Podcasts about PPO

Client who's husband passed away, importance of life insurance.  Beware of commercials for Medicare and dental. 5 recommended PPO plans.  Getting rid of Medicaid??

Health Insurance is Rigged & Controlled by the Big Companies w/ Donvan Ryckis of Ethos Benefits   - AZ TRT S06 EP10 (272) 6-15-2025              What We Learned This Week Health Insurance is primarily run by the Big 4 - BUCA: Blue Cross United Healthcare, CIGNA, Aetna To Insurance Co's – Premium = Revenue, and they are not going lower profits, so no incentive to lower costs Health insurance employer group plans can be broken down into 4 Parts Network PPO is what people typically think of when they think of health insurance There have been revisions to the Healthcare Act passed in 2021   Guest: Donovan Ryckis, Ethos Benefits https://ethosbenefits.com/   https://ethosbenefits.com/documentary/ https://businessofbenefitspodcast.com/   Our Ethos is Simple: Fiduciary First. Act in the best interest of those we serve—no matter the cost. ‘Ethos' represents the guiding principle, character, or spirit of a person or organization. It's the ‘why' that drives decision-making and fuel's purpose. Our Ethos is deeply rooted in the story of our Founder, Donovan Ryckis. Over a decade ago, Donovan, a fiduciary Series 65 securities advisor specializing in retirement and pension planning, was approached by a client facing a dire situation. The client's publicly traded broker claimed there was no solution for a staggering 37.5% health insurance renewal increase—a cost that threatened the business and its employees. With no prior experience in health insurance markets but guided by his unwavering fiduciary principles, Donovan took on the challenge. The result? He mitigated the risk entirely, delivering a solution 12% below the current rate. This allowed the business to thrive and ensured hundreds of employees wouldn't have to choose between basic necessities and skyrocketing health premiums. That moment sparked a revelation. The fraud, waste, and abuse Donovan had fought in retirement planning paled in comparison to the challenges in healthcare. He saw an opportunity to bring transparency and fiduciary principles to an industry in desperate need of change. Donovan pivoted his career, becoming one of the first fee-based health insurance advisors in the nation. By removing all conflicts of interest in broker compensation, he laid the foundation for what is now the leading innovative employee benefits agency in the country, delivering higher quality care at a significantly lower cost to employers nationwide.       Notes:   Ethos Benefits deals with employee benefits, with a primary focus on group health insurance   Per Donovan ‘Employee benefits are rigged'   Insurance company premium equals revenue. There is no incentive to lower cost, as it would lower profits.   ACA Obamacare passed in 2010, and it capped profits for insurance companies at 20%   Insurance Co's are working to expand their pool to make more profit   Health Insurance guarantees inflation keeps going up, so family of 4 could spend 35K a year   For a business, healthcare cost and employee benefits are a top 3 P&L expense   Ethos strategies can create a 30 to 40% reduction on premium impact to lower costs for a business   The HQ is in Florida, but they are a virtual office with agents and clients nationwide   Healthcare finance and delivery + Improving employee benefits     Seg 1   Donovan's bio, he was a financial advisor with a Series 65 license before he got into health insurance. Around 2014 he moved into health insurance seeing an opportunity for better service.   Typically you see agents who are working for the health insurance company and not really working for the employer companies they are selling to.   Health insurance is primarily run by the Big 4 – BUCA: Blue Cross United Healthcare, CIGNA, Aetna.   Health insurance employer group plans can be broken down into 4 Parts:   1.    TPA or third-party administrator 2.    Network PPO or HMO 3.    Pharmacy benefit RX 4.    Insurance that covers the caps the limits on the stop loss   PPO is your primary network and open on using referrals HMO is a non-preferred network typically has less offerings and tight on referrals   Ethos Benefits helps employers to break up the four parts of a group plan and customize   Network PPO is what people typically think of when they think of health insurance.   Network and the Big 4 health companies have a tighter deal with doctors and contract prices. A lot is pre-negotiated with a set of rates, which is the point of a PPO. This is where you get larger claims and they run in the system of healthcare.     Seg 2   Pay more for healthcare in the U.S. than the rest of the world   The biggest pharmaceutical companies are in the US Pharmaceutical companies in flight prices, and also set the prices They make money through spread pricing   Employers can actually pick up their own Pharma benefit and get the rebates that the big health insurance companies are not giving them   Healthcare system is a rigged game The fraud waste and abuse extremely high in health   401(k) and retirement benefit industry is actually tighter with more disclosure than the healthcare industry   Regulated better since the creation of the Securities Act in the 1930s and updates that ran through the 1970s and beyond with things like ERISA   There have been revisions to the healthcare act passed in 2021 - started in Jan.2022   Actions had 3 disclosures: ·         Brokers comp and bonus ·         Data with gag, clauses, and full access to data upon request ·         Benchmarking for drug cost     Further Notes via Google:   The revisions you are likely referring to are part of the Consolidated Appropriations Act of 2021 (CAA). While the CAA was passed in late 2020, many of its provisions, including those related to transparency in healthcare, became effective on January 1, 2022.  The three key areas of disclosure you mentioned are directly addressed within these regulations: 1.            Broker's Compensation and Bonuses: The CAA amends ERISA Section 408(b)(2) and requires service providers, including brokers, to disclose specific information to group health plan fiduciaries. 2.            Data Transparency (Gag Clauses and Full Access to Data): The CAA prohibits gag clauses, which prevent plans from providing access to their data. It also requires health insurance carriers to attest annually to their compliance with this prohibition. Moreover, the Health DATA Act, a proposed bill, would further reinforce the right of employers to access their data and hold service providers accountable for non-compliance. 3.            Benchmarking for Drug Costs: The CAA includes provisions regarding pharmacy benefit and drug cost reporting, which aims to provide greater transparency and potentially lead to better benchmarking of drug costs. The Build Back Better Act, a separate piece of legislation, also included provisions for Medicare to negotiate drug prices, further impacting drug costs and potential benchmarking.  These revisions aim to increase transparency in healthcare pricing and empower consumers and employers to make more informed decisions about their healthcare coverage.    Seg 3   Ethos works with Employers to create business plans usually with a 3 to 5 year time horizon. The goal is long-term to lower healthcare cost.   Example would be a company with 100 employees with 50 to 80% of them on the health plan (does not include dependents).   Ethos wants to keep the demands of a company low, easy transition.   Ethos handles employee Qs and healthcare navigation. Ethos is full service.   Risk handled 1 of 4 ways - Reduce, avoid, retain, transfer - Transfer to insurance   Broker wants to transfer risk Company can control costs Careful not to have too much disruption with a switch to a new company   Ex - start with pharmacy part NDC National Drug Code Run report vs costs   Pharmacy benefit mgr   Pre packaged health plan Gets co approved pharmacy benefit Save 5 - 15% on costs (30%)   Separate - parts of group plan     Seg 4   Brokers comp - incentives from big insurance companies   Opening move - edit pharmacy benefit piece   State by state - regulators and rules   Employers / employees Know the network and PPO   Nationwide covers insurance part – Stop-loss Insurance   30-40 major stop loss companies Ex: Allstate Met Life Sun Life   Stop-loss insurance for group health plans acts as a financial safety net for self-funded employers, protecting them from large, unpredictable medical claims. It is a form of additional insurance.   Healthcare risk is incredibly predictable on group basis   Overall predictable w stats, actuarial analysis   Gag clauses look at dataset from current carrier   Prescription database sets   3rd party admin are less of a concern, lots of claims   Average of 18 claims per employee per year, includes dependents   Data - review AI Claims analytics software   AI claims analytics software is transforming how insurance companies handle claims by leveraging artificial intelligence and machine learning to analyze data, automate tasks, and improve decision-making.    30 - 40% reduction in premium w Ethos     Further Notes via Google: Group Medical Plans Breakdown of the common components of a comprehensive employer group health plan, particularly within the context of a self-funded model.  Here's a more detailed explanation of each part: 1.            TPA (Third-Party Administrator): A TPA is a company that provides administrative services for self-funded health plans. This includes processing claims, handling enrollment, and managing other administrative tasks that would typically be done by an insurance company. 2.            Network (PPO or HMO): This refers to the group of doctors, hospitals, and other healthcare providers that the health plan contracts with to provide services to its members. The network defines where employees can go to receive care and often dictates the level of coverage they will receive (e.g., in-network vs. out-of-network benefits). ·                                             PPO (Preferred Provider Organization): Offers more flexibility, allowing members to see out-of-network providers, though with higher out-of-pocket costs. ·                                             HMO (Health Maintenance Organization): Typically requires members to stay within the network for covered services, except in emergencies.                 Pharmacy Benefit (RX): This component manages the prescription drug coverage for the plan. It includes negotiating drug prices, processing claims for prescriptions, and managing the plan's formulary (list of covered drugs).                 Stop-Loss Insurance: This is a crucial element for self-funded employers. It protects the employer from catastrophic claim costs. If an individual employee or the entire group's claims exceed a certain threshold (the "attachment point"), the stop-loss insurance kicks in to cover the excess costs, limiting the employer's financial liability.  Additional Considerations: ·                     Data Access: Self-funded plans often provide employers with greater access to claims data, which can be used to analyze healthcare costs, identify trends, and implement strategies to improve employee health and manage costs. ·                     Benchmarking: Employers can use claims data and industry benchmarks to compare their plan's performance to similar organizations and negotiate better rates with providers and other vendors. ·                     Wellness Programs: Some employers offer wellness programs to encourage employees to adopt healthy behaviors and potentially reduce healthcare costs. ·                     Essential Health Benefits (ACA Compliance): Group health plans must comply with the Affordable Care Act (ACA), which requires them to cover a list of essential health benefits, such as outpatient care, emergency services, hospitalization, and prescription drugs. ·                     Other Benefits: Group plans can also include other benefits, such as dental, vision, life insurance, and long- and short-term disability insurance.  Understanding these different parts is essential for employers to effectively manage their group health plan, control costs, and provide valuable benefits to their employees.      Investing Shows: https://brt-show.libsyn.com/category/Investing-Stocks-Bonds-Retirement       ‘Best Of' Topic: https://brt-show.libsyn.com/category/Best+of+BRT      Thanks for Listening. Please Subscribe to the AZ TRT Podcast.     AZ Tech Roundtable 2.0 with Matt Battaglia The show where Entrepreneurs, Top Executives, Founders, and Investors come to share insights about the future of business.  AZ TRT 2.0 looks at the new trends in business, & how classic industries are evolving.  Common Topics Discussed: Startups, Founders, Funds & Venture Capital, Business, Entrepreneurship, Biotech, Blockchain / Crypto, Executive Comp, Investing, Stocks, Real Estate + Alternative Investments, and more…    AZ TRT Podcast Home Page: http://aztrtshow.com/ ‘Best Of' AZ TRT Podcast: Click Here Podcast on Google: Click Here Podcast on Spotify: Click Here                    More Info: https://www.economicknight.com/azpodcast/ KFNX Info: https://1100kfnx.com/weekend-featured-shows/     Disclaimer: The views and opinions expressed in this program are those of the Hosts, Guests and Speakers, and do not necessarily reflect the views or positions of any entities they represent (or affiliates, members, managers, employees or partners), or any Station, Podcast Platform, Website or Social Media that this show may air on. All information provided is for educational and entertainment purposes. Nothing said on this program should be considered advice or recommendations in: business, legal, real estate, crypto, tax accounting, investment, etc. Always seek the advice of a professional in all business ventures, including but not limited to: investments, tax, loans, legal, accounting, real estate, crypto, contracts, sales, marketing, other business arrangements, etc.  

Dealing with dental insurance can feel like a never-ending maze—especially when you're unsure whether you're getting the reimbursement you deserve. In this episode, we're joined by Adriana Steinberg of Apex Reimbursement Specialists to talk about how dental practice owners can take control of their insurance strategy and boost profitability through effective PPO fee negotiation, credentialing, and billing improvements. Topics covered in this episode: The current insurance landscape and its impact on dental revenue How PPO fee negotiation works (and why it matters) Credentialing strategies that avoid lost income Outsourced vs. in-house dental billing How to benchmark and track your reimbursement trends Connect with Adriana: https://www.apexreimbursementspecialists.com Visit us at willowcfo.com for more resources and to subscribe to our newsletter.

In this episode of the Less Insurance Dependence Podcast, Gary Takacs and Naren Arulrajah unravel one of the most frustrating and often hidden realities of PPO resignation: umbrella plans. Many dentists think they've successfully resigned from a few insurance plans, only to find themselves unknowingly locked into a much larger web of networks. Gary and Naren explain what umbrella plans are, why they exist, how they're strategically designed to confuse and fatigue dental teams, and what you can do about it. Book your free marketing strategy meeting with Ekwa at your convenience. Additionally, at the end of the session, get a free analysis report to find out where your practice stands online. It's our gift to you! https://www.lessinsurancedependence.com/marketing-strategy-meeting/  If you're looking to boost your case acceptance rates and enhance patient communication, you can schedule a Coaching Strategy Meeting with Gary Takacs. With his experience in helping practices thrive, Gary will work with you on personalized coaching, ensuring you and your team are prepared to present treatment plans confidently, offer financing options, and communicate the value of essential dental services. https://www.lessinsurancedependence.com/csm/ 

Struggling to balance efficiency with patient connection in your dental practice? In this episode of the Thriving Dentist Show, Gary Takacs shares expert tips on how to increase patient trust, improve case acceptance, and create a new patient experience that builds lifelong loyalty. Learn how to reduce PPO dependence while delivering exceptional care—and hear actionable local SEO strategies from Naren Arulrajah to help your dental office rank higher on Google Maps. Perfect for dentists, dental teams, and practice owners looking to grow a relationship-driven, profitable dental practice.

Lee Camp digs into the new US/ Palantir partnership to track everyone. Plus the new ceasefire plan. PLUS the new plan to go after Russia. PLUS much more.To learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Lee Camp digs into the new US/ Palantir partnership to track everyone. Plus the new ceasefire plan. PLUS the new plan to go after Russia. PLUS much more.To learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Host Becky Annison explores the UK's court backlog crisis and its troubling ripple effects throughout the justice system. Her guest, Adrian Usher, the UK's Prisons and Probation Ombudsman, explains how delayed trials are creating a bottleneck in prisons, with some Crown Court cases now being scheduled as far ahead as 2028, and he outlines the human cost of these systemic failures. Adrian explains why coming into his role as PPO after a long career as a police officer changed how he thinks about prison sentences, and he discusses with Becky the many difficulties inmates face under current prison conditions. This thought-provoking episode challenges legal professionals of all specialties to consider their duty to an increasingly strained justice system.

JCO Editorial Fellow Dr. Lauren Shih and JCO Associate Editor Dr. Stephanie Wheeler discuss the ASCO 25 Simultaneous Publication paper "Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare." Transcript The guest on this podcast episode has no disclosures to declare. Dr. Lauren Shih: Hello, and welcome to our 2025 ASCO annual meeting series where we cover some of the top JCO papers published simultaneously with their abstract presentations at this year's meeting. I'm your host, Dr. Lauren Shih, JCO editorial fellow, and I'm joined by JCO Associate Editor Dr. Stephanie Wheeler to discuss the Journal of Clinical Oncology article and abstract presentation "Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare." Let's start with the relevance of the article. Dr. Wheeler, can you explain this to our listeners? Dr. Stephanie Wheeler: Thank you so much. Let's get right into it. So this article is really about understanding different types of Medicare plans and what we should expect to see in terms of their use of low-value treatments for cancer patients. So, as Medicare really is focused on trying to limit the use of low-value cancer treatments, we really need to better understand the drivers of variability. So we know that many cancer patients have multiple treatment options available to them. We also know that the vast majority of older adults beyond age 65 are insured by Medicare, and about half of them are on Medicare Advantage plans, which are serviced by private insurance. And private insurance companies in this case are receiving capitated payments for Medicare beneficiaries to manage their service utilization and reduce costs. So, with respect to Medicare Advantage versus the traditional fee-for-service Medicare, it's not really been known to what extent low-value treatments are differentially used by these types of plans for cancer patients. And so that was really the focus of this article. What the authors found is that across six different types of treatments, in general, the folks who were enrolled in Medicare Advantage plans had reduced use of low-value treatment. So that's a good sign for Medicare beneficiaries. And although the relative difference in that use was somewhat low, this translates to a significant number of Medicare enrollees across the country not receiving these low-value treatments. And of course, this translates to considerable savings at the society level. Dr. Lauren Shih: Are there any additional key results that we should review? Dr. Stephanie Wheeler: Yeah. So I'll tell you just a little bit more about the methods and also their findings. So they looked at six different low-value treatments, and this was in, again, 100% of national Medicare enrollees from 2015 through 2021. So the six low-value treatments that they examined were the use of G-CSFs among patients receiving low-risk chemotherapy and denosumab for those who had castration-sensitive prostate cancer. Then they also looked at four high-cost treatments, including using nab-paclitaxel instead of paclitaxel for patients with breast or lung cancer; second, adding bevacizumab to carboplatin plus paclitaxel for ovarian cancer; third, using brand-name drugs instead of generics when generics were available; and fourth, using biologics instead of biosimilars when biosimilars were available. And these are all, by the way, non-recommended treatments according to a variety of guidelines, including NCCN and ASCO's Choosing Wisely guidelines. So they used the Medicare claims data to examine use of these regimens. They also analyzed results by type of Medicare Advantage plan, whether people were enrolled in a health maintenance organization plan, or an HMO, or a preferred provider organization plan, or a PPO. They also looked at the largest Medicare Advantage insurers—including Aetna, Blue Cross Blue Shield, Cigna, Humana, and UnitedHealth—and limited their analyses to those that had complete encounter data. And what they found across the board is that the enrollees in Medicare Advantage plans generally had lower use of these low-value treatments. And the largest differences between Medicare Advantage and traditional Medicare plans were in the outcomes, including G-CSF use and using denosumab for castration-resistant prostate cancer, and then the combination of bevacizumab, carboplatin, and paclitaxel versus carboplatin and paclitaxel. And all of these had a change in use ranging from about 19% change to 24% change in use. This is significant as a field as we look at ways in which different plan organization can influence use of treatments, particularly given the excess cost of cancer care. This is something we really want to pay attention to. So I'd encourage folks to look more closely at the results by treatment type as well as the results by plan type to see a little bit more about what was going on across different plan types. Dr. Lauren Shih: Great. And are there any outstanding questions that need to be answered? Dr. Stephanie Wheeler: Yes, there always are, of course. I think the study has several strengths that are worth noting. First, they have 100% of Medicare enrollees, so there's national coverage there, which is, you know, quite outstanding. They also use an appropriate choice of analysis to help deal with some of the selection. So they use inverse probability of treatment weights, and they control for practice and county indicators to try to get some realistic adjustment for the selection that happens in terms of how patients are enrolled in different Medicare Advantage versus traditional fee-for-Medicare plans. These statistical approaches are a good idea, but they are limited by the observed variables that we can use for these kinds of adjustments. And so any unobserved—confounding or any unobserved factors that would influence selection in these plans aren't going to be captured well. So preferences, for example, that patients may have about different types of plans when they're insuring themselves and their families may not be captured. Second, the data that are used are only encounter data from those plans with complete records. That may mean that smaller Medicare Advantage insurers or those that don't have as comprehensive records are not included. So this may not be reflective of their practice patterns. And then third, of course, this only looked at six different low-value cancer treatments. It remains to be seen whether this kind of finding extends to other types of low-value cancer treatments, and that's an opportunity for future study. Finally, I would say that we don't exactly know why these patterns exist. It could be that Medicare Advantage plans have different approaches to prior authorization. They could have more in-house quality control and management to really understand, among their population for whom they're receiving Medicare Advantage payments, to really look at care quality and assess Choosing Wisely guidelines. We don't know exactly how that's playing out. And so we need additional data to really figure out what's working here and what are opportunities for future policy and payment innovations that can further reduce low-value care. Dr. Lauren Shih: Great. Thank you so much, Dr. Wheeler, for speaking to us about the JCO article, "Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare." We really appreciate your insights. Dr. Stephanie Wheeler: Thanks for having me. Dr. Lauren Shih: Join us again for the latest simultaneous publications from the ASCO 2025 Annual Meeting. Please take a moment to rate, review, and subscribe to all ASCO podcast shows at asco.org/podcasts. Until then, enjoy the rest of ASCO 2025. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Clinton Timmerman and Russell Schafer are joined by Steffany Mohan, who hails from the greater Des Moines area of the Hawkeye State.  Steff has gone from owning one office to five, including a sleep center, and even has some that are completely fee-for-servcie vs others that are heavy PPO.  If you're possibly looking for a job or even just need someone to talk to, Steff invites you to reach out at steffmohan@gmail. Ask her to tell you about her favotire Tom Arnold story from her Ottumwa days. 

Lee Camp digs into the recent Venezuelan elections, 10 horrible things hidden inside Trump's "beautiful" bill, and moreTo learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Have you ever wondered how the insurance plans you accept today could make or break the sale of your dental practice someday? In this powerful episode, Michael Walker sits down with Kim McCleskey and Kyle Francis from Professional Transition Strategies to uncover how your current insurance participation, especially with PPO plans, can dramatically affect the value and marketability of your dental practice. Kim and Kyle share real-world stories, actionable advice, and clear steps for dentists who are planning a future transition or simply want to strengthen their financial foundation. They discuss common misconceptions about reimbursement rates, the role of insurance in buyer interest, and how to begin making smart, strategic changes. Book your free marketing strategy meeting with Ekwa at your convenience. Plus, at the end of the session, get a free analysis report to find out where your practice stands online. It's our gift to you! https://www.lessinsurancedependence.com/marketing-strategy-meeting/  If you're looking to boost your case acceptance rates and enhance patient communication, you can schedule a Coaching Strategy Meeting with Gary Takacs. With his experience in helping practices thrive, Gary will work with you on personalized coaching, ensuring you and your team are prepared to present treatment plans confidently, offer financing options, and communicate the value of essential dental services. https://www.lessinsurancedependence.com/csm/ 

Lee Camp digs into the recent Venezuelan elections, 10 horrible things hidden inside Trump's "beautiful" bill, and moreTo learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

The former Israeli Prime Minister Ehud Olmert has accused Israel of war crimes. Plus the US and Germany have decided to remove all range restrictions for Ukraine.To learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

The former Israeli Prime Minister Ehud Olmert has accused Israel of war crimes. Plus the US and Germany have decided to remove all range restrictions for Ukraine.To learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Peter Kuipers, CFO of Clover Health. Peter shares how Clover's technology-first approach is enabling earlier chronic disease diagnosis, improving care quality, and driving down costs—while expanding access through a premium-free PPO model and partnerships with other payers.

Lee Camp and Eleanor Goldfield cover Trump's new massive giveaway to the rich, cuts for the poor. Plus, Israel sh---ing at diplomats, and much more!To get FREE help navigating Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option. *Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Lee Camp and Eleanor Goldfield cover Trump's new massive giveaway to the rich, cuts for the poor. Plus, Israel sh---ing at diplomats, and much more!To get FREE help navigating Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option. *Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

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.  

Many dentists feel trapped in the PPO system—working long hours, doing more dentistry, and still questioning, “Where's the money going?”In this episode of The Dental Boardroom Podcast, Wes Read, CPA and CFP, talks with Dr. Anissa Broussard about her powerful shift from PPO dependence to a thriving fee-for-service practice. Dr. Broussard shares how she reframed her mindset, leveraged social media to attract ideal patients, and built a brand rooted in authenticity and trust.They also discuss the financial and emotional challenges of leaving insurance behind—and how purpose, leadership, and smart marketing can lead to lasting success.Whether you're a dentist considering a fee-for-service model or want to better align your practice with your values, this conversation offers both inspiration and actionable insights.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Peter Kuipers, CFO of Clover Health. Peter shares how Clover's technology-first approach is enabling earlier chronic disease diagnosis, improving care quality, and driving down costs—while expanding access through a premium-free PPO model and partnerships with other payers.

Tiff and Kristy talk about how to reach an ideal state: three-day work weeks and clearing that seven-figure mark. Their advice includes block scheduling, mining your patient base, aligning your team, and more. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript Tiffanie (00:01) Hello Dental A team. I am back here today with Kristy. I am so excited to be here, Kristy. And for those of you who maybe this is your first podcast with us, my name is Tiffanie and I am a dental consultant here with the Dental A Team. And as Kara said, we're taking over the podcast. So I've got Kristy, one of our other amazing and just beautifully minded and just sweetest ever.   consultants. Kristy, you are just one of the most amazing human beings I've ever met and I'm just so excited to have you here on the podcast with us as well as on our team. So happy Friday. It's Friday here for us and we are we've got a couple podcasts we're going through today, Kristy. I'm really excited for this one. But before we get started, how are you today?   Kristy (00:47) doing wonderful. The weather's great and I'm here with you. It's equally ⁓ mutual feelings to be here with you and podcast for our people. So love it.   Tiffanie (00:59) Amazing. Thank you. I'm glad you're having good weather. It's hot here. So be prepared for that. I know you're coming to Arizona soon. So it's very hot here right now and it should cool down a little bit next week while you're here though. So you should be fine. Maybe bring some of that nice weather with you. So today you guys, really want to chat. There's a few things I want to chat about and today on this podcast, I wanted to chat through   really making your life whatever it is that you want that to look like. And a lot of the doctors that we work with want to obviously cut down clinical hours. I think that's something that's on everyone's radar is really being able to.   Work the days of the week that you want to in the practice and then investing that additional time back into your family and into your personal life, your friends, all of those spaces that you would normally spend that time, whatever that looks like for you. And Kristy, we've talked about this a lot and I actually, have one plan I can think of off the top of my head right now that we have worked really hard to get his schedule and his intentionalities exactly what we're talking about today. And what he does so that everybody can hear is he works about three and a half   days per week and definitely definitely clears over seven figures and so what I wanted to talk about today is really how do we get to that three day per week clinical time and that seven figure mark that you know we're dentists here like you guys should be you guys should be making that if that's what you want to make you should be making that and how do we make that happen as a reality and when I first started working with this practice years and years ago he was like gosh I think you know Tiff   long-term, like within five years, this is what I want to be making, but I think I'm gonna have to add a fourth day a week. I'm gonna have to work Monday through Thursday. And I was like, well, maybe, but I mean, do you want to work Monday through Thursday? And at the time he said, I maybe by the time I get there, I do right now, I don't. Great, well, if you change your mind, then we can add it, but let's build this without that fourth day.   And he along the way decided, you know what, actually want to do two Thursdays a month because it fits, it just fits with his lifestyle, fits with what he wanted to do. So it turned into, you know, average of three and a half days per week. But he stuck to the idea of creating his practice to look like what he wanted it to look like. And I remember Kristy early on and still to this day sometimes that happens, but I remember early on him really acknowledging the fact   that this was what he wanted for himself, for his family. This is what he, you know, was active in his community and within his church. And he wanted this to be a reality for him. His opposing side, what was happening there, was that he was on a lot of dental forums with a lot of classmates and people he'd met at CE courses or wherever along the way. And he was really, really getting wrapped up in the numbers of it all and what...   what they're doing and having a bigger practice and adding operatories and adding an associate and five hygienists and he was thinking, gosh, to get where I want to go, all of these doctors feel like they've made it, you know, and do I then is that what I need to do to make it? And I think all of us do this, whatever position we hold, think even as like a mom, right? It's like just that compares the night as we look at other people.   other moms and we're like, how come I don't do that or should I be doing that or etc. And it's got to be so hard to live that way. Right. And really, really, what we had to do was we had to take a step back and think about what is the most important thing for you right now? What do you want your life to look like again? Right. And what does that mean in your life if you're posting?   And we had to create all of those spaces from a feeling standpoint and then implement them. So my story, that practice, know, it just pops into my head. He's the one that pops in my head when I think three days, seven figures. And he's just come such a long way and it's had its trials and its tribulations, but I really wanted to take a step back and look at what did we do? How did we create that for our clients?   and how do we help someone to get to that point? And Kristy, I know you've worked with a lot of practices as well, and you've helped dentists do the same thing. So I wanted to take them through some of those processes today and the build out of those goals with the intentionality behind it. Kristy, I know you...   work with a ton of practices and I know you've done this a million times and if I were to come to you and say, gosh, I have this dentist who wants to work three days a week, this is the amount of money that he or she wants to make, take home, the profit. What would be the first space you would, you would coach on? Where would you say, let's start here?   Kristy (06:04) Yeah, I love that you're speaking that because again, we can make those goals. We just got to clearly define them. And to your point, I would definitely start with scheduling it, right? If that's what we need to make, let's reverse engineer it and block schedules so that we ensure that's happening. The other part that I would add in there is it's kind of funny that you're saying like three and a half days a week because ⁓   What we tend to see is when we do add those block schedule and doctors hit that three, three and a half days a week, they tend to be more profitable during the time that they're there rather than working five days a week. So yeah, most definitely I would start with number one, looking at that goal and then reverse engineering it into the schedule using their scheduling blocks.   Tiffanie (06:55) For sure. I love what you said   there because it makes me think of, always tell my son like, gosh, you would take and I would too, right? If I gave you an hour in the morning to get ready, you would take the hour and be rushed.   But if I give you 30 minutes in the morning to get ready, you're gonna be ready at 28 minutes. Like you're gonna get it all in, you're still gonna get it done, you're just always gonna utilize the amount of time that you have. So what you said there is I do agree, I do see a lot of doctors that will work.   less clinical than other doctors and their intentionality behind getting the production in there, especially when there's a really good why behind it is so high that they work harder to get that production there and to maintain it. And so they actually do become a lot of times more profitable than doctors who are working maybe five days a week because their production is getting spread out, especially on the scheduling side for a team. They're like, well, I got to have something on Friday. We got it. We've got to be here. So   I'm gonna put this crown on Friday, whereas if we were only Monday through Wednesday, it would probably get stuck on Wednesday this week rather than Friday and giving so much availability to the patient. So I totally agree. And you're spot on with the goals. So that's exactly what we did. We said, okay, well, if you wanna make this much money, take home, what does that look like fixed cost-wise, overhead-wise? So we had to build out what that goal meant.   how we could get the practice to be profitable enough to make that much money as take home and then reverse engineer that. So we had to say, what does that look like? All the multiplication, the addition, all of those pieces. What does that look like in a production goal?   so that 98 % or higher of collections gets you to that profitability. Then you have to backtrack and say, well, great, this is how much money I need to make this year, maybe a million dollars, right? We wanna break one million this year. How do I do that? What does that look like per month in production?   Then we say, okay, divide that by how many days per month we're working. So if we're working three days, right, it was probably about 12 days on average. So what does that look like every day? And how much production does that equate to? And I do have to say a caveat here.   because I think it's easy to say, yeah, but what about the fee schedules? Totally agree with you. You need to get your fee schedules up. Number one, if you can do anything about your fee schedules, go work on those. First and foremost, number one, get those things in line. But I do have to say this dentist I'm thinking of specifically is in the heart of a very saturated state and a very   difficult area to get ⁓ fees increased and he is PPO driven in lot of different directions. So it is possible. It just depends on what you're willing to do and then also what treatment you're doing. So what we have done with that is we've built out that block schedule. We've built out how his optimized days would look. So when is he doing his crown preps? When is he doing his large treatment? ⁓ Is he doing root canal?   love them. So which root canals is he doing if he's going to do them? Oral surgery, like what are we doing in those three days? And how do we build the production to match that daily goal? And then it was a, there, are there things that you want to be doing that maybe you're not doing a lot of yet? And he, this specific dentist, I've got another doctor, I've got a couple doctors that are like, yeah.   Tiff, I want to do implants and I want to do cosmetic cases. I want to build smiles and do smile design. And I'm like, well, great. If you can get one or two smile designs a month, are you kidding me? We're halfway there. So then what we had to do is we said, OK, great. Where would we do those in the schedule? When they come, where would we put them? And build that out as well. So the implant.   Obviously the implant placements like those were going to go first. Where are those going to be and how many implants do we need per year to help equate to that goal? then Kristy, I know you've done this a few times as well, looking at the marketing space, right? Because what do you feel like Kristy then?   We've got this goal set, we've got this block scheduling in place and we're like, okay, great. We want to do more implants and more cosmetic cases. Kristy, what would you then look for to increase those within the practice?   Kristy (11:38) Yeah, well number one, I always like to go mining in our own patient base, you know, and I love that you mentioned like the service mix and doctors wanting to do specifically in this case, the implants, because it's funny how many times we hear that and then we go back and look like at the last 12 months and maybe they've done five implants, you know, I love doing them, but why aren't we doing them, right? And so just by recognizing that, putting a goal to it and then   Tiffanie (12:01) Yeah.   Kristy (12:08) consistently going back and measuring that. We've talked about this before Tiff, if I'm gonna go buy a white car of a specific brand, all of a sudden I start seeing all those. So to your point, I would go back to our patient base. I would definitely make sure the team is aware of that goal and then enroll the whole team on how do we find more of these patients that could use implants, right?   Then amongst our own patients when they're coming in, do they have missing teeth? Did we do a recent extraction, right? Have we discussed this before and it's time to bring it back up? So ideally that's where I would go because they're already in your practice, they love you, you've got a relationship with them and you'll be amazed at how many patients you'll find just by putting it front of mind and enrolling the whole team behind you to look for it.   Tiffanie (13:06) I agree   and training them on the right questions, the right scenarios. Like what are we looking for? Are we looking for missing teeth? Are we looking for cracks? we like bringing that awareness? I totally agree. think everything we want is actually already here. We're just not tuned in to see it. So just like the car, we want the white Camaro because we never see a white Camaro. We make that decision to like, that's what I'm going to get. I'm going to get a white Camaro because no one has them, right? Or a purple Camaro because no one has them. And this   Kristy (13:35) Thank   Tiffanie (13:36) the next thing you know, you're like, well, shoot, I was wrong. There's a million of them. I want something different. And you're just going to keep going on that road because you brought the awareness to you. So I love that analogy. And I think it's so fitting for any, any treatment that you're trying to increase in your practice. It's already there. We're just not attuned to looking for it yet. So there's already opportunities there. How do we get the team members?   Kristy (13:41) Thank   Tiffanie (14:04) in line with seeing them to support you in the diagnosis. Now, the biggest thing I can say right now is if you have this goal or a different goal, I don't care what your goal is, if your goal is to work three days and make seven figures, that's fine. ⁓ Whatever your goal is, enlist your team in the support factor of achieving that goal.   because without them, it's all on you and there's no way, doctors, that you can do it all. You cannot, you will not remember.   all of these spaces to look for the implants, especially if you're like, well Tiff, gosh, Kristy, I want to do implants, I want to do cosmetic cases, I want to try all on fours, I want to, you know, I want to reduce the number of root canals I'm doing, but I want to do more extractions, like gosh, dang it, there's 16,000 different things that you could want to do that are top of mind on your brain, but what is the decision of today? What is our focus?   How are we gonna measure it and how are we gonna stay consistent? I've had multiple dentists ⁓ wanna add more implants and Kristy, I love how you said to go back through the inventory, because it's exactly where we started. Many, dentists have done this very successfully. I know with me, with you Kristy, with all of us and on their own, really looking at how many did I do? How many have I done? Because sometimes, right, we'll think,   you get your hair cut and you're like   10 people tell you, gosh, your hair looks amazing, right? And the one person is like, I don't know if I would have done bangs. Like that was a bold move, right? And the next thing you know, you're in the mirror going like, gosh, dang it, should I have done bangs? Because one person out of 11 said that, and that's what you remember. And so when it comes to this, think the same philosophy applies because you might think, gosh, I've done a million and you did two. Or you're like, I didn't do any. And you're like, oh my gosh, I did 16. How is that possible?   Kristy (15:40) Yeah.   Tiffanie (16:04) we weren't looking at it. And if you've done whatever number you've done, how do we increase and layer on top of that? Because if you could find five last year...   I guarantee there's probably 15 more that we either diagnosed and didn't get acceptance on, or we just didn't see. So Kristy, to your point, really adding that in to even your morning discussions of looking at the patients and saying, who's eligible for whatever treatment it is that you're focusing on? Do we have patients coming in today that are actually eligible for that treatment? Do we have patients that we've already diagnosed this on? Can we ask, why aren't we scheduled? What's holding us back from getting this treatment done? Why not today?   Where can we find those opportunities within the patient base we already have? And then dialing in your messaging to the community. Because you've got to start making sure that you're attracting the patients that are going to build your business to meet the goals that you want. We cannot.   Just like we can't make everybody happy, we cannot serve everyone in the dental community. You are built to serve the community that fits your desired outcome. So if you try to blanket, serve everyone, you're gonna get a crazy mixed bag and you're probably gonna be really stressed out. But if you commit to serving the people that fit your avatar and who you are,   you're going to be able to reach these goals really easily. So dial that in with your marketing company or your marketing gal at the practice, whatever that looks like, dial that in. I know I've had a couple of practices, Kristy, that have struggled with new patients or they've had a flood of new patients. And when we look at it, they've had a flood of new patients, but struggling to meet production goals. And I'm like, well, one, maybe we have too many new patients or two, what kind of new patients are you getting? And I've had   all kinds of scenarios, but one that comes up a lot is too many limited exams, and we're focusing on same day treatment or like quick turnaround and not converting to comps, which it's technically a new patient into the practice, so count it how you want to. But when we've got, I don't know, 40 new patients and 25 of them are limited exams, 15 are only new, we're gonna struggle. So, Kristy.   We've got a lot here ⁓ going on all kinds of different tangents here and we still have one more point that I wanted to get to, but let's recap. So we've got.   Kristy (18:29) Bye.   Tiffanie (18:36) building out the goal, reverse engineering that and making sure we've got block scheduling in place, which we're not going to clearly do like a huge block scheduling podcast today, but there are a million and you can email us Hello@TheDentalATeam.com for tips and tools as well. And then dialing in that marketing space to make sure we're getting the patients that we want internally marketing to our patients, making sure that we're speaking to them and then externally marketing to the patients that we want as well. And then Kristy this is a space, this next one that I'm going to   you to get to. This is a space I think you do really well with teams, so getting to the seven figures production is one space of it, the right patients, that's just one space of it. But we can produce all we want and if the money's not coming in you're not, you're just...   upside down and you guys are just tired. So Kristy, I can talk, we can both talk production for freaking days and marketing for days, but what do they need to do on the flip side of that and what support, again, from their team members do they need to make sure they have in order to reach this goal?   Kristy (19:39) Yeah, absolutely. I always like to say, number one, let's start with ⁓ what is our parameters for the office? Your team members that are presenting finances, they need to have the understanding, what can they do? What are the tools in their tool belt ⁓ to offer to patients? And then it really is about getting creative. Even if the office is wanting everything paid in full on the day of service,   You know, are we letting patients walk out the door just because they can't pay it all at one time? You know, we could get creative and potentially even do like a layaway process, right? Or if these are big treatment plans, you know, do we have the right third party financing? There's specific finance companies that do larger amounts. And so getting to, you know, when we're presenting financials,   Tiffanie (20:28) Yeah.   Kristy (20:37) understanding truly what are the parameters, setting the realistic expectations within the office of what is our goal for finances. We want 98 % as a minimum goal for collections. So ideally we're meeting that. then also just making sure we have means for people to say yes financially, if you will.   Tiffanie (21:05) Yeah, yeah, and I love the way that you go through that with your clients on getting that yes and getting the financial options dialed in because it is different for each doctor in a lot of ways. And in addition to that, making sure we have that follow up process. So if we can have the tools to treatment plan correctly, collect   in advance or on the day of treatment over the counter correctly, fantastic. And then on the flip side of that, we've got to have the systems in place for insurance claims follow ups. And then if there's anything outstanding after insurance for patients, how are we gonna get that money? How are they gonna pay? And what are our options for that? Because just like you said now, Kristy, making sure we have those options for treatment planning and case acceptance. Well, what do they do? What are their options if they have a bill?   leftover, is it the same? Like what does the team do with that? So I agree having those protocols written and having them dialed in and trained is massive. So thank you. That is a space I think you really thrive and I've watched you train, I've watched you train doctors on how to do collections. So I think that's impressive in itself. So I want to make sure you, you got all that out there. Thank you. So recapping, we've got   Making sure you guys know what it is that you want first and foremost. Know what it is that you want. Reverse engineer from there on how you're gonna get there. So build the financials out and then also build that block scheduling in there you guys. We harp on block scheduling and we're not the only consulting company that works with block scheduling and there's a reason for that because it freaking works. I just got off a call with the doctor an hour ago that was celebrating a 6 % decrease in overhead for quarter one because   is working, collecting is working, the protocols that they put into place and she specifically said the block scheduling is working. So this is within an hour of us recording this, go do it. And then making sure that your marketing is working internally and externally, you're attracting the patients that you want into your schedule and getting those collections processes in place you guys. If you don't have them, if you need help with any of this, you know to reach out, that's what we are here for.   We love giving information out. That's why we have all of these podcasts. I don't even know how many we have anymore. There's just a slew of them. whatever it is you need, just go to TheDentalATeam.com and search in the podcast tool bar and it will be there.   Kristy, parting words. I love, I know I shocked you with this, you're going to be shocked anymore, but I love your parting words always. So if you could wrap today's podcast into a bundle and impart some wisdom on these doctors that are listening, what would it be?   Kristy (23:48) Yeah, I would say number one, track and measure, right? If that's your goal to do more of that, let's get more of it. Track and measure. When you have cases closed, really take a look at what did we do? Like how can we repeat what happened? Your conversations, everything, you know? And then when you are treatment planning implants, because we were talking about implants, say, and you have patients that leave and don't schedule.   Make sure your admin team or treatment coordinator, whoever is presenting that treatment, writes down what was the patient's words, what were their objections, because that's where our opportunity lies. And a lot of people automatically think it's a financial thing. And sometimes it's not financial. Sometimes it could be from the clinical side, how can we get better at presenting that treatment, expressing the benefits and   Tiffanie (24:34) Thank you.   Kristy (24:43) of doing the treatment, consequences of not having an implant, right? And add an expense if we don't do it. with that, really dial into those opportunities, celebrate your success, and then where the opportunity lies, we can certainly help bridge that gap for you. So, yeah.   Tiffanie (25:02) I love that. Thank you.   Alright guys, you heard it from us here today. Go get to work, go build out those goals, go figure out what that looks like for you and for your lifestyle, what you want. And as always, drop us a five star review below so we know that this was helpful and beneficial for you and so that others can find it. Hello@TheDentalATeam.com is an easy way to find us or TheDentalATeam.com are all kinds of different avenues to chat with us. So if you need anything, when you need anything, and when you're ready to take that next step forward on creating this in your own   life, reach out, we're here to help you and we'll catch you next time.  

Lee Camp digs into Trump's admission that 300,000 Gazans have been killed, DOGE may be coming to an end, a social media star is mocked for speaking to the police, Biden has cancer, and Trump is working to crush the ICC. All that and more!To learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Lee Camp gets into the Liberal media going nuts over Pentagon firings AND RFK Jr. outing Trump and his $100 Million from Big Pharma PLUS the truth about Zelensky! To get FREE help navigating Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option. *Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Lee covers the shocking deal between Trump and Hamas PLUS the many other ways Trump seems to be leaving Israel out of things. AND the shocking technological advancements in China that the US can't seem to stop. That and much more!To learn more about Chapter Medicare Advice, call 757-349-8232 or go to AskChapter.org/Camp *Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Lee gets into the attack on Israel's airport that is turning Israel into a no-fly zone. Plus, why both India and Pakistan want war. AND much more!Lee Camp livestreams 3 days a week, and Unredacted Tonight comes out on Thursdays at 7pm ET. Make sure you don't miss an episode!Today's Sponsor: To get FREE help navigating Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp*Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and standalone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently, we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Lee Camp & Eleanor Goldfield reveal the truth behind Trump's new UNHINGED federal budget PLUS India's attack on Pakistan, the police again go after Columbia students, and US contractors being used WHERE?! All that and more!To get FREE help to navigate Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp*Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and standalone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently, we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

Explains language models (LLMs) advancements. Scaling laws - the relationships among model size, data size, and compute - and how emergent abilities such as in-context learning, multi-step reasoning, and instruction following arise once certain scaling thresholds are crossed. The evolution of the transformer architecture with Mixture of Experts (MoE), describes the three-phase training process culminating in Reinforcement Learning from Human Feedback (RLHF) for model alignment, and explores advanced reasoning techniques such as chain-of-thought prompting which significantly improve complex task performance. Links Notes and resources at ocdevel.com/mlg/mlg34 Build the future of multi-agent software with AGNTCY Try a walking desk stay healthy & sharp while you learn & code Transformer Foundations and Scaling Laws Transformers: Introduced by the 2017 "Attention is All You Need" paper, transformers allow for parallel training and inference of sequences using self-attention, in contrast to the sequential nature of RNNs. Scaling Laws: Empirical research revealed that LLM performance improves predictably as model size (parameters), data size (training tokens), and compute are increased together, with diminishing returns if only one variable is scaled disproportionately. The "Chinchilla scaling law" (DeepMind, 2022) established the optimal model/data/compute ratio for efficient model performance: earlier large models like GPT-3 were undertrained relative to their size, whereas right-sized models with more training data (e.g., Chinchilla, LLaMA series) proved more compute and inference efficient. Emergent Abilities in LLMs Emergence: When trained beyond a certain scale, LLMs display abilities not present in smaller models, including: In-Context Learning (ICL): Performing new tasks based solely on prompt examples at inference time. Instruction Following: Executing natural language tasks not seen during training. Multi-Step Reasoning & Chain of Thought (CoT): Solving arithmetic, logic, or symbolic reasoning by generating intermediate reasoning steps. Discontinuity & Debate: These abilities appear abruptly in larger models, though recent research suggests that this could result from non-linearities in evaluation metrics rather than innate model properties. Architectural Evolutions: Mixture of Experts (MoE) MoE Layers: Modern LLMs often replace standard feed-forward layers with MoE structures. Composed of many independent "expert" networks specializing in different subdomains or latent structures. A gating network routes tokens to the most relevant experts per input, activating only a subset of parameters—this is called "sparse activation." Enables much larger overall models without proportional increases in compute per inference, but requires the entire model in memory and introduces new challenges like load balancing and communication overhead. Specialization & Efficiency: Experts learn different data/knowledge types, boosting model specialization and throughput, though care is needed to avoid overfitting and underutilization of specialists. The Three-Phase Training Process 1. Unsupervised Pre-Training: Next-token prediction on massive datasets—builds a foundation model capturing general language patterns. 2. Supervised Fine Tuning (SFT): Training on labeled prompt-response pairs to teach the model how to perform specific tasks (e.g., question answering, summarization, code generation). Overfitting and "catastrophic forgetting" are risks if not carefully managed. 3. Reinforcement Learning from Human Feedback (RLHF): Collects human preference data by generating multiple responses to prompts and then having annotators rank them. Builds a reward model (often PPO) based on these rankings, then updates the LLM to maximize alignment with human preferences (helpfulness, harmlessness, truthfulness). Introduces complexity and risk of reward hacking (specification gaming), where the model may exploit the reward system in unanticipated ways. Advanced Reasoning Techniques Prompt Engineering: The art/science of crafting prompts that elicit better model responses, shown to dramatically affect model output quality. Chain of Thought (CoT) Prompting: Guides models to elaborate step-by-step reasoning before arriving at final answers—demonstrably improves results on complex tasks. Variants include zero-shot CoT ("let's think step by step"), few-shot CoT with worked examples, self-consistency (voting among multiple reasoning chains), and Tree of Thought (explores multiple reasoning branches in parallel). Automated Reasoning Optimization: Frontier models selectively apply these advanced reasoning techniques, balancing compute costs with gains in accuracy and transparency. Optimization for Training and Inference Tradeoffs: The optimal balance between model size, data, and compute is determined not only for pretraining but also for inference efficiency, as lifetime inference costs may exceed initial training costs. Current Trends: Efficient scaling, model specialization (MoE), careful fine-tuning, RLHF alignment, and automated reasoning techniques define state-of-the-art LLM development.

In the "Medicare Advantage Minute" segment, our article of the day has a headline that reads: "The Decline of PPO in Medicare Advantage". When times are tight, MA plans reduce the number of plans with the greatest freedoms. This leads to a discussion of the greatest Medicare supplement plan ever created: High Deductible Plan G. A combination of the finest health insurance protection with the most cost-effective premium rates. Almost everyone who sees it ends up buying one! How about "Your Medicare Benefits 2024"? In that article we find out how glaucoma screenings are covered by Medicare! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.

Angela Holland: Preferred Dental Solution Join Elevated GP: www.theelevatedgp.com Free Class II Masterclass - Click Here to Join Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram Angela Holland is a seasoned dental insurance expert and the founder of Preferred Dental Solutions, a firm dedicated to helping dental practices nationwide maximize their insurance reimbursements. With over a decade of experience in the dental industry, Angela has become a trusted advisor for practices aiming to enhance their financial performance through strategic insurance management. Angela began her career in dental consulting in 2013, quickly recognizing the challenges practices faced with insurance billing and revenue cycle management. In 2018, she founded Preferred Dental Services, focusing exclusively on remote insurance revenue cycle management. Under her leadership, the company grew rapidly, culminating in its acquisition by a NASDAQ-traded corporation in 2023.  Following this success, Angela launched Preferred Dental Solutions, offering specialized services in insurance credentialing and PPO fee negotiations. Her team provides live progress updates and guarantees increased insurance revenue, reflecting her commitment to transparency and results.  Angela's expertise has led to significant financial improvements for her clients, with some practices reporting revenue increases of up to 46% with major insurers like Cigna and MetLife. Her dedication to empowering dentists and her deep understanding of the insurance landscape make her a valuable partner for practices seeking growth and efficiency. For more information or to connect with Angela, visit Preferred Dental Solutions.

Welcome to HALO Talks! In this episode, host Pete Moore sits down with Tom Morrissey, founder of Solo Health Collective and a seasoned veteran in the health insurance world, to unpack the complex—and often misunderstood—landscape of healthcare for self-employed professionals. With a career spanning decades at Cigna and deep experience serving everyone from major corporations to solo entrepreneurs, Tom shares how he's dedicated his life to helping small business owners and solopreneurs access quality, affordable health coverage. Despite his success in the large-account space, Tom noticed an unmet need: Small and mid-sized businesses were often overlooked by health insurers and weren't given access to innovative cost-saving or health improvement solutions that benefited the bigger corporations.  If you're a personal trainer, group ex instructor, wellness coach, massage therapist, or any professional running your own business, this conversation is a game changer. Tom explains the differences between HMO and PPO plans, why traditional ACA ("Affordable Care Act") options can fall short for the self-employed, and how his company's unique group plan model is designed to deliver robust coverage (including preventive care and nationwide access) with transparent pricing and minimal out-of-pocket surprises. Plus, hear about partnerships with organizations like the Freelancers Union, and learn how innovative features like HSAs can work for you—even covering perks like fitness classes. On the healthcare issues facing entrepreneurs, Morrissey states, "We saw the growth. It depends on who you listen to, but estimates are that there'll be 90M solo business, owners by 2028. I want to say there's about 60M now. The guys and gals that own these businesses . . . I think, especially when they're young and healthy, are the ones that get screwed the most in healthcare. You know? All they really have access to is ACA plans." Key themes discussed Challenges of health insurance for solopreneurs and self-employed. Differences between PPO and HMO health plans. Underwriting and rate-setting for solo business owners. Preventive care coverage and HSA/HSA usage changes. Brand trust versus new insurance providers like Solo Health Collective. Partnerships with organizations such as Freelancers Union. Long-term cost sustainability for healthier insurance collectives. A few key takeaways:  1. Solo Health Plans Are Filling a Major Gap: Morrissey explains how traditional health insurance often overlooks solopreneurs and small business owners, especially in the HALO space. His company, Healthy Business Group via Solo Health Collective, is designed specifically to provide comprehensive PPO health plans to solo business owners—offering an alternative with more flexibility and better coverage than typical limited-network ACA and HMO options. 2. Key Plan Advantages-PPO Access and Maximum Out-of-Pocket Clarity: Unlike many ACA or HMO plans that limit provider networks and access, Solo Health Collective offers nationwide PPO plans, granting members broader access to healthcare providers. They also have a straightforward approach: After the deductible is met, there's no coinsurance—meaning your deductible is the absolute maximum you'll pay out-of-pocket for covered expenses (with all preventative care covered in full and not applied to the deductible). 3. Plans Are Designed for Solo Business Owners With Medical Underwriting: To qualify, you must have an EIN (Employer Identification Number) and be a business owner without employees. Members go through a quick, five-question medical underwriting process, which allows the plan to provide tailored age, and location-based rates—often significantly less expensive than standard individual policies, especially for young, healthy professionals. 4. HSAs and Innovative Usage for Wellness Are Embraced: The plan supports health savings accounts (HSAs), and Tom shared how, thanks to evolving IRS guidelines and technology, people can now use HSA funds for things like fitness classes and certain wellness purchases, expanding the value of pre-tax health dollars and encouraging preventive care and healthy lifestyles. 5. Long-Term Value and Stability Solo Health Collective is built on a self-insured, level-funded model supported by robust reinsurance (Odyssey A+ rated.) This allows the collective to stabilize costs and potentially keep renewal increases lower than the industry average—especially as it pools healthier, proactive members like those in the wellness and fitness industries. The long-term goal is to create a sustainable, affordable health insurance solution specifically for entrepreneurs who have historically been underserved. Resources:  Thomas Morrissey: https://www.linkedin.com/in/tommorrisseyhbg  Solo Health Collective: https://hbgsolo.com   How It Works: https://hbgsolo.com/how-it-works  Freelancers Union: https://freelancersunion.org/insurance/health  Promotion Vault: http://www.promotionvault.com HigherDose: http://www.higherdose.com

Lee Camp digs into the hidden side of the day's news. Israel is on fire for a hidden reason. Trump wants to reopen Alcatraz, and here's why that's insane. Plus much more!To get FREE help to navigate Medicare and Medicare Advantage, call 757-349-8232 or go to AskChapter.org/Camp*Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan's contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently, we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don't directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your option.*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.

I'll never forget the first time I sat down with a dental insurance representative, and started asking questions. I began with questions based on all the “false information” that had been thrown at me through the years regarding PPO contracts, such as: “sending in fee-for-service (FFS) fees increases PPO reimbursement rates”, or “you can't upgrade patients on PPO plans” and many others. Her response to my questions was very interesting and not what I expected.Support the show

Ready to market smarter in 2025? In this episode of the Less Insurance Dependence Podcast, Gary Takacs and Naren Arulrajah reveal the four essential marketing pillars your practice needs to grow without relying on PPO plans. Learn how to master organic SEO, build trust through Google reviews, improve call conversions, and optimize landing pages while attracting the right patients and boosting profitability.  Listen now and unlock your 2025 marketing strategy!     Book your free marketing strategy meeting with Ekwa at your convenience. Plus, at the end of the session, get a free analysis report to find out where your practice stands online. It's our gift to you! https://www.lessinsurancedependence.com/marketing-strategy-meeting/  If you're looking to boost your case acceptance rates and enhance patient communication, you can schedule a Coaching Strategy Meeting with Gary Takacs. With his experience in helping practices thrive, Gary will work with you on personalized coaching, ensuring you and your team are prepared to present treatment plans confidently, offer financing options, and communicate the value of essential dental services. https://www.lessinsurancedependence.com/csm/ 

In this insightful episode of The Dental Boardroom Podcast, Wes Reed, CPA, CFP and founder of Practice CFO, breaks down the real financial impact of staying in-network with PPOs versus transitioning to a fee-for-service (FFS) model. Using a crown-focused case study, Wes illustrates how fewer procedures can yield significantly higher profits under FFS — even with some patient attrition. If you're a dental practice owner evaluating your profitability strategy, this episode will give you a clear-eyed view of the numbers that matter.Key Points Covered:The purpose of PPOs: high patient volume but lower profit margins.FFS model: fewer crowns, less overhead, but more profit.Why many dentists feel trapped in PPOs despite shrinking reimbursement rates.A detailed crown-based financial comparison: 30 PPO crowns vs. 20 FFS crowns.Key overhead costs: fixed vs. variable and their implications in each model.Why switching to FFS can potentially double your net profit.The long-term sustainability challenges of staying in-network.How patient relationships and brand strength affect attrition rates when transitioning out-of-network.Practical considerations for associate-driven vs. solo practices.#DentalBoardroomPodcast #PracticeCFO #PPOvsFFS #DentalEconomics #FeeForService #DentalPracticeGrowth #DentalProfitability #OutOfNetworkDentistry #DentalCPA #DentalBusinessTips #CrownCaseStudy

Got questions? Send Ericka a Text!Dental insurance verification is stuck in the 1990s, but insurance companies have dramatically changed how they operate—leaving dentists with surprise balances, frustrated patients, and a mess of accounts receivable. In this eye-opening episode, I reveal how insurance carriers are secretly leasing networks behind the scenes and potentially pulling your practice into networks you never directly signed with.Drawing from a recent consultation where a practice saw their AR spike by $70,000 due to inadequate verification, I walk through exactly why checking just the basics—deductibles, maximums, and coverage percentages—is no longer enough. The game has fundamentally changed. Through leased networks and umbrella plans like Connection Dental and DentaMax, carriers can apply completely different fee schedules than you expect, even when you think you're out of network.Most importantly, I share the specific questions you must ask during insurance verification to protect your practice: Are we in-network or out-of-network with this specific plan? Are we directly contracted or leased through another network? Which fee schedule applies to our office for this plan? Does this patient's plan fall under a specific PPO tier, group or level? These questions will transform how you set up patient accounts and present treatment plans.Ready to stop the bleeding and take control of your insurance verification process? Download my free verification checklist in the show notes and start mapping your complete network participation status today. Your billing department—and your bank account—will thank you. Want to learn Dental Coding and Billing? Join here:https://tr.ee/efzYrY7mp-Would you like to set-up a billing consultation with Ericka? She would love the opportunity to discuss your billing questions and see how Fortune Billing Solutions may help you. Email Ericka:ericka@dentalbillingdoneright.comSchedule a call with Ericka: https://calendly.com/ericka-dentalbillingdoneright/30min Perio performance formula: (D4341+D4342+D4346+D4355+D4910)/(D4341+D4342+D4346+D4355+D4910+D1110)

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

Can a hygiene-driven model thrive for PPO dental practices in 2025? Tune into The Thriving Dentist Show with Gary Takacs and Naren Arulrajah to uncover why a robust hygiene department is your practice's secret weapon—despite soaring costs and dwindling PPO fees. Discover proven strategies to skyrocket hygiene profits, break free from insurance constraints, and dominate dental SEO marketing. Don't miss this game-changing episode packed with expert insights to elevate your practice!

The Medicare Advantage Minute points out more trouble for Medicare Advantage plans. Hospitals have seen increasingly aggressive denials of payments with every expectation of more denial pressure to come! In Your Medicare Benefits 2024 we learn how Medicare covers doctor services. No secret, their fees are Part B expenses. Finally, we hear from Linda, wife of a happy MLM Medicare supplement client. Two years away from Medicare age herself, she is concerned because her favorite hospital and long-time doctor have been deemed "out of network" due to a merger or an acquisition. Turns out she has a PPO plan, not an HMO. Even though these providers are "out-of-network" they are not out-of-bounds to Linda. For a somewhat less robust insurance coverage she will still be able to use them at will. Two years from now, with original Medicare plus a supplement, her network concerns should be a thing of the past. I am looking forward to helping Linda join her husband as another happy client! Contact me at: DBJ@MLMMailbag.com (Most severe critic: A++)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.

As Vice President of Practice Intel at Dental Advocacy Group (DAG), Cynthia bring over 20 years of experience in the dental industry, helping practices maximize revenue, optimize insurance reimbursements, and implement strategic growth initiatives. Before joining DAG, Cynthia spent years as a dental consultant, working directly with practices ranging from solo practitioners and multi-doctor offices to large DSOs. This hands-on experience has given her a unique vantage point—she understands the challenges and opportunities that come with each type of practice model. Whether it's navigating insurance complexities, fine-tuning operational efficiencies, or transitioning to a fee-for-service model, she's seen firsthand what works and what doesn't. At DAG, her focus is on helping dentists take control of their profitability by negotiating better PPO contracts, improving fee schedules, and ensuring that insurance participation aligns with their long-term business goals. She is also leading the charge with Practice Intel, an innovative KPI analytics platform that gives dental teams real-time insights to drive smarter, more profitable decisions. Beyond her professional work, Cynthia is a wife, mother, and proud new grandmother—so she understands the importance of work-life balance and building a business that supports your life, not the other way around. Her passion is helping dentists thrive, not just in their practices, but in their personal lives as well.

One of the biggest challenges facing dentists today involves contracting with PPO plans through insurance companies. On The Art of Dental Finance and Management Podcast, Art discusses this challenge with Ben Tuinei, President of Veritas Dental Resources. For over twenty years, Ben has helped thousands of dentists obtain higher reimbursements, manage the array of contracts put in front of them by insurance companies, and successfully resign from insurance company plans with a minimal loss of patients. Ben and Art discuss how dental practices can negotiate fees with insurance plans, what umbrella insurance policies are and how they work, and what a dentist must consider from an insurance perspective if they are considering buying or starting a practice from scratch. Ben also details the steps a dentist should take to educate their patients when considering the move to an out-of-network provider, including key interpersonal skills for front desk administrators.

Want more? Join the 30MPC Discovery Course TODAY and get first dibs: https://clubpass.30mpc.com/discovery-course YouTube video version: https://www.youtube.com/watch?v=y0H6G7toc9s ACTIONABLE TAKEAWAYS: Structure Your Call in 3 Parts: Great discovery calls have three distinct chapters—(1) the first five minutes to establish credibility and set your PPO agenda (Purpose, Plan, Outcome), (2) the next 20 minutes to uncover meaningful problems while building trust, and (3) the last five minutes to run your Five Minute Drill and determine if it's worth setting a next step. Use Discovery Trees to Guide Questions: Map out your prospect's problems in four layers—situation, operational pain, executive problem, and business impact. Use simple transitions like “so what?” to climb down the tree, and reverse it when execs start with big priorities. Don't just ask questions—build a roadmap first. Balance Give and Take: If you only ask questions, you're interrogating. Use playbacks, pile-ons, praise, and parallel stories to add value throughout the call and build trust. Use vertical questions to go deeper on one topic instead of jumping all over the place. Run a Tight Five Minute Drill: In the last five minutes, validate if they want to solve the problem, when they want to solve it, and how they buy. Suggest the timeline and buying process based on what you've seen work—not what they think they should do. If they're serious, schedule the next step while you're still on the call.

More management and insurance knowledge in my newsletter: https://www.odysseymgmt.com/newsletter   Are you a dentist or manager in a seemingly endless struggle to stay profitable on PPO plans? You're definitely not alone. One of my first trusted resources in dentistry was Unlock the PPO's Sandy Hudson and Lisa Weber. Sandy joined me for a truly nerdy but very informative chat about networks and negotiations. We talked about the hidden challenges within shared network agreements and how she avoids “over-networking” and helps us understand opt-out procedures.  

Are you spending money on marketing but not seeing results? In this episode of the Thriving Dentist Show, Gary Takacs and Naren Arulrajah tackle 10 real dentist-submitted questions on effective marketing strategies for 2025. Learn why SEO for dentists is your secret weapon for high ROI, how Google reviews can boost your practice's credibility, and when digital ads make sense. They also reveal the hidden costs of PPO plans—those “insurance write-offs” could be your biggest marketing expense—and share how to redirect that budget to grow your practice. Packed with practical, no-nonsense tips in plain language, this episode is a must-listen for dentists ready to stop guessing and start thriving. Tune in now to transform your dental marketing! 

In this episode of the Shared Practices Podcast, Dr. Richard Low interviews Dr. Simon Wu about his journey from associate to successful practice owner in Southern California. Dr. Wu shares how he navigated the challenges of buying a practice with high overhead and low new patient flow, the strategies he used to turn it into a thriving business, and the role coaching played in his success. Listeners will gain insights on evaluating practice opportunities, negotiating PPO fees, and scaling a practice while maintaining work-life balance.

Kiera is joined by Dr. Robert DiPilla to talk about his world of dentistry, including the transition from cosmetic to holistic services, how he educated his patients, lessons learned during his multi-practice ownership, and more.   About Dr. DiPilla: Dr. Robert DiPilla studied dentistry at the University of Detroit-Mercy, and then went on to attain a Fellowship for Dental Implants at the Harvard Club. He was quickly recruited to Manhattan, where he honed his dentistry techniques, and had the opportunity to work on many high-profile clients. Dr. DiPilla became a partner at the renowned Rosenthal Dental Group on Madison Avenue, and earned the title “the dentist's dentist” by his peers in the industry. Dr. DiPilla has had the privilege of perfecting the smiles of celebrity clientele such as Kathie Lee Gifford, Wayne Gretzky, Steve Duchesne, and Sarah Ferguson among others. While Dr. DiPilla maintains a Manhattan office, he now focuses on the location where his career began in the Detroit Metropolitan area. He contributes regularly to nationally circulated trade publications, and continues to be recognized as a leader and expert resource in aesthetic dentistry. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript Kiera Dent (00:00.768) Hello, Dental A Team listeners. This is Kiera And today I am so jazzed to have an incredible guest. We have been following this man. We've been wanting him on our podcast. He is incredible. And I feel like what he's doing is changing the way dentists are doing dentistry. I think he's kind of in this new age, new era, adapting with the times. And so was so excited to bring him on and have his knowledge. So welcome to the show, Dr. Robert DiPilla. How are you today?   Dr Robert DiPilla (00:25.484) I'm doing well. Thank you very much. I'm excited to be on your show. There are so many great things about you and your show. I I once again, I went back to some of your podcasts and you some great, great guests on.   Kiera Dent (00:37.376) Well, thank you. am quite shocked. Dental A Team is about to release their thousandth episode. And I was thinking, I cannot believe I've been on this microphone a thousand times. So I'm super honored that you are a part of that journey. And really everyone who listens to the podcast knows our ultimate goal at Dental A Team is to positively impact the world of dentistry in the greatest way possible. so bringing guests on like yourself, people who are passionate about dentistry, making sure that we keep the passion alive in dentistry, making sure that people realize   I believe we're in the best industry we possibly could ever be in. And so I'm super excited because I feel like you're taking a new edge spin to some things in dentistry. So before we get into some of these fun topics, Dr. DiPilla, why don't you take us through kind of your journey? I know you have a pretty interesting route of how you were able to go from where you were and where you started in dentistry to where you are today. So if you kind of want to take us on your journey, that way the audience gets to know you as well.   Dr Robert DiPilla (01:31.854) That journey starts 36 years ago. I graduated at the University of Detroit, Mercy in 1989, and I did a residency at Harvard at the Harvard Club for doing implants. And from that, I really was interested in the cosmetic realm. So you got to think about in the early 90s. And it was kind of like touched upon. And I was very fortunate.   to take a course with Bill Dickerson and Larry Rosenthal. And this is the first time they were together in doing these particular courses. And my first patient for my aesthetic course was my sister, believe it or not. when I mentioned this, it was an amazing journey. She was very appreciative. It was a great case. And from that, one interesting point.   Kiera Dent (02:16.68) Wow, that's brave, an aesthetic course.   Dr Robert DiPilla (02:30.828) when I was in the lecture and they were talking about different materials, different processes, the way to do things. I know once again, I just graduated, I did like a little surgical residency and I thought to myself, mean, the auditorium was packed, there's probably like a hundred students. And I'm like looking around and I'm thinking myself, am I the only dumb one here that doesn't know this?   I said, this is insane. And they're going over these seven different steps to do bonding and veneers. I'm like, my gosh, did I learn this in school? you   Kiera Dent (03:05.28) Did I skip that day? I promise I didn't miss too many, right? That's what you're probably thinking, like I was there.   Dr Robert DiPilla (03:10.237) I would promise I was there. But I promised myself since then, it was like a real, not say a low point in my life, but it was a low point in the sense of how come I didn't know this? And I kind of pride myself in understanding things and certain process and procedures. And I said, from that day, this will never happen again. So that journey led into teaching with Bill Dickerson before it was LVI and also   aesthetic advantage with Larry Rosenthal. And as you know, there were two separate groups and I had to make a decision on what camp was I going to go into. Was I going to do the LVI camp in Vegas? And mind you, I'm in Michigan. Or do I go to New York route? And my decision was New York was closer. So I went with Larry Rosenthal. So I was an instructor with him for about three or four years. And then I was invited to be a doctor in his office.   And I was there for a good 10 years. that journey right there was probably the highest point of my life in that particular aesthetic office. There was a lot of great contacts, a lot of great people that we met. And I always say everything is a blessing for me. I don't hold anything back as far as this was a disappointment. This didn't happen for me because I think everything is a growing experience.   So for me, being in Larry's office was really, truly, truly, like I said, a blessing. It was a great thing for my career. And then I knew that when I started having a family and kids, New York for me personally wasn't the place for me. Coming from the Midwest, Midwest values, I wanted to have the family where I grew up because my mom is still here and my extended family is here as well. So once again, from that, I left New York.   Kiera Dent (04:51.21) You   Dr Robert DiPilla (05:01.806) And then, but I kept a practice in New York as well, because I had a lot of patients to see. And I started my own practice in Birmingham, Michigan. And that was in 2000, probably 2003, 2004. And then from that, you know, we grew to five different practices. So it's been a really challenging once again, but it's been a great journey for us.   Kiera Dent (05:15.338) Wow.   Kiera Dent (05:25.706) That's incredible. And so I'm curious because when I first started as a dental assistant, one of the doctors that I worked for had a practice in California and Utah. And so every Thursday or Wednesday, I think it was, we would close out in California and he'd catch a flight and he'd go to his practice in Utah. He'd be there Thursday, Friday, fly home, and we do Monday, Tuesday, Wednesday. So did you fly back and forth between your two practices?   Dr Robert DiPilla (05:45.93) I did the same thing. When I moved back to Michigan, I would work in Michigan Monday, Tuesday, Wednesday, would fly out to New York and work Thursday and Friday. And then plus New York's a great city and I stayed for the weekend and I flew back the first flight out 6 a.m. on Monday morning to make it to my practice at 9 a.m. So I did that for seven years. So back and forth. then once again,   Kiera Dent (05:56.106) Yeah.   Kiera Dent (06:02.806) sure.   you   Dr Robert DiPilla (06:12.462) It was great. To me, people, how did you do that? Why did you do that? It was just my routine and it worked out really, really well. And then there was some point where I kind of have to slow down and kind of give that up a little bit because I wanted to build more practices in Michigan.   Kiera Dent (06:27.414) Sure. No, that makes sense. And I was just curious because when that Dennis would do it, I thought like it was so wild, but it made sense of how he was able to have the two practices. So it's either you fly back and forth for a while or you get associates. Did you end up keeping that practice in New York or did you have an associate running it or did you end up selling it and then focus in Michigan?   Dr Robert DiPilla (06:45.186) Yeah, no, I actually, believe it or not, a lot of my New York patients actually will fly to Michigan to have their work done. And then the rest is I gave it to a really good friend of mine, Dr. Michael Krause, that's in the city on 49th and Madison. So, you know, basically a lot of my patients just kind of ended up with him.   Kiera Dent (06:52.564) Incredible.   Kiera Dent (07:06.728) Amazing. And that's great to know. And I hope dentists heard that of when you are really great at your craft, they will fly, they will come to see you. And I think that that's something that's different in today's world. I think that it's very common for patients to fly other places rather than just going to their dentist down the street. I think people fly for different surgeries to different places. Now I think for your day in day out routine dental care, you'll probably stay closer to home. But also we only go six, like two times a year. So it's really not that much to travel if you want to.   Dr Robert DiPilla (07:25.919) percent. Yeah.   Yeah.   Dr Robert DiPilla (07:34.798) Yeah, there's a lot, know, as you know, there's a lot of patients that will seek out plastic surgeons and they will go to a certain destination if it's New York, LA or Miami. And that's the same thing with dentistry. I mean, I've been very fortunate. I've had a of patients from Miami that will fly up and for me to do their work, their veneers, New York, of course, all the way even from LA. So it's been it's been a wonderful thing. I'm very humbled, you know, to do that. I don't take that take that lightly.   Kiera Dent (07:40.214) Mm-hmm.   Kiera Dent (08:02.812) No, and I think that there's when you love what you do and you're really great at what you do, people fly. I mean, I am a dental snob. think being in dentistry, it makes me one of the worst patients. And so I'm always nervous. And so I do travel to dentists out of the state. And I think it's something of the world has changed. And so I love your journey. I love the passion you have. I love that you've built multiple practices. I think you bring an interesting perspective. And so I'm super curious because you've kind of gone into a holistic route as well. So   I'm curious, how do you go from dental implants, veneers, which feels very cosmetic, into holistic? Like what's kind of the bridge? How have you done that? Because I think people feel like I'm either traditional dentistry or I'm holistic dentistry. And I feel like you're bridging this gap. And I think the world is bridging this gap as well. I don't think it's as polarized as it used to be, but what's kind of your take on that and how did you transition? What got you excited about that? Give some insights.   Dr Robert DiPilla (08:53.684) I mean, you   You know, for you as you know, being a hygienist, know, to me, for our patients, we want to make sure that they have a healthy foundation. a healthy foundation is the bone and also the gingival tissue. And, you know, it doesn't matter how great of a cosmetic dentist you are, how great of an implantologist you are, the tissue has to be stable. It has to be making sure that, you know, the oral microbiome is sufficient.   Kiera Dent (09:05.299) Mm-hmm.   Dr Robert DiPilla (09:25.774) You got to make sure that the biofilm is eliminated. And one of the biggest things that, I mentor 22 doctors here in Michigan, from guys who've just, guys or gals who've just been out a year and guys like myself that been out for 36 years. One of the things that I try to impress upon them is that don't be a mechanic of the mouth. And my feelings,   is that dental schools right now, and once again, different than my era, is just really, they're really teaching you how to pass the board exams. And then the real age of dentistry is what you get after as far as continued education. And I think it's really important, as you know, even being a hygienist, is that you have a patient that comes back, yet you did scaling and root planning.   Kiera Dent (10:01.694) Right.   Dr Robert DiPilla (10:17.15) and you see him back in three months and they're saying, yeah, I brush every day, I floss every day, I have the water pick that you recommended, I'm doing the oral care, I'm doing this. And they come back and it's like, my God, are you really flossing? Are you really brushing your teeth? No, no, I am. But why is that? Why are we doing maybe supervised neglect or super profis? The question comes in is that we have to understand why, my biggest thing is the why, why is that happening?   You know, we incorporated now we're doing genetic testing, we're doing saliva testing for our patients because as we know, a lot of, you know, reintroduction of refractory periodontitis that happens. So even the same thing with my hygienist, you know, we're very strong in continuing education. We're very strong in not just scaling and root planing teeth, just for the matter of fact of doing it. And one of the things that, you know, my hygienist, they all know,   is that if you're doing Scanlan Root Planning, what type of attachment do you want back? So I think you have to have a strong foundation in histology. You have to know the periodontium very, very well. And a lot of times in school, yeah, yeah, that was that class. I had it, but this is what I want to do. So I think for us in dentistry, you have to move away from being that mechanic of the mouth, because I can teach my assistant to prep a tooth, easy. But you have to understand the diagnosis and the   Kiera Dent (11:26.774) you   Kiera Dent (11:38.368) you   Dr Robert DiPilla (11:42.094) And it also goes back to different materials. The whole rage now is zirconia, crowns, and it's a lot stronger. But is it really? Is it lithium disilicate, or is it philospathic porcelain? So I think there has to be an understanding of where to place those materials in the proper patients and proper occlusion. So because a salesperson comes in, oh, this is the latest and greatest, doesn't mean that you should buy it. So I think.   Kiera Dent (12:09.824) for sure.   Dr Robert DiPilla (12:10.894) For me, it's kind of taking a step back and understanding dental materials, understanding the periodontium, understanding all that. I the classes that we hated in school, believe it not, I've been doing this for 36, are probably the most important now than anything else.   Kiera Dent (12:25.67) No, for sure. And I'm so grateful you talked about that because agreed like the healthy foundations, I think it's so easily overlooked. So I'm curious, how did you start to incorporate this with your patients? Because you didn't come out of school having this, you didn't learn all these things right away, you started incorporating it. I think people are oftentimes afraid to add this into their practices due to patient pushback. So how did you, how did you educate your patient base?   Dr Robert DiPilla (12:48.702) Well, yeah, I think it's just having a good communication with your patient and being authentic. with our patients, we're there for them in a sense of we don't push anything, we don't sell anything, we just educate our patients. And a lot of times, if I've seen a patient for 10, 15, 20 years and I'm watching them get worse,   And, you know, I'll just have that, you know, that radical candor with them saying, hey, listen, you know, where do you want to go with this? What do you, how can I help you? You know, do you, mean, for some reason I'm watching you getting worse and I don't want that. So what can I do to help? And then we kind of castor them in that, in that direction as much as possible. You know, there's, we'll do a lot of like nutritional counseling and we see a lot of patients that, as you know, they come in, you know, they're not, they're not healthy. And I have the,   Kiera Dent (13:39.51) All right.   Dr Robert DiPilla (13:42.21) I guess the personality to talk to my patients and say, listen, I want you to see this person. I care about you. I've seen you for many, many times. And I just, you know, I see some things that I don't like. So what I want you to do, here's a referral. I want you to see them. And then nine out of 10 times they'll come back and say, my God, thank you so much. I didn't know I had this underlying condition.   Kiera Dent (14:07.84) That's incredible. And I agree that education, I think is the new age of communication. I think a lot of patients want to understand more. think we live in this digital era where people are consuming so much more information rapidly and they want to be educated and they want to know what's going on. And I do think social media has, has ramped this up exponentially for people to want more education rather than just blindly following. And so I really love that you took it that way. I want to ask you a couple of questions about   growth of practices because I think so many people grow practices or they feel that they need to grow practices or they need to expand their practices. I'm curious after having done that, you've had practices in multiple states, you've grown your, like walk me through, like when do you grow as a dentist? When do you not grow as a dentist? What are some things that you learned through that growth of multi-practice ownership, especially with dentists that are in today's world? I think that there are some that are brand new.   There's the DSO on the radar and on the horizon for people. Walk me through some of your thoughts around this practice growth, multi-location, when do I grow, what do I do with DSOs? I'm super curious because you've done it and you've done it for a long time. What are some of your thoughts around that?   Dr Robert DiPilla (15:08.718) 100%.   Dr Robert DiPilla (15:17.582) I'm going to let's go back when I was like I said, very fortunate to be in Larry Rosenthal's office in New York City. And everyone knows Larry Rosenthal is the premier, know, veneer office to go to. So I was once again, I was very, very fortunate to go there. But well, my dismay, I was the young kid.   Kiera Dent (15:37.364) It's incredible, by the way. like, like, let's just stop for a second. Like, that's incredible that you got to work there with him.   Dr Robert DiPilla (15:44.622) So think of a patient that's there, know, we had celebrity CEOs, we had every mogul you could imagine we had. And you got this young kid walking in and they're like, well, kid, move away, where's Larry? Where's Larry? So what I had to do, I had to kind of reinvent myself. And, you know, and I had to figure out what type of avatar patient, you know, do I want? And I think that it doesn't matter if I'm in New York, if I'm in Birmingham, Michigan.   Kiera Dent (15:44.947) Yeah.   Kiera Dent (15:57.715) Yeah.   Dr Robert DiPilla (16:11.274) I'm if in Salt Lake City, Atlanta, doesn't matter. You just have to figure out what avatar do you want. And then you kind of go where that avatar is. So an example, this is what I did. So in New York City, I need to get a haircut. So for me, I went to the biggest celebrity hairstylist you can get. And it was Orbe in New York City. And why did I do   Kiera Dent (16:37.556) Yeah. Okay. I mean, you do have great hair, by the way. So, I mean, it must have worked out for you. I like it. It looks great.   Dr Robert DiPilla (16:41.582) Well, thank you so No way. It's not what it Well, thank you. So I went to Orbe and why did I go to see him? Because Orbe has what a lot of celebrity clientele. And for me, it was building a relationship with Orbe. You come in, your first appointment, who are you? What do you do? Oh my God, yeah, I have a dentist and that, that, that. As you know, when you say you're a dentist or a hygienist, oh, by the way, can you look at this?   Kiera Dent (17:10.633) haha   Dr Robert DiPilla (17:11.758) So what that does is that it kind of opens up the dialogue as much as possible. So from him, I've been seeing him for two to three years. And once again, it's something that you always have to continue going. If you do it once or twice and it doesn't work, well, that's not going to happen. So they go into the gym, you work out once or twice, you're not going to be in shape. it's of those things that you perpetually just have to do. So I was very fortunate seeing him for years. And from that,   Kiera Dent (17:32.083) Right.   Dr Robert DiPilla (17:39.49) I had my own celebrity clientele that came into Larry's office. It was great. All right, how about another one? So I was fortunate they had the LA Reebok Club where I used to live on the Upper West Side. And then joined a gym, of course. And I wanted to find out who was the best trainer who trained all the celebrities. And then once again, the same thing. So I think it's important.   Kiera Dent (17:44.308) Mm-hmm.   Dr Robert DiPilla (18:06.818) you know, to find out because I'm going tell you a lot of the celebrities and a lot of moguls, they're not calling to make the appointment. They have someone as an assistant to make their appointments for them. So I'll give you an example. I was working out in East Hampton for a little bit because I bought a house in in Amiganza. And as I was doing this renovation, I never really worked on Fridays, but in East Hampton, I worked some Fridays and I was fortunate   that I had a logistics manager for the Rolling Stones that came in. Built a relationship with her. And then from that, because she's a logistics manager, she does everything for the Stones. So I was very fortunate. She called me up, hey, Mick has a concert tonight at Madison Square Garden. He wants his teeth cleaned. He wants them checked out. Can you do it? Sure. What time? Nine o'clock at night. What?   Kiera Dent (18:39.082) Well.   Kiera Dent (19:01.735) I'm   Dr Robert DiPilla (19:03.342) So those are the things that you have to do. If you want that type of avatar, you want that type of clientele, then you kind have to do whatever it takes to go above and beyond to make sure that that happens. So don't think that if you want that type of practice, there's going to be some sacrifices that you're going to have to do. So for me, my personal story, for me being in New York, I was so driven, driven, driven. That's all I did. That's all I did. And I was married at the...   at the time. you know, looking back in retrospect, it affected my marriage. So, you know, my ex-wife, we're great, we're still great friends, but it affected because I just, for me, I was driven. This is what I wanted to do. I was out. I was going to opening of galleries. I was opening up to restaurants and because I wanted to be successful. But with that, there are some consequences that come with it.   So you have to kind of be prepared. You they always say, you know, the balance of life, you know, what to do as far as your career and work. I mean, there is, but you're going to sacrifice, you know, somewhere. You can't have it all, as they say. So you're going to have to kind of give up some.   Kiera Dent (20:12.853) Great.   Do you, looking back, are you grateful that you've made the decisions you've made or do you wish you would have done things differently? Like knowing what you know now. Walk me through because I think people people often wonder this.   Dr Robert DiPilla (20:26.466) Yeah, there's no, for me, there's no regrets because even if there was a regret, I always look at it as something that will make me better down the road. mean, listen, we're all gonna have failures. Things are gonna happen, but you have to learn from that. I mean, for someone to say, this has never happened to me and da, da, da, either they're lying or they have not, they've just graduated yesterday. I didn't tell my associates the same thing and that they had a bad day.   Kiera Dent (20:49.724) Yeah.   Dr Robert DiPilla (20:56.046) patient was complaining or something, I said, listen, it's going to happen. As long as you know in your heart you did the right thing, that's all you can do.   Kiera Dent (21:05.593) I that. And I appreciate that because I think so many times people feel like I should have known this right from the get go. But I think a lot of learning is experiencing too. And so going through it and making different decisions. And like you said, what's the type of life? What's the type of avatar do I want? And then crafting your practice around that. I really love that you highlight. I feel like you crafted your practice and your craft around the avatar, patient and life that you wanted.   I think at the beginning you probably hustled a lot more than you thought you would need to, but I think that that's the beginning of practice ownership. I think that's the beginning of any career. And then you're able to then start to curate it into what you wanted it to be. And I think so many dentists don't realize that that is a possibility for you if you want it to craft it for what you want.   Dr Robert DiPilla (21:50.486) No, listen, mean, there's many different practices, as you know. There's the elite practices that are doing, know, veneers and an example who took over Larry Rosenthal's office is Mike Appa. Mike Appa is a great dentist. When I was leaving Larry's office, he was coming in and he took it to the next level. And I missed, from my era, we didn't really have Facebook or Instagram or anything like that. So I'm kind of like the, know, the lagger in that particular point.   But he took that and made it to a different level as far as his career going to Dubai. And now he has multiple, multiple practices. But once again, there is some sacrifices. I'm sure it has not come easy to him. He has put in a lot of work, a lot of time, a lot of dedication to craft that for him. I look at it as, man, that's amazing. Good for him. Other people can get jealous of that.   but they don't understand the hard work what it takes to get there. It's like the basketball player, like, my God, he's making all this, how did he get that? But he forgot all the thousands and thousands of hours being in the gym and also practicing. Sometimes we forget that.   Kiera Dent (22:58.037) Yeah.   Kiera Dent (23:03.55) Right. Right. I think that it's been so just I love I love your passion. I love the life that you've lived. I love the I love that you were so committed to never being that person and then look at how that that drive and that determination took you from where you were to where you are today. I'm curious speaking to dentists who are maybe I don't know two three four years out.   What advice would you give them from all your years of practicing of the things you've been able to do, the clientele you've had, the team you had? What would be advice you'd give to that population of dentists right now? Knowing everything you know, knowing the climate, knowing the, like I said, DSOs are on the horizon. Do I become a private practice owner? Do I work corporate? Do I own multi-practices? What would you give? Again, we're talking four or five years out. I feel like this is right where they're starting to get that itch. They've got their, they figured a lot of things out.   Well, what advice would you have for that dentist?   Dr Robert DiPilla (23:57.454) So it's funny that you say that because three of my associates, I have been out four to five years. And we get together, which is great, which I love is we get together once a month at my house over here and we kind of go over some kids' education things and just kind of talking to them as far as what their successes are, what their stresses are, and also what they're stuck. We call that three S's. And I always tell them, listen, I don't want you to be me.   Kiera Dent (24:03.528) Mm-hmm.   Dr Robert DiPilla (24:27.5) I want you to be you. If you're interested in Invisalign, then go for it. And I think that a lot of younger dentists feel that, my God, I have to do that endo. I have to do that extraction. I have to do that filling. I have to do this because there's so much money and debt from dental school and you can't do everything because something's gonna, you're gonna get hurt on one perspective.   My advice, I've been doing this, like I said, for 36 years, find out what you really, really love to do and then do that. Is it gonna pan off the next day? No, it's gonna take time. And I think we live in a world that it's instant gratification and everyone wants everything done yesterday. It's just the law of averages. You're just gonna have to do it, do it, do it, do it and keep it until you get there. For me, like I said, I was going for the implant route.   Kiera Dent (25:16.519) Right.   Dr Robert DiPilla (25:26.474) I loved surgery. And then I found that niche that I wanted to do was the aesthetic world. And then, okay, I'm doing some aesthetics. We're at Larry's office. We're doing 10 veneers on the bottom, 10 veneers on the top and the bottom. And I'm thinking to myself, yeah, the bite doesn't look that great. I said, well, there's something more to this. And then I went down to Rabbit Hole. I did Pete Dawson's chorus.   Kiera Dent (25:47.568) I'm   Dr Robert DiPilla (25:55.746) I remember at Panky. So I went another route as far as now doing full mouth rehabilitation. Going back to, you know, Facebook, Centric Relation, doing everything that needs to be done. How am supposed to get back to that? Right? And then, you know, getting there. So, you know, for me, that is my niche now. And from, you know, I'm building a bigger office in Birmingham. I think I'm crazy what I'm doing right now.   Kiera Dent (26:08.108) The baseball, that's a throwback.   Dr Robert DiPilla (26:25.016) but I still have passion for what I do. feel like, you when someone said, you've been out for 36 years, I feel like I've only been out for five years. I still love this profession. I love what it's given me, the opportunity, but sometimes I don't like the direction where it's going in. And that kind of goes back to what you mentioned about the DSOs. Don't get me wrong, I'm not popo-ing DSOs. I mean, I think there's a place for everyone.   Kiera Dent (26:33.611) Yeah.   Kiera Dent (26:47.198) Yeah, I'm curious on your take. You've been in this for a long time.   Dr Robert DiPilla (26:55.24) I mean, know dentists are in Medicaid offices, great. We know that patients are in PPO offices, great. Fee for service, better. And then also group practices that, you know, my associates are in. And then there's DSOs. Once again, I'm fortunate to be part of Dicama's group, and it's one of the premier law firms that have put all the DSOs together.   Kiera Dent (27:06.698) Yeah.   Kiera Dent (27:18.805) Mm-hmm.   Dr Robert DiPilla (27:25.358) And some are great, some are amazing, but some have failed. And I think one of the problems I feel that corporate has is that if you do the CEO, you're looking at what? You're looking at the numbers, you're looking at the metrics, right? You're looking at the KPIs. But if you're in the trenches, you can't treat every office as the same. It's different. The hygienist has a different personality. dentist has a personality. You have different patients, demographic of patients.   Kiera Dent (27:31.04) Right.   Dr Robert DiPilla (27:54.648) So I think for dentists, we're just a different animal as far as the field that we're in. It's very, very personal that we have as far as our offices. And like I said, I have five offices. All five are completely different. If I try to implement every single detail thing in Birmingham to do it in Detroit, no. Same thing in Detroit to do at Sinclair Shores, no. It has to be customized to that particular practice.   Kiera Dent (28:22.782) Yeah, no, and I think that's such wise wisdom because working with hundreds of offices, I don't have an A to Z cookbook. I don't tell them like implement this. I know systems that will work, but we customize it to your area because the patient base, like you said in New York compared to Birmingham, Michigan, they're going to be very different patients. They're going to have different needs, different like all of it is different. The pace of it is going to be different. Your attrition rates will probably look differently. And so I agree with you completely that   Dr Robert DiPilla (28:36.046) That's great.   Kiera Dent (28:52.52) Everything is not apples to apples. I'm curious, how do you lead all five of those practices? Do you have, like, what does your team structure look like? Because so many people do get stressed out with multi-practice ownership. What have you done to reduce that stress level for yourself and make sure that they're all successful?   Dr Robert DiPilla (29:06.262) Yeah. No, it's, we just had our all company meeting. I call it the summit meeting. And, you know, it's amazing that, you know, 10 years ago, I had one office and maybe four employees. Now I   Kiera Dent (29:13.672) Thank you.   Kiera Dent (29:20.928) Did you hear that everyone? 10 years ago. So this is something that in his 36 years of dentistry, he did 26 years. I also think people need to realize they sometimes feel like they're too old to open up multiple practices. They feel they're too far in their career. They needed to do this earlier. So I hope people are hearing your timeline of 26 years solo practice and now 10 years making five practices, but also there is a timeline around that. So continue please. But I just want to highlight, this was not an overnight thing for you either.   Dr Robert DiPilla (29:23.5) Years ago, Yeah. Single practice.   Dr Robert DiPilla (29:51.054) It's not. I'll go back and I'll tell you the reason why for that. And for me, like I said, going to New York, I wanted to be the best. I wanted to be that celebrity dentist. And when I came back to Michigan, I centered everything around me. People came, they flew in from out of state to see me. And one of the things, I can't scale me. And one of the things that I have to open up   Kiera Dent (30:12.63) Yeah.   Dr Robert DiPilla (30:20.174) the offices and kind of passed the baton to my other associates. So, you for me, that was like the biggest thing is the key is letting go. And like I said, we had a summit meeting two weeks ago. And like I said, I had five employees in one practice. Now I have five practices with close to 70 employees. You may say, my God, how do you do that? I hire smart people smarter than me.   Kiera Dent (30:43.082) Yeah   Dr Robert DiPilla (30:49.79) to do that. I have a great CFO. I have a great regional manager and I have great office managers. And one of the biggest things that we, we constant, constant role play a lot of the things that we do in the office. And why is that important? One of the things that we did when COVID happened, before we opened up, we had a month where we did Zoom calls.   like this, and we did a role play because when patients come back, they're gonna have questions. And what are we doing to protect them and ourselves? And it was really important for the front desk, it was really important for our managers, hygienists and assistants to make sure we're getting our message across. One of the things that I never wanna hear on the phone is if a patient asked a question,   and our front desk, our personal, I don't know. I don't know what we're doing. So, you to me, it's just having those questions answered. And what we did is I call it the kind of the soft opening, like what a restaurant would do before they opened up fully, they would kind of, you know, bring in some of their guests or their family members to have a soft opening. So that's what we usually do from that. But the main thing, you for me,   Kiera Dent (31:51.997) That's   Dr Robert DiPilla (32:15.112) is I just hire great people that are around me that will integrate the vision that I have. So there's a great book and I highly, highly recommend for dentists. And I know Gina Whitman very well, it's called Traction. I don't know if you've heard the book or. And it's amazing. And then the follow-up book is Rocket Fuel.   Kiera Dent (32:33.75) We are diehard traction people. We help offices with it. It is incredible. Yes.   Kiera Dent (32:41.903) Amen. When you were talking about integrator, was like, he's a visionary needs the integrator. Did you, did you hire?   Dr Robert DiPilla (32:45.198) I'm the 100%. I mean, for me, I'm definitely the visionary. know what I want to see. And then my CFL is the integrator. I have so bad ADD, I'm like, don't squirrel. Okay, what happened over here? No, no, no, no, get on track. We gotta do this. So for me, like.   Kiera Dent (32:57.848) you   Kiera Dent (33:03.382) How did you find your CFO integrator? you go through one of Traction's hiring things? Did you find them through? How did you find that integrator? Because I think that's such a key piece in growth. How did you find yours?   Dr Robert DiPilla (33:14.572) Well, luckily she was with us and within the company and we just hired up for her. She just went from low level to higher hiring and she got it. She understood the whole process. mean, when she read the book, she, I mean, my God, this is the missing piece for us. And I love that, that passion that she has for that and then just kind of put everything together. So I was very fortunate in that respect. But when we do our hiring,   Kiera Dent (33:21.462) amazing.   Kiera Dent (33:32.118) Yeah.   Dr Robert DiPilla (33:43.746) We hire within our culture and who we are. And sometimes it's difficult to do that. We did that right after COVID because some people didn't feel like they wanted to come back or didn't feel safe to come back as far as some employees, which is fine. And there was a shortage of dental assistants and hygienists wasn't an issue for us. It was more assistance. And I hate to say that we hired people that weren't the right fit.   Kiera Dent (34:08.97) Mm-hmm.   Dr Robert DiPilla (34:13.71) And I'm going to tell you that was a big mistake because it's going to take you longer to find another person. So I'd have no one. do it myself compared to not have the same, the right person that would fit in our culture.   Kiera Dent (34:29.974) I agree. That's wise wisdom. And I think so many people get desperate. And I mean, I've done it. I think we've all done it, right? We've all made those hires and we're like, agreed with you. We'd rather wait it out till the right person comes through rather than doing those desperate hires. And I think it's   Dr Robert DiPilla (34:41.966) Yeah, it works out. And really works out. I'm a true believer that, I mean, there is a plan and you just kind of have to wait it out and it comes in because the same thing in our downtown Detroit office, we were waiting for someone and we thought someone, oh my God, she's going to be great. Oh my God, she's moving from Boston. She's going to come here. She's ran a periodontal office. Oh my God, we love her. And then got ghosted. Like what the hell happened? And then the next day,   Kiera Dent (35:07.38) Mm-hmm.   Dr Robert DiPilla (35:10.85) We got another resume. Lauren, I mean, amazing. I mean, just that blessing that comes through. So I think the best thing to do is just wait it out, hire within your culture. And if they don't fit, they're not the right team member for you.   Kiera Dent (35:28.916) I love that. Dr. DiPilla, something I have found so fascinating with our podcast today, just so appreciative. I feel you have wisdom. And I think wisdom oftentimes lacks. And I think it comes from experience. I think you've learned from the things that you've done. I'm not saying you're old. I'm saying that I hear wisdom from you. And I think you had this wisdom even when you first started your career. I think you learned things. But I feel you lived your own.   Dr Robert DiPilla (35:42.114) You're saying I'm   Kiera Dent (35:56.438) I feel like you grew because you wanted to grow, not because you felt like you needed to. I feel like you waited when I'm sure a lot of your other colleagues were building multi-practices and you're like, this is what I'm enjoying doing. And what I've heard is as you've shifted and morphed throughout your career and the way you've presented it, it sounds like you've done it based on intrigue and curiosity and things that still keep the passion within you. And I feel like...   You're a great example of someone who can be practicing dentistry for 36 years and still have passion, fire and fuel behind it, rather than the what I see a lot of right now of burnout. And I was trying to put the pieces together as we were chatting and I'm like, I think honest to goodness, you've done everything because it was a passion and a curiosity and it fueled you rather than drained you. And I also really love that   you believe that there's a higher path for you. Like you said, it's just because one door is closing, it means the other door is opening, but that door is not quite ready yet. So be okay with this door closing. But that would how I would summarize you. Obviously, please fill in any gaps I may have missed. But I think that that's so refreshing to hear that I think a lot of us can take stock in and learn from you as well.   Dr Robert DiPilla (36:49.806) 100%.   Dr Robert DiPilla (37:05.474) Wow, well, thank you for that. That's, thank you. But for me, right now, I think it's important to, like I said, pass the baton to my other dentist and kind of elevate them as much as possible. And I think if you're in a group practice or if you're in a single practice, sometimes we live on our own little island and you don't know where to do. would...   Kiera Dent (37:10.197) You're welcome.   Dr Robert DiPilla (37:31.66) get a couple of your friends, colleagues, whatever, just go out to a restaurant, hang out and kind of talk your story. Because we're all in it and we all go through the same things. And maybe I'm blessed with mental resiliency, I don't know. I mean, there's a lot of things that are kind of thrown at you. But for me, for my upbringing, mean, things bother me, don't get me wrong, I am human.   But I know that my purpose is stronger than the noise that hear that's behind me. And for me, where am I going to go from here? What's the next 10 years look like? And For me, my legacy and what I want to hear is that when I'm long gone and a patient goes to another dentist and says, hey, who's your other dentist? And I say, well, I went to DiPilla All I want to hear is that, you know what?   Yes, I heard great people. That's all I want to hear. You went to one of the best. That's it. That's all I want to hear. I mean, I that's my legacy is that make sure that we as a group, as a team or organization, we've done the right thing by you and also by the the patients and also our team too. We got to take care of our the team that supports us very,   Kiera Dent (38:54.25) That's beautiful. And I think as you said that I think maybe a takeaway from today would be figure out the legacy that you want to leave. think that that legacy, just did a mastermind group with some people in person and I had them write when they were, you know, I didn't give them an age. I just said, when you're sitting back looking at your life, what do want to feel? What do you want to experience? And what do you want it to be said about you?   And it was crazy because people started making different decisions in that moment because the legacy of who they want to be and what they want to leave behind radically shifts what you're doing today. And I think that that's a beautiful takeaway from today. I have loved our conversation. I thoroughly enjoy you as a human. I think you're just doing a beautiful work, an example of keeping the passion alive in dentistry and doing great things no matter what's going on. any last thoughts you have, how can people connect with you?   Dr Robert DiPilla (39:34.926) Thank you.   Dr Robert DiPilla (39:44.238) I think for anyone guys who have been graduating, this is like the best time to be a dentist. I mean, I'm so excited. mean, the technology is amazing. Things that we used to do before and we can do now, digital workflow, 3D printing, AI, it's amazing. So, for me, I go into work every day. I'm very passionate what we need to do. But for me,   It's time for me to kind of like maybe work maybe in the chair once or twice a week and then work on the business. And that's where I'm more passionate about as well. And then kind of like I said, elevating everybody else. But once again, this has been a real, real pleasure and I can see your passion as well and much, success for yourself.   Kiera Dent (40:28.682) Likewise, thank you so much for joining today, Dr. Tafilla. I hope everybody who's listened takes away a few golden nuggets and gems because I really do believe there was so much value and wisdom in this podcast today. I think that there's so much beauty. love podcasting with people like yourself that are just so optimistic of the future. So thank you for joining us and for all of you listening. Yes.   Dr Robert DiPilla (40:49.816) My pleasure.   Kiera Dent (40:53.78) All of you listening, thank you for joining us. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.  

Many dentists feel stuck in PPO plans, especially in small towns where every other practice is in-network. They worry that going fee-for-service isn't possible in their area. But what if that belief is holding them back? In this episode, Gary and Naren share the story of a dentist who thought exactly that—until he saw things differently. Instead of seeing his town as a challenge, he realized being the only fee-for-service practice could actually be an advantage. Patients are looking for quality care, and many are willing to pay for it—if they know where to go. Gary breaks down the mindset shift needed to leave PPOs successfully, no matter where your practice is located. He also shares practical steps, including how to market your practice, attract the right patients, and build strong relationships that keep them coming back.   Book your free marketing strategy meeting with Ekwa at your convenience. Plus, at the end of the session, get a free analysis report to find out where your practice stands online. It's our gift to you! https://www.lessinsurancedependence.com/marketing-strategy-meeting/  If you're looking to boost your case acceptance rates and enhance patient communication, you can schedule a Coaching Strategy Meeting with Gary Takacs. With his experience in helping practices thrive, Gary will work with you on personalized coaching, ensuring you and your team are prepared to present treatment plans confidently, offer financing options, and communicate the value of essential dental services. https://www.lessinsurancedependence.com/csm/ 

Are you overwhelmed trying to navigate PPOs? Then keep listening! In this episode of Practical Solutions Day, Kirk Behrendt brings back Sandi Hudson, founder of Unlock the PPO, to decode some of the biggest challenges when dropping PPOs. You didn't go to dental school to deal with insurance. Let the experts do it for you! To learn more about Sandi's company and the key things to consider before dropping PPOs, listen to Episode 863 of The Best Practices Show!Learn More About Sandi:Join Sandi on Facebook: https://www.facebook.com/UnlockThePPOFollow Sandi on Instagram: https://www.instagram.com/unlocktheppoLearn more about Unlock the PPO: https://unlocktheppo.comLearn More About ACT Dental:ACT's webinars: https://www.actdental.com/135ACT's website: https://www.actdental.comACT's Instagram: https://www.instagram.com/actdentalACT's YouTube: https://www.youtube.com/actdentalACT's Facebook: https://www.facebook.com/actdentalACT's LinkedIn: https://www.linkedin.com/company/3137520/admin/feed/posts/ACT's Twitter: https://twitter.com/actdentalMore Helpful Links for a Better Practice & a Better Life:Subscribe to The Best Practices Show: https://the-best-practices-show.captivate.fm/listenJoin The Best Practices Association: https://www.actdental.com/bpaDownload ACT's BPA app on the Apple App Store: https://apps.apple.com/us/app/best-practices-association/id6738960360Download ACT's BPA app on the Google Play Store: https://play.google.com/store/apps/details?id=com.actdental.join&hl=en_USJoin ACT's To The Top Study Club: https://www.actdental.com/tttSee the ACT Dental/BPA Live Event Schedule: https://www.actdental.com/eventGet The Best Practices Magazine for free: https://www.actdental.com/magazinePlease leave us a review on the podcast: https://podcasts.apple.com/us/podcast/the-best-practices-show-with-kirk-behrendt/id1223838218Main Takeaways:Fee-for-service dentistry is...

In this episode of the Less Insurance Dependence Podcast, co-hosts Gary Takacs and Naren Arulrajah discuss what it truly means to achieve financial independence through your dental practice. They break down the steps to financial freedom, including how to grow revenue with high-quality new patients, why PPO write-offs limit your wealth, and smart financial strategies like pension plans and investments. Gary and Naren also highlight eye-opening statistics from the American Dental Association (ADA) about how few dentists can retire without lowering their lifestyle—and how you can ensure you're on the right track. Book your free marketing strategy meeting with Ekwa at your convenience. Plus, at the end of the session, get a free analysis report to find out where your practice stands online. It's our gift to you! https://www.lessinsurancedependence.com/marketing-strategy-meeting/  If you're looking to boost your case acceptance rates and enhance patient communication, you can schedule a Coaching Strategy Meeting with Gary Takacs. With his experience in helping practices thrive, Gary will work with you on personalized coaching, ensuring you and your team are prepared to present treatment plans confidently, offer financing options, and communicate the value of essential dental services. https://www.lessinsurancedependence.com/csm/   

Kiera and Britt have a deep discussion on the ins and outs of hygiene right now, including what's on hygiene grads' minds, the right ranges for skill sets, how different practices are staying scrappy amid the dearth of hygienists, and more. Episode resources: Sign up for Dental A-Team's Virtual Summit 2025! Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript Kiera Dent (00:00.822) Hello, Dental A Team listeners. This is Kiera. And today I have Brittany Stone, the one and only No BS Britt. And today I'm asking her to play Hygiene Britt. If you didn't know, it's actually fun. It is. And it was funny because yesterday, Britt and I actually like had, we were heavy in Dental A Team mode. And then I called Britt back probably like a minute later and I said, Hey Britt, can you be Hygiene Britt for me? Cause I have a hygiene question.   Britt (00:26.988) you   Kiera Dent (00:29.102) So Britt, welcome to the show today. How are you?   Britt (00:32.308) I'm good, how are you doing?   Kiera Dent (00:34.23) I'm great. How does it feel to be hygiene Britt? Like go from, mean, you're Dental A Team's operations manager, you're also consultant, like all the things. How does it feel like go back into that clinical space sometimes?   Britt (00:45.678) I mean, hygiene are roots, man. Like that's the beginning. So it feels to me, I know you guys haven't known me as like hygienist. Like, yes, I know hygiene stuff, but you never worked with me clinically as a hygienist. But to me, I'm like, yeah, that's me.   Kiera Dent (00:54.872) true.   Kiera Dent (01:00.91) I'm glad because it is fun. I actually was talking to Jason last night after you and I had chatted and I said, Jay, it was actually really fun to talk to Britt about like where we started. I mean, I'm dental assistant, Kiera, office manager, Kiera, treatment coordinator, Kiera. No one's known me as that in Dental A Team. And so I'm just going to throw it out there because you never know who's listening to the podcast and who would ever like take me up on this idea. But if there's someone out there,   that would love to allow Dental A Team to come in for one day and go back to our roots. So Britt, we probably have to do this in Arizona, because I think you're only licensed in certain states, right? Okay, so Arizona offices, if you know someone in Arizona, all of our crew will be there in March and there might be a few other times, but I think it'd be funny to see a Dental A Team take over. Like how would it be for Tip to be an assistant?   Britt (01:35.318) Yeah, currently still just Arizona. My OG state over here.   Kiera Dent (01:52.462) me to either be an assistant or a treatment coordinator, and Dana to go back into hygiene and just see like how it would run. if anybody's open to letting us come back into our, like put the scrubs on and just see like, shoot, we'll cover for a day for you guys.   Britt (02:01.198) .   Britt (02:06.358) It would be like a good and wild time all at the same time because I think we're all a little bit more maybe assertive than we might have been in some of our olden days in those positions.   Kiera Dent (02:14.038) Hahaha   Kiera Dent (02:18.316) I agree. And this is why I want to see like what would Dental A Team do if we were all put into one office at one time. So anyway, if you're interested, email me Hello@TheDentalATeam.com This isn't a passive ask. This is like, I really think it'd be so fun. We've talked about it so many times, like what would it be like? So, Hey, if you're ever interested in Dental A Team.   Britt (02:23.046) Yeah.   Britt (02:35.982) Usually what we do is we say if we could all only be one role, so no doubling up on roles, this is the game Kiera likes to play, who would be which role within the office is usually how this goes. yeah, not to say we don't get along, we would have a fantastic time, but you'd get a lot of ideas that they would run quick, I'll tell you that.   Kiera Dent (02:45.118) I do.   Kiera Dent (02:49.762) and   Kiera Dent (02:55.608) Thank   Kiera Dent (02:58.99) Well, and I'm like, believe it or not, I would actually not go for office manager. So I'm out on that. Shelby will probably take on office manager role, even though she's never done it, she'll do great. But it is kind of funny, Tiffany, we were talking the other day and I said, Tiff, I remember being a dental assistant and I had hours of time sitting there like root canals, crown preps, where I just thought of all these ideas and Tiff's like, I would like, I literally would hate if you actually went back to that and had that much time to think of ideas.   Britt (03:08.014) Thank you.   Kiera Dent (03:26.904) Fair enough. anyway, throwing it out there, Britt and I have a good time, but truly I do think it'd be fun if an office allowed us to come and just like see what would happen if all of us went back into it. You might hate it. Don't worry, doctors. You can still keep like one or two main assistants. Like we won't fully do it, but like we're, we think we'd be the A team. I'm just curious if we'd actually be rated A, B, C or D going back in as a whole team. Exactly. But on that note, pivoting into what we want to chat about.   Britt (03:47.327) Put our money where our mouth is. Is that what you're saying?   Kiera Dent (03:55.96) Britt and I wanted to get on the podcast and I really wanted Britt to be on this podcast with me because Britt is a hygienist and believe it or not, I have had actually some clients ask Britt and Dana like, hey, if you ever want to like leave consulting and come back to hygiene, hey, poo poo on you, that's terrible, don't do that. We don't poach your people, don't poach ours. But it is interesting because I do know that hygiene is a hot topic and so I thought Britt, if we came on the podcast today and we actually chatted about...   Britt (04:08.174) Thank   Britt (04:12.056) you   Kiera Dent (04:22.508) All right, let's talk about hygiene. How do we get hygienists? How can we hire? How can we attract? What are maybe some out of the box thinking today? And also doing on both sides of the coin because I do know we have hygienists that do listen to the podcast as well. So shout out to you listening in and educating yourself and understanding kind of the predicament the doctors are in because it's this constant, like I do feel over the last four years since COVID, the hygiene pay range has like just like escalated up this ladder, which is making it hard for practices to stay profitable, which then leads to if   The practices can't maintain profitability. I do actually wonder and this is kind of just my thoughts and I'm sure Britt you've thought of it. Will there come a point where hygienists are actually asking for too much that dentists say it's not worth it for hygienists? I'm just going to hire a dentist. So I'm just like just so we know and I want hygienists. So it's going to be kind of like a really open conversation. My goal today is that none of what we bring ever should be weaponized against people. So there might be some ideas discussed hygienists if we're talking about certain things to me. This is not always on where you can go in.   take this to your doctor and demand certain things and doctors if that happens, like it sounds like that's a great opportunity to coach that hygienist out and bring someone else in and vice versa. Hygienists and doctors, like doctors not weaponizing and saying, hygienists we're so high, I can't afford to do this or things like that. I think really understanding the dynamics of where we're at, I think is gonna be a good conversation. So Britt, you, hi, Janice Britt, welcome to the scene, hello.   Britt (05:45.454) Thank you. I'll put that hat on. And it's all in fairness, right? I think that's what it comes down to in any working relationship. And even when it comes down to talking about things like compensation, like it should be a conversation for both sides, right? And sometimes there's things that can be done. Sometimes there's things that can't be done. And sometimes performance-wise, it doesn't warrant being done. So I think that's just the mindset to go into it with always when it comes to those conversations is it is a conversation. It should be a conversation.   demands back and forth and finding the best fair solution.   Kiera Dent (06:20.502) Yeah, absolutely. And Britt, I'm so glad that you're open to this. And Britt, the reason I love her in operations next to me, like I feel like her and I are really good yin and yang. think Britt and I truly, we have very different personalities. We have very different mindsets. We have very different pieces. And I think when you can bring those two perspectives to the table, I'm very strong entrepreneur. I'm very strong business. very, like Britt will tell you, I come in very strong on those and Britt will come in very strong on team.   Britt (06:32.876) you   Kiera Dent (06:45.282) I think that to have someone like that in your corner to me is invaluable because it allows Britt and I to really, like we say hash, like we really do go back and forth knowing that our ultimate goal is to land on what's fair and best for the business, what's fair and best for the patients, what's fair and best for our team, what's fair and best for every player in the scene and the arena. And I believe when you can have these conversations, you can get there. So Britt, I wanna just kick off.   It's something that's come up and I'm just curious from your perspective as a hygienist, because you are a senior hygienist. You've been in the ranks. You haven't been there as a brand new grad. And there are some hygienists who are feeling like these new grads are coming out asking for quite a lot. I've actually been told that a lot of the hygiene teachers are actually telling them to ask for higher amounts. And I'm really curious, like, do you feel that there should be ranges where if you've been out of school for say zero to five years, it's kind of like this is your range.   if you've been out of school from five to 10 years or 10 years plus, because some of those senior hygienists do feel like, hey, I've been in here, I've been running the ranks. And then I'll give you the flip side that I also think of, but sometimes my senior hygienist might not be as up to date as my brand new grads out of school. So there's this like, there is an experience piece of you've been with the patients longer, but sometimes like, I know certain hygienists don't do as much perio, whereas new grads do more perio sometimes. So.   Again, I'm not here to judge the hygiene world. I'm just curious, Britt, from your perspective, being a hygienist who's been in the realm for a while, what's your take on like, should there be ranges based on experience or is it on performance? Like, what's kind of some metrics that you see that would be beneficial when we're looking at compensation to be fair across the board?   Britt (08:22.414) I mean, you know fairness is a big thing to me, right? So I and this will be a probably to some maybe not the most popular opinion But I do think it's the fairest and I no matter the role right whether it's a hygienist whether it's an assistant whether it's a front desk whether it's an associate coming in I'm big on it comes down to skill set and what are they able to do? Right? What what's their skill set in the position? How are they able to perform? What things can they be?   responsible for and own and make sure that they get done. Now with a new grad, would I probably be a little bit conservative on what they start them out with and say, hey, here's your path forward, right? Once you show me XYZ, you're running on time, you're making sure your diagnostics are quality, all those things, this is your path forward as far as compensation goes. But I do think it should be a skill set based compensation, not just like tenure based compensation. I'm not a big fan of tenure overall, no matter like   Kiera Dent (09:21.517) Mm-hmm.   Britt (09:22.176) like where it is. The thing that I will say along with that though is to make sure that our owners, right, whoever's making those decisions on compensation, that we keep it all fair. So I think sometimes some of those more senior ones, maybe they've stayed at a rate for a really long time and maybe haven't been increased according to inflation or what they're paying other people now. And so like that piece needs to be fair as well. So make sure, I'm a big fan of tears, what's   the skills and make sure that it stays within those tiers. And yeah, if you've been with me for a long time and you've got a full set of skills for hygiene and you do really well, you should be at the top end of that top tier. And if not, then we need to have a conversation and talk about it and see how we can get you there. Because that's ultimately my goal for any of my team members is how do we get you performing to the top of your skill set, your ability or your license. And with that should come like fair compensation that comes along with it.   Kiera Dent (10:22.392) So, okay, I really like that. I've got two follow-ups on that. One is what are like set skillsets that could be ranging someone up? Are we just talking perio? Are we talking laser? Are we talking like, what is it that is specifically for hygiene, the skillset? And I do love, I hope you guys all asked like that, like every person should be performing at the top of their license. So that's follow up question number one. Second is gonna be about a compensation question. So what are those skills that you feel will range them up exponentially?   Britt (10:50.252) Yep, so for me, like basic skills, running on time. If you have an anesthesia license, you're doing your anesthesia, if that's allowed within your state. Chart audits are good. You're getting everything that needs to be done, that your charting is complete. You're getting all your diagnostics done. You're coming prepared to huddle. You're being a team player. All of those things are kind of like my basic level stuff.   Kiera Dent (11:16.846) Should they like interjecting real quick on that? Should they be hitting a certain production amount or is it more just those? It's like, what is the production amount that they should be hitting in like basic skill level before they even move on?   Britt (11:29.038) Yep. I think whatever your basic goal is, I'm usually depending on the area, depending on your PPO fee for service, right? There's going to be a little bit of a difference, but I'm usually like a 12 to 1500 is usually around kind of like my base, depending on if you're PPO or if you're fee for service kind of on that upper range. And then as you as you one, I think get more confident with perio, have those conversations, perio percentage rate, that's case acceptance for peri   percentage rate would be a next level to look at. So not only are you having the conversations, right, you can do it, but how effective are you educating patients in advocating form to get the treatment done that's needed? So this is where a few more specific metrics are gonna come into play. So per year percentage is gonna start to come into play looking at jumping to that next level. I'm also gonna start looking at how well are you setting up doctor and teeing up doctor for treatment.   That's going to be my mid range that they need to be able to have those conversations. TFDoctor, be a partner in that conversation. So that's kind of like my mid range ones and my high range ones I'm going to tie in. Yeah.   what's your case acceptance coming out of your room? How well are you supporting the doctor and advocating for those patients? Having conversations because at some point with hygiene, right, there's clinical skills and with those, right, doctors should be checking, sure, check my perio from time to time on my charting to make sure we're aligned. Yes, if I'm missing stuff that I shouldn't be missing, then like absolutely those should be things that are talked about and would keep me in that like basic pay range if I'm not doing well at my job.   But to get up into that advanced pay range, it comes to a lot of the soft skills. Are you adding in that scan? Are you on board? Are you advocating for the practice and getting things done? Are you talking about treatment? Do you have good case acceptance coming out of your room? It's a lot of those soft skills and showing initiative instead of like, no, that's too much. I'm not going to do that. It's almost like a difference in personality and an initiative once you get to those higher range and you know them, you see those hygienists that are just rock stars and they're like, yep, they will   Britt (13:34.33) help out, they are a team player. Yep, I can get that done. I've got time to do it. They are having the conversations, they're supporting the doctor really well. That's my top tier. That's what I ultimately want everyone to be.   Kiera Dent (13:47.918) And I think that actually really helped in like that 1500 that 1200 range like there has been a model out there of like three times their pay and I'm just curious Britt. Is that even a realistic number from your perspective now of three times a hygienist pay? I do say for fee for service usually at a four or four point five times their pay but with PPO schedules and with the new rate of hygienist coming out, do you still feel like three times their pay is fair?   Britt (14:14.242) I think it is a great starting point, right? There's across the country, and this is where like you can pull the economics of it into it, right? Depending on the area, depending on how many hygienists there are.   Like that's something that we, I think, have seen across the board that impacts higher ranges or lower ranges, right? That's the way a free economy works. Welcome to it. So, right, depending on the area, I would say yes, that is, everyone should be shooting to hit that. And some of our areas where   you know, it's a little bit more competitive or depending on, you know, well, we'll throw it out there. State laws, different things that have to be offered, right? That impacts the price and how expensive it can be to pay a hygienist. And I'll say to my hygienist, you guys are worth it, right? Especially you're that top tier hygienist. Like you guys are worth it. But from a business standpoint, there's like we got to we got to stay profitable at the end of the day. And so I do think that three times fee for service   us up to like four times pay is a great place to start. And if we are not there, then we need to start looking at other factors. Is it reasonable? Most of time, yes, 100 % it is. Some cases, depending on the area where there's like those shortage, those higher ranges, like it's a little bit more of a struggle. And that's where it comes to the conversation of, all right.   hygiene or associate. And we've definitely had those practices where it's like, for what I'm paying this hygienist, I can have an associate who can not only do hygiene, but can also do treatment. Which direction should I go?   Kiera Dent (15:38.862) Mm-hmm.   Kiera Dent (15:48.96) I agree. I think, I think the hygiene world, like making sure that it's cognitive of that too, because I think it could be a dangerous zone where without trying hygienists actually like work themselves out of the marketplace. I agree. think hygienists is such a valuable player on the team. And so just making sure that like we're cognitive of that. And I love that, Britt, you bring that from a hygiene perspective. I will also say though, I don't just think it's fully on the hygienist. And Britt, I know you agree with this completely that   Britt (16:15.555) Mm-hmm.   Kiera Dent (16:16.334) looking for that three times and instead of saying like we can't get there, let's look to see how could we get there. So it has the office actually looked at their fees and are we making sure that our fees are competitive, that we're negotiating with the insurances. This doesn't mean you have to drop in and drop your insurance plans, but it does mean we need to be very effective with it. Looking to see can we add in laser? Can we add in PRP or PRF? Can we add in some of those adjunct services? Are we adding fluoride? Are we getting all of our x-rays on the right series?   Are we billing out the correct comp exams for it? Are we looking for those additional pieces and looking for like, what are all the codes that we can bill out within hygiene? Of course, not over diagnosing things out or billing things out. But I think like, let's also look at medicine. They bill for the gauze, they bill for the cotton, they bill for all these things. And I'm not here to say like nickel and dime your patients, but I am here to say.   I think they're starting to become a world where we've got to start being more proactive on what we do, bill out to insurances to hit the rates that the hygienists need to be producing as opposed to just doing what we've always done. So I think like as an office collectively working in conjunction with a hygienist, let's not just throw our hands in the air and say like, they're too expensive. There's no way they'll hit it. No, that's not true. There's actually a lot of hygienists who are being paid those higher ranges and they are producing three, four times their pay. I have hygienists in...   less affluent areas able to hit that. And so it's kind of like the four minute mile. People thought it couldn't happen, couldn't happen, couldn't happen. Well, I think sometimes it's telling us it can't be done. We actually find ways to make that true rather than saying, hey, other offices are doing that. Let's get creative and let's let's let's work together and figure out what we can do. So I want to maybe have some commentary. Please do.   Britt (17:51.118) Yeah, I want to make a quick plug on this because I know I threw out there like there does come a point where like sometimes we sit there and we contemplate of like associate or not the hygienist and me do I want doctors doing hygiene? No, I don't. don't. No. Do doctors want to be doing hygiene? No.   Kiera Dent (18:04.27) No, I don't either and I'm not even a hygienist.   Now.   Britt (18:11.072) No, they don't want to, right? So like it's not an ideal solution, but when it comes to a business being able to survive and stay profitable and keep running to take care of patients and provide livelihoods for everybody, like some that's the that's the business side of my brain that it's like sometimes those are things that we have to contemplate and see what's the best decision moving forward.   Kiera Dent (18:30.296) for sure. And I'm glad you put that because the ultimate goal is to not replace hygienists. The ultimate goal is no. But I think it's like, look at other businesses. Do you think other businesses wanted to convert to AI? The answer is probably not. But due to necessity of profitability, like to me, that becomes a survival skill. Like is this business going to live or die? They're going to find ways to live. That's a natural human tendency. And so I think it's like, let's partner together. Let's find the solutions. I even have some practices who have elected to go   Britt (18:35.598) I don't want that.   Kiera Dent (18:59.064) hygiene, like no hygiene in their practices. so knowing that, like, but again, this is just getting scrappy. This is doctors just like, we have to find a way to survive. think it's   Britt (19:01.71) Mm-hmm.   Britt (19:08.14) And out of necessity, if they can't find one, right? Like sometimes that's kind of been the state that some of them have been in, so.   Kiera Dent (19:15.342) for sure. So Britt on that we did talk about like baseline pay and we talked about longevity of it. What happens when you have a seasoned team that has been there? And we've got hygienists, they love the practice, they love the things they're doing. recruiters are pretty impressive these days. Like I do feel everybody's being bombarded with other offers constantly. And it's like you might be very happy. But hey, like sometimes dollars do count. What do you do for a practice?   when like these new grads are coming out and let's say they're asking because like right now I have a practice and the new grads like literally looking on indeed all practices hiring right now are like $5 an hour more than what they're currently paying like their highest hygienist. Like what do you do in that realm because like if you've got three or four hygienists now I've got to increase everybody $5 an hour just to be able to bring one new hygienist in. I think this is where it's like this wave of constantly like chasing a number but it's not just one person I'm chasing it's multiples.   what do you recommend for businesses and new grads? Because I'm like, if I tell this new grad, like, well, this is where we'll start to, I've got seven other offices willing to offer this hygienist that they only need one hygienist. They can do it because the finances make sense for them. What do we do in those scenarios to help these practices out?   Britt (20:27.724) Yeah, I think having a community near you to know kind of what people are really getting paid, right? There will always be, especially in your more like city, right, areas, there's always going to be someone out there who can pay more.   There's gonna be an offer on the table somewhere. I always say question that. Know what you're getting into on those ones that are like real high from everybody else. But I think it's a real question of what are you ultimately looking for? One, with that higher rate you better believe you're still, you're gonna have to make your way, right? To make it worth paying you that amount. So that's gonna be there.   Also, you know, what do you value in the people you work with and the type of things that are being done and the care that's being provided in practice not taking a hit at anybody but I'm like that's an overall it's not just a dollar like sure you can go out and you just want to pick a job based on dollar Go for it. If you want it's risky in my opinion Look at the whole picture and see kind of what you're gonna be living because we spend a lot of time at work, right? It's a it's a big part of our life and we spend a lot of time and I don't know I take a lot of pride in where I work. So I care about when   the people and what we do. And I hope that's the same for our providers out there, for our hygienists out there. But I think take a look overall.   And then I think when it comes to those rates, so have a community know what like the actual rates are not just the jobs that are out there and what people are getting paid. Make sure you're competitive like 100 % the rates need to be competitive and if you fall in behind some unlike yeah we might need to see what we can do and see if we can start to get back within the range of the market to stay competitive. And then   Britt (22:16.45) that also I think brings confidence in knowing you're offering something fair, right? So if I'm like, if I know, hey, it's competitive, it's fair.   We're a great place to work. I always want to get people in to come meet us, experience us, because again, it's more than just a dollar. If they're making a decision just off of a dollar, they're probably not the right person for me anyways. So I want to get them in, let them see the whole picture. And then, you know, when it comes down to it, at the end of the day, I can offer what I can offer and offer a path of like, hey, this is where it starts. And here's what you can do moving forward in the potential. But we're getting to know each other. And   I'll say this recently, especially for assistants as well, because I think it's the same, similar scenario in assistant world, is some of the doctors that know their affair, they come in, they're confident.   have people who like them and they're like, okay, you know, not to say it always happens, right? It won't always, but it's more likely to happen instead of just chasing a dollar amount and trying to like outbid someone. So I think still be confident in your moves. Don't jump too fast. Make sure you're competitive. Make sure you're allowing people to see the whole picture of you. I'll add to that. Make sure you're actually a good place to work along with that so that you attract people.   Kiera Dent (23:12.878) Right.   Kiera Dent (23:32.398) Agreed.   Britt (23:34.382) because I think trends and you'll see articles and research out there, money matters and there's always going to be those people where money is their top priority, but life I think these days matters to people a little bit more.   Kiera Dent (23:46.22) I would agree. think that that's something that the shift of the, think money used to be the currency that people were going after. And I think now it's time and lifestyle that is the new currency. so realizing that and recognizing that, Britt, let's say an office, the going rate is higher than what you are really like able to afford in your practice. What's your take on offering like a lower base, but commission from a hygienist? Like does this, I don't know how it lands for hygienist. Is it like, well, I want the guarantee of like knowing that I can   let's say it's $5 different between offices, but this office is really struggling, but they can offer you the commission base. How attractive is that to a hygienist? I have my opinions, but I'm not a hygienist. So I'm just curious from your state, what you hear from colleagues in the industry. Cause I know you see very connected to the hygiene world. What are you kind of hearing around?   Britt (24:33.42) Yeah, I think it's a super fair model. I know when I was managing, that's the model we were off. I want you to know that you can count on something that's reliable, right? So that's where I do like having a base that's very reasonable, that's very fair, that is an amount that easily hygienists should be able to produce and make that and cover themselves.   But for those who do like hustle, right? They're not gonna be like, well, I've got an opening, I'll just go home. Or like, I'll just like chill. Like they want to work. They wanna keep people on their schedule. They want to be supportive of the team. They should make more. And so it's even just a fair from a multiple hygienist in an office. I'm like, yeah, yeah.   working hard I should make a little bit more than the person that's kind of slacking off a little bit. And so I like that model to where one you know what you can count on because there's that base there. And then yeah commission is going to be ultimately whatever you want it to be right? Like that's where you've got some control and if it's a commission based on production or adjusted production or collections whatever route the doctor ends up going   fees rise in the practice, right? That's you naturally kind of build in that increase over the years as office fees change.   Kiera Dent (25:56.782) Fair, that's a good point. And Britt, I have so many more questions I wanna ask. I think for today, keeping it here, I really also think one thing to plug on the commission that I think Britt, you and I have done a really good job. Like, mad kudos to you within our company, because we do offer our consultants based in commission. So I think like we can actually speak to this model pretty well. But something I really pride ourselves on is we actually go and look at real numbers. I don't want to be going for my best hygienist and offering off of my best hygienist.   We want to find an average between like our lowest producing hygienist and our highest producing because I would rather set a clear expectation with that hygienist coming in of like, if you do basically like bare minimum, this is what you'll be making. And then if you choose to like go more, which there are opportunities, this is the range you could do. And literally when we do offers, we literally show a hygienist or like in our instance, it's a consultant. Here's what it is. Here's what the averages are.   And for me, I think that actually makes me way more confident going in because I'm not offering the highest end. We have we have consultants that produce a lot more than other consultants. But I don't want because that just sets an expectation for that hygienist coming in. This is what I think I'm going to be paid. And then when I'm not, they get angry with you versus it being like, this is where I think it's very fair. This is very realistic. This is the time frame. Realistically, I think you can hit it. This is an average day. Here's our actual numbers. This is an actual hygiene schedule.   So that way I really do think that that will make you more confident when offering. If you can't offer say that $5 more or you want to bring people in and maybe you're a little bit less than that. You don't want to raise your entire hygiene team. And again, hygienist, it's not because I don't want to raise you. Like I just want to make that super clear as a business owner. I want to pay my entire team exponentially well. Like truly this is like my heart of hearts. Like Britt knows this. I'm constantly looking like how can we raise people? How can we do it?   Britt (27:38.413) Thank   Kiera Dent (27:40.918) I also know as a business owner, my job is to make sure I keep the business profitable because if I don't, I've actually heard every person that we serve in the community of patients. I've heard our entire team of being able to afford it. And also I don't want to be stressed as a business owner, like fully. would, I like, I love you and I want to pay you. I also want to be able to sleep at night and not constantly stressing of do I need to take a second mortgage out on my home? So like just understanding it's, it's a business, it's a person, it's a human, but I think be fair with your numbers that you offer.   And Britt, I do want to do another episode. I'll just tee it up of what do hygienists feel about assisted hygiene? Cause it is a model that's starting to come as popularity of not being able to find hygienists. Is it something of we like it, we don't. Also, I know there's conversations around, we shorten hygiene appointments to be able to see more patients as insurances aren't reimbursing as much. So I definitely want to like tee it up of having a few more hygiene conversations. But Britt on this, thank you for giving you the perspective of like the ranges of how to pay and what you feel about base plus commission.   Britt (28:13.528) Thank   Kiera Dent (28:38.874) Hopefully we were able to give you guys some tips on how can we attract these people. think like you said, Britt, having a great place and a great reputation within the community, having longevity of team members, it's been shocking. Britt and I have been doing interviews and I don't know if you picked up on it, Britt, but the last, I think two or three interviews we've done, one of the questions they've asked is how long is your longest team member and can we ask why they've stayed? It's been shocking to me that that's a question that has come through. It's been consistent.   Britt (29:02.156) Consistent. 100%.   Kiera Dent (29:05.132) And I'm thinking it's because people really want to work in places long-term and there's so much jostling that I think they're also wondering, are employers keeping team members too? So just note, that's been a very random comment that's come through on our last very, and we're talking like yesterday. We just had an interview yesterday, that question was asked, so it's very real. But Brittany, any last thoughts you've got you want to wrap up today? I appreciate your Brittany hygiene today, coming to the table for the perspectives.   Britt (29:29.102) No, I just, I think it's a good conversation and agreed on running numbers and especially if you're wanting to maybe like transition within your practice, right? Hygiene wanting to propose it or doctors wanting to like switch over so that it's a much more sustainable model for you. Run the numbers and see what it looks like, right? That's reality and I'm with you on like low and high end when it comes to hiring. Worst thing you can do is set expectations you're not gonna meet.   Kiera Dent (29:54.094) Agreed Well, Britt, thanks for being on the pod. You guys, appreciate you. We will definitely come back. I know there's lots of questions. I know this is hot right now. So, Britt and will definitely podcast again about assisted hygiene, what we do for shrinking hours. Is that even doable from a hygienist perspective? Or is that like, no, there's other solutions because I know everybody right now is just trying to find solutions for the pickle that we're in wanting to maintain and...   really pay these hygienists what we believe that they deserve. So Britt, thanks for being on it. And for all of you, if we can help you and your hygiene team, if these are issues you're struggling with, if you're like, am just like hitting my head against a wall. I don't really know what to do. Reach out. That's what we do. Hello@TheDentalATeam.com And as always, thanks for listening and we'll catch you next time on The Dental A Team Podcast.