Podcasts about dsos

Dentistry is changing fast — from new technologies and practice models to the growing focus on oral-systemic health. In this episode, I sit down with Dr. Abdi Sameni, Clinical Associate Professor at the Herman Ostrow School of Dentistry of USC, founder of the Los Angeles Dental Symposium, and practicing clinician at WLA Dental Center in West Los Angeles. Known internationally for his work in dental photography, esthetics, and interdisciplinary care, Dr. Sameni brings decades of experience and perspective to what it takes to make a lasting impact in today's profession.We cover:How dentistry has evolved and where it's headedHow dental photography can improve diagnostics, treatment planning, and case acceptanceThe real effect of DSOs on dentists and what it means for your futureWhat makes the LA Dental Symposium a standout event for cliniciansThe critical connection between oral health and systemic health you can't ignoreThis episode is a must-listen for dentists who want to stay competitive, sharpen their skills, and build a career that lasts — while making a bigger impact on patients and the profession.Learn more:Dr. Abdi Sameni's WLA Clinic: https://www.wladentalcenter.com/IG: @insta_abdisLA Dental Symposium: https://www.ladentalsymposium.com/_______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.

"You need to understand what you're about to sign." Connect With Our SponsorsGreyFinch - https://greyfinch.com/jillallen/A-Dec - https://www.a-dec.com/orthodonticsSmileSuite - http://getsmilesuite.com/ Summary In this conversation, Rob Montgomery shares his extensive experience in legal work focused on the dental and orthodontic space. He emphasizes the importance of legal guidance for young dentists, particularly when navigating contracts, lease agreements, and partnerships. Rob discusses common pitfalls in lease agreements, the significance of understanding personal guarantees, and the challenges associated with associate agreements and partnerships. He also addresses the misconceptions surrounding DSOs and encourages young dentists to pursue ownership opportunities while being mindful of the legal implications of their decisions. Connect With Our Guest Robert H. Montgomery, III, Esquire, P.C. - https://www.yourdentallawyer.com Takeaways Rob Montgomery has been practicing law for 30 years, focusing on the dental field.Young dentists must understand the importance of legal guidance when entering contracts.Lease agreements can be complex and often favor landlords, requiring careful review.Personal guarantees in leases can pose significant risks for practice owners.Associate agreements should clearly outline paths to partnership to avoid future disappointments.Partnerships and buy-ins are often the riskiest transactions in dental practices.Minority buy-ins in DSOs can lead to unfavorable conditions for dentists.Dentists should not feel pressured to work for DSOs; ownership opportunities still exist.Having a strong legal and financial team is crucial for success in dental practice ownership.Understanding the business side of dentistry is as important as clinical skills.Chapters 00:00 Introduction and Background of Rob Montgomery02:53 The Importance of Legal Guidance for Young Dentists06:00 Understanding Lease Agreements and Common Pitfalls09:11 Navigating Associate Agreements and Partnerships11:58 The Risks of Practice Buy-Ins and Partnerships24:04 Understanding DSO Partnerships and Their Implications31:17 Navigating Associateship Agreements and Partnership Promises38:40 Advice for Young Dentists in a DSO-Dominated Market  Episode Credits: Hosted by Jill AllenProduced by Jordann KillionAudio Engineering by Garrett LuceroAre you ready to start a practice of your own? Do you need a fresh set of eyes or some advice in your existing practice?Reach out to me- www.practiceresults.com.    If you like what we are doing here on Hey Docs! and want to hear more of this awesome content, give us a 5-star Rating on your preferred listening platform and subscribe to our show so you never miss an episode.    New episodes drop every Thursday!   

In this episode, I sit down with Dr. Ben Fishbein — founder of Fishbein Orthodontics, multiple-time DeNovo opener, bagel store entrepreneur, and Smile Doctors partner — to break down one of the most misunderstood topics in orthodontics today: DSOs, OSOs, and what it really means to join one.If you've ever said, “I'm not ready,” “I could never give up control,” or “I don't need help,” this episode is for you. Ben was once a staunch no—until he actually had the conversation. Now, with multiple thriving practices, ownership in a national DSO, and an expanding local business portfolio, he shares what changed his mind—and why most orthodontists are asking the wrong questions entirely.Whether you're exploring a potential sale, considering DeNovos, or just want to sharpen your vision, this episode will reframe how you think about your career path—and the opportunities right in front of you.QUOTES"The most frustrating thing to me is when someone says, ‘I'm not ready to talk yet.' Why are you not ready to learn something that might be so good it changes your life?"— Dr. Glenn Krieger"I was a naysayer too. I told the Smile Doctors team, ‘There's less than a 2% chance I do this.' Then I listened—and it all started making sense."— Dr. Ben FishbeinKey Takeaways04:50 – Why so many orthodontists dismiss DSOs without ever really hearing the facts06:50 – “30 years in 7” — how Ben's early hustle shaped his future faster08:36 – Why listening to opportunities is part of your duty to your team10:15 – Why selling a practice isn't selling out—and how orthodontists misjudge entrepreneurship15:12 – How partnering opened Ben's eyes to investments he never considered before16:48 – The surprisingly valuable business lessons from running a bagel shop20:19 – Why Smile Doctors' DeNovo model works—and how it's redefining growth24:18 – “Get the information. Don't say no to something you don't understand.”25:37 – Ben's biggest advice to younger orthodontists: “Just go for it.”Additional Resources I've seen firsthand how running the numbers—really running them—has changed the trajectory of practices and lives.Want to get in contact with Ben? https://amandafloydconsulting.com/fishbein-fundamentals This isn't about selling out or giving up control. It's about knowing your options, making smart financial moves, and understanding when an opportunity might never come back. If you've received an offer and aren't sure whether to take it, DM me. I don't get paid either way—but I've had this conversation hundreds of times and I'll help you think it through.

While the financial pieces often dominate the conversation in a DSO sale, there are many more factors involved in the process other than EBITDA and multiples. Christy and Charles help practice owners take a step back and understand all the key considerations when partnering with DSOs. From how the practice value is truly calculated, your preferred workback timeframe and your life after the sale, understanding these components will help you set the right expectations.

Our latest episode featuring two incredible guests, Shannon Pace Brinker, CDA, Founder & CEO of Chairside Assisting & Angela Severance, Training & Education Mgr. for DSOs of Ivoclar. They bring a wealth of knowledge and experience in the dental assisting and education space. We had a fantastic discussion about the challenges and opportunities in clear aligner therapy.  Here are three key takeaways that stood out: The Importance of Consistent Training Understanding Materials and Techniques Navigating Insurance and Documentation To learn more about clear aligner therapy education and how Ivoclar can assist your DSO with education and better patient outcomes reach out to Angela Severance at Angela.Severance@ivoclar.com You can learn more about Shannon and Chairside Assisting at https://www.chairsideassisting.com/    

Ash is live at the Southwest Dental Conference, and he welcomes David Mitchell Mejia, a third-year dental student at Texas A&M with a background in accounting. David joins the show to ask key questions that many dental students have about transitioning from school to the business side of dentistry. Ash provides guidance on topics including choosing a practice location, building a team of professional advisors, exploring financing options, and the importance of reviewing associateship agreements.The conversation covers practical steps dental students and new grads can take to better position themselves for professional and financial success. Ash discusses building relationships with legal, accounting, and insurance professionals, and emphasizes tailoring decisions to individual circumstances—whether deciding to open a practice, join a DSO, or remain an associate. Other important topics include managing personal finances, setting up retirement savings, and the differences between working in DSOs versus private practice.Key Topics Discussed: Transitioning from dental school to professional practice• Choosing a practice location and its impact on personal life• Importance of building a trusted team of legal, accounting, and financial advisors• How to evaluate and negotiate associateship agreements• Deciding between opening a practice, joining a DSO, or becoming an associate• Understanding compensation structures and non-compete clauses• Differences between DSO/corporate dentistry and private practice• Managing personal finances and planning for taxes as a new dentist• Retirement planning options such as IRAs, SEP, and 401k• Recommended resources and strategies for gaining business knowledge in dentistry

In this episode, Teresa Williams, COO of Dental Express, and Alan Rencher, CTO of Henry Schein One, discuss how DSOs are using data, cloud technology, and streamlined operations to stay nimble, improve patient access, and scale sustainably in a changing dental landscape.This episode is sponsored by Henry Schein One.

In this episode of the Group Practice Accelerator podcast, Jamie sits down with Polaris in-house strategist, Founder & CEO, Diwakar Sinha to explore the growing appeal of the de novo strategy in dentistry. Instead of, or in addition to, acquiring existing practices, more dentists and DSOs are choosing to build from the ground up—and for good reason. Diwakar shares his insights into what de novos can offer within your growth strategy, and hints at an opportunity to learn firsthand what it takes to launch one successfully.

On today's episode, we bring you part two of Dr. Mark Costes' live presentation from Nashville at a Shine event, where he uncovers the immense pressures dentists face in practice ownership. From the isolation of clinical work to skyrocketing student debt and decision fatigue, Mark explains why fewer dentists are choosing ownership and how this impacts the future of the profession.   He breaks down the pros and cons of startups versus acquisitions, explores the growing influence of DSOs and private equity, and shares why building scalable practices is critical for long-term success. Mark also offers practical guidance for vendors and consultants to become invaluable partners to doctors navigating this complex landscape. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Top 5 Topics:- Doctors vs. Dentists: The Surprising Lifestyle Trade-Offs- Oral Surgeons vs. Periodontists: Inside the Hidden Rivalry- The Insurance Scam: Why Your Dentist Isn't Paid Fairly- Who Really Runs Dentistry? Private Equity, DSOs, and the Decline of Autonomy- From Wine Tasting to Surgery: How Passions Outside Medicine Make Better DoctorsQuotes & Wisdom:“You know you're doing well when the nurses trust you with their care. That's the ultimate compliment.” (00:00)“Dental school does a terrible job of exposing students to what perio really is—we're not just doing cleanings, we're doing real surgery.” (02:33)“Having a strong relationship between oral surgeons and periodontists is so crucial. That's how you best serve patients.” (03:53)“Hospitals don't pay surgeons to take call anymore. Why should young doctors work for free? This is where the system is failing.” (05:25)“Insurance companies are still paying based on 1970s rates. Everything else has inflated, but our work is being devalued.” (12:54)“Most DSOs are owned by investors, not dentists. They know money—but they never took an oath for patient ethics.” (14:42)“Interviews aren't multiple-choice exams, they're conversations. Find common ground and show who you really are.” (33:37)“Anything you can do with your hands—fashion, textiles, sewing—will make you a better surgeon.” (32:07)“Just because a wine is expensive doesn't mean it tastes good. Everyone has a different palette.” (34:59)“Four years in, life looks so different—you finally feel more stable, and that's when the real world begins.” (41:37)Questions:00:05 – Did you notice doctors steering their kids from medicine toward dentistry?01:11 – What did you mean when you mentioned “beef” between oral surgery and perio? 02:10 – Do you feel dental schools do a poor job of showing what periodontics really is?04:39 – Why don't more oral surgeons want to take trauma call in hospitals?08:32 – What are your thoughts on dental schools “boxing” specialties into insurance-driven niches?27:32 – How did you first get into running your wine Instagram pages?Now available on:- Dr. Gallagher's Podcast & YouTube Channel- Dose of Dental Podcast #169- 8.2025#podcast #dentalpodcast #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #doctorlife #dentistlife #oralsurgeon #doctorgallagher

On today's episode, we continue with part two of Dr. Mark Costes' in-depth conversation with Kyle Francis of Professional Transition Strategies. Kyle breaks down why recapitalizations have become more difficult for DSOs, how deal overhang and shifting market conditions are impacting valuations, and why understanding the right equity structure is crucial for dentists.   He also shares what makes a dental practice a “first-round draft pick” in the eyes of top DSOs, including the importance of EBITDA, geography, provider risk, and infrastructure. Kyle closes with key insights on how to time your transition and why it's essential to begin with the end in mind. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://professionaltransition.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

On today's episode, Dr. Mark Costes welcomes back Kyle Francis, founder and CEO of Professional Transition Strategies, for part one of a powerful interview. Kyle shares his journey into the world of dental mergers and acquisitions, how he built a company focused solely on seller-side representation, and why time can be a deal's biggest enemy.  He dives into the intricacies of practice valuations, the differences between individual-to-individual sales versus private equity-backed DSO sales, and the common misconceptions many owners have about liquidity and equity. Kyle also sheds light on how market competition has driven higher multiples and what makes some DSOs thrive while others fail. Be sure to check out the full episode from the Dentalpreneur Podcast! EPISODE RESOURCES https://professionaltransition.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast

Zach and Kevin are joined Alan to have an in-depth discussion on the business of dentistry. They explore the surprising contradiction many dentists face: the challenge of maintaining a profitable practice while also promoting preventive care and serving "healthy" patients who need minimal treatment. They discuss how a shift in the dental landscape, including stagnant insurance reimbursements and rising overhead costs, has made it less viable for some practices to rely heavily on a traditional recall model. The conversation touches on how different dental practice models, such as DSOs, may approach this issue and suggests that offering a wider range of services, like clear aligners, can help make healthy patients a more valuable part of a practice. Join the Very Dental Facebook group using the password "Timmerman," Hornbrook" or "McWethy," "Papa Randy," "Lipscomb" or "Gary!" The Very Dental Podcast network is and will remain free to download. If you'd like to support the shows you love at Very Dental then show a little love to the people that support us! -- Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code “VERYDENTAL10” you'll get another 10% off your order! Go save yourself some money and support the show all at the same time! -- The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! -- Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! -- CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even  their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!

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.

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.

Do you feel like the world of dentistry is shifting faster than you can keep up? Are the rising wages, dwindling hygiene staff, and growing influence of DSOs leaving you wondering what's next for private practice? In this episode, I sat down with my longtime friend and podcasting pioneer Dr. Alan Mead to unpack a critical and controversial topic that's sweeping through the profession: “hygiene light.” We dove deep into the Nevada bill that's igniting fiery debates, explored how mid-level providers are reshaping the profession, and discussed how dentists can pivot, survive—and thrive—through these changes. This episode isn't just about what's happening—it's about how we can take control of our future. Whether you're a seasoned dentist, a new grad, or a hygienist trying to navigate the chaos, this conversation will offer clarity, context, and a solid path forward. Timestamps: @05:20 – What's Actually Happening in Nevada @09:30 – The Hygiene Pay Boom & Shrinking Labor Pool @14:40 – The Medical Model is Coming to Dentistry @19:21 – How I Pivoted My Practice Model @24:51 – What Happens When Hygiene Light Becomes the Norm? @34:53 – Why This Will Be a Net Positive for Dentistry @47:14 – My Vision for Multi-Doctor, Lab-Integrated Practices Connect with Dr. Tarun Agarwal,DDS LinkedIn : https://www.linkedin.com/in/tbonespeaks/ Facebook: https://www.facebook.com/tbonespeaks Tiktok: https://www.tiktok.com/@tbonespeaks Instagram: https://www.instagram.com/tbonespeaks Who is Dr. Tarun Agarwal? Dr. Tarun Agarwal, DDS is considered one of the top dentists in the country. He is a recognized speaker, author, and dental leader. He has been featured on CBS, NBC, ABC, FOX, and News 14 Carolina. Dr. Agarwal has been awarded '40 under 40' Business Leaders by the Triangle Business Journal. He is regularly invited to teach other dentists around the world and recently built a training center within the practice dedicated to sharing his expertise. Most importantly he is a dedicated father of three wonderful children. His biggest accolade was being voted 'Best Dad in the World' by 2 of his 3 kids.

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, 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.

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.

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  

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.