person? Are we paying within the realm? What do we need to do? Could we add on other services within our practice? all on X cases, ortho cases, things like that. But I really think like it's a huge challenge that I think you've got to stay on top of. Otherwise, before you know it, you're gonna just be like inundated and not be able to hire team members because we weren't watching it. We didn't know our numbers. We didn't know what we needed to be producing.   We didn't build block schedules to make sure that our practice could actually run lean and efficiently. And then challenge two, which I think has been hitting hard, which we'll just kind of address, is like staffing shortages and team retention. But I will say that this is like an if. Like there's so many offices out there that I know have incredible cultures. And so what I really feel like needs to happen in this realm is you've got to be an office that in a place that people want to work for. I started noticing that the new currency is time.   Time is the new currency, I think, in where we're at right now. Time and compensation and being happy. But I don't think it's as high on compensation as people think it is. Yes, it's a piece, but I see team members that are getting paid less, but for great cultures are saying because they want this work-life balance. They want more time. They want to be able to be with their kids. They want to be able to feel appreciated with their boss. They want to feel like they're doing a great job. And that is more the currency of today. And so how can you build this culture where   We attract a bunch of people to our practice. We have team members that want to stay with us and that we actually know that, like, we're looking to see how can we maximize this. I am seeing a trend, I'm not saying this is how you have to be, but I am seeing a trend where there is a four-day work week of employees actually tends to lead to less burnout and less team turnover. I don't know what it is. My five-day practices tend to have a bit more of that, but the four-day, and again, they, so they're not,   just open four days or open five days, but they have these rotating shifts and rotating days where they're off. I have seen that that's helping. And so I really feel that when you can build this amazing culture, build it to be a place where you're excited about, add fun things in, watch your overhead, watch those costs. But I really think it's something that's possible. think back to why you started to practice. You wanted to change, you wanted to do things differently. You want to have a team where you were so excited. I know that's what I get excited about. love, I love having a team. love.   loving on them. I love giving them opportunities. I love seeing them flourish in their lives. I love being excited for the growth they're having and so really trying hard to build this incredible team culture to cut the team turnover, to keep it to where you're this like raved about practice where everybody wants to work for you. I think would really, really be an incredible thing for you to just take on. And I know we've heard about it, but I think like, look at your culture, look at the things. I had to do a deep dive of this last year.   Britt and I, sat there and we're like, all right, what is the team saying? What are the issues that we know we're seeing consistently? And what do we want to do to change to make this a better environment and a better space? And I feel that only teams in incredible culture, but there were things that we were struggling with. were things of that we needed to change. There were things that had shifted since I started the company. And I think you've got to stay on top of that. Otherwise, I think you can easily get outdated. So that's a quick wrap.   I think the biggest opportunities are definitely AI membership programs and then also getting virtual, like getting everything up to date and online. And then challenges of course are going to be higher costs and then staff shortages and team retention. But I honestly believe that those who adapt, those who innovate, those who listen to this and they don't just passively listen but actively implement are going to flourish. They say a lot of times the biggest millionaires and billionaires are born during times of hardship and harder times. And so I think   Instead of looking at this like, my gosh, the world is falling apart. Look at this. I'm like, this is the greatest time in dentistry. This is where you get to rise to the top. This is where adding customer service or doing unreasonable hospitality or being a different work culture will actually set you apart. Like you have a chance, like it's not all just set anymore. You have a chance to shuffle and ruffle and make your way to the top. And I honestly believe that you can future-proof your practice. You can get ahead of these trends. You can look ahead and   You can be the practice who is proactive and looked and saw where to get the worm and how to navigate your practice rather than being the one who wished that they would have innovated sooner. And so really just to call the action and truly if you want to future proof your practice, you want to get ahead of these, us. We're on Instagram, DentalATeam or email us, Hello@TheDentalATeam.com I'm happy to pop on a strategy session with you, give you a free practice assessment for your practice to look at maybe where the gaps are, maybe where your blind spots are, maybe we can help you out.   And honestly check out our newsletter. We have a newsletter that goes out so you can always subscribe go to our website TheDentalATeam.com We try to keep you guys on top of this of just insights and knowledge to where we can really help you and your practice thrive And so really this is truly what the Denali team does. This is who we are This is what we love to do and if you're ready to take on opportunities and overcome your challenges reach out Now's the time I do not believe that having a practice should be hard. I do not believe that these things are just   Let me talk about it. It's time to implement. time to take action. And it's time for you to be the elite practice that you were destined to be. And as always, thanks so much for listening and I'll catch you next time on the Dental A Team podcast.  

Kiera is a guest on the Dentalligenstia Podcast, hosted by Nick Zagar and Remy Isdaner. She talks about the connection between success and knowing your practice's numbers for the following: Production Overhead Collection New patients Case acceptance Kiera also gives tips on streamlining workflow, working through scratch starts, startup versus seasoned practice needs, and more. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00.16) Hello Dental A Team listeners, this is Kiera and today I am so excited. I did an incredible podcast and I just thought it'd be fun for you guys to hear it, to listen to it. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast. Welcome to the Dentalligentsia podcast. I'm Nick Zager and we have Remy Isdaner, my partner, and we are Mirlo Real Estate Partners. Today we have a special guest, Kiera Dent from the Dental A Team. Welcome Kiera. Thanks guys. I'm super excited to be here.   I love what you guys are doing. I'm just jazz. And I'm glad that I didn't have to say the name of your podcast because I would have totally botched that. So thank you for taking that on for me. I love what you guys are doing. And I'm just super, super excited to be here. I love geeking about dentistry and business and all things. So thank you guys. I'm really honored to be here. We appreciate that. you know, our favorite clients are typically early to mid-career dentists. And we love what you do to support.   our mutual clients and really want to know a little bit more about you and why you do what you do. How did you get into this? Yeah, for sure. Well, luckily for both of us, we love the same type of clients. So it's really fun. I actually started my career in dentistry in high school. I was offered an opportunity to either go into nursing or dentistry. And I thought, hmm, I want to wear scrubs. Like that was my end goal. And I thought, learn the whole body or learn the mouth. I'm surely going dental route. So that was honest to goodness. The reason why I got into dentistry.   I was a dental assistant for years and then became office manager, treatment coordinator, scheduler, biller, you name it. I have not been a hygienist and I'm not a dentist, but my husband, he went to pharmacy school at Midwestern Arizona. And during that time, I'm a little hustler. I found out if I could work at the college, I'd get a discount on his tuition. And so I knew there was a dental college and so I found out, got a job at the dental college.   And I was super blessed, super fortunate. And I worked there for three years with dental students. And one of the students asked me while we were in school, she said, hey, Kiera, do you want to come help me open my practice in Colorado? And I was like, heck yeah. Dental assistant to practice owner. Like, this is a great plan. I never knew how I'd be able to do this. I'm not a dentist. And I'm like, I see what you guys do in dental school. Yes, I want to say yes to this. So I went and helped her open the practice in Colorado. And we took our office from 500,000 to 2.4 million.   The Dental A Team (02:25.773) in nine months and opened our second location. And what I found from that was I learned a lot. We built a pretty big group of practices and I learned so much from that of what not to do. My marriage was about in shambles. Her marriage was about in shambles. My health was deteriorating. I was working from 2 a.m. till 10 p.m. trying to make these practices grow and I thought, well, shoot, one, if I could help her grow a practice, I wonder all my other students that I love.   Could I help them grow their practices and give them the confidence as well? And two, there's got to be a better way to do this than what I've been doing and what she's been doing. Like, yes, we have success on paper, but behind the scenes, we're deteriorating as human beings. And so that's really what spurred my passion. I never worked with a consulting company. Everything that Dental A Team's consulting is are things that I wish I would have had when I was a practice owner, things that I wish I would have known.   things to help all of my dental students. It's fun because it's becoming full circle. A lot of those students are now buying practices and coming and working with me, which is super fun. But really the passion comes from how can I help these dentists live their best lives, get the profitability they want, but also get their team bought in because most consulting companies work with just the dentist or just the team. And I thought, but if I can get the team on board, these dentists lives become a lot easier. And so it's really fun to talk about both sides of the coin.   And shoot my last name is Dent. So I think I was destined for this career path. It's not a stage name It's just the third fiance finally like I didn't get married I just took three fiancees to get a better last name So that's kind of my story and how I got into it and truly just love love this industry and love helping dentists Flourish and succeed and help more people But nursing never had a chance Yeah, I mean the scrubs if it would if they would have cuter scrubs than maybe but   The fact that I had the short path didn't just the mouth, but it's funny. I don't even get to wear scrubs anymore. like, man, that was a short lived moment. yeah, nursing. don't think I could do rectal trumpets. That's just like, I mean, I'll take the mouth all day long versus that. I don't think I could. I have such a gag reflex. I don't think I could honestly do it. Well, talk to us about some of your favorite client stories. gosh.   The Dental A Team (04:39.725) So knowing that like the startup to the mid range are kind of the ideal clients, I was thinking of a couple and one comes to mind. He attended one of our summits. We have one in April every year for doctors and teams. And so he attended it. And I remember he had like a really funny name on his screen because I see all the participants. I really try to make our summits really engaging and active. And I remember it was iPhone. And so I just kept calling this person out. was like, hey, iPhone, how you doing over there?   just kept kind of like razz and I had no clue there's no camera on it just says iPhone and lo and behold iPhone decides to sign up with us and he had just bought his practice and paid in full for consulting which I was always like man that's a pretty like gutsy move you just bought a practice but I also like people that are gutsy and this committed to it and what was interesting is we'll call him iPhone if you listen to this you'll know exactly who I'm talking about but over the course it's been about two years now iPhone has gone from   Being a practice owner who literally knew nothing about ownership had a pretty seasoned team when they bought their practice And went through all these hard transitions like I'm telling you this was a labor of love on both sides the consulting side and his side from needing to transition out his office manager who was really really causing a lot of like Shakes within the practice and and driving the team in a direction. He didn't want to go   So learning how to hire, learning how to lead, learning how to present treatment plans, learning how to put KPIs into the practice. Like you want to talk about a jumpstart to business ownership. And I remember he's like, Kiera, I'm not even taking home a paycheck. And those moments always rock me because this is real life for a lot of dentists. And my goal is to help them get to taking home their paychecks quickly. And so about six months, he was taking a little bit, but we started like at six months, he was able to take his full paycheck and then fast forward to   I just saw him actually last weekend and he was sharing that now he's producing over 250,000 a month in his practice, collecting home a paycheck, has a new office manager that was sitting next to him. They've shifted the culture. This office manager said that this doctor like makes for Phil Seen, Heard and appreciated. He understands his KPIs. He's got a profitability margin of 60%, which makes me so proud.   The Dental A Team (06:59.629) excuse me, his overhead 60 % profit margin of 40%. He knows his numbers. He knows how to look at it, getting ready to possibly expand his practice. But he said, we were just meeting last week and he said, Kiera, I want to give back because Dental A Team's given me so much. so having him help coach other practices now of things that he's learned really just inspires me. But I think about this man of...   like the rocky road he went on to get there. And I think that his journey is not unique. I think this is so common for so many owners who buy practices two, three, four years in, but to be able to have him be an example of what can happen and for him to be going from about 150,000 when he first bought the practice to now doing 250,000 a month, just to give him the confidence, I think as a leader, as a dentist, to get a team bought in and on board.   the fact that he knew his numbers and it's been, it'll be two years in April since he bought his practice and joined. And I think that is one of my most favorite stories because to see him excited about life, to see him excited about his practice when there were some dark days, I remember like his name, we'll just say iPhone was on our schedule a lot of times to give more support and to review resumes and to teach him how to hire for culture and to build a culture.   That is a magical experience. And there's, like I said, so many things from KPIs to numbers to culture to hiring to diagnosing and getting patients to accept you when the other dentist was still a part of the practice and moving on. He's honestly one of my favorite clients because I think his story is so relatable to how so many other people feel. And to see him now on the other side of it, truly beaming, I think is honestly one of my favorite stories. I have so many favorite stories.   But I think he's a really recent telling one that is just a fun success story to share with people. That's super cool. And he's got a great name. I know, right? iPhone. I'm like, it's easy because I was like, who is this? Who shows up? Like, I hate it on meetings. Like, get your name of who you really are because I want to call you. There's another, she's now a client. And I was speaking in person and, you know, front row, was like, hey, what's your name? And she's like, I'm going to be anonymous.   The Dental A Team (09:13.803) So we have a running joke now that she's just anonymous, even though she's a client now. And she's like, I'm so glad. But now she's like, secretly optimistic anonymous. So, you know, we've kind of changed that around, but yeah, it's fun to have clients show their personalities. But yeah, if you're on an event, put your dang name on there. Otherwise, maybe you'll be iPhone forever. Fair enough. I'd rather be iPhone than anonymous, but point taken. I've got a serious question.   for you based on that great story, but first I'm gonna joke. So it's on record in our company, there's a iPhone, Samsung battle and I'm on the iPhone side and Nick's on the other side. And we have it on record here on this podcast that Nick said something to the effect of, that sounds awesome being iPhone or iPhones are awesome.   So just just want to make sure that that we're all in the same page there, you know, Remy I'm happy in our company. It's the same. It's like Apple versus HP I'm diehard Apple everything connects in so seamlessly. So Remy we're on the same. Yep. I phone over here It's definitely definitely for the Samsung. I'm sick of the green bubbles, but they are getting better now I can see that you're writing I can see that it's been read. So I mean, hey, they are making some progress, but that's been like, you know decades in the making speaking the same language   Okay, as promised, I'd start with jokes and then, you know, that was a great success story and your passion is clear. Let's talk about those KPIs. So what are some of the KPIs that young dentists, newer dentists should be looking for? And I asked that question and then also add a preface. We talk to doctors all the time who have no, it's clear they have no...   connection to what the business side of dentistry is doing in their own practice. And I get it, we get it, that they didn't set out to run a business necessarily. They set out to provide the best oral health to their community. But it is a business after all. And so what are some of the things that those young dentists should be looking for? Remy, I'm so grateful you asked this question. It was not pre-planned.   The Dental A Team (11:36.073) My passion came actually from teaching people how to run successful businesses because as a business owner myself, profits seemed elusive. I remember like, what the heck is a freaking KPI? I didn't even know what that meant. And I really love in dental hygiene, there's no judgment. And I just want people to feel safe and confident to ask those questions. And I think dentists really feel this need to know everything because you are a doctor. And I just want to highlight that, guess what? None of them know it. Like 99 % of dentists that we work with   don't understand the business, but yet understanding the business and the numbers, I feel is like your treasure map to success. It helps you see where are broken systems in your practice to fix. So rather than just trying to pump a bunch of systems, let's look at the numbers to see which system we really can impact. Also, when you know your numbers, you can make smarter decisions of who to hire, when to hire, things like that. And so for people who don't understand KPIs, like I said, someone told me that I was a Dr. Seuss of systems. So I take that.   as a huge compliment to try and make it so simple for people. I believe KPIs are like the vitals of your practice. It's like when you go to the doctor, they always check your like height, weight, your blood pressure, your temperature. They're gonna check those things because if any of those things are out of whack, we're gonna have like an immediate plan. And I feel like that's similar to KPIs within a practice and KPIs can get a little extensive. So if we're talking about a brand new practice, things I start small and then we get bigger.   And so like main things that are really going to give you a nice suck on your business, if you're not careful are going to be your cashflow. So that's going to be your overhead. I'm watching your production and your collections because oftentimes the practice is producing enough, but your team's not collecting that money. So we want to make sure we have a 98 % collections ratio. I'm also going to watch your AR. So AR is your accounts receivable, checking from patient portion and insurance portion, because a lot of times practices actually have the money in their practice.   but they're not collecting, it's just kind of sitting there in overdue payments that are due to you, whether that's from patient or insurance. If we can look at those, we can figure out where's our collection problem. it we don't have clean claims sending to insurance or we're not collecting from patients and we're sending statements or we're not even calling. So I'm really gonna watch those super, super tight. And then if you want to go, excuse me, further down the line and things that I'll watch are gonna be like your lab costs, your supply costs, marketing can come into place.   The Dental A Team (14:00.685) scheduling, we can look at your scheduling and see like number of new patients coming in. That's a big one that I really like to watch because if we're not getting enough new patients or on the flip side, we're attritioning, AKA we're not keeping them in for re-care and reappointment percentages. We can get a leaky bucket and just keep filling with new patients but not retaining the ones that we have. So I like to watch your attrition rate. I also like to look at your case acceptance. So what are you diagnosing and what's being accepted to see is it a diagnosis problem?   or is it an acceptance problem? Whatever doctors wanna make, there is a study and a standard of three times what you wanna produce is what you need to be diagnosing. So if you're not watching this diagnosis amount, you might not be diagnosing enough to be able to get what you want on your schedule for your production. So I like to watch that. And I like to watch your case acceptance of dollar for dollar. So if you're presenting a thousand dollar treatment plan, how much of that thousand is actually being accepted? Are we accepting 100 % of that? Are we accepting 50 % of that?   and then asking questions of why, because case acceptance is usually one or two words from our exam to our treatment coordinator. And then I like to watch your hygiene percentages. So what's your hygienist producing per hour? I like three times pay for PPO practices, and I like four times pay for fee for service practices, and that's on adjusted production. So let's not go off of gross, let's go off of adjusted. Gross feeds the ego, net feeds the family.   So let's not be feeding our egos. I know it feels really good to say you're producing 260, but if you can only collect 150 of that, let's live in real life world. So those would be some zones. And then like, again, if you want to go like next level, you're already doing that. Some things we found over the last year of tracking hundreds of offices were open time in a schedule and your dollar per hour production, because a lot of times just open time in schedules, we found you could actually hit your goal.   if we could fill those spaces and then figuring out protocols for your team just to keep that schedule full. So I said a lot of KPIs for you, but really your main ones, you've got to be watching our production, collection, overhead, new patients and case acceptance. If I could only pick five, those would be my top five that I would start with. And I'm going to give six, like your reappointment percentages. Cause if we're not reappointing, that's really going to kick you down later on. And it's going to make a lot more work for you. And I think those are some pretty easy ones to watch pretty quickly.   The Dental A Team (16:18.733) but then also hopefully giving a lot of other ones for you to be able to watch in addition to that, that depending upon where you are in the journey of your practice, things to be looking at and doctors, you don't have to track all this. You get your team to track this for you. And then you get this lovely report that comes to your desk every week or every month. You review it, you assess it, and then you make the changes accordingly.   How do you help the practices that you're working with refine their systems to streamline their workflows to ultimately maximize their productivity? So Nick, on that, I'm just going to sound like a broken record. I literally look at their numbers, because whatever their numbers are looking at, these KPIs, that's going to tell us where the system's broken in addition to what your team is saying is a problem. So usually it's like communication or it's   low case acceptance or overhead or cashflow issues. And so what we're gonna do from there is we're gonna look to see what is the system in place. So if we're having an overhead issue and cashflow issue, well, I'm gonna look at the billing system. Like, let's look there, because that's where the money's at. So let's figure out what is our process, who's doing what, and where is the breakdown, and then we're gonna refine the system. I don't believe teams like to do hard things, and I don't like to do hard things, and so.   everything we implement should be easy because teams will gravitate towards ease and also not making someone remember things. So that's a true system. So we'll put in things like we can put automated notes or we can change our note templates if we're consistently missing something on our claims, we're gonna fix and adjust that system. We're also gonna look to see running certain reports that we put on an automated system for them. It's on a sheet for them. That way they don't have to remember to do this.   We create handoffs where it's on their route slip. So no one has to remember, like just with your memory, it's already built as a true system. And I think a lot about like McDonald's or Chick-fil-A or some of these companies that are able to mass produce and give you the same experience wherever you go. Well, let's build that and let's make a very simple system that everybody can follow rather than hoping and praying our team members remember and they don't drop the ball. So I'm going to look at those numbers. I'm going to look to see where the gap is and then dig deeper to find   The Dental A Team (18:33.461) root problem and then add an automatic system as much as we can to fix that problem forever. Are you dealing, how much of your business are startups, scratch startups versus acquisitions, also new practice owners through acquisition versus, you know, I guess that's the question, those two paths.   I tend, and I think it's just due to who I am and the things I did, I tend to attract more acquisitions in our company. So we're probably 75 % acquisitions, 25 % scratch start. We've worked with a lot of scratch starts. We've done a lot of pieces with scratch starts. But for me, I'm of the opinion, it's already there. My job is just to come and be the miracle girl on a practice that's already there. I know that I can successfully add hundreds of thousands to a practice very quickly.   adjust their overhead and make them profitable within just a couple of months. Scratch starts, we can do the same thing, but there is more of building that base to get more people in to build it. However, you don't buy someone else's problems when you do a scratch start. So in Dental A team, again, I think it's due to my experience, the things I've done. Like I said, I took a practice from 500,000 to 2.4 million in nine months. I know which systems to quickly shift and adjust. I like to say that we're...   We're a miracle girl for practices. You just sprinkle us on and we watch it bloom. Scratch starts, like I said, usually I'm about six months to a year before we're gonna start to see that churn and burn. And it's just due to building that patient base, which doesn't exist in the scratch start typically. But again, we've had several scratch starts. We've had several be a very successful, but that would be the reason I think why. But again, I don't shy away from scratch starts. I've done plenty of scratch starts and I do love that you get to build everything that you want and it's brand new.   You get to set the systems up from day one. I just think I like to. It's already in place and now my job's just to optimize and magnify it and make it even stronger for them very quickly. But I'm a fast results person. I like to see results quickly. Scratch starts long term have amazing results. Short term they're a little bit harder to get that churn on. Sure. Are people, are dentists typically onboarding you during the acquisition process so you're already known to them and their, you know, their,   The Dental A Team (20:55.281) They're acquiring with you on board versus an acquisition where things are just not, things don't feel right and they're not turning out the way the doctor planned or not as fast as they had hoped and then they're onboarding. So I think the doctors who do the best are the ones who bring us on usually month one or two before they open a practice. And I always say when you open a practice, it's like having a baby.   people nest the two months before they have the baby and then baby comes in, it's like screaming mayhem for about six months until you figure this out. And I really do believe that that's how practice ownership is. So the offices who I found do really, really, really well are the ones who bring us in one to two months before they actually add us into their loan of their additional cashflow that they need. So it's part of their purchase. That makes sense. Versus the ones that are like, Hey, I don't have cash, but I need help.   because every office does this, literally every single one of them they're in and I call it the six months shakeout. As soon as you buy a practice, it is bananas for six months. Like you have high costs, you have high expenses, nothing shaking out. You're trying to win over all these patients or bring in new patients. Like it's mayhem. And that's actually when you need consulting the most. Like you need someone to pull your head out of the sand, tell you do step one, step two, step three. This is where you actually need to focus rather than just being psycho and trying to like do all the things, but never getting anything done.   So I really love when they come. Otherwise, and I'll say, I'm really pro, of course, being a consultant, I'm pro this, I'm really pro hiring a consultant that can actually like put money on your books. So a lot of things people buy when they're buying a startup, they actually don't add revenue for them. So it's just a lot of cost without a lot of adding to it. And so there's lots of great consultants out there, but I'm really pro find someone who's done what you need to do successfully multiple times.   and bring them in because a consultant for us, our fee is guaranteed covered every single month. Like I'm never worried about that, but we tend to do two, three, four, five times our fee, adding that in in production and reduction of overhead for a practice very quickly. So I never worry about, I understand the owners do worry about fees because it can feel scary with everything you're adding on, but be intentional with what you're purchasing, what can add money to your books rather than just taking money off of your books.   The Dental A Team (23:19.462) Go ahead, Nick. Well, I was going to switch gears into talking about building and developing a strong team, since you just mentioned that. And I wanted to start by actually saying that when we're working with a client and they're looking for, you know, to a relocation option or they're looking to buy a building or just a general lease, mean, these are all super negotiable things inside, you know, inside of their   you know their business world but you know the the You know the highest expense that they likely have is payroll and so they can't really That's not something you're not gonna retain high-level talent by you know negotiating like a like like a madman like you would with a landlord for example, and so I wanted to talk to you about what are key qualities that a you know a dental practice owner should look for when hiring   key team members. For sure. I'm so glad that you said that rented landlords are negotiable because I think people feel like it's fixed. And I'm like, no, listen, listen, this is why you need Nick and Remy. Talk to them. They'll help me negotiate this down. Agreed teams are a bit trickier to negotiate down here. You're not going to probably get the best people. No one wants to feel like they're being bought on sale to come onto your practice. but as a landlord, yeah, I want the best deal. My labs and my supplies, I want the best deal.   But for teams, so I'm gonna kind of give two different answers because I think startup practices versus maybe a little bit more seasoned in their career actually have two different needs typically. As a startup, I'm really pro them hiring basically an office manager that knows how to do a lot of the things that they don't know how to do. So we need someone who's strong with case acceptance, strong with billing, strong with leadership, strong with hiring, and it's going to be an expensive hire. But what that...   that expensive hire is going to do is going to exponentially grow your practice for you. While dentists are in the back doing dentistry, you have someone who's really your yin to yang in the front office for you. So I'm really pro and I'm really pro not hiring just one person, but two people in the front office. I've seen a lot of embezzlement in my time. I've seen a lot of just funny things going on in the front office. And also if you only have one person up front, you're literally like SOL, which stands for so out of luck.   The Dental A Team (25:38.758) Um, in my opinion, like you really will be S O L if that one person leaves because you know nothing in the front office. So I'm super pro hiring those people and hiring really good talent when you're a startup. Now, if you're a little more seasoned, figure out what's going to be your yin and yang. If you've got a good biller or you can outsource your billing, um, maybe you don't need as high quality of, or as expensive of an hire that way. But what I have found is typically I like to see payroll around 30 % of your collection. So we're collecting a hundred thousand.   about is going to be spent for payroll costs, not including doctors. And so for that, that's also your fringe benefits, your 401k. And what I've seen with a lot of doctors is team members are only listening to their dollar per hour, but doctors, you're paying a lot more than just a dollar per hour. So we've actually created a really beautiful form for our offices that's kind of like their total compensation package that we recommend giving like once or twice a year to your team so they actually see what they're producing.   Now, hygienists are coming in as a really hot topic, depending upon the area you're in. And a lot of those are like, they're kicking that overhead, the payroll amount really high, but you need a hygienist because they're a producer. And so what's happening, we have a couple of hygienists on our team as consultants. And what they're recommending is let's have a really good base, base plus commission. And then looking back at your hygiene schedule to show this hygienist based on what we've already done. I don't like to live in like theories.   because no one wants to live in theories. They want to feel confident. So if I can hire hygienists for X amount that is fair within the market rate, but give them a commission, so anything they produce over that, showing on historical trends of what my practice has been doing, that's gonna help me keep my payroll costs lower, but I'm gonna be able to pay this hygienist more and be able to actually offset my payroll costs because they're producing more, but I can keep my payroll lower. So that's where I do think you can quote unquote negotiate.   But I really feel strongly, you've got to show them with confidence that they can do this and you've got to have an incredible culture. Culture and time tend to be the currency of hiring great team members right now. And so if you don't have a great culture, if you're not a great boss, you're not gonna hire great talent. I've seen offices paying their employees less than other people in the market, but they have such a great culture that team members want to stay. And then also looking at this time off, PTO is becoming a really hot topic and I feel like since 2020,   The Dental A Team (27:57.872) We're seeing more of this lifestyle that people want to be living more so than like the 401k traditional benefits, depending upon the age of the person you're hiring. Cause I do think there's two different age groups that want two different things. And so being aware of that and cognitive, think you can get creative with what you're doing. So I think that's a lot of great ways to bring it on, but you've also got to be clear on what your culture is and what your tip is. And you've got to be careful not to hold onto those sour apples that are truly destroying your practice.   One of the best quotes I heard is, the worst thing you can do to your best employees is tolerate the poor performance of your worst employee. And so really being cognitive, and I know that's hard, but trusting and believing that you can bring these great people in. So we put awesome ads out. I tell people to write to their ideal person, figure out who they want of their ideal person, and then posting those ads consistently and following up can be really good ways to get it. And then like,   Great culture does not mean you give everything to your team. It also means that we hold them accountable, that we have structure, that we have systems in place, but giving them the autonomy within that to create what they want to. I think are some hopefully simple pieces based on where you are, of who to hire, how to keep those costs lower. Also, what a good framework of what your payroll should be. And then also realizing the amount of payroll you've got, that should be producing. So make sure that you're.   payroll dollars are actually giving you the production that you should be getting from it. And if not, maybe it's time to make a couple of changes that way too. Yeah, one, one always is, is trying to kind of create a culture that promotes accountability and collaboration and continuous improvement. And you can probably, you know, inside the mission statement of the, of the, of the practice kind of address some of those things so that you have some ground rules. But ultimately at the end of the day, it's about   the leadership and also needs to live those values as well. Yeah. And on that Nick, am really pro core values. When I first started, I heard a explanation of core values and they said, usually when you start a practice, you have three core things that really were the core of why you started this practice. So think back to what those three, those are like your true core. And when I thought back, I was like, yeah, for me it was do the right thing.   The Dental A Team (30:16.272) have a ton of fun and make it easy for clients. So like those are my three. it's do the right thing, fun and ease. And then we have aspirational ones in addition to that, but really truly like our core values go on our job board. So like when we're hiring people, we say these are our core values, this is our company. Every Wednesday we're highlighting out team members that have been exhibiting core values within our company. So each team member shouts someone out about the core values. And I really have found that   That's how you build culture. Culture is a slow burn, but it's a consistent burn. And so if you have that and you really live, breathe and bring that in, your culture, it will take a little bit of time. say it's kind of like moving the Titanic, but the consistency piece will start to shift it to where you have that incredible culture. And then if you have someone who's not, have the one-on-one conversations rather than the full team conversation. Get really, really good at having uncomfortable conversations. I love the quote. I've added my own little.   sprinkles to it. I say your success and happiness that's care is added is directly proportional to the number of uncomfortable conversations you're willing to have. And I like adding happiness to it because I think like my success is one thing, but my success and my happiness, I want to be happy when I go to work. I want to have a great time. And so just getting really good with those uncomfortable conversations. And I say, it's a conversation. It's not a confrontation. And like, let's get to the root cause. Let's solve the problem rather than the person.   and let's move that forward. I think those are some hopeful quick tips for people to start to change that culture because it can be done and it's paramount for bringing in great team members as well. Well, that's a really important piece of the puzzle is communication, especially since everybody has a different communication style. you know, I wonder what your guidance is about how somebody who owns a practice can, you know,   can become a better communicator or overcome some of those challenges to be able to kind of understand how to communicate to different members of their staff or what have you. For sure. I'll give a couple of books. I believe there's so much wisdom found in the minds of men and authors. And so The Five Dysfunctions of a Team by Patrick Lanzione I think is a great one to figure out how to build that trust and healthy debate between you and your team members. so encouraging that.   The Dental A Team (32:43.974) and digging down deep into that. Also, there's a lot of personality traits, tests that are out there. I really am pro disc. There's also a company called Culture Index, and I think they teach you a lot of how to communicate. And something I learned early in my career that I try to pass on to our clients is hire people who are complimentary to you, not necessarily the same as you. Your biller is going to have a very different personality than your scheduler.   I want a bubbly outgoing scheduler who just makes my patients feel incredible. And my biller, do not want them being the party scene. I want them to be the person who's so detailed on every single number. Well, those two personalities are also going to be different communication styles. My biller, can probably be a bit more direct with. My scheduler, might need to have a little more finesse with. The five love languages at work is another great way to see how do people prefer to be communicated with. And then also just asking. I think asking people of,   hey, like some people really wanna be direct and just told directly, other people need like the sandwich, the compliment, here's what we need to work on, the compliment, because otherwise they're gonna feel like they're an utter failure. And so I think as leaders learning, I used to always communicate the way I like to be communicated too. And I feel like that was so naive on my part, because that's how I prefer, does not mean that's how other people prefer. we have, when we hire new hires and we recommend this for our offices,   We actually have them take a quiz within our practice and it tells me their favorite things for appreciation. What is it? If I was to get them a gift, what would be something very meaningful to them? How do they prefer to be communicated with? Is it direct? Is it collaborative? And then we have them read the same book so that way we can speak in the same communication language with each other. And then coming in to when it's an uncomfortable conversation, owning that and saying, hey, like this is uncomfortable for me to say.   We address the root problem and then we ask for feedback of, Remy, how did that land? I want to make sure that what I was trying to convey is actually how you heard it. Then Remy can come back and say, Kiera, I felt like you thought I was a jerk and that I'm not working. And I'm like, my gosh, thank you for saying that. That's not at all how I was saying it. What did you hear? That way I can change this to make sure we're on the same page. That communication takes finesse, takes time, but I will say I would rather invest in that skill than having the constant turnover.   The Dental A Team (35:06.96) train that's going on. And if you're in maybe a bad culture right now and you don't know how to fix it, anonymous surveys, we send them out for a lot of our clients when they're in this particular spot and start to ask honest feedback of what does this doctor or team need to do to change? What's causing the turnover? What's causing the breaks in the practice from the team members perspective? And then adjusting our communication styles accordingly to really try and help that communication. But I really love asking for feedback of how that landed.   I think that's one of the easiest ways to get that feedback very quickly on communication. So we've talked a bit about communication, I guess, with your own staff, but paramount to any successful dental practice, they need to have strong communication with their patients because enhancing a patient experience, I think, really kind of goes hand in hand with growth and all the other   types of things you need to consider to raise the, do better, I guess, for lack of better word. So. I think patient communication, you're right, it's paramount. And learning, I think that's handoffs. I think that's having everybody speaking the same thing, doctors giving good exams on that. But then also finding out what your patient drivers are similar to a team driver. What is ultimately their number one objective? Is it cosmetic?   Is it function, is it cost, or is it longevity? I said those in a very important order. believe order matters. Because if I put cost first, I'm highlighting cost. But if I put these in a very strategic way, I've done this with hundreds of offices, and we've asked thousands of patients, I will tell you 99 % the time it's not cost. It's usually function, it's longevity, cosmetic, how it looks. And then of course, figuring out within cost. But if you can figure that out from your patients and learn to communicate with them in their style, utilizing disc profiles as well.   You're exactly right, Nick. You'll get higher case acceptance, you'll have a better patient exam. If you have handoffs where everybody's speaking the same language and we're passing the baton off from person to person so that way nothing gets dropped, you will be shocked. We've increased case acceptance. I had a practice, they were getting about 25 to 30 % case acceptance and we literally got 100 % case acceptance that day just by changing a little bit of how we communicate in our handoffs.   The Dental A Team (37:27.462) The patients would walk up to the front and say, doctor wants to see me back in two weeks for a crown for an hour, I need to get that scheduled. And if your patient is that clear and your communication is that clear, you can only imagine what that does for your practice and your production and your reviews, because that patient's not confused anymore, they literally know what to do.   The Dental A Team (37:50.822) Can you share any practical tips on how dental teams can educate their patients more effectively about their oral health and treatment plans? Yeah. So I'm really pro hygiene. The hygienists have hopefully an hour with them. And so I'm really big on visuals. And so we work with our practices to build kind of like explaining it helping these patients see like on x-rays where you can use, there's a lot of AI softwares out there. I love Pearl. I love Overjet. They can help educate the patients of what's going on in their mouth.   And what I found for patients is there's a lot of mistrust. And I know dentists hate this analogy, but it is kind of like a mechanic. And so we're looking under the hood and the patient's like, I see nothing but black and white up on there, but you're telling me to like squint my eyes and there's a little cavity right here. So I think also helping train your patients of like, this is a good tooth. And this is a tooth where there is decay, showing intraoral photos for them, helping them so that way when they're going through their teeth, it's like, okay, tell me what you see on this tooth.   the more the patient can actually grasp it and understand it, the more they're going to actually accept that treatment. But in addition to that, one of my hygienists that's a consultant on our team, she gave me some really good advice and she said, never ever, ever use little league words for major league problems. I think oftentimes we don't want to offend the patient or want to make it feel better. And so we're like, well, there's this like little cavity. The tooth is bombed out. Like, why are we saying it's a little cavity rather than telling them like, this is what's going on now.   Yes, they're still finessed, so we don't wanna make them feel bad about it, but we also need to help them see the severity. And what I found is when you're confident in your diagnosis, when you're confident in how you're presenting treatment, your patients are actually buying your confidence, they're not buying the treatment. And so you being confident, and I've helped hundreds of them practice, I literally have an office and we've added multiple millions to their five locations by simply helping them present treatment better and stronger and more confidently, because truly the patient is buying your confidence. And so now, never over diagnosing.   but getting that patient to see it and truly telling them what's going on. And then I always love to say like, here's a comprehensive exam and the good news is, this is how we're going to get you like great back to great oral health and using the good news is, or the great news is that way the patient feels like there's hope and optimism and then giving them a really clear plan of where you want them to start. That way it doesn't feel overwhelming or daunting. Cause you can teach a patient all these things.   The Dental A Team (40:14.448) They just need to know where to start and how you're gonna be able to help them get the success that they're looking for and to get back to oral health. Not all patients have it. And I say that not like these problems did not happen overnight. So it's not gonna get fixed overnight. Our bodies are always decaying. Like we're always like aging is as fun and thrilling as that is. Same thing with our teeth. And the great news is this is how we're gonna get you healthy.   We've talked a bit about, you know, communication and creating a strong relationship, I guess, with your patients. Talk to us a little bit about how dental practices can develop a strong presence inside their local community to build trust and attract more patients. Yeah, there's an office that I really love. We were just chatting with them and something that I think this office did so well is they have the goal to be   the hometown dentist in their city. That's the vision of their practice. They want all of their patients to feel that way. So it's a very large practice. They have 15 operatories and they've still been able to maintain that hometown feel and they're very connected to their community. Another practice they said that our goal is to change the way people feel about going to the dentist within our community. And so I think the way that you can get this like stamp in your community is one, having that be part of your vision where you want to be   that local dentist to your patients where it's that hometown dentist feel in your practice, then your practice, your patient experience will feel that way. But then these offices, the two that I explained, they're very involved in the Chamber of Commerce. They're very involved in the little league sports. They're very involved in giving back and providing for these communities. I have another dentist and she created what's called the Thrive Home, where it's literally being able to give back to the community with all the different specialties like OT.   PT, dentistry, to give back within the community. And I really think if that is something that is your MO, treating your patients that way, asking for their referrals and their reviews, and then also being able to have that presence. I know growing up, for me, our chiropractor was so well known, that chiropractor was everywhere. They were at all the football games, they were all the high school events, they were at the town hall, the chamber of commerce, like.   The Dental A Team (42:30.106) Everybody knows that Ellison Chiropractic is the number one chiropractor in the area. And I will say it's because this family was so involved in the community. We saw them everywhere. And so I think how can you also do that and giving back to it? But I think my biggest recommendation, if you want to grow patients based on your community, I think it comes from genuine care and genuine authenticity that you actually love this community that you want to give back. If it's just to pull new patients in, there's other ways to do it.   But I think really, truly, you want to give back to that community you want to serve. I think patients will feel that when it's true and genuine and authentic. We understand how important marketing is to a practice and how it gets teeth through the door. And it's expensive, and it's money we're spending. But I think you hit the nail on the head. In addition to traditional marketing, there's so much more you can be doing in   involvement really is the key. The more involved you can be in your community, the better. Whether you want that hometown feel or you're focusing on productivity and efficiency and I think getting yourself out there and being a part of something is invaluable. That's great advice. When our clients hire us, it's normally because they   They feel totally lost. They're beginning the journey of practice ownership or real estate ownership. They have a lot of student debt. They are about to borrow a lot more money. And it's really scary. we try to really hold their hand through that process to kind of give them those tools so that they can ultimately make the right decisions.   for their practices real estate. And so it's really cool to hear you and how infectious your energy is and you have really good support systems for your clients to really ensure that they're not missing anything and are really maximizing their potential. And so that's really cool to...   The Dental A Team (44:54.078) to hear from you. Switching gears a little bit, I want to talk about the future and industry trends to see if there's anything that you're seeing or anything that you think your clients are going to face in the next five to 10 years that they should be preparing for. Yeah. And Nick, thank you. I just wanted to highlight what you said because you're right, it's terrifying. It's terrifying to go into that much debt.   I remember I used to call my dentist 2.5 because we were 2.5 million debt. And I was like, that back straight because you need to keep these hands and that back good. And I would just always say like 2.5, 2.5 because we were 2.5 million debt. And I think that that's where my passion comes from profitability overhead systems because I know how daunting it can be to be an incredible clinician, to be an incredible business, to be an amazing practice, but not to have the cashflow to support what you just went into debt for.   And so that's really where I'm pro like know your numbers, use the systems, utilize your team because, and I will say this again and again and again, a dentist who is financially successful and secure is the best boss to have. And health health teams, want your dentist to be successful and profitable because they're more solid, they're more stable and they're not stressed out, which is going to make a better boss for you. And so agreed. It's very daunting. It feels very scary, but I will promise you if you know your numbers,   It can feel awful at the beginning, but it can actually make it so much better for you. So thank you for highlighting that Nick, because I think I've just seen so many students so stressed about cash and staying up at night. I've had it myself. And so speaking from real life experience, giving you the tools out of that dark hole, I think is one of the greatest gifts we can give to these dentists who are already giving the gift of smiles and confidence to all their patients. Being able to do that same for dentists is such an amazing thing. And now,   Speaking of like what's in the future, shoot, DSOs are on the horizon. I think an AI, like these are two hot conversations. My doctors tell me that they are probably getting a DSO offer at least three to four times a day. And that is ratcheting up. They're getting so many offers constantly from DSOs. They're finding them. And I don't blame them. I think Wall Street is smart. They've realized that dentistry is a great business to invest in. mean, we're hearing 50 % overhead. So we've got exponential profit within.   The Dental A Team (47:19.474) Dental practices are profitable, typically speaking. And so I think that these are some things for doctors to be aware of. And I think educating yourself on making sure that you're selling or you're living your life the way you want to, rather than like just getting an offer on a bad day. So I think the DSO offers are dangerous because when you have a bad day in dentistry, it's very easy to look at that EBITDA number and say, I just want to sell. I want to get rid of all my problems, but I want to also caution and advise.   to know exactly what you're getting into because I've had some dentists sell. I think DSOs can be great for a lot of practices. I think MSOs can be great. I can see legacy practice and partnerships being great. There's so many amazing things and I don't think there's really a wrong route to go in dentistry. The wrong route I think is when you make an emotional decision that's not going to impact your life the way you want to. And so being very cautious, I think of when do I wanna sell and also what really is a good deal because I had a doctor and their epita,   They talked to some DSOs and he's like, cure it. It's going to be great. I'm going to get five mil for this. And I said, we'll call this one hometown. Like he's not the hometown, but like, we'll just call him. I got iPhone anonymous hometown now. So I was like hometown. I just want to point out that next year you're going to produce 5 million based on our block scheduling and also on the expansion of your practice that we just did. You are going to produce 5 million and they did. So I said, you're going to actually get short changed on this DSO deal. If you're like.   But if you're done with dentistry, it's a great deal. But also you're going to have to work for this person as an associate when you're going to make five mil next year, just in producing on your own and you don't even need to sell. This hometown does not want to be done with dentistry for about 10 years. So I said, you are shortchanging yourself where you can build this. You can exponentially expand into this, but you've got to make the decision of where you want to go and what you want to do. But the five million sounded so attractive to this doctor.   when they didn't realize that their practice was already producing that and would produce that with ease the next year. So I think like being really cautious of that, that you're not making, I feel like I'm so passionate because I feel like your business not only is providing for your life right now, but it's a long-term asset. And like what you guys do with the real estate, these are long-term assets that are building their wealth portfolios. Let's not, let's not do botchy investments, kind of like stocks, right? The stocks we all know just like dropped like, shoot, if you're watching that, you're going to freak out and you're going to want to sell everything.   The Dental A Team (49:40.68) but they know be stable through your investments, stay steady and not make those irrational decisions I think is so paramount because the DSO offer seem very appealing right now, especially on those like hard dental days. So that's one that I think dentists really need to be cognitive and aware of and knowing what your end goal is, what your retirement goal is, what you ultimately wanna sell out for. So that way when these offers come through, you can be educated and educating yourself more because I promise you.   I do not believe DSOs are going away. think in the next decade to two decades, we will see dentistry become more similar to healthcare. I know I'm like very hated about this. I've had this opinion for several years. My husband works in standard medicine. He works for hospitals and I'm like, gosh, like what was going on in the hospital scene is now what we're starting to see in dentistry. It's not gonna be too long before they're all bought up, but I'm also watching standardized healthcare now trying to shift into private practices and get out of the DSO.   like with air quotes around it. So I think just being cognitive of what you want to do and what you want your legacy to be. But also I don't fault you. I mean, a lot of these dentists are going to be able to get incredible retirements that they may never have been able to get similar to people buying homes in COVID. Like they're getting insane value, insane interest rates. it can be a very wise financial investment deal for you, but just do your homework. Cause I've seen some DSOs go under and people have lost pretty much their entire retirement. So that would be something I definitely highlight on. And then also watching AI.   The doctors are not into AI, they've got to get into AI. That's where I mentioned Pearl and Overjet, they're helping with diagnosis. I can already see they're riding on the wall that insurance companies, guarantee you, are probably already using AI. And so making sure that you are staying at least up to par with insurance companies, if not further ahead. Utilizing virtual assistance, think staffing costs are going to continue to be skyrocketing. And so for that, what other things can we do? like...   Opportunities force innovation. And I think we're in an opportunity zone to force some innovation and to be on the cutting edge of that. I do think right now, doctors who are not online, depending upon where you are in your career, if you're not online, having a presence on social media, if you're not getting involved in AI, I am going to caution that I think those practices very easily could get left behind unintentionally to where it might be hard for them to come back. So just even dabbling in it, getting some team members that could help you with that, I think is super important. And I would say this year,   The Dental A Team (52:04.51) I would add some sort of AI to your practice. Whatever you choose to do, just so you start to experience it, use it. There's so many things and I think honest in the next five years, I think AI is going to radically disrupt how practices are operating that I think it's important to like at least be dabbling so you're not completely left behind on accident.   You think the AI is, I mean, it's mind blowing and the applications just seem endless and hard to keep up with. you, so are you, if I hear you correctly, you're talking about AI integrations on like the practice management side of things versus patient care, right? Like patient care, so yeah. Yeah.   I think patient care is going to be tricky. I think until they get robots who are amazing, do think like the clinical side of dentistry probably will maintain pretty accurate. But I do think your front office and a lot of your systems will get changed. And I'll just highlight, there's a practice that we work with and she has, it's a pediatric practice. She's got incredible- call them? Sorry, what? What are we gonna call them? this one, we're gonna call this one, we'll just say jammin'.   so this one's jammin. I do like that we're naming all my offices. right. So jammin jammin has a pediatric practice. She's got an entire amazing team, but she has like eight support virtual assistants behind the scene for this practice. In addition, she has made her own AI bot called Amy and Amy. That's actual name of the AI bots. That one's real. didn't change it. mean, I should have called it like Joker, but like that's not really going to work jammin and Joker. This was actually called Amy. but Amy.   responds to to Jammin's practices day in and day out to make sure patients are happy. Now they live in a very affluent area, so it's very fast paced. But what I love about this doctor is she realized in order for me to keep my patients happy and to meet their demands, there's AI and I can create an AI bot that responds exactly how our practice would, but I'm actually not having to pay a team member, an actual human being to do this. And they're able to get all the needs met. That's what I mean by.   The Dental A Team (54:13.37) looking to see where can AI integrate. And I think it's going to hit your front office faster. But I think like software is meh, like that one's tricky. Software's are tricky to me, but I'm like billing. I guarantee you AI is going to take that over for sure. Hands down. It's going to take it over. I think answering phones and scheduling phones, I think are, the way we send out claims for sure. Like that's all within your billing realm. there's some softwares that are trying to act as office managers. think reading X-rays are going to definitely be taken over by AI.   hands down and I am curious and I don't have an answer for it, but I'm super curious. How is that going to impact diagnosis? I work with some practices in Canada and Australia and they're more streamlined. There's not really a lot of change. Like it is what it is. It's standardized healthcare over there. And I'm curious with AI coming in and I know I'm going to be like, I might get ripped on this. I'm welcoming the reviews because I think it's worthwhile to talk about. I'm curious how AI is going to impact diagnosis.   And what can be diagnosed and what can be actually built out which leads me to believe similar to medicine That's why there's bill like they bill out every single possible code that they can't I mean for the gauze for the cotton and I'm super curious that I don't know I think it's worthwhile to look into is that gonna impact our diagnosis and how we're billing should I maybe be looking and knowing those codes more thoroughly? Depending upon how it's gonna be. I don't know. I think that that's huge speculation on my part, but I   I can't help but think that AI is going to impact our diagnosis in a big way. We're insurance companies, which then leads me to think companies might be leaving insurance. right, like we might be going more fee for service. So then you got to ramp up your marketing. But I think that's going to be a big spin that's probably going to be hitting us in the next couple of years.   The Dental A Team (56:02.27) It's scary and exciting. don't know what else to Scary and exciting. It feels wild, right? But I'm like, don't think dentistry itself is going to change much. I still think we're going to have our craft. It's a very, very humanistic, very crafting. But I'm super intrigued. And I think for me, I'd rather take it on as like, let's be excited about it. Let's get into it. Let's see. How can we dabble? How can we influence it rather than being told like, is what's going to happen now?   I would prefer to be a pioneer through it and I think first office is to innovate. I I prefer to be like second, third, like I'm not gonna be like right on the first in case everything botches, but like second, third, get in there because these things, I don't think it's going to go away. I think it will adapt and morph, but I think it's here for a while. I hate that I didn't ask you this way earlier, but are you also, are you working with all different specialties or are you strictly general?   That's a great question. We actually work with all. So we have pediatric, GP, oral surgery. The only one we don't dabble in is ortho. I think there are some incredible consultants out there that do ortho. Ortho has its own software. It's its own beast. It's its own animal. I do work with ortho and GP, so we're very familiar with it. But ortho, I just think there's consultants that rock the ortho world, but all other specialties. We have clients within all of those and really love them in all their areas. We tend to specialize GP and pediatric, but we have clients of all.   all specialties minus ortho. Yeah, I The reason I asked is that I was speaking to, you know, an endo group who was actually starting to transition to fee for service. And I don't know, maybe that'd be a good introduction. Yeah. The fee for service world is weird. I really, offices want to cut. They want to just cut the insurance right now. And I'm like, hold please, before you do that, realize it's a retention piece for your patients. And if you don't have a great experience and you also don't have great systems in place,   and you also don't know how to maintain these patients, I had a practice to do this and they almost lost 50 % of their entire practice. So I'm really pro, like you can drop insurance and I'm not here to say not to, but I want you to be very thorough and educated on it and know worst case scenario, best case scenario. I think fee-for-service is gonna dip in a lot more, but if you're not careful, fee-for-service patients are free agents and never forget that. So they can go anywhere at any time. They're not tethered to you like they are with insurance. So making sure.   The Dental A Team (58:25.202) before you start cutting and get all excited about fee-for-service, I'm here to say do it, but do it correctly. Because I think there's a right way and a wrong way to do it. And I've seen it hit practices really hard if they don't do it correctly. Good to know. The time we spend with people like you is meant to help dentists and really end support staff all around. And they all offer different types of great information and fe

The Deadcast begins our virtual tour of the new Enjoying the Ride box, visiting the cradle of the Dead in Palo Alto/Menlo Park (with a detour to visit the Warlocks' earliest shows) before heading to San Francisco with stops at the Fillmore West and Winterland.Guests: Connie Bonner Mosley, Ron Rakow, Ned Lagin, Ron Pietrowski, Tyler Roy-Hart, Les Earnest, Doug Oade, Eric Schwartz, Blair Jackson, Michael Parrish, Dominic Stefano, David LemieuxSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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For the 50th anniversary reissue of Tiger Rose, we explore the lost story of Robert Hunter & Jerry Garcia's only full-length studio collaboration, the Dead lyricist's 2nd solo album, produced by Garcia & performed by an all-star cast including Garcia, Mickey Hart, & Donna Jean Godchaux.Guests: Kathy Veda Vaughan Bogert, Mickey Hart, Barry Melton, Ron Rakow, Howie LevineSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In the 2nd part of the Deadcast's Phil Lesh tribute, we get deep into his singular bass playing with Phil's son & bandmate Grahame, Phish's Mike Gordon, & musicologist Rob Collier, while touring Phil's high adventures with Ned Lagin, radio co-host Gary Lambert, & other friends.Guests: Grahame Lesh, Mike Gordon, Ned Lagin, David Crosby, David Lemieux, Gary Lambert, Rob CollierSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.