Podcasts about dsos

Kiera takes listeners behind the scenes of Dental A-Team, sharing what exactly happens in Doctor Mastermind conversations. This includes unfiltered Kiera and consultants sharing top-level expertise, elite doctors sharing secrets of the trade, wealth diversification conversations, and so much more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:01) Hello, Dental A Team listeners, this is Kiera and I hope today's just a great day. I really do hope that you're thriving and not just surviving right now. I hope that you're fulfilled and you're not just living there, going along and really disliking your life because I believe we get one life. So let's make it the most fun that we possibly can. You guys today, I wanna take you behind the scenes of Dental A Team. Like let's take you behind the curtain and just kinda let you see what goes on behind the scenes.   There's some really awesome things that Dental A Team is doing and I feel like it's really fun to just know like, okay, what does consulting look like behind the scenes? What things do you have in place? And I wanted you to see like what happens behind the scenes. We have Dr. Masterminds, ⁓ what happens in there, what happens with your team meetings? What does it look like? And so if you've ever been curious of what's behind the scenes in consulting, well, welcome. I wanted to take you behind the scenes. So just so you know, Dental A Team was created to help doctors and practice owners ⁓ not just survive, but thrive.   to help teams not just survive but thrive, to be able to say yes to more things in your life by being focused on what you as a person want to achieve, improving your leadership, improving your life and like truly your personal life, making sure your business is working for you and not the other way around. We also do it on profitability, making sure you're profitable, that the cash flow is there, that it's predictable, that you understand where your numbers are at and then having systems and team development. We call that the yes model so you can say yes to more in your life. So you, earnings, system and team development. And that's really what our.   the whole thing about consulting is. So what we do is we literally take you and we have an introductory call and we look to see what your practice is like, where your gaps are, and basically build a game plan with you of what is this gonna look like over the next 12 months together. And we decide, hey, where are you at? you a practice where we're gonna fly into your practice? Is this a practice where we're going to just do virtual calls with you? What's going to be the best option? And I will say our most popular and what most people want is someone to fly to the practice. ⁓ And so behind the scenes, what happens from there is once we decide what...   what type of consulting is going to be best for you and your practice. From there, then you get paired with a consultant. You're like, how do you know the consultants? I'm like, well, my background needs to be marriage and family therapy. Like literally, I'm really good at reading people and 90 % of the time we get a perfect match. And what we're looking for is your practice needs the consultant skills and what they've done because all of our consultants have a clinical and front office experience and they've all had to grow multiple practices. So some come from DSO.   All of them have had to come from private practice. They literally have been there, done that, done it successfully. And we're looking for personality types. Are you going to jive? Some consultants are very high energy and some are a little more lower energy, more calm. ⁓ What's going to pair well with your team? What's going to be like, I remember there was one office and they said, Kiera, my team. There I was like, wow, Kiera comes in with a lot of energy. We get.   along better with no BS Brit, which is true. Brit doesn't come in looking like she's a hummingbird on Monster. She walks in a calm, cool, collected. She's chill. Some offices need a hummingbird on Monster. Others need a Brit who's more calm, cool, collected. So we're looking at experience, personality fit, and then also what's going to truly drive and get the results you're looking for. So that's really how we match you with your consultant. Then after that, your consultant, you and them, get on calls. We get on calls every other week.   So we're really working with you to make sure that there's accountability, but it's not too often and you're not depending on us, but you have time to actually make some headway in between those. So it's set calls. So you always know perfect. I've got my set calls. They're also really good accountability check-ins. So I have a personal trainer and we used to do only virtual and I had a call with her all the time and I actually did better on my workouts than I do when I see her in person because I knew we had a set call and I had to show up with my results because she was going to ask me about them. And that's actually why we have these set calls.   So you always follow through on the accountability because we're really big on making sure that what we commit to, what we put into place, we're truly driving results forward. You do not need to be perfect. We just need to make sure that we're getting the results we want. We're tracking our numbers. We're looking at the P &Ls. We're looking at your KPIs. We're looking at your team. And we're also talking about the issues and the growth of where you want to go in your practice. So we've got those two calls. And then in between those two calls, you literally get to texts, calls, emails, whatever you need. At any time you have a consultant in your pocket, any moment. So whatever comes up, because business does not happen on set cadences.   at the most random times. So you always have a consultant at your fingertips. And then I think the part that I really wanted to show you behind the scenes is every single month we have a doctor mastermind. It's the first Tuesday of the month and we call it think tank Tuesday. And this is where I ⁓ tell all of our doctors, this is where you're basically hanging out in Kiera's living room, virtually. Right? Like I want you to just like let your hair down. I don't care if you're making dinner. I don't care if your kids are there. I want you as a human. I don't care if you're driving home. I don't care if you're at the swim meet. We have doctors.   all over the place because this is your real life. And I want you to just pretend like we're hanging out in a living room, let your hair down. There are no team members allowed at these think tanks because I want doctors to fill a safe space where they can talk about it they can talk about with other doctors of what's going on. What do they suggest? On here we have guest speakers that come in. We also, a lot of times this is my mastermind. This is my billion dollar club group where I just want to hang out and I want to talk about things that aren't talked about all the time.   So for example, last month we went through and we did one on a P &L deep dive. And these are things that I do not share on the podcast. These are things that are not shared publicly. These are things that I reserved specifically. So it's the 10 % that's reserved for only our Dr. Mastermind. And I'm really digging deep with them and I'm showing them things that we specifically do in our company. So things that I'm not going to necessarily publicly announce on the podcast. I share a lot of our life here, but we actually went through an entire P &L deep dive and we showed them exactly what we do in our company and how we do it how you can get your office managers there.   and how you're able to look for the profitability, how we set up projections, how we're able to grow and scale, how we're able to get right people, right seats. We did another one with org charts and we broke it down. We brought in ⁓ Prosperity and Brian Harris talking about embezzlement, things that we will never share publicly, but specifically for our doctors. We bring in different guest speakers. ⁓ bring in, we have them like work on different business models. I did one where we worked on a lemonade stand to show them how they can in crisis mode on their business, pivot, shift and adjust.   We often will do like an issues list of what's going on, what are the hot topics people are dealing with, and then let's collectively work on it. So we have a doctor who's going through some interesting things with legal within their practice and using the whole team. We have another practice that's struggling with their finances and using collectively the whole team will sometimes hot seat our offices and let them work together. So really it's, I would say it's my most high level material that ever comes forward. And I think when you see behind   behind the curtain of what's happening in the Stockroom Master Room. Like I said, you get to attend, parts of it are recorded, but then I always do what's called the after party. The after party is where I feel like it's ⁓ Kiera unfiltered. ⁓ There are no cameras going, there's nothing being recorded, there's no AI bots allowed to be in there. It is literally Kiera unfiltered. And we will talk about where we think the world's going, what we think we need to be prepared for, what we think about political pieces.   These are things that honestly I will not publicly ever speak about and I only reserve them for our doctor mastermind. And the rules of it are there is no recording. And if I ever find out that people are recording, they will be immediately dismissed because we need a space in this world as business owners and as colleagues and as entrepreneurs to be able to speak freely, to be able to speak safely, to be able to share what's on our hearts, to be able to talk about team members without our team members being there. Team members don't worry, it's not in a negative way. It's truly like, hey, I'm struggling.   I don't know what to do with this and I need help. Because what I found is in business ownership, it can be so lonely. can be so just ⁓ sad, if you will. It can be like, gosh, I feel like I just need help. And so what we wanted is to create this space. Like I said, you're hanging out in my living room. We're having these ⁓ dinner conversations, if you will, of whatever's on your mind. And it's just, it's really fun. And I feel like it's, people have told me that they absolutely love being a part of Think Tank, because it's a space where people come and they,   They just, I feel like it's something where they just are able to be themselves. It's the first time you're not expected to be a doctor. You're not expected to be the one who knows everything. You're not expected to do X, Y, or Z. None of those things are an expectation. You're able to just show up and be. You're able to show up and feel safe. You're able to show up and just hang out. And so a lot of the pieces that we've been doing are, we also have like doctors. We have some of our elite doctors share secrets that they do in their practice. So.   people on how they do branding, other people on DSO conversations. We literally had a very ⁓ controversial think tank where we brought in and we talked to pros and cons of DSOs and should I sell to DSOs and what do people think and what are people navigating because it's so hard. It's hard to find out ⁓ like, what are we going to do and how are we going to do this? And like, what are the different pieces and what should I do and how do I navigate through this of people that truly are like-minded?   that are just like you. And so other things that we have are like wealth diversification. We're talking a lot about wealth and where we're going to go with wealth and how we're going to be able to do these things and multi practices. Should we do it or should we not do it? Should we, ⁓ how do we create one through 10 year plans? ⁓ Team conversations. Tiffany does an amazing job of talking leadership and hard conversations and ⁓ strategies like billing strategies again that we're not sharing on the podcast. And so really just showing you like behind the scenes we bring in.   We had a really awesome guest come in and talk to us about how to use resources and tools to hire better and get right people right seats. Talking about like, we have some authors that come and speak to us. We have some clinical dentistry. We have offices talk about how they're able to scale and grow and real talk. Like, what are we really afraid of? Like, what's really going on in our world? Let's talk about identity loss. Like, what happens when you stop having your practice? Like, what are you going to do there? And   just different zones, different areas. ⁓ Doctors who are really smart, we had a doctor come and chat with us about associate onboarding and how they're able to get their associates producing over a hundred grand like six to eight months into practice, like to hiring them. Like that's a huge feat that most aren't able to do. And this is straight out of school. And so sharing those tips, sharing those resources, ⁓ I think is one of the most valuable pieces of our consulting because... ⁓   business owner. attend Tony Robbins. I'm in Tony Robbins elite coaching where I literally have been to his house. There's about 40, 50 of us that go and I put myself in those circles to be able to bring back information to our group of things that like I'm working with multi-million billionaires across the board, rubbing shoulders with them, asking them of things, getting resources, figuring out like what are their VA companies that they're using for virtual assistants? How are they growing? How are they scaling? There's people in medical, there's people in real estate learning from   Ray Dalio speaking to us on wealth diversification, talking to really brilliant people to find out to make sure that I am living my best, highest self to then also bring back to our doctors. Our teams are bringing back things that they're hearing from offices to be able to bring their best pieces to help them create org charts and clarity and whatever it is, those are the pieces that we're bringing into our think tank. And like I said, being an owner.   Seeing this, I wanted people to truly figure out how can I do this? Like, can I, how can we create this? How can we build this? How can we sustain this? And so having that as a space every single month for our doctors. And some months I think we have better topics than others, but always the after party is a place where I feel like people really truly come to unite, to help each other, to grow. And I think it's just a really special place. So we have our, your specific practice consulting, then we have where we'll fly to your practice. And in that day and a half, had a   really awesome testimonial from a client. said, Kiera, Tiff, Britt, Dental A Team, what you guys are able to accomplish in a day and a half visit is what it usually takes me six to 12 months to accomplish. And I feel like that is something of just huge appreciation and gratitude because our consultants really do drive value. This is not an office that I consult, it's another consultant on our team. And I feel like just knowing that that's the value of us coming into your practice, like that's the ROI that I can't explain to you until you've experienced it. It is.   getting your whole team aligned, it's getting things in place, it's fixing little things that you didn't even know were a problem that we see in other offices that we can come execute and implement for you. And really getting your whole team aligned in such a fun, easy way. So we're working on doctor, we're working on leadership, we're working on case acceptance, we're working on getting team alignment, we're listening to hygiene exams, we're looking at your numbers and metrics. ⁓ And then what we're really doing is every single month we're assessing you as a person, your earnings and profitability and the systems and team development. What do we need to do based on those numbers?   And then in addition to that, we have one other fun thing behind the scenes curtain of our consulting where we actually come in person for these in-person doctor and office manager or leadership masterminds. And they are so special. These are really like being in a very intimate setting. So we cap it right now. It's around 50 people that we bring in and we we do life and business on purpose. And so we teach you how to do like the last time we taught people how to life map and how to look at their entire life, because we were like, how do I have time to do it all?   And it's like, let's actually teach you how to do it in a very strategic way. We did leadership hard conversations and how to make hard conversations easy. And we actually practiced with each other. So we actually lined up office managers and doctors from other offices and had them actually ask the questions and role play with someone who's not your person to give them feedback on how they could actually land these conversations better with their teammates and to have both doctor and office manager they're learning.   We did almost like speed dating where we had people go with other offices and ask their questions and give value. So it's always a give and receive within our community. We hot seated offices, so like your biggest pressing issues and had a group of people help you out on it. We had everybody like list off all the issues that they're dealing with in the practice and made this giant list of issues and actually started collectively as a group, solving it, sharing resources. And it was probably one of my favorite pieces of the entire event where we all worked together to solve.   We did a deep dive on the P &L and chart of accounts and teaching people how to look at them and saving for taxes and saving for their buckets and creating the fun in life and helping team members understand this as well. And just doing it in a really positive life on purpose, business on purpose. Like we had people tell us that those in-person masterminds were worth their entire year of consulting by the value that they got, the energy that they got, the... And then we do it a day and a half. Like we have five people in Thursday night, if they want to hang out, they do not need to.   We're there all day Friday and it's half day Saturday so you can fly home. We try to make it really awesome, really easy, really intentional, ⁓ but where it's high value. And then everybody hangs out Friday night together. We wanted it to be a networking opportunity and something really awesome that we did that I don't think a lot of other people do is we built it to where we had people's strengths. And so if I'm struggling with ⁓ office management leadership, we've literally listed off the office managers or the doctors that were there. And if they were really good at it.   who you should go talk to and made it really easy for people to network, to connect, to share ideas. We had AI innovation. Just again, things that are not shared publicly because I wanted, there's a zone where I want to give as much value to this world. There's also a zone of there's 10 % that I will never speak publicly about. It's a space where I want to hold it back for our clients, not because I don't want to share it, but because.   It's stuff of, it's maybe a little highly charged, ⁓ sharing opinions and doing it in a safe way where you know that you're not judged and that people want to hear the ideas and it's safe and it's a space for us to have deeper conversations, more in depth, working on your practice for you and really ensuring that we're driving your results. And so that hopefully is just like a sneak peek behind the curtain. And what does consulting look like? What do we do in these doctor masterminds? What do we do on these calls?   Like I said, it's always looking at your numbers. It's always looking at your systems, looking at you and your vision in your life and making sure we're getting the results for you. And like I said, collectively across the board, we're always giving at least a 30 % increase in production. Now again, some are higher, some are lower. You've got to show up to the table too. We are incredible at what we do, but it's a two-way street. You've got to be ready for it. It's just like, can't expect my gym trainer to get me six pack abs when I'm eating candy every single meal and I'm not working out. That's impossible. She gave me the plan. She gave me the map. She did everything she was supposed to.   I also have to show up. And so it's two way. But I think having someone there, having somebody who checks in on you, somebody who's not going to let you fail, somebody who's so committed to you and your results and your team on your side, it's a cheerleader behind the scenes. It's one of the greatest gifts I think we could ever give any business owner and team. And that's something I think that's just really special that sets the only team apart is we do this specifically for you.   and your team. We're not just expecting you to take everything back and go implement with your team. So we hear you in our doctor masterminds, we hear you in our visits and we get the whole team bought in as well. have implementation days to help your team get bought into it. That way it's not all on your shoulders, doctors. It's not all on your shoulders. And so I thought it would just be fun today of like what really happens in these mastermind calls, what really happens in these in-person events, what really happens when you fly to our practices. And what I will tell you is as a business owner, I believe in RO.   And so our team knows, we always say Dental A Team equals results. And our team has passion for excellence and results focused to make sure that you're getting the results you want, to make sure that we are delivering at the highest value. And I will tell you, it is magic to watch offices change. is magic to watch people get their lives back. It's magic to watch people get excited and reinvigorated over dentistry when they lost that passion and that sparkle of something that they loved so much. So that just inspires you. If you're like, gosh, I really am curious if I'd be a good fit.   Like I said, I'm really sticky on making sure that we have this great community of humans. Consultants are joining us from other consulting companies and like, Carrie, I don't know what you do. You bring in the best people. And I'm like, well, great. That makes me so happy. And it really is that I want people that are like-minded. I want people that are excited. I want people that want to give and to receive. I want people who are committed to themselves. I want people who want to live life on purpose, who want to do business on purpose, who, even though they don't know all the answers, they're not afraid to ask the questions. ⁓   that are willing to help their fellow neighbor to show up and to talk about things that aren't necessarily publicly talked about and to share opinions in a safe space and to hold space for one another with no judgment, but true like care and curiosity. I want people who know that there's a higher, a next level and they want to go for it. I want people who are curious about the future. I want people who ⁓ challenge and inspire. I want people and   As I say this list, you might be sitting there judging yourself unfairly and saying like, well, I'm not that person. And what I will say is, ⁓ you actually are that person. Because if you don't think you are, you probably are. And if you are that person that's like, yeah, this is me, this is what I want to do, you are also that person too. I found that 90 % of the people that we talked to are incredible fits. The only people who aren't great fits are those who are so egotistical and arrogant and rude to their teams that I'm like, thank you, but no, thank you, you're just not a great fit.   because I believe that I want people who are invested in their teams. I people who love dentistry, even if they don't love dentistry, but they love business. I want people that want to get to that next level. I want people that are hungry. I want people that love life and know that there's a better way and a higher way of living life. I want people who want to expand on their leadership and be their best leaders to show for their team and their families and themselves.   Those are the people. So that's your DNA. like, well, I just talked about, sounds fun and exciting. I'd love to chat with you. I truly would. I love meeting people. I love people on the podcast. And I love just giving you a space to feel safe, to feel seen, to feel heard, to feel like there's answers and solutions, to feel a lift in life, to feel like there's hope, to give you that silver lining and joy again. So if that fills and resonates with you, I'd love to have you join us. So reach out, Hello@TheDentalATeam.com. Just know that we are committed to you, that we love you.   I think all of our consultants would say that they absolutely love their clients as humans and they're so proud of the work that they're doing. And I think it's just a very positive space. It's a very collaborative space and it's a very results focused space. ⁓ And so join us. I'd love to have you reach out. Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.  

Growing your practice can be incredibly exciting, but incredibly intimidating. Kiera tells listeners how they can scale with confidence by giving specific questions to ask yourself. These include: Are your systems running smoothly? Are your teams aligned and accountable? Do you have a clear data back-growth plan? And more! Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:00) Hello, Dental A Team listeners, this is Kiera. And today I'm super jazzed because I feel like this is such a great question that so many offices ask me of like, okay, Kiera, how do I know that my practice is ready for the next level? How do know I'm ready to add in more team members? How do I know I'm ready to add an associate? How do know if I'm ready to add another location? And I feel like so many of these things sit in our brains and we're always wondering like, how do you know? It's like, how do you know when you're ready for the next baby?   but instead of like babies, which like really, how do you really know? There are certain things to know or how do you know if you're ready to get married? Well, there are certain things actually. So let's take some of that guesswork out, make this a little bit more fun and have a great time on today's podcast. I'm excited and I hope you're excited. The Dental A Team was built for doctors. It's built for team members. That's why it's called Dental A Team. It's consulting for dentists and teams. I hate as a business owner where people just teach me and I have go try and take it back to my team.   but I love being taught, I love being focused and I love having high level and then I love having implementable things for my team, but from someone who's been there, done that and done that successfully. So that's what we've created. We have a space for doctors and CEOs and entrepreneurs to come and get together like-minded where we're talking high level. This is where I come into play. We have fun, we have business freaking tactics. We call it Think Tank Tuesday and we literally get all together and have a great time. And then we have our in-person mastermind where we're doing the same thing as business and life on purpose.   And then we have our consultants, including myself, our consultants then work with your team. We're going to be teaching your team members how to make your vision a reality, how to scale, how to have the conversations. I say we're like little fairy godmothers for your team members, where we literally are hanging out with them to help them know the resources and the easiest path to get the results they're looking for. That's what we're obsessed about. That's what we do for offices. And I hope that we're a part of your office. And if not, I hope we're apart really, really soon. All right, you guys, let's dig into how do we scale with confidence?   Because growth is super freaking exciting. Like, oh my gosh, we're growing. But back to me, when I first started, we were 500,000 to 2.4 million in nine months in my first location. We bought our second location and you better believe it was fire. And fire is exciting, but it burns hot. And it got hotter and hotter and hotter. And it was because I didn't have a plan. We just were like, sweet, we're at this amount. So let's buy our second location. And it became mayhem and it became crazy. And so it's one of those things of like fires can be beautiful and we can sit there and roast s'mores.   But fires can also be very, very volatile. They can destroy, they can burn fast and they can burn hot. And so this is a zone where if we have a plan, we're going to do really well. If not, we get burnout, we get turnover, we get stalled progress. We actually get sloppy. We actually could fall into really scary things. Like for us, it was full blown burnout. I was on burnout or my owner was on burnout. We were working from 2 a.m. till 10 p.m. every single day. ⁓ Our marriages were falling apart. Like everything was bad. Everything. It was not good.   and we would show up to work just to feel like we were like barely, like nose barely above water, but you better believe there's water getting into that. And so this is something where I really wanted to come on today of how do you know and how can we scale with strategy? How can we scale and know that we're ready for the next level? Because if I would have known this, I would not have bought my second practice. I would have optimized my first practice. I would have put a few more things into place and then bought the second location. But you know, I was young, dumb, I was reckless. We were just like.   We can do this. did the first one, but the first one wasn't like barely hanging on. We had two pending lawsuits on us. Like there were wild things going on, but yet shoot. I think that sometimes it's good to have a little bit of naive, ⁓ but I think it's more important to have a good plan and a good process. So this is the goal. It's not about adding ops and team members. It's truly about making sure our foundation's awesome, making sure that we know what we're doing, making sure we've got a good plan and then executing it. And that does not mean it needs to take a long time. You can scale very quickly, just making sure you have a few key places.   And I like to tell people our goal is to get flagship practice number one solid. We stamp it out and then we just stamp it out, map it out. We have a few nuances that we change based on location and demographics, but generally speaking, it's about the same thing. ⁓ $1 million, one practices versus multi millions, multi practices, multi ops, two very different models of business. So on that, this is what we love to do today. This episode is really for owners and offices asking the question of what's next, but scaling smart.   not fast and also looking at like the DSO landscape of where we headed. Do I DSO? Do I grow? I have a practice and what they were thinking about doing is they're thinking of selling out to a DSO. And I said, cool, but like, what's your plan? I'm like, I still want to keep doing dentistry. And I said, all right, let's look at the numbers. And what was wild is a DSO is going to pay this practice 5 million. And right now you might be like, dude, that's so much. Like I'd sell in a second, like one more bad day and like give me the DSO's number. calling them.   But we looked at and I said, all right, let's expand out a couple more ops, which you've already been thinking about doing. And realistically in the next one to two years, like that's what the DSO is going to do. They're going to come in, they're going to expand this out. So either you can sell to them and live here and do it with them, or you can do it before that. And literally we did that. And this practice in two years is making 5 million net profit. And I think about that because it seems so tempting to sell to the DSO and how it's like, but you're giving up all of this. And if we just had a quick plan.   This doctor now is working about two days a week. They have associate doctors in place. They have this beautiful building and they're looking for the next expansion piece. Beyond Happy, this is their plan. And they're literally making more than they would have with the DSO. And so just be careful, because I think sometimes DSOs can seem so sexy and alluring when we're having bad days. You better believe it. There have been days when I'm like, someone walks by and offers me a buck for Dental A Team. They get it, right? We all have those days as business owners. That's not a joke. It's real life. But I think this is where we can like,   not make reactive decisions, but actually figure out how we wanna scale. And what I will always say is when we scale and what's next, I want you to always ask the question of what do I want in my life and what do I want my life to look like? Because we can scale. You can have 10 practices and say, only wanna work one day a week. That's totally allowed. It's just a different strategy. Or you can say, wanna be a clinician. I love doing the dentistry. Again, different strategy. I was on an on-call yesterday with a potential client and they were like, Garrett, we need systems. We need to have help with our finances.   our financials and we also need help training our team. And I was like, rock on, that's right up our alley. And at the very end of the call, I said, Hey, is there anything else you feel like I should, I need to know? they're like, well, yeah, we're considering selling in a year. And I was like, wow, that changes the entire plan of what I would do because I would not be building all the systems if we're planning to sell in a year. I'm going to be cranking your EBITDA. We're going to be working on case acceptance, adding production to this practice to make sure we're getting top dollar for the sale while also making it easy and enjoyable to live there at the same time. So one of those things of   where you want to go and what your North Star is, radically changes your question of what's next. It's what's next based on what you want to do. So when we look at this, I really want you to think about and look at these pieces of what's next. And again, some of these things might change depending upon what your next is. If we're selling to a DSO, it looks very different than if we're building a legacy practice. So just know a lot of these pieces might be dependent upon where you want to go.   So number one, I think this is a great thing. If you want to grow, you want to add another practice, you want to add more ops, you want to add more team members, you want to grow to the next level financially, is make sure your systems are truly running without you. So you don't need to be there in every single decision. Doctor, you don't have to be answering, signing off on what are we ordering? We don't want to be signing off on payroll. We literally have built this delegation ladder. We have team leads in place. The systems are running where the team can execute daily. We have end of day checklists. We're not having to look over every single thing.   We have checklists of what people need to be doing. It's very clean. People are in the right seats. They know what they're doing. We have clear operations manual built out for scheduling, billing, case acceptance, hygiene, all these different areas of our practice. It's clear. We have it mapped. We have documented systems that are followed by all. So not just documented, but truly followed by all. ⁓ And honestly, it's something where doctors, would recommend, a fun thing. You're welcome. I'm giving you a vacation. You leave for two weeks.   I want you to leave the practice for two weeks. And when you're gone, I want you to see that practice thrive while you were gone. Did it barely survive? Was the team able to make decisions without you? What systems fell apart and let's fix that. This is something where doctors are always a little nervous to take time off for production. Yes. But I say it is absolutely essential and crucial doctors that you take time, you leave the practice so you can actually find out what's breaking down. Same thing with office managers and leads. We need them to leave. We need you out. And what's wild is when offices, I see them. So for example, I have a doctor.   They usually take about two to three weeks up in the summer. They usually take two to three weeks off in the early spring. And it's awesome. And what happens is on those months, production doesn't The practice doesn't fall apart. The office manager is able to execute the way the doctor would execute. Team culture runs the exact same, whether the doctor's there or not. And that to me is a sign of your systems are not dependent upon you. So if you want to do a stress test, rock on. Prep your team. don't just like spring it on them. That doesn't usually go well.   but stress test and go for two weeks and see what happens to your practice. And then also look to see when you go around and you're doing your CEO time, let's rate every single department in our practice on a one to 10 of how are they doing? Could they run this without you? Do they know what they need to do? Are we hitting the KPIs that we need to hit? And if not, do we need to put some systems into place that can run independent of you? So that would really be a good stress test of go on vacation and also rate your departments and see where maybe our system is lacking. Now.   I will also put a word of caution because a lot of times doctors, are very meticulous. That's why you're dentists. That's why you're working on that little box on the MO and you do so well with your very, very, very, very fine skills because that's what you do day in and day out. A lot of offices are actually ready to scale with their systems. Being systematized where it runs without you does not mean perfect. And I really want you to hear me loud and clear. It is not about being perfect. It's about being scalable and that this can run without you and that you're really able to move things forward. So.   A lot of people get stuck and they don't grow because like, don't have every system in place. No, we're talking that like the bulk of your KPIs are able to be hit. The bulk of our systems are able to follow. The culture doesn't dip when you're gone. Production doesn't dip when you're gone. ⁓ But you might be more ready than you think you are. So be careful. There's a second side to it. Make sure that we're good on that rather than just being like, ⁓ my systems will never be perfect. Cause honestly, systems will never be done. Your practice will never, ever, ever, ever, ever be done. But that doesn't mean it's not time to scale. So that's your system's text. Number two.   Teams aligned and super accountable. So this is different than the top one because it's about systems running. But when the teams align, this is us hitting our KPIs. So we have leads in place. They own their area. They own their numbers. They hit their metrics consistently. We literally have a weekly leadership meeting. Even if that's just your whole team, we're hitting our metrics. We're reviewing our wins and we're all staying accountable to it. So this is what we're looking for is team high level accountability. If we say we're going to do it, we follow through. If we say we're going to get this KPI, we do it. If we say we set this goal, we hit this goal.   And honestly, a big piece of that is we're not having a ton of turnover. So that's helping me know that your practice is stable. Your team is stable. We're hitting these KPIs. So if you're not tracking your data, you're not tracking your numbers, you have no clue. I would strongly advise not growing and adding more ops because all it does is it just makes the chaos even bigger. Trust me, I did it. I had no numbers. I had no KPIs. I had no accountability. I had no team members reporting up. And then all of sudden my problems doubled because now I had a second location and none of this was in place. I will tell you, it is a train wreck. You can get through it.   but it is not fun and I almost didn't get through it. So for this is just make sure that we have our leads, make sure that they're reporting. And I have a practice who started doing this and they were around like 3 million ish and they grew to 5 million, but just been putting their numbers in every single week, their leadership teams looking at their numbers, they're making adjustments every quarter. We're setting goals for them and we follow and that's just happening in one year. So exponential growth can happen and be careful because you can actually squeeze more juice out of your lemon.   in your current practice by even following these steps. So this can be growth internally. It's kind of like a house, right? Like we can go buy a new house or we can just make our house even more awesome. There was an office that I knew and they literally were like, we can go buy another house, but why don't we just invest the money here? And they've made their house this incredible oasis, made it even better. They have even more fun. That's something that you can do in your practice too. So don't, don't worry. It doesn't mean have to sell. doesn't mean you have to scale. It doesn't mean you have to have multi-practices. It doesn't mean you have to expand.   It means you could even do this within your practice, looking at these pieces will exponentially help you grow to the next level with ease. Number three that you're ready for is you have a clear data back growth plan. So we're looking at this and we're making sure that like, our KPIs are tracking and that we are profitable and we have the right patient flow to be able to grow. We have the right team members. We have a pipeline in place to bring on another doctor. We have a pipeline in place to have more hygienists coming in. Like we are not going to get stuck in that area.   We have an office manager or regional manager that has the bandwidth to be able to go. Our billing team is very consistent. Our collections sit at 98%. ⁓ And then what we have from here is we're going to have a scaling growth plan. So when I work with offices, we had a doctor reach out. They were at a four ops practice and they're going to an eight, they thought, and we pushed them to a 10. I asked them, are you so glad we went to a 10? And they said, Kiera, the answer is yes. I thought you were crazy. And I was like, nope, you will never regret having more ops. But they started with us. So we're talking four ops to 10 ops. And what we did before is we literally started with this practice.   about 12 months before they expand and we started putting together the plan of, all right, we're gonna start saving money. This is how much it's gonna cost. This is how many team members we're going to need. So let's start building the pipeline for it. We're going to need a doctor at this point in time. So you're gonna need to start working on that. We're gonna be meeting with the contractors. We're going to be expanding this out. And honestly, this doctor is so happy because they have the cash. So when they built it out, they weren't cashflow stressed. They had a new patient plan to grow. They had a plan for a new doctor. We had associate onboarding documents in place for them. We had a hygiene pipeline.   We had the new patient plan. We had the doctor's plan of what procedures this doctor was going to do. And literally this doctor was like, well, another building just came up. Do you think that I'm ready for it? They had just opened the 10 ops. And I said, well, the answer is I actually think you are pretty well ready for it because we had the KPIs. We were tracking the pieces. We had a plan and we did this for almost 12 months. There's another office that was bringing in a partner. And for 12 months, we figured out how much is their true pay of true compensation.   We worked through all those different pieces for them. So that way when the partner bought in, it wasn't this chaos for them. And I think this data-backed growth plan of knowing what the reality is of how much your expenses will be, having things in place, having your reserves, your financial reserves, that's going to make it to where you are not stressed out of your mind when you take this on. Because cashflow, resources, not having enough money.   That's going to cause chaos. That's going to cause frustration. This is going to cause like, oh my gosh, I don't think I can do this. Then on top of it, you have systems. Then on top of that, you have team members that aren't accountable. And you're like, oh my gosh, I now have like 25 team members and it's so stressful. And like, I wish I never would have bought the second practice or I wish I never would have expanded. And I'm like, it's not that you wish you would never would have expanded. You wish you would have just done it differently. That's what it is. You wish you would have just done it differently. You wish you would have had a plan in place. You wish you would have had the cashflow for it.   Because it does take, like when we expand out, I told this doctor, said, I want you to plan three to six months of reserve of cash of covering all these expenses. So we're building up, building up, building up. They were very profitable at the beginning, like very profitable on this for-off practice. They just were expanding it they were too stuck. Like they had no more space. Same thing with my other practice. They were eight and they went to 15 ops. They were just stuck. But if you don't plan for these pieces, I said, I want you to have three to six months worth of cashflow.   when you go into whether we're getting that as a loan or working capital or you're building this up over the next couple of months while we build this out, these doctors are so secure. And then what we do is once we expand it, know that we know the metrics that we need to hit to be able to pay for all these expenses that we just put into place, still give a great patient experience, still give great case acceptance, still give great exams, still give great hygiene, so we're not sitting here stressed out of our minds, we're having to do all these pieces.   because my gosh, we just bought this so now like sell as much as we possibly can because I'm stressed out of my mind. It takes all that stress out for these doctors and it really makes it to where they reverse engineer and we figure out staffing, space, systems, finances, protocols, when do we do this, how do we build this out? And it's wild because when you have someone who can coach and guide you through that, it's insane how much better prepared you are. Also with these doctors.   We squoze the juice out before they expand it. So how can we maximize and optimize? I another doctor who had four ops. Like, here there's no space. I'm building this building across the street. It was a beautiful building. And I'm like, but you actually have space for one more op in this practice. And they're like, what? Why didn't you come four months earlier? And I was like, well, hi. So we added another op, even in the time they were building the practice, we spent the money on it. And it's crazy because that one op produced about $400,000 $500,000 in just one year in that one extra op.   We were then able to take that money and obviously apply it to the next building and they were able to maximize that space that they were in. So looking at that reverse engineering is really going to give you clarity. And so when we look at these three strong signs of you're ready to grow with strong systems in place, team accountability, and then a clear plan forward that you're planning for, you're preparing for, you're executing on, and this is going to truly help you have confidence. Confidence comes from being prepared. Confidence comes not from being perfect.   Confidence comes from, know where I'm headed, we've got these pieces. And I tell every single doctor we work with, I'm like, listen, we're gonna do our absolute best to plan and repair. We're gonna do our absolute best to get the numbers in place. There will be things we forget every single time, because we're not perfect. But the antidote to fear is action. The antidote to fear is having a plan. The antidote to knowing if you're ready to go is to be prepared in these areas. And so I really think when you look at this, like, don't have to guess if I should go.   Don't guess and be like, Kara, where it's like, we've got the first one, let's just add on a second one. You're welcome to, it's just a thrill of a lifetime that I think adds more burnout, more stress, more chaos than necessary. And I'm like, you can have the same growth, you can have the same scalability, just with more strategy, more fun and more predictability. So if you're interested in about it, don't guess, like just DM us. We have ideas to how to scale, we have different pieces you can DM us scale, you can say like, hey, I'm thinking about this, how do I know? We'll get on a complimentary practice assessment with you.   give you like complimentary advice, truly, we're gonna help you build a plan and see how we can fit, how we can help you. But really, if you're thinking about it before you sell to a DSO, even this practice I was talking to, I was like, listen, there's other options because we work with hundreds of practices, we see different scenarios, this is why we get our doctors together, is because the more we learn and the more we educate each other, the better decisions you're able to make. Do not be paralyzed by fear and not make a decision, because what's worse than making a wrong decision is not making a decision. So make the decision.   Execute and truly let us be your guide get a guide guide through it. It makes it so much easier You're able to scale faster not be stressed out and really this is what we excel at This is what we're great at so reach out Hello@TheDentalATeam.com comm click on our link on TheDentalATeam.com podcast Make sure you're following along for more tips and tricks because our goal is to make your life less stressful More fun and more predictable and as always thanks for listening. I'll catch you next time on the Dental A Team podcast  

Ranked the #1 DSO Podcast! Welcome to The Group Dentistry Now Show: The Voice of the DSO Industry! Navigating the Complexities of Dental Insurance: A Guide for Emerging DSOs We welcome Kyle Wallace, Managing Director, and Herb Ford, Vice President of Business Development, both from Risk Strategies. With over 35 years of combined experience in the insurance industry, Kyle and Herb share their insights on optimizing insurance coverage tailored specifically for DSOs & emerging dental groups. In this episode, you'll learn about: The importance of having a comprehensive insurance program for DSOs and emerging dental groups. Common pitfalls and challenges faced by dental practices when managing their own insurance plans. The significance of working with a dental-specific insurance team and understanding the unique risks associated with the dental industry. Strategies for risk management beyond just insurance, including the importance of cybersecurity and employee practices liability insurance (EPLI). To Learn More: Read the article: Optimizing Insurance Coverage for Multi-Location Dental Practices - https://www.groupdentistrynow.com/dso-group-blog/insurance-coverage-dso/ Visit the Risk Strategies website for more information or to receive a consultation: https://www.risk-strategies.com/dental Contact Information: Kyle Wallace: k.wallace@risk-strategies.com Herb Ford: hford@risk-strategies.com Phone: 972-663-5190 If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes https://apple.co/2Nejsfa and a Thumbs Up on YouTube.

Feeling like corporate ortho is closing in? Think again.In this brutally honest and motivational 5-Minute Friday episode, I get real about the fear-mongering flooding our industry—especially when it comes to OSOs and DSOs. If you've been told that you have to hire a consultant, or that you can't compete with corporate money, this episode is your wake-up call. The truth? You're not under attack. You're just distracted.Knowing where you're headed is the best and only strategy to get ahead. You need a plan; OSOs, DSOs, and Corporate Dentistry are not coming for you; in fact, they have nothing to do with your journey. Once you have a plan, you can get expert help to support you and teach what you need, and your practice will be more solid.Key Takeaways00:00 — Economic pressures and industry fear-mongering01:30 — The real impact of OSOs/DSOs (and why it's overblown)03:00 — How to filter the noise and make decisions for you04:00 — Consultants vs. coaches: understanding what you actually need05:30 — My story: investing $57k I didn't have (and why it was worth it)07:30 — Time is your most valuable currency—use it with intention08:50 — Practical advice: write your 6-month plan, then find the right help09:45 — Why you're not being “attacked”—and how to stay focused on your goals11:30 — The upcoming Orthopreneurs coaching program teaserAdditional ResourcesWant to connect with orthodontists who believe in lifting each other up?Come to the final Orthopreneurs Summit in Las Vegas this September. Trust me—it'll be the most impactful event you've ever attended. Go to opSummit2025.com and grab your spot today.- For more information, visit: https://orthopreneurs.com/- Join our FREE Facebook group here:https://www.facebook.com/groups/OrthoPreneurs

Send us a textDr. Chad Duplantis sits down with Eric Swarvar of Midwest Dental to fill us in on how AIDA can help independent dentists compete with DSOs.Check out our educational partners for more information: AIDA: https://aidagroup.org/Midwest Dental: https://midwestdental.com/Atlanta Dental: https://atlantadental.com/

On this episode of the Dentist Money Show, Matt and Christine discuss the growing trend of dentists selling their practices to DSOs. They talk about the emotional and financial factors driving these decisions, including stress, boredom, and FOMO. The conversation helps practice owners assess whether they're truly ready to sell or not. Tune in for some insights on avoiding regret, preserving long-term value, and finding fulfillment in your career. 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.

Kirk Huntsman joins host Ron Aaron and co-host Carol Zernial to talk about uncovering the link between Alzheimer's and sleep apnea on this edition of Caregiver SOS. Special guest-cohost Tina Smith fills in for Carol Zernial on this episode of Caregiver SOS! About Kirk Kirk Huntsman, Chairman and CEO, Co-Founder of Vivos Therapeutics. R. Kirk Huntsman is a co-founder of Vivos Therapeutics and has served as the chief executive officer and a director since September 2016. In June 2020, he was elected chairman of the board. In 1995, he founded Dental One (now Dental One Partners), which, as president and chief executive officer, he grew to become one of the leading DSOs (dental service organizations) in the country, with over 165 practices in 15 states. After a successful sale of Dental One to MSD Capital in 2008 and subsequent merger in 2009 with Dental Care Partners, Mr. Huntsman was appointed in 2010 as chief executive officer of ReachOut Healthcare America, a Morgan Stanley Private Equity portfolio company. In 2012, he founded Xenith Practices, LLC, a DSO focused on rolling up larger independent general dental offices, which was sold in 2015. From January 2014 to September 2015, Mr. Huntsman founded and served as chief executive officer of Ortho Ventures, LLC, a US distributor of certain pediatric oral appliances with applications for pediatric sleep-disordered breathing. Since November 2015, he has served as the chief executive officer of First Vivos, Inc., which is now our wholly owned subsidiary. He was also a founding member of the Dental Group Practice Association (DGPA), now known as the Association of Dental Support Organizations (ADSO). He is the father of Todd Huntsman, who is a SVP at Vivos and runs the Product Development and Manufacturing Division. He holds a BS degree in finance from Brigham Young University. Hosts Ron Aaron and Carol Zernial, and their guests talk about Caregiving and how to best cope with the stresses associated with it. Learn about "Caregiver SOS" and the "Teleconnection Hotline" programs.See omnystudio.com/listener for privacy information.

In this 5 Minute Friday episode, I'm bringing some tough love. If you've caught yourself saying, “I just don't have time to work on the business,” it's time for a wake-up call. Because in today's ultra-competitive market—fueled by economic pressure, fewer referrals, and more ortho grads—you can't afford to drift. And no, it's not the OSOs or DSOs taking you down… it's the lack of a clear, intentional plan.I get it—you're driving kids to soccer, juggling home life, and trying to breathe. But I promise you: if you're not investing real time into writing and executing a growth plan for your practice, you're falling behind. This episode is about calling that out—and helping you change it. Because burnout doesn't come from overwork... it comes from working hard with no direction. Let's fix that.Key TakeawaysIntro & mindset shift (00:00)Why “I don't have time” is a dangerous lie (01:10)The leadership gap hurting modern practices (02:30)What past generations did better—and why it matters now (03:45)The truth about today's competitive environment (05:30)How to get ahead: planning, training, and implementation (06:40)My final challenge to you (07:30) Join me at the final Orthopreneurs Summit in Las Vegas this September. We'll map out the tools, mindset, and strategy to take your practice—and your leadership—to the next level. Go to opsummit2025.com now to secure your seat. Payment plans are still available... but not for long. Let's go.- For more information, visit: https://orthopreneurs.com/- Join our FREE Facebook group here: https://www.facebook.com/groups/OrthoPreneurs

In this episode of The Dental Boardroom Podcast, host Wes Read, CPA CFP®, is joined by Myles Davis, founder of Dentrec—a platform designed to bring clarity and consistency between dental practice management systems, bank accounts, and accounting software like QuickBooks.Wes and Myles explore the common yet often overlooked issue of reconciling collections data with actual deposits. They dive deep into how disorganization or gaps in reconciliation can lead to embezzlement, financial misstatements, patient trust issues, and inefficiencies in team performance tracking.Myles shares how Dentrec is helping DSOs and solo practices alike automate reconciliation, allocate deposits correctly (especially across multiple offices or tax IDs), and keep all systems—from PMS to bank accounts to financials—in sync. Learn why this simple yet powerful solution is transforming dental practice accountability, financial health, and team transparency.Key PointsDentrec helps reconcile collections data from PMS (like Open Dental, Dentrix, Eaglesoft) with actual bank deposits and QuickBooks.Lack of reconciliation can lead to embezzlement, financial misstatements, tax underreporting, and loss of patient trust.Dentists often don't catch missing funds or misallocated deposits due to lack of time, process, or tools.Dentrec is especially useful for DSOs with centralized banking or shared TINs across practices.Automation and accountability reduce human error and increase practice efficiency.Embezzlement remains alarmingly common—40% of dentists experience it at least once.Dentrec also tracks whether payments were correctly posted to patient ledgers.The “fork test” analogy shows how disorganized workflows cost teams time and money.Aligning PMS, financial reporting, and bank data helps owners stay informed and in control.#DentalBoardroomPodcast #Dentrec #DentalFinance #DentalEmbezzlement #PracticeManagement #DSO #DentalTech #FinancialReconciliation #WesReed #MylesDavis #QuickBooksDental #OpenDental #DentalAccounting #CashFlowManagement #DentalPracticeGrowth

In today's Part 2 episode, Morgan Hamon returns for Part 2 of his conversation with Dr. Mark Costes, diving headfirst into the intricate realities of selling a dental practice. From decoding EBITDA and enterprise value manipulation by private equity-backed DSOs to the critical role of quality of earnings reports and add-backs, Morgan unpacks what dentists need to know before entering any transaction. They explore the benefits and tax pitfalls of owning versus leasing commercial real estate, the real story behind cost segregation studies, and how depreciation recapture can sting if you're not prepared. Morgan also shares eye-opening advice on selling timing, managing post-sale windfalls, and the limited tax mitigation options available to W-2 dentists. Plus, they wrap up with some lighthearted stories and unforgettable insights from Morgan's days landing F-18s on aircraft carriers. EPISODE RESOURCES https://www.eisneramper.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Ken Kaufman reveals how accrual accounting gives dentists the same financial clarity and growth advantage as big DSOs and how AccruDent makes it accessible to every practice.

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

In this special edition, we are sharing Dental A Team's podcast episode where Ryan joins Kiera Dent of Dental A Team Kiera to dive into DSOs. They discuss such questions as: Are they the best financial choice for your practice? The best life choice? Are the horror stories true? And so many more. 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.

Dr. Snyder criticizes dentists for feeling controlled by insurance companies, DSOs, and their own staff, likening their situation to colonial oppression. He emphasizes the importance of breaking free from these constraints to achieve true independence and success. He outlines a 90-day plan for dentists to improve their practices, including identifying and removing tyrants, focusing on attracting, converting, and delivering, and potentially dropping PPO plans to increase profitability. He also encourages dentists to embrace hard work and systems to build a better business and provide superior patient care.Listen in!Thank You for enjoying this episode of Delusional: Winning the Weekly War of DentistryRESOURCES:Learn more about LEGIONSubscribe to DELUSIONAL: Winning The Weekly War PodcastWrite a Review on iTunes‎

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

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

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

The Bulletproof Dental Podcast Episode 401 HOST: Dr. Peter Boulden GUEST: Emily Ryba, OS Dental DESCRIPTION In this episode, Peter Boulden interviews Emily Ryba, founder of OS Dental, discussing the challenges of data visibility in dental practices and how OS Dental addresses these issues. Emily shares insights on the importance of accurate data integration, user-friendly dashboards, and empowering dental teams with targeted analytics. The conversation also touches on the advantages of data warehouses and how OS Dental levels the playing field for single practice owners against larger DSOs. TAKEAWAYS Emily Ryba is the founder of OS Dental, which addresses data visibility issues in dental practices. Many dental practices struggle with fragmented data from various software systems. OS Dental provides a solution by integrating multiple data sources for accurate financial visibility. The platform allows practice owners to see real-time data and make informed decisions. OS Dental customizes dashboards for different dental specialties to enhance usability. The importance of targeted analytics for different roles within a dental practice is emphasized. Data warehouses can be expensive and complex, but OS Dental simplifies this process for users. The platform aims to empower teams by providing actionable insights tailored to their needs. Emily encourages dental professionals to engage with OS Dental for better data management.  CHAPTERS 00:00 Introduction to OS Dental and Market Gaps 02:53 Client Success Story: Transforming Data Visibility 05:48 The Importance of Accurate Data in Dentistry 08:41 Customizing Data Solutions for Dental Practices 11:36 Overcoming Data Overload: Focused Dashboards 14:42 Setting Goals and Achieving Growth in Dental Practices 17:45 Understanding Data Warehouses and Their Role 20:25 OS Dental: Bridging the Data Gap for Practices 23:35 Conclusion and Invitation to Connect REFERENCES Bulletproof Summit Bulletproof Mastermind  

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

In today's Part 2 episode, Dr. Mark Costes continues his compelling conversation with Dr. Lincoln Harris, CEO of RIPE Global, diving deep into the innovation behind their game-changing dental training platform. In this second half, Dr. Harris reveals how their software and hardware ecosystem is built for scalability, with a focus on improving clinical outcomes and associate productivity—fast. From cutting-edge cloud simulators and proprietary mannequins to custom LMS channels and data-driven ROI models for DSOs, it's all about getting measurable results and breaking down barriers to skill adoption.  Plus, the two discuss strategies for associate engagement using “carrot and stick” methods, and how RIPE is positioning itself as the productivity partner for DSOs worldwide. Mark also shares his vision for sustainable global mission clinics through Smile Outreach International, and Lincoln generously offers RIPE's support to train local clinicians in underserved areas. EPISODE RESOURCES https://www.ripeglobal.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

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

In today's Part 1 episode, Dr. Mark Costes sits down with the always insightful Dr. Lincoln Harris, founder of Harris Dental Boutique and CEO of RIPE Global. Fresh off recording 26 podcasts at Thrive Live, Mark kicks things off with high energy and hands over the mic to Dr. Harris, who shares his incredible journey from Queensland, Australia to Colorado, USA.  The conversation dives into the evolution of RIPE Global from an in-person CE provider to a global force in dental education, now offering cloud-based procedural training, proprietary LMS software, and cutting-edge hardware. Dr. Harris unpacks how their unique platform helps new grads and DSOs alike boost productivity and clinical skill, all while tracking real implementation and ROI. You'll hear how they tailor training programs to individual needs and how the system can even be white-labeled for other educators. EPISODE RESOURCES https://www.ripeglobal.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Luke Infinger and Dr. Kyle recently fired rapid-fire questions at ChatGPT, asking how orthodontics might look in five, ten, and fifteen years. The ChatGPT offered bold predictions from autonomous DSOs to gene-editing gels. Luke and Dr. Kyle did not accept everything at face value, but they agreed on one point: practices that prepare will profit, […] The post Does ChatGPT Know the Future of Orthodontics? appeared first on HIP Creative.

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

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

What happens when a new grad skips residency and buys a practice? What do DSOs really offer early-career dentists—and what do they take away? And how do you stay ethical in a system that often puts production before patients?In this episode, Teeth Matter host Ellie Halabian sits down with Dr. Naved Fatmi, D.M.D. (@drnavedfatmi)—a practice owner, educator, and former Chair of the Florida Board of Dentistry. Appointed in 2015 as the youngest board member ever, Dr. Fatmi brings deep experience from both the operatory and the regulatory level.Together, we unpack:Residency vs. Private Practice: Which path builds a stronger foundation?The DSO Dilemma: Do they help or hinder your clinical growth?CE That Sticks: How to actually apply what you learn.Understanding Your Demographic: Why your patient base should drive your business strategy.Financial Security: What it really looks like in today's dental economy.Whether you're a student, a new grad, or a practice owner, this episode gives you a rare look into the intersection of dentistry, leadership, and long-term career thinking.To learn more about or connect with Dr. Naved Fatmi, go to:Website: https://www.healthandwellness-dentistry.com/Instagram: @drnavedfatmi_______Don't miss out on these deals: Prioritize your wellness—shop my daily essentials here: ⁠⁠⁠⁠⁠⁠https://teethmatterpod.com/store⁠⁠⁠COCOFLOSS - Use code TM20 to get 20% off ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://cocofloss.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ FIGS - Use referral code to get 20% off ⁠⁠⁠⁠⁠https://fbuy.io/figs/elliehalabian⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠If you want to join the conversation about the realities of dentistry, follow: Instagram: ⁠⁠⁠⁠⁠⁠⁠@_teethmatter⁠⁠⁠⁠⁠⁠⁠ LinkedIn: ⁠⁠⁠⁠⁠⁠⁠Ellie Halabian⁠⁠⁠⁠⁠⁠⁠__________________________If you enjoy the podcast, subscribe and rate ⭐️. If you think a friend will enjoy it, please share it with them.

In this Becker's Healthcare podcast episode, Erika Spicer Mason speaks with Dr. Eric Tobler, Chief Clinical Officer, and Christin Lisenby, Vice President of Hygiene at Dental Care Alliance, about the growing importance of clinical engagement in driving dental practice success. They explore how empowering clinicians, aligning on standards of care, and building culture across multi-site settings are critical to sustainable growth and improved outcomes. Tune in to hear real-world strategies and insights from one of the nation's leading DSOs.This episode is sponsored by Dental Care Alliance.

In this episode, Dr. Catherine Watkins, a seasoned dentist with over four decades of experience, joins the podcast to share her unique perspective on dental education, licensure compacts, continuity of care, and the critical importance of maintaining dentistry's identity as a surgical profession. She also discusses emerging technologies, DSOs, and the growing need for equitable access to care.

In this episode, Dr. Catherine Watkins, a seasoned dentist with over four decades of experience, joins the podcast to share her unique perspective on dental education, licensure compacts, continuity of care, and the critical importance of maintaining dentistry's identity as a surgical profession. She also discusses emerging technologies, DSOs, and the growing need for equitable access to care.

In this episode, host Bill Neumann takes you on-site at the Dental City Warehouse in Green Bay, Wisconsin, where he explores the exciting advancements in supply chain modernization, robotics, and technology within the dental industry. Join us as we interview a panel of supply chain experts, including: John Mathys - Co-owner of Dental City Joe Cavaretta - Founder of Cavaretta Consulting Group Stephanie Schoenrock - Senior Consultant at Cavaretta Consulting Group Brandon McCarty - CEO and Founder of Curemint Jordan Lorenz - VP of Sales and Marketing at Dental City In this episode, you'll learn about: The importance of investing in technology and robotics for supply chain efficiency. How Dental City has modernized its operations to better serve customers and support employees. Key metrics and statistics that drive performance in the dental supply chain. The role of AI in enhancing operational efficiency and customer service. The evolving landscape of the dental industry, including market consolidation and the rise of DSOs. To learn more visit https://dentalcity.com/ You can contact Jordan Lorenz at jlorenz@dentalcity.com or John Mathys at jmathys@dentalcity.com  To contact the other panelists, you can find their contact information here: Joe Cavaretta at joe@cavarettaconsultinggroup.com or visit http://cavarettaconsultinggroup.com/ Stephanie Schoenrock at stephanie@cavarettaconsultinggroup.com  Brandon McCarty at brandon@bpmsolutions.ai 

In this episode of the Nifty Thrifty Dentists Podcast, Dr. Glenn Vo interviews Greg Essenmacher, CEO of GnA Consult, about the systems, strategy, and operational support that dental practices need to thrive, especially when scaling into more complex procedures like full-arch dentistry. Greg Essenmacher is a trailblazer in All-on-X dentistry, revolutionizing single-office practitioners into thriving implant practices that often expand into large group practices. With over a decade of full-arch consulting experience, Greg has: Launched the Neodent brand into the U.S. market for the Straumanngroup. Helped hundreds of practices increase full arch profitability, case acceptance, and patient outcomes. Helped practices turn Full Arch into their most valuable asset—boosting EBITDA and long-term valuation Greg's formula focuses on results you can see—higher margins, more arches, and a team-driven system that runs without the doctor spending 1+ hours in every consult.

Dive into the future of enterprise data with the latest episode of Tech-Driven Business. Mustansir Saifuddin welcomes Shawn Brown, of SAP, for Part 1 of an in-depth exploration of the SAP Business Data Cloud (BDC). If you're navigating the complexities of data management and analytics within the SAP ecosystem, this episode is unmissable. Shawn breaks down the fundamental 'why' behind BDC, revealing how it's engineered to drastically reduce data preparation time, cut costs, and empower businesses to make faster, more accurate decisions. Tune in to understand how you can your team can take advantage of all that BDC offers to SAP customers looking to unlock true value from their data. With over two decades of experience in SAP solutions, Shawn Brown currently serves as Senior Director for SAP's Center of Excellence. Known for expertly identifying customer needs, Mr. Brown excels in presenting tailored solutions involving Business Technology Platform, Business Data Cloud, S4HANA, and Business AI. A proven leader in demand generation and partner relationship management, Mr. Brown has successfully driven initiatives that enhance customer experience and streamline cloud solution adoption. Renowned as a thought leader and strategist, Mr. Brown frequently shares insights with CIOs and business influencers, fostering strong, trust-based relationships across multiple industries.   Connect with Us: LinkedIn: Shawn Brown:  Mustansir Saifuddin:  Innovative Solution Partners  X:  @Mmsaifuddin YouTube or learn more about our sponsor Innovative Solution Partners to schedule a free consultation.    Episode Transcript [00:00:00] Mustansir Saifuddin: Welcome to Tech- Driven Business, brought to you by Innovative Solution Partners. I'm honored to have Sean Brown of SAP join me to kick off an essential two part series to unpack a topic that's on every SAP user's mind. The Business Data Cloud or BDC. If you're looking to understand how BDC can transform your data landscape and drive real business value, you are in the right place. [00:00:32] . [00:00:32] Welcome to Tech- Driven Business, Shawn. How are you? [00:00:35] Shawn Brown: I am good. I'm good. Things are going well, staying busy. [00:00:38] Mustansir Saifuddin: That's awesome. That's awesome. So glad to have you on our show and I'm really excited for the topic that we are going to discuss today. You ready for it? [00:00:47] Shawn Brown: I am. I'm excited as well. [00:00:51] Mustansir Saifuddin: Yeah, so I, I know we had talked in the past a couple of times and right now , the hot topic everybody's talking about from SAP and in general is the whole idea, the concept, and now the actual product called Business Data Cloud and what it really means for SAP customers. I like to use this time to dig deeper into this conversation and have a better understanding of exactly what this brings, what kind of landscapes that are changing with this new product, and to expect, you know, if you're a customer interested into, in going forward with BDC. [00:01:28] Shawn Brown: -. [00:01:28] Sure. That sounds great. Yeah. [00:01:32] Mustansir Saifuddin: Awesome. Okay. So I think every time we, we have this new products, right? And SAP is really good about and talk, people talk about rebranding and all that. Let's talk about the why of why should SAP customers adopt BDC. What is different about BDC that SAP customers should be asking that question. [00:01:53] Why? [00:01:55] Shawn Brown: Yeah, this is, this is my favorite question to start. Anything in the space that is outside of packaged solutions, you know ERP, HR Supply Chain and, and the capabilities we have in those areas because the why is something that it, it should be the driver for everything. Right? And, and for BDC, I would say the first thing we wanna talk about is it's a, it's a new product. [00:02:24] But it's an evolution of everything that we've been doing for years. It's, it's capabilities that our customers already know about. And it's taking all of the capabilities that we have offered over the time that we've been, been in the data and analytics space. And it's the, I call it a next generation, right? [00:02:45] It's the next generation of what was. And so when we get into the why. I would say the first thing that we really gotta say is, is the reason for BDC is it is to short circuit the amount of time it takes to prepare from data to finally analytics and planning and all the steps in between, where we're often times organizations see it as this, this wheel that. [00:03:15] They start with the data that's in the source system. They're gonna extract a, transform it loaded profile it, catalog it you know, press governance on it. Maybe make it in, you know, in a marketplace setting. Organize it so that it can be easily digestible, create some standard analytics, and then now we can actually start analyzing it. [00:03:34] And the why is really about reducing the amount of time it takes to go around that whole wheel of, Data all the way around to analytics and planning and reduce the amount of prep time and increase the amount of analysis time. Because if we think about how much time a person gets to analyze the [00:04:00] data, let's say for example, and this is a, this is actually a number that is, has been verified with numerous customers and with, the analyst firms like Gartner and Forrester and TDWI is that it takes as much as 70% or more of the actual workload and investment to go from data to analytics. That's not, so that means the analytics is just 30% or less of the time. So if we think about how much each question costs. You have to add in all of that cost that even deliver up the analytical or, or deliver up the, the data in a way that it can be analyzed. [00:04:45] So BDCs goal is to shrink that time of preparation and actual delivery of data for the analyst purpose or for the AI purpose, or for any application purpose. Shrink it as much as possible so that, the questions that are asked are cheaper, and essentially we can ask more questions. We don't have to continue to reformat the data, deliver the data in a new way to get to the final answers that we're trying to seek. [00:05:20] So I would say savings and costs. Savings and money. More data, more, more analysis time. That's the why for BDC. [00:05:31] Mustansir Saifuddin: Yeah, it totally makes sense. I think one of the things that while you're talking about this that stuck out for me was, we always talk about time value, right? And, especially when it comes to analytics, It's such a critical part of any organization's path forward and the numbers that you're just sharing from Gartner and other resources, [00:05:51] where if the majority of the time is gone into the data collection, the data refinement, all that, there's no time left or a very minimal time for your analytics part, which makes it really difficult for organizations to make quick decisions. So I think what I'm hearing from you, the why: the time value becomes very important in this case. [00:06:13] Shawn Brown: Correct. Absolutely. [00:06:16] Mustansir Saifuddin: That's good because that kind of takes me into this conversation, like, Hey, benefits. When you have that, why understood, what are some of the benefits that BDC will provide to SAP customers who want to go on the journey? Because benefits is really the reason why it will make sense for them to move forward. [00:06:33] Shawn Brown: For sure, for sure. And this is the one that's always interesting for organizations because they're focused so much on the actual preparation of the data that oftentimes the benefits that they can glean from all of that effort are, are fleeting, so they look at the, the overall effort and they go, oh yeah, there's, there's a lot here that is really based on, on how much it took to get here. [00:07:01] And the faster we can deliver the capabilities for analysis purposes for any AI purposes, the faster we can make decisions. The faster we can adjust based on those decisions. And so when you think about the speed at which organizations operate, to be able to answer those questions faster is probably the number one benefit that you can get. [00:07:27] And then you also get into accuracy. What, what questions are we asking? And if we don't have to go through this rigorous effort of moving data from all of these source systems and joining it all back together, and then building all that business context. Data integrity, is that a, a concern? It is for most organizations, they're concerned about what this looks like at its end state. [00:07:57] And the other thing that still [00:08:00] exists in the world of business, especially in the analytics space, is the typical spread marked problem. Where people just take the data that they're looking for, they extract it out of whatever solution it's been delivered to them. Maybe it's cheap cloud storage on flat files, or maybe it's been all dumped into an ODS, an operational data store, and then they're accessing the data as they like. [00:08:26] If they don't understand the details of the data and the relationships that occur with the data, and they don't have the original business context that the data came from in its source system, then if they do extract it to whatever they like, then somebody can walk into a meeting with one version of the truth and another can walk in with another version of the truth. [00:08:48] They all can believe that they're accurate. They all can argue over why their version of truth is correct and the others is not. So the confidence in the data is the other thing. We take away a lot of those concerns, because when you have it coming from those source systems and the preparation of that data has been provided in this case by SAP, for SAP systems, at a minimum, you're going to have much more confidence that the data [00:09:17] is delivered to you in a way that respects all of the integrity that it came from. That the accuracy of the data is as accurate as it was entered into the business application upon which it was the source. So the speed of delivery, the accuracy of the data. These are, these are major advantages that you get with regards to using BDC versus [00:09:43] the, the older school, I'll call it older school 'cause I'm an old guy. The old days of Bill Inman and star schemas and relational database systems that we created. These massive data warehouses. It's an older school thought, and it was one that was born outta this idea that we had to get the data from those source systems because we couldn't query the source systems at runtime. [00:10:06] All those things contribute to, to today where we're curating the data for you. It's been curated by SAP from all SAP systems, so if you have any questions about the quality of the data, in that case, you then you should have questions about the quality of your data in its source. there's a bigger issue, so speed of delivery, accuracy of data. [00:10:32] Those are probably my, my two top benefits that customers are going to get out of this. [00:10:38] Mustansir Saifuddin: Absolutely. That makes total sense. I think one of the things that really stuck out for me was the whole concept of end-to-end governance . Does BDC do a better job? And how, is that integrated to this whole BDC realm of the different pieces that makes up BDC? How is data governance and security working within those parameters? [00:11:03] Shawn Brown: Yeah. So in BDC, you're getting role level security on all the data. At that point then you're asking questions like, where do I, how do my users access the data? What are they allowed to see? What are they not allowed to see? All those capabilities can be integrated into BDC. You, you can deliver all of those capabilities directly within BDC. [00:11:27] You start off by setting up some broader, who's the, who's the group? What systems are they accessing? So if I'm in finance and I'm looking at finance data, I probably have access to let's say S/4HANA as the backend system that is storing all this data. All the users within the finance team that have access to S/4HANA can have access to that space of data. [00:11:55] And I use that word space because this is a concept that, again, there's nothing [00:12:00] new. We've invited these concepts into our thinking a while ago, and now it's just another generation of what we're doing here. So that idea of a space is I can include the data that is necessary for a line of business hr, finance, supply chain, and that's what they can see. [00:12:20] And if I need to, all of the rest of the data is accessible through BDC. It's just a question of whether I want to provide the rights to access those other data sets to another line of business, for example. So if I said I wanted to join let's say expense information that's in Concur with employee information, that's in success factors, I can easily join those data sets [00:12:48] bring in forward, from one space to another. And decide at a row level and column level, what individual data set I need to join across groups or individuals, if you will. [00:13:06] Mustansir Saifuddin: I think that's super good because that's where a lot of the questions come in. You know, every time you do move your data from one environment to another environment that you need to have your own new set of governance and security and, it can be role level security or whatever else you wanna do, [00:13:21] you have to kind of redefine that. It seems like it's all built into the BDC portfolio. You're leveraging your source system objects and then be able to apply the same rules that you may have built in. [00:13:37] Shawn Brown: Yeah, the, the analogy I always liked was it's kind of like, and I don't know if they're really like this. I mean, maybe there are not. I just remember old movies that you'd have these Japanese styled homes and they were like, the walls that were almost paper thin, that you could, you almost felt like you could just push your hand right through the wall and just grab something that was in the other room. [00:13:57] I liken it a bit like that in terms of spaces. The spaces are separated in that way with a, a level of access that is very simple to provide when necessary, but distinctly in separate spaces, separate areas, so that that's the benefit. That's the simplicity of being able to access data from any LOB or any third party for that matter. [00:14:23] If you wanted to access that third party data in BDC to any other data that's in BDC as well, whether it's finance, hr, supply chain, whatever it may be, warehouse inventory, whatever it may be. [00:14:38] Mustansir Saifuddin: Totally. Now, since we talked about the benefits, let's look into the details. Like what steps are involved if someone wants to take on this journey and move to SAP BDC? [00:14:53] Shawn Brown: Much of that begins with where are they right now? Let's take a few different scenarios? if a customer is, let's say, already using some SAP solutions, I would say, let's go with the most rudimentary that has been around for a while now for SAP. Let's talk about, they're using HANA Enterprise. [00:15:09] They've, they've been taking a lot of data from their SAP systems and dropping it into HANA Enterprise on-prem. This is a natural next step to that on-premise approach where you said, all right, I, I don't necessarily wanna be in the position of housing systems like this myself and my own data centers. [00:15:28] I want to put them into the cloud. This is a simple transition , to take the data from a HANA Enterprise, drop it into BDC and start using that data in essentially what would be a component of BDC, Datasphere. But it's built on HANA Cloud. And HANA Cloud is built on the same technology that HANA Enterprise is built on that in terms of its capabilities, what it can do. [00:15:52] It's a natural transition for that case if you're talking about a customer that's already using let's say another old product from [00:16:00] SAP, BW. Right. BW has been a really challenging one for a lot of organizations because they've had such value and such benefit by using BW to access data in SAP with those BW extractors. [00:16:14] And in many cases, they've built a lot of and invested a lot in BW in the framework itself. Creating their own objects, creating their own cubes, creating asos, DSOs and so forth, depending on what versions of BW you're on. Not necessarily wanting to just abandon that investment. There's another great example of is, once you're, once you're at least BW 7.5 and above, we make it very simple for you to go ahead and take all of that in BW investment and move it directly into BDC in its format, in its same format as a BW environment. [00:16:54] BW for HANA, same thing, move it right into BDC, it would be in a cloud-based environment that way as well. And essentially all of those connections back to the source systems still persist. When we talk about how do we take advantage of the investments you have, that's where you say, all right, well, I can access them through the BDC framework in [00:17:16] BW that is now part of BDC and use it for whatever purpose I leave it in BW in that case, or I can start taking those particular assets that I have in BW and using the data product generator that is now part of BW embedded in BDC, I can then change those assets in BW to data products. Which is the lowest level form of data that we have in BDC, and in this case, just for those that may be listening and wondering, am I copying the data? [00:17:51] Yes . And we can come to this in a minute as to why you're copying the data, but we are copying the data from its source system, and we would be copying the data from BW as well, where we wanted to make it a data product in BDC. And we can talk about why that is in a minute. 'cause it's a shift. It, it's a bit of a shift in terms of what we've talked about in the past with regards to a whole play the data where it lies, federate versus materialize [00:18:18] that data in, what was Datasphere, which is now part of BDC. That idea of moving those assets from BW into BDC as data products, over time allows us to decommission those, those deployments of BW. So that's the benefit is, we now have a path for BW customers to migrate to BDC, [00:18:45] not give up those assets that they've created and leveraged for so many years in BDC, and then over time decommission BW altogether. Or, if you're really interested and you really like using BW, keep it. That's the other benefit of moving a BW 7.5 environment to BDC is, you're gonna get three more years of mainstream maintenance. [00:19:09] And for example, for BW/4HANA, we're pushing that end of life date all the way out to 2040. That's a long time that you can hold onto that BW environment if that's what you choose to do. But the benefit of BDC is that we're going to give you the mechanism to actually migrate it over and then as your backend systems, particularly like S4 changes, [00:19:31] you're gonna need to change a lot of what you're doing from a BW extraction anyway. Don't do it in BW anymore. Do it in BDC. Now, those are some of the SAP scenarios, but some of the ones that I get as well are, we already have a strategy with our SAP data. We're pulling it into S3 buckets. [00:19:55] Azure Data Factory, Snowflake , all of these third [00:20:00] party extraction destinations and why would I go ahead and use BDC in that case? And the reality is, you have to ask yourself this question where we started in the first place. How much time and energy are you spending going from data all the way around that wheel to analytics? [00:20:20] If you're like the typical organization and it's north of 70%, 80%, 90% as a CIO, I heard last week talking about this, 90% of their time is spent just moving data to get it prepared for analysis. How much do you want to continue to do that? And nobody likes to be looked at as a cost center. Everybody likes to be seen as somebody that is providing value to the organization. [00:20:50] If you're part of an organization and you are seen as a cost center, because the amount of energy it takes to get the data from where it sits to where it needs to be is exorbitant, nine tenths maybe of the overall cost of asking those questions. That's not a great place to be. If you can shrink that as much as possible, then you can actually live up to some of those things that everybody would like to say. [00:21:19] Like, data is the new gold, data is the new oil. The value of data is, is immeasurable. We can do so much with our business because of the data. We could be a data-driven organization. All of these things can become possible, but not so easy when nine tenths or eight tenths of the cost, it's just getting the data where it needs to be. [00:21:44] That's the big thing that needs to be focused on as it relates to some of these ideas that let's go ahead and do the, what I still call old school extract, transform, load, model, profile, catalog govern and, create all of the overhead that is necessary to actually deliver those analytics back to the organization. [00:22:07] And if, you're in a part of your organization where you think it's good enough for me to just extract all the data and drop it over here and let the business go have fun, that's another one where you're not providing additional value to the organization. [00:22:19] What the business community really wants is they want curated data that is business context aware, that is in a position to help them answer questions out of the box, push button. An actual software as a service. That's what we've got with BDC. So this idea that of you've already got a strategy in place, [00:22:44] it might be working right now because you did a ton of work to get you where you are. But here's the kicker. It's probably all going to change, maybe not next year, but maybe two years or three years, maybe the next time you do some major upgrade and we've become more efficient in terms of how we store the data in the business applications, or, [00:23:12] any of the other business applications that you use, they change their underlying architecture in how they are actually storing the data in those source systems. Guess what just changed with your data strategy? Potentially everything. And we have customers that this has happened to them. Where I've walked into a huge SAP customer and I had a conversation with him where I said, we're gonna go ahead, and this is before we had two separate entities of BDC and BTP. And I walked into this session with the customer and said, here's what we're gonna do. [00:23:43] We're gonna go ahead and tell you everything that we can do in the space of data and analytics and everything within the platform space. And the customer said, I don't think we really need to hear about your data and analytics strategy, because we're pretty well set on that. And I said, I want to talk to you about all these things and I need to talk to you [00:24:00] about this one as well. [00:24:01] This one's not negotiable. I need whoever's responsible for data and analytics to be in the room to discuss this. And that person did arrive and that person pretty much felt like they had everything figured out. They didn't wanna, engage in the conversation at all. Pretty much arms crossed throughout most of the most of the meeting. [00:24:19] And we finally got to a point where they said, all right, I can see that there's some benefits, you know, to how this works. But I'll tell you, they were on ECC on HANA. And so fast forward six months and they're negotiating the RISE opportunity with S4/HANA in a private cloud and RISE, and they now realize that everything needs to be changed. [00:24:50] It's good that we had this conversation with them about how you can access the SAP data through, at the time, Datasphere, which is now Business Data Cloud, because they now understand that for them to be able to get access to the data in the way they want, the fastest way they want, and for the fact that we're curating all that data for them, and then providing them out of the box insights with our insight apps. [00:25:14] This is pretty much a no brainer in their part. They knew that they had to explore it, and they knew they had to explore it for the SAP centric question, but also for the non SAP centric question where they want to pull smaller data sets to non SAP capabilities because we are gonna curate those scenarios through data products that will allow them to pull that data into those non SAP scenarios. [00:25:40] So this, these are some of the big plays, we've got that existing SAP solutions, we've got that non SAP centric approach. And then, ultimately, if you haven't got to the point that you're deciding what you're going to do or you haven't don't have a very mature data strategy, maybe you're a growing company, at some point you're going to need to go ahead and start asking those data and analytics questions. [00:26:05] Just know that it's very expensive, as I've said before, to move the data from one place to another, place it there, do all of those things that we've talked about in the past, and then deliver analytics, just pull it out of the box. The last comment I'll make is "that pull it out of the box" sometimes that's not as useful as we think it is. [00:26:25] If I said, you have to dig a hole, it's 10 feet deep and you started from ground level, you have 10 feet to dig. But if I gave you something that got you 50% of the way, I dug five feet for you, I dug six feet for you, would you rather just dig five more feet or four more feet, or would you just rather start from ground level and dig 10 feet on your own? [00:26:48] That's the value that we were trying to demonstrate through BDC. [00:26:53] Mustansir Saifuddin: Good explanation. And I think it is really clear that a lot of times conversations come up about SAP customers talking about their on-prem, their legacy systems and how they will benefit from BDC, but your examples went beyond HANA Enterprise to other non SAP solutions where customers have already been on the journey and they don't see the value at least at this point. [00:27:20] But, after seeing the example you use, it's very logical for them to start thinking in those terms. Also saying, Hey, I simplify my landscape? Still get , if not same, at least, the value that whatever else that BDC brings to the table, like the whole AI capability, all of that can be leveraged by adopting this platform. On a personal note how do you stay on top of, you know, this changing technology world, and business at the same time. How you keep up with all this? [00:27:58] Shawn Brown: Yeah, as you [00:28:00] might imagine in the space of SAP, oftentimes it's hard enough just staying on top of all of the different options we have and different things that we have in terms of technology. So one of the ways that I like to keep up in, in the SAP space is called the BTP Talk podcast, which is a pretty good one. [00:28:18] It actually goes to a number of different you know, platform and data analytics related scenarios. Data skeptics is another pretty good podcast that I get a kick out of. There's another one I'm trying to think of that I use from time to time as well. [00:28:32] Analytics Power Hour. That's it. Yeah, the Analytics Power Hour is another good one. And, I've been paying attention to Tech-Driven Business as well too, so I like this one too. But, you know, the thing that I've been finding too is that, these days, things move so quickly and we think we know where we're going and then something comes along and, and change makes us change direction again. [00:28:53] And AI has probably been the biggest driver to that. The thing that I would say that that it's probably most interesting in terms of how I've changed how I operate is I actually ask AI to provide resources for me on particular topics. For example mid early last year there was a lot of talk about vector engines and knowledge graphs. [00:29:14] And the easiest thing I found to really kind of get a little bit more, versed on the topics was AI itself. I started asking for resources and, and I'll use for example, ChatGPT in some cases I like using Grok as well. From time to time they seem to provide a little bit different types of approaches and levels of interaction. [00:29:35] I kinda like how, grok will ask me follow up questions, which is pretty neat as well. But that's a great way to learn about topics that you are wanting to become more versed in or learning where the resources are to find those topics. So those, those are some of the things that I like to use. [00:29:58] Mustansir Saifuddin: Great list of ideas to kind of keep up with the changing, I mean, just everywhere around us. taking from AI to just carries to anything else. A lot of conversations going on so many different directions. How do you even keep up with them? So I'd like your suggestions, and I know we've talked about a lot of different things today. What is the one thing or one takeaway that you want to leave our listeners with? [00:30:24] Shawn Brown: Hmm, probably in, in the audience of that are responsible for data and analytics. If you're a CDAO, or an analyst or somebody that's responsible for enterprise wide analytics: I would focus on two things because these two things are probably the most important to the people that you serve, your business community. [00:30:50] Point number one is, they want analytics quickly. They want to be able to ask questions quickly. They don't wanna wait. They don't want to say this report, these data sets that you've provided me, they look really interesting, but I'd like to add this and this and this, and when can I have that? [00:31:12] If you can't say you can have that now, then you're taking too long. The other point is. We need to stop being looked at as a cost center. We need to stop being looked at as a place that is a necessary evil. We gotta ask questions of the system. We've gotta extract data everywhere and put it in someplace that we can start answering questions or even not even doing to the extent of actually providing the analytics out of the box. [00:31:40] Instead, we're just providing data sets for people to access. We need to be able to offer real value to the business community. Those are the ones that are footing the bill. Those are the ones that are actually paying for everything. So we need to be in a position to deliver it very quickly, [00:32:00] and it needs to not be expensive, and it needs to be accurate. [00:32:06] Mustansir Saifuddin: Absolutely [00:32:07] Shawn Brown: Those are the elements I think are the key takeaways. That's really the foundation of what we're doing with Business Data Cloud. That's the whole purpose behind it. [00:32:16] Mustansir Saifuddin: Absolutely great advice and a great way to sum up the session. It's been a great conversation. There's so much to gain from this product and, and direction, that SAP's taking. I'd like to thank you very much for joining us today in our show, and look forward to having further detailed conversation with you. [00:32:36] Shawn Brown: Thanks, I appreciate your time as well. [00:32:39] Mustansir Saifuddin: Thanks for listening to Tech-Driven Business, brought to you by Innovative Solution Partners. We have covered the critical why behind BDC, the immense time and cost savings it promises, and the tangible benefits like enhanced speed and accuracy for SAP customers. Sean's key takeaway? Focus on delivering analytics quickly to your business community and strive to offer real accurate value moving away from being seen as just a cost center. [00:33:15] . We would love to hear from you. Continue the conversation by connecting with me on LinkedIn or X. Learn more about Innovative Solution Partners and schedule a free consultation by visiting isolutionpartners.com. Never miss a podcast by subscribing to our YouTube channel. Information is in the show notes.

Richard and George explore the financial journey of a dentist's career through three key phases: income generation, wealth accumulation, and eventual stagnation. They discuss critical decisions around practice ownership vs. DSOs, income benchmarks, and strategies for building generational wealth. This episode offers practical financial guidance for dentists navigating each stage of their career. Check out our events page for our upcoming events https://sharedpractices.com/events/

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

In today's Part 1 episode, Dr. Mark Costes sits down with Eric Giesecke, CEO of Planet DDS, for a deep dive into how a Harvard-educated engineer ended up revolutionizing dental software. Eric shares his journey from nearly buying a lawn care business to acquiring Planet DDS through a unique entrepreneurial path called a search fund.  He breaks down the evolution of their cloud-based platform, Denticon, and why DSOs are drawn to its open API structure and advanced revenue cycle management tools. The two discuss the cultural quirks of the dental industry, the pain of PMS switching, and the future of automation and vendor trust in dentistry. It's an insightful look into how innovation and business acumen are shaping the tools that drive modern dental practices. EPISODE RESOURCES https://www.planetdds.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Ever wonder if the challenges you're facing will disappear once you grow your practice? In this episode, Emmet sits down with J.W. from SupportDDS to talk about why the problems don't vanish—they multiply. They swap stories from the Destination DSO event, share real conversations between owners with 18 and 1600 locations, and get honest about leadership struggles, crucial conversations, and the hidden roadblocks that can stall your growth. If you're wearing too many hats or feel like your team depends on you for everything—you're not alone.

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

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

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

Why Orthodontic Advertising Matters More Than Ever In today's competitive healthcare landscape, orthodontic advertising is no longer optional—it's essential. With more practices opening, DSOs expanding, and patients shopping around online, how you market your services can make or break your growth. Smart advertising isn't just about throwing money at Facebook or Google. It's about strategy, […] The post Orthodontic Advertising: Proven Strategies to Attract and Convert More Patients appeared first on HIP Creative.

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

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

In this episode, Ash discusses the evolving landscape of dental practice ownership, particularly whether it's still worth buying or starting a dental practice. Ash explains that the decision is much more nuanced than it was a decade ago. Factors such as market saturation, shrinking reimbursement rates, and increased competition from DSOs and PE-backed practices mean that buying or starting a practice requires extensive research and self-reflection. The conversation covers challenges unique to both startups and acquiring existing practices, including location selection, identifying business models, and coping with the demands of being both a clinician and a business owner.He also addresses the realities of working with DSOs, selling a practice, and the trade-offs of joining larger organizations versus independent ownership. He also talks about why it's important to understand your career goals, personality fit, and risk tolerance amidst a shifting generational mindset and increasing concern about burnout.Key Topics Discussed:The current viability of buying or starting a dental practiceThe impact of urban saturation and DSOs/PEs on dental ownershipKey factors and research required for successful startupsStartup vs. acquiring an existing practice: pros and consBusiness acumen and the challenge for cliniciansEffects of market demographics, location, and business modelsLender requirements for practice acquisitionThe importance of team dynamics in transitionsDifferences between selling to DSOs vs. individual buyersAlternative equity opportunities for associatesGenerational differences in ownership goalsBurnout and realistic career considerationsPlanning for exit strategies and financial obligations

Coming out of dental school, the type of practice you work for should be a choice made with your long-term goals in mind. With the attractive financial packages, reduced risk and business responsibilities and a “fear of missing out” effect, it's easy to see the appeal of DSOs over private practice. To help new dentists navigate the facts and make an informed decision, Christy and Charles weigh in on both DSOs and private practices and the situations where each could be the right fit.

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

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

On today's Part 1 episode, Dr. Mark Costes welcomes Matt Mulcock, CFP, managing partner at Dentist Advisors and co-host of The Dentist Money Show. Fresh off a trip to Nicaragua together, they dive into Matt's journey from the fitness industry to becoming a trusted financial advisor for dentists. Matt shares the importance of working within a niche, the differences between commission-based and fee-only fiduciary advisors, and why Dentist Advisors takes an education-first approach. They also discuss the rise of private equity in dentistry, the shift in practice valuations, and how younger dentists are being presented with life-changing offers earlier in their careers. If you're wondering whether to take chips off the table or hold out for long-term financial security, this episode is packed with insights to help you make smarter financial decisions. EPISODE RESOURCES https://dentistadvisors.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

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

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

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