Podcasts about dso

On today's episode, Dr. Mark Costes sits down with Dr. Kwane Watson, the visionary founder and CEO of Kare Mobile Inc. With a background in both private practice and corporate dentistry, Dr. Watson has pioneered a transformative model of mobile dental care using single-operatory vans combined with proprietary technology. He shares how Kare Mobile addresses healthcare inequities by partnering with insurance companies, counties, and institutions like jails to bring care directly to underserved populations.   Dr. Watson also explains the inner workings of his fleet, the ROI of mobile care, how self-scheduling software boosts efficiency, and why he's expanding his tech-forward DSO model. From manufacturing vans in-house to scaling digital dentures and tele-dentistry, this episode showcases the future of accessible, scalable, and entrepreneurial dentistry. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://karemobile.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Kiera is joined by Ted Osterer of Synergy Dental Partners to talk about the money field of dentistry in this moment of 2025, including tariffs, negotiating and raising fees, finding supplies, and more. 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 today I am jazzed. I have a super fun guest on the podcast today. We're going to talk about the tariff sheriff, how that's impacting dentistry, the rise of dental supply costs, and honestly what to do because I'm so annoyed by all these pieces. What's the economic outlook? How do dentists freaking survive? Like, gosh, it just seems like a funny world out there. But we have Ted Osterer. He is with Synergy. I love this buying group. I think they're   Absolutely incredible. We're gonna shed some light for you guys. So Ted, welcome to the show today. How are you?   Ted Osterer (00:32) I am doing very, very well. Thank you so, so much for having me. Congratulations on your thousandth episode recently. I'm happy to be a part of this and any value I could bring to your listeners, hey, we're all better for it.   Kiera Dent (00:39) Thank you.   Well, thanks, Ted. And yes, ⁓ I'm still in utter awe that we hit a thousand episodes. Like when I started this, it was just a whim, a pipe dream. Jason and I were hiking. It's not a joke. I literally was hiking half-dome. Mind you, Jason had said, hey, let's go down to Yosemite. I'd love a nice relaxing weekend down there. And I had learned that you could go get, like, this is prior. You can't do this anymore. That you could get these like day passes, like these day camping passes. And if you just went and sat at this little lodge for a few hours.   So I was like, Jay, yeah, of course we'll go down there for this very calm, welcoming, welcome, like very easy, relaxing weekend. Little did he know I had full plans to try and get half dome tickets and like hike half dome. I even brought the gloves, like I was ready to go. And sure enough, I got the lottery, got the tickets. Jason was like, what the heck? We're going to freaking hike half dome. Like, Kiera, we haven't even prepped for this. We haven't done any of this. We don't even have a hotel. We got a hotel an hour away. We had to drive an hour outside of town. It was the nastiest hotel. They were like,   I'm not even joking. There was like hair and like this little pill on the pillow that were not ours. Jason's like had the worst sleep of his night and I'm like listen there's no hotels around me of 70. Like we're filing so we had a place. We went back super early the next morning to hike Half Dome and lo and behold on our hike I said Jay I think we need to build a podcast. This is where it all started. It was like one of those things that I never imagined a thousand episodes would hit and here we are.   Ted, you're hanging out with me a thousand in. And I think it's just fun because of all the value, all the stories, all the people. And like you and I were talking about pre-show, the podcast is really just a place where I get to selfishly hang out and just have a good conversation with people that I like. I get to meet new people in the industry. And as a byproduct of my nerdiness and excitement of meeting people, all of our listeners get benefited by this. So Ted, I'm so happy you're a part of this. Thank you for that. ⁓   Outside of Yosemite, let's talk about the rising cost of dental supplies, the tariffs, how this is going to impact. Because I know people are really nervous about it. I see in lots of dental groups out there, and you guys are really great. That's why I had you come on, because I think you're a huge solution to these problems. So take it away, Ted also, so the listener know how on earth did you even get into dentistry? Let's talk about that first, and then let's talk about what this even looks like for dental practices long-term.   Ted Osterer (03:00) How did I get into dentistry? ⁓ It was fate, it was just destiny. Growing up, I had 13 teeth pulled. I had braces for five years and it was like, well, I'm here for life, I guess. And this is just how we can all grow as a unit. ⁓ I've been in dentistry for about 15 years now. I started out as a dental supply rep. I was going door to door for over five years and...   funny enough that, you know, this isn't the, I grew up in the New York area. This is the major metropolitan New York area. And I had a really good buddy and he was like, I think you'd be a really good fit actually managing anal practices. And I can actually introduce you to someone. And it was like a small like eight practice group. I can introduce you to somebody, the practice on the Upper East Side of Manhattan. Go see if you'd be a good fit. And I'm just kind of like, sure, guess. know, it's like always like have a conversation.   And I had a conversation and sure enough, I got along really well with a particular office manager ⁓ from this group and I went to go work for this office manager. ⁓ Within three months, I had my own practice. I was a practice manager. You know, it's so funny going from a supply rep to an office manager, right? I learned the first and I'm not saying this is everybody, but I learned the first day of being in a dental office that I knew nothing.   Kiera Dent (03:59) Yeah.   Ted Osterer (04:29) about what happens in a dental office, right? Like I'm like, could, God, it's gonna be a piece of cake. I've been in dentistry for five years. And so I could tell you how strong and impressive material was. That does not help with insurance codes or posture downgrade or presenting treatment or creating a schedule or reading a schedule, anything like that. So, much respect to everyone that manages offices that's listening right now that my goodness, you're fighting the good fight. Keep up the good work. ⁓   Kiera Dent (04:40) does not.   Agreed.   Ted Osterer (04:57) I did that for some time. I was recruited to work for care credit. I oversaw New England for a few years where then they moved me to South Florida. And then a few months after that, I was recruited by Synergy. I've been here since 2021. And this is really, really cool. You know, I came to Synergy because the message was, do you want to make an impact in the dental world? You know, like you love what you do, but do you really want to make an impact? Do you want to help independent dentistry? And I was like,   man, what a line, right? Like I was suckered in and I really wanted to make a difference. And sure enough, almost four years later, we're still here at, you know, we're the largest dental buying club in the country. We are the fastest growing dental buying club in the country. And we're just trying to preserve independent dentistry by giving them the same supply and overhead cost at a 20 plus practice DSO would get. that, know, we were founded by dentists. It was as black and white as, Hey,   If enough of us order from the same places, they'll give us a discount. And now we have people in charge of negotiating pricing. You know, we have a dedicated team to each member to make sure that they're getting the values worth here at Synergy and they're not ordering more than they have to. And you you asked about tariffs, the rising overhead costs, all of that really, really fun stuff, right? Let's dive into that, right? You know, the perceived economic uncertainty of everything. Are prices going to go up? Yes, of course.   Does that mean you need to buy everything right now at the same time to save money in like six months? No, you probably shouldn't do that either. You know, the waiting game generally always pays off, be it in dentistry or outside of dentistry when it comes to money, you know, you're better off just kind of, you know, hold the chips, hold down the fort, you know, you're, it's not, you do not sound the alarms, of course, right? You know, the price of your crowns is not going to go up 10,000 % like.   Kiera Dent (06:21) Yeah.   Ted Osterer (06:50) Calm down, chill out, right? It's what we've monitored. Have tariffs affected some prices? Yes. ⁓ Many have already gone down. Many have plateaued with that price increase and we kind of have a safe, what, just gauge on what those actually are, right? The percentages have been minimal. It's a few dollars here and there.   Kiera Dent (06:52) Yes, I agree.   Ted Osterer (07:17) Again, the industry is not belly up. really should not be your ⁓ primary concern. Providing optimal quality ⁓ of treatment should be your number one concern still to this day. I don't think it's going to make a difference whether you're getting a new sensor or not. If your sensor goes, you're OK.   Kiera Dent (07:36) It's It's really true. Well, Ted, I love that. And I love your story. And I love that you have the real life experience in dental practices, because that's something that we pride ourselves on at Dental A Team. It's like, we've been there, done that, and done it successfully. And you're right. Being in a practice is no small task. It's no small feat. And ⁓ I think the supply costs, I do agree with you. think certain people were getting a little bit, maybe extra on this, of how concerned we are of cost. And I don't think it's a wrong thing.   to look at, to project down and to forecast forward to make sure that you keep in line with your overhead. Like people who are looking at this, I'm high-fiving you because you actually are looking at your numbers and you understand the cost of your supplies. But at the same time, I remember I was at a, I have a friend who's very wealthy. We're talking like this person brings in 28, 30 million annually a year. And like, I just giggle because it is a great friend.   Ted Osterer (08:25) Sounds like a great friend. There you go. All right.   Kiera Dent (08:29) I thought he said he was a   cosmetic dentist when I met him and he's surely not a cosmetic dentist. He's a cosmetic chemist. So skincare, things like that. And I remember we were talking and he was like, yeah, I just got so freaked out about the stocks. I pulled everything out of the stock market. This was two years ago. And I'm like, bro, like the amount of gains because you got so scared is incredible. And I had another friend, we were sitting at a wealth conference and we had like Ray Dalio there and Paul Tudor Jones and gosh.   Marks, Howard Marks, like so many of the big players in wealth and they weren't talking. And this guy named Harry Dent came in and Harry Dent has been known for being right and wrong on predictions of the market. And I remember like, I'm not kidding you. We talked in this conference of do not make rash decisions. Like we're here to gather all the information, synthesize it out and then make best decisions. And I kid you not, we are two days into this five day conference and I met this guy and he's like, Harry Dent just freaked me out. I went and sold all my...   like sold everything like that night pulled everything out of the stock market. I was like, dude, you're the reason people talk about what not to do because you should never be this radical. And so I feel like while those are extremes, I feel like dentistry can kind of be that way with the supply. Like we feel it's the stock market plummeting on us within our supply chain because we've got tariffs on there. When the reality is let's remember dentistry by default, a lot of our products already have very high margins on them. Like I'm not going to say it to the world in case there are people who are not dentists listening.   but you can just think about fluoride for one second. So fluoride has insane margins on it, which are very profitable for you. The bulk of dentistry is very profitable. So these small rises, agreed, let's take a look at that. But like you said, Ted, it's not the end of the world. So I am curious though, from my like nerdy side, what things have gone up the most? What are you guys seeing across the board that the tariffs or the uncertainties, like the economy's gone up you guys. Bread, I'm shocked.   or gasoline, you want to talk about gas prices? Like I don't know, in Florida it's way cheap. Here I'm in Reno in California. I kid you not in Truckee it was $7 a gallon and I like wanted to throw up the gases that much money, but I'm like if gas for a gallon is $7, bread prices, I mean you're paying five bucks, six bucks a loaf for bread, like supplies are going to be higher. It's not something that I'm like, oh my gosh, my cotton rolls went up. Well yeah, of course they went up. does like everything in the world has gone up.   Home prices have gone up, but I am curious, what have you guys seen that the tariffs hit the most? Like what are some of those supplies? But we're ashricking this. Everyone listening, you have to promise you will not be either of my two friends who go radical. So when Ted tells you which one's worth a little bit higher, do not go out and give me like your prepping situation where you go buy all this because you're freaking out about it. Like steady the course, stay consistent, and just like watch the scene because most things will level out just like in stocks, just like in investments. But if we're radical and being wild on it, that's where you get.   Like it just does not benefit. So I think Ted, everyone has promised. I made them just promise like everybody. Yes, you promise. Don't be radical. Ted, what are some of the ones that are seeing the highest hits? Like what, what products, what things are you guys seeing?   Ted Osterer (11:33) Since you all promised ⁓ not to be radical, I will go ahead and share. Yeah, unbreakable. We know that's unbreakable.   Kiera Dent (11:36) You promised.   It's unbreakable.   You did that, you like kissed the thumb, something like that. And then you like do a dance. All of them have done that, right? Nobody better lie. Don't be radical. Okay. They're good.   Ted Osterer (11:52) Excellent.   So for those listening at home, I did a very, very impressive interpretive dance, but for those watching, you saw it, it's all good. ⁓ So with a lot of the terrorists I've seen, and look, it's so volatile, you know, and for those, again, listening, I'm doing that thing with your finger, you go up and down a lot about how much it goes up and down. You know, look, I mean, you saw a lot of the anesthetics made in Canada go up a significant percent.   You saw a lot of lab cases sent from overseas or, you know, it's funny enough, for those that don't know what the gray market is in terms of the supplies in the industry, Products are made overseas, totally fine, right? There's nothing wrong with products that are made overseas. However, sometimes they're made in factories that are only authorized in certain countries, even though it could be big name, know, supply partners, major manufacturers.   I won't name drop, you know what I mean? I'm not trying to, you can Google it, you have access to the internet, congrats. When it comes to, these products that are made overseas are only regulated to be in select countries, they still have to be refrigerated certain ways, they still could have, they could have been made a long time ago, they're set to expire. They are mailed here and then they are sold to the United States, they're unregulated. You'll see their costs are...   Insanely low to the point where it's too good to be true spoiler a lot a spoiler it is too good to be true right in the event that someone You know your malpractice insurance Is kicked in you use great, you know gray market products. You might be losing a case and that's not the smoke you want However, in the event of these tariffs funny enough what went up these gray market products, right? ⁓ They went up to the point where   Kiera Dent (13:25) Yeah.   Interesting.   Ted Osterer (13:46) They're the same pricing, if not more than what your rep is offering you now. know, and look, you don't want to be caught with something like that. And it goes to show you that you, again, you're worried about optimal care. You should be worried about what you're putting in your patient's mouth as well. And depending on where you order it from, right? Like picture yourself, you're a patient in a chair, okay? And an assistant walks in to set,   you know, to set the room, to put the supplies that you're going to use on that tray and she opens an eBay box. Imagine what the patient must be feeling knowing that or an Amazon box. It's like, wait a minute, if your patient's aware at all, you probably don't want that. And now that price is the same price that a major dealer is going to offer you or a rep can offer you. That's the worst case scenario. I believe that that's what I've seen went up the most. And there were some labs from overseas.   Kiera Dent (14:23) Yeah, no. No. No.   I'm just.   Ted Osterer (14:44) ⁓ where the tariff was taking effect, a lot of the tariffs they were getting, were passing directly onto the consumer. I've seen that stop also. I'm not gonna say it's not gonna happen again, but it's not like you can order in bulk all these cases, you know? So, you know, again, when it comes to your labs, if you're satisfied with your lab, play the waiting game. You should be fine.   Kiera Dent (14:53) Mm-hmm.   It's true.   Yeah, that's actually really helpful to know Ted, because I was really curious and I think it's one of those things of, I don't know, I'm the clinician inside of me. I originally dental assistant, office manager, treatment coordinator. We have a lot of hygienists on our team. ⁓ I think all of us in consulting, well, yes, we watch the numbers exponentially, which is why I brought Ted on. I wanted synergy to be here. I think it's a great solution for your numbers. The biggest thing I will also say is like,   Please don't be so obsessive with the numbers that you cut your amazing dentistry and you are actually not doing the best dentistry for patients. I believe that when we do good by our patients, when we take care of them, when we use great products, I'm not saying you have to be I have a car. I'm not saying you have to be like high, high end. You can if you choose, but just making sure that we're doing right by our patients. Like I said, dentistry is a very profitable industry.   as is, like we have done a really good job of keeping the practices profitable in spite of insurances and all of that. But I really just want to make sure people, when we're looking at this, let's not penny pinch and nickel, like watching all of our nickels when we're actually doing a disservice to our patients. So agreed, like that gray market, things like that. Yes, I like to be a good shopper. I love to get a good deal, but making sure that it's a good deal that's also taking care of your patients would be my like word to the wise.   Again, I believe that when we are good and we're honest to our patients, people feel that there's good karma, there's good energy, it's all the way around. So Ted, how does synergy work? Like how do you get around this? Because things are going up. Being a business owner, mean, our margins are, they've been high, so maybe they're a little less high. I will also say, like doctors, I hope you've increased your fees too. You should do that. like, it's not just supplies that get to go up.   Dentistry also gets to go up and it should be going up. And if you haven't raised your fees, I'll just asterisk that right now. Like that is very common. It's very normal. It should be done every single year. I think that's a way to offset some of these costs for you too. It's ethical and honest, but Ted kind of walk us through like independent dentists, which are most of the practices listening. We do have some DSOs on there. I think sometimes you can feel like, I don't know. It's like the little brother who's watching the big brother drive the car and it's like, why can't I get these deals? Like I know I'm just one practice, but.   Sometimes you feel neglected. sometimes feel like distributors and manufacturers don't give you as good of a deal. Like, let's be real. The DSOs do get better deals than you do. I I've heard, I go talk to a lot of people and they're like, well, yeah, if you've got 20, 30, 50 practices, we're going to give you like pennies on the dollar compared to my solo practice that's going to be paying more for it due to the bulk distribution. So how can we have that of like, how can Independence Dennis win? Not have these costs hit them and to still play in the big leagues, even though they don't want to necessarily practice that way today.   Ted Osterer (17:53) Yeah, awesome question, right? You hit on the head. What did DSO's do? They strong arm these dealers, manufacturers, distributors, and they say, look, I have 30 offices. We all want to order from you. We'll commit to this amount of spend. We'll commit to this amount of product. Give me the absolute best deal that you will, or I'm going to the other distributor that's on the next page of this advertisement that I am looking at, right? So they're just negotiating fees all day.   That's what the ESOs are doing. They have people in place to negotiate these rates all day. That's what Synergy Dental Partners has, Independent Dentistry, ⁓ I mean, look, it's alive and well. We see it every day, you know, just because there's not major conferences that you're demanded to go to like the ESOs and things like that doesn't mean they're not alive and well and band together and know what's actually going on in dentistry, right? So Independent Dentists will subscribe to Synergy.   to have access to the same pricing that those 20 plus, 30 plus practice DSOs would get, right? We negotiate with these supply partners all day long on the supplies that you're already using, right? I mean, that's what we do. We bully our vendors. We come to an agreement with specific supply partners to be in our network and have very attractive offerings that they will only offer to Synergy members, right? We're partnered with major distributors. We negotiate with...   them all day, we're partnered with different implant organizations, with different rotary organizations, with different services. Depending on what you're looking for, we're going to offer you something that you would not be able to get on your own, right? Do you have to order in bulk with a synergy member? No, that's the point of us because we have enough dentists all ordering from the same place that the bulk is taken care of. Order as you go, right? So Darby is our anchor supplier, shines the largest distributor in the country.   Patterson's the second largest distributor in the country. Darby's the third largest distributor in the country. When you place an order with them, everything comes in one to two days. As a synergy member, any order over $249, there's no shipping charges. And let's think about that in itself. Do you have to order in bulk now? No, do you have to hit a crazy minimum? No, you can order four times a month and not pay shipping. Everything's gonna come in one to two days. Now regarding all these manufacturer deals,   Kiera Dent (20:01) awesome.   Ted Osterer (20:15) Oh, I like to buy four to get one free. like to buy three to get one free. You hear the word free. Awesome. Great. Now we do have a lot of offerings just like that care, right? However, we've negotiated the net costs of those buy four, get one threes, get one free, buy three, get one free for just one. So you can order one. You don't need to spend $700 on your favorite composite to get one free. And now shade C3 is going to sit on your shelf for the next three years and it expires. You're going to throw it away anyway. So you wasted all that money.   Kiera Dent (20:23) Right.   Mm-hmm.   Ha!   Ted Osterer (20:43) The point of us is inventory control. It's cash flow management. I mean, if cash is what you're worried about, well guess what? mean, order as you go, you're probably not gonna pay shipping anyway. You have the supply you need. My goodness, Kara, have you ever had to clean out a supply closet? Is it not the worst day of the month? You know, when people order the wrong things, yeah, maybe you'll return it, or what are you gonna do? You're gonna check it off that checklist and then put it where you think it goes. Now it's gonna sit there forever. Yikes, right?   Kiera Dent (21:02) Yep.   Yep.   Ted Osterer (21:13) You know,   with Darby, things are easy to return. You order as you go, it's not gonna get lost in some shuffle if you order as you go, right? We are partnered getting discounts with Strom and NeoDent for implants and BioHorizons and Zest for the locator attachment through overdenture materials, Comet and Brassler for rotary. ⁓ We just rolled out our partnership with Bisco. We're partnered with UltraDent, Crestor, LB, Phillips. I'm going to put your listeners to sleep as I shamelessly plug these.   Incredible companies offering the incredible deals are giving our members but the whole point of us is Carrie said you love to shop Bad news pal. I'm taking that phone away from you. We've done that shopping for you We know where your pricing should be is every price the lowest price on the market. I can't confidently say yes It's not true. I can confidently say that a lot of them are the best price in the market But every price is going to be competitive and if you're taking four or five hours to place an order with six tabs open   texting four different reps. That's four patients that you could have seen in that time. not only, let's say you order from all those places. Now you got five different shipping charges. And now you don't know when any of these orders are gonna come. It could take weeks. Something could be on back orders. Something could be expired. But hey, you saved a dollar on gloves. Congratulations, you know?   Kiera Dent (22:16) you   I love it. And I think that this, is why I like Synergy. I feel like it's, you get the Costco discounts without the bulk requirements. And that's something that I really enjoyed about it because something we teach with our clients is do not be stocking up. I remember I worked at Midwestern University's dental college for a few years. And I remember I went through their supplies and because there was so much   Ted Osterer (22:44) Yep.   Kiera Dent (22:58) We, like, I remember throwing away boxes and boxes and boxes of expired supplies, things that we couldn't use anymore. And it was disgusting. And I was shocked and I was like, that's it. We have to get this to where we can see everything. And so we're really big in consulting of like tip out bids, having clear things, having it where your order is not like tucked in boxes and nooks and crannies. ⁓ And the way you're able to do that is by buying as you need it, rather than buying. Like I remember buying when I was an assistant ordering.   Ted Osterer (23:07) What a waste.   Kiera Dent (23:25) I think like 10 boxes of gloves. Like we had them stacked everywhere. It was just like an absurd amount because we were like, well, we got the deal. We need to have this versus like, no, like what are we using? That also keeps our costs down. We're not having these high end fluxes and low drops in our supplies. We're able to have that more consistent, have more consistent overhead. And like you said, sometimes Costco is not the cheapest. Sometimes I can get it cheaper at other places, but the reality is the time we're saving and also the more dentists buying within Synergy.   more we're able to get the bulk discount. So it's like, it's the biggest DSO you can be a part of without being a part of a DSO, like air quotes around it, because you're not a part of a DSO, but it's the collective community group that's driving down the pieces for it. And Ted, correct me if I'm wrong, I feel like when I've talked to Synergy in the past, you don't have to give up your reps, because I know people get really weird about like, but like we've been best friends with so and so, and it's like, you can still order from the companies you want. Is that correct? Or do you need to like order through Benco? I thought it was like something with that, but help us understand like,   Do I have to give up my rep? Do I have to only order through your guys' people? How does this work for me to transition over? Because I do know dentists are very loyal and I think that's an amazing attribute. I would say like stay loyal. Also make sure that your overhead's making sense as you're going and buying supplies.   Ted Osterer (24:36) If you're a member of Center Gentle Partners, feel free to order from whoever you'd like. There's no minimums or anything like that. Now, are you better off buying from the suppliers in our network if you're trying to save money and time? Yes, like you just said. So Darby's our anchor supplier. They're the only distributor that we work with. If you're best friends with the Banco rep and you're looking to save money,   and you give us a shot and like I said the sole point is to save money we can very much help you and there's plenty to go around that if you need to order from Banco who you mentioned earlier or any other distributor have at it but I mean if we can cut your supply cost by 25-30 % you keep your reps for service you keep your reps for whatever you choose to keep them for yes by all means we are not offended there's no exclusive like that.   Now relationships are important. know, like you said that regarding manufacturers, if you have a rep already with Darby, you don't have to change who you're already ordering from as long as they're network. We don't force you to do anything differently. But hear me out. You brought up Costco. Now, you know, you went to Costco, you you only have how many free hours in a week? You know, either you can get that at Costco or you could spend the gas money and the time.   Kiera Dent (25:44) Yeah.   Mm-hmm.   Ted Osterer (26:01) to hit up Walmart and Publix and somewhere else on the way home and now you're too tired to go do whatever it is that you wanted to do that night. But hey, you saved like 26 bucks, have at it, well done. How valuable is your time to you? Yeah.   Kiera Dent (26:05) Yeah.   Well done.   Yeah. And if your gas is $7 a gallon, you did not actually make any money. thinking about that, but like for dentists, I think there's a good book, Dan Martell, I raved about him quite a few times to buy back your time. And I think this is a zone where we can have, where you can actually save time. You can save money and you can actually, even your assistant. So doctors, you might not be ordering, but your assistant's ordering. Think of like, if I didn't have to give up five hours or four hours of my assistant's time, which is what I used to have to block off.   Ted Osterer (26:22) You   Kiera Dent (26:43) and you can see more patients with that assistant rather than them ordering that right there is a cost saving. So I did some quick math because I heard what you said. If we are able to save you usually 25 % on your supply costs. So I just thought, okay, let's say there's a million dollar practice. This million dollar, that's about 83,000. We'll just do 84,000 rough math. A month is what this practice would be producing. We like as a consulting company for your supply costs to be about 5 % of that. So I was like, okay.   That'd be like 4,200 bucks that month that could go towards supplies. If you guys save 25%, that's a thousand dollar savings, over a thousand dollar savings on that 4,200 a month. I was thinking about that, like a thousand dollars a month. This is on a million dollar practice. I didn't go for a sky high one. If you're bigger than that, obviously it's way more than that. But I just thought Ted, like, if you could save a thousand dollars a month, cause I know you guys have this, like you guys have sexy stats on how much you're able to save practices. I understand you might have to have two, three conversations with your reps.   of like, guys, for us, we care about you, we love you. The reality is, I'm willing to have that conversation if I'm gonna get thousand bucks a month. Because that's now $12,000 for the year. And I think about, well right there, if you're looking at other things, virtual assistants can cost you $12,000 for a year. They can do all your billing, they can do outsource pieces for you, you could hire a personal assistant for you for $12,000. Even that extra $1,000 a month, I'm thinking, could you bring on different team members for that?   What does that look like? I understand like a full assistance not going to cost you 12 grand, but I'm like virtual assistance are outsourced billing, different things that you could use those funds for that right there to me. I'd be willing to have some conversations and just look at. So that's where I want to, I'm really big on numbers because I'm like, cool, 25%. But I'm like, when it breaks down to like thousands a month that I could then reinvest and use in better areas, just like I'm like, you guys, you can keep spending money on Indeed. Go for it. And I'm not here to say indeed is not great.   but you could also switch to AvaHR, which used to be VivaHR. It's literally 149 bucks a month for unlimited posting of ads. I took my cost of posting ads. I'm doing the same thing. I'm literally posting ads on the exact same platforms. I used to spend $15,000 a year on that, and now I pay about $1,200 a year. Right there, I'm like, that's a switch I'm willing to make. Yes, bummer, I don't get to like post directly to Indeed anymore. Same thing, I don't maybe get to like buy directly from my rep.   you still can keep the relationship. Like if you need to buy equipment or different things like that, like you can still keep the relationship. But I think, and they will try to sweet talk you, but I've seen it with the buying groups, the savings that you get, I just say have the conversation. A thousand bucks a month, go on, get a massage, do something fun. Like, I don't know, take your kids on vacation for 12 grand, whatever it is, but that's just literally buying the same materials through a different platform and getting...   money kickback. don't know. To me, Ted, it's always been a no-brainer, which is why I bring you guys on the podcast. So that's my spiel. But Ted, anything you have to take, wrap this up because I think with the tariffs, with the rising costs, realizing it's not that big of a deal, buy as you go. You can use these buying groups. You can be like a DSO, but you can buy what you need, not having to get all these deals. You're able to cut your costs. You said about 25 % on supplies and just go look at what you spent on supplies last three months. Think if you got 25 % of that back.   I think I'd be willing to have a conversation. But Ted, you tell me what you think. Those are my thoughts on this.   Ted Osterer (30:06) I said, I was going to say like the exact same thing, unfortunately, but I, you know, I'll take that one. I'll take that one second further to really, really simplify it. Right. And just summarize everything you just said. You know, we're partnered with over 50 supply partners, including eight different labs. Right. So as a consulting agency, right. Like we see labs as high as 10, 15%, you know, it should be what six to 8%.   Yeah, so I mean, let's say you're a million dollar practice. That's the practice Kiera just said. If I save you just 1 % of your overhead, that is a $10,000 that Kiera's talking about. And it is so easy to save that as a member of Synergy. And my goodness, thank you so much for having me on. It really means a lot. And thank you for acknowledging.   Kiera Dent (30:59) Yeah,   of course. I think it's a matter where Ted, I, when I get really passionate about things, like I love Swell. They do their Google reviews so well, you're able to save costs on your marketing, but get like really incredible patients. When I see a zone where I'm like, supplies are supplies are supplies. I understand you love your rep, but I'm like, supplies are. If I can get the exact same anesthetic, like I need my Lido, it's certified and I can buy it from Benco or I can buy it from Shine, but I can get it for...   X versus Y and I'm going to save substantially to me that's a way doctors it. I think that this is just being a higher level CEO that realizes just like DSO CEOs do as much as I love the product from X. I'm going to buy it from here because I'm literally able like it's the exact same thing. just get it on sale. So why would I not do that? And as a female like that's girl math for you Ted. Like if I can get it on sale, I'm going to buy it because I can use it to go get what I want over here. I just think like   These are the zones, dentists, that the elites do. These are the zones that the multi-million dollar practices are doing. So learn from their strategies. Again, it's gonna be one, two, three, maybe a little bit uncomfortable conversations. You don't need to burn the relationship. But I would say if I was you sitting there looking at my overhead, looking for ways to do cash flow, I would radically consider something that's not going to impact your patient care, that's going to make your practice much easier and also give you more time back in your life. So that's why I you guys on. Again, I don't work for Synergy. We don't have an affiliate relationship with them.   I love them, I adore them. I truly think you guys are just doing a great thing in the business. We are working on a partnership with them in the future for all of our clients. It's something that's really been big on my mind because I feel like, hey, why not? All of our clients that are with us, let's get them the best deals. But this is why I wanted you guys on the podcast. So Ted, how can people connect with you? How can they try you guys out? Again, you don't have to burn your rep. can just go even test it out. ⁓ But how can they try you guys out just to see what this looks like for their practice?   Ted Osterer (32:53) Go to the TheSynergyDentalPartners.com know, leave your information with us. Please, please, please tell us that the A team sent you, you know, of course extra promotional offers if the A team, I mean, A plus team in my book, of course. ⁓ Yes, yes, A plus plus. And please let them know that you were sent by them so we can make the offering even more attractive for you. And you know, when you join Synergy, you don't even have to have that typical conversation. You can just hide in the bathroom.   Kiera Dent (33:05) Thank you. Thank you. I agree.   Ted Osterer (33:23) and we're all good. It's okay.   Kiera Dent (33:25) Yeah,   it truly is. Don't make this wild, you guys. ⁓ Ted, I appreciate it. Thank you so much for coming and talking about what the reality is and what things have gone up in pricing and how you guys have been able to watch it go up and down. You're seeing so many more supplies than just the solo practitioners seeing. so you're able to see, kind of like stock markets, we're able to see at a bird's eye view of what's really going in the landscape of it. And I want to just remind people, you guys, the future is bright. No matter what's going on, the future is bright. There's always solutions.   Ted Osterer (33:29) Thank you.   Kiera Dent (33:53) And I think right now is where we get a bit more scrappy, a bit more innovative, and truly you shouldn't be seeing much of a hit. Like shoot, if you're seeing a hit, just switch over to Synergy and you won't even see that hit. So try it out. ⁓ Ted, thank you for being on the podcast with me and thank you for everybody. I really think this is an awesome way for you guys to truly take care of your practice, take care of your patients, and make life easier, which is what we're all about. So Ted, thanks for joining me today. I super appreciate you.   Ted Osterer (34:03) Yeah.   ⁓ I'm happy to be here. Thanks again.   Kiera Dent (34:19) And for all of you listening, thanks for listening and we'll catch you next time on the Dental A Team Podcast.

Why Your C-PTSD Isn't Getting BetterTopics covered: sense of self, childhood trauma, DSO, CPTSD, PTSD, relationship problems, emotional triggers, psychology, assessment, measurable goals, journal prompts, childhood trauma, trauma response, attachment. In this episode I go over Disturbances in Self-Organization, a diagnostic criteria set that separates PTSD from C-PTSD. We can fine tune our healing efforts if we know which of the three DSO ideas affects our functioning the most. This episode also discusses a tool we are developing to measure C-PTSD progress and gives resources such as what therapy modalities might be the most useful for the category that you score the highest in.Join the Monthly Healing Community Membership

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!  

Alan welcomes back friend, dentist, and coach Dr. Paul Etchison to talk about his unique career journey. Paul shares how he went from working in a high-volume clinic to building a startup practice that grew so quickly he was forced to bring on associates. He details the specific strategies he used, like prioritizing new patients and intentionally creating capacity, to scale his single office into a five-doctor, 9,000-patient practice. Paul also opens up about his battle with burnout, the decision to sell to a DSO with the intent to exit, and the surprising realization that led him to stay. This conversation is packed with actionable insights on creating systems, delegating, and building a practice that grants you the freedom to work less and live more. Key insights: From High-Volume to High-Value: Paul's journey began in a busy HMO/Medicaid clinic, which taught him speed and what he didn't want in a practice. Forced Growth: His startup became so busy through organic referrals that he was "forced" to hire an associate to handle the capacity. The New Patient Engine: Intentionally holding schedule blocks for new patients is a key strategy to drive growth and justify adding hygienists and doctors. The Magic of Two (Plus) Associates: While one associate adds profitability, Dr. Etchison believes the second associate is when the magic happens, making the owner's personal production less critical. The Path to Less Clinical: Paul now works only a few half-days per month by successfully transitioning his practice to be associate-driven. Burnout and the DSO Sale: Feeling overwhelmed, he sold his practice to a DSO at age 39, planning to exit dentistry. Why He Stayed: After the sale, he successfully delegated leadership duties, which rekindled his passion and led him to stay on after his contract ended. Delegate What You Dread: Tasks you hate are often tasks another team member will enjoy; learn to delegate effectively. Design Your Ideal Work Week: Consciously identify what brings you joy versus what drains you, and restructure your role accordingly. Build a Practice That Runs Without You: The ultimate goal is to create systems and a leadership team that allow the practice to thrive, whether you are there or not. Some links from the show: Paul's "Practice Clarity and Frustration Exercise" Paul's website (with details about his upcoming Mastermind!) Join the Very Dental Facebook group using the password "Gary," "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!

On today's episode, Dr. Mark Costes sits down with Holli Perez, CMO and co-founder of DirectDental, to discuss the workforce challenges reshaping the dental industry. Holli shares her journey from being laid off in a DSO leadership role to launching a game-changing dental staffing platform that now serves practices in all 50 states. The conversation dives deep into the realities of temp staffing, the growing hygienist shortage, and why nearly 30% of dentists are reportedly doing their own hygiene work.  Holli also unpacks practical strategies for improving employee retention, creating compelling job listings, and recognizing when toxic leadership is sabotaging team culture. With DirectDental now a part of Henry Schein, Holli gives a behind-the-scenes look at their future initiatives to onboard new grads and streamline dental hiring across the nation. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://directdental.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Ryan Isaac of Dentist Advisors returns to continue his discussion with Kiera about the future of dentistry, including options aside from DSOs. The question a practice owner should ask themself, Kiera and Ryan say, is what that individual wants out of their life — then consider the best platform to get you there. 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 this is going to be part two of mine and Ryan Isaac's conversation where we're digging into DSOs to sell to not to sell, all of that. And I truly am so excited for you guys here, part two. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.   Kiera Dent (00:17) why don't we take a pause and just think of like, what's the future of dentistry as now the future pioneers of dentistry? And what are we going to do to our profession? Yes, there's top dollar. Yes, there's things about it, but is there a way to influence?   and make sure that the integrity of dentistry can maintain long-term. I have no answer to that, but again, this is Kiera Dent sitting on my podcast where I think that there is a voice and an influence and like on Dentist Advisors podcast, is there a way that we can influence our industry in ways that will protect and still pay out? Because I'm like, even if you don't get the 10X EBITDA, you still can get a freaking great payout if you do your life right to where you can be financially set up.   Ryan Isaac (00:33) Mm-hmm. ⁓   Kiera Dent (00:58) still be able to sell your practice, not have to sell it in ways that could potentially hurt the industry. I'm not saying one's the right answer or the wrong answer. There's no judgment on my side. It's just, let's maybe think and consider how it could influence. Can we get people that could be private equity higher up that could help protect it? Those are things that, and again, I'm just Kiera Dent here in Reno, Nevada.   Ryan Isaac (01:03) Mm-hmm. Yeah.   Same, okay.   Okay. Yes. No, these are the questions.   You're totally influential. I think it's just in the opposite direction. ⁓ I don't think we can influence private equity. Private equity is ruthless in every industry. They don't. It feels dirty. It feels dirty. And I have a question for you, but I just want to say really fast. ⁓ I do feel like, yes.   Kiera Dent (01:30) It's dirty. It's dirty.   Is there a way though, Brian, you   don't finance better than me. Is there a way that there could become dentists that could become in private equity where they own it? Because once you, there's no way to insulate, you don't think. Because once you get to that level, you just, I mean, I've had.   Ryan Isaac (01:44) Yeah, but they'll do the same thing. I mean, they'll want the same thing.   Now, money's money. It's why capitalism runs   the world. mean, that's why, you know, it's like why it influences politics and money and business runs the world, you know? ⁓ Okay, hold on. There's so many good things here. Number one would be not every group will be a DSO, private equity backed DSO. And you know, many, many ⁓ clients and just dentists around the country who will end up being owners of   Kiera Dent (02:05) Okay.   Ryan Isaac (02:19) 20, 50, 100 group practices that will stay privately held and ran by owner doctors. That will be a chunk of this ⁓ group practice ⁓ takeover. So in that space, the influence can still be huge. ⁓ I think the chance to influence the integrity of private practice is in those who don't sell to DSOs.   I think it's in the industry, educated in influencing the industry for people who aren't going to sell and who are going to maintain control. Now, I do think that in the future, more and more dentists will be in a group. ⁓ are probably, yeah, be fewer and I can see why it would make sense to do that. There would probably be fewer and fewer people with just solo doc, solo location practices. know, some towns and rural places, that would be hard to do.   Kiera Dent (02:47) Mm-hmm.   I do too.   Ryan Isaac (03:15) So I think you're Dorothy, is that what you said? I'm Dorothy. I think that is possible, not with private equity, but with still the owner doctors that still exist and the group practices that are ran by dentists, not private equity back. I think the influence is still gonna be, I mean, if you took the projections of what will stay private,   Kiera Dent (03:20) Yeah, hi.   I agree.   Ryan Isaac (03:40) and then the chunk of the group stuff that'll be non DSO non-corporate, that's still got to be 40, 50 % of the industry eventually.   Kiera Dent (03:49) I would think so.   I mean, look at it right now. There's corporate dentistry within. And again, there's nothing wrong with any, because I have clients that are in corporate dentistry that run their practices like private. They take care of their teams. So it's one of those things I still think, like even if you are, and that's another way that we can influence this, if you are part of a private equity-backed DSO, you can still influence your practice. You're still the dentist working in the practice. You can still run culture. You can still run change.   Ryan Isaac (03:59) Totally. Absolutely.   Yes.   and hit it.   Kiera Dent (04:16) ⁓ I know the doctors I have, they're part of a very large group corporate and things that we have done together, like I work with them, they're my only corporate practice that I work with, but we have literally influenced the top tier CEO. They've asked what these offices are doing differently. They're taking things that I've helped bring into the practice and they've asked like, what's changed in your practice? Like we hired this girl who teaches us to run it like private practice. Their culture's incredible. We're even right now petitioning up to the top people because they're writing off things that you can actually   bill out to insurance that they're making them write off when it's like, actually, no, we can bill it as a non covered service and actually have the patients cover. So I'm like, I do still think whether you're in private equity, but I think you've got to be a strong enough doctor where you advocate for the rights of your patients and the rights of your practice. And I'm super proud of my client who does this because her and her husband, they go to bat and they're like, they write some pretty direct emails to the CEO of this and say like, hey, and they're a big enough force. Cause I mean,   Ryan Isaac (04:55) Mm. Yes.   huh.   Kiera Dent (05:15) They're the top tier practice in their area. have them making like, we are adding multiple millions to their offices every single year. But I'm like, I think that's also how dentists, even if you're in private equity, even if you're in group practices, I think at the end of the day, are clinicians and clinic, like you are, you are the product. And I think that they have, I think dentists have more say than they might realize that they do to influence the industry and keep it more positive and more ethical than it could be otherwise.   Ryan Isaac (05:38) Yeah.   Yeah, I totally agree. I totally agree with that. We all know people who are in those group models that are still running like amazing, almost privately held practices. The other thing that's interesting that's different than medical, because it always gets compared to the medical field consolidation that happened, is medicine has a distinct difference and advantage in that they have hospital systems where gigantic campuses where they can house hundreds of doctors in one place, right?   It's just not that's not a thing in dentistry, which I think will will force it to stay a little unique, different than medical, because you can never have a giant campus building with, you know, 400 dentists. Yeah, like 500. I mean, I don't know. I guess never say never some some group might invent that and you know, like the dental campus of the city. I don't know. Yes, it's possible. But it seems a lot less likely. Yeah.   Kiera Dent (06:18) Mm-hmm.   500 off, you imagine?   Say hi.   I mean, dental schools have a lot, but   I'm like, okay, I think the piece that would be really hard is to justify 500 beds, like 500 ops. You've got your hygiene that's cranking. So you gotta have, in a 500 bed, would need, like, we can only see 500 patients a day. so you can only see if it's 500 a day, that's how many patients you could actually see. I don't think that would be a full city, and we're basically taking over whole city.   Ryan Isaac (06:55) Yeah.   No. Yeah.   Kiera Dent (07:03) And then you might   not be pulling out that much dentistry outside of all of that to be able to fill that many doctors in their schedules. Cause so much of it's hygiene run, it's like a two to one ratio that I think that would be the zone. ⁓   Ryan Isaac (07:07) No.   I love this analysis. Yeah, I   couldn't go that far, but there you go. That's exactly right. So I do think it'll stay different enough in nature because of that. ⁓ And yeah, I, to go back to the, love your question. We've been kicking this around a lot in dentists advisors and I want to reiterate the same thing. There's no judgment here. There's no right or wrong. For some people, it's absolutely the best decision to exit with the DSO and just find the right one. Take your time. ⁓   Kiera Dent (07:19) There you go.   I agree.   Ryan Isaac (07:43) to go through the deals with someone who really knows what deals look like, not just a friend or a CPA unless that CPA is looking at hundreds of deals. Call Brandon, right?   Kiera Dent (07:51) Seriously, I'm like, why? He's got like every flavor of ice cream available of DSOs for you. And like, what are your goals with your financial advisor? What do you need to retire? And then you make sure that the deal is going to actually get you that because like you said, Ryan, it's your greatest asset. And that's where to me, it breaks my heart when people do this. And I was actually, when we were talking about assets, ⁓ there was a stress test portfolio that I heard at a conference that I thought was really awesome that I think about often. so thinking about when you said like, we're investing into this stock.   Ryan Isaac (07:59) Yeah.   That's it.   Kiera Dent (08:20) portfolio, like we're basically putting so much of our biggest asset and so many of our dollars into one single stock. And they said, just stress test your portfolio. If my two biggest portions of my portfolio. Okay. So the two biggest portions right now. And I think about this often, even you and me, Ryan, if those two asset classes dropped yesterday, cause I always do like, if they dropped tomorrow and you're like, well, I'd freaking move things. No, if it dropped yesterday, so there's nothing you could do. Do you have the staying power for things to recover? So like, I don't need to liquidate my assets.   Ryan Isaac (08:24) in one single, yeah.   Mm.   Kiera Dent (08:50) can still have income from our other assets and buying assets that are down. So looking at that, and I think about that often, like, so if your biggest ones are in the stock market and in your DSO and both of those dropped yesterday, like that's all that's gone. Could you still be okay? And if not, maybe look at other ways to diversify that portfolio. I'm not an advisor, Ryan. So you speak to like, if you agree or disagree on that, because that's my thoughts on it.   Ryan Isaac (09:11) Yeah.   Although yeah, no,   that's a really ⁓ logical way to look at stress testing something. If the stock market disappeared as a whole yesterday, all, yeah, well, we just, every publicly traded company in the entire world would be gone simultaneously. We would all be in so much trouble. Like we just wouldn't have cell phone service or gasoline or, you know, like a million things. Yeah, for a minute.   Kiera Dent (09:26) You say that we're all gonna go to the apocalypse, like.   Good thing you're by the ocean. You at least have a good time there, Ryan. I need   to get out of Reno, Nevada for that one year fact alone.   Ryan Isaac (09:44) Yeah, yeah. For me, yeah,   it would work for a minute, but then we would have no grocery chains, there would be no shipping distribution, there'd be no trucking, there would be no like, you know, we'd be done within like a week. You know what I mean? So, but you're the logic of it is true. It's almost like what if we just looked at stress testing a deal, you know, and you said there's usually three parts in a DSO deal, there's the cash up front, there's usually some kind of earned back, or bonus system, that's usually a smaller piece. And then there's the equity piece.   And if one of those didn't exist, if one of those dropped off, what would this deal look like? And I think the question we have to ask is if the equity didn't hit, you know, if they don't get returns on multiples on their equity, like they're projecting and always, of course, the projections are huge, you know, always, always. If this does not come in like you expect, let's just say it's half of what they expected that which would be probably fair to say, or it's all you do is get your money back one day.   Kiera Dent (10:32) always.   Ryan Isaac (10:43) What does this now look like to you? Is this a survivable thing? And is this even something you would be interested in doing? But again, you said this before, I've been saying this, go talk to someone who knows what these deals look like, like Brandon. I'll give you an example. with a client a few weeks ago who had an offer. They were getting a lot of pressure from the group where this came from. They were kind of involved in like, well, I won't even say it. It was just a group of people of other dentists that were kind of pooling practices together. And this buyer,   Kiera Dent (10:50) you   Ryan Isaac (11:14) just a lot of pressure, a lot of hype, right? A lot of hype. And the deal as the details started coming through started smelling really weird. And even he was just like, I don't know. He talked to Brandon for 30 minutes and it became so obvious so quickly how bad this deal was. And now he's pushing the brakes a little bit. He's going to ramp up his profitability, work on the practices some more. He still wants to consider a sale, which is great with that's fine if that's still what you want to do.   Kiera Dent (11:38) Yep.   Ryan Isaac (11:43) But I think that conversation probably just saved him millions of dollars, literally in 30 minutes of conversation. So just talk to somebody, please, about these deals. There's every flavor out there. There's so many ways that they can twist and bend these things. And yeah, there's just a lot of moving pieces in there. So just be careful. Yeah, just talk to someone. Be careful.   Kiera Dent (12:02) I would like, and what   you said, also think like, make sure that you're also selling it for top dollar. This is something I really love about working with you guys, working with clients is if we know that there's a sell on the horizon, think one of the best things you can do is truly like pulling a consultant, pulling somebody. And like I was talking to a doctor the other day and they're like, KK, we want you to come in and help us like with our systems, but they're selling in a year. And I was like, well, respectfully as your consultant, I'm not going to sit here and deal with systems.   Ryan Isaac (12:13) Yes.   Please.   Kiera Dent (12:31) If you're selling to a DSO, odds are a lot of those systems they're gonna bring into you anyway. Our best thing we can do is make your life easy right now, boost your production, reduce your overhead, increase your EBITDA so you get top dollar on the sale while making it like amazing. Like we'll still put systems into place. We'll still take care of your hot fires with your team right now. But like, why not go, it's like, if I know I'm selling my house in a year and if I did a few things to make it exponentially higher.   Ryan Isaac (12:32) .   Yeah.   Kiera Dent (12:56) in the next year of my sell, why would I not do that now? And for us, it's not even like a house where I'm just painting the walls. We're literally boosting your production. We're pushing your overhead down. We're helping your whole team get on board for that. So that way your asset really is the best asset you can get. And we're not doing it in a hard way. So I know it feels like a push, but just know Dental A Team's way is ease. So it's like, it's going to be an exponential growth for you, but with like ridiculous ease. And most of our clients, we just did a huge study across the board of hundreds of our clients.   Ryan Isaac (13:13) Mm-hmm.   Kiera Dent (13:24) And on average, they're seeing a 30 % increase in their production and a reduction in their overhead within their first three to six months of working with us. So like even if you have a year or two year timeline, that right there, so getting the right deal, making sure you're selling it at top, like squeezing the juice out of every single thing we possibly can get out of your practice. ⁓ But then also I feel like what happens in that scenario, Ryan, I see it all the time, is when we come in and we like powerhouse it up with them.   Ryan Isaac (13:34) Thank   Kiera Dent (13:51) They're like, wow, I'm working two days a week and I would make what this DSO was going to offer me and I don't even have to work. Why would I get rid of this practice right now to the DSO? That happens more than I can tell you because it's like they didn't realize it could happen this way. And I'm like, just tell me what you want. Like you want the DSO, you want to work two days. Why don't we build you that right now and like keep the asset that you've got and sell it when you want, which is going to make you the same amount of money as the DSO, but it's on your terms.   Ryan Isaac (13:59) Yes. Yep.   all the time.   Kiera Dent (14:20) So I think that like people don't realize that you can have the benefits of the DSO today. I think the only piece you can't have like, but I give air quotes on can't is like, you still are an owner, but I'm like, there's literally ways for you to sell to partners, have it pay out to you. And you can actually get rid of that ownership piece if you don't want it ⁓ and still have it be the same type of a deal. I think like, don't forget that there's also deals outside of DSOs that you can do internally. ⁓   Ryan Isaac (14:26) Yep.   Kiera Dent (14:48) but it is shocking Ryan how many practice, like I had a doctor and he's like, Kara, I'm going to get 5 million for my practice on this. And I was like, rock on in two years, we literally will make you 5 million net post-tax in two years. was like, literally, and that's net that's post-tax like in two years. I was like, this is not a good deal for you financially if you're going after the financial dollar. So I think just be smart with how you look at this because I don't know, right. And you do it to me all the time. You're like, Kara, yeah, go sell.   Ryan Isaac (14:58) That's what you're make in two years of income. Yeah. Yeah.   Mm-hmm.   Kiera Dent (15:17) but you can also just get the life you want and have your practice and your business run differently, why not consider that scenario too? So I think.   Ryan Isaac (15:19) Yeah.   Yeah, I'm,   yeah, okay. Sorry, finish your thought. I just like what you just said. I just love that. I was gonna ask you this exact thing. I was gonna ask you this exact thing. I was gonna say, Kiera, aren't there ways someone could step back and pause and say, why am I interested in selling to a DSO and then just try to create it through the work you guys do easily?   Kiera Dent (15:27) Okay, so yeah, take it.   100 % and right you do   it to me all the time. You're like Kiera. Well, what would you want your life to look like if you were to sell it? I'm like, I would care if you stopped if you sold what would your life look like? And I'm like, I do this. I do this. I do this. You're like, all right, then why don't we just make your business do that today? I don't think people realize how like you can manipulate your business to truly support the life, the finances, everything you want. Like it's shocking. I'm like just basically give me the North Star and we will manipulate the entire thing for you.   Ryan Isaac (15:59) Just do it.   Yeah.   Yeah.   Kiera Dent (16:14) in ways you didn't even know. like, I need Ryan to know our North Star where we need to get. Then we break it down to your, like what lifestyle you want to have. And then we just crank, like, it's like shake and bake. It's such an easy thing for us to do. And we're still doing it with like amazing ethics. It's under your control. It's your culture. It's your business. It's your life. But I mean, I have a doctor who's producing over 5 million a year, working two days a week, taking home DreamPaycheck and they were going to sell it to a DSO. And I'm like, it took us two years to get them to the offer.   and they're like, they're so happy and they're able to now, like you said, I think one of the best pieces on this is they got everything that they would have gotten from the cell. But in addition to that, they didn't lose everything that they've built to where now they can go build and create, like you said, the two day a week practice where they're having it, but they've kept their huge asset over here. And so I just think like, I don't know. I feel like there's so many more options on the table than people necessarily think there are. And so.   Ryan Isaac (17:03) Mm-hmm.   Kiera Dent (17:12) Maybe don't listen to all the noise, be the smarter. It's like when everybody's doing X, maybe there's a Y that would actually benefit your life.   Ryan Isaac (17:16) Yeah. A million percent.   Yeah. I mean, Warren Buffett has a quote around that. It's a little bit different with stock market buys and sells and greed and fear. But yeah, that's exactly it. Yeah. I love that you said that. I assume. What are we like 45 minutes already? I assume that you probably want to wrap this thing up, but I wanted to end it with that exact question you went there, which is like, can't we do this? Can't you? No. I mean, that's not the job we do. The Dental A team can help design.   that what you're trying to accomplish that you think some private equity firms gonna come in and give you. And again, let's all just remember, private equity firms, ⁓ they don't love you.   Kiera Dent (17:57) It's true.   Ryan Isaac (17:58) They love your money   and they are not stupid. There's a reason why they gobble up every industry in the economy is because they make us believe they're just giving us sweetheart deals. Like, they're gonna give us so much money. Isn't it so crazy? Like, no, they're really smart. They're gonna get so much more money from you than you're gonna get from them. So if they want your thing so bad that they're gonna chase you down and send you offers and every time you decline, they're gonna be like, okay, wait, what about this one?   Kiera Dent (18:15) They are.   Ryan Isaac (18:26) They want it so bad. You must really be holding something really special. So how can you make that thing become your dream scenario without having to give it up? First, just consider that again, no judgment. There is no right or wrong. Maybe that is your path and that is best for you. Great. If you do the work and the, you know, the research and you're just sitting and you're asking smart people like here in the Dental A Team, you know, about all the details and you're asking yourself why through all this process, that's just, that's the whole thing. So I'm glad you   Kiera Dent (18:31) Mm-hmm.   Yeah.   Ryan Isaac (18:56) Assuming we're ending it soon. I'm glad you ended it with that because that's what I was thinking about   Kiera Dent (19:01) Well, and I'm glad I'm going around the same beach because I feel like DSOs can be such a buzz. I think it's, I don't know. I just thought about, I remember when Jason and I were graduating from pharmacy school and we had a lot of debt on us and it was so tempting to go the 10 year loan forgiveness plan. So tempting. And Jason and I decided like, Hey, we don't want to like hope and bank that in 10 years, we're actually going to get all this paid off.   Ryan Isaac (19:07) yeah.   Mm-hmm.   Kiera Dent (19:29) And if it doesn't happen, what's it going to cost us at that point? And so we elected to just go for it to pay for it and to basically have it like, it's within our control rather than someone else holding my future. And I think that's how I often live my life of like, is there a way that I can get my dream life or I'm not banking on someone else holding up their end of the deal, hoping and praying that their equity makes it and it's something that we can actually do with ease? Why not do that?   Ryan Isaac (19:33) Mm-hmm.   Kiera Dent (19:55) Ryan knows it was a huge issue with me and Jason for about a year to pay off his student loans, but the growth and the life that we were able to achieve that we wouldn't even be done. We still would not even be done with our debt right now. And it would have ballooned and not all of the debt's being eliminated. Like there's so many things around these loan forgiveness programs that I think about that with DSOs too. You have so much banked in, the hope, the promises, like everything has to go right for this huge multiple to have it there.   Ryan Isaac (20:07) yeah. Yeah.   Uh-huh.   Kiera Dent (20:24) Is there maybe a few other paths that you could look at that might get you what you ultimately want, give it to you with more control on your side, and also be able to allow you just more flexibility and freedom. Again, no judgment. think what Ryan and I are trying to bring to the table is maybe just consider looking at things differently to see what's the best path for you. And I say like, right back at you, Ryan, use your financial advisors, know what your magic number is, know what you need, and then figure out which option is going to be that.   Ryan Isaac (20:48) Yeah.   Kiera Dent (20:52) while also providing you the dream life that you want. So Ryan, thanks for the riff today. It was a solid time.   Ryan Isaac (20:54) Yep. Thank you.   It almost felt like planned. was so smooth.   Kiera Dent (21:01) So, mean, it does help when we're good like peanut butter jelly. Like we're very aligned on how we see, that's why I think our clients work so well together because like Denali team clients going to Dentist advisors, it's amazing. We think on similar investment strategies and like just the planning and the protecting clients. And on the other side, it's, Hey, here's our financial number. Denali team literally can like give the gas and give the pieces to it of tactical. So thanks Ryan. was a good time.   Ryan Isaac (21:04) Yep.   Hmm.   We all want to do. Yeah.   Yeah. Yeah. We want to grow and protect that business and make it, you know, it's your whole life. Make it as good as you possibly can. You guys are so good at that.   Kiera Dent (21:34) Great.   Well, Ryan, if people are interested in connecting with you, how do they get connected? Because again, I think for me, before I even talked to DSOs, I always tell them like talk to your financial advisor, figure out your project number. That way you actually can then have even one filter on what deals you're looking for, what plan you need your business to be. So Ryan, how do they connect with you?   Ryan Isaac (21:41) Yeah, totally.   Million   percent. So I'll always say friends of the Dental A Team always can email me directly. I'll always have a conversation with anyone no matter what you're looking for. You don't have to be trying to hire a financial advisor. You might just have a few questions and I will always get on the phone and talk to someone. Just email me directly if you ever want to. Ryan at Dentist Advisors dot com. It's with an O.R.S. You can all just also just go to our website dentist advisor dot com. have   probably thousands of hours of free content on there, podcasts, articles, webinars, everything. You can book a consultation with our whole team there at any time. go learn as much as you want, listen to anything, tons of free stuff on there, but that's the best thing. I'm always happy to have a conversation.   Kiera Dent (22:29) It's amazing. And just so you know, Ryan does not take very many clients. So that's why I love him being on here. He's one of the founders. I think Ryan's one of the smartest people I've ever met. So definitely take him up on it. I know tons of our clients love meeting with Ryan because Ryan will tell you like, Hey, you don't need me or Hey, here's someone better for you. So I think it's just like, you're just an incredible human who ultimately cares and loves about these dentists, which is why I just appreciate you. So check him out. Yeah, of course. And for everyone listening, thank you for listening and we'll catch you next time.   Ryan Isaac (22:31) Yeah.   I do. Yep, I do. Thank you. Thank you.   Kiera Dent (22:59) the Dental A Team Podcast.  

On today's episode, Dr. Mark Costes sits down with dental transitions expert Greg Auerbach, Senior Director at Henry Schein Dental Practice Transitions. Greg unpacks the critical mistakes dentists make when preparing to sell their practices—and why waiting until you're ready to retire could cost you big.  From understanding valuation methodologies like cap rate and EBITDA, to the difference between DSO deals and private practice transitions, Greg offers data-driven insights on how to boost your practice's value well before it hits the market. Whether you're five months or 15 years from a transition, Greg lays out a clear case for how and when to start preparing for one of the biggest financial events of your career. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://www.henryschein.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

In any relationship, the foundation of trust makes or breaks the success and longevity of it. So, why should dental practices and the relationship between the practice, its professionals and customers, be any different? In the latest episode of The Dental Economist Show, host Mike Huffaker welcomes Mark Musso, CEO of Specialty Smile Partners, to explore leadership lessons from retail to dentistry, building trust in DSO partnerships, and navigating industry evolution. Mark brings invaluable mentorship philosophies to the conversation, offering actionable insights into AI implementation, strategies to scale while maintaining quality patient care and the critical importance of transparency. Tune in for a reminder on why it's vital to set the tone early on and start building the foundation of trust from Day 1, in dentistry and in life.

Ever wondered what the future of dentistry really looks like? In this episode of The Thriving Dentist Show, Gary Takacs sits down with Dr. Aman Kaur, founder of Women in DSO, for an inspiring conversation about what's changing and what's possible. They dive into the rise of women in leadership, how DSOs are evolving, and why emotional intelligence and mentorship are becoming must-haves in every modern practice. You'll also hear how technology and generational shifts are reshaping the industry, and why now might just be the best time to be a dentist.  

Kiera is joined by Ryan Isaac of Dentist Advisors to dive into DSOs. They discuss such questions as: Are they the best financial choice for your practice? The best life choice? Are the horror stories true? And so many 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 I am freaking jazzed for today's podcast. It has been way too long. Me and this guest talk quite often on like life and personal and business, but podcasting it's been a hot minute. I've got Ryan Isaac from Dentist Advisors, my personal advisor, one of my dearest friends. I think we're siblings in another life. Ryan, welcome to the show today. How are you?   Ryan Isaac (00:07) Mm-hmm.   Thank   Thank you.   I'm really good. just realized I was trying to hit mute and cough, but I hit like a chapter marker instead. So there you go. To your listeners or your ⁓ editing team, then there's a chapter marker while I'm coughing. So in your intro. Yeah. Tis the season.   Kiera Dent (00:35) You're welcome. Yeah, that's fine. I'm   okay with it. This is real life. We're sitting on, I mean, Ryan, you're sitting on the couch. I should get like my posh chair. I've been considering changing up my podcasting zone. Yeah, of course. All of us can see it. We're excited for that.   Ryan Isaac (00:40) Hahaha   Can I show you? Can I just give you a little vibe check here? I mean, it's actually, that's   the ocean. I'm on a little summer getaway for a second. So yeah. Yeah.   Kiera Dent (00:54) my gosh.   That's amazing. So that's Ryan's   life. Ryan's living his rich life over there. He's like truly. So, okay. If you're new to the podcast, Ryan is my personal advisor. Like truly he actually works on. We talk about my life. He's helped me make some really good decisions and not make some bad decisions. So I feel like financial advisors. My best advice is you gotta just find someone you trust. And I know Ryan is way more conservative than me, but cares about me as an individual so strongly. And Ryan, huge kudos to you.   And so we talk about it a lot, but something we talk often is like, what's our rich life? And I remember Ryan for years, you were like living in your van, truly driving to California all the time to be by the beach, because you love surfing so much. So it just makes me so happy to see that you are living your best life by the ocean. You're doing what you teach all of your clients to do of living their version of a best life. Something that we try to do in dentistry and dental team too, like, hey, let's help your business provide you the best dream life you want. So that's Ryan.   Ryan Isaac (01:36) Yeah.   Thank you.   Yeah, yeah.   Yeah, thank you. And there's no there's no right way to do that. I mean, everyone has their own thing that's worth the money or worth spending on. We're just kind of joking around about this, too. There are people who will sit in ⁓ small rentals or apartments on millions of dollars because to them having lots of security and liquidity is more valuable than houses or everyone's got something different. But, you know, we're all we're all chasing it, hopefully.   Kiera Dent (01:57) Catch y'all.   I think it's called the like emotional ROI and what helps you sleep at night in your financial world. So Ryan and I usually get on the podcast and we'll talk about finances. I mean, obviously dentist advisors, Ryan do a spiel. What is dentist advisors? Just so people know. I think you guys are financial advisors for dentists specifically. I'm not a dentist, but I can speak honestly, but a spiel. And then we're going to actually go like a hard left turn of what we're going to talk about today. Like really.   Ryan Isaac (02:26) Ooh. Uh-huh.   Yeah. Thank you. ⁓   Yeah, yeah, our   on ramps coming up here really soon. We got to get over it. We got to get into the right lane. Dentist advisor started ⁓ almost A Team years ago now with me and Reese Harper. Shout out to Reese Harper. And yeah, we were dedicated to being ⁓ an independent fiduciary fee only ⁓ advisor for dentists to manage investments and give financial advice. Ultimately,   Kiera Dent (02:51) Yep.   Shout out to Reese.   Ryan Isaac (03:17) you know, a dentist path through school and debt and taxes and all the stuff they go through, ⁓ you know, buying a practice, building businesses. There's no reason why all of that should not pay off every it should pay off for every dentist. There is enough money to be made in dentistry. And so our job really and you kind of said this with the you know, in the intro, ⁓ I really do feel like just protecting my clients, you know, and that's a philosophy that we've.   built into our business. There's no reason why dentists shouldn't make it to the life they want and to the finish line financially. so, you know, ⁓ it's more about consistent, small, good decisions for long periods of time and avoiding like a few big mistakes that could derail you forever. So yeah, we have a custom financial planning process, ⁓ a lot of like reporting and data, and we just manage and track ⁓ dentist finances and make sure they end up in a good spot, safe and healthy and   Happy, hopefully.   Kiera Dent (04:15) which I love about you guys, Ryan, and I really think you guys do a great job. And this is something you've taught me. And we have a friend who said a great quote that I feel should be your quote. I can't give it like, so you can take it and like make your version. But they said like regular investing is like vanilla ice cream. It won't make anyone jealous, but it always tastes good. And I felt like that's such a great way to look at how you've taught me how to invest. ⁓ At the end of the day, it's just a small, consistent thing. So I think Dentist advisors does really well. And Ryan, something you've done for me. ⁓   Ryan Isaac (04:24) well. Okay, okay.   Mm.   Mm-hmm. Mm-hmm. Mm-hmm.   .   Kiera Dent (04:44) Like it's so dumb, but I know you're watching me and I know like when I, like you're really not watching me, but I feel like you're watching me.   Ryan Isaac (04:49) Yeah, well, let's   hold that disclaimer here for a second. I see your numbers. I see your accounts. I see your emails. Every time you save money, I'm like, Kiera, good job in the email thread. Gold stars. Yeah.   Kiera Dent (04:53) Like, I know he's not, like, he watches my account for sure.   That's   all it is. And I just know having Ryan there where I need to send it in every single month of what we're going to invest. We've talked about the plan has been such a game changer for me. So that's why I love Dentist Advisors. And like we said, we're now like taking our off ramp because Ryan and I want to talk about DSO sales. I think this definitely implies to a financial advisor. We have a lot of clients that we send to Dentist Advisors. We work such hand in hand with both sides. Like we love what you guys do. You love what we do. It's   Ryan Isaac (05:19) Mm-hmm.   Kiera Dent (05:30) Truly like the best peanut butter and jelly sandwich or whatever your favorite. If you want this to be meat and cheese, peanut butter and honey, whatever it is, I think it's the best duo. Yeah, exactly. That is the best. Captain Crunch, but would you rather Captain Crunch or Reese's? Or.   Ryan Isaac (05:37) Captain Crunch in 2 % milk, you know.   No. I would actually say   fruity or cocoa pebbles, to be honest with you. Or cinnamon toast crunch. Can we arrive there? Okay.   Kiera Dent (05:52) We both disagree on that. So cool. Okay, can handle Golden   Grahams or are we like back to the s'mores run? Remember the s'mores Golden Graham?   Ryan Isaac (06:00) Yeah, I do remember   the scores. How are we like not landing on the same one at all? What about honey butches of oats? Wow. Okay. ⁓   Kiera Dent (06:05) It's okay. That's fine. I'm not like the biggest serial fan and I go through phases. I love Lucky Charms, but I'm not joking.   Those marshmallows give me the chills. Like I can't crunch into it without it being like full body chills. So I don't know. weird. But back on this. So we've actually had a lot of clients that are debating of do I sell? I sell to a DSO? And I'm like, talk to freaking Ryan.   Ryan Isaac (06:18) Yeah, it's like biting Styrofoam. Okay. All right. Okay. Okay. Anyway. Yeah. Yeah.   you   Kiera Dent (06:32) I don't know what you want to do for your retirement. I have no clue how this is gonna impact you with your taxes. I don't know all the stuff, but what I do know is I'm a freaking miracle girl, so we're gonna get you top dollar for your cell, but like let's talk DSO. Cause also like DSO to not DSO, like I don't know Ryan, there's a million things. So let's Rift. You wanted to talk about this. I love this. Let's do it.   Ryan Isaac (06:41) Yes.   Yeah, yeah. Yeah,   well, and so you said something a few minutes ago about ⁓ dentist investments. And yeah, like our job is to help manage investment money for people ⁓ in a really long term kind of boring way, if we're being honest. But yeah, it's very yeah, it's just like it'll be there forever. Just let it do its thing. But the biggest investment any owner is going to have is their practice. And that is the thing   Kiera Dent (07:08) vanilla ice cream ish.   Ryan Isaac (07:18) is why you and a team is so important because the thing they should protect above everything is their practice investment, their business investment. There's nothing more impactful to a dentist's entire life and not just their money, but their entire lifestyle, probably their mental health, their wellbeing, where and who they spend their time with. So it is by far the most important factor in all of this. And so the world that we're in now is that   DSOs are an option to sell to, to work with, to become a part of. They are in some shape or form, you know, supposed to become the majority of the industry in the future. I think that's a broad category. think the category is more like group practice will become the majority of the industry. I'd love to hear what stats you've heard and what you actually see. think people talk about, you know, 60 to 70 % consolidation in the industry.   becoming some kind of DSO or group practice. ⁓ yeah.   Kiera Dent (08:19) Yeah, I was actually at an AI conference with   that just literally this last week. And they said that they're estimating 65 % of the market will become in the DSL world in the next like five to 10 years. So I think a lot of people are expecting, which is so funny to me because I remember, gosh, I think I was Mark, this is a long time ago, we were at the dental college. And so we're probably talking like,   Ryan Isaac (08:32) Uh-huh.   Yeah, okay.   Kiera Dent (08:46) 2018, 2019, I remember talking to the students, like, what do you think is gonna happen? And I'm like, I know I'm unpopular, because even Mark wasn't on board with this. And I'm like, I think I'm unpopular, but I'm pretty confident DSOs will be the future. And they're like, you're full of it. They're like, there's no way. And I'm like, I mean, I'm not emotionally invested in this, but if I look at what's going on, my husband's in healthcare. This is what happened to pharmacies. This is what happened to mom and pop shops, like for medical.   Ryan Isaac (08:57) Mmm.   Yeah.   Kiera Dent (09:14) I cannot think for one second the dentistry and with the EBITDA like offers that you're getting, it doesn't matter. And Jason, were talking about this the other night. I'm like, even if doctors want to have a legacy practice, that's great. You sell to this person, but this person now is younger. They have more debt and DSOs is like one bad day and this DSOs right on their doorstep. They're going to sell. Like it's just, I mean, you've got to some really strong guts around you to not think about a DSO. And I think DSOs,   Ryan Isaac (09:42) Hmm.   Kiera Dent (09:44) can often hit you at emotional times. Like Brian, you know me. There have been times that I told you like someone offered me a buck for Dental A Team, they could have it like one bad day. It's just like shirt. Like everybody has it in business ownership. So I think that that's where the DSOs are super attractive to people. But like I was talking to an office yesterday who's considering working with us and they're like have a one year buyout. And they're like, we're thinking about doing this DSO. And I was like, all right, but like what's your ultimate end game? What are you trying to achieve?   Ryan Isaac (09:46) Mm-hmm.   yeah. Yeah. yeah. We all have those days. Yeah.   Kiera Dent (10:12) you met with other people to talk about DSOs, there are other options and he's like, well, it's too big for these partners to buy. I'm like, well, it's actually not like there's ways for partners to buy you out if you want. think it's just, DSOs feel like the easy button, but I don't know if they're really easy. And I think that that's where I'm a little bit on the fence and I'm super jazzed for us to rift on. Is it really the best financial choice? Is it the best life choice? I don't know, Ryan, you know, the finances more than I do. just.   Ryan Isaac (10:14) It's on.   Mm-hmm.   Same. Yeah.   Yeah.   Kiera Dent (10:40) I do good job of helping people get their assets where they want them to be. So they have choices and options of what they want to do.   Ryan Isaac (10:42) You do.   Yeah, so I think, you know, it makes a lot of logical sense, especially the way it started with DSOs, that it would have gobbled up a lot of the industry. Hearing 70 % made a lot of sense to me. Maybe we're just in a dip in a lull, which we totally have become, we've entered into that because of the, you know, the debt and rate situation that happened over last few years in inflation and, you know, just interest rates. Money got really expensive. It was hard for a lot of companies to grow across a lot of industries.   And, uh, but, and I, I'm, uh, I want to say these statistics correctly, uh, from smarter people than me in the DSO space. I think there's something like maybe, you know, 350 to 400 technical DSOs in the country right now. And I've heard in multiple sources that up to a third of them are in some kind of financial receivership right now. Meaning, and I know you've seen this with clients too. DSOs have grown and they purchase and they borrowed money and then   rates hit them and they grew too fast. They went ahead of themselves and they defaulted. And ⁓ there are some major DSOs, huge ones that I did not ever think would happen that went into default that are going bankrupt that are changing ownership. ⁓ People are losing their equity money, they're not going to get their payouts. ⁓ And they're they don't own their practices anymore. I mean, there, we have some clients in that situation. So   Yes to the consolidation in the future of that because of just that's the nature of economy sometimes in industries. And I don't know if it's going to hit 70. I don't know. It makes me wonder. ⁓ Those multiples are down a lot than they than they used to be. And they'll probably you know, they'll probably fluctuate, come back up a little bit more when money gets easier. ⁓   Kiera Dent (12:22) I don't know anything.   Ryan Isaac (12:36) Also, I think people are getting a little bit wiser to it. Do you see this? I mean, let's say three to five years ago, it was the most exciting thing to get an offer sheet across your desk and be like, know, some multiple of you, but this is insane, I'm done. I do find people way more hesitant and not as excited about that number anymore. What have you seen with that when people see those initial numbers?   Kiera Dent (12:47) Made it.   think people are way smarter. think the grads coming out of school have been trained on business a lot more than say dentists 20, 34 years ago are trained and not to say dentists 20, 30 years ago weren't. I just think it wasn't like we weren't talking EBITDAs. You weren't selling like this. So you didn't there was no need for it. ⁓ And I think in the past, I think the reason people are more skeptical right now, Ryan, is because they're hearing the like horror stories coming through. So people are like, hold on. Maybe it's not as like   Ryan Isaac (13:12) It's different. Yeah.   Kiera Dent (13:28) rosy as it was. I honestly like DSOs might be a little bit of dentistry's dirty secret. Like there's a small piece of me feeling that way and not all DSOs I'm not here to blanket statement it, but I do think there's like, think the dentist is the one getting ripped off in the whole scenario. like, because Ryan helped me, this is where I, guys welcome. This is what Ryan and I used to talk about off camera, but I'm just going to like have the conversation here because I'm curious. So your clients, okay, so hold on.   Ryan Isaac (13:43) Mm-hmm.   Yeah, let's do it. Yeah, huh?   Kiera Dent (13:58) answer your question, no, they're not as excited about it. And also I think that they're being flooded with a bajillion offers. And so almost like overwhelm of who the heck do I have? Who do I trust? Who do I know? 400 DSOs out there. They're being bombarded every single day. I have heard dentists tell me they get four to five offers every single day of a DSO, which is why I'm like one bad day, you click open an email and like bottom, bottom, there you go. So I do think Bron and Man.   Ryan Isaac (14:02) Yes.   Yep. Yeah.   Yeah, you're done. Like, yeah, that's the buyer. Yeah, take it. Yeah.   Kiera Dent (14:22) Brandon Moncrief with Dental Transitions is probably the smartest DSO man I've met and I think you and I have circled. He's really brilliant on like who he knows offers that you can get like he kind of knows how to navigate the DSO world of what you want, which I think is awesome. But what I'm curious on Ryan. Okay, so you said you have clients. So when you sell to a DSO, there's lots of different makeups of how they can do these deals for you. But let's say there's I think the most standard one I usually hear is they pay you about 50 % of your practice is worth like you're giving it to them.   Ryan Isaac (14:24) Yes.   Yeah, I still send people there. Yeah.   Mm-hmm.   Kiera Dent (14:52) You also have them 50 % in equity in their business, hoping like with stock shares, hoping that it builds and that's like basically your payout. So it helps with tax. It helps with like future investments of the EBITDA. Those are the things that they're going to be dealing with. But my question is, so like your clients, they sold, they don't own their practices anymore. They're an associate there now ⁓ and they're getting paid. They don't have to do the management, billing's taken off of them, hiring, all that. But let's say these, so let's say I sold to Ryan Isaac DSO.   Ryan doesn't have a DSO just for clarity, but let's pretend I'm dentist. We got to make sure I don't want him getting in trouble. He's a financial advisor. So Ryan doesn't have it. okay, we're selling, okay, lies. We're selling it to Captain Crunch DSO. All right, let's just go safe. Captain Crunch DSO. Captain Crunch buys me. I'm now, I got my 50 % payout. have 50 % equity in Captain Crunch DSO and I'm now working as a dentist there, but I don't own my practice anymore.   Ryan Isaac (15:23) Yeah, just so we're clear here. Yeah, yeah. I've highly regulated. Yeah, might be in trouble for that.   Kiera Dent (15:49) Captain Crunch DSO is growing, growing, growing. Everything's looking good. I've got my stock in it. Captain Crunch loses its funding. They go bankrupt. What happens to me? Because odds are they go bankrupt. Another like lucky charms DSO is going to come buy Captain Crunch. Like they get a penny, dollar. What happens to me as the dentist when Captain Crunch goes under, but then lucky charms comes to buy me. How does that work for me as a dentist?   Ryan Isaac (16:02) Yeah.   Yeah,   I'm watching that happen right now with a gigantic national specialty DSO with some clients. And what has happened is that their equity money is likely gone. So they got their payout money.   Kiera Dent (16:19) Mm-hmm.   Even   with Lucky Charms coming in to buy it. My equity money's gone because it was with Captain Crunch. Do you love that I did cereal for you?   Ryan Isaac (16:28) Thank   I love it. It's so good. And I'm trying   to like, like who's more evil in this hierarchy, you know?   Kiera Dent (16:35) I think Lucky Charms isn't more evil. Lucky Charms is one who capitalized. They saw a dill. They don't care about the dentist. I'm not saying that they don't, but it's like hungry, hungry hippos. One goes out, someone's going to come buy it all. That's what they're going to do.   Ryan Isaac (16:37) Who's more well capitalized? Yeah.   Yeah.   Yeah.   Yeah, this   would be such a good question for Brandon again, and I'll just second that every time someone has questions about deals, or they want to compare things, ⁓ or get to know the space a lot more, I send them to Brandon. So just find Brandon Monacree, if he's on all over the internet and all of our content. Yeah, there you go. So it depends on the structure of the deal. It depends on the fine print and the paperwork. ⁓ In the ones I'm seeing right now, these dentists   Kiera Dent (17:04) dentaltransitions.com. Yeah, he's everywhere.   Ryan Isaac (17:17) lot, their practices are not there. So their practices are still gone. And they likely are not going to they're definitely not going to get any return on their equity. Some of them depending on how early they got in might get their equity back or, or parts of their equity back. But a lot of it's just, you know, when another company when a big financial company comes in to save a bankrupt company, it's ruthless, you know, I mean, they're they're cutting and they're scrapping   as much as they possibly legally can. they'll do that, of course, because that's good business for them. So what I'm seeing, and again, I'll just say that it's probably different in every single scenario of this. But what I'm seeing is one that happens. ⁓ These dentists are losing their practices, they're not getting any return on their equity money, and many of them probably won't even get their full equity back. Luckily, some of my clients that I'm thinking of were in early enough and the fine print of their deals was good enough that they're going to get some of their equity money back.   Kiera Dent (17:48) course.   Ryan Isaac (18:15) ⁓ that's it. They're done. So what really happened in that transaction was they got front loaded a certain amount of years of income, paid some taxes, paid off their debts and lost their practices and worked a job for three or four years at a very low salary compared to what they produce. ⁓ many of them got really burned out, bombed out, kind of lost their fire and spark for the work. ⁓   And they're back to square one. Some of them have enough money to be finished. What is interesting though is even the ones who have enough money to be finished are still contemplating starting or buying another practice where they can legally and doing like a really chill lifestyle two day a week thing. Really common. Other people will fully lose their equity. And in a situation, again, back to your point, a lot of people are   Kiera Dent (18:54) and   Ryan Isaac (19:05) Maybe it's not as excited about this. The multiples aren't what they were. Then they could come back. I don't know. A lot of people just say the longer this goes, the smaller the multiples will become, which is, yeah. No, we're definitely not. And so now we're talking about an offer where someone's coming to you to take away like your main, main asset, your cash cow, the biggest thing in your whole life. They're going to front load five or six years of income. You have to pay taxes and pay off your debt with that money first.   Kiera Dent (19:13) which I would agree on that completely. I don't think we're half as high.   Ryan Isaac (19:33) The deals that you mentioned, some are 50-50. I've seen them in thirds where it's like third buyout, third earn out where you have to keep producing and then a third equity. I've seen them 70-30, 60-40. They can really be any shape or size. ⁓ Yeah, but they're smaller. And so now we're talking about, you know, five or six years of front loaded income. You pay taxes, pay off your debt, and then you just hope that this company that bought you and essentially what's happening if you think about it.   Kiera Dent (19:48) They really are.   Ryan Isaac (20:02) You're taking like seven figures of money and you're putting it into a single stock. You're investing into a single stock and it's a very small privately held company. I know it feels safe and secure because it's your field, it's dentistry, know, all these things are, but you're taking seven figures of your money and you're putting into one single company where right now maybe up to a third of these companies are failing.   Kiera Dent (20:08) Thank   Ryan Isaac (20:30) It's not not a gamble, you know, and the whole kicker in all these deals, as you know, and your audience knows, Kiera is all in that equity piece. Everything else is just front loading your income for the next five or six years and taking away your ownership. And then, you know, really changing the nature of your career and your work. And it really does change people. It changes. And I'm not saying it's always for the worse, but it is change changes, teams changes, the patient experience changes, the culture and the vibe.   Kiera Dent (20:34) huh. ⁓ huh.   Mm-hmm.   Ryan Isaac (21:00) And so if that one little equity piece does not pan out the way that they say it's going to, ⁓ you know, that's the part that everyone's kind of wising up to. And if you're under, let's say, your late 50s, if you're younger than your late 50s, I think it's becoming a tougher decision for people to make. in late 50s or above, it's kind of like, I'm done anyway in three or four or five years. Might as well get top dollar.   even if the equity doesn't fully pan out all the way, it might be more than a private buyer. But even then, I've seen the math on a lot of things and like, it's close. And yeah, you've seen it all too. So yeah, it's tough. It's tough to watch the ones that fail. ⁓ Some of these, some of these, and you've probably seen, we're not going to name anybody, but you've probably seen them too. Huge practices, multi-location, huge DSOs that now...   Kiera Dent (21:25) Mm-hmm.   Agreed.   Mm-hmm.   Ryan Isaac (21:52) own these practices. And okay, here's a question for you. What do you think is going to happen, let's say 10 years down the road or longer, when all these DSOs have been bought by the next company and been bought by the next company? And then in the end, some like third and fourth party removed private equity firm, international private equity firms holding 10s of 1000s of dental practices around the country?   What is that like in the industry? mean, you're in the practice as you know that you're like in the heartbeat of that. What does that mean for the industry? What does that feel like? Does it feel weird?   Kiera Dent (22:27) It does feel weird. And I think this is where I've been, I don't know, Ryan, you know me. just sit over here and think of ideas all day long. I've been like, how can we like, hi, I'm Kiera. I live in Reno, Nevada right now. It's like, how can some, I feel like I'm like Dorothy in Kansas right now. It's fine. It wasn't the destination, but it ended up being, it's fine. It's got really great. No state income tax. All right. That's really one of the main reasons we're here. It's not.   Ryan Isaac (22:42) I like to write now by the way. Just a little shout out. like to write now. Yeah. Loud and clear. Yeah.   Yeah, fine. It's pretty in some seasons. There you   Kiera Dent (22:55) But it's okay. We have Lake Tahoe. ⁓   Ryan Isaac (22:55) go. Okay. Okay. All right. Okay.   Kiera Dent (22:59) But only half of Lake Tahoe because California owns the other half. So it's okay. But I've thought about it. like, how can, like, it's like I'm Dorothy in Wizard of Oz right now. It's like, how can we somehow influence these private equity firms? And there might be no way. But these are the questions I think of often, because I do think if we're not careful, it will radically shift the way dentistry is done. And it will turn into a business rather than into our   Ryan Isaac (23:02) Yeah, you're half.   Okay.   Kiera Dent (23:24) our healthcare profession. I mean, I look at modern medicine, my husband's in it and it is a freaking drill machine. Like his number one thing was patient productivity and they had to have so many patients, otherwise they were going to fire providers. And their providers worked hard. They weren't getting paid what they like want to get paid. And so I'm actually watching in healthcare, lots of my friends in healthcare, nurse practitioners, doctors branch off and go open up their own practices because they're sick of working in modern medicine. So I'm like,   Ryan Isaac (23:24) Mm-hmm.   Yeah.   Kiera Dent (23:51) if we can look at modern medicine and see how the healthcare system has been working and how can we do something now as like you said, third, fourth remove private equity, owning all these dental practices, like is there a path? And I don't know, right? Like this is I feel like I'm like Dorothy sitting in Kansas of like how on earth can we influence it? But I'm like, if enough brilliant people start thinking this way, what can we do now to show that you can be profitable and ethical and still give great dentistry where we're not having to like,   Ryan Isaac (24:08) Hmm.   Yeah.   Kiera Dent (24:21) not running it like a private equity business, but still showing. so Britt was like, we need to become the Wegmans. Like, have you been like up north, like Wegmans is an amazing grocery store. They're not the biggest, but they still are ethical. And I'm like, if we even had a few private equity that's third and fourth removed that would still run practices that way, I think dentistry would still feel the same. Something else though, that I think of like new dentists coming in that I think is really paramount is you've got to look at the future of the industry. I think the current doctors,   Ryan Isaac (24:39) Mm-hmm.   Kiera Dent (24:50) that have been in dentistry have like safeguarded and kept dentistry like we're healthcare when we want to be and we're not healthcare when it doesn't benefit us. Like we literally have straddled the spine line. It's still a little bit of the wild wild west dentistry is not as regulated as far as like our fees and like what we're able to charge in every single practice and like insurance is schmuck. get it. But I'm like, you also only have $2,000 of max most of the time that we're dealing with rather than it being like a hundred percent of what your patient base is and like what the patients are paying out. So I'm like,   Ryan Isaac (25:11) Yeah.   Kiera Dent (25:19) I feel the pioneers of dentistry have actually done a really good job of setting it up to where dentistry is still very profitable. It's still able to be its own thing that I'm like, let's, again, I feel like I'm like Dorothy sitting on my soap box in the middle of prairie fields and saying like, hey, why don't we take a pause and just think of like, what's the future of dentistry as now the future pioneers of dentistry? And what are we going to do to our profession? Yes, there's top dollar. Yes, there's things about it, but is there a way to influence?   and make sure that the integrity of dentistry can maintain long-term. I have no answer to that, but again, this is Kiera Dent sitting on my podcast where I think that there is a voice and an influence and like on Dentist Advisors podcast, is there a way that we can influence our industry in ways that will protect and still pay out? Because I'm like, even if you don't get the 10X EBITDA, you still can get a freaking great payout if you do your life right to where you can be financially set up.   Ryan Isaac (25:51) Mm-hmm. ⁓   Kiera Dent (26:17) still be able to sell your practice, not have to sell it in ways that could potentially hurt the industry. I'm not saying one's the right answer or the wrong answer. There's no judgment on my side. It's just, let's maybe think and consider how it could influence. Can we get people that could be private equity higher up that could help protect it? Those are things that, and again, I'm just Kiera Dent here in Reno,   Ryan Isaac (26:22) Mm-hmm. Yeah.   Same, okay.   Okay. Yes.   Kiera Dent (26:38) Yeah, of course. And for everyone listening, thank you for listening and we'll catch you next time.   Ryan Isaac (26:37) Thank you.   Kiera Dent (26:42) 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!

If you're navigating the complexities of staff dynamics, practice transitions, or rapid DSO growth—this episode is for you. Because here's the truth: hope is not a strategy. And when it comes to managing workplace conflict, ignoring the problem won't make it go away—it just costs you more. To break this down, I've invited Dina Lynch Eisenberg, Esq., a nationally recognized ombuds and conflict resolution consultant, to the show. Dina brings decades of cross-industry experience—from Coca-Cola and Twitter to DSOs and private practices. She specializes in resolving internal conflict, protecting team culture, and preventing silent turnover. In this episode, Dina and I discuss: What an ombuds actually is—and why every growing practice should consider working with one The hidden costs of unresolved team tension, from failed associate retention to lost productivity How DSOs can better support both legacy staff and new acquisitions during transitions Why HR alone isn't enough—and how the neutrality of an ombuds creates psychological safety Practical strategies for conflict prevention, including conflict style assessments and mediation training The powerful shift from "culture" to "community"—and how that reframes your leadership Whether you're managing five locations or fifty, this episode will help you take a hard look at your organizational health—and give you tools to proactively strengthen it. — Key Takeaways 00:42 Introduction and Event Announcement 03:30 Understanding the Role of an Ombuds 05:43 Dina's Journey into Dentistry 10:00 Common Conflicts in Dental Practices 15:14 The Impact of Ignoring Conflicts 18:40 Ombuds vs. HR: Understanding the Differences 21:18 Ombuds Engagement: Temporary vs. Long-term 24:33 The Cost of Unresolved Conflict 27:10 Organizational Health in Dental Practices 28:31 Lightning Round Q&A 32:40 Conclusion and Contact Information   — Connect with Dina LinkedIn: Dina Lynch Eisenberg Email: hello@happypracticeconsulting.com Resource: Self-Assessment for DSO Leaders    — Learn proven dental marketing strategies and online reputation management techniques at DrLenTau.com. This podcast is sponsored by Dental Intelligence. Learn more here. This podcast is sponsored by The Doc Sites, the leading provider of websites and online marketing for dentists. Find out more here. Raving Patients Podcast is your go-to place for the latest and best dental marketing strategies that will help you skyrocket your practice. Follow us for more!

In this episode of the Dental Board Room Podcast, Wes Read CPA, CFP, continues AI in Dentistry series with a very special guest, Dr. Wardah Inam, founder and CEO of Overjet AI. With a background from MIT and Harvard, Dr. Wardah Inam is at the forefront of AI innovation in dental care.Overjet is the first FDA-cleared dental AI platform for both caries detection and bone level measurements. It's used by solo practitioners, DSOs, insurers, and dental schools alike.Dr. Wardah Inam walks us through how AI is reshaping diagnosis, patient communication, insurance verification, and revenue cycle management inside dental offices. We explore the use cases, adoption challenges, and the exciting path ahead for AI in dentistry.Whether you're a dentist, DSO leader, or simply AI-curious, this episode is packed with actionable insights.Key PointsWhat is Overjet AI:First FDA-cleared dental AI for cavities and bone measurementsTrusted by clinicians, DSOs, insurers, and educatorsMission: Standardize diagnostic precision and elevate patient careOverjet's Core Offerings:Smart Imaging: AI-integrated radiograph analysis from image capture to diagnosisAI Overlays: Enhances existing imaging and PMS softwareRevenue Cycle Management Tools: Insurance verification, real-time treatment cost estimatesReal-World Use Case:Insurance verification days before the appointmentCo-diagnosis in the operatory using AI visualsTreatment plan clarity with insurance coverage breakdownsSupport for morning huddles, treatment follow-ups, and care consistencyAI for Diagnosis and Patient Communication:Color-coded visuals improve patient understanding and trustBoosts treatment acceptance by 10–20%Helps uncover underdiagnosed conditions like periodontal diseaseWhere AI is Going in Dentistry:Moving beyond the operatory into operations and admin efficiencyFuture possibilities in note-taking, billing, and clinical support#DentalAI #OverjetAI #AIinDentistry #DentalTech #DSO #DentalInnovation #PatientExperience #DentalBoardRoomPodcast #SmartDentistry #DentalDiagnosis #CaseAcceptance #FutureOfDentistry

On this episode of the Dentist Money Show, Matt, Jake, and Christine unpack a real-life case study of a dentist who was approached with a roll-up offer from a DSO. They discuss the fine print behind private equity deals, the financial structure, emotional impacts, and the long-term implications of selling to private equity. This episode explores what dentists need to know before signing a deal and why protecting independent ownership still matters. If you're considering a DSO offer, tune in to hear this case study. 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.

Fuchs Dystrophy is an important condition to be aware before operating on any patient.  Cataract surgery, in particular, can cause someone with otherwise asymptomatic Fuchs to develop debilitating corneal edema.  Then again, not everyone with Fuchs Dystrophy is destined to develop corneal swelling.  So how do we determine which patients are at increased risk of corneal decompensation?  How do we know which Fuchs patients warrant combined cataract surgery and endothelial keratoplasty?  And as an alternative to corneal transplantation, how do procedures such as DSO or potentially even endothelial cell injection, factor into our treatment of the condition? Dr. Guillermo Rocha joins the podcast. Become a supporter of this podcast: https://www.spreaker.com/podcast/blind-spot-the-eye-doctor-s-podcast--5819306/support.

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.

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!

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

Industry expert, Doug Houseman, joins PLMA for a deep dive into the critical role to be played in the energy industry by Distribution Systems Operators (DSOs). We'll explore how DSOs enable DERs, and how DSO business models differ from traditional distribution utility models and why, plus we'll discuss examples of successful DSOs and how they coordinate DER activity via programs and markets. And, we'll answer your questions, including why it's critical we increase flexibility on distribution and transmission systems now, as a path to transitioning the U.S. to a DSO model.

Why is January the best month for dental growth and September one of the worst? In this episode, Gary Bird breaks down why dental practices often see huge patient spikes in January and major slowdowns in September. Learn how dental offices can attract more new patients, improve treatment acceptance, and increase production during slow months. We dive into dental marketing strategies, patient behavior trends, and how to boost dental practice growth even during seasonal slumps. Whether you're a dentist, dental office manager, or dental marketer, this episode offers actionable tips to grow your dental practice year-round. Discover why September drops in dental production and how to fix it. Connect with our Host, Gary Bird, Here ⤵️SMC: https://smcnational.com/Personal: https://thegarybird.com

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?

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.

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

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.  

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