Podcasts about dsos

In this episode, Dr. Bryan Laskin exposes one of the biggest blind spots in dentistry: the lack of care traceability. While practices can prove every dollar collected, most cannot prove what happened after a diagnosis was made.   For dental leaders, DSOs, and practice owners, this creates a costly visibility gap that impacts patient outcomes, treatment acceptance, referrals, and revenue.   Discover why care traceability is the missing link between diagnosis, treatment completion, patient trust, and revenue.   #Dentist #DentalLeader #DSO #PracticeGrowth

In this episode, we unpack the consolidation of private practices and the growing influence of Dental Support Organizations. While many independent dentists view consolidation as a threat, Peter and Craig argue it may actually create one of the greatest opportunities the profession has ever seen. They explore the economic forces driving DSO growth, including insurance arbitrage, private equity investment, rising operating costs, and changing ownership models. But beyond the numbers, the conversation focuses on something much more important: what independent dentists can offer that large organizations often cannot. Peter, Craig, and Ian discuss why personalized care, strong patient relationships, community, and entrepreneurial freedom remain powerful competitive advantages. They challenge the idea that independent practice is becoming obsolete and explain why dentists who embrace leadership, innovation, and business education may be better positioned than ever before. The discussion also explores AI, technology, customer experience, insurance dynamics, and the future of practice ownership. As dentistry becomes increasingly consolidated, the question isn't whether the industry is changing. It's whether practice owners are willing to evolve with it. The golden era of dentistry isn't behind us. It belongs to the dentists willing to build it. If you've ever wondered what the future holds for independent practice ownership, this episode is for you. DESCRIPTION The Bulletproof Dental Podcast Episode: 445 HOSTS: Dr. Peter Boulden, Dr. Craig Spodak, and Ian de Jongh In this episode, Peter Boulden, Craig Spodak, and Ian de Jongh explore the rise of DSOs, the accelerating consolidation of dentistry, and what these trends mean for independent practice owners. The conversation examines the economic realities driving consolidation, the advantages and challenges of private practice ownership, and why community, leadership, technology, and patient experience may become the defining factors separating thriving practices from struggling ones in the years ahead. TAKEAWAYS DSO consolidation continues to reshape the dental industry Insurance arbitrage remains a major driver of acquisitions Independent practices still possess significant competitive advantages Personalized patient care is difficult to replicate at scale Community creates resilience during periods of industry change Leadership and business education matter more than ever Technology and AI will accelerate practice evolution Customer experience can become a powerful differentiator The future belongs to adaptable practice owners Consolidation creates both risks and opportunities Dentists must actively choose their path rather than react to industry trends The golden era of dentistry is still available to those willing to build it TIME STAMPS 00:00:00 - Introduction and Welcome 00:00:43 - Discussion on DSOs 00:01:34 - Statistics on DSO Growth 00:03:07 - Impact of Interest Rates on DSOs 00:04:21 - Historical Perspective on DSOs 00:05:15 - Comparison with Dermatology and Veterinary Practices 00:07:05 - Relationship-Based Nature of Dentistry 00:08:33 - Business Coaching in Dentistry 00:10:02 - Pause in DSO Consolidation 00:10:17 - Example of DSO Unwinding 00:12:09 - Financial Distress in DSOs 00:13:01 - Rollover Equity in DSO Sales 00:14:47 - Importance of Upfront Cash in DSO Deals 00:16:00 - Independent Dentists Thriving 00:18:20 - Personalization of Care 00:18:49 - Example of Personalized Service 00:20:52 - Customer Service in Dentistry 00:22:46 - DSO vs. Independent Practice Quality 00:24:02 - SOPs in DSOs 00:26:06 - Moats for Independent Practices 00:28:28 - ADA Statistics on DSO Affiliation 00:29:01 - Macro Factors Affecting Consolidation 00:31:14 - Insurance Arbitrage in DSOs 00:33:01 - AI and Service Businesses 00:34:27 - Future of Independent Dentistry 00:36:09 - Importance of Community 00:37:03 - Power in Numbers for Independent Dentists 00:37:34 - Personal Experience with DSO Sale 00:39:09 - Paycheck Advance Analogy 00:40:15 - Summary and Closing Remarks 00:42:27 - Outro and Call to Action

Does your front office feel overwhelmed? Kiera shares what the problem is 99% of the time, as well as how to clear up the confusion, and three tactics that bring about clarity and control very quickly. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Trasnscript: Kiera Dent- Dental A Team (00:00) Hello, Dental A Team listeners, this is Kiera. And today, I just wanted to talk about front office overwhelm. Like, dun, dun, dun, dun, dun. That's a real thing, it's a real deal. This happens all the time. And I just want you guys to be able to fix that quickly and easily. So today, we're here to wrap. We're here to have a good time. We're here to talk about the front desk overwhelm and how you can fix that and do it with a ton of ease. So.   If your front office feels overwhelmed, if you feel like they're overwhelmed, if you're ever scared to walk up there because you're like, my gosh, they're always stressed out. This is the episode for you and your front office team, because honestly, it's usually not that they have too much to do. It's that they're just, I call it front office soup. Then they're just all like, it's a bowl of spaghetti and we're all slurring and slopping and it's just a mess up there. But because we just have to figure out what matters and who does what.   And it usually, in front office team members, I hope you hear me loud and clear, I'm not being a jerk, I'm Kiera Dent from the block and I've sat in your shoes and I understand it and I've been in your shoes and I know this overwhelmed feeling. It's not usually a workload problem. Usually what it is, is it's a role clarity problem. 99.9 % of the time, if we clean that up and we like untangle the ball of spaghetti, everybody's super happy, everybody's clear and things start rocking and rolling. So.   Again, this is where we're at today. I wanted to just give a quick tactical podcast for you for that front desk overwhelm. And I want you to just know that like at Dental A Team , every single consultant on our team has been in your shoes. ⁓ I don't just say these words on the intro to the episode. We don't just understand you. We genuinely are you. We've been in your shoes. We've sat in your shoes. We've sat at the front office. We've taken the phone calls. We've had the schedule fall apart last minute. I've had the treatment plans not close. I've had doctor on my case saying, Kiera.   get the schedule full and I'm like, I don't really know what to do, okay? I've had that phone running a million miles a minute. We get it. It's chaotic up there, but it doesn't need to be chaos. And so when we have all that, how can we take the urgency away and help you focus on the important thing? And so this is gonna help us kind of figure out like, why do people get overwhelmed? How do get the confusion cleared up? And then what are three things that bring clarity and control very quickly? That's not gonna take months and months to get that stabilized, but to actually do it really quickly.   If you don't know us, hi, we're the Dental A Team. I'm Kiera Dent. Dent really is my last name. It took me three fiancees. You can ask me about that later. It's a real joke, but it's a real life. I love dentistry. I love helping people have their best lives. And I love the dentistry as the platform that brings us all together. I've been a dental assistant, a treatment coordinator, a scheduler, biller, an office manager, regional manager. have all my own practices. I took my first office from 500,000 to 2.4 million in nine months and opened a second location.   To say I've been around the block is not a lie. I have bought practices, I've sold practices, I've been parts of DSOs, I've been part of boutique practices, I've merged offices, you name it. I don't think that there's a single thing that I haven't done yet in dentistry, so try me. I'd love to meet somebody that I'm like, yep, never heard of that before. ⁓ And our job is to make dentistry fun again. Our job is to make you love your life again. Our job is to bring simple clarity. But as a business owner myself, I hated where I'd go to conferences and people would just talk.   to me and I have to go back and rally my team and I realized I'm gonna create a business that's gonna make your life easier. So we actually work with doctors and teams. We help doctors set the vision, where are we all going? And then we figure out your finances. Let's make sure you're profitable. And if you have tax aversion, like you're so scared of it. Not that you don't pay it, don't get me crazy on that, but that you're so scared because you feel like you're making money but you're always broke. We help offices actually like find the money, keep the money, make the money. Like let's have you be profitable.   And then the other part is how do we do system and team development together? I call that the yes model. You first vision, making sure you're taking care of E stands for earnings and profitability. S is systems and team development. Doing that yes, success model. So you can say yes to more in your life. Truly, truly. And teams freaking love us because guess what? We get this. We understand it. Doctors love us because we're magic magicians that can fix it with your team, but also help you be profitable. It's like.   Let's put a bow on all the beauty together. So let's talk about your front office because everything freaking feels like a priority. my gosh, I gotta answer the phone and check patients out. I gotta try and schedule all the doctors asking me questions. I gotta keep my doctor busy. I've got constant interruptions nonstop. As soon as feel like I get patients checked in, that hygiene team's bringing them right back out. It is nuts. And it's because we just don't have priorities hierarchied. And also we're not using time when we need to.   So when front office is jumping between five tasks and finishing none of them well, that's chaos. And so how can we actually make it to where things aren't as chaotic? Because yes, you're always gonna have interruptions. And I think for us to never feel like, I can never have interruptions, like that's not my perfect date. That's not real life. We signed up for an amazing job that's very busy up front. And I feel like my job in front office, I say like, I'm here for air traffic control. Like that's my job. And I'm gonna make sure every plane lands easily, AKA every patient has an appointment. I get them scheduled. We're gonna have calm.   Like I want to feel like JFK's airport. Like we're there. I just think about that airport and that air traffic control. I'm like, they have people flying in and out like mayhem or you can go to Atlanta or you can go to like any big city. Like think about that air traffic controller. And that's who like, I want to be at the front office. So front office team members, hopefully that's a good vision for you of, Hey, yes, we've got a million things going on, but we are laser focused on what's the most important thing. And so I love to give like, okay, number one, our scheduling person, what's their number one job? Their number one job is to make sure our schedule is filled to goal every single day.   That's your job. So hygiene and doctor like bada bing, bada boom, that's your role. You keep them on there and you do not leave the day until your schedule is full. Like I'm not having you go home like, well, I did my best. ⁓ Outcomes over activities. I am big on this. We own our role. We don't just do a job. We own that. So if I'm a scheduling guru, you better believe I'm going to have my hygiene schedule full, full. That doesn't mean perfect. It means full and productive. And I'm going to have my doctor schedule the goal.   treatment coordinators, your number one job is to have your doctor's hitting goal or exceeding goal every single day. Not a full schedule. I don't want all the white space filled in. But if my doctor needs to be hitting 5,500, you make it rain sister or gentlemen, you go figure out how to do it. You go look at your unscheduled treatment plans. I'm not gonna say you sit here and call 20 unscheduled treatment plans unless you're an office that's 7.5 million, then yes, maybe we'll put that as a job. But 99 % of the time, your job is to call as many as needed to get your schedule full, period.   So scheduling coordinators, it's to make sure we're running on time, hygiene's full. Sometimes I have doctor over there. Treatment coordinators, you're always responsible for getting doctors scheduled to go. Billers, 98 % collections, non-negotiable. We gotta have money in the bank, otherwise we're broke and we can't feed our team. And we've done the work, we need to collect the money. So from there, and then office managers, your job is to make sure profitability is there, KPIs are being hit, and the whole team is flourishing. So that's just like a very simple like.   Yeah, but Kiera who's first on phones first on phones is scheduler first person they're always on it unless you guys like no we want them to be concierge style we have a concierge then they're not first on phones but we have somebody who's first who's second who's third on phones so as that phone rings we've got it can you set up a phone tree so where if they've got billing questions it just goes to the billing line and the biller can help with that if you're like Kiera I only have two people in my front office fan freaking tastic we need to have dedicated power hour time so front office and scheduler usually does insurance verification too typically that's who's gonna do it   but sometimes my treatment coordinators, like they want to make sure that they get all their insurance verification done and they have maybe a bit more time than our schedulers do. So again, it's who's got the most amount of time and who's the best with bandwidth on that. That's how I'm gonna set it up. If you have a bill or a dedicated bill or they're gonna do insurance verification for you, insurance verification should take you two to four hours max. And I'm talking to max a day. If we're taking longer than that, we gotta figure out how to be a bit more efficient and I got great ways to do it, like lump them together. I got a ton of podcasts onto it.   but we've got to just make sure that each person, and I love end of day checklist where, and it's not we wait till the end of the day, it's we get this stuff done during the day, but by the end of the day, all this needs to be stamped, signed, delivered. So scheduler, you're responsible for hygiene, making sure it's full and up to par, possibly insurance verification, possibly doctor, depending upon your office. Treatment coordinator, non-negotiable doctor scheduled to go every single day. I'm talking if I'm working four days, three of my four have to be to go, period. And the first patient of the day,   Please, please, please, please, please do not leave me one that's unconfirmed. And you're like, well, it's full. If they're unconfirmed, they're not showing. Like I might get lucky, but don't do that. Make sure it's a guaranteed confirm. Move those patients off. I've got a ton of verbiage for getting patients off the schedule. So we're not sitting there with like, to me, those are like gap fillers. Like it makes us feel good, but it's not gonna actually, like that's not me owning. I know that patient's not gonna show up. I call and call and call until I get people.   So I start doing my confirmations at usually eight or nine in the morning. So I've got time and I do a 48 hour confirmation guarantee. So if they're not there, and then we started implementing with a lot of offices that if they don't call and confirm you, we are moving you off the schedule to open that space up because we do need confirmation you will be here. I have moved patients off the schedule. Yeah, I'm gonna have about five people mad at me, but guess what? It's gonna fix 95 % of my problems. I can handle those five upset patients with me. I can handle that. If someone comes in duplicative, I can handle that.   Ladies and gents in the front office, air traffic controllers, you're also word ninjas. And you gotta learn to word ninja your way through a lot of things. Words are free. You can handle those hard conversations, but what we can't handle is not having productive schedules to where doctors aren't making money, we're not making money, and we're gonna go under. We can't handle that, but I can handle one or two upset patients. But I can also set up expectations so they're not upset with me, because I don't want to get berated. That's no fun for anybody.   So clear ownership, who does what, what are the simple KPIs for each of them? Put that in place, have us track it. That just right there, hopefully cleaned up 90 % of your issues. Now everyone was like, yeah, but we all do it together. High five. I love that you have teamwork. Like genuinely love it. Teamwork though is that game where it's who's on first, what's on second, I don't know, is on third. it's like who, like what thought everybody was going to do it? Everybody thought nobody was going to do it. So then somebody picked it up, but then nobody respond like,   It's a mess. So I love that y'all help each other. We just have to know at the end of the day, who's the one who puts the button on it? Who's the one who puts the final bow on it? Yes, we can all help each other, but I need a clear owner of each specific thing. I need a clear owner of hygiene and getting them scheduled. I need a clear owner of insurance verification. I need a clear owner of doctor's production. I need a clear owner of collections. Like I need those clear buttoned, tidied, and I need a clear owner of who answers the phone first.   There are several others. I know that there's more and you're like, but what about this? What about this? Again, it's just playing this game and you guys can get sticky notes, write them all up, put them there. I have end of day checklist. I'm happy to share with people, but we've got to have roles are shared, but they've got to be owned. So like it's a clear owner. You can have help. I'm fine with that, but you have to own it and you've got to own those results. Again, it's outcomes over activity. I am so grateful you called 50 people, but if we don't have people on the books, you gotta call 51 or 52 or 53 or 54.   And when you own that and you know that, guess what? How do I become a killer treatment coordinator? Because I knew I had to put people on the schedule and I wasn't gonna call them all night long. I was like, I got a family, I wanna go home. But I knew that that was my responsibility and I owned that result. So when we have shared responsibility, it actually creates drop in responsibility. So clean it up, if everyone owns it, no one owns it. So we have clear owners. And then what we have from there is we just have set systems. So what is our system for doing scheduling?   What's our power hour? I put schedulers back there, I put insurance for everybody. Put them behind the door for two hours where they're not being disrupted. Unscheduled treatment plans. Give that treatment coordinator one hour of blocked time. Go make it rain, honey. Like call the patients, text the patients. We are focusing on highest level priority things. Look over your treatment tracker. Practice your verbiage. What are the things that aren't closing for you? Why? But we actually spend it. And so put the systems into place. What is it? Some people have like...   To me, these are slightly aggressive checklists, but if it works for you, it's not aggressive. It's like by 10 a.m., all confirmations need to be done. By 12, all insurance verification needs to be done. By two o'clock, all of the schedule is filled to capacity. And then we're scheduled two days out or whatever it is. You can have it where it's benchmarks like that so we don't get stuck and then it's like four o'clock. I'm like, where did our day go? Sometimes those mile markers really can help, but we have to have set systems, set processes that everybody's following and we all know it.   And that's going to help because this helps when we bring on new people. How do we schedule? How do we treatment plan? How do we follow up? Getting those protocols written so it's not just living in our head. If it's in our head, we're dead. We got to get it out. We got to have those systems and protocols written. so systems don't live in people. ⁓ Systems like we're not relying on people. We're relying on systems. So when I look at that, systems are on paper or in video form, not in memory. That then helps.   Like if there's just one person that's like, well, Sue's out. We had a Sue in one of my offices. I'm like, I don't know how to do the billing. I don't know how to collect the money. I don't know how to schedule patients. Sue did it all. But if Sue goes on vacation, the practice is donezo. Like you cannot be reliant on a Sue in your practice. We need to have systems. We need to have processes. Yes, I want clear owners. But if that owner's on vacation, which they should be like our marketer Eve, she just went, she's like, it was awesome. I disconnected for an entire week. Didn't check Slack.   I knew everything would be taken care of and I came back and she had like three Slack messages of things that were missed. That is truly a systematized organization. Yes, I'm having a little kudos moment. It just happened yesterday. So yes, it's a brag moment on our side. But I think about that. Like could your Sue, Alison, Kiera, Tiffanie, Jenny take off for two weeks and would you guys be okay? And if the answer is no, we gotta get those systems written and then we need to send them on vacation and test it and see how we survive.   because we've got to be able to have it. So the three things that will fix this very quickly is number one, we've got to get clear ownership and that's ownership, not just job descriptions. Ownership, who owns scheduling, who owns phones, who owns our collections, who owns our treatment plans, who owns our doctor schedule. Get those things and eliminate overlap. Everybody in the front office is going to feel 20 times better and then have it on KPIs where we're tracking it every single week so we can see the progress and make sure it's true ownership, not just checking boxes.   Number two is we have a priority framework for an office. So what is it? Because like I can have my checklist and I can know this. Number one is my KPI. But before my KPI, patient in front of me, always. Always, always the patient who's in front of me. Then it's my KPI, that's my number two. And then it's gonna be team needs. And then from there, always phone for me. Phone is pretty high up there. Like I say, it's patient in front of me, phone. And then it's gonna be my KPI.   So you can be like, well, that phone's ringing. Okay, great. So then I can throw it and be like patient in front of me, KPI phones. Phones are so valuable. And if we don't answer and take care of it, but let's get a phone tree because we don't need to answer every phone call. The phone calls I really need to answer are my new patients. That's what I need. Also stop letting cancellations happen on your voicemails. Save yourself some time. The dermatologist that I'm going to, no voicemail. Like literally it's not even there. I can't leave a voicemail. And I have to call during business hours, period.   Like that's just how it works. And if I want to get into them and you might be like, but I'm so nervous. I'm going to have patients that won't call. That's fine. But I leave a voicemail and I have it. And I say, don't accept any appointment changes via voicemail. Please call during business hours. I also do not accept them via text message. I make my patients, if they're going to break up with me or having a phone, a voice to voice conversation, you're not just able to text me. Like we don't break up via text here. You get to call me, have a conversation. And that's how I'm going to help save my time on that as well. Have a phone tree.   Make sure that it's really set. So you know it's patient, my KPI, phones, whatever your guys' thing is, but make that priority framework for you so everybody's following it, we all know. So that way we're not sitting here with this like built up resentment of like, duh, you should be fixing the schedule. When it's like, they're with a patient. Now, team members, I have that priority framework, but that doesn't mean I don't get to own my KPI. My number is my responsibility. And yes, I can sit here and chat all day long with my patient, because they're number one, but that doesn't mean that I don't get to own my number.   I'm responsible for owning, like own that thing, air traffic controllers. You can't just be like, well, my job is to like make sure the plans land, ⁓ treatment and schedules. And then be like, but like I got busy and we were chatting with the pilot. They're gonna crash. No, you can chat, but you need to still own your role, okay? And then number three is build simple, repeatable systems. So that way like Sue, Jenny, Sarah, Kiera, Tiff, anybody can go on vacation.   and we're not gonna drown and think, yes, we'll be tired and we'll be glad they're back. Like I missed Eve, I'm super happy she's back, but our company didn't go under without her. And that's how your team should be as well. So, front office overwhelm is usually not about the team, it's just about clarity and consistency. It's about roles and systems being clear and defined, so that way confidence can go up and stress can go down. And I know you might be like, this was such a like 20 minute podcast to clean up my whole front office. And I wanna say like, it really can be that easy.   I think that teams get in this, I think ego gets a little bit in the way of like, I've always been doing this. I think it's a little scary to shake up a role cause you're good at it. ⁓ But I think, not I think I know, if I have done this in 500 plus practices with our entire team, I know we can do it for you and your team too. And it's not a set, deadly team is not a set like, you have to do this. Like that's a cookie cutter. That was me like pressing my Christmas tree into the cookie. ⁓ You don't have to just be a Christmas tree or.   an ornament or a square or a triangle. It is what is best for your practice. We will share best practices, but ultimately this is your teen year practice. They live there, I don't live there. So let's make it a place that they're happy to live. Let's make it a place that you're clear. And then doctors is great for you. So if you need a scheduling issue, you go to Kiera. If you have a treatment plan issue and your day's not scheduled, the goal, you go to Sarah. If you have an issue with billing, you go to Monica. Like you just go to your correct people. So that will help you. So look at that, see it really does like.   clear front office creates a calm place. And ⁓ I just want to say that it's very doable. We do this all the time. think I'd say probably like 70 % of our consulting is on front office and just helping because it is a slush pond up there and it does get messy and we're all trying to help each other and we all have the same goals and desires, but it's on the execution of those goals and desires and how it's being done to create the simplicity or the chaos. So reach out. I'd love to help you out. Let's see if you're a great fit. Let's see if we can help you.   take the pieces, implement today, whether you reach out to Dental A Team to get help for your front office because they just don't know it. If your front office listens to this and you guys have a meeting and you divide it up and make your end of day checklist, whatever it is, but do something to go from that chaos to that calm. It is very doable. We do this all the time. I would say we are freaking experts at it. So reach out, Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.  

On this episode of The Dentist Money Show, Matt and Christine have a conversation with Joshua Scott, owner and CEO of Studio Eighty Eight, to break down what drives practice growth in today's dental market. They discuss the difference between branding and marketing, how private practices can compete with DSOs, the biggest marketing mistakes dentists make, and why authentic storytelling and patient experience matter more than ever. Whether you're a startup or an established practice, tune in for practical insights on attracting ideal patients and building long-term momentum in your practice. You can check out Studio Eighty Eight here! 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.

Thinking about buying or selling a dental practice? The decisions you make years before a transition can significantly impact your practice value, retirement plans, and long term financial success. In this episode, dental transition expert Dan Van Eps shares what dentists need to know to navigate today's practice sales market with confidence.Art Wiederman and Dan Van Eps discuss the current state of dental practice transitions, including what buyers are looking for, how practices are valued, and the common mistakes that can reduce a practice's sale price. They explore why preparation is critical, how sellers can maximize value before listing their practice, and the importance of building the right advisory team. The conversation also covers financing, lease negotiations, due diligence, rural versus urban practice opportunities, and the growing influence of DSOs. Whether you are planning to retire in the near future or simply want to understand your options as a practice owner, this episode provides practical insights to help you make informed decisions and avoid costly mistakes during the transition process.Connect with Dan✉️ Email: dan.vaneps@henryschein.com

Welcome to the third episode of Group Dentistry Now & Black Talon Security's Dental Cyber Watch Live. As dental groups rush to adopt artificial intelligence, many are spending on tools no one uses and feeding patient data into platforms no one controls. The result is wasted budget, hidden liability, and growing security exposure. In this episode of Dental Cyber Watch Live, Bill Neumann (CEO, Group Dentistry Now) sat down with Gary Salman (Co-founder and CEO, Black Talon Security) and Matthew McGaw (founder, DSO Compass; co-founder, Relay) to unpack the promise and peril of AI in dentistry. The clear message for DSOs of every size: AI is transformative, but only when paired with governance, training, and due diligence. Here are the key takeaways. Shadow AI: The Risk You Can't See Shadow AI is the unmonitored use of large language models — ChatGPT, Gemini, Claude — by employees without policy, oversight, or controls. Staff turn to these tools to work faster. The problem is that no one is watching what data goes in. Salman described the scope at a recent DSO event with roughly 20 leaders, representing practices from 10 to 200-plus locations. Most reported a mix of LLMs already in use across their teams. Few had standard operating procedures governing what could be entered. Fewer still had any technology to monitor that activity. The exposure is real. Information uploaded to a free model may be anonymized, but it can resurface when others ask similar questions. "When the product's free, you're the product. They're not doing you a favor." — Gary Salman, Black Talon Security For an organization handling protected health information, that is a compliance event waiting to happen. The fix doesn't require shutting AI down — it requires structure: enable privacy settings so platforms don't train on your data, write SOPs that define what can and cannot be entered, and train staff on why it matters. The AI Graveyard: Paying for Tools No One Uses The "AI graveyard" is where promising technology goes to die. It's the software a DSO bought with enthusiasm, then abandoned because of poor implementation, failed training, low adoption, or clunky integration — while the subscription keeps billing. McGaw pointed to two familiar culprits: "shiny object syndrome" and the "Hawaiian shirt guy effect," where a charismatic salesperson wins the room and the product never fits the problem. Neumann offered a grounded example. Some automations at Group Dentistry Now worked well. Others proved clunky and were better handled manually. A buried tool isn't just a wasted subscription. It drains training hours, erodes staff confidence in future rollouts, and makes the next investment harder to champion. The escape route is unglamorous but reliable: plan, implement, and train before you scale. Roll out to a small group, confirm adoption, refine the workflow, then expand. Design Backward, Build Forward The smartest framing of the conversation came from a concept Salman credited to Andy Farina of Destination DSO: design backward, build forward. Understand the problem you're solving first, then align products to it — never the reverse. Most purchasing runs backward. A leader sees an exciting tool, then invents a reason to need it. McGaw captured the trap: "Sometimes the problem that they think they have to solve isn't always the problem that is really the problem." Salman's advice for separating substance from hype was blunt: "Stay away from the shiny penny and buy the gold." Before any AI purchase, leaders should define the problem, set clear criteria for success, evaluate fit against those criteria, and only then buy. Vendor Due Diligence — and Who's Really Liable Many DSO leaders misunderstand a critical point: under HIPAA, breach liability sits with the healthcare entity — the DSO — not the software or technology provider. Assuming the vendor carries that risk is a dangerous shortcut. That makes cyber due diligence non-negotiable. Before signing with any AI vendor, ask: How do they access, store, and share data? Who, specifically, has access to it? What security measures protect it? Salman's larger point: security should be the first question in any technology evaluation, not the last. Too often it's raised only after the contract is signed and the data is already flowing. Building AI Securely The throughline of the discussion was AI governance, risk, and compliance treated as a foundation, not an afterthought. For organizations handling patient data, that distinction separates innovation from exposure. Leaders should expect real safeguards from any tool touching PHI: scrubbing confidential data like dates of birth, Social Security numbers, and patient health information on upload; annotating sources so answers can be traced; flagging possible hallucinations; and hashing files to protect their integrity. Pair those safeguards with disciplined implementation, and today's investment doesn't become tomorrow's graveyard occupant. Protecting What You've Built AI is a genuine opportunity for DSOs willing to pair ambition with discipline. The risk isn't the technology — it's deploying it without control. Three steps to start now: Audit current AI usage to learn which tools your team uses and what data flows into them. Establish AI governance and SOPs before the next tool goes live. Make vendor security due diligence standard, with security as the opening question. Is your DSO adopting AI faster than it can secure it? Get these fundamentals in place, and AI stops being a liability waiting to surface — and becomes the advantage it promised to be for your practice and your patients. Get the MAX Surgical Specialty Management Case Study: https://dso.pub/4v8OwfP  

Part two of Kiera's conversation with Howard Farran on the Dentaltown podcast. As a business owner, the greatest gift you can give yourself is to get systems in place so you are not dependent on core people. This second part of Kiera's conversation with Howard is about determining your weaknesses as a practice, building systems to fix those weaknesses, and letting your practice hum regardless of who's sitting in the seats. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:02) Hello, Dental A Team listeners. This is Kiera and quick heads up, today's episode is a special repost from a podcast I joined as a guest. It is a great conversation for practice owners who want to progress without carrying everything. I cannot wait for you to hear it. Let's dive right in.   speaker-0 (00:16) And you know, I was doing a million dollars in the eighties, a million dollar practice, and I went to two and and I I thought I actually think I had a higher treatment plan acceptance rate than my buddies on just measuring the same day. My clothes is always like, you don't want to come back. I mean, we could you know, I'm when I'm doing the hygiene check, I'm gonna say, I'm gonna leave. The hygienist gonna Denise Missy, they'll numb me up.   speaker-1 (00:21) They're like eight million now there, Howard.   speaker-0 (00:44) And and then and then move her to room eight and we'll we'll we'll knock this out in 30 minutes because you don't want to drive all way from work and then kid and school. You just pulled your kid out of school, now you want to do it twice. It I just always s insisted on just the same day because if we do this because from my perspective, if we do this filling a day, it's two fifty. If you walk out that door, half of you never come back until it hurts, and then it's a twenty five hundred dollar root connected crown.   speaker-1 (00:50) Amen.   speaker-0 (01:12) It's only one tenth the price to do the filling. I got a room. The hygienist can numb you up. And then I always hit the hygienist on the show and said, You should have numbed her up before I got here and I could be doing it right now. And she laughed and she said, but that's illegal. I said, I'm not a lawyer. I'm a dentist. Let's get this done. But just by really leaning on same day. And I really think that was a huge part of our success.   speaker-1 (01:37) Well, and Howard, I think what you said is like going back to the COVID crank, I think so many business businesses right now have lost that like customer service and let's make it easy. Like, as you said, one of our core values in Dental A Team is ease. And I'm always like, How can you make it easy for everybody? Because that's what people want. Like you said, like no one wants to take time off for the dentist. I'm switching dentists right now and they're like, So you're gonna come in for a hour appointment and then we'll bring you back in like three months for your hygienist. And I told my assistant, I was like, just call them back. I was like, tell them no, no, no, like   Make it easy. I don't want to come back. And so I think when offices take on the mentality, I have grown practices 10, 20, $30,000 a month just by same day treatment. Like just get it done. Let's train our team. Like, let's be quick. Let's have that quick turnaround time. Now, of course, doctors, you've got to be like Howard can get that done and he can rock it out and he's great. If you're a dentist that is not quite that quick, like we do not want to scale back all your patients. So maybe you do like add, add on an extra filling that's already in the quad that you're getting numb.   Like, where can we do it? Can we add that fluoride in today? Can we add in this thing? Can we take the scan today? Because you're right, no patient wants to take time off of work to come to the dentist. So like let's just rock it out, make them a raving fan because we went above and beyond to make them happy.   speaker-0 (02:49) And and and it also is a good variance counterbalance to no shows and cancellations. You know, she said yes, and then your next patient didn't show up as opposed to reschedule this one a week from now and then then this doesn't show up. But hey, I want to ask you, I'm gonna hold your feet to the fire on this. True. Would you rather build a dental office on rock star employees or rock star systems?   speaker-1 (03:16) ⁓ this one is I think the this it's ⁓ it's interesting because I think that there's space for both. However, Rockstar employees can walk out that door and then you are left. And I say that this to me is where as a business owner, you're shackled and you're always going to feel scared. You're gonna feel scared to hold accountability, you're gonna feel scared to ask people to do their job because you're so afraid of them leaving. Whereas if you have systems, I'm not here to say be a jerk, like that's not what we're here for, but it becomes so much easier to just   plug and play. And then also for team members, they tend to stay longer because they understand they've got clear systems. And people get really weird on systems, Howard. And I think they feel like systems are so hard. And it's like, I'd rather just bring someone in who knows what they're doing. And I'm like, but make that repeatable. So if they're out and I make my rock stars go on vacation for a week. I'm like, absolutely. And people are like, no, no, no. I don't want them to leave. And I'm like, you need them to leave because you need to see where it breaks down and you need to build systems. But I will say as a business owner, the greatest gift you can give yourself   is to get systems in place where you are not dependent on those core people. Like I want great team members that love my patience and do what they have, but I want it to be a repeatable process that every time, no matter if I've got Susie, Sarah, Jenny, Mike, John, anybody, we're giving the exact same experience. Like I look at Chick-fil-A and it's the same amazing experience. Every time I walk in there, they say the same thing and none of us are annoyed by that. And teams are super happy and thriving. I interviewed a guy who's a big wig in Chick-fil-A and I was   Fascinated by the culture. I was like, tell me more about this. And he's like, we have systems. We have buddy systems. We have it built on systems. That is the core to great success. And it's the core to like less stress in your business. Like obsessively, I am so obsessed about simple systems. I've been called the Dr. Seuss of systems. Make it so simple that anyone can do it. And then hire amazing talent that treats your patients with the great culture that you want.   speaker-0 (05:08) Yeah, and if the systems are so good, they don't even have to have dental experience. I mean, I the best receptionist I had was the the teller at Chase Bank next to me and I absolutely said her, I said, You are so dang good. You're always happy, always you remember my name. I said, What do I have to do to get you to work for me? And she she told me and she's been here for you know, over a decade. just the same things.   speaker-1 (05:36) Howard, I want to highlight, I hope dentists listen to you. ⁓ there are not a lot of dentists that are scrap like you. And that's something I love about you. And this is just like a little, it's not intentional, like boost your ego, but like please take it. Like it's a good boost. You are so scrap, right? It's like, let's just get that done. Like again, like let's do same-day treatment. My best employee in the company was my next door neighbor. I knocked on her door. She like took care of my plants when I traveled. She's like, those things are gonna die. I was like, the fact that someone as a neighbor just watered my plants to be nice to me.   She's been amazing. She's been with me five years, best incredible EA I've ever had. You ask the bank teller. We look for great talent. You build on systems. And I just hope the dentists realize like, just saying yes and GSDing, like, let's just get it done. That is something that I think so many people have like lost that art. And truly, that's what impresses me with your podcast, with who you are. And I just hope that people here, you don't have to go for perfect. You don't have to find this perfect person. You just gotta be scrappy and gritty.   And your practice will grow and you'll have great team members with you. Like it's not actually hard. And I think we make it hard, but just hearing your examples, I hope people listen as a dentist, this is what makes successful dentists in dental offices and great team culture as well. That is the core vote values that he's got. And it is why he's so successful. And I hope dentists can learn from that.   speaker-0 (06:53) Well, thank you. And I got did I ever tell you a story about the third hygienist they hired? I I already had my two full time hygienists, everything was great. And ⁓ this ⁓ young girl walked in, just graduated straight out of hygiene school, and I could hear someone giggling up front and they said I was busy, you know, she wanted to talk to me and then she just took it upon herself just to just to walk through the office and I I er and anyway, long story short, I finally got done. I broke, I met her.   speaker-1 (06:57) Tell me, I'm ready.   speaker-0 (07:20) And had no opening for hygiene, and she was so into the office, and she's asking all the right. I can just feel her energy, she's like sucking out my soul. And I and the first thought I said is she's from Alwatukee, she lives in Alwatuki. Do you want to compete against this girl for the next 40 years? Or you know you want her on your team, you don't have room for her on their team, but she ain't gonna end up across the street. I hired her and told everybody we'll just have to figure it out because this is a rock star personality.   I mean, you know, she just walking through like she owned the place and probably probably one of the top two or three, her and Jan, probably the best employees I ever had. I mean, unbelievable. ⁓ how do you get the dentist to stop being the limit to his own growth? I mean, it's it seems like I don't know about dental school curriculums, and it seems like shooting yourself in the foot has got to be the first and the last course they teach you there. How do you get the dentist to quit being the ceiling to their own practice?   speaker-1 (08:21) Think it's a I actually want to just like shout out a lot of the dentists. I feel that the new generation of dentists coming through actually are very prone and open to understanding business and recognizing there's so many books out there that talk about like CEOs and owners of businesses are the bottleneck to their success. And so I just want to say, like, I think a lot are starting to recognize that, but I think that there's still a lot that don't. And I I usually help people say, like,   When the pain is bad enough is usually when people change. Or you can recognize that you need to get yourself out of the weeds. You need to become the CEO of your business. You need to be working at the highest level of your ⁓ license. And everybody in your practice needs to be doing the same. And if you're not, like I do a delegation exercise. I just did it with our doctors on Tuesday. I was like, write down everything that you're working on right now, everything on your to-do list, everything there. And then I want you to go back through it and I want you to literally look at that and like only things that you can do. And like, please don't like   Boost your ego, but what are the things that only you could do? And I had a group of 50 doctors the other night and they were like, really, it's like vision, culture, and profitability. Like everything else can be someone else can do. And so when doctors recognize like that is your sweet spot and no one else is doing that, you need to have other people in there. Like you're welcome to hold it all yourself. But there's also another path where you can elevate people around you. You do great dentistry and you own the visionary and the CEO seat. Be obsessive in there.   But I think so many of them want to just do everything. I'm like, that's great, but you're gonna run right into burnout really quickly. So it's a helping them realize, go look at your to-do list. Honestly, of that, who can you delegate this to? Who can do it better than you? And who's gonna be somebody that's gonna light up and be excited about it and get yourself continually moving towards that CEO seat? I think so many dentists don't realize that they are a CEO of a multi-million dollar business. And I think, like, look at Jeff Bezos, look at some of these really prominent people.   That are great CEOs. What are they doing all day long? They are not answering emails. They're not responding to these things. Like they're not doing any of that. They've got teams around them that are incredible at that. How can you get yourself closer to that? Because that is where the practice flourishes. But if you're sitting there doing every single thing, you're stopping it constantly. It's truly a bottleneck. ⁓ and I think that's when people are ready for it, when people actually recognize that, there's there's two types of dentists. There's the one who calls when they're absolutely burnout, exhausted, and they can't see like past like one foot in front of them.   There's the other dentist that realizes I don't want to be that. I've seen too many dentists like that. And I want you to coach me into how to become like not there. And I say, like, life's so much easier. I have a dentist hired us two months before he started his practice. As a brand new practice owner, this year he should be clearing 2.5 million. And I'm like, why? Because he recognized, get out of the way, have these other people do it, train my team. I'm going to bottleneck this. I don't want to be burnt out. I want to be present for my kids.   Teach me how to be the CEO of my practice and empower my team. And so I'm like, again, it's choose your hard. Which path do you want to live? It's all in Wonderland. There's both, there's paths. It's just what path do you want to go on? And also what mentors and what people be the CEO of your practice. Do not be the operator that's doing it all.   speaker-0 (11:35) You know, I always call a great idea is I always call them a giraffe. I'll never forget when I took my kids ⁓ to a ⁓ Serengeti and the guide was so funny, he would he would all of a sudden he'd stop. Well he stopped for a reason. He's giving us a guide and and it was one of these long tour to trucks where you'd stand up in the middle and you look out, and after about five minutes, we just said, What? What? And he's like, It's right in front of you and we're just like, Well, we're looking all around, my boy, everybody's gonna find it.   And he says, Are you kidding me? Look at that tree. Look at to the left of that tree. And it was a giraffe standing right next to the tree. Totally camouflage. And that that's what I mean when I say, you know, they can't see the giraffe. And here's a missing giraffe for 40 years. Remember the great Jennifer D. St. George? She's still out there. I love her to death. And she had this lecture on schedule. It's called Rocks, Sand and Water. She goes, You gotta schedule your rocks first. Do all your rocks. And then she'd fill up a glass with rocks.   And then she say, Then you can do your sand. And she'd pour like a half glass of sand on top of the rocks and you still didn't have a full. And then she'd say, and then the water, then she'd take like a full bottle water and pour it in the sand and and it was still full. And I already know when you talked about block scheduling, I already know that at least fifty to a hundred and fifty percent of the dentists said, ⁓ I don't care if I do a root canal in the morning or night. I they they don't understand block scheduling.   They don't understand rock, standing water. They haven't for 40 years. Jennifer lectured for 40 years and and I still don't think anybody saw the giraffe. Can you just slow down and talk about you just made the example about how all you did was change the scheduling and you got the it up. So show that giraffe. What what does that giraffe look like?   speaker-1 (13:23) Well, thank you, Howard, because I do love giraffes. I do have freckles and have I've definitely been like and have a very long neck and I'm very tall. So I do love giraffes in and of itself. So thank you. Like let's just talk about it. ⁓ but I I agree. It's so I don't know. I think as a team member, you just get obsessed with making puzzles. And like for me, I'm like, how can I maximize and squeeze more juice out of your lemon tree? Like, let's just do it. It's gonna be a great time. ⁓ and so what I love to do is.   Like, let's just go through and build you a perfect day. And I love to build my rocks. And I used to do like high production. And then I learned it was even more fun if I put a dollar amount on those high production blocks. Because as a team member, like, hi, Kiera, I'm Kiera. I sit up front. I am now looking for puzzle pieces that are coming through my puzzle. And instead of just filling your day with a bunch of water, aka no production, I'm actually able to like fill you full.   Make sure I've got you up to production and then I move on to my next day. And then as I have my little water that comes through, I just fill in the gaps. And you, doctor, are so happy. And I did this with an office and the doctor was like used to making five, seven thousand dollars a day max. We got him to a twelve thousand dollar day and he walked out the door at four o'clock. And normally he was there till 536. And he's like, Here, how'd you do it? And I was like, Because we actually put in blocks, we actually scheduled it of what's the most efficient way to use your time.   And it's playing seduco in a schedule is how you really do it. It's like perfect. Where is the doctor? And then where does doctor need to be for hygiene exams? What does my hygienist need to be producing? How much period do I have? How many new patients do I have? Let's block those so I can get those people in on our schedule. Make sure my hygienists are up to goal every single day. So, like, what are they supposed to be producing? Usually three times their pay is typical. And then on the doctor side, doctors, what do we want to be producing for the year? What do we need to be producing per day? Let's build in those dollar amounts.   That is going to make you feel so easy to get through to get to exams where you're not running behind. And now let's figure this out. And when we go through, and I look to see how much procedures cost, how much like on average, how many new patients we need, how many SRPs we need, how many perio maintenance we need. And then you take those pieces, those are your rocks, and I'm gonna go build a schedule to where it actually flows really, really well. And then from there, I'm gonna duplicate that over every single week.   And what's crazy about it is when you do this, people realize they're gonna be walking out with $10 to $12,000 days, getting out on time. We're doing the easy stuff in the afternoon, the harder stuff in the morning or whatever you like to work. I don't care. And when people see how much they can produce with minimal effort, no extra patience and no extra time, like usually that's how it builds. You're able to, like you said, see the draft, but it's crazy because you're a happier dentist, you're not running behind all day long, and you're actually profitable. We hold those blocks, I usually say for 24 hours as team members.   And me as a treatment coordinator, I am scanning my canvas, I'm scanning my own scheduled treatment to find something of that dollar amount or that rock to fill in my blocks. And I'm not gonna put multiples in there. We're gonna make sure if you only have one root canal system, we're not putting two next to each other. If you have one implant system, I'm not doing two back to back. Like you just have it to where the day flows and 85% of your days will be great. And the other like, you know, 15% are like, shoot, we couldn't get anybody in it. We just fill it with whatever we can, get you up to that, put emergencies in there.   But that's how you do it. And it's so, it's so satisfying. I've got an office that they lost two doctors. So I've only got two doctors. We are producing as much as they were on four doctors with better blocks, better scheduling. And it's just incredible to see how much more efficient you can be with your time without more patience, more effort. And it's very, very fun and fulfilling. And when people follow it, they're shocked at how much their practice grows without any, like hardly any extra effort.   speaker-0 (17:07) Tell me, tell me this. Why do my DSO buddies, who have hundreds of office locations, tell me that that when someone calls their office, they can convert 70 to 80% of the people on the phone to getting their butt physically measured in the chair? And that in private practice, it routinely shows up at about 42%. How can Heartland   close seventy to eighty percent of the callers as measured by you called on the phone and now your butt is sitting in a chair in private practice forty two percent. What do you think explains that the most?   speaker-1 (17:44) I think Howard, it's they're obsessive about numbers. I have an office that works for Aspen and I've just watched like they are obsessive about KPIs and tracking and measuring. And I feel like in private practice, we don't track and measure nearly as much as they do. Like they've got metrics, they've got numbers, they're looking at it. And so what they do in Heartland and corporate, they're smart businesses. They look to see where is our leaky hole and how are we going to fix it. So I know what they're doing is they're watching their call conversions.   They're talking to their offices and they're setting this of like your goal is 75%. And this is the training and the verbiage. And we're going to track this and we're going to measure it because what we track and measure improves. And I like tell me a private practice out there that's like, we know our call percentage rate. None of them could probably tell us, but you ask a DSO and you better believe they're going to know all their metrics. And that's where I love like so many offices are obsessed about systems and what system do I put into place and how do I grow my practice? And I'm like,   Number one, let's figure out where you want to go and what's your vision. I call that why. And then E is earnings and profitability. Like based on those two things, based on where you want to go and what the profitability and our our numbers are, then you determine the systems. And then we look at those metrics of the profitability and our KPIs and the metrics, and you put systems into place for that. So these DSOs are so good at tracking and measuring. And like I've got a practice doing 29 million. And what we do is we have a scorecard. They know.   We just hit the most important things that are going to drive the needle forward and we watch those numbers like a hawk and that's all we coach and focus on. You coach and focus on those items, your practice will grow. But I promise you it's because they're tracking, measuring, and training to that and having metrics of what they need to hit. They're not better than us. They're just better at measuring and then improving those numbers.   speaker-0 (19:24) Well, they they say that just by weighing yourself at the same time every day will start bringing your weight down just because you're focusing on it. Totally. And things like that. ⁓ I want you to do the same thing to treatment plan. Why do you think most patients are saying no? And what's the draft that one of my homies could listen to right now that could help him increase his treatment plan acceptance rate?   speaker-1 (19:46) I think the no is just surface level. And what you gotta hear is what they're not saying. And I also would say a lot of people, they're like, it's about money. And I'm like, again, you're looking for reasons and you're gonna continue to find that. So for me, my mantra, and this is a great thing for the homies out there, my mantra is everybody says yes to me and everybody loves me. Like, no joke, I say that every time I'm going into a treatment plan. Why am I sitting here thinking about my gosh, they can't afford it or they can't do this? You're creating more of that.   Rather than going in with a confidence, they're buying your confidence. Like hands down, I can I can close a fifty thousand dollar case same day. Let's swipe a credit card, like let's buy a boat. But it's confidence. And I'm walking in there of like, we're doing this, we're doing it now. My job is just to figure out how you're paying for it. And so when we look at that case acceptance, I've coached an office and we've added, I've got five locations. All I do is train their treatment coordinators. I just rep them. We are constantly going through reps. We add   One to two million annually amongst those five offices just by focusing on it. And I'm like, it's 80% psychology. What are you thinking about? You walk in there, everybody loves me, everybody says yes to me, and let's make this happen. And I do it in a way where I love them. I give them like a warm virtual hug, like I'm not actually hugging. I want them to feel so comfortable, so confident. But then I also say, like, watch out. How are you using words? Words are free, Howard. Like, I'm not going to lead with, do you want to get this done? No, I'm going to assume they want to get this done.   Hey Howard, let's get that treatment done. So I'm gonna schedule you. Doctor is really busy. So I'm gonna do Monday or Wednesday, which works best for you. ⁓ Kiera, I want to talk about fees. Howard, absolutely, I'm gonna talk about fees. Let's just make sure we get this time locked in. I've got Monday or Wednesday, which do you prefer? We schedule you on Wednesday. You're already halfway there for me. I've got you scheduled. Perfect. So treatment's gonna be this amount. This is what the total will be. This is what our insurance estimates are, this is what our total will be when I see you on Wednesday. What questions do you have for me? Howard then asked me. I'm not gonna say I'm like, so do you want to talk about money? Do you want to get scheduled?   Like, why? Why am I bringing this up? Like, let them come up with it. Give them the time. Have the things. Don't bombard them, but be so confident. If I've got a great dentist that I know has great dentistry, they diagnose my job is to close and let's have that type of attitude. Walk in their doctors, don't be like, I don't know if they want to do this. Like, what if they can't afford? No, be the freaking clinician that's like amazing and like they all love you. They say yes to you. Diagnose them. Stop scrimping on them. Like morally, that is your job is to tell me what's going on.   Your job is to diagnose for me and then I get to make the decision from there. But truly it's eighty percent psychology. What are you thinking about? What's your mantra? And then twenty percent is skill, but get that confidence because they're buying your confidence, they're not buying dentistry.   speaker-0 (22:18) Then I want you to pontificate on ⁓ this. ⁓ I watch this in my own eyes. ⁓ every American I know that's as old as me, ⁓ or by the time they die, has bought one new car in their lifetime. Am I right? You know any do you know anybody that lived to be 80 that never bought a new car? Yeah, yeah. And right now the average new car is 50,000.   speaker-1 (22:41) They all do it.   speaker-0 (22:45) And I would say ninety-five percent of all the dentists go to retirement and they never sold one case for the price of a new car, which would be fifty thousand dollars a day. And then I watched Clear Choice, my favorite DSO, because they rolled out a hundred locations, and the only thing they sell is fifty thousand dollar two arcs all on fours, twenty-five thousand dollars an arch. They rolled into Phoenix and all the world surgeons and paradox, like, I don't know, I don't know if I like this.   And they start doing all these infomercials. Remember, remember, orthodontists have always been ahead of general dentists in advertising. All the orthodontists were advertising before 10% of the flipping general dentists were. And when the general dentists finally got to like two or three percent, the orthodontists were at five. And now all my two million dollar dental orthodontist offices on up are spending eight percent on marketing. Here's clear choice.   You go through the channels, they got all these 30 minute infomercials and and all this stuff like that. No, I never I never had heard of an all on four until I heard it on a clear choice deal. And then all my paces were coming in saying, Do you do all on four? I'm like, what are you even talking about? Then then they tell me, and then because I I would have called it a you know, four implant. You know, I didn't think of four, say whatever. And and then the next thing you knew.   Every oral surgeon and peridonist in the valley of Arizona was doing more cases because they were selling it to so many people that our pace that we were benefiting from it. So I just want to hold your feet to fire. How come ClearChoice with a hundred locations? Don't tell me it's demographics. They're in the hundred biggest cities in America. And and in each one of those cities, 95% of the dentists will retire without selling a single $50,000 case. And ClearChoice is doing it in their backyard.   Every single day of the week. Explain that to me.   speaker-1 (24:42) gosh. I I don't disagree with you. And I think there's I I ⁓ to me it's kind of like the four minute mile, right? Like so many people did not think that they could do it. And then once the four minute mile broke, it was like, my gosh, now all these people can do it. I still cannot run a four minute mile mark. Like I'm still working on that, Howard. So I get it. There's like limitations still. But I think a lot of dentists I watch, a lot of them get weird. Like they get uncomfortable. They feel like, well, do they really need it? Should I really offer this? Like   They get into this weird space in their head rather than just like, why don't I just offer it? Like I have a dentist who literally presents $250,000 treatment plans consistently. And they do all like full cosmetic. I have another doctor. It's 75 per arch, 75k per arch, and they're closing them consistently. And I think there's a space of like, why are we not doing this? And like you said, clear choice is doing it in their backyard. I think there's a   My background's marriage and family therapy as well. So I studied that when I was in college. And so I love the psychology of it. And I think so many people are truly afraid of rejection. And so they're like, I'm just not going to offer it. And they like justify it in their brain of why, like, I don't need to do that. Like other people can do that. Like, I want to make sure I'm taking care of my patients. And they live in this world that's their own reality. And I think that we all create our own reality. And clear choice is like, no, there are patients out there that do this. My client that does 250,000 consistently.   My other client who does 150,000 consistently, that's just their level of comfort, right? And so, how can dentists get to a higher level of comfort? I think one, be confident in your clinical skills. If you know you're the best dentist out there and you can do this, like for me, I feel like that's my moral obligation to make sure that patients are getting the best dentistry because they don't know if Howard or John or Sarah or Tom is a better dentist than you. So if you aren't confident that you are a dang good dentist,   Your job is to make sure that those patients know that. The second thing is get more confident presenting larger cases. and I tell all the offices I coach on these large cases, like please drop the mindset of a large case. I think we psych ourselves out by being like, ⁓ it's like a $30,000. Like, no, it's just a case. There's no big, there's no small. It's just a case. And I'm going to present what this patient needs and I'm going to present it to them. And I'm going to believe that they want this and I'm doing the best thing. And then we get to decide from there. And our job is to make this to where it's easy. We follow up.   There are so many people that want to do this, but I think people hold themselves back and they live in lies that they choose to tell themselves, but they believe are truth. But they're only the truth to you because there's other people doing it just like the four-minute mile, and you can too. So I think it's a matter of why not? And so when dentists are nervous about this, the way I usually am able to break it is like going from a $5,000 treatment plan to a $50,000 treatment might feel a little scary.   And so I'm like, perfect. Let's just diagnose one more thing or let's present one treatment that we normally wouldn't. And let's start to like build that confidence for you. And whether they choose to say yes or no, you just got to work on your presenting, like presenting skills. It's not like they're not saying yes or no to you. It's just how are we presenting it? How are we using the words? Are we assuming the yes? Are we assuming that they want to do it? There's so many ways that you can present treatment better. Like it's an art, it's not a skill. But I think people choose like Howard, they   They just want to live in this world and they believe that that's the world. And so I'm like, until you choose to get uncomfortable, it's like we've got a little thermometer in our world and in our world. Like if I say that I am comfortable at 75 degrees, if the temperature goes up to 78, I'm like, this is out of control. Get it back to 75. If it drops down to 70, I'm like, it feels uncomfortable. So how can we take it to where I can get comfortable getting out of my 75 degrees and move me to the next level of whatever that is, to where that becomes my new norm. And then I move myself up to the new norm.   There are people doing 35, 75, 150,000. And I don't say that for you to like belittle yourself, but to see that's possible. Other people are doing it. Believe in yourself. If you're the best dentist, be confident in that. And then truly, please, for the love of everything, I am a patient. No hygienist offers me fluoride Howard. No dentist offers me emphasizaline. I would say yes to both of you, but you are selfish. And I'm saying this with like love and respect. You are selfish by not giving me the chance to say yes or no to you.   And I would say give more people the opportunity to say yes to you, offer it, get better at it, check to see why they're saying no to you, refine that and keep offering. I love my offices that set it a 35% case acceptance because I know that they're presenting 50, 2000, like they're sending 10,000, 15,000, $50,000 cases consistently because they know that the more things that they say yes to with great dentistry and great confidence, the more people will say yes to them. But like get out of your own way.   nudge it up a little bit more, get uncomfortable, but truly do great dentistry, offer to patients and stop like holding back and assuming that they don't want to do it because more patients want to than you believe that they do.   speaker-0 (29:37) And you know, a lot of dentists don't like the blood and guts. They don't want to place implants. They don't want to play certain modes. I get it. But you know what? I know a handful of dentists, at ⁓ five at least. I think the sixth one might have retired, but one of the reasons they're probably so big, they didn't they didn't like blood and guts either. But they would always tell ladies, they go, Well, I'll tell you what, before you go back to your twenty fifth wedding ⁓ school high school anniversary or or whatever, I mean tell you what, you always remember   For 50 grand, the price of a new car, what we do here is we take everything out, every filling and crown comes out, we put it all back in in the most beautiful portion. You'll leave with a Hollywood movie star smile. I know it's a lot of money, it's 50 grand, but you gotta think about that. And he and they both tell me they say, Well, you know, if you say that 10 times a month, yes, someone always always says it. And they go, Really? I'd have a movie star smile, and I'd say,   Absolut flipping Lutley, man. We take all that old crap out and veneers, inlays, onlays. I mean, when you're done, you'll look like a movie star. And and and I got a a a couple that is in not so rich areas of town like Tempe and Chandler Mesa. And they say that they have to say that about 10 times ⁓ to get one or two to do it. And in North Scottsdale Paradise Valley, ⁓ boulder area, ⁓ they they they say it's about a one in three close rate. If they just say it right like,   Be because when when someone gets a new car, what do they do? They drive around, they show it to everybody, you know, they just they they just love it. So I we're over an hour and we try to keep it under hour. So I wanna ask you one question. But first you said your background's a marriage advice and I just wanna tell you the best marriage advice you can have. Just like you're saying, it's all in your attitude. You don't you know, you start every day. When you wake up, the first thing you do is you tell your wife, I love you. Not you again. And ⁓   speaker-1 (31:35) I agree.   speaker-0 (31:35) If you if if you just drop the U again and it's so last question. What are ⁓ the one or two KPIs that ⁓ you think every dentist should be reviewing every single week? And what should they stop tracking? That's my final question.   speaker-1 (31:49) Hmm, this is a great one. ⁓ KPIs for dentists to be tracking specifically. ⁓ I really feel like the things that are gonna move you forward on a weekly basis are we've talked a lot about them. Your case acceptance is gonna drive you fast, like forward the best. Like track that, look at that, review it, get really good with that. And then I also really like to look at my hygiene. How is my hygiene doing? What's my what are they producing?   And then if you wanna add a third, like look at your schedule maximization and optimization. Like those are gonna be like really big, like heavy hitters for you constantly. And then I'm gonna throw in one on a monthly basis because I'm really big on I prefer weekly, but I get most aren't obsessive with me. I call it like my mind and my money. So every morning I meditate and I look at my money. So that's like my mantra of how I do it. But if you wanna do it at least monthly, you've gotta be looking at your overhead and your PNL and like what you're producing, what you're collecting, and what you're spending. ⁓   Just if you look at it alone, you're gonna get better. So it's like weighing ourselves. Now things for them to stop tracking. Gosh, there's like to me, I actually feel like really I don't want to say everything, like keep tracking, but I actually think people over track on a lot of things that don't move the needle forward. Like we want to track on, I don't know, I just see people like, well, we're gonna track on this and this and this. And like it's just like it feels like it's such a smorgasborg of items. But I'm like, what really is gonna move your practice forward?   Production collections, new patients, case acceptance, our scheduling optimization or overhead. Like those things and like sure you can look at like dollar amount per patient if you want, like so our marketing ROI. But like that's like really the core. And the more you can simplify it down, the easier it is for you. Cause like you can get lost in data, like buried in it, and actually not be able to execute on what really is gonna move you forward. And I'm like, I've got offices and I'm just a broken record. I say profit and production, profit and production, and that ties to collections. If you focus on that, your practice will grow.   So those would be the things that I'd end with.   speaker-0 (33:42) Garrett, you are a gift to dentistry. Thank you so much for all that you do for dentistry and thank you so much for coming back on the show. You gotta promise you'll come back again before the dirt nap. Gonna come back on again.   speaker-1 (33:52) I will.   I will. Don't take a dirt nap anytime soon, Howard. The world needs you and I'm grateful to be a part of it. So thank you.   speaker-0 (34:00) ⁓ thanks for all you do. It was an honor to podcast you.   speaker-1 (34:03) Likewise, thank you so much.   The Dental A Team (34:05) And that wraps up today's guest interview. If you liked this style of episode, let us know and we'll be sure to share more of them. For more resources, events, next steps, head on over to TheDentalATeam.com. And as always, thanks for listening. We'll catch you next time on the Dental A Team podcast.  

Part one of Kiera's conversation with Howard Farran on the Dentaltown podcast. They discuss how many details a dentist should know about their business, what about the COVID-19 pandemic still haunts practices, the AI of dentistry and the human care of patients, hidden gaps draining profitability, and more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Hello, Dental A Team listeners, this is Kiera. And today we are sharing a guest interview I did on another podcast. And it was too valuable not to bring you guys here.   this episode, you're gonna hear this host lead the conversation and then I'll wrap us up at the end. I cannot wait. It was truly one of my most   episodes and I truly hope you enjoy.   The Dental A Team (00:17) It's just a huge honor for me today to bring back Kiera Dent. How are you doing, Kiera? my gosh, Howard. It's so great to be back. I remember my very first podcast with you. I was actually at an office in Alabama and I went like hid in this room because I was starstruck podcasting with you. So to be able to be back on the show with you ⁓ several years later is just fun. I love what you guys are doing. I love Dentaltown. I love your posts. so it's really fun to be back. So thank you. ⁓ the honor is all mine. Just remember Kiera likes Shakira.   And Dent is just her nickname. The full name is Dental Queen Goddess. So thank you. And ⁓ she is the founder and CEO of the Dental A Team, committed to elevating dentists and their teams to their highest level through customized in-office and virtual consulting and training. Her vast experience ranges from the front office to assistant, regional manager, and dental practice owner, giving her a perspective few consultants can claim.   She and her team work with hundreds of dental practices nationwide and confidently say we don't just understand you, we are you. Among her many accomplishments, Ciara has grown a practice from 500,000 to 2.4 million in just nine months with a doctor straight out of dental school. She's coached hundreds of practices, authored numerous articles, and designed a customizable operations manual manual that serves as a roadmap for systems and team success.   Her Dental A Team podcast has amassed nearly 2 million downloads, making it one of the most impactful resources in all of dentistry. Kiera lives every day by her core values. Do the right thing, ownership, passion for excellence, ease, grit, innovator, die, and fun. Her motto says it all. There is always a solution. And my gosh, I just want to tell you the truth. And the reason I was so excited to bring you on. It seems like dentistry has turned into two groups of dentists.   There's all the old farts like me who, you know, we had, you know, we had great practices, great lives, great careers. And then you got these younger dentists that look at us and say, ⁓ man, you graduated in the good old days. You know, you didn't have five hundred thousand dollars of student loans, you didn't have DSOs, Delta hasn't given us a raise in four generations, and and and they're mad at the ADA. I think they're even mad at their mom. I I they're I think so and they're not happy. Do you have any good news?   For these dental graduates with $500,000 of student loans, or did they make the wrong decision and should have become a plumber? I mean, you know, plumbing is always a backup plan if dentistry doesn't work. So I think you're like at least in that realm. Like, you know, there's always options. But I love dentistry and I actually, ⁓ I think we're actually in the best time of dentistry. And I know that yes, there's the good old days. Then Howard, those were great days for you. But I think like, how many options do people have now? We have AI, we have these innovations, and I mean.   Your my example of a student straight out of dental school, we actually had one million. So I actually called her 2.5 because we had $2.5 million. So from student debt to practice loan debt to buying another location, all within a couple of months of us starting the practice. And so I called her 2.5 every time I walked past her. I was like, get that back straight, girl. Like we got 2.5 mil of debt on us. but to be able to grow our practice in nine months was   Absolutely incredible. And I think that that's where dentistry is amazing. There is no cap, there is no ceiling, and you have a way to truly impact and change people's lives. And I'm like, you have DSOs as options. Like there were not the times where you were getting the multiples that you get today. You also have like there are so many avenues that dentistry can afford you. but I think it's a it's a matter of what you choose to focus on, is what you're going to find more of. If you want to sit here and say, ⁓ my gosh, it's awful. We have 500,000 of debt. And I'm like, Yeah, but guess what? My husband had   Not quite the same, but we had several hundreds, thousands of dollars of debt. And he's a pharmacist. And so I understand what it's like to come out of school and have hundreds of thousands of dollars of debt on us. But guess what? He's making, you know, hundred, hundred and fifty. If we're lucky on a good day, we're capped out. It took us forever to pay back our student loans. But as dentistry, you have untapped and uncapped potential. And so for me, you get to change people's lives, you get to give them confidence, you get to help them have better health, and you're able to make people smile like.   I can't think of a better opportunity to be a part of. And I'm not just Pollyanna over here. I coach hundreds and thousands of offices. I've seen the good, the bad, the ugly, and the in between. But I'll tell you, depending upon how you choose to view this, you can either find the good or the bad. And I'd recommend like, let's find the great because it's a gold line of opportunity if you want to see it. What what do you say to dentists who say, Mm-mm, you know, I I really don't want to complain really a bit. I mean, on paper my   My practice looks perfect. I got two hygienists. I do a million dollars. I do all this, but just internally it just feels chaotic and stressful. So it looks like on paper he's doing everything right. But she says, I still feel like chaos and stress. What's what's that about? I think like welcome to being a business owner. I think that there's two sides of success. In the word success, there's literally the word suck. Like there are parts of success that are going to suck. Like that's just how it is, guys.   And so that chaos and internal turmoil, I think I there I have lots of offices where you don't have to be that way. And I think going from like operator doing all the pieces, being stressed out into like a CEO of a business. ⁓ I think sometimes dentists are such gunners doers, they're so hands-on that they have this internal chaos. But there there are paths again that don't have to be that way. But I also think this is part of the game of business that we signed up for. And I think when you get to the level like Howard.   You've seen, I've seen over our career, we've got the gunners and the doers and the like zero to two year business owners. Like it's freaking chaos. It's psycho. Like you're learning these things just like you're back in dental school. But as you mature, you start to realize that the chaos is just part of the game. And the more you're able to learn to weather it, to see it, and to not do all the pieces, elevate your team, get great people, do like hire it out. You can hire, I mean, a practice is doing a million and you got great profitability and overhead.   You can hire a lot of great people to take away a lot of your problems. And so like, let's get some of those things done. And then you actually become happier and you make more money. So that you don't have to sit in that chaos. I think that there's a part of it that will always suck. but there's also a part that can really be the successful part too, that's fulfillment and enjoyment. But you got to make the steps and take the steps to do it rather than just sit and complain about it.   Love it, love it, love it. ⁓ what do you what do you say about the ⁓ the dentist who got out of school, goes and works for a major DSO, say say he's working for Rick Workman, Heartland, and he works there two years, and you know, he you know, he's working for a guy that owns eighteen, nineteen hundred dental offices, but he can't tell you the code for a profit. Can't he'll say, like, you know, are they paying my pay right? Really? You can't check at you. I mean, it it's like   It's like they'll listen to a forty hour lecture on the difference between two different composites, but they did I mean th they worked through two years, they don't know insurance codes, they can't check out a patient, they don't know the software. I mean, I had one guy tell me, ⁓ the only thing you could tell me about the practice manager software is the brand name. He couldn't tell me and then he's asking me, you know, it what which one you know, but anyway, do you think do you think a dentist doesn't need to know all the business details?   Or do you think that's a blind spot and you can't delegate anything till you can do it and master it? I think that there's two types of owners. And I think that there's some that are really great at hiring people that they are great at hiring people, knowing it, listening to podcasts, hiring coaches, training the team, and like having somebody spot check for you. Then there's others that like they've got to know the ins and outs. But I think that like Howard, there's   To me, there's also a middle ground where I think that you can go sit with your biller for one day and just like say, like, walk me through your process. So you have a general idea and an understanding of what they do. Go watch to see how they schedule. ⁓ I think when it comes to billing, I do think the dentists have a very big blind spot. And to me, that is like as a business owner, not to know how your money comes to you. To me, that feels like a pretty big blind spot of like even just understanding that knowledge. And so   If I were to say, I don't think you need to know the ins and outs. I love like I recognize this. I was a business owner of it. I own practices. I worked with hundreds of dentists at Midwestern University's Dental College. Like, I hear what you guys are taught. Plus, I'm a team member on the other side. And so I created a billing course and an office manager course because I just want a dentist to know like, what should I be able to expect? And I think like if you want to just have a general overview so you don't get blindsided, you you can have it. I think you can quickly within like a week.   Know the bulk of like everything you need to know in a practice very simply, very easily. So that way you can delegate. That way you can have it. You're not gonna be perfect. but I think just having a general awareness. And then I love to give doctors just a quick checklist, like once a month, go spot check, go grab an EOB. Even if you don't know what the heck that EOB is, go ask your front office for it, check it. And just the more you learn that language, just like the language of business, I think it doesn't need to be an overnight sensation.   But I do think the more you're aware of it, I don't think you have to do every single role though to be a successful practice owner. And I mean, shoot, if Heartland can do it, I think it's a good example. But I think who are you? And are you a hands-on tactical person? Are you somebody who's really good at hiring people, t trusting other people, getting the checklist and spot checking? I think you can do it either way. But my recommendation is like just like one week, go like sit in every seat of your practice and get a general awareness and educate yourself on the things that you don't know. I'm really big on money, understanding at least how insurance works. And then also how do we like   present cases, what are kind of the flow that way those big zones that really impact your financials, you can you can be aware of. So those courses, those online CE courses, your website is The Dental A Team. The Dental A Team. Now I think the A Team, you need that guy with the Mohawk and all the bling. I mean that's who I am in my like spare time. This hair is just a facade. Like, you know, I hang out as Mr T. Mr T. Mr T, Mr T, yeah.   That's why I was thinking the A Team, but is that on your on your website, the th those courses? Yeah, they are. So we have an online library, it's all C E. We've got downloadable checklists, we've got operations manual. You got it. That's exactly right. And Howard, in real time, I'll have our marketing team actually put together a code. If you guys put in Dentaltown, since you're listening, we'll make sure that you guys get a coupon code for that as well. Well, since it's my compass podcast IRS that you just put Fabio.   you want Fabio? Okay. well in that case. So ⁓ so is I also see you have a ⁓ Summit twenty twenty six is live on Friday, April twenty fourth. Grab your ticket. Where's where's that show gonna be? Is it Reno where you are? You know, that's actually virtual, Howard, and it's one of our like favorite comebacks constantly. And the reason I do it virtual, people have been asking me for years, like, why don't you do it in person, Kiera? And what I found is   Because it's so like again as a team member, I really struggle to get my team ramped up, amped up, and have it be financially affordable. So what I found is if we can have it virtual in your practice with your full team, you guys are able to get this boost and surge of energy and have a good time. So it's for leadership teams, it's for doctors. ⁓ we've been doing it for six years strong and we tend to have hundreds of offices. You get your whole office there, you have a good time.   But yeah, it's virtual and it's C E and it's a great time. ⁓ I attend a lot of Tony Robbins, a lot of Brendan Bouchard, Rachel Hollis. So we've learned how to do people have told me the online experience is so fun. ⁓ we just get continual people coming back year after year after year. So yeah, come join us. It'd be a great time. I love Tony Robbins because ⁓ you know, my boys they wrestled year round from age five to fifteen.   Yeah. Made our garage. I got two real wrestling mats from the manufacturer in Pennsylvania delivered by an AJ Miller. So I never ever parked in my garage ever. And we would we were listening to that Tony Robbins 30 day, 30 day personal power. Yep. And then I and then I bought my first laptop when I went to MBA school. And so I took notes on it. And then when I was done, I I ⁓ closed down Saturday and I went to a studio Saturday, Sunday, and I ranted out my notes.   And I said, this has got to be 30 hours because I mean it's still Tony Robbins 30 day personal power. And that was the 30-day dental MBA. ⁓ and it worked out to be about thirty hours. But I'm telling you, the pandemic changed everything. That was when ⁓ online CE at Dentaltown just went through the roof and it hasn't come back and dental meetings haven't come back. Cause why do I need to fly to Chicago to listen to you if I got a Zoom call or   or streaming video or this event. I mean, I mean, just think of the plane ticket, the hotel, the sitting and attending. If you're in Phoenix, you know, just to get to New York is a five hour flight. I mean, why I I gotta fly five hours each way when I could see you on YouTube or a podcast or or whatever. But I wanna but I want to go back to that pandemic because that pandemic, I really think the reason you can really do this so successfully today is because of that pandemic. That's why we realize   I don't have to be in the flesh to learn knowledge. And and like I I I feel fine talking to you. I me too. The only thing I regret is teaching my mother how to do that. I got her FaceTime and all that kind of stuff. And because she calls to tell me about ever every one of her exciting things is junk mail she has. She's eighty seven and she believes every piece of junk mail. I love it. She's always free freaking out on her junk mail. But but I want to talk about the pan the dark side of the pandemic.   And that is a lot of people think about 20% of the hygienists left to practice. Before, you know, when I got out of school, your labor was supposed to be twenty percent, your overhead was supposed to be fifty percent. And by the time it was it didn't even take 10 or 20 years, and and due to insurance, I think not keeping up, ⁓ overhead went to basically two thirds. It went to about sixty-five percent and labor went to about twenty five, sometimes twenty-seven percent.   I'm hearing thirty percent labor all the time. And I mean I mean I'm talking about serious dudes who know the business of dentistry. And I don't I don't want to get my buddy Rick Kirstram out of me. He owns a hundred comfort dentals and he said he can't he said he's got the mean and lean where labor is twenty. He says he's got mean and leans with labor at twenty-eight, twenty-eight and a half. So so the the pandemic is ⁓ it that was five years ago. Why do you think it   seriously impacted labor cost of the pandemic. I do, Howard. And I think I think we kind of have this perfect storm, right? Like I think we've got multiple waves coming at us that have impacted. I think the pandemic pushed out those that were like, you know, I'm done. Like, like I'm good. I'm at the end of my career. I don't really want to do that. ⁓ a lot of hygienists are female and I think a lot of them realize they did not need two incomes anymore. And so it's like, you know, I want to be with my kids. I want to be home.   And then hygiene schools don't pump out a lot of hygienists and it's usually like a two year span. So yes, I have actually seen like hygiene is it really did, and then it clicked up. So the cost of hygienist has gone up astronomically. I mean, I think the highest I've seen of a hygienist being paid was 85 an hour. And to me, I was like, at that point, that was up in ⁓ it was up in Washington, up by Bellevue, Mount Vernon, that area. And I literally saw the the posting for 85 plus a a bonus, and I was like,   Screw that at that point. Like in all respect to hygienists, I'm gonna hire a dentist for that cost. Like I truly will. And that's not being disrespectful. It's just like a dentist is a more multifaceted. I understand they are not great hygienists, but if I have to and I'm gonna be putting this number up, like we've got to get to a space where it does work. So yes, I do. However, there are more hygienists coming onto the market. I still know that this is one of the hardest things, but ⁓ I have a practice that's out in Maui, rough life, huh, Howard? I get to fly to Maui to go do work, like.   You know, shout out to that office. ⁓ but what we found is we were able to find a way to get the hygienist to be paid exponentially higher by doing assisted hygiene. And so I think I'm seeing people innovate. I think I'm watching them create. I think I'm seeing people do some more outsourced costs in the front office. And so they're able to then offset the costs of the clinical team. ⁓ I think that people are just getting innovative and creative. And what I want to highlight is while this feels annoying, this is also business. And if we don't innovate and if we don't continue to evolve,   We actually decay and decline as an as an organization and as an industry. And so I know it's annoying and I absolutely empathize. And you're right. Like for me on our payroll, we're at 30%. Like I've had that as our metric for our clients for the last five years because payroll costs have gone up. But I'm like, but just because they've gone up, like let's look at several other industries. I mean, we're not here to like love on or hate on McDonald's, but I'm like, they have kiosks. They figured it out.   I checked in at a hotel in downtown San Francisco. There was no person there when I checked in. It was literally a person on Zoom just like this. I clicked in, they said hello to me. They took my information, but they didn't have to have a physical body in the office. And I think with AI and technology, dentistry is going to evolve, but I think the art and the care of patients does not need to evolve. And so, like, let's put our dollars where that matters and let's be able to look and innovate in other ways that keep our costs low. ⁓ I still think dentistry, I mean, why is there a one percent default rate on loans? Like,   Banks are still lending. We had the first down year of DSOs last year and the first uptick of private practice last year. And so when I look at these things, like it is still a great business to be in, even though labor costs, like, guys, again, it's just another flavor of business. So like let's figure out how to innovate. Let's figure out how to do it. And like, yes, I'm gonna pay for great people. I see team members as assets, not liabilities. And I'm gonna cut and chop on other areas that I can, but I'm also gonna be smart with my labor costs and make sure each person hitting their KPIs, they've got numbers that they're driving.   We are running this as an efficient business while like loving and taking care of our patients at the same time. I'm glad you mentioned bank loans because it's less than one percent default rate. Yes. All the defaults have the same thing in common. They all had their license taken away. Right. Always. And and if it's for drugs or alcohol, they now treat that as a medical disease. And the dentists still say, Screw you, I'm not gonna quit doing biking. And then they run south of the border. And that's why whenever you find a dentist down there that looks like me.   They're running for free Vicada. They they they said I'm not peeing any. So unless you, you know, do something just horrible. I mean, and you know, you have you have to get your it licensed in your way. But I w I wanna tell you about you know, there's just so many other things that you can focus on besides labor, like increasing their productivity. ⁓ I know dental offices. you can get a full if you pay a dentist in the Philippines five dollars an hour.   You get the best dentists in the Philippines. And I and there's dental offices that with Zoom and things like that are doing all their insurance and their claims and all that stuff. I mean, ⁓ so the with with with ⁓ with the internet, I mean you can literally have someone ⁓ be at the front desk ⁓ on a on a kiosk that's actually a dentist from the Philippines from five dollars an hour who when he's not busy can be calling your insurance companies all that. I I want to ask you another thing that's really hot on Dentaltown.   today. Everybody keeps talking about these dental insurance EFTs versus virtual credit cards. but basically everybody's reporting that major dental companies like even Delta are gonna stop sending paper checks and you gotta do it all electronic. And I guess that that electronic could be free, but it could be you know it could be another three and a half or three percent credit card fee on all your claims. Or what or what are your thoughts on all that? I'm hard on that   I have and I'm a hard no on the credit cards. Like, why? Why are you doing that? EFTs are so fast. Like there's absolutely no reason to be paying this. Explain to my home. A lot of them don't even know what a EFT. Mo I I bet 80% of the the dentists listen don't even know what we're talking about. Will you explain it? Will you explain it like I just graduated from dental school eight minutes ago? Of course. Well, I think that this is also where going back a little bit where you said, like, do dentists need to know the business? To me.   You don't even have to know that much, but I want to just challenge you that if you're getting a three, three and a half percent cut on your payments for quote unquote ease, that's a real big hit. And I would just challenge you to think about like for what and why. And so coming in, there's different ways the insurances are going to pay you. So they're gonna pay you via paper check, they're gonna pay you via EFT, which is a electronic fund transfer, or they've got this new thing where they're gonna pay you via credit card. And like honestly, to me, the credit card is so scammy.   And I've talked to so many people and like educate me, like, why would anybody do this? Like, I cannot comprehend. Like, I'm already taking a cut on insurance as is. Like, thank you for my marketing fee to be an insurance. Like, that's how I view that that write-off. Like, I know you hate it, but you're also gonna, you're either gonna have to do that, or you're gonna have to pay for marketing to bring in fee for service patients. So, like, again, let's just think about that. But I'm like, so I've already got a cut there, but I'm then gonna take another hit in addition to that for a credit card ease.   So as we're talking about that electronic fund transfers, they deposit straight into your bank account. The reason that some offices don't care for electronic fund transfers is because like trying to match it up is a like it kind of dumps and chunks into your bank account. So all you need to do is help your team members. Like there's ways that you can have it where it automatically emails your team when that comes through. So then they can go online and they can find out what the EFT was, so then they can balance and like enter it in.   I do think dentistry software is so dated because what happens is when we get paid from the insurance company, we get either like it's called an EOB, it's an explanation of benefits, and it's like batch checks. So when they dump this money to you, Delta's gonna give me like 20 grand. But like, who do I allocate that 20 grand to of all these patients? So that's I think where some people have like, well, electronic funds are so annoying and this and that. But I'm like, they're very quick, they're very fast, they're a lot safer than paper checks. Paper checks people do get embezzled on.   That I literally see no reason. Like, I don't care if you get it like one day sooner with a credit card, you are paying a huge hefty fee on that unnecessarily when electronic fund transfers are pretty much just as fast. Like maybe a like smidgey of a delay. But to me, that's a that's a very worthwhile smidgey of a delay. Because you're getting your payments so much faster. And as long as you're staying on top of it, you should still be able to maintain a 98% collections rate, even if you do checks or if you do electronic fund transfers. It just is so.   So dumb. I've yet to see a reason. But to me, I'm like insurances are so smart because it's just another way for them to take a chip out of what they're paying you and to have it come back to them. So again, think of the motive as to why they're offering. These people are not dumb. Those insurance companies, if you've ever gone to a business who's the biggest building in the entire city, it's your insurance companies. They're not dumb businesses. And I think we need to be smarter business owners that out think that. They always but Delta always says, we're   Yeah, so is Rolex Watch. Rolex Watch is a non profit. And and some of the CEOs of some of the anyway, we won't go there. But ⁓ yeah, ⁓ so what other ⁓ besides you know, when when someone tells me about their overhead, I tell them, look, I can't call the government and have my tax rate lowered. I can't call the nuclear power plant SRP or APS and tell them to lower my electric bill. I mean, something I i if the hygienists can   Wants a dollar an hour and if I say no, I'll give you 75 cents and she can go get a dollar across the street. I mean the market sets many, many prices. So the only way to fight that back is to ⁓ increase your productivity. You know, I mean if if if you have a dollar in labor and they do a dollar in dentistry, your overhead is a hundred percent. But if your dollar in overhead can do two dollars in dentistry, now it's down to fifty percent. So how so ⁓ are there other   ⁓ hidden gaps that are quietly draining profitability, or has it just come down to production? Or is it both I like I'm so glad you brought this up because I think like it's so easy to sit here and say, like, dentistry's not profitable. But I'm like, go find me another business that has a one percent fell rate that usually can run twenty to thirty percent profit margins if you run a business right. And this is not just Kiera sitting here fluff. This is like I got real clients running at these margins consistently. They've got large practices, small practices.   And so when I look at this and I'm like, okay, how do we make this more efficient? A lot of people want to go to the first thing of like, let's cut insurances. And I'm like, yay, pop the confetti, but be real smart. Because again, you're gonna then increase marketing fees, you're gonna lose a lot of your patient base. Like, let's just think through the ramifications. And so there's lots of different ways that we can increase productivity and not have to go for the cut. So I look at three levers that I found that can increase a practice. So one is we can increase our production. We're talking net production, not gross, like please feed your family, not your ego. So that's number one.   Number two is what's your collection percentage? Cause half the time doctors feel like they're broke and they don't have money, but your money's sitting in AR, which is your aging reports or your accounts receivable. We're not collecting the money and we don't have a good billing process. We got to get our collections up to 98%. And then the third thing is like we cut costs. And so looking at that, a lot of people want to go to just cut costs. I'm like, but in dentistry, let's break it down. If I want to add 10 grand more to my practice.   I love to help teams. Most offices are working four days a week. So if we're wanting to add 10 grand to a practice, working four days a week, let's do 10,000 and we're working 16 days a month. That's an extra six twenty-five a day. Well, how can we make six twenty-five in a dental practice? Let's think about our fluoride applications. Let's think about FMXs. Like I'm just talking, this is your lowest hanging fruit for you. Let's talk about could we add one or two fillings? Could we add like same-day dentistry, which is going to make more raving fans for our patients? There is so much ease in there.   Now, to increase our production, we can also look at our case acceptance. Doctors have so much case acceptance. And also, what are we diagnosing? I'm like, doctors, if you want to be producing 100 grand a month, the statistics are you need to be diagnosing three times that amount. And then we need to make sure our treatment coordinators are really good at diagnosing explaining treatment to them. They're not diagnosing, but they're explaining the treatment. They're presenting it in a way. We're not using insurance as our main driver. We're using it as like a coupon. And then we're really good at our follow through and our follow up.   Gotta have a right person, right seat in your treatment coordinator seat that's obsessive with hitting the right goals. And so there's like so many little ways. Like you can in I have added block scheduling, which I know is like a consultant's number one favorite thing to talk about, but like make it really make sense and easy for your team. I've added a million to a practice with no extra days, no extra work. We literally are just being more strategic with how we schedule. And so there's just so many little ways that I want dentists to realize like,   To me, I get really excited. This is where I geek out as a consultant. I geek out and I love to help that is because I'm like, how can I like squeeze more juice from the lemon you're already in? Like, let's just make more lemonade. Let's figure out ways to do it. And then let's make sure our costs are effective. So we teach your teams how to look at the business as a business. We teach each team member about their one KPI that's really going to drive it forward. We help them track. I just did this with an office manager this week and she's so lit up to look at her numbers, to look at her metrics, to see how she can do it.   And when they start to see how they can click it through, it's not you trying to push and drive more money. Like doctors, I tell everybody, every team member, you want your doctor to be so freaking profitable. Because if they're profitable and they're like they're secure, your life is so much better. So like I'm like dentists, we got to get you profitable, we to get the cash flow, we got to get you less stressed because you're gonna be a better dentist and a better business owner. But how are there's so many little easy ways where it's just low-hanging   Typically I'm able to add 10 to 30% of production in usually 90 days to an office, like very consistently with just small little reps, no real extra work. How are we doing our exams? Are we being directive in our treatment planning? Are we using like, okay, next visit I want to see you for this? And when do I want to see you back? And how much time is this going to take? Like, let's break down the barriers of treatment planning. There's so many little simple things that if you just implement, you can be very profitable very easily.   And then look at your P L. If you're not looking at your P and L every single week or month, like just being aware, getting into the language of business, that's also gonna help you too. So yes, cut. ⁓ but I found that it's always a lot easier to make sure our collections match, our production matches, and we use those little low hanging fruits. ⁓ and it's there. Like dentistry is such a magical, like, like it's a great lemon tree. You can make a lot of lemonade out of a dental practice. I want you to tell me if I'm right or wrong or or   I think I think there's two threes to double your price. Number one, if three people call your front desk, one is going to come in because they're smart and they need to they know they need to get their teeth clean. One isn't gonna come in for anything and you can hear them vaping and smoking and drinking beer and eating Cheetos on the call. But one out of three needs a little extra push. And if you train the person answering the phone, they can close that one out of three. And if they do, they doubled your practice. Then when they get in, you still got the now you got three people in chair.   One's gonna do what you say because you're a doctor and they've done their their author search and and you say they got a cavity, they're not gonna argue with you. One's not gonna do anything. In fact, in fact in fact I was like I had about a dozen patients that in the middle of my treatment plan, they asked me if they could just take a cigarette break ⁓ from my presentation and they went outside, had a cigarette, came back. They're gonna do it. But the other one in three needs some some closing skills. And so if you if you can close on the phone   You doubled your practice. You you got two butts in instead of instead of one. And if you fix your treatment plan presentation, you're gonna do two cases at one. And I think it's so funny now because the dentists have never let their hygienist or assistant, let alone receptionist, do any diagnosing treatment plan. But now AI, Pearl, and Overjet diagnosing all the cavities. So you wouldn't let your hygienist while she's in there for an hour.   Diagnose and treatment plan and sell the dentistry, the assistant while they're taking FMX, they they can't point out, yeah, see, that's a cavity, you don't need a filling and a root now. yeah, they couldn't do it because they were humans. But now Pearl and Overjeck can do it all day long and you're good with that. I mean, so so what how do you how do you double the close rate from one out of three to two out of three on the phone? How do you double the treatment plan acceptance rate from one to two out of three? Yeah. Do you do you agree those are possible goals?   Absolutely, Howard. I think again, this is the low hanging fruit that people are like, but that feels so hard. And I'm like, choose your hard. Like, is it harder to spend a little time with a front office and train them how to do this? Is it a little like, or is it harder to be cash flow negative? Like you choose what's your hard to me? Absolutely. Let's go after that. And I agree with you. Like teaching a team to preheat an oven, I call it what would doctor do. And so like, let's train our hygienist.   Like I tell all hygienists, doctor should be the second opinion, not the first opinion. And you got Pearl and you got Overjet. And so just spending a little bit of time with your team. So what we typically do for case acceptance, like let's go hit that one quick and then we'll talk about scheduling. Is I'm really big on let's get the whole team where we're talking the same language. So we recommend, like, what would doctor do? I recommend you run this over the course of six weeks, is typically how long it takes, anywhere from six weeks to maybe three months.   but we're gonna sit there and we're literally going to go through. We're gonna pull up an FMX. We're gonna do it one day over lunch. Hygienists, doctors, and if you want front office and dental assistance, rock on. But really, I want my like people that are seeing the bulk of my patients with doctor and hygiene. We're gonna look there and I want all of our hygienists to start like if we have an FMX up there and the interaurals, what is doctor going to recommend and how is doctor gonna talk about it? We're not just gonna sit here and have a nice little chit-chat. We're each gonna write it down because I wanna make sure every hygienist starts to get very, very comfortable. And the goal that I tell all hygienists is   Your goal should be at the end of this, what would doctor do training over six weeks? And if doctors are really consistent with it, I'm like six weeks of training to be able to double your practice and increase your case acceptance to me is a very good use of my time. So if I can do that, doctors and hygienists, you should be able to have 95% accuracy with your doctors at the end of this. And they do it. So hygienists get really lit up and they get very excited about it because now they're able to preheat the oven. They're able to talk to patients about it, use Pearl, use Overjet.   And then doctors, when they tee it up to you, and I say like hygienist, you've got to be the ones who first like introduce it, talk about it with the doctor as soon as they come in, but be real quick. So we introduce the patient, we compliment the patient on something, we recap the treatment that's discussed and we say something personal. Hygienist, you do that, your doctor exams will be much shorter for you and doctors will love it because it's very quick. If we can get that dialed in, and then doctors, you have a very like confirm the treatment.   then recommend exactly what needs to happen. And then we take that same baton up to the front office and front office, we schedule first. We then present the treatment. We use insurance secondary. I'm never leading with insurance. You do these little items which seem like, ⁓ no, that's like very quick, easy things. You're going to rapidly be able to help those ones. And then I do a two two two follow-up. So if they did not close for me and I'm going to go through it and I'm going to work through and I'm going to track all the people that didn't say yes to me and all the people that did say yes to me.   I'm gonna look for patterns. What are people saying yes? Like those are easy ones. Those are the gimme's. Those are the easy patients that Howard said. I'm looking for the people that say no and what's my pattern in there? And how do I change my verbiage? Because treatment planning is 80% psychology, 20% skill. So like what are you thinking? How are we presenting it? What are the words we're saying? One or two little changes usually will close that. What are the patterns and how can I get that number up higher? And I follow up with them in two days, two weeks, two months to make sure that they don't follow off.   People are like, Kiera, you really make your treatment coordinator do that? And like, yeah, I was your treatment coordinator that closed $50,000 same day. And this is exactly what I did. This is how I've trained co offices across the nation to do it. You just have these simple little things that help them out. And then you flip over to our scheduling. Like, I think scheduling's easy, Howard. I genuinely do. I'm like, half of it is just be nice. Like you got the COVID crank, and so many people are so grumpy and so like.   Annoyed when they pick up the phone, then I'm like, you can already leap your ahead by just being nice and being excited to welcome a patient. Then take like charge of that conversation. So let's take the ownership of that conversation. If someone's Do you take my insurance? I'm going to quickly redirect and say, my gosh, how did you hear about us? I'm going to answer that, but I want to find out how did they hear about us? If it's our Google reviews, if it's a referral, if it's somewhere else, I want to like say, my gosh, you're so lucky to be here.   We love our patients. We love our reviews. I can't wait for you to be a great raving fan too. let's talk about this. I can everything can be overcome. Please do not let being out of network stop people. It's a thousand dollar coupon and we're turning people away over that. No, no, no. We are better than that. And if we are the best dentist, they need to be coming to us. We need to win these patients over, make them feel so loved. Let's get them scheduled. Let's make this a great experience for them. Let's make them feel so excited. I did it with PT called like six offices.   And the office I chose, like so many people were annoyed I was calling. Can I put you on hold? Can I do this? And I was like, no one really wants my business. If you're just nice and you take control of that conversation, you can easily turn and transform your practice. So hopefully that was like not too much. I like I love these things. I love training treatment planning. I love training how to like take control of a phone call. I love helping teams overcome those little simple objections because it's very, very simple things.   that make massive leaps and bounds of change. And it's a great way to double your practice very easily, like you said.   The Dental A Team (36:13) All right, Dental A Team listeners, that was the guest interview that I absolutely loved. And I hope that if there was one idea that stood out to you, don't just agree with it, but actually go implement it this week. And if you need help setting this up in your practice or you need help just navigating or need a friend, head on over to TheDentalATeam.com and I'll be able to help you guys out. Click on the book of call or any way that we can support and serve you. That's what we're here for. That's what we're obsessed with. And as always, thanks for listening and I'll catch you next time on the Dental A Team podcast.

Hiring and keeping an associate sounds simple until the interview process, compensation questions, and culture-fit issues start to derail everything. In this episode, Kirk Behrendt brings on Cassie Tallon, an operations expert and founder of The Fractional Match, to explain why most dental practices fail when hiring associates and what to do differently. You'll learn how to evaluate fit beyond clinical skills, how to set compensation expectations with transparency, why paying on collections matters, and how to prepare your practice so an associate can actually succeed and stay. Listen to Episode 1058 of The Best Practices Show!Main Takeaways:Decide whether you want an associate purely for production or someone you will develop into a leader and potential legacy successor.Use a recruitment service instead of posting a job yourself without understanding today's compensation models and contract pitfalls.Evaluate relational and empathetic patient-care philosophy early, not just clinical procedure capability.Confirm the associate is coachable and willing to be led during onboarding, not just eager to produce immediately.Start onboarding with financial clarity—how the P&L works and how pay is calculated—to prevent distrust and turnover.Pay associates on collections to tie compensation to real revenue and reinforce documentation, billing, and follow-through habits.Fix patient mix, services, and marketing before hiring an associate instead of expecting the associate to solve a broken model.Snippets:00:00 Hiring Associates Is Hard01:06 Meet Cassie Tallon03:41 Associate or Partner Choice05:30 Recruiting Landscape Today06:56 Fit Over Clinical Skills10:40 Pay Models That Work12:35 Equity and Autonomy14:31 Fix Patient Mix First19:10 Develop Associates Skills22:00 Retention and Transparency24:02 Work Life Satisfaction27:47 XChange Soft Skills Talk30:01 Final Advice and Wrap UpGuest Bio/Guest Resources:Cassie Tallon is a dental operations leader with 20 years of experience spanning multi-doctor practices and DSOs, including supporting growth and operational efficiency across multiple locations. She is an author focused on dental operations and has dedicated her current work to helping dentists improve efficiency, navigate growth decisions, and strengthen systems without adding unnecessary overhead.Resources mentioned:The Fractional Match: thefractionalmatch.comBook: Permission to DreamBook (upcoming): Permission to ScaleMore Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Most dental teams were never taught about waterline safety in school, yet it has become one of the most important infection control topics in modern dentistry. In this episode, Angela Simmons shares why dental unit waterlines remain a misunderstood area of compliance and what practices need to do to better protect patients. Angela and Kevin Henry discuss the challenges of getting waterline protocols, infection control procedures, and risk management strategies implemented consistently across dental practices and DSOs. They also explore how overloaded dental assistants are often expected to manage critical compliance tasks without enough training, support, or understanding of why those tasks matter. The conversation highlights the value of standardized processes, better communication, and investing in team education to improve compliance, patient safety, and long term practice success.

On today's episode, Dr. Mark Costes welcomes back longtime friend, mentor, and returning guest Alastair Macdonald for a deep conversation on dental partnerships, practice ownership, and the costly mistakes many dentists make when trying to retain associates. Alastair shares why selling equity too early can create long-term problems, how fear-based decisions often lead to bad partnership structures, and why production alone does not make someone a strong business partner.   He and Dr. Costes also unpack the shifting economics of dentistry, the rising pressure from DSOs, and the importance of building dynamic, values-aligned partnerships that can grow with the business over time. The episode also previews their upcoming Dental Success Summit session, where they will go even deeper into frameworks for creating healthier, more strategic partnership paths. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://partnerships.sovereigndentist.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Documentation, charting, and insurance narratives are taking time away from patient care, and many teams are already stretched thin. In this episode, Kirk Behrendt sits down with Rushi Ganmukhi, founder of Bola AI and former MIT AI/NLP researcher, and Cassie Tallon, a dental operations leader and author, to explain how voice-enabled AI can reduce clinical documentation burden, improve note quality, and help practices get paid faster. You'll learn where voice tech fits best (perio, restorative charting, and clinical notes), what it changes operationally, and how to identify the friction points in your own workflow. Listen to Episode 1055 of The Best Practices Show!Main Takeaways:Voice technology can reduce the time and disruption of perio charting by allowing hands-free entry during hygiene visits.Faster perio charting supports more comprehensive perio exams, which can improve identification and treatment of periodontal disease.Delayed or incomplete notes can delay insurance submission and cash flow, creating a backlog of unsent claims.Templated, generic notes and late documentation can weaken clinical records for both insurance review and legal defensibility.Insurers are increasingly requiring more documentation, including perio charting for restorative claims, to support medical necessity.Effective adoption of AI tools depends on fast implementation, flexibility in workflows, and customization to an office's documentation preferences.Practices can start by tracking daily workflow “sticking points” for a week and mapping which issues could be reduced with voice-driven documentation.Snippets:00:00 Voice tech as the “hidden power” of AI for practice efficiency.01:00 The documentation burden: perio charts, restorative docs, and insurance narratives.02:10 Rushi's background in AI/NLP and MIT research, and why he entered dentistry.04:35 Why voice tech fits clinical environments better than consumer voice assistants.06:00 Bola AI's early focus on voice perio charting and expansion to notes and restorative charting.07:05 Why integrations with practice management systems matter (Dentrix, Open Dental, Curve, Patterson, Henry Schein).08:00 The time cost of manual charting and its impact on hygiene workflows.10:00 How delays and backdating notes can hold up insurance submission and revenue.11:20 The risks of cut-and-paste templates for insurance and legal documentation.13:00 Insurance requiring more documentation, including perio charting for restorative claims.14:00 Why “decay” alone is not a sufficient clinical reason in a narrative.15:00 How dental-specific logic and terminology improve accuracy over general dictation tools.16:35 What “plug-and-play” adoption should look like in the operatory.18:10 Handling variation across practices (sleep/airway, medical billing, pediatrics, customization).19:00 Current curiosity vs. adoption: workforce shortages and the cash-flow case for AI.22:00 Overview of Bola's three core products: Voice Perio, Voice Restorative, and AI Scribe.26:00 A practical challenge: measure how long perio charting takes and identify workflow friction points.29:00 Final guidance: start small, solve specific problems, and choose tools proven in clinics.30:10 Where to learn more and request a demo (bola.ai).Guest Bio/Guest Resources:Rushi Ganmukhi is the founder of Bola AI and has a professional background in artificial intelligence and natural language processing, including research experience at MIT focused on helping computers understand human speech and language. He leads Bola AI's work applying voice technology to dental workflows, including perio charting, restorative charting, and AI-assisted clinical documentation.Cassie Tallon is a dental operations leader with 20 years of experience spanning multi-doctor practices and DSOs, including supporting growth and operational efficiency across multiple locations. She is an author focused on dental operations and has dedicated her current work to helping dentists improve efficiency, navigate growth decisions, and strengthen systems without adding unnecessary overhead.Resources mentioned in the episode:Bola AI (demos and product information): www.bola.aihttps://smilesource.com/exchangeMore Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

Dentists often keep operating beliefs long after the market, technology, and patient expectations have changed. In this episode, Kirk Behrendt sits down with recurring guest Dr. Tom Hedge, practicing dentist and educator, to unpack myths dentists still believe — from selling to DSOs and misunderstanding recap/valuation, to overestimating the cost and complexity of modern technology, imaging, magnification, and hygiene staffing. You'll learn how to rethink “rules of thumb,” evaluate DSO offers more clearly, adopt practical tech that improves diagnosis and case acceptance, and use education and community to stay adaptable. Listen to Episode 1052 of The Best Practices Show!Main Takeaways:Dentists often assume what worked ten years ago will keep working, even when costs, fees, and alternatives have changed.DSO deals can break down when recapitalization happens and cheap money is no longer cheap, shrinking what DSOs can “skim” between dentist pay and profitability.A “second bite of the apple” payout is not guaranteed, and dentists can lose value if the DSO is not financially strong when the holdback comes due.Technology prices and workflows have changed dramatically, and many tools (cameras, scanners, digital X-rays) now deliver faster diagnosis and better patient understanding.Patient imaging can be created quickly using AI tools, which can help patients visualize outcomes and move forward without high-pressure selling.Magnification and hands-free lighting can simplify clinical work, reduce operatory clutter, and improve the patient experience compared to traditional overhead lights.Investing in continuing education moves dentists from “not knowing what you don't know” to confident clinical decision-making, but learning never stops.Snippets:00:00 Welcome And Setup02:04 Why Myths Persist02:38 Rethinking Fees03:42 DSO Big Check Myth05:31 Recap And EBITDA08:19 Independent Dentistry Future09:39 Tech Costs Myth12:59 Hands Free Operatory Tech13:50 AI Smile Imaging Fast15:58 Magnification Lighting Simplified17:33 Hygiene Crisis Reframed19:27 Education And Community20:35 SmileSource Exchange Invite22:09 Final Takeaways GoodbyeGuest Bio/Guest Resources:Dr. Tom Hedge is widely known as one of the top-notch cosmetic dentists in the United States. He received his Bachelor's degree from Kenyon College in Gambier, Ohio, where he majored in biology and chemistry. While studying at the Ohio State University College of Dentistry, he conducted research resulting in the publication of seven abstracts and one paper, which received numerous awards at the state and national levels. After graduating from dental school, he completed a general practice residency at Richland Memorial Hospital in Columbia, South Carolina. This advanced education included training in anesthesia, pediatrics, emergency medicine, geriatrics, TMJ treatment, endodontics, periodontics, orthodontics, oral surgery, prosthetics, and implantology.Dr. Hedge is nationally recognized not only for excellence in clinical programs, but for sound business practices that make full use of the newest technologies in dentistry. He is an alumnus of the renowned Las Vegas Institute for Advanced Dental Studies, as well as the Pankey Institute for Advanced Dental Education. Dr. Hedge is a frequent contributor to dental publications, as well as professional development magazines.Resources mentioned in the episode:Smile Source Exchange: https://smilesource.com/exchangeMore Helpful Links for a Better Practice & a Better Life:The Best Practices Show: https://www.actdental.com/podcast/Best Practices Association: https://www.actdental.com/bpaUpcoming Events & Workshops: https://www.actdental.com/events/Smile Source: https://www.smilesource.com/Subscribe on Apple Podcasts: https://podcasts.apple.comSubscribe on Spotify: https://open.spotify.com

You've felt it. Walk into one practice and everything feels light. Walk into another with the same tech and the same training and something feels heavy.That feeling is the new edge in dentistry. The emotional physics of how a practice operates under pressure.Inside this episode:The 1% details Dave Brailsford obsessed over to end 110 years of British cycling losingWhat "under pressure" really means in a dental day, and where the advantage actually hidesThe signals patients pick up before you've said hello, invisible on any spreadsheetPress play to learn the one thing DSOs can't buy. The invisible system behind higher case acceptance, more referrals, lower turnover, and a calm that compounds.

This week, Dr. Grace Yum sits down with Dr. Noha Nour, current President of the Orange County Dental Society, to talk about leadership in organized dentistry and the importance of building strong professional communities. Together, they discuss mentorship, advocacy, and how dentists can create meaningful impact within the profession.  Episode Highlights: How adaptability and life experiences shaped Dr. Nour's leadership journey The value of mentorship, networking, and organized dentistry Conversations around private practice, DSOs, and insurance reform Balancing practice ownership, leadership, and motherhood Why attending conferences and building relationships creates opportunities  Ready to thrive as a dentist and a mom? Join a supportive community of like-minded professionals at Mommy Dentists in Business. Whether you're looking to grow your practice, find balance, or connect with others who understand your journey, MDIB is here to help. Visit mommydibs.com to learn more and become a part of this empowering network today!

In this episode of Navigating Dental Insurance, Jordon Comstock and Tessina Bullock sit down with Elijah Desmond, co-founder and CEO of Dental Pitch Brokerage, to talk about practice valuation, preparing for an exit, and how dental owners can create a more valuable business before selling. Elijah shares his story as an entrepreneur, motivational speaker, event creator, DJ, and dental industry connector. He also breaks down why most dentists wait too long to prepare for a sale, why “no” is one of the most valuable words in business, and how his Dental Pitch model brings buyers and sellers together in a Shark Tank-style format. The biggest takeaway: dental practice owners should start preparing 5–7 years before they want to sell, not when they are burned out and ready to leave tomorrow. Key Topics Covered Elijah's background in dentistry, events, entrepreneurship, and motivational speaking Why relationship capital matters more than almost anything Why Dental Pitch Brokerage only works with a small percentage of practices Why practices under $2M in revenue may need advisory work before selling Why 3–4 chair practices are harder to sell Why sellers who refuse to consider DSOs may limit their market How Dental Pitch creates a faster, more human buyer/seller process Why culture fit matters in a practice sale Why sellers should get a Quality of Earnings Lite The difference between a basic valuation and forensic financial analysis Why adjusted EBITDA drives practice value How improving EBITDA from 13% to 20% can create major valuation lift Easy EBITDA levers: labs, distributors, merchant services, insurance negotiation, software consolidation Why efficiency can be more valuable than simply chasing more production DSO Pricing and how group purchasing can help private practices improve profitability Strong Pull Quotes “Your no is so much better than your empty yes.” “Dentists wait way too long to sell.” “You should reach out 5–7 years before you want to sell.” “Culture is everything.” “If I save you $10,000 and it goes straight to your bottom line, that may be $60,000 in sale value.” “CPAs are historians. We want forensic accounting.”Contact To connect with Elijah, visit: DentalPitchBrokerage.comDSOPricing.com

Andrew Smith, CEO of the Association of Dental Support Organizations rejoins the show to share: What to expect at the 15th annual ADSO Summit The Emerging Dental Groups to Watch awards & panel Updates on the ADSO's accomplishments this year DSOs and dental group practices can save 20% by using code DISC20GDNMEM. Visit https://dso.pub/ADSORegister26 The 15th annual ADSO Summit takes place in Chicago at the Hyatt Regency on June 15th - June 18th. 

Send us Fan MailDr. Eric Roman is the founder of Dental Associate Growth and the joyFULL Growth platform, a dental coaching and systems company purpose-built for dental groups and DSOs. Over a 15-year career, Dr. Roman has built and exited two dental groups, hired and developed hundreds of associate dentists, and coached more than $1 billion in annual dental revenue. In the last 18 months of intensive associate coaching, his team analyzed more than 10,000 real dentist-patient interactions using AI measurement tools and worked directly with more than 200 providers across the country. His research consistently reveals the same counterintuitive finding: Associate performance problems are not clinical. They are behavioral, systemic, and entirely solvable. He speaks and consults nationally in the group dentistry and DSO space with a reputation for naming clearly what most people in the industry are only thinking privately.✨Connect with Dr. Roman: Website: https://drericjroman.com/LinkedIn: https://www.linkedin.com/in/drericjroman/Instagram: https://www.instagram.com/drericjroman/

What separates dental assistants who stay stuck from the ones who grow into leadership and management roles? In this episode, Sherrie Busby shares the mindset shifts, career decisions, and uncomfortable moments that helped her build a 42 year career in dentistry and become a respected educator, mentor, and industry leader. Kevin Henry and Sherrie dive into the reality of growth in the dental field and why leadership is not just about standing in front of a room or having a management title. They talk about how dental assistants can create opportunities for themselves by learning new skills, saying yes to uncomfortable challenges, and becoming valuable inside the practice. Sherrie shares her journey from single mom working at Pizza Hut to becoming a dental assistant training developer and speaker, along with the lessons she learned from failure, rejection, burnout, and personal growth. The conversation also explores the role of DSOs, mentorship, continuing education, and the importance of taking initiative in your career. Whether you want to become an office manager, mentor, educator, or simply feel more fulfilled in dentistry, this episode offers practical insight and motivation for dental assistants who want more from their career. Connect with Sherrie Busby Email: Sherrie.Busby@yahoo.com Podcasts Dental Assisting Uncharted: https://www.youtube.com/playlist?list=PLrjkyvO6G1h0SDcqniI9yoMsIMQUqDAtC ZenOne Podcast: https://www.youtube.com/@ZenOne_Dental/featured ------------------- Dental assistants play a powerful role in whether patients move forward with treatment. You are a key part of the patient journey, and having the right financial options can make all the difference. CareCredit is a health and wellness credit card that offers flexible financing options, so patients can pay over time for the care they want or need, subject to credit approval. When money isn't the obstacle, patients say yes. Want to make CareCredit part of your practice's offerings and strengthen case acceptance? Email me at kevin@kevinspeaksdental.com and let's make it happen for your team.

Alan sits down with George Khoury, VP of Enterprise Sales at Net32, to discuss the evolution of the dental supply industry. Drawing on his 30-year career—spanning the early days of digital X-rays at Schick to nearly two decades at Henry Schein—George provides a candid look at why the traditional "high-touch" sales rep model is facing significant pressure. They explore how Net32 functions as a transparent marketplace, empowering independent "mom and pop" practices to access the same pricing advantages and catalog variety as large DSOs. The conversation highlights the shift toward tech-driven efficiency, the importance of price transparency, and how clinicians can reclaim control over their practice's overhead without being tied to a single distributor. Some links from the show: Net32 Join the Very Dental Facebook Group using one of these passwords: Timmerman, Paul, Bioclear, Hornbrook, Gary, McWethy, Papa Randy, Frank 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! We're proud to be supported by the folks at Net32! I'm a big fan of the Bioclear Method! I think you should give it a try and I've got a great offer to help you get on board! Use the exclusive Very Dental Podcast code VERYDENTAL8TON for 15% OFF your total Bioclear purchase, including Core Anterior and Posterior Four day courses, Black Triangle Certification, and all Bioclear products. Are you a practice owner who feels like the bottleneck in your own business? If you're tired of being the hardest-working person in your office, I've got something you need to hear. Dr. Paul Etchison, is hosting a virtual event that is a total game-changer. Paul is honestly one of the most brilliant minds in dental leadership today, and he's hosting the 3-Day Freedom Practice Workshop from February 19th through the 21st. He's going to show you exactly how to break through that two-million-dollar revenue ceiling while actually compressing your clinical week. It's about building a leadership team that takes ownership so you can finally step into the CEO role you deserve. Head over to DentalPracticeHeroes.com/freedom to grab your spot. And do me a favor—mention the Very Dental podcast when you sign up. It's 100% guaranteed, so you've got nothing to lose but the stress. Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code "VERYSHIP" you'll get free shipping on your order! Go save yourself some money and support the show all at the same time! The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even  their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!

In this episode of The Dr. Bryan Laskin Podcast, Dr. Bryan Laskin sits down with dental tech expert Dave Pryor to discuss the future of dentistry, AI, DSOs, patient experience, and why clinicians must take back care. From AI receptionists to treatment acceptance, this conversation dives into what's helping practices grow and what's quietly damaging the patient experience.  Check out CairDemo.com.

Germany sits at the centre of Europe's energy transition: over 800 distribution networks, deep intraday markets, and a flexibility gap roughly 40 times its battery fleet. But the real question isn't whether the market is big - it's whether it saturates as battery capacity grows, or scales for years yet.Philipp Man is co-founder and CEO of Terralayr. He joins Ed Porter to unpack the operational reality of building Germany battery storage at scale, the regulatory tension around grid fees, and the contrarian view that Germany's flexibility market is structurally larger than most forecasts suggest.They cover:- Why operating Germany battery storage is harder than capital alone can solve.- Why Germany's TSOs are positive on BESS, why DSOs are nervous and what regulators need to fix.- What the Bundesnetzagentur grid-fee review means for the BESS exemption running to August 2029.- How splitting merchant capacity across multiple optimisers outperforms single-optimiser tolls.- Why flexibility revenues are convex, dominated by tail events, and structurally larger than forecasts predict.Want to track Germany's battery storage pipeline, grid-fee changes, or flexibility market data? Ko, Modo Energy's AI analyst, is built for exactly these questions. Free sign up: https://modoenergy.com/sign-up?utm_source=podcast&utm_medium=podcast_apps&utm_campaign=philipp_man&utm_content=ko_signupTranscript available here: ⏱ CHAPTERS00:00 Introduction01:01 What everyone gets wrong about Germany battery storage04:50 Inside Terralayr's 8 GW pipeline07:00 German grid fees and the 2029 BESS exemption11:00 Why DSOs are nervous about battery storage14:30 Nodal pricing, FCAs and the one-price-zone problem18:30 How layer's virtual battery auction works24:30 Will Germany's BESS market saturate35:30 Markets outside Germany — UK, Spain, Nordics37:00 Advice for new entrants and the coming consolidation40:30 Contrarian view: flexibility revenues are convex`You can watch or listen to new episodes every Tuesday. Transmission is a Modo Energy production. Your host is Ed Porter - Director EMEA & APAC at Modo Energy.Music licensed via Artlist.

Germany sits at the centre of Europe's energy transition: over 800 distribution networks, deep intraday markets, and a flexibility gap roughly 40 times its battery fleet. But the real question isn't whether the market is big - it's whether it saturates as battery capacity grows, or scales for years yet.Philipp Man is co-founder and CEO of Terralayr. He joins Ed Porter to unpack the operational reality of building Germany battery storage at scale, the regulatory tension around grid fees, and the contrarian view that Germany's flexibility market is structurally larger than most forecasts suggest.They cover:- Why operating Germany battery storage is harder than capital alone can solve.- Why Germany's TSOs are positive on BESS, why DSOs are nervous and what regulators need to fix.- What the Bundesnetzagentur grid-fee review means for the BESS exemption running to August 2029.- How splitting merchant capacity across multiple optimisers outperforms single-optimiser tolls.- Why flexibility revenues are convex, dominated by tail events, and structurally larger than forecasts predict.Want to track Germany's battery storage pipeline, grid-fee changes, or flexibility market data? Ko, Modo Energy's AI analyst, is built for exactly these questions. Free sign up: https://modoenergy.com/sign-up?utm_source=podcast&utm_medium=podcast_apps&utm_campaign=philipp_man&utm_content=ko_signupTranscript available here: ⏱ CHAPTERS00:00 Introduction01:01 What everyone gets wrong about Germany battery storage04:50 Inside Terralayr's 8 GW pipeline07:00 German grid fees and the 2029 BESS exemption11:00 Why DSOs are nervous about battery storage14:30 Nodal pricing, FCAs and the one-price-zone problem18:30 How layer's virtual battery auction works24:30 Will Germany's BESS market saturate35:30 Markets outside Germany — UK, Spain, Nordics37:00 Advice for new entrants and the coming consolidation40:30 Contrarian view: flexibility revenues are convex`You can watch or listen to new episodes every Tuesday. Transmission is a Modo Energy production. Your host is Ed Porter - Director EMEA & APAC at Modo Energy.Music licensed via Artlist.

Stewart Gandolf speaks with Andrew Smith, CEO of Association of Dental Support Organizations, about how the industry is shifting beyond rapid deal-making and into a more disciplined focus on operational performance, technology, and patient experience.

Paul Keel, CEO of Envista with his over 20 years of experience in the dental industry discusses: Digitization transforming dentistry The growth of DSOs and dental groups Despite short-term volatility dentistry remains strong To learn more about Envista visit: https://envistaco.com/en To learn more about Envista's portfolio visit: https://envistaco.com/en/businesses  

Welcome back to the Shared Practices podcast.In this episode of Ask George, we're diving into a question we hear all the time from aspiring owners: How do you build a real business instead of just buying yourself a job? Whether you're preparing to purchase your first practice or thinking about expanding into your second or third location, this conversation will give you a clearer, more honest picture of what ownership really looks like today.Dentistry has changed a lot over the years. With more options like DSOs, choosing private practice is no longer the default—it's a decision. And for many, that decision means stepping into the role of an entrepreneur. That comes with real challenges: managing rising staff costs, dealing with insurance reimbursements, and navigating tighter margins, especially in a post-COVID landscape. But at the same time, it creates an opportunity to build something that can grow beyond your own clinical work.So what's the difference between a job and a business? If everything depends on you being in the chair day in and day out, it's still a job—no matter how successful it looks on paper. A true business is built to operate and generate income even when you're not there. That shift in mindset is what separates operators from owners.George breaks down a practical path to get there, including how to build around multiple providers, improve efficiency, and create systems that support long-term growth. From bringing on associates to optimizing your space and team, it's all about creating a structure that doesn't rely solely on you. Ready to take the next step in your dental practice journey? Visit https://sharedpractices.com to learn more about our Buyer Representation and Coaching services, designed to help dentists buy, grow, and optimize profitable practices. You can also use our Free Look to evaluate dental practice opportunities with real data before making a decision. For daily Dental Moneyball insights, strategy tips, and updates, follow us across our social channels.

I've had hundreds of conversations with orthodontists about DSOs, OSOs, and private equity—and here's the truth: most of you are making decisions based on incomplete, outdated, or just plain wrong information. In this episode, I sit down with Connor Jorgensen, Director at Tusk Practice Sales, to cut through the noise and talk about what's actually happening in today's market.If you've ever wondered what your practice is worth, how equity really works, or whether you're leaving money (or opportunity) on the table… This episode will give you clarity—and probably challenge a few assumptions along the way.Quotes“When someone tells you you're going to get a 5–7x return on your equity… that's unrealistic. If you're making decisions based on that, you need to run for the hills.” — Connor Jorgensen“If you're going to count DSO equity as zero, then you have to count your private practice as zero too. You're just trading one form of equity for another.” — Connor JorgensenKey TakeawaysIntro (00:00)Why “just say no to DSOs” is bad advice (00:16)Connor's background and insider perspective (04:08)OSO vs DSO vs multi-specialty: what actually matters (06:24)How brokers work—and who they really represent (09:09)Equity vs cash: what orthodontists misunderstand (11:19)Why 5–7x equity claims are misleading (13:12)The biggest mistake advisors make about equity value (16:18)Why selling often beats holding long-term (18:07)How OSOs improve profitability overnight (24:55)Cultural myths: what really happens after you sell (28:02)Why education—not opinion—should drive your decision (29:57)Additional ResourcesConnor and the team at Tusk Practice Sales will walk you through a complimentary orthodontic valuation analysis—no pressure, no obligation, just real numbers and real insight so you can make the right decision for your future.

Brannon Moncrief is the Principal and CEO of McLerran and Associates, where he helps  multiple surgeons buy and sell their practices every year. Join us as Brannon shares insights  from more than 25 years in buying and selling dental practices, including how to prepare for the  inevitability of selling your business, considerations for selling to DSOs, and the status of the  dental market in 2026 in comparison to previous years. Brannon shares what is trickiest to  navigate about the transactions he deals with and offers valuable advice for practice owners  pursuing DSO affiliations, from early planning to knowing your options, finding the right partner,  creating a competitive environment, and more. Join us for an incredibly informative conversation  about the complexities of selling your dental practice and how to get the best deal possible.  Key Points From This Episode: • Brannon's background in the financial side of dentistry.  • The story of how he purchased McLerran and Associates 15 years ago and grew the  business. • Why selling your business is one of the inevitabilities of life and how to prepare for this.  • Common reasons an OMF surgeon might decide to sell to a DSO. • The status of the dental market in 2026.  • How DSO deals are typically structured: equity, structure, and more. • The trickiest thing Brannon and his colleagues deal with on a day-to-day basis. • Advice for practice owners pursuing DSO affiliations. • The importance of creating perspective and optionality for the right partner. Links Mentioned in Today's Episode: Brannon Moncrief on LinkedIn — https://www.linkedin.com/in/brannon-moncrief-aa681272/ Brannon Moncrief Phone Number — 512-660-8505 Brannon Moncrief Email — brannon@dentaltransitions.com McLerran and Associates — https://dentaltransitions.com/ Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/ Dr. Grant Stucki Email — grantstucki@gmail.com Dr. Grant Stucki Phone — 720-441-6059 

Welcome to the second episode of Group Dentistry Now & Black Talon Security's Dental Cyber Watch Live. As cyber threats evolve from basic extortion to destructive warfare, Dental Service Organizations face an entirely new landscape of risk. In episode two of Dental Cyber Watch Live, Gary Salman (CEO, Black Talon Security), Brian Colao (Director of Dykema's DSO Industry Group), Michael Friguletto (CEO, Beacon Oral Specialists), and Bill Neumann (CEO, Group Dentistry Now) unpack recent high-profile breaches and discuss how DSOs must adapt. The clear message for dental groups of all sizes: annual security checks are no longer enough.  

The Bulletproof Dental Podcast Episode 431 HOSTS: Dr. Peter Boulden,  Dr. Craig Spodak and Ian de Jongh DESCRIPTION In this episode, Peter Boulden, Craig Spodak, and Ian  De Jongh (CEO of Bulletproof) explore the critical role of accountability in dental practice management and how it directly impacts growth, hiring, and team performance. They break down effective hiring strategies, emphasizing the importance of involving team members, setting clear expectations, and building a culture of ownership. The conversation also dives into associate development, highlighting the mindset required for long-term success, the importance of mentorship, and creating clear pathways to partnership. With insights on retention, motivation, and the evolving role of DSOs, this episode provides a practical framework for building a high-performing and aligned dental team. Want to be on MyStory? Email MyStory@bulletproofdentalpractice.com. If your story is selected, you'll join Peter and Craig on the podcast. We also launched the Bulletproof Hotline. Call anytime and leave a message to share your story, ask a question, tell a joke, or leave a note for Peter and Craig. We'll listen and respond with real-world feedback. Hotline: (561) 933-5575 TAKEAWAYS Accountability is a key driver of action and results in practice management Involving team members in hiring improves culture and long-term fit Clear communication of expectations sets the foundation for success Hiring slow and firing fast leads to stronger teams Empowering staff in hiring decisions builds ownership Motivation is tied to individual drive and long-term goals Associates need clear career pathways to grow and succeed Partnership opportunities attract and retain top talent Monthly check-ins support new graduates and associate development Understanding practice performance and financials is essential Mentorship plays a critical role in developing dental professionals The dental industry is evolving, requiring adaptability and strategic thinking   CHAPTERS 00:00 Introduction to the Hotline and Its Purpose 02:47 Accountability and Action in Practice Management 06:03 Hiring Strategies and Team Dynamics 11:46 Empowering Team Members in Hiring Decisions 15:11 Mindset and Motivation in Associate Growth 21:40 Navigating the DSO Landscape 25:19 The Importance of Partnership Pathways 30:07 Understanding Associate Dynamics 34:49 Key Questions for Associates 38:54 Announcements and Closing Thoughts REFERENCES Bulletproof Summit Bulletproof Mastermind  

On today's episode, Dr. Mark Costes sits down with Kyle Francis of Professional Transition Strategies to unpack the current state of the DSO and private equity marketplace. They dive into why valuations for single practices remain strong despite industry noise, how interest rates are impacting large group recapitalizations, and what's really happening behind the scenes with private equity-backed DSOs.   Kyle shares insights on deal structure, liquidity challenges, and why smaller practices continue to be highly attractive acquisition targets. The conversation also explores the pros and cons of selling to a DSO versus a doctor-to-doctor transition, including autonomy, risk, and long-term upside. This episode is a must-listen for any dentist considering a transition or trying to understand where the market is headed next. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://professionaltransition.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

What if the reason your practice is not scaling has nothing to do with systems, marketing, or hiring? In this episode, Dr. Bryan Laskin explains why so many DSOs and growing practices struggle to scale despite strong leadership, capital, and systems. The real issue is variability in patient experience and a lack of clarity, connection, and confidence. If you are a dental leader, DSO executive, or practice owner looking to scale effectively, this episode will challenge how you think about growth and refocus you on what actually drives results.

Heather Trombley, President & COO of DentalEZ, Jinesh Patel, Cofounder & CEO of UpTime Health and Dr. Scott Kalniz, CEO of Kalniz Consulting discuss: Shift from large capital purchases to predictable monthly subscriptions Smart connected equipment = predictive maintenance DentalEZ, Uptime Health & Darby partnership Much more To learn more about TotalOP visit https://dentalez.com/ & click on the TotalOp link.  To learn more about Uptime Health visit https://www.uptimehealth.com/ Connect with Dr. Scott Kalniz on LinkedIn - https://www.linkedin.com/in/scott-kalniz/  

Kiera is a guest on The Zero Balance Podcast with John Stamper! She and John discuss the advancement of software over the past few years, and why the current culmination — artificial intelligence — isn't something to be skittish around in your practice.  Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Hello, Dental A Team listeners, this is Kiera. And today we are sharing a guest interview I did on another podcast. And it was too valuable not to bring you guys here.   this episode, you're gonna hear this host lead the conversation and then I'll wrap us up at the end. I cannot wait. It was truly one of my most   incredible episodes and I truly hope you enjoy.   John (00:19) What's going on everybody. Welcome to another episode here on The ZeroBalance podcast brought to you by the team at Quanta Suite. Very excited to keep this thing going. Uh, our last conversations and episodes crazy to think it's 2026 already were at the Dykma conference. And I had the privilege of spending time, not only with the Quanta Suite team, but also a lot of great individuals that came on the podcast and talked about what they were seeing in that case, it was in the DSO space. Uh, I'm very excited today to   be with Kiera Dent from the Dental A team. I've known Kiera for many years. We were actually just talking before we came on here live. ⁓ she is doing a lot along with her team to help dental practices, take things to the next level. she's been in dental for many, many years. And so we're going to have a conversation today, ⁓ kind of around all things AI and automation and love to have her, you know, kind of share with all of you what she's seeing, you know, her and her team are working with dental practices on a daily basis. And obviously, you know, the Qantas suite team is, is creating.   their software in an effort to be able to support practices in the RCM world. But Kiera, it's such great to have you here. How you doing?   Kiera (01:26) Oh my gosh, John, it's great to see you again. And I love chatting about all things dentistry. I love having the last name dent. I love dental. love AI. love, um, it's crazy. Dental A Team hits 10 years old this year, which is like absolutely wild. Uh, 2026, I was getting ready to, know, writing my goals out and I was like, Oh my gosh, I turned 40. My husband turns 40. We've been married for 15 years and Dental A Team hits 10 years this year. So   ⁓ and I bring that up only because like, it's like a trifecta of a cool year for me. ⁓ but I think as you were discussing, like being in dental consulting for 10 years, having worked in front office teams, having worked at a dental college, having owned dental practices, having bought and sold, having consulted like 300 plus offices physically, ⁓ watching the DSO emerge, watching AI come in. I just think it's really like such a fun time for us to be in dentistry and so many great advancements and, yeah.   In Dental A Team, we are obsessed with doctors and teams, like getting them aligned, getting them streamlined, helping dentists be like CEOs and owners of their practices. We love ⁓ Josh, we love what he's building in DCS and now in Qantas. We think that they're doing some really fun, incredible things. And Dental A Team, we're just really big on, I think, streamlining dental practices, helping them say yes to more things. So getting them in their vision, getting financially free and profitable.   and then getting systems and team development to support that. And AI is definitely being a big player. And I think dentistry is, it's so fun because it's been such a, like, I think slow roll on evolution in certain ways. Sometimes I think we are very archaic. My husband's in healthcare and medicine and he's like, wait, that's your guys' software. I'm like, don't judge. I know it's a little dated. He's like, they didn't even have that when I started my career 15 years ago. ⁓ But I think,   to watch dentistry evolve into AI and automations and different things. I think we are in such a special time. So yeah, we work with solo practices. We work with multi practices. We work with emerging DSOs. We work with DSOs. We've got consulting for kind of a broad spectrum and kind of our sweet side, like two to five to $10 million practice. ⁓ We definitely have built a lot of things that can help multi offices, but yeah, we really love those offices that are obsessed about team, about culture and about.   just positively impacting the world of dentistry in the greatest way possible. So John, super excited to talk about it. I feel like we just have like so much knowledge to bring to the table and just rift and discuss and give your listeners hopefully a fresh, fun, positive perspective on the world of AI dentistry and of course bringing team and doctor perspectives to the table for you today.   John (04:03) Well, thanks for sharing that. you can see, everybody, Kiera comes with a ton of energy, but it is rooted, as she mentioned, in years of experience in this industry. And here's where I wanted to start, Kiera. So I want to go back maybe like five or six years in dentistry when there was a lot of new software platforms that were coming to dentistry, patient engagement, right? It was like this big giant party and a lot of practices were excited. You may remember though, as someone that works directly with the dental practices with as much   excitement as there was there also was a little bit of overwhelm right because it's like where do we start like how do we build these in and it's funny that you talk about your husband because yes in dentistry these are all somewhat kind of new to the industry and so practices are figuring how to use them and I do feel like okay maybe a couple years ago with like firms like yourself that have really helped these practices figure out how to utilize them they got that under their belt and then   here comes AI, right? And here comes this whole new way for these practices to be able to communicate, you know, task orient and all that stuff. So that's kind of the first place I'd like to start is that when you look at the work that you do now with the dental practices and I say the word AI, where is everybody's heads?   Kiera (05:13) Yeah. and agreed. I think, I think that this is just evolution of business. Like if I were to like even simplify it down, I think dentistry has been so much like we drill teeth, we fill teeth, but I'm like, guys, we have evolved. We don't do wooden teeth anymore. we've evolved and now there's laser and there's PRF and there's more advancements to dentistry that we do. Like I have a practice, I call them my PRF powerhouse and they've added PRF to their practices and we've added multi-millions to their office.   But like, yes, financially, that's been amazing, but their patient care has gone up so much, like the amount of results we're seeing. so when people are like, software's AIs, I'm like, hold on. You have evolved in your dentistry and you've seen how much it's evolved and how much better it is. I mean, the way we used to do crowns compared to how we do crowns, we can do same day crowns. We look at how we do ortho. We look at the different like skill sets that we've been able to add in. I feel like AI is the same thing. And I think when we get a little skittish, that's actually where I feel like we're   at more danger of a society. as I don't want to use the word old John, but I'm like, Hey, if you're not going to innovate and like you're going to die. there's innovate or die. We've got to grow and evolve or we're going to be left behind. And I mean, I think we see that with certain practices who elected no, no, John, I'm not going to have online and online. No, they're going to see my sign. They're going to drive by. This is how I'm going to be. Well, if you don't have an online presence today,   you're pretty much not visible anywhere in the world. No, no, no, John, I'm not going to do Google reviews. I don't need to do Google reviews. Well, Google reviews are how people find you. And now it's becoming AEO where AI is actually now searching for offices. I mean, we just did a trip to Iceland and where did I go? Chat GPT. And where's my next place I go? I go to Instagram, TikTok. What are the best places to go? No, John, I don't need to be on social media. We don't need to have that presence. We have our marketing. We send postcards.   Well, if you're not on Instagram, people are going there now. They go check your Google reviews and then go check your online profile. So I think for dentists to maybe recognize that high five, like you actually have evolved over the last several years. You've evolved. You are morphing and as businesses, it is an innovation or it is a die. And so when we talk about AI, AI is going to be awesome. You guys, AI was created. Like I think so much of the reason it took off is because we had 2020, we shut down.   Then we went through 2021 of the great resignation. We could not find people. You want to talk about hygiene shortages? Well, great. Now we're able to bring in people and you're like, but AI is not going to replace hygiene. Correct. But AI is actually helping with perio charting and different pieces that we're able to utilize. It's cutting down our costs that we're able to have on some of the billing and the revenue cycle management that we actually have alleviated funds to be able to pay the higher costs of hygiene that's offsetting. So our businesses can still be profitable. So when I look at it from a business,   I think guys, welcome to 2026, welcome to AI and get excited about it. And rather than being afraid of it, let's start to embrace and you don't have to be the earliest adopter, but I will say similar to like, I'm not going to join the internet. I'm not going to have Google reviews. I'm not going to do Instagram. We have watched that those who wait too long, I'm not going to do online payments. John, that's my favorite. Like we still expect checks. I don't even know how to write a check guys. Like truly I'm like, who accepts checks? ⁓   But things like that are so dated and so cumbersome compared to how the world's evolving that you are niching yourself more and more, more to less and less and less of a patient base. And if that's your exit strategy, rock on, it's a great one. But if you're not on the exit strategy, you definitely need to get on board with AI. And I think like we have a practice in Maryland, she's a pediatric practice and she's like, we call it AI Amy. And well, yes, our team gets annoyed with ⁓ AI Amy. They've trained an AI bot to be able to schedule for these   DC parents that want to make appointments at all hours of the day and they want to talk to someone. AI Amy schedules and guess what? AI Amy schedules about 75 % correctly and the team's annoyed and the doctor's like, you never get to be mad at AI Amy because that was 75 % of patients that we didn't even have to schedule. 25 % were a miss. Perfect. But that was 25 % out of 75, like a hundred percent. We, that's a quarter. We've literally cut down our space. And so I think when it's looking at   scheduling tools, revenue cycle management, ⁓ looking at how we use it for hygiene. Doctors like using Pearl or ⁓ Overjet to help with diagnosis. Case acceptance is going up. And while it's not perfect today, I think getting in the language, getting in the familiarity so you don't accidentally get too dated, AI is going to take off faster than anything else. If you're not on chat GPT, if you're not utilizing it for things, it cuts down man hours and people are like, but I don't want people to lose jobs. And I'm like,   You're not, we're elevating, we're lifting up our practice and we're morphing into where the world and society is going and your practice and your patients will thrive because of it. So that's my take. And I know I kind of went on a soapbox for you, John, but I think doctors need to realize it's not as scary as I think maybe some of them are looking. ⁓ It's something we've always done. It just looks different today.   John (10:22) Well, I'm glad you shared all that because I've been talking with people a lot lately and I feel like in unknown times or times where many of us don't know kind of where things are going to be, it really calls for leadership. And I think that's what's important. I think that's what you shared. think that practices are looking for people like yourself and others that are living this. They've dove into it. They're embracing it. They're learning how to get the maximum out of it. And so I glad you shared that. All right. So that's the first piece, right? That's kind of like the overwhelming the tech.   you mentioned a little bit about revenue cycle management and I wanted to get your thoughts as well on this other thing that dental practices are facing which is patients now come in and are having the same type of expectation of the experience on the business side of the practice, their billing and their payments and all of that, that we have with other businesses that we work with.   And so now a dental practice is getting questions as you know so well, like, okay, like am I gonna be able to pay easy? Are we gonna be able to track all this easy? Because that's how we do it with other businesses. And now all of sudden the dental practices have had to wake up and they have to make sure that that part of their practice is also, you know, automated and where it needs to be. So love to have your thoughts on that part as well.   Kiera (11:37) Yeah, and John, just to piggyback of where you were talking about dentists getting on board, I will just plug, and this is why we built an in-person mastermind, is because I recognize dentists feel like they're on isolated islands. And when you can get around really smart, you are the equivalent, proximity is power. And so getting around dentists that are not afraid of this, being in groups, listening to podcasts like this, if we can serve on that, rock on, I'm happy to do that. I would just encourage you to...   surround yourself with smart people that are getting involved in this and people that push you out of your comfort zone. People that have voices that are maybe not the same of what you normally listen to. Like if you're always listening to Fox News, maybe listen to CNN or if you're listening to CNN, then go to Fox. Like you need to hear opposing opinions on this. And I would just really encourage people to be a part of innovation rather than being destroyed by innovation would be my recommendation. And then going into this patient payment.   John, it makes me laugh because dentistry and I did a podcast, I should go find it. was several years ago and I'm like, why is dentistry on payments? Like we're in the 1800s, like put it on my tab. I'm like, what is going on in dentistry? Like nowhere else do you go and you're like, got my groceries, but could you put that on my tab, John? Yeah. Yeah. But yet in dentistry, we're like, yeah, we'll bill insurance and then we'll charge you for that. What are we doing? And I just think like,   Our revenue cycle management in dentistry is so dated and archaic that I'm like, ladies and gents, it's an amazing way for you to make a lot more money with a lot less effort if you just update a little bit on your revenue cycle management. Like we are so archaic ⁓ and dental insurances are using AI. Like why do you think Pearl and Overjet exist? Well, you better believe that the insurance companies are ripping that too. They're using AI to see their claims.   ⁓ so with payments and patients, do think like patients are expecting us to have online scheduling. They're expecting us to have easy ways to pay. mean, I've even seen some dental offices that take payments in Bitcoin and I'm not here to say you need to go clear to Bitcoin or like some extremes, but I do think that there's this evolution of, I don't want to wait a long time. I don't want to have weird payment things. want to people like John, I think it used to be the society where we worked eight to five.   We left our work at home. didn't have computer or at work. We didn't have computers. Our phone was a landline. It would shut off and we were home. That does not exist anymore. So most of the time I feel like our eight to five is our quiet time at work. And then after hours we're like, ⁓ I need to pay for this and I need to take care of this appointment and I need to schedule the kids for this. And we do that while we're sitting in bed scrolling through Instagram and like, shoot, I need to make that payment.   I feel dental practices, they have such an amazing opportunity if they will update and use more modern, I would say, like it's not even AI guys. We're just talking about getting onto the playing field. If you would do that, I have watched practices that implement these processes, their AR, their collections, their profitability are exponentially more, I would say consistent and constant as much as...   as opposed to being like inconsistent and fluctuating like they were in the past, because patients can pay all the time. Patients can send things forward. And I do think like, yes, dentistry people want that good old home, like girl and dentists that like takes care of them. But I think a lot of times the way you've evolved with technology also helps people see how have you evolved in your dentistry as well. I do not want to go to somebody who's still paper charts. I get concerned about   Are we up to speed on our current things? That's so foreign to me. No one else does that anymore that I think we to be careful that we don't accidentally date our dentistry by not being up to speed on our payments as well.   John (15:27) So you just built the bridge to the next thing I was going to ask you, right? So we talked a little bit about technology and embracing it, the patient experience and what they expect. And then this final thing is the perception of the patient in looking at the practice and the technology that the practice invests in. And again, 10, 15 years ago, when maybe dentistry was not as proactive and patients were just going to the practice. Now practices are, it's more competitive. There's more practices in every city, many across the country.   And so with that becomes this image that you portray to the patient and your business that you are making those investments to stay up to speed to be able to provide those types of services. And so talk about that a little bit. And I think that   for many dental practices, like for many of us that are entrepreneurs, like we've lived in this ROI world, right? If you ever were someone that had to raise cash or capital, you get those questions. And from a dental practice perspective, right? It's like, okay, we're going to make this investment in technology and rightfully so. What's the ROI on this? And I do think, and I loved your thoughts on this, that companies are doing such a better job of being able to paint that picture of, okay, you're going to make this investment. You're going to put this technology in the practice. It's going to make your patient experience better. But here is going to be   the return on investment, you are going to unlock a lot of your AR that's out there, make things easier for your patients. So talk about that a little bit.   Kiera (16:50) Yeah. I'll just get like paint a story of a practice. So there's a practice in Texas and this practice is amazing. Like they truly have a castle of an office. am blown away at how stunning this practice is. They are up to par on all the latest technology. They do a lot of these items in their practice, but what they were doing was the patient came in. So the waiting room was beautiful and they would just walk the patient straight back to the back.   Now this is a practice who's been around multi-generations of dentistry. They do service in other places. They have a state of the art lab they do in-house. Like it is a practice that should be showcased and they were struggling and their revenue was down and we went in person with this office and we consulted their team and we taught them like, we're going to have you guys take them on a patient tour. like, this is a pretty large team. think there's about 35, 40 people and we like made them role play walking through this practice and showcasing.   this ROI items that they've put into it. I you guys are using this, but do your patients actually know that you're doing it? So we do this, we implement it, we track a few things with them. Fast forward two, three months post visit, their reviews exponentially went up, their new patient counts went up, their revenue, they had their highest revenue number they had ever had and their culture of their team was happier. And I was like, I don't think I can sit here and say it's a coincidence. So like the patients love the tour.   Like they love seeing this practice. They love seeing what's going on. And what is as is it just gives confidence. And I say, John, if you and I were to go to ⁓ a surgeon, right? I'm going to want to know that that surgeon is the best freaking surgeon and that I'm going to put my confidence in them because I only have one arm, one hand, one leg, one neck. We'll have one set of teeth too. And so helping patients get the perception of who you are as a dentist and showcasing, I have seen like I've worked in hundreds of practices.   And some of my best offices do not showcase like they're the best and perception is a lot. Now there's some practices who actually are not great dentists and they showcase like they're amazing. And so you've got to make sure that who you are is what you're doing. But the ROI, and I wanted to showcase that practice, they have invested in a lot of this technology. They have invested in advancing their practice and it shows and they're able to show their patients. And we had direct correlation of higher reviews, higher new patients and higher production. And so I think.   Just that example, and this was done just a couple of months ago. We were out there in September and in December they had their highest month. So it wasn't a long-term ROI churn. It was very quick. so I think in general, medicine has evolved. think across the board, we're talking healthcare as a whole has leveled up. They uptick higher. Patients are expecting more. I mean, we go anywhere and technology is higher. You go to the movie theater, you go to the restaurants.   everything has upleveled. And if you and your practice are not up leveling, and I don't think it's hard for dentistry, I'm like, you guys already have a 3d printer or you already have a scanner or you already are taking digital x-rays. Just tell your patients, you do this showcase it around because I think the, the fallacy that you might fall into is like, but patients are just loyal to me. I think I to be careful because there's so much online noise that while a patient might love you,   they're seeing other offices that might accidentally take away your patients and they're doing it. Like it annoys me, John. I have a patient sitting in my chair and like, yeah, I just went to Dr. Thompson down the street from my ortho. I'm like, so we do ortho here, but they didn't know we did it. And so don't accidentally not showcase your work and showcase how great you are and how up to par you are that you're accidentally losing patients that are silent levers of your practice. ⁓ because you didn't showcase how great you were and let your patients know what you actually do.   I think that's the trap and the opportunity if you take it to be able to keep your patients with you and keep them happier with you when there's still noise and chatter because they know they're at the best practice that's investing and elevating and giving them the best patient care they possibly can have.   John (20:52) Yeah, I've been thinking about that a lot lately, just this kind of invisible credibility that comes with what you just talked about, which is when a business, in this case, a dental practice is making the investment in these newer technologies. A lot of times as patients, we don't say it, but we know, like you said, you walk into a practice and you see there's in your own life, you know what it took to remodel your house or to get a new car or whatever the case may be of the things that are important to you. And so I think more and more patients know   and understand what a dental practice or a business has to go through when they up their game. I believe that you get a lot of credibility out of that, right? Versus maybe the one that doesn't do that. Maybe the thought becomes whether it's real or not. Hey, why aren't they doing that? Like are things not good here? Like, do I have something to be concerned about? And in many cases, perception is reality. And again,   It's going to run through to patient care. We all know that. think the last thing I wanted to get your thoughts on, and you talked a little bit about earlier was AI in the sense of case acceptance because you know, you and I both have been in this industry for many years and have watched all the courses that dentists and hygienists and dental assistants have had to take on how to present good treatment and get case acceptance.   and we've watched them struggle for many years, Kiera, and then all of a sudden we have these newer technologies where you can show the patient where the work needs to be done in their mouth. And it's crazy, right? All of a sudden, I'm like, wow, that's me? That's where I have to get work done? the dentist is like, I've been telling you this for like, why didn't you just believe me? And in front of our eyes, this technology is now instilling confidence in the patients. And ultimately, it's a win for everybody.   Kiera (22:36) Yeah, think it's such a beautiful time for dentistry right now because we've been living in shades of gray for so many years. We advanced from like little tiny thumbnail ⁓ x-rays to on the screen x-rays that are still in gray to now having AI that can show patients exactly what's going on. And it's colored and it's showing them and it's giving measurements. And I think like what an amazing opportunity for you.   to use tools at your fingertips where you're not having to try to convince a patient of like, can you kind of see this like little gray box within this like other gray box that they truly cannot see? To now, this is what we're seeing. This is how it is. And to still give the doctors the liberty to be diagnosing. I know some have said that like AI is so aggressive on it. And I'm like, you don't have to diagnose that, but you now have a tool that's going to at least highlight. And I think dentists, you're so busy. You're running from exam to exam to exam. You have something.   that can look for all these things, prep it. You can train your eye. You can tee up all your associates that come in. Your hygiene team can learn collectively and your patient now has visible proof. It's like the, and I know dentists hate being compared to mechanics and I'm very sorry. I think it's just such a good like analogy. I go, you know, right? Like I go to the mechanic and like, here, you need new breaks. And I'm like, but do I really? Cause I've been scammed so many times patients like, do I really need a crown? John? Like, are you sure?   John (23:50) analogy I say because   Kiera (24:02) And we have taken that guesswork of, you sure? To being able to show them with black and white proof to where they're bought into it. They know they're not being scammed by you. They can see it with their own eyes and they're much more likely to accept treatment. I say, like confidence is what people are buying when they're saying yes to dentistry. Confidence is what increases your case acceptance. And this is a layer of confidence for you as the dentist, for your patients to see, for your team to all speak the same language.   care if AI is over diagnosing, don't over diagnose. You are still the doctor. Like this is just a tool in your tool belt. But I think it's something that hands down, I am so pro using it. I'm like, doctors also be so vigilant because insurances are denying claims based on the same software. Like they're using AI as well. So you might as well be in the game with them to see what they're seeing, to learn, to educate AI. So you're a part of it.   They use AI in medicine all the time. They use AI overlays on their x-rays that I'm like, yes, I get that it's not perfect. Yes, I get that it's clunky, but gosh, it's a freaking good tool that I would strongly advise you trying out, getting to know, using and learning. Even if it just helps you. I think about it. If I'm able to get 1 % more on case acceptance, go look at everything you're diagnosing. Usually that's a pretty good uptick, but not even just on your bottom line, but on the amount of patients you're able to help and serve. ⁓ why not?   Like what, what are you holding back on? I would just say, don't be afraid. Like just get in the game because you'll learn it's a lot better for you than it is scary. And there's a lot more good than there is harm.   John (25:39) Yeah, no question. Well, here's how I want to bring us home. You work with a lot of dental companies and I believe that this gap that I've seen for years between like the companies that are bringing the technologies to the dental practices and the practices themselves, it's exciting to kind of watch that gap close, right? Like I'm seeing more and more companies kind of listen and say, hey, what problems are you having? How can we utilize our resources to help you solve these problems? And you know,   We talked a little bit about at the onset, you know, the relationship that you have with Josh and DCS or whatever. And what's exciting is that you have companies that are starting, ⁓ and doing and solving one problem and then taking a lot of that feedback and then creating, you know, in this case, another technology platform and an effort to kind of elevate that problem. I mean, to be able to solve that problem with their solutions. What's that been like, right? Like talk a little bit about when you watch these companies evolve and continue to listen to the dental practice and bring these technologies to help these practices.   practices up their games.   Kiera (26:41) Oh, I think it's amazing. Actually. I am such a pro. Like I'm on a couple of different boards as well. And I think it's something where when I look at it, I'm like, why are these people doing it? And it's because we love dentistry. Like I look at Dental A Team team and what I used to consult versus what we consult now, like there's DSO, there's different needs than what a solo practitioner has. And so Dental A Team evolved and we became something of what are we going to do to serve the DSO thing and still be able to give back.   What is Josh with DCS? Like we heard this, we saw the need and we built something to help on that other avenue. To me, I think like, how awesome is it that you have people that are in the weeds, in the trenches have been here? I mean, I've got a decade of consulting, not to mention my like five years prior to that of assisting and all the other things prior to before that, like five more years. Like there's so much, like you have people that are so embedded in dentistry and they've seen the evolutions.   that they're willing to come forward. They're willing to execute. They're willing to stamp. They're willing to work hard to evolve these products and softwares to give back to you. And I think like people who are deeply rooted in dentistry, building these products, they're the best ones. Like I watched Modento, which I'll just give them. Like they were built by a hygienist and a dentist, and they were able to be one of the best softwares when they first started that I've ever seen. I'm like, I could tell this was built by people that got it. And so watching DCS like,   They get it. They're in the trenches. They've been watching this. They know what they're doing and they're moving it forward. We've been watching offices. We've been working with DSOs. We see what the nuances are and we build and create stuff to serve the dentist. Gosh, I just think it's magic and I think it's beautiful. And I think like, how lucky are we to be in these spaces to have people that have had enough time in the industry to know what the next layer is that you need before you even know. It feels like Henry Ford to me in a little bit like,   They said, if I give the people what they want, they'll want a faster horse. But if I give them what they need, it will be a car. And they don't even know that they need that yet. And I think that that's where we're evolving is being able to anticipate the needs of what offices need prior to them even realizing it's a need. And that to me is like just epic and incredible of a society and a community that really wants to give back and serve and make dentistry the best it can be.   John (28:55) Well, and who would have ever thought that a dental company would take the time to create a podcast like this, the zero bounce podcast, right? As a way to continue to add value and of course, invite amazing guests like yourself. I can tell everybody. I remember, I don't know how many podcast episodes Kiera has done, you know, in the past over many years. I remember the actual weekend that she was building and putting up those black panels behind her. ⁓ and so it's like, you know, you're, you're, you're definitely   listen to someone, you know, when you talk about someone that has rolled up their sleeves and dug in an effort to move dentistry forward, Kiera, you certainly have done that. And, ⁓ I know the DCS and Quanta Team really, really appreciate you taking the time out of your busy schedule to show your passion. And I think more importantly, help dental practices bridging a lot of these technologies and how to implement them. So any final thoughts as we wrap.   Kiera (29:47) Yeah, well, huge appreciation, John. And thank you for helping me with the background, because I definitely asked for you and your help and your insights. So appreciate that. I love it. Thank you. But I think, again, it's an evolution. And I would just say AI is going to be awesome. And there's going to be glitches, and there's going to be problems with anything. But I think the more we can embrace and we can innovate, we're either going to innovate or we're going to die. And we're going to be either on the path forward or we're going to be left behind.   John (29:55) So good.   Kiera (30:14) I think, Denissure, we have such a beautiful gift to give people confidence and clarity and smiles and health that no other profession is able to do. So I think it's just a moral charge for each of you to look to see where is maybe one area of AI or advancement that I'm willing to step into this year. So I commit to not getting dated. ⁓ And I think DCS and the Qantas team are a great place to start. think on our side, if there's anything we can do with team, with consulting, with...   like shoot, hate doing this. I don't want to go rally my team. Great. We love to do that. We do the part that no one likes to do just like DCS. They do the part of billing that no one likes to do. ⁓ I think we like do the dirty work of dentistry, but we love it we have a passion for it. So if we can help them serve in any way, TheDentalATeam.com Hello@TheDentalATeam.com. ⁓ huge partners of DCS and have referred many people to them over the years and just excited for what they're doing. So be excited guys. We live in the best times. We live in the most innovative times. And I think it's just.   a really amazing miracle that we get to be a part of dentistry and the changes. And I think everybody needs to realize what you do or don't do is going to have an impact on our future of dentistry. And I think that that's a moral charge each of us should take to be able to preserve the sanctity of our dentistry. That doesn't mean we stop it. That just means that we're able to positively impact. We're able to keep the integrity of our profession. And each of us, think, have a moral charge to do that. And so get on board, be a part of it, be a part of the noise, be a part of having your voice heard.   and I'm truly just excited and honored and happy to help in any way we can.   John (31:45) great way to wrap. And if you're watching this on YouTube, love to have you subscribe to The ZeroBalance podcast. If you are an audio podcast listener and you're listening to on Spotify or Apple as well, subscribe. And each time the Quanta team adds a new episode like this great one with Kiera, it'll come through on your listening device of choice. So Kiera, thanks so much. Best of luck as you continue to do great things. It's a big year for you, like you mentioned, 2026. So I'm excited to stay connected and watch all the great things that you and the Dental A Team are doing. So until next time, we'll see you everybody.   The Dental A Team (32:13) All right, Dental A Team listeners, that was the guest interview that I absolutely loved. And I hope that if there was one idea that stood out to you, don't just agree with it, but actually go implement it this week. And if you need help setting this up in your practice or you need help just navigating or need a friend, head on over to TheDentalATeam.com and I'll be able to help you guys out. Click on the book of call or any way that we can support and serve you. That's what we're here for. That's what we're obsessed with. And as always, thanks for listening and I'll catch you next time on the Dental A Team podcast.

The patients who ghost you aren't going to cheaper, more convenient DSOs. They disappear because of an unaddressed threat response your practice triggered and never resolved. Disarm that first. They exhale. They accept treatment. They tell people about the place that didn't feel like dentistry. That's your real job. 

On this episode of The Dentist Money Show, Mike Baird, CEO of Accelerate Dental joins Matt to break down what's happening in today's dental market. From shifting industry dynamics to the growing influence of private equity and DSOs, Mike shares a behind-the-scenes look at how macro trends are shaping practice valuations and ownership decisions. They explore what differentiates successful practices in this environment and how dentists can position themselves to thrive. Whether you are looking to grow, sell, or simply stay competitive, this episode is all about cutting through the noise and helping dentists make smarter, more intentional decisions in a rapidly changing landscape. 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.

You've probably said it — "Nobody wants to work anymore." But what if the problem isn't your people? What if it's a management model from 1911 that somehow ended up running your practice?The Model You Never Chose — There's a reason your team does exactly what's asked and not one thing more. It was designed that way — over a century ago, by someone who never met a hygienist.The Finished Product Fallacy — You've already written off at least one person who could have transformed your practice. This is the belief that made you do it.Domestication vs. Activation — Two ways to lead in 2026. Most owners are running the first one without knowing it. The second one builds something DSOs, AI, and your competitors cannot touch.Listen now — because while you're reading this, your best team member is quietly deciding whether your practice is still worth their best. You have a smaller window than you think.

Alan is joined by Jack Minahan from Henry Schein Practice Transitions for a deep dive into the modern landscape of dental practice sales, recorded live at the Chicago Midwinter Meeting. The conversation moves past the outdated stereotypes of the transition industry, with Jack providing a data-driven look at why private practice ownership remains the dominant model despite the high-profile growth of DSOs. They explore the critical "replaceability" factor for clinicians, the strategic timing of technology investments, and how "goodwill" functions as the lifeblood of a practice's value. From navigating real estate hurdles to the necessity of an emergency exit plan, this episode provides a practical roadmap for dentists at any stage of their career to protect their most valuable professional asset. I. Introduction Live from Chicago: Recording at McCormick Place during the Chicago Midwinter Dental Meeting. Meet Jack Minahan: Transition specialist at Henry Schein Practice Transitions. The "Face" of Transitions: Moving past the stereotype of the veteran broker to modern, data-driven expertise. II. The Current State of Dental Sales Who is Selling?: Most sellers are in their 50s and 60s looking for retirement, but younger doctors are seeking lifestyle changes. The DSO Myth vs. Reality: * National data shows ~13% DSO ownership vs. 87% private ownership. Banks are still lending 100% of purchase prices to qualified private buyers. Ownership Trends: Younger doctors (10 years out or less) are leaning toward associateship, while veterans remain the primary owners. III. Preparing Your Practice for Sale The Value of Cash Flow: Why "Cash is King" regardless of how dated the wallpaper might be. Replaceability: The difficulty of selling a practice where the owner performs highly specialized procedures (implants, ortho) that a buyer may not be trained in. To Tech or Not to Tech?: Short-term (0–5 years): Avoid massive debt; focus on small aesthetic wins (paint, flooring). Long-term (10+ years): Invest in technology to stay competitive and efficient. IV. Navigating the Transition Process The Timeline: From finding a buyer to closing typically takes 3–18 months. Valuation & Appraisal: Analyzing new patient counts, hygiene retention, and overhead. Real Estate Realities: The difference between owning a standalone building versus leasing in a retail hub. Goodwill: Defining the "un-pinnable" value of patient relationships and reputation. V. Closing Thoughts The Power of a Plan: Why having an "emergency exit plan" is vital even if you aren't ready to retire. Resources: How to find a Henry Schein representative in your specific region. Some links from the show: Henry Schein Dental Practice Transitions ADA Practice Transitions (ADAPT) Join the Very Dental Facebook Group using one of these passwords: Timmerman, Paul, Bioclear, Hornbrook, Gary, McWethy, Frank, Papa Randy, or Lipscomb!  The Very Dental Podcast network is and will remain free to download. If you'd like to support the shows you love at Very Dental then show a little love to the people that support us! I'm a big fan of the Bioclear Method! I think you should give it a try and I've got a great offer to help you get on board! Use the exclusive Very Dental Podcast code VERYDENTAL8TON for 15% OFF your total Bioclear purchase, including Core Anterior and Posterior Four day courses, Black Triangle Certification, and all Bioclear products. Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code "VERYSHIP" you'll get free shipping on your order! Go save yourself some money and support the show all at the same time! The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even  their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!

Why does your dental practice get harder to run the moment you hit three locations? In this episode, Chris Hadziev from Planet DDS shares data from over 8,000+ practices on why some offices grow nearly three times faster than others. New patient flow is one of the key drivers. But the deeper story isn't just about getting more patients in the door. It's what happens next. Chris shares how one growing group had all the right tools in place, yet nothing connected. Their ops leader became the system, manually stitching together reports just to keep things running. It highlights how the 3 location mark is when systems begin to break down. What once worked at the beginning starts to create friction instead of momentum. This episode walks through what's actually driving the gap between top and bottom performers, why operational consistency beats expansion, and how small breakdowns in case acceptance quietly limit your production without you realizing it.  

In this episode of the Dental Boardroom Podcast, Wes Read continues his analysis of the ADA Health Policy Institute 2024 study, focusing on one of the biggest shifts in modern dentistry who actually owns the industry today.This episode dives deep into the rise of Dental Service Organizations (DSOs) and compares them with traditional private practice models. Wes breaks down real data on ownership trends, career stages, and practice sizes, and shares practical insights from years of advising dentists.Beyond the numbers, he explores the hidden challenges of scaling multi-location practices, the financial trade-offs of choosing employment over ownership, and the reality behind DSO deal structures.The episode closes with a strong perspective on the future of DSOs, why many may struggle in the long term, and why private practice ownership remains the most powerful path to autonomy, control, and wealth in dentistry.Key Takeaways1) Ownership Trends Are Shifting Younger dentists are moving away from solo ownership. The majority of older dentists still prefer private practice.2) DSOs Are Growing, but Not Dominating Only a small percentage of dentists are DSO-affiliated. Most practices are still single-location setups.3) Scaling Is Harder Than It Looks Expanding beyond one location adds significant complexity. Many dentists struggle in the “in-between” growth phase.4) Stability vs. Wealth Trade-Off DSOs offer more predictable income. Private ownership offers significantly higher long-term earnings.5) Small Income Gap = Massive Lifetime Impact Even a $50K annual difference can lead to millions lost over time.6) DSO Deals Can Be Misleading Higher valuations often come with strings attached. Earn-outs and equity rollovers carry uncertainty.7) Early Players Win in DSOs The biggest gains go to early adopters. Late entrants typically see limited upside.8) Private Equity Plays a Short-Term Game The focus is often on scaling and reselling, not long-term operations.9) Future Risk for DSOs Talent retention and performance consistency are major challenges. Many DSOs may struggle as original owners exit.10) Private Practice Still Wins (for Most) Greater control, autonomy, and wealth-building potential. The best path for long-term financial success in dentistry.What You'll LearnThe current breakdown of DSOs vs. private practice ownership in dentistryWhy solo practice is declining among early-career dentistsHow student debt is influencing career decisions and risk toleranceThe real challenges of scaling from one to multiple locationsHow DSOs are structured and how their deals actually workThe difference in income and long-term wealth between owners and employeesWhy many dentists may be leaving money on the table by choosing DSOsThe role of private equity in shaping the dental industryPredictions on the future of DSOs and potential market shifts

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

Dentistry is entering a new reality for DSOs and group practices. Growth alone isn't the strategy anymore. Leaders today have to manage enterprise risk, operational consistency, and long-term valuation. Dr. Bryan Laskin shares a powerful leadership framework from his mentor Dan Sullivan called DOS: Dangers, Opportunities, and Strengths. Using this lens, he walks through the three biggest dangers facing dental organizations today, the three opportunities that can unlock predictable growth, and the three strengths dentistry already has built into its model. This episode of "The Bryan Laskin Podcast" challenges leaders to rethink how they operate at scale. Because when organizations operationalize connection, clarity, and confidence across every location, they create the one thing investors, teams, and patients all value most: predictability.

In this episode of The Dental Boardroom Podcast, host Wes Read talks with Matt Coggin about how dental education is evolving in today's fast-changing healthcare landscape. They explore how dentists can stay competitive through continuous learning, team training, and effective communication, while navigating challenges like staff turnover, AI integration, and the rise of DSOs. The episode highlights practical strategies for improving clinical skills, patient care, and overall practice performance.Key Topics CoveredEvolution of dental education and continuous learningTraining pathways for early-career dentistsBlended learning: online modules + hands-on workshopsImportance of training the full dental teamEnhancing patient communication for higher case acceptanceIntegrating AI into dental practiceAddressing staff turnover and operational consistencyImpact of DSOs and private equity on dentistryKey TakeawaysContinuous Learning Is Essential: Ongoing education improves both clinical skills and patient outcomes.Support for Early-Career Dentists: Structured training helps new dentists gain confidence in procedures and decision-making.Blended Learning Works Best: Combining online modules, workshops, and coaching reinforces knowledge and practical application.Team Alignment Matters: Training the entire dental team ensures consistent patient experiences and smoother operations.Communication Drives Growth: Clear patient communication increases trust, case acceptance, and overall practice success.AI Is Emerging in Dentistry: Tools can assist diagnostics and treatment planning, but must be integrated thoughtfully.Staff Turnover Requires Planning: Structured onboarding and ongoing training help maintain efficiency despite staffing changes.DSOs and Private Equity Influence Practices: Scalable education systems are key for multi-location or corporate-backed practices.

Dr. Christina Blacher, Founder of Christina Blacher Consulting & Angela Severance, RDA, Training & Education Manager for DSOs at Ivoclar discuss: Education as a strategy not an event Standardizing treatment planning & materials Digital workflow integration Clear aligner therapy focused on function & oral health Access Ivoclar's Learning Pathways: free on-demand webinar series for DSOs - https://dso.pub/4jtCvNj Email Angela Severance, RDA: angela.severance@ivoclar.com LinkedIn: https://www.linkedin.com/in/angela-severance/ To learn more about Dr. Christina Blacher or to contact her you can visit her website: https://www.drchristinablacher.com/ LinkedIn: https://www.linkedin.com/in/christinadean/  Instagram: https://www.instagram.com/queenofinvisalign/  

On today's episode, we're sharing a special DSN webinar featuring Dr. Mark Costes and Kyle Francis, founder of Professional Transition Strategies, titled Mastering Your Practice Valuation: What Today's Buyers Are Actually Looking For. With over 600 dental transitions and 25 practices owned, Kyle brings unmatched insight into how valuations really work in today's changing landscape. Together, Mark and Kyle explore why the old method of valuing practices based on collections is outdated, and how modern buyers—especially DSOs and private equity groups—assess value through profitability, scalability, and risk. They break down the differences between doctor-to-doctor sales and private equity-backed deals, explain what seller discretionary earnings and EBITDA actually mean, and share how practice size, location, payer mix, and clinical capacity influence multiples. Whether you're planning to sell soon or years from now, this conversation is packed with strategies to make your practice more attractive and maximize its value. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

With the Oscars just around the corner, Matt, Jake, and Christine borrow a page from Rotten Tomatoes to rate some of the most common financial decisions dentists make. From 401(k)s and brokerage accounts to the often-overlooked importance of bookkeeping and financial organization, they break down which strategies actually hold up over time. They also dive into big-picture business decisions facing practice owners today, including marketing investments, expansion opportunities, DSOs, and the pros and cons of owning your practice building. Which financial strategies are fresh and which ones do we think deserve a thumbs-down? Listen to find out! 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.

This week, the Dental Amigos welcome Mustafa Shah-Khan, DDS PA, Founder of Simplify Dentistry, Key Opinion Leader (“KOL”) for Komet USA, and practicing general and restorative dentist in Charlotte, North Carolina. Dr. Shah-Khan is a nationally recognized author and advocate for independent dental practitioners, focused on clinical excellence, operations, and entrepreneurial growth. In this episode, Dr. Shah-Khan shares his journey from clinician to community builder and discusses the shift from owning a dental practice to building a true dental business. The conversation explores associates, DSOs, financial mindset, entrepreneurship outside the operatory, and how dentists can design careers with more autonomy, balance, and long-term freedom. To learn more about Dr. Mustafa Shah-Khan and Simplify Dentistry, visit: Website: https://www.simplifydds.com Facebook Group: https://www.facebook.com/share/g/16CznwDdEx/ YouTube: https://youtube.com/@simplifydds?si=c4S00rM4_zk-hiP9 Listeners who want to reach Paul can do so at Paul@DentalNachos.com and those who want to reach Rob can do so at Rob@RMontgomery-law.com.

The loan bill hits before your handpiece warms up—and it's bigger than your first apartment. We sat down with Dr. Alan Mead of the Very Dental Podcast to unpack the sticker shock of modern dental education, the real math behind associate versus owner income, and how to build skills that actually move your take-home. No five-step frameworks, just honest stories, practical tactics, and plenty of laughs to keep it human.We start with the big question: is dentistry still worth it when new grads face $4–5k monthly payments? From there, we break down the critical early decisions—whether to chase ownership for upside or remain an associate and become indispensable. You'll hear why leadership and communication pay as well as implants and endo, how to structure CE so it pays you back, and what case selection looks like when you need wins fast. We also talk about DSOs: why they can accelerate skill development and production, and how to spot the burnout traps before they grind your spark into dust.Skill building is a theme throughout: stacking meaningful repetitions, documenting questions in real time, and cornering instructors until ambiguity dies. We share the value of curation—picking a clear clinical lane, aligning your systems and team, and letting focus become your competitive edge. Along the way, we swap dental school war stories, joke about dentists opening doomed restaurants, and remind ourselves that humor is a survival skill when the numbers get heavy.Whether you're a new dentist staring down a $500k note or a seasoned clinician wondering if ownership still makes sense, you'll leave with a clearer playbook: pick a lane, get the reps, invest in communication, and let the value drive the income. If you're ready to design a practice that buys back your time and sanity, subscribe, share this episode with a colleague, and leave us a review—then book a strategy call at dentalpracticeheroes.com/strategy.Join us for Free Live Trainings and Community Discussion in the DPH Hero Collective on the DPH App.  Click Here to Join! Take Control of Your Practice and Your Life We help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams. Ready to build a practice that works for you? Visit www.DentalPracticeHeroes.com to learn more.

On today's episode, Mark sits down with Dr. Vishal Sharma, Director of Clinical Education and Operations at Spear Education, to explore the evolving landscape of dental education. Dr. Sharma shares his journey from building and scaling private practices to leading clinical education initiatives across DSOs, and now helping shape the next generation of learning at Spear.  The conversation dives deep into hybrid education models, the growing role of AI in diagnostics and training, challenges facing early career dentists, and why blending in-person mentorship with virtual and self-paced learning is the future of dentistry. They also discuss how technology, efficiency, and accountability are redefining both clinical excellence and career satisfaction for today's dentists. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://www.speareducation.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast