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Part two of Kiera's conversation with Brannon Moncrief, principal and CEO of McLerran and Associates, is about common misconceptions with private buyers and DSOs. These include which tends to have more patient and/or staff turnover, types of equity that matter more than others, when deals tend to go south, and a ton more.

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Transcript:

Kiera (00:23)

Can you walk me through private buyer versus DSO? Like what is the dark? What's in the shadows? What are like the horror stories? And I don't want to freak people out. I feel like it's just a good way to educate of like what things can go wrong instead of just looking for all the things that can go right. And then we're able to make the most educated decisions.

 

Brannon Moncrief (00:39)

absolutely. So let's talk about private buyer deals first. So couple of things that we see in the private buyer world. One, I think a lot of sellers are under the misconception that selling to a private buyer means protecting their legacy and less change for their practice post sale compared to selling to a DSO. I would tell you that as long as you're selling to a good DSO.

 

And there are good and bad players out there, no doubt. We'll talk about that in just a minute. As long as you're selling to a good DSO that is in the business of buying great practices, partnering with great clinicians, and wanting to just perpetuate what you've built, more change will actually occur in your practice post sale with a private buyer than a DSO. And the reason being is that a private buyer is going to show up every day. They have bought 100%

 

Kiera (01:30)

For sure.

 

Brannon Moncrief (01:31)

of your business. They're going to physically show up to your practice every day.

 

They're likely from a different generation. They were trained differently. And they will have different ideas and different motivations clinically and personally, professionally, financially, about where they want to take the business. Therefore, you're going to see more change faster when you sell to a private buyer than selling to a DSO. And because they physically show up to your office every day, they have a different personality than you. You have these long-term relationships with your staff and patients. They might not click.

 

Kiera (02:05)

Mm-hmm.

 

Brannon Moncrief (02:05)

So you might see

 

more patient turnover, you might see more staff turnover with a private buyer than a DSO. A DSO is not gonna plant somebody in your office that's going to, you know, wear the DSO cap all day and transform your business into something that it's not. They're gonna rely on you to continue doing what you do well and then outsource all the administrative and operational tasks that you're not ultimately good at to them.

 

And behind the veil, they'll help make your business operate more smoothly and more profitably. So I think that's a big misconception that, if I sell to a DSO, they're gonna destroy my legacy, they're gonna change my practice. If I sell to a private buyer, that's the perpetuation of of what I've built over the past 30 years. That is not necessarily the case. from a private buyer, you know, perspective, I think dealing with associate to purchase and partnerships.

 

It is a big thing to talk about. The partnership failure rate is extremely high. It's higher than the divorce rate. Partnerships

 

Kiera (03:07)

Mm-hmm. Yes.

 

Brannon Moncrief (03:09)

are very easy to get into and very hard to get out of. So you need to make damn sure that you're ready to get married to somebody from a professional perspective and have an ironclad partnership agreement

 

Kiera (03:24)

Anyway.

 

Brannon Moncrief (03:24)

where you address everything that could go wrong on a go-forward basis because

 

Kiera (03:28)

Yep.

 

Brannon Moncrief (03:30)

there is a high probability.

 

That there are going to be, whether it's life events or disagreements within the business, that you're gonna have to get through. And if you don't have

 

Kiera (03:38)

Mm-hmm.

 

Brannon Moncrief (03:39)

the right partner, communication is going to break down and the business is going to suffer, you know, as a result. We've also seen a lot of situations where an associate will join the practice with the intent of eventually becoming the successor and the owner, but the associate and the seller don't work out the details on the front end. And oftentimes when

 

They're ready to consummate the transaction. They have very different ideas about what the business is worth or how the deal is going to be structured. Sometimes the timing doesn't align. You know, sellers said that they were going to sell the practice in two years. Two years comes around

 

Kiera (04:14)

Okay.

 

Brannon Moncrief (04:14)

and they're like, you know what? Life's pretty good. You know, I'm only working two days a

 

Kiera (04:17)

Yeah.

 

Brannon Moncrief (04:18)

week now. I'm playing a lot of golf. You're working your ass off. You know, I'd like to wait another two years. And you're going to continue, you know, supplementing my production and helping create this lifestyle practice for me.

 

And then the associate's got to go, crap, do I wait two more years or do I bounce and try to find another opportunity? Or vice versa, where seller said,

 

Kiera (04:39)

Mm-hmm.

 

Brannon Moncrief (04:39)

Hey, I want to be ready to sell in two years, you get there and you know, associate just started a family, right? Or decided they don't want to pursue

 

Kiera (04:46)

Yeah.

 

Brannon Moncrief (04:47)

practice ownership. And now seller's going, do I wait for this person to mature and turn into my successor? Or do I need to start over with somebody

 

Kiera (04:57)

Mm-hmm.

 

Brannon Moncrief (04:58)

else? So if you're gonna go down that path.

 

My advice is to have those conversations on the front end and establish the rules of the game

 

Kiera (05:05)

Great.

 

Brannon Moncrief (05:06)

and do it in a formal framework in writing.

 

Kiera (05:09)

Mm-hmm.

 

Brannon Moncrief (05:10)

don't wait until the day you're ready to sell to sit down and have serious discussions about when that's going to happen, how it's going to be done structurally, how the practice is going to be valued. Do it on the front end. And then from a private buyer perspective, I would just say like a lot of these deals can go south post sale.

 

Kiera (05:31)

Yeah.

 

Brannon Moncrief (05:31)

As a

 

result of a breakdown in communication between buyer and seller and arguments over petty, petty stuff. Right.

 

Kiera (05:38)

Yep. Yep.

 

Brannon Moncrief (05:40)

And I will tell you that the number one way that buyers and sellers get sideways in a private buyer deal is over accounts receivable and credit balances. so y yeah, you you you know I'm speaking your language here.

 

Kiera (05:51)

You're not wrong. I do.

 

Brannon Moncrief (05:56)

Making sure that your AR and credit balances are as clean as possible when you go to sell, and

 

Kiera (05:58)

Mm-hmm.

 

Brannon Moncrief (06:01)

ideally selling the AR to the buyer and writing them a check for the credit balances at close so that the day

 

Kiera (06:10)

You're done.

 

Brannon Moncrief (06:11)

after the sale, every dollar of revenue that comes in it belongs to the buyer. And there's no

 

Kiera (06:16)

Yep.

 

Brannon Moncrief (06:17)

weird conversations about, for instance, patient patient comes in.

 

Kiera (06:21)

These make me laugh.

 

They're a mess.

 

Brannon Moncrief (06:24)

We see these things all the time. So a patient comes in post sale, seller's no longer there, but seller did not sell the receivables. So the buyer is collecting the seller's receivables and remitting them to the seller post sale. Patient

 

Kiera (06:36)

Yep.

 

Brannon Moncrief (06:38)

comes in that has a previous balance with the seller, gets work done by the buyer, the new owner, writes one check at the front desk. What do you think the front office person does? They don't, they just deposit the check into the buyer's

 

Kiera (06:50)

They deposit it. Exactly.

 

Brannon Moncrief (06:52)

bank account.

 

And now the buyer has some of the seller's money sitting in their bank account and it hasn't been properly accounted for at the front desk. Eventually, especially if that happens multiple times, there's going to be a problem. And even if there was no malice, right, involved, the seller's going to get pissed off that the buyer is not abiding by their word and collecting those receivables and remitting them to them properly, even though the buyer didn't mean to.

 

End up with some of the sellers money in their bank account. So these are the types of things that one, if you can plan for it on the front end and make it as clean as possible, you know, in regards to how you structure the deal, how you how you navigate the agreements. But two, on the back end, just communicate and be calm and behave

 

Kiera (07:40)

Mm-hmm.

 

Brannon Moncrief (07:42)

like normal people and do the right thing. And as long

 

Kiera (07:46)

Yeah.

 

Brannon Moncrief (07:46)

as everybody does that, everything's gonna be fine.

 

But we have seen people get in lawsuits over 300 bucks. I mean, just crazy,

 

Kiera (07:54)

Yep.

 

Brannon Moncrief (07:55)

crazy stuff. And unfortunately, we haven't talked about this yet. It's a very emotional process, especially doctor to doctor. For the seller, they're selling their identity. They're they're dealing with talking about their own mortality, right? And it's their baby. it's been their life's work, you know, for the past 30 years. It's not just a financially impactful.

 

Transaction. It's very emotionally impactful. And for the buyer, you know, they're five years out of school. They've got a significant amount of student loan debt. They're about to triple the amount of debt they have when they go and buy your practice and borrow another million bucks to do so. They're starting a family. They're buying their first house. Like they got a lot of balls in the air. They're at a completely different stage in their life than the seller.

 

Kiera (08:47)

Yeah.

 

Brannon Moncrief (08:48)

it's a lot.

 

It's a lot of stress, it's a lot of pressure. So you've got high emotions on both sides of the transaction. And that's why you normally see erratic and poor behavior and poor communication and things go off the rails over very, very small issues. And that's where hopefully you've got a good broker involved. You know, they're helping, you know, hold hands on both sides and serve as that buffer and manage those emotions, both during the transaction and and afterwards. So

 

Those are some of the dark paths that that you can go down from a a a

 

Kiera (09:18)

Yeah.

 

Brannon Moncrief (09:20)

private buyer perspective. You know, from a DSO perspective. Yeah, absolutely. Please.

 

Kiera (09:23)

Can I jump in? I'm gonna jump in real quick on some of the because I agree

 

with you. And I'm always let's talk about the credits in the AR real quick. there's a piece of me that's like, as a buyer of this, do you really want to be paying your front office girl to go collect money for this person that you now have to pay back? The answer is a hard no. So when I think about that, of like, let's just think through the logistics of how this AR is going to get collected. Cause I did this on my first practice purchases when I giggled and it was a freaking nightmare and I had a

 

have all the writing down and I had to say like, my gosh, like we owe this guy this much money. And it was just dumb. I was like, I wish we would have gotten it for a lesser deal. Whatever we collected, we gotta keep. We're motivated to collect it. I'm not trying to pay my front office girl to go hustle her booty while she's on my dime to go collect for this seller. So that was a big zone. I don't disagree with you. And the credits get a check up front because you're going to be redoing their work and you're going to be so annoyed with how much redo dentistry you're

 

Having to do or all those credits sitting out there that you're like, my gosh, I paid for this and I'm doing it for free. So absolutely agree with you on that. And I've been through two partnerships myself. I've been on dental practices. So speaking of that partnership, I always say plan the divorce from the day one. Like, what's gonna happen? How are we gonna separate? What are the things like what's gonna happen if I don't want to keep working? How does that look? And when you said that, Brannon, like again, speaking from real life cura, I've gone through this a few times. if I would have known what the outcomes were going to be from the seller.

 

Coming in as a buyer, because I always put money in. I was annoyed. Someone sold it out from under me. And I was like, what the heck? Like, how did I not even know this was selling? Like they're like, sorry, you lost money. And I'm like, but I didn't even get to see the books and I put money in to purchase this. It was like, hey, I want to go in, like you said, start a family, or I want to go be with my husband, or like these different things. And I was like, no, you can't. Like you're part of this deal. And I was like, I didn't even know I was part of this deal. So really talking about like what are those big things, what's going to happen.

 

Because when everybody has the rules of the game before we start the game, we can play the game way more fairly with each other. And agreed, when I look at the life cycle of the seller and the buyer, the buyer, like you said, is coming in at a very young early stage. Like imagine them as like toddlers in their professional career. And you are like ready to go off and play pickleball in retirement. You're on very opposite sides. Your team is at a very opposite side. So recognizing, I love that you said that people are going to feel this way of

 

my gosh. Like I never thought about the legacy changing so much with selling to a private buyer. I am curious before you head to DSO, I have this opinion and I really am curious if you can back it with facts. So many dentists feel like they're doing the right thing by selling to a younger buyer to keep their legacy alive. However, what I have seen is they do and they feel good. They brush their shoulders, they've sold it to their associate that's gonna take care of the legacy.

 

Well, that associate, like we just said, about the life cycle of them, they're young, they got debt, they got a lot of debt on them, they've got a lot of things. And these DSOs are chirping in their ear left and right. That I've seen a lot of those younger buyers actually sell to a DSO. So it's a few years after they did the legacy. So the reason I bring that up is because I think a lot of legacy dentists are wanting that legacy and they're not even looking at the DSO route because they think they're doing the right thing. But then that younger buyer then just flips around and sells it to the DSO for a higher multiple. So I'm curious, like.

 

Is that true from your perspective and what you've seen? Because I just think it's important for dentists to not feel like they're being the good old boys or the good old girls and like doing the right thing. But then the next dentist is just selling it for the higher multiples that they could have gotten.

 

Brannon Moncrief (12:50)

Think it's it's noble in principle, but in reality, it's kind of a falsehood, right? We have

 

Kiera (12:56)

That's how I feel.

 

Brannon Moncrief (12:57)

we have had multiple clients on the DSO side that were those associates that bought the practice. And as soon as the seller walked out the door, right? So

 

Kiera (13:07)

Yep.

 

Brannon Moncrief (13:07)

and a lot of those deals, the seller actually stayed on for a year or two, and the practice grew substantially post-sale, or

 

Kiera (13:13)

Mm-hmm. Yep.

 

Brannon Moncrief (13:14)

was already in the position to be a candidate for a DSO sale.

 

But the seller chose to go the private buyer route to protect private practice dentistry and their legacy. And then right when they walked out the door, I got the phone call. Hey, I bought this practice two years ago. I've doubled it. You know, my EBITDA is sitting at 700,000. I want to sell it and then go back to being an associate. And,

 

Kiera (13:38)

Exactly.

 

Brannon Moncrief (13:39)

you know, they they basically triple what the seller could have gotten. You know,

 

Kiera (13:43)

Absolutely.

 

Brannon Moncrief (13:44)

if the seller had

 

waited, put in the same amount of energy, and then sold it to a DSO, they would have been way better off economically. So it's noble, but I do think that if you have a practice of the caliber and size that a DSO would be interested in purchasing, you need to at least explore it. Don't just discount

 

Kiera (14:04)

Feel the same.

 

Brannon Moncrief (14:05)

it and say, hey, that's not the right path. That's not good for dentistry. You need to do ultimately what's right for you. Because

 

Kiera (14:13)

Mm-hmm.

 

Brannon Moncrief (14:15)

Whether you like it or not, private equity is here to stay. DSOs

 

Kiera (14:18)

I agree.

 

Brannon Moncrief (14:18)

are here to stay. Your stand is ultimately not going to matter in the big picture of how private practice evolves.

 

Kiera (14:29)

Mm-hmm.

 

Brannon Moncrief (14:29)

so I I agree with you. You at least should look at it. It may not make any sense, right? We may go through it and hey, at least you looked under that rock. but to completely ignore it based on principle, I don't think is a good idea.

 

Kiera (14:43)

I agree. I just wanted to like throw that out there because I feel like so many legacy dentists are really trying to do the right thing in their minds. And yet these younger doctors, and I'm not here to like throw shade at the younger doctors, it's just the different lifestyle that they're in. It's the different I mean, shoot, how can any of us, if we had that much debt and loans on us, not explore a DSO when I have a way to get out of that debt and I don't have to work for the next thirty years of my life? It's just a different style that they're living in. So okay.

 

Let's do let's do a quick wrap of the dark side of DSOs. Thank you for like going a little longer with me. I definitely want to have the part two of this because I feel like people are just always curious about what's under the hood on both sides.

 

Brannon Moncrief (15:20)

No, I I love it. I do want to check one more thing on partnerships, because we've actually had this conversation on with some of your clients, large practices with with

 

Kiera (15:27)

Mm-hmm. Yep.

 

Brannon Moncrief (15:30)

multiple associates that are DSO targets, where a the founder is contemplating do I s do I partner with a DSO or do I I give or or sell minority own equity to my associate doctors? And a lot of them have decided to go the minority equity route to their associate doctors.

 

I want to make the point that if you're going to give or sell minority equity to an associate, one, even if they're minority partners, they're they're going to want to say in what happens with the business on a go-forward basis. They're going to want to see it at the table, even if you're not equal partners, especially if they're paying for the equity. And two, they are not likely going to step up and help you run the business. So I think what

 

Kiera (16:13)

So true.

 

Brannon Moncrief (16:14)

you should look at it as is it's a retention tool, not

 

Kiera (16:18)

I would agree.

 

Brannon Moncrief (16:18)

a

 

Not a tool to offload the operational and management responsibilities where you know you're gonna be able to be on a yacht most of the time while your associate that's got 15% equity not only works chair side but also runs the business for you. And that's where, if that's what you're looking for, like less operational and management responsibility, I think the DSO makes more sense because they're gonna pay two or three times the price.

 

That a private buyer is going to pay. And they are designed to provide you with support from an operational perspective. So just be careful about your mindset. And if you're gonna sell minority equity to associates, understand that's a retention tool, not a tool to offload your operational and management responsibilities. And therefore, again, you may wanna look at the DSO route.

 

As opposed to selling minority equity to your associates, at least, at least look at it. And sometimes

 

Kiera (17:23)

Mm-hmm.

 

Brannon Moncrief (17:23)

that helps put you in the right frame of mind, at least, should you proceed with your associates, as opposed to selling, pursuing a sale to a DSO. The other thing is also just thinking about the back end. What happens when you go to sell the majority of your equity? Are your associates

 

Kiera (17:40)

Mm-hmm.

 

Brannon Moncrief (17:41)

your buyer? What happens if they don't want to buy? Right.

 

Kiera (17:43)

Right.

 

Brannon Moncrief (17:44)

Now you're stuck where you own 60% of the practice and you've got two associates that both have minority equity ownership and they're like, hey, I'm happy. I don't want to buy your 60%. by the way, I'm the future of this practice. I'm gonna block a DSO sale. And

 

Kiera (17:58)

Mm-hmm.

 

Brannon Moncrief (17:59)

now it's like, well, what the hell do I do with the remainder of my equity? Right? If I can't

 

Kiera (18:01)

Yeah.

 

Brannon Moncrief (18:03)

sell to a DSO and my associates don't want to buy it, what happens now? So we've seen that.

 

Kiera (18:08)

Yeah, 'cause I have heard

 

I've heard a rumor that if you have minor minority partners with associates that it is actually harder to sell to a DSO. Is it because of this or is it also on the DSO side because now they got multi partners that they're having to convince and sell to?

 

Brannon Moncrief (18:22)

ESO actually loves it. That option is still

 

Kiera (18:23)

Okay.

 

Brannon Moncrief (18:24)

available to you. However, those minority partners have to be on board and complicit with the sale.

 

Kiera (18:29)

And I know you think

 

because all the owners are like, Yeah, but I put it in our agreement that they can't do this. And I'm like, but they're an owner. Like they own. You can't just override them. And they o don't own just I mean, I had like a five percent in one and they overrid me hard and it was sold before I even knew. And I was like, Got it. Like, but it was five percent. I was very, very, very tiny. I still don't think that that was legal, but it did happen. So like there was one. But

 

Like most of the time you're giving them like fifteen to twenty percent equity in your business. That's not a small five percent. And they're also working in the business day in and day out. I was a five percent quiet minority, like wasn't even in the business. There's different ways that these deals are done. So that's good to hear that it doesn't block you on the DSO, but I do agree on the associates. Make sure they're really bought. And I think owners feel like, no, they're gonna be on board with me. And I'm like, you have to realize they have like 10 more years, 20 more years they want to work. They don't want to sell their business and go be an associate somewhere else.

 

And you're like, but they're gonna get a big payout. And I'm like, but they don't because they're in so much freaking debt because they just bought your practice. So there are different pieces that I think you need to consider of that minority partner that's very different than you in your OG years of like, this is your retirement. They're not there to retire. They're they're still hungry and they still want to work. And so I I agree with you. Those minority partners feel really good, but I sometimes see them as more golden handcuffs on the seller, like the legacy doctor, than they are on the associate. It's a great retention piece.

 

But it also puts you in like less options in the future too.

 

Brannon Moncrief (19:54)

And like you said, you can design the legal agreement in a way that you have a drag-along right, a unilateral right to legally

 

Kiera (19:59)

Mm-hmm.

 

Brannon Moncrief (19:59)

do whatever you want. However, if they're now the primary producers, they're the youth, they're the future of the business, the DSO is going be super sensitive to making

 

Kiera (20:09)

Mm-hmm.

 

Brannon Moncrief (20:09)

sure that they're complicit in the sale. And if they're not, regardless of what your legal agreements say, if the key providers in the future of the business are not on board, the buyer is going to back away from the deal.

 

Kiera (20:21)

Right.

 

Brannon Moncrief (20:21)

And

 

that's where these deals go south. So you just need to think through all of this. And these are some of the roadblocks, some the challenges that we see in the private buyer world, especially as it pertains to partnerships and, you know, associates.

 

Kiera (20:35)

Awesome. Okay. flip side DSO. Tell me about the dark side of DSO.

 

Brannon Moncrief (20:41)

I would say there's there's several. So first and foremost, the reason that we exist as sell side advisors is DSOs and private equity from a buying perspective are relatively predatory. Their goal is to buy low and sell high. And they have created an entire ecosystem of trying to get in front of sellers without them having proper representation, without

 

Kiera (21:08)

Mm-hmm.

 

Brannon Moncrief (21:08)

having competition at the table.

 

Because they know if they have a conversation in the dark and do a deal without the seller having proper representation, without being in a multiple offer situation, they can pay less for the asset. So

 

Kiera (21:25)

Mm-hmm.

 

Brannon Moncrief (21:26)

many DSOs have built huge marketing machines that push out a lot of direct mail. They have business development teams where their only job is to bird dog potential sellers and they pay, oftentimes, both.

 

You know, advisors and doctors to introduce them to potential sellers. If you're gonna go down that path, those are shark-infested waters. You've got

 

Kiera (21:50)

Mm-hmm.

 

Brannon Moncrief (21:51)

to make sure you have proper representation, whether it's us or somebody else, you've got to have a sell-side advisor at the table. You have to be in a multiple offer situation to create the leverage that you need to maximize the economic outcome. And I would say, even more importantly, the optionality you need to find the right buyer.

 

Because not all DSOs are created equal. And if you've talked to one, you've talked to one. They're all different. So you need to shop around, you need to date around to find the right fit, because fit and deal structure are the two things that are gonna impact your long-term happiness if you go down

 

Kiera (22:25)

Mm-hmm.

 

Brannon Moncrief (22:26)

the DSO path. Yes, the valuation matters. Yes, the cash at close matters. But the type of equity you hold, the rights you have

 

Kiera (22:34)

Yeah.

 

Brannon Moncrief (22:34)

with that equity.

 

Who you partner with from an operational perspective and from a financial perspective is going to dictate your long-term outcome. So

 

Kiera (22:43)

Mm-hmm.

 

Brannon Moncrief (22:44)

that's first and foremost is DSOs are predatory. Don't do this on your own. Thinking that you're going to save a commission, you will cost yourself millions and a lot of heartache down the road. Secondly, again, kind of going back to the DSO's going to change my business. You know, they're going to destroy my legacy.

 

I will say there are DSOs out there where the suits think they're smarter than the doctors. And

 

Kiera (23:10)

Mm-hmm.

 

Brannon Moncrief (23:11)

I would argue that long term those DSOs are going to crash and burn. So you

 

Kiera (23:15)

Agree.

 

Brannon Moncrief (23:15)

do not want to be sitting at the table with one of those buyers, right? And that's also why you need to fill that table in a competitive process so that those buyers stand out in a bad way. So that you know, hey.

 

Kiera (23:30)

Mm-hmm.

 

Brannon Moncrief (23:31)

Based on all these interviews that I've done with all these potential buyers, I don't like those two people. I don't like what they had to say, how they answered my questions, comparatively speaking, to the other buyers at the table. They're good actors and bad actors. You want to make sure that you stay away from the bad actors. Again, big part of what we do, vetting these DSOs and making sure we only bring the best of the best options to the table because they're continue to be bad actors in the marketplace.

 

You will also hear some horror stories about how a DSO came in and tried to change my business and ruined my business. I will say that a lot of those stories are not completely truthful. You don't have context.

 

Kiera (24:15)

It's true.

 

Brannon Moncrief (24:16)

Oftentimes, what happens is the seller takes their foot off the gas. The seller takes

 

Kiera (24:21)

Mm-hmm.

 

Brannon Moncrief (24:21)

5 million, 10 million cash at close, and then loses the motivation.

 

continue to work hard and manage the business and the business suffers as a result. Well if I'm the DSO that bought that business and my partner completely checked out post sale because they hit their retirement goal, my only option is to lean in, put my hands on the business and try to write the ship. So oftentimes when you hear those horror stories, there's a precursor there that is not explained. Bad behavior on behalf of the doctor post sale

 

cause the DSO to have to have a heavy hand from an operational perspective. So there are those bad actors out there, but there are also stories online that I see all the time where I'm like, what's the truth here? Because I actually

 

Kiera (25:10)

Mm.

 

Brannon Moncrief (25:12)

know that potential that actual DSO, I've done 20 deals with them and I've never heard that story from one of my clients. So you either weren't ready to take on a partner, right? Emotionally or financially. Some doctors

 

Kiera (25:25)

Mm-hmm.

 

Brannon Moncrief (25:26)

Can't make that shift, right? You need really think about that. If you haven't been an employee for 30 years, are you employable? Right. Are you gonna do you play nice with others if you've

 

Kiera (25:36)

Mm-hmm.

 

Brannon Moncrief (25:37)

been, you know, king of the hill for the past 30 years, right? You need to think about that as well. So that's that's another nuance. The biggest one is the equity, right?

 

Kiera (25:48)

Mm-hmm, mm-hmm.

 

Brannon Moncrief (25:49)

For a long time, nobody talked about the downside in the equity because.

 

Private equity is making money hand over fist for about a decade previous to 2024. there were many recaps from 2018 to 2023 at really great returns. I mean, some BSOs hit multiple recaps at a three to five X return on invested capital. Those are amazing financial outcomes. But the game changed in 2023 when interest rates increased rapidly. And

 

The capital markets tightened up, along with the fact that we were mid-consolidation, meaning that any industry that's being consolidated by private equity, you're gonna have winners and losers. But it takes time for that to play out. It takes five to ten years to figure out who are the winners and losers. They're not all going to be successful. When you layer on a rapid increase in interest rates, and these are heavily levered businesses where

 

The carrying cost of the debt is substantial, along with significant inflationary pressure on overhead, along with being mid-consolidation cycle where the winners and losers start to separate themselves from each other. It accelerated the the path of the losers, right? And you can get several casualties, multiple DSOs fail. Now, that doesn't mean that the practice is all closed. It just means that they're kind of zombie companies from an equity perspective. And

 

The doctors likely are not going to have a good outcome on their equity long term. And then you've had other DSOs that were built on a strong foundation, the winners of the game that have done remarkably well, despite the more challenging macroeconomic environment that we've been up against the past few years. So anytime you're talking about private equity, there's winners and losers. And all other outcomes are going to be somewhere in between. They're going to be people that go to zero. They're going to be people that get a unicorn outcome, a 5X return on equity with three recaps.

 

And then there's going to be people that get a more modest return. We want to keep you away from the losers. And I'm happy to say it was relatively easy for us to identify who the losers were going to be. You know, you play in the sandbox enough. You stand at the water cooler and listen to the the talk. You meet the management teams, you hear the investment thesis, you watch their buying behavior. It's relatively easy to figure out like whose house of cards versus

 

Who's built on a strong foundation and who's going be successful? So of those DSOs that have been, you know, pure casualties, gone bankrupt, we haven't sold a single practice to them. I'm proud to say that. now, will there be more casualties in the future? Yeah. Yeah, there will be. but I will say the reckoning that we've been through over the past few years has caused private equity and DSOs, for lack of a better phrase, excuse my language, to get their shit together.

 

Kiera (28:52)

Mm.

 

Brannon Moncrief (28:53)

So long term, it's been good for the industry because DSOs have had to become operators, not aggregators. They've had to learn how to integrate and operate the businesses that have acquired and grow those businesses post-sale. As

 

Kiera (29:06)

Mm-hmm.

 

Brannon Moncrief (29:06)

a result, they become much better operators and much more astute and much more disciplined about what they buy, what they pay

 

Kiera (29:13)

Mm-hmm.

 

Brannon Moncrief (29:13)

for it, and how they structure deals. So they've just gotten a lot smarter. So you're going to see less casualties on a go-forward basis than you've seen over the past few years.

 

And I do think that you're going to see more recaps and modest but positive results on the equity with some DSOs, not all, over the next few years. So the reckoning's been painful for some, you might say many, but I think it was a needed reset. and it's a natural progression of any private equity backed industry. But be careful because

 

There are plenty of DSOs out there today that are actively buying practices that will put a letter of intent in front of you and show you that your equity is going to see a 20x return over the next

 

Kiera (30:02)

Yeah.

 

Brannon Moncrief (30:02)

15 years through multiple recap events. I can tell you that some of those DSOs I am 100% confident are going to go bankrupt. We do

 

Kiera (30:10)

Mm-hmm.

 

Brannon Moncrief (30:11)

not allow those DSOs to sit at the table with our clients. But that doesn't mean that they won't give you some crazy financial projection that's never going to come true. So

 

Kiera (30:20)

Mm-hmm.

 

Brannon Moncrief (30:21)

Again, having proper representation, people that know the lay of the land, that know who to bet on and who not to bet on, that's extremely important because yes, the equity does have a potential wealth creation opportunity, but it does have risk. And that risk

 

Kiera (30:38)

Yeah.

 

Brannon Moncrief (30:39)

has been illustrated, you know, over the past few years in a major way.

 

Kiera (30:43)

Totally. And Brannon, I I love how you talked about to me, I feel like if you're going into a DSO cell, make sure your cash at close of whatever it is you're good with. Like if you never see your or your recap or your any of that investment, like again, this is how I live. So please live how you want. Brannon might absolutely radically disagree with me. I've always felt like if I'm good with how much I'm getting at cash at close, fanfreakantastic and anything I get beyond that is gonna make me exponentially.

 

Like wealthy, like it's the stock market. We have no clue which stocks we're betting on. And you have a very small pool, you can do better. But like you are betting in a very like volatile, like to me, it's very volatile. I think about Bitcoin. People who got in early on Bitcoin, they're freaking living their life in the best way. Those who went through the really, really, really bad hit, they're not living their best life. I watched this like multi, multi, multi-million, almost billionaire in Bitcoin go from like kingpin to popper. Like

 

Literally overnight. I watched him go in like his life and he had everything in Bitcoin and he was one of the top people and it dropped. And I feel like that's the same thing in dentistry. Like you said, you're betting on a a company and you have no idea to know what the future of that business is going to do. So I agree with you. I think that people get their shorts burned when they're banking on all those like huge, huge recaps and all of this equity being worth so much. It's like I don't really want to be with them and I don't really want to be with the lowest end.

 

I want to be in that middle of the pack and I hope I choose the right one to bet on. But again, the

 

way Kiera Dent lives, I live very modest. I live very conservative. And I would rather like, am I good at my cash on

 

close? So if nothing else happens, fantastic. And if something else does happen, I'm going to surely pick my best one. But then I'm really happy no matter what the outcome is. And I'm hoping that I bet on the right one that does give me a great recap. But at the same time, I'm really happy whether it does that or doesn't. I also love that you talked about like they are not planning to come in to take over.

 

But you do have to accept that you're working for a new boss. And I don't think people realize that. Like you do. You are now an associate. You are not making the same as what you were making before as an owner. That is the price you've got paid when you've got that check up front. And I think sometimes people forget that check up front, whether you're a seller on a private side and you're getting a check there, and now you're getting an associate pay, or you're selling to a DSO and your paycheck is not as much. That's something else that I recommend you look at. Like, what does my life look like post sell? Like I did get that big check, but now I'm gonna live on a much lower income.

 

Let me maybe practice that for a year before I actually sell. I did that with a doctor and he did much better. He's like, This is all I get. And I was like, Yeah, that's your future life. I think that's that's it. But you're also gonna get a very large payout, but that becomes your day in, day out, and make sure that you're comfortable with that. So Brannon, thanks for like digging into this. I really appreciate the part one, part two today. Are there any last thoughts you have as we're wrapping up today?

 

Brannon Moncrief (33:23)

Just a couple of things that I'll speak on. I think that was well said. Your approach to, hey, you got to be happy with a cash at close, that I would say is the most conservative approach, but that's a no-brainer, right? If the cash at close gets you where you need to be and everything else is gravy, great. I would argue that the type of equity matters a lot. So,

 

Kiera (33:40)

I would agree with that.

 

Brannon Moncrief (33:41)

so the private equity has gotten wise to the fact that this is a provider-centric business. And the way you create alignment with providers is joint venture equity.

 

retained practice level equity. That is real ongoing equity in your business post sale that has EBITDA distributions. So

 

Kiera (34:00)

Mm-hmm.

 

Brannon Moncrief (34:00)

it helps soften the blow as far as your your you know the cut and your take home pay on an annual basis. And it's real equity in your business that has real value and is going to throw off EBITDA distributions along the way. So I would argue that that equity is a lot safer than than

 

Kiera (34:17)

I would agree with you completely.

 

Brannon Moncrief (34:19)

than holding company equity.

 

If you own equity in the DSO, the outcome could be amazing. It could be terrible, right?

 

Kiera (34:27)

Agreed.

 

Brannon Moncrief (34:27)

Could be somewhere in between. So you do need to think about like what is your annual burn rate? What is your postclosing compensation going to look like? How does your chair side wage versus the joint venture equity distributions play into that? And understanding that holding company equity has significantly more risk than joint venture retained equity in your practice.

 

you've got to look at it, you know, in a holistic way.

 

Kiera (34:54)

Mm-hmm.

 

Brannon Moncrief (34:55)

but I I I think a lot of your comments were were spot on. And yeah, look, you got to talk about the good and bad, right? And there

 

Kiera (35:01)

Mm-hmm, mm-hmm.

 

Brannon Moncrief (35:02)

is nothing in life that is typically a no-brainer with nothing but good. I would also argue that nothing that we've talked about today has all bad, you know, associated

 

Kiera (35:12)

Mm-hmm.

 

Brannon Moncrief (35:13)

with it. So it's a balanced equation. You gotta take a holistic approach, you gotta get educated.

 

And I appreciate you having me here to help do that.

 

Kiera (35:21)

Yeah, Brannon. Thank you so much for that and agreed. The varying types of equity. Thank you for that correction because you're right. There are safer equity that you've got in the holding one. That's a full-blown like bet on it and good luck. I really agree with you on like know what it's going to be post-close what's your day in, day out burn rate and like what you need to survive on. I feel like that answers so many questions. And Brannon, I I appreciate you doing this. And I hope everybody listening, like, let's do pen to paper. Reach out to Brannon. I know, Brannon, you guys do free valuations for.

 

Any client that comes through zero pressure, that's why I really love you guys, you will talk to them. I feel like you're very highly educated. You're one of the biggest brokers in the industry where you're doing the most transactions of most. And so you're seeing more and more deals. And I feel like having somebody who does more and more deals, like when I've talked to other people, I'm like, what's your average deal size? Like, am I your higher deal? Am I your lower deal? When I'm talking to financial advisors, I want to know what their average portfolio size is. I don't want to be the largest and I don't want to be the smallest. And I need to make sure that who I am at my size of practice.

 

You've done it multiple times and you're very, very proficient with it because Brannon, you just see, like you said, you've 1500 deals. That's a lot of deals to sit at the table to know the good, the bad, the ugly. You're not going to be perfect at it, but you're going to have a lot more at bats that are going to be more congruent. So, Brannon, if people are interested, they kind of want to put pen to paper, start to look to see what it is. Again, I hope you're not ready to sell. Like Brannon said, and I say, Let's catch you a few years before you're ready to do that. That way we can start to make it the best it can be. My side included, we want to catch you before you want to sell. I don't want to have to like do.

 

Like Hail Mary moves for a whole year trying to get you to your buy and your EBITDA that you're looking for. but Brannon, if people want to reach out to you, how can they connect with you?

 

Brannon Moncrief (36:55)

One of best ways to reach me, I give my cell phone number is to text me and schedule a discovery call. Every conversation we have with a potential client always starts with a 30-minute, confidential, casual discovery call just to get to know each other and figure out does it make sense to move on to the next step and do a thorough evaluation and start that education process? You can text me at 512-660-8505.

 

Or you can email me, Brannon, that's B R A N N O N @DentalTransitions.com. But yeah, anybody listening would love to carve out thirty minutes just to get to know you and talk about your why and and what's next.

 

Kiera (37:37)

Absolutely. And Brannon, anyone who comes from Dental A Team, be sure to let them know you heard them on the podcast. Brannon does an amazing job taking care of our clients and our listeners. So be sure to let them know. And Brannon, thanks for your time. I feel highly educated. I hope everybody did. I hope you guys enjoyed part one, part two of this today. Brannon, thank you for being such a wealth of knowledge in the industry. We adore you. Our clients adore you. And I'm just grateful for you today. So thank you. Yeah, likewise.

 

Brannon Moncrief (37:58)

See you. Good to see you. Bye everybody.

 

Kiera (38:00)

And for everyone listening, thank you for listening. And as always, thanks for listening. And I'll catch you next time on the Dental A Team podcast.

 

This episode is all about dentistry as a relationship-based field—finding your patients' motivations and blending what they want with what their teeth and mouth needs. Tiff and Kristy provide tips on getting to know the human in the chair (even when you're seeing 30 to 50 patients a day), so they truly feel like their needs are being met.

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Transcript:

Tiffanie (00:01)

Hello, Dental A Team listeners. We are back here with you on our consultant takeover, is what I like to call it. The consultants here at Dental A Team, myself, Tiff, Tiffanie, Tiff, Spiffy Tiffy, whatever you want to call me, and at least one other consultant every single month will come to you with some actionable, implementable words of wisdom and advice, things that we've seen in offices on the road. We do virtual consulting, we do in-person.

 

Boots on the ground consulting, and we also do masterminds in person. Right now they are located in Phoenix, where all of our Dental A Team doctors and their mass their office managers can come mastermind together. So a lot of the things that we come to you with are from our experience. We are all experienced in the office. We've had hygiene hygiene or dental assisting, and all of us have had front office and at some point or another have managed a practice, andor some of us.

 

Kiera have owned practices. So we've got a vast wealth of knowledge here within our company. And then again, also we are still experienced as in we are going into offices and we're helping to innovate. So Dental A Team does it differently because we will smash all the knowledge that we're getting, all of the experience that we're getting, and create new exciting things without completely reinventing the wheel. But again, just putting it out there that we're not stale and stagnant. We are.

 

constantly in offices and our teams constantly talking about the things that we're doing. And today I bring with he with me to you, Miss Kristy. Kristy, you have been in dentistry for a while, same as me. We've both been in it for what feels like forever. And you did some really cool things in office. And one of my favorite things about your experience is not only like the boots on the ground experience that you have, you've been in

 

so many practices physically in practices as a dental consultant, but you really work on personal development and leadership as a skill set to layer on top of the dental. And I love that. I I you know I love the same kind of genre of learning. We share books

 

DAT- Kristy (02:11)

Yeah.

 

Tiffanie (02:11)

and podcasts all the time. but how do you I'm gonna like just ask you a little snippet how do you feel that that layering in your consulting

 

as you're working with team members and doctors, how does that layering help you to get them to that space of change where they're ready to implement something new?

 

DAT- Kristy (02:32)

Yeah, I love that you say that tip because I think truly if if I had to summarize it, it's really investing in the per person, you know. while I think we love to vision our teammates or, you know, even as doctors and employers, we think they're gonna stay forever, right? And that's kind of our goal. But sometimes it's not meant to be that way. And I I truly believe that investing in the person, whether they're

 

staying there in that practice or moving on or heck, how many go back to school and then come back to you? So I think you know we talked about systems earlier today and there's only so many systems within a dental practice, but when you can layer in and invest in the person on top of teaching systems, it just takes it to a new level. And I I liken it to how we treat our patients, you know?

 

Tiffanie (03:30)

Yeah.

 

DAT- Kristy (03:30)

We can

 

and it ties to our conversation today, I know, but so many times we can just jump in, diagnose, treatment, plan, tell, or we can really get in relationship and figure out what patients want and create a different experience. And I think to your question, Tiff, no different than how we deal with teammates or employees,

 

Tiffanie (03:50)

Yeah.

 

DAT- Kristy (03:50)

investing in them for sure.

 

Tiffanie (03:53)

Yeah, I completely agree. As you were speaking about that, I started thinking, my gosh, yeah, it is it's just that relationship, right? Like you said to the patient experience as well. And being able, I think for our consulting team in general, I think we're all a little bit more inclined towards that like personal development and leadership side. more so than many people I've met in the profession that are very like ready to go, let's just

 

change this thing like do and i i get that because people get excited for dentistry too and we do as well i think i i love the people aspect of it like dentistry paved my way is what i say i think it's cool i think it's awesome but it's not end all be all it's more to me it's more about the people and like you said investing back into them and i think that's something that Kristy you do really well and i know the rest of our consultants do as well

 

Of really investing in the human that's on the other side of the screen, or that's standing in front of us when we're in person and really letting them know and understand that we do care. Not even just I was gonna say making them think. That's not even it. Like we're not making people think anything, we're truly investing in them and letting them know that this is the right place. This is where they should be, and they love their jobs, they can love their jobs and inspiring them.

 

To love what they're doing and love the patients that are coming in. And then I think, Kristy, what you do is create a space of safety for them and then a space of learning. So they get to see, they get to be poured into. And the best part about pouring into someone is the idea that they're going to take that and pour into someone else. So then you're pouring into your teams and your doctors when you're working with them.

 

And then hoping right that now they're pouring into the patient. And to your point, what we're talking about today is patient like treatment planning and really why we're not getting the yes right away. The patients that are saying, I need to think about this. And I think Kristy, to your statement, to the point of your statement, we've got to make sure that we've poured enough into the relationship to be able to speak to.

 

treatment plans to issues and problems because like you know you go get your car oil done and then all of a sudden this man you've never seen before he's not even the guy who checked you in comes in he's like Kristy he's like you need and he goes down the list and you're like who are you like

 

DAT- Kristy (06:19)

Yeah.

 

Tiffanie (06:19)

why are you like I what are your credentials like how do you know this and and when we're so automated or busy

 

I fear that we might get in that same space within a dental practice.

 

DAT- Kristy (06:34)

Yeah, I I agree one hundred percent, Tiff. And I think we do get in that space, right? We get busy and and they do come to us for our knowledge. And you know, don't get me wrong, we have a due diligence to diagnose and and treat and tell them what we see. However, I I I literally like I joke about this, but when I teach like even phone coaching and I say to people, why are they coming in for a cleaning?

 

They're like a cleaning. And I'm like, but what's a cleaning? Like, why are they

 

Tiffanie (07:05)

Yeah.

 

DAT- Kristy (07:06)

literally coming in for a cleaning? What do they it they're coming for what it gives them? N there's nobody that calls on the phone and says, Hey Tiff, will you make sure my hygienist has really sharp instruments so she can scrape my teeth? You

 

Tiffanie (07:20)

Yeah.

 

DAT- Kristy (07:20)

know? Like nobody says that ever. They're coming

 

Tiffanie (07:22)

Yeah.

 

DAT- Kristy (07:23)

for what it gives them. And if we want,

 

To really interact and change lives of patients and get them to say yes more often, we really have to figure out what their motivation is. And again, it ties with that diagnose treatment plan and tell them what they need. But in reality, and especially in dentistry, I think patients truly buy what they want, not always what they need, right? And the want

 

Tiffanie (07:50)

yes.

 

DAT- Kristy (07:51)

usually has an emotional side to it.

 

Tiffanie (07:54)

Yeah, that's so funny. Yesterday I went to Target. I went Target's dangerous.

 

DAT- Kristy (08:02)

Ha ha ha.

 

Tiffanie (08:03)

I went to Target. So my fiance Aaron and my son Brodie, they decided to it was

 

I said it looks nice outside. Apparently it was still very hot. But I told them maybe you guys should go, you know, to the driving range and hit some balls. I've been waiting months to be able to go golfing, right? So I'm like, why don't you guys go hit some balls? I'll run to the store. I had to get everything, groceries and stuff. I said I'll do the pickup and I gotta run to Target for a couple of things. So I go to Target with the littles, right? So I've got a 13-year-old boy, 10-year-old girl, and I'm like Roman Target, you know, and I'm just taking my time. And I said, gosh, you know, sometimes Target just

 

Target needs to tell you what you need. You don't always know what you need going into Target,

 

DAT- Kristy (08:43)

Yeah.

 

Tiffanie (08:43)

right? And I'm like, doo-doo doo. And then later that evening, one of the boys, one of the one of the older boys, said something about, I can't remember, something about the my Target experience, right? I think Brodie, Brodie's like unpacking Target, right? And he pulls out this like loaf pan and he's like, What what what is you went to Target for this? And I was like, well.

 

I didn't, but I know that I needed another loaf pan and it happened to be $2 off. So it made it into the cart. And something Brodie goes, I said, I I told the littles when we were there it was very dangerous that Daddy let me go to Target without a keeper because when Brodie was little, and honestly to this day he's 18, but ever since he was about four, he would be in the cart and we're at wherever Target

 

DAT- Kristy (09:36)

Mm.

 

Tiffanie (09:37)

or whatever store it is.

 

And I'm just going, I'm like, ooh, ooh. And he'd be like, mom, mom, is it a want or is it a need?

 

And that's so true though of everything, right? Target, I will drop two, three hundred dollars because my house needs these things, right? Well, the holidays. I might need this. I want everybody, everything to be the same. And Aaron's like, who's coming for the holidays? Like the kids, right? Like I'm like, I don't know, but what if? Like, what if I and I want it to be aesthetically pleasing, but then when I go into, you know, a practice, I know these patients are the same.

 

We're gonna go drop two, three hundred dollars on something that makes us feel good in our home. We want it to feel great, but how is it making us feel to have that treatment done? So if we are looking for aesthetically pleasing something, and I come in and I ask for whitening, I ask for you to tell me how to make my teeth look better. And you say, Well, guess what? You've got this gaping issue back here. We can't even touch this. I'm like,

 

Yeah, well, that's been there for a long time. Like I the holidays are coming and I really want wider teeth. And I'm negated and I'm not paid attention to. And so there's a bunch of different sides, right? But to your point, Kristy, just like Target, I'm gonna be like 24 bucks. That's that's a loaf pan. I need it for the holidays, right? I want it right now, and I'm probably not gonna use it at the holidays. Who knows? I have no clue, but I have it in case I do.

 

And treatment wise, if we're not feeling tied to the emotional aspect of it, we're gonna think about it. Like, mm, I put something back at target. Cause I was like, honestly, like that's not actually the color I want. I'm not tied emotionally to that color. So like you can keep that target. I'll get this one instead. Not that I didn't buy something, I I replaced it with something, but the emotional aspect to it, I was able to get rid of something because I wasn't emotionally tied to it. I said, that's okay.

 

But the things that I felt emotionally tied to, I kept in the cart and I paid.

 

DAT- Kristy (11:46)

Yeah.

 

Yeah. Agree with you, Tiff, so much. Again, I think we can mesh the two together, but I I'll I always share a little story. I had a friend that was looking for an SUV and

 

Tiffanie (12:00)

Mm-hmm.

 

DAT- Kristy (12:01)

she went to the car lot and they were like, my gosh, you're gonna love this car. It has three rows of seats and you can put your kids' friends in here and blah blah blah. And you know, they were really telling all the great features of this SUV, but unfortunately she didn't have kids.

 

Tiffanie (12:17)

no.

 

DAT- Kristy (12:16)

So while

 

it was all true, it wasn't speaking to her why. So she didn't end up buying the SUV. She went down the road and bought a different SUV from somebody else

 

Tiffanie (12:25)

Yeah.

 

DAT- Kristy (12:26)

because they figured out her why was to put her surfboard in, not to put kids in. So again,

 

Tiffanie (12:30)

They asked her the questions.

 

DAT- Kristy (12:32)

you can you can mesh the two together, but really taking that step back to figure out what are our patients, what do they want? And

 

Tiffanie (12:40)

Yeah.

 

DAT- Kristy (12:40)

speak to that thing that we're telling them they need, but speak to it in a way

 

that

 

goes ties to their want. Yeah. Yeah.

 

Tiffanie (12:49)

Yeah, that's a beautiful story because that is

 

a lack of empathy and a lack of wanting that that that's the connection. So when you have the patients come in that and and Kristy, you're coaching, you ask the questions, you get to know the people so that you're coaching to the people. That's we say we customize our consulting and we do. Dental A Team.

 

customizes our consulting to your practice. That is an aspect of the customization. It does not mean that we're revamping everything and we'll trial and error everything. Like we have systems that are tried and true that we know work. We've got the systems. We're going to make sure that every practice is working off of these systems and that we if you're already using a version of it, like we manipulate it to make sure that it fits for you. But our customization is I'm going to speak to you in a way that speaks to you. Like I'm not going to

 

The way I talk to Kristy, even is probably not the way I the same way I talk to Dana, even just in the fact that Kristy's your kids are older. So the conversations

 

DAT- Kristy (13:53)

Yeah.

 

Tiffanie (13:54)

I'm gonna have with you about our kids, I'm not gonna talk to you like I can, and I know that you would love nothing

 

DAT- Kristy (14:00)

Yeah.

 

Tiffanie (14:00)

more than to hear about the littles, right? But it's like I relate to you on my big because you have bigs. Dana, I can relate to the littles that she's got because

 

DAT- Kristy (14:11)

Yeah.

 

Tiffanie (14:11)

there's littles in my life. So

 

Getting to know the human on the other side is is the key. And coming up with a few questions that can be repeatable. That's not, what did you do last weekend? Or it's Wednesday. So it's either, what did you do last weekend? What are you doing this weekend? Do you have to go back to work? It's like, hey, tell me about work. What do you what do you do? I see like your insurance on here, but like, what do you do for Wells Fargo?

 

DAT- Kristy (14:39)

Yeah.

 

Tiffanie (14:40)

Ask a real question. So like.

 

What are some questions that gets them actually talking? I hate the yes or no. And and fine, like, what did you do last weekend? Like, my gosh, tell me more about that. And I am truly interested in that, but we all ask that question. So maybe our treatment coordinators, our doctors, our dental assistants, hygienists, like come up with one question that you can ask. And maybe you've got three that rotate that like sidelines someone, you know, that.

 

is out of the ordinary that makes someone be like, Wow, you actually want to know about me. That's cool. Like it's

 

DAT- Kristy (15:17)

Yeah.

 

Tiffanie (15:18)

awesome that we remember their kids and the sports and those. And people do feel seen. They feel great because they're coming in for their recalls for it with that. But I think it's that really truly caring and that intentionality that helps a patient say, Yeah, I do, I do want to get this done. Cause to your point, Kristy, it's like

 

a mom, like do you want you do you want your kids to have healthy teeth? Like let's show them what healthy teeth look like. Like I would hate for you to be on vacation with your kids or at a sporting event and you eat a a nut or a popcorn kernel and this tooth breaks on you in front of the kids. You got this emergency, like I don't know what it needs to look like, but something to that effect where we're really getting to know the human on the other side.

 

DAT- Kristy (16:02)

Yeah, I agree 100%, Tiff. dentistry is a relationship-based field, period. It just really is. And and even to your point, even with coaching, like we can come in and say, NDTR, you need to do NDTR. But I think we are no different than our patients. And we need to understand the why behind it. And and again, if we're looking to do something that maybe is a little bit foreign to us or a little bit uncomfortable.

 

knowing the why behind it and and speaking to what we want. I mean, we talked about that earlier. What's working, what's not working, what do we want more of? If we can speak to what we really want or what that patient wants and they feel heard, wow, it just is we're stepping in a forward direction that, you know, people want to feel validated and heard, seen. Yeah.

 

Tiffanie (16:57)

Yeah. Yeah, I totally agree.

 

Yeah. Yeah. And those simple intentional questions make all

 

DAT- Kristy (17:05)

Yes.

 

Tiffanie (17:05)

the difference. And it doesn't add time. I know we get busy like dentist dentistry is hard because we are a relationship-based field. Hands down.

 

DAT- Kristy (17:15)

Mm-hmm.

 

Tiffanie (17:15)

You said it perfectly. We are a relationship-based field and we're really breaking busy.

 

So we're trying to build relationships with sometimes 30 to 50 patients a day and individualize that care and that attention. And it's hard. So something that helps that and helps patients say, yes, let's do this, rather than, no, I need to think about it, is making sure that we are also communicating with one another, like celebrate.

 

the knowledge that you have about this patient. So if Kristy's my treatment coordinator and I'm a hygienist or dental assistant and I found out something really cool about this patient, I'm transferring that information to Kristy. I'm like, my gosh, did you know she's a Pilates instructor down the street? Like we've been asking for Pilates or did you know she owns the coffee shop that we go to all the time? Kristy's like,

 

DAT- Kristy (18:08)

Yeah.

 

Tiffanie (18:09)

what? Tell me more. How did you even get into that? Because we're genuinely interested. So I don't it we I

 

We said this on the last podcast we just recorded. You said this, Kristy. You said sometimes we make it more difficult than it needs to be. And this is that space. You can be busy and intentional. Being intentional

 

DAT- Kristy (18:26)

Mm-hmm.

 

Tiffanie (18:27)

doesn't add to your busy. You need to be intentional about getting to know the person and intentional about helping the next person save time in their job too and transfer that relationship.

 

DAT- Kristy (18:43)

Yeah.

 

What is this saying? We you made me think of it be interested, not interesting, right? Right. So

 

Tiffanie (18:49)

Yeah, yes, yes.

 

DAT- Kristy (18:52)

again our ease, but to your point too, Tiff, a lot of times I know we were talking about patients saying they need to think about it. Usually it comes back to two things. In in my opinion, it comes back to one of two things, perceived value, or we didn't find a financial solution.

 

And so both of those take getting into communication with the patient and figuring out like what is their lifestyle, what is their budget, what are they wanting? And if if a patient walks out and says that, I just challenge you to take a step back and could you answer some of those questions? And if not, let's go back to the root of why are they here? What were their motivators for walking in the door? I mean

 

I joke about this too. Everybody says they hate. Well, not everybody. I think I'm the opposite, but most patients say

 

Tiffanie (19:44)

There's a few of you outliers out there.

 

DAT- Kristy (19:46)

they hate going to the dentist, right?

 

Tiffanie (19:48)

Yeah.

 

DAT- Kristy (19:49)

And if that's true, no one's forcing them to walk in the door. So why are they there? They're there for something. And and they're

 

Tiffanie (19:53)

Yeah. Yeah. Yeah.

 

DAT- Kristy (19:57)

choosing you. So, number one, be grateful they're choosing you and acknowledge that, but also like figure out.

 

Why are they looking at this SUV? Why are they coming to our dental practice? Right? What

 

Tiffanie (20:08)

Mm.

 

DAT- Kristy (20:10)

is their why? What is their want? And find a way to tie it back to that.

 

Tiffanie (20:16)

Yeah, you made me think of the car ride this morning with the littles and sis is in like the best mood ever today. It's Monday when we're recording this, you guys. She's in the best mood and she's like and I'm gonna do this and my friends, but then they're both sitting back there saying that they hate school, right? Like they hate school. And I'm like

 

I think I said that when I was a kid too. And looking back, like school was such a massive part of my life. That's where all my friendships were formed. That's where we had fun, we played, we learned. Like looking back, I'm like, I didn't hate school, but I think we're supposed to hate school. I think

 

DAT- Kristy (20:54)

Mm-hmm.

 

Tiffanie (20:54)

we're supposed to be like, I don't want to do this.

 

But I don't think we actually hate it. Like that's such a strong word. And dentistry, you're supposed to hate dentistry. Nobody likes going to the dentist. We say it all the time. We make it true, right? We do, they do, everyone says. And it is an incredibly invasive space. It's a very intimate situation. You sit your patient in a chair that

 

you they can't get out of because there's

 

DAT- Kristy (21:22)

Mm.

 

Tiffanie (21:22)

so many things in the way. I can barely clean around it, right? And then we lay them back and make them open their mouths and we're hovering over them. They literally are stuck. It's so intimate. And then we're standing there telling them everything that's wrong. No, they they don't like going to the dentist. But if we can make it different, if we can look back at our schooling and see the relationship and the fun and the you know the

 

playground and the recess and the PE, like all the things that actually made school fun, if we can look back and see that, can't we help them in some way with our relationship see the dentist in a different way too? Because

 

DAT- Kristy (22:02)

Mm-hmm.

 

Tiffanie (22:03)

school was about the relationships, even the teachers, like the teachers I loved was because I was in relationship with them, not because of what they taught me. Right. So if we can make sure

 

that we think of it in that way, like how can we, how can I make you love being here today because you feel seen, you feel valued, you feel heard. And I am, like you said, more interested in you than being interesting. That changes the game. And that could

 

DAT- Kristy (22:28)

Yeah.

 

Tiffanie (22:29)

spin how people think about the dentist.

 

DAT- Kristy (22:32)

I love that Tiff so much because again, we all know the things we have to do or should do.

 

Tiffanie (22:38)

Yeah.

 

DAT- Kristy (22:39)

Then how again, how can we sprinkle in something that's just a little bit different and you know gets patients thinking, actually, here's a good one. I heard somebody the other day talk about why do we even call our patients patients? And I was like, I love that. We should be calling them our guests or our clients

 

Tiffanie (22:59)

Yeah.

 

DAT- Kristy (22:59)

or our this, right? Patients.

 

Patience in the word patience means they're sick. And so just by changing

 

Tiffanie (23:05)

Exactly.

 

DAT- Kristy (23:06)

and reframing that, it gives you a different outlook and different, you know, you you just show up differently. So I

 

Tiffanie (23:13)

Yeah.

 

DAT- Kristy (23:14)

I think little tweaks like that, but but really being in relationship and figuring out their why is huge.

 

Tiffanie (23:21)

I agree. I love that you said that because Kiera actually, she spoke at an event this past weekend and the keynote speaker on Friday was talking about all of this stuff, very similar to what we're talking about today. And that's something he said. He said, I don't call my patient, and this is just like a tidbit, you guys take it, whatever. We're this is not a Dental

 

DAT- Kristy (23:40)

Yeah.

 

Tiffanie (23:40)

A Team, we're changing everything, but this is us talking today. He said, I don't call my patients patients, because when you think of patient, you think of an ill.

 

Or an elderly, someone who's going to the doctor because there's something wrong. He calls them his clients because they are a client of his dental practice. And sometimes he finds something that they need to invest in. So if you go to the financial advisor, to your bank, to you anywhere, you're investing in something. You're a client of that person's. You're not a patient of theirs.

 

DAT- Kristy (24:12)

Yeah.

 

Tiffanie (24:13)

So I I

 

I found that very interesting in in mimicking what you just said, Kristy. I do think it changed everything is mindset. Everything is mindset. And if you can help the other person's mindset be different, then no, then I need to think about that. That's then you've done your job because now you've allowed the patient to see the path to health. Otherwise, they're stuck and not able to get out of their own way.

 

DAT- Kristy (24:39)

Yeah,

 

I love that tip. It's funny because we didn't we didn't know I didn't know you heard that, but it tied right in. And and I

 

Tiffanie (24:47)

Yeah.

 

DAT- Kristy (24:47)

truly think even just saying it, like when we say it, we present different when we say the words. So

 

Tiffanie (24:53)

Mm-hmm. Mm-hmm.

 

DAT- Kristy (24:55)

yeah. this is a good one. This is fun. Yeah. Yeah.

 

Tiffanie (24:58)

I agree. I agree. Thanks, Kristy.

 

I would say action item would be to think about how you are intentional with your patients. And is there a handful of questions that you can keep on the tip of your tongue that really allow you to open up space of communication with your patients? Think you chat GPT it, I don't care, but what can you ask your patients to really get that communication? And remember, communication flows, it doesn't stop.

 

You're either talking to someone or communicating with them. Kristy, thank you so much. This was so cool.

 

DAT- Kristy (25:34)

Yeah.

 

Tiffanie (25:35)

I love it. do you have anything last minute, any action items you feel they need to go run away and paint the town red with?

 

DAT- Kristy (25:45)

No, just I challenge everybody to figure out on a day-to-day basis what is why are they choosing here and what are they looking for today? If you can answer those questions, you probably already have started a good relationship with them. So that's it.

 

Tiffanie (26:00)

Mm.

 

I love it. Okay. Go do

 

the things, you guys. Go take a look. Go dig in deep and know that you're doing wonderful things. You're out there helping people become their healthiest, most beautiful selves in whatever way that can possibly be. And it is your job to make sure that you pave that path for them to get healthier. So do everything you can. drop us a five-star review below. Please leave a comment if you have any tips, tricks, anything that you're doing that you know is working, or any feedback you have for us, we do love to see those come up. Make sure you share this with a friend.

 

Anyone outside of dentistry too, I know we work with a lot of businesses. I know there's a lot of other healthcare at least companies and practices that listen to us. So let us know how those work as well. And as always, Hello@TheDentalATeam.com. We are here to help serve you in the best ways possible. Thanks, and we'll catch you next time.

Kiera is joined by Brannon Moncrief, principal and CEO of McLerran and Associates and expert on dental practice sales and DSO affiliates. The two talk about running your practice with a mindset to sell (maybe not today or tomorrow, but eventually). That means thinking about your business as it is and preparing it for a private buyer or DSO or associate transition; "keeping your foot on the gas" when it comes to finances; knowing what those sale numbers can look like depending on how successful your practice is; and more.

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Transcript:

Kiera (00:00)

Hello, Dental A Team listeners. This is Kiera. And today I have one of my favorite people in the industry on the podcast today. He and I have podcasted multiple times. I just think he's a wealth of knowledge. And today I'm really excited because I think that the landscape of what to do with our practices, whether I have a private buy, whether I have an associate legacy transition, whether I go to a DSO, like what do I do? And how do I make my practice like a viable asset as opposed to just a job for me for the rest of time?

 

I feel like Brannon Moncrief is one of the best of the best in the industry to answer these questions. He and I chat shop often and he is a wealth of knowledge for me. So Brannon, welcome to the podcast today. How are you?

 

Brannon Moncrief (00:38)

Thanks for having me. Appreciate the kind words.

 

Kiera (00:41)

Of course. you and I were just chatting. I think you and I have talked like, what, this is our third time in less than a week. So it's kind of fun to have this in a a real podcast setting. but Brannon, for those who don't know you and don't know about your business and what you do, just give the listeners a little bit of background of who Brannon Moncroep is, and then we're gonna dive into how people can valuate their practices and kind of like what do I do in this choose your own adventure landscape that they're living in.

 

Brannon Moncrief (01:05)

Appreciate that. I am the principal and CEO of McLaren and Associates. And I've spent pretty much my entire professional career on the business side of dentistry, about 25 years now. I can't believe it's already been that long. I I wish. I wish. That's the filter on my camera.

 

Kiera (01:17)

It's okay. You're not a day over 25, Brannon. You just started this from a baby. it's a nice one.

 

Brannon Moncrief (01:27)

thank you. So I spent the first 10 or so years of my career as a dental lender, lending money to dentists all across the country to

 

Buy and start practices. And then I purchased McLaren 15 years ago. The legacy business that I acquired was a small mom and pop practice brokerage firm focused on traditional practice sales, doctor-to-doctor, practice transitions, specifically in Texas. Scaled that business significantly over the past five, six years, expanded it nationwide. So now we have offices all across the country handling doctor-to-doctor deals.

 

In general dentistry and across all different dental specialties. And then a lot of your audience has probably seen me on different podcasts, webinars talking about DSO affiliations. We got heavily involved in the DSO and private equity space about seven years ago, really out of necessity. We were watching a lot of doctors that we thought would engage us to sell their business to another clinician choose to go down the DSO path for one reason or the other.

 

And we knew that private equity was likely here to stay and gonna consolidate our industry rapidly. So we evolved. We built out a team, built out a process to provide cell set advisory to large practice owners who, for one reason or the other, are gonna choose to affiliate with a DSO or private equity as opposed to sell in a traditional sense to another doctor. So we've done about 250 DSO affiliations across the country, general dentistry and all dental specialties.

 

And

 

then we've been involved in about 1500 private practice sales. So have really seen everything that can go right and wrong in monetizing your business. But I look at my job first and foremost to educate doctors regarding what is your business worth, private buyer versus DSO? What are the pros and cons? What are the nuances of each of those options? Get you educated, and then you get to choose your own adventure from there. And we help you execute. We help you take the practice to market and monetize it.

 

at the highest possible outcome and also ensure that we find the right fit for your practice, the right buyer to protect your legacy.

 

Kiera (03:33)

No, Brannon, I think that you guys do so much in the industry and you've helped the industry. And I've learned a lot working with you, working with several of our clients. And I feel like this is just something as a business owner, whether you are thinking of selling today or selling in the future. I remember when I first started Dental A Team, people were like, Kiera, you're gonna sell it. And I was like, always. Like I'm always building this to be sold. That doesn't mean that I want to sell it today or tomorrow or the next day.

 

But I would be an absolute rookie if I didn't think about selling this at some point in time. I think you build businesses better when you have that exit in mind. Again, that doesn't mean like I have no intentions of rapidly firing this off. I've been here for quite some time. I feel like I'm getting cozy in this chair, just like I'm sure Brannon and you are in your business. but it's constantly building it, innovating it, creating systems, creating EBITDA, creating those profit margins that are necessary. So when the day comes, because I don't believe that any of us are probably going to really know.

 

The day we want to sell. I've seen plenty of doctors who have had divorce hit, they've had death hit, they've had accidents. I had a dentist get hit by a bike. Like he was on his bike and he got hit by a car, so he didn't get hit by a bike. He was on a bike getting hit. And I'm like, I promise you that day leaving the office, it wasn't like, I'm on a bucket list to get hit by a car today. Like that just surely was not there. But he had built his practice to where if he wanted to sell, he could, or we had the systems and processes in place to give him the options. And I think that just preparing for this gives optionality long term.

 

So you're doing it on your terms as opposed to being forced to make a rash decision unexpectedly. So going into that with that mindset, and I hope people, and I know Brannon, you agree with that. Otherwise, we wouldn't be podcasting. You and I have very aligned interests in the industry. But I am really curious, like helping people to kind of have that mindset. Like, what are some of the things that DSOs versus private buyers versus like just transitioning to an associate? What are some of the things? Because I know that there's different flavors and factors. Like, I don't like mint chips.

 

But I definitely like a grasshopper shake. Like I like both, but don't give me the little chips in it. It's disgusting. Like I prefer the like Oreo mashed up with the mint flavoring. So like I'm gonna prefer different things. And I guarantee you that while both might like the same flavor with air quotes around it, there's nuances that both of those buyers are going to want differently. So how do people, when they're looking at this, thinking about that future sell? again, not tomorrow, but when they're when the time comes, whether planned or unplanned, what should they be preparing for for both of those different types of buyers?

 

Brannon Moncrief (05:57)

Love

 

what you said about like being prepared to sell at any moment in time. Because if you take the steps to prepare your practice to be marketable, valuable, and sellable, those are the same steps you need to take to make your business hum, you know, on a daily basis, right?

 

Kiera (06:12)

Exactly.

 

Brannon Moncrief (06:13)

but you never know what life's gonna throw at you. So you always want to be prepared, whether you're looking two years down the road or 20 years down the road. we'll kind of bifurcate our conversation today in a flip-flopping back and forth between private buyer versus DSO because they're really.

 

know two different worlds. So when

 

Kiera (06:27)

Mm-hmm.

 

Brannon Moncrief (06:28)

we talk about the private buyer world, you want to do check as many boxes as possible as far as what private buyers are looking for when they call somebody like McLaren and say, hey, I'm looking to buy a practice. And we ask, okay, great, tell me about what you're looking for. Because the answer is pretty consistent. Typically private buyers are looking for a practice within 60 miles of a major metro area. So urban, suburban markets.

 

Those practices are going to see higher valuations and more demand than practices in tertiary or rural markets. Doesn't mean that if you're in a tertiary market, you can't sell your practice. It just means that all things equal, it might take a little bit longer and it might trade for a lower valuation. they're looking for five plus operatories. Most young dentists these days are relatively entrepreneurial.

 

And eventually want to grow into a multi-doctor practice for one reason or the other. A lot of that is lifestyle driven. Some of that may be value driven, the fact that they eventually want to sell the practice for a premium to a DSO or private equity. They're looking for PPO and fee for service practices. So if you have an HMO component or a Medicaid component, that's definitely going to impact demand and valuation. They're looking at technology, equipment, facility, curb appeal.

 

All of that matters when you go to monetize your business, but you also want to be evaluating what is your runway to selling the business and are you going to get the ROI on that investment at sale, right? If you're six months away from selling, probably doesn't make a lot of sense to pour a lot of money into technology and equipment and updating your practice. But if you're five years away, seven years away, 10 years away, you're going to get the benefit, the ROI of that investment along the way. And it's going to make your practice more valuable and more sellable when you go to sell.

 

you want to make sure that your financials are updated and clean. You want to make sure that you're working with, you know, a dental CPA. we see a lot of messy financials, and that becomes a serious problem when advisors step in on the buy side and are trying to figure out, you know, what is the true overhead of this practice? What does the cash flow actually look like after removing all those personal and discretionary expenses you're writing off to the business? And a lot of the private buyer deals are going to be contingent on financing. So lenders are looking, you know, through that.

 

That same, you know, lens as well. I would say keeping your foot on the gas, you know, that's one of the biggest issues that we see where we start looking at financials for a client that's ready to go to market. And I'm like, damn, I wish you

 

would have called me three years ago. And there's always an

 

Kiera (08:56)

Yes.

 

Brannon Moncrief (08:58)

explanation. No, I'm spending more time with the grandkids, I'm playing more golf, you know, I'm traveling more, the patients are still there. The reality is buyers care about the most recent couple of years of performance.

 

So you want to keep your foot on the gas leading up to a sale. You want to sell at a peak, not a valley. Otherwise, you just need to be conscious of the fact that you might be transitioning your practice without being aware of it. What we call sunsetting an office. And that's a strategy, but

 

Kiera (09:25)

Mm-hmm.

 

Brannon Moncrief (09:25)

we want it to be a conscious strategy, not an unconscious strategy where you sunset the practice from a cash flow perspective and then you call me and you want to sell it for what it would have been worth three years ago. Right. So keeping your foot on the gas.

 

is a big one. And the earlier you start planning, the more optionality you're gonna have. So

 

Kiera (09:45)

Mm-hmm.

 

Brannon Moncrief (09:45)

if you wait until the day you're ready to sell, you got one option, right? It's a it's a short-term transition. Sell tomorrow, you're likely out the door within four to six weeks, unless you have a large multi-doctor practice. So the earlier you start planning, you can think about, you know, does a DSO make sense? Is it does it make sense to do some type of internal succession planning? You know, bring associates on as minority partners and then step out.

 

you know, over a period of time or do some type of associate to purchase. So start planning, I would say at least three to five years in advance. That's that's really key. Start having these conversations, learn what drives value, get a feel for what type of transition strategy you ultimately want to deploy and what you can do in the meantime, you know, what levers you can pull to increase profitability, increased demand and marketability leading up to a sale. And that's where you know somebody like you comes into play, right? You can help pull those levers

 

And help the doctor increase the value of the practice leading up to the sale. So that's really what matters in the private buyer world. Now, the DSO world is going to mirror a lot of that. what I would layer in there is DSOs care a lot about EBITDA profitability and making sure that, you know, your practice is generating at least, let's say, two million dollars in top line revenue, four hundred thousand dollars or more in EBITDA.

 

That's really the size practices that they're looking for. And I would say if you fall below that metric, you might have some DSOs interested. But in my opinion, makes no sense to consider a DSO affiliation if you're doing less than $2 million in top-wind revenue. It's just not, in my opinion, economically motivating comparative to hanging on to the practice for a little while and then eventually selling it to a private buyer. But key-man risk is a big deal. Engineering the practice in a way that it's not.

 

solely dependent upon you both from an operational perspective and

 

Kiera (11:37)

Yeah.

 

Brannon Moncrief (11:38)

from a productivity perspective. So, you know, becoming a multi-doctor practice that is not solely contingent upon you clinically. And then, you know, building out your team to where it's not so dependent on you operationally on the day-to-day as well. So I think in the DSO world, it's really about profitability, it's about that key man risk. And then it's about having enough runway

 

To

 

exit to fulfill the post-closing requirement that the DSO is going to require. So the industry has moved towards a norm of five years. That doesn't mean you working five years full-time, chair side. It just means they want you to have a vested interest in the business for five years post-sale. So if you wait until the day you're ready to exit, DSO is off the table. So

 

Kiera (12:23)

Yeah.

 

Brannon Moncrief (12:26)

those are the three things I think that make DSO a little bit different than private buyer. But ultimately,

 

All of those things, I think, are smart business, even if you're five, 10, 15, 20 years away from a sale.

 

Kiera (12:41)

Yeah. And Brannon, I love that you talk about this because you're exactly right. Like these things are what you actually want your business to be as a business owner. You want it to be profitable. You want it to not be dependent upon yourself. You want to have less key people like reporting up to you. You want to have it where there's a team in place. Like those are the things that actually make dentists happier in the long run, too. And makes them not want to sell just in like a bad day flash sell. We all have bad days, every single one of us listening.

 

I promise you, Brannon, if someone walked by on the wrong day and was I'll give you a buck for your business, you're like, Yeah, take it today. Like I've surely had those days. but it's like just I think also having that peace of mind of knowing what it is. You said a few things, and I don't want to get like I understand you and I both kind of play Switzerland in the industry, but I also know we do know some key players. You talked about CPAs that you really love because I agree, having clean financials as a business owner and also as somebody who's looking to sell.

 

Who are some of your favorite dental CPA specifics? Like and again, I'm not here to say like these are the only ones. I know you and I both have some of our faves. Are there any that you're finding that are really good to prep for sales and to help people just see their financials better from your opinion?

 

Brannon Moncrief (13:49)

Typically, if you're, you know, a smaller practice, you know, let's say one to two locations under three million dollars in top line revenue, you know, AD CPA is a great place to start, right? that's the Academy of dental CPAs. So I think that's a great place to start. That is a group of DSA individual CPA firms that specialize in working with dentists, and each of them has a geographical focus, right? So you can find that member that

 

works in your area. we also do, you know, a decent amount of work with Profy.

 

Kiera (14:24)

Mm-hmm.

 

Brannon Moncrief (14:25)

Profile works with a lot of large, you know, multi-location practices. So if you are a little bit more sophisticated, a little bit larger, that would be a good place to start. And then I'm sure, you know, you have a handful as well here that you would recommend.

 

Kiera (14:41)

Yeah, absolutely. Yeah, I found agreed profile. We do a lot of work with a lot of their clients, agreed on that smaller and like please take that we're not talking smaller, like I know this business is large for you. I think when Brannon and I are speaking, dollars are what's going to get evaluated on. So if you're in that one to three, that's what you're being evaluated. It doesn't mean that it's a small business and you're not going to get a great multiple. It just means like certain CPAs have different tax strategies based on the size of revenue that's coming through your business. So

 

Really getting somebody, I remember I I remembered calling my this is funny, Brannon. I called my processor, my lending processor, and I was like, I think I need a better deal. Like I'm such a big client. I'm transacting 10 grand a month, and you should definitely give me a better deal. And I giggled today because I can only imagine the person on the other side of my gear like that's such a small transaction amount compared to half of our other people on there.

 

But for me, that was a large amount and that didn't change my lifestyle of believing that $10,000 a month of transaction was so much that I felt like I deserved it. But when I go into these ranks of talking to buyers and talking to people, I think knowing yourself and being comfortable with the business that you've got and the ROI you're going to get from it, it doesn't matter. It matters on what your life and your end goals are. It doesn't matter on the dollar amount. Now, if you're looking for a different lifestyle, like if I wanted a $10 million sell and I'm transactioning $10,000.

 

Well, we can see that clearly the math's not going to math. So I just want you guys to realize like picking these CPAs, I do think it is pivotal and paramount to choose a CPA that knows your size of business and then recognize you will probably outgrow that CPA. A CPA who's transacting one to three million is not going to be your best CPA when you're transacting five to ten million. There's different strategies involved. And I have seen it multiple times where my clients who have been with somebody for so long, because that's who they needed when they started.

 

You've got to make sure that CPA is growing with you at the same size and they're able like, and you don't wanna be the big fish in their pond. You wanna be the small fish in their pond, knowing that they've done a lot more. But again, not being so small that the the people can't help you because sometimes those larger firms, they are gonna charge a lot more when you're at one to three million. It does not financially make sense for your profitability to be paying that much because you don't need that much. So I do like I'd Bailey. I found I'd Bailey, especially for some of those large DSOs.

 

Scott Haberman is somebody I really love and recommend a lot. I think he does a lot of DSO transactions, a lot of multi-locations, a lot of that higher level. If you're that one to three to even four, I would definitely not recommend calling him. Fees are too high for that size of business that you're at. So that was helpful, Brannon. On that, I also was curious when you were talking about this. I think you did a really good job of of listing it of the things that are going to make it more valuable. I'm also curious, like, what are you seeing of multiples when they do sell? So, like if I'm selling to a legacy, like what's my benefit?

 

versus my con, like pro and con me of selling to a a private buyer versus a DSO buyer. Like what does my life look like on both of those scenarios?

 

Brannon Moncrief (17:36)

Okay. This is a this is an in-depth conversation, but I love the question. So let's let's let's

 

Kiera (17:40)

I know, me too.

 

Brannon Moncrief (17:43)

juxtapose, like you said, private buyer versus DSO. Let's start with valuation first, and then we can start with with some of the more qualitative factors involved. So from a valuation perspective, most of the time when you're looking at valuation through the lens of a private buyer, we're talking about the age-old benchmark.

 

of

 

a percentage of revenue or a multiple of net cash flow before doctor compensation and debt service. We'll also talk about an EBITDA multiple, although most private buyers don't look at valuation through the lens of an EBITDA multiple. So you're

 

Kiera (18:20)

Why is that,

 

Brannon? This like is a piece I genuinely don't understand.

 

Brannon Moncrief (18:26)

Primary reason is that most private buyers are going to buy your practice and it's going to be their baby. They're going to step into your shoes. They're going to take over all the production. And therefore, the profit that they're going to realize from the business is a product not only of the EBITDA, but also the clinical chair side wage. So they do

 

Kiera (18:45)

I see.

 

Brannon Moncrief (18:46)

look at it differently comparative to multi-location practice owners or, you know, DSOs. Not to say that that's correct.

 

But the reality is that, and again, I'm sorry for using this terminology, but a smaller practice, right? Look, it's all relative, right? A million

 

Kiera (19:02)

I think it's fine. Mm-hmm.

 

Brannon Moncrief (19:05)

dollar one-doctor practice is a very, very successful one doctor practice. But most practices doing less than, let's call it 1.5 million in top line revenue are not generating any amount of meaningful EBITDA. It's just impossible given the overhead structure, you know, of a dental business. But there's still

 

profitable businesses that have value for the owner operator. And that is what most private buyers are looking at. They're looking at it through the lens of the owner operator, the chairside clinician that's going to not only take home that EBITDA, but also that chairside wage. So they're

 

Kiera (19:39)

Got it.

 

Brannon Moncrief (19:40)

typically going to pay somewhere in the range of 70 to 90% of annual revenue. And that is the most current year's annual revenue. Now you'll see outliers, right?

 

If you're located in a tertiary market, if you have an antiquated office, a smaller office, you know, let's say sub $700,000 in revenue, you might trade on the lower end or below that 70% of revenue range. If you're in a really sexy market, you know, like in Austin, Texas, a Phoenix, Arizona, a Charlotte, North Carolina, where there's a tremendous amount of demand, you might trade for 100% of revenue, especially if you have.

 

you know, a fully updated high-tech office with six operatories and your, you know, fee for service and you're, you know, netting, you know, 50% profitability, right? That so you have outliers on both ends

 

Kiera (20:32)

Mm-hmm.

 

Brannon Moncrief (20:32)

of the spectrum there. practices often trade for anywhere from, let's call it two times to two and a half times net cash flow before doctor compensation and debt service. So if the average general dentistry practice nets 38%,

 

Before doctor compensation debt service, multiply that by two. That practice is trading for 76% of revenue.

 

Kiera (20:57)

Mm-hmm.

 

Brannon Moncrief (20:58)

And then from an EBITDA perspective, although we just talked about the fact that most private buyers don't look at valuation through the lens of a multiple of EBITDA, most private deals are trading for some that have EBITDA, right? That have meaningful EBITDA. They're trading for somewhere in the range of four to four and a half times EBITDA.

 

But that would be a larger private buyer deal. A practice with EBITDA of three or four hundred thousand may trade, you know, for anywhere between 1.2 to 1.5 million. And that practice likely has top line revenue of anywhere from 1.2 to 1.8 million.

 

Kiera (21:36)

Mm hmm.

 

Brannon Moncrief (21:37)

When we look at valuation through the lens of a DSO, and when DSOs are looking at practices, they don't really care about revenue. It's all about profitability. It's all about EBITDA. And I know most of your viewers understand what EBITDA is, but think of EBITDA as absentee owner profit, the profit that's available for the investor. EBITDA stands for Earnings Before Interest, Taxes, Depreciation, Amortization. What it really means is after all the true overhead of the business is paid.

 

After the doctors are paid a market wage to work chair side, including the seller, what is the passive absentee owner profit left for the investor? And DSOs are paying anywhere from five on the very, very low end to let's call it nine times EBITDA. Nine times EBITDA would be a platform investment, probably five or more locations with EBITDA of 5 million or more.

 

Five times EBITDA would be a much smaller practice. Let's call it $1.5 million in top line revenue with $250,000 in EBITDA. Where, in my opinion, a practice that size that's trading for five times EBITDA, why sell to a DSO? Just hang on to it and eventually sell it to a private buyer. You're gonna get around the same valuation from a private buyer that you would from a DSO in that particular situation. Most practices are selling for

 

Somewhere around seven times EBITDA practices that we take to market. And most of the time we're talking about a one to three location practice with revenue in the three to ten million range, with EBITDA in the 700,000 to let's call it two million range. Most of those practices are going to trade for somewhere around seven times EBITDA, might be a half a turn lower, might be a half a turn higher, depending upon.

 

The geography and the other characteristics that we talked about, you know, previously. So when you're talking about, let's say a $2 million practice, let's just take an example, right? Private

 

Kiera (23:39)

Mm-hmm.

 

Brannon Moncrief (23:39)

buyer valuation versus DSO valuation. So $2 million top line Rev practice with $400,000 in EBITDA. In the private buyer world, you're gonna have to find a relatively confident, sophisticated private buyer with some experience and a pretty good personal financial statement that can knock down a practice of that caliber.

 

On a good day, that practice probably trades for somewhere in the 1.5 to 1.8 million range from a private buyer perspective. In the DSO world, let's say that practice trades for seven times EBITDA, it's trading for 2.8 million, right? Seven times 400,000. So pretty big gap. You know, you're talking about at least a million-dollar gap. And as the practice gets larger and as the EBITDA number gets larger,

 

It gets harder and harder to sell from a private buyer perspective, just because there's only so many private buyers that have the confidence, the skill set, the financial backing to buy a practice with top line revenue of five million. And in the DSO world, DSOs start to get really, really excited about the larger and larger the practice gets. So that gap between the private buyer valuation and DSO valuation, it increases exponentially as the practice grows in size from a revenue.

 

and EBITDA perspective. But in the example that we just outlined, while the gap is a million bucks, right? Let's just call it 1.8 million versus 2.8 million, there's a lot of nuance regarding

 

Kiera (25:04)

Mm-hmm.

 

Brannon Moncrief (25:05)

what happens with that gap, right? And the commitment on behalf of the seller post-closing, the private buyer deal, you're probably going to get 100% or very close to 100% cash at close. And you're likely going to be able to exit the business in relatively short order.

 

Let's say six months or less.

 

Kiera (25:23)

Right.

 

Brannon Moncrief (25:24)

In the DSO world, yes, you're getting a higher valuation, but it comes with structure. You might only get 60 or 65% cash at closing. So the cash at closing is actually going to look similar to the private buyer deal. And then there's likely gonna be an earnout component and some type of equity component where you have upside and the ability to get to that 2.8 million number or higher, you know, post sale.

 

It is going to come with that post-closing commitment of three to five years. So a lot more structure involved, a lot more nuance involved. You've got the post-closing commitment of the DSO deal. You've got the equity component that has a risk reward proposition. So it's not as cut and dry as saying, DSO's going to pay me 2.8 million versus private buyer is going pay me 1.8 million. That's a million dollar gap. DSO all day long. No, you got to look at the details. The details

 

Kiera (26:15)

Mm-hmm.

 

Brannon Moncrief (26:16)

match.

 

But I would say as you cross that four million, five million top line revenue mark, it's a lot more compelling to go the DSO route than it is to go the private buyer route. As you move down from that two million top line revenue mark, it's a lot more compelling to go the private buyer route versus the DSO route. That gap in between that two to five million dollars in top line revenue, you know, $400,000 to a million dollars in EBITDA, it's debatable. It it depends.

 

Kiera (26:46)

Mm-hmm.

 

Brannon Moncrief (26:46)

Right. On your specific situation, your goals, the characteristics of your practice, and really, yeah, what you're trying to accomplish. And that's where we spend a lot of time with clients, educating them regarding, hey, let's do evaluation through both lenses. And then let's unpack the gap, the economic value gap. And then let's unpack the nuances. And then most importantly, let's unpack your why. Right. Like what is your

 

Kiera (27:09)

Mm-hmm, mm-hmm.

 

Brannon Moncrief (27:11)

runway to exiting the business? Why are you looking to monetize it? And then we'll lay over.

 

you know, all of that qualitative and quantitative information to decide what is the right route for you to go down.

 

Kiera (27:22)

Yeah. And Brannon, I love that you talked about it because they're I think when people hear just dollars, right? Like 1.8 versus 2.8, like of course I'm going that. But like you said, I think the big pieces I've watched with people selling in both realms, like you said, your lifestyle of selling to a private buyer is usually a lot easier. You're done. Like I cash out, I'm out, like I'm done, and I can put that money into, and I'm getting almost a hundred percent of that close. Just like you said, both of them you're getting about the same of money at close.

 

And I think people need to realize like the DSO is still a gamble. Like there are pieces when you're investing and there's buybacks and different pieces. And it's based on you performing, you might not get all of that additional amount. You also might get it. And so just being comfortable and like, could you put these into investments? What are you planning to do with this money when you close? Looking at some of those things of what because like we were looking at a deal structure the other day. And I was like, well, dang, if they took the money now and invested it over the next 10 years, as opposed to working for 10 more years and probably not being able to get that.

 

Would they get the same type of returns if it was invested properly versus continuing to work? And so this is, I think, where for me, I get obsessed with this psychotic puzzle of like, you know, the pictures where it's like got lines everywhere and they're like overlapping and crossing and there's no like rhyme or reason. That's how I feel like it is when you're going to sell because there's so many different scenarios that you could play. Like, do I want to invest it now? And like, what's my run rate? And do I have spousal or partner support that we wouldn't even need to touch that if we were to sell now?

 

Am I the primary provider of this? So if I were to sell now, like this is it, game over. I need to live on this now. Is it that if I work for a few more years and get it up to five million? But like me working for three to four more years to get it to that five million mark and then needing to work for a DSO for three to five years, do I have eight to 10 years left in me that I want to continue working? Because that's the realism if I were to sell it that way. So I agree with you. I think it's really like, what's my why? What number do I actually need to make? That's why I feel like having a good.

 

CPA, having a good financial advisor, knowing like what your your target end day is, if you know that number of what you would ideally like to get, I think it's so much easier to work backwards and then also lifestyle of what you want to do. So, and as you said it, it finally made sense for me, Brannon, because I'm always like, why does one care about top line and one care about EBITDA? But putting it in simple terms, like please tell me if I got it right. I feel like I'm your student today. I took a bunch of notes. My learning today was the reason that a private buyer would be buying it at

 

A number and a multiple based on revenue, like top line production number, and that's adjusted production, everybody. So don't get excited. They're gonna be looking at that. They're not going at your 1.9 when you're only collecting one. They're for sure going off that collection amount. Like, don't get excited about that. But they're gonna do that is because they're coming in and they're the they're a a dentist. So they can remake that money. That's what they're able to do. Yes, they're taking home profitability versus a DSO as a legitimate investor. They're not coming in as a dentist, they're not working as a dentist, they don't care about that top number.

 

They care about what's my passive pro profitability in there because that makes it a good like no investor that I've found comes in and wants to take over and become an employee. They want just the passive money. They're gonna put people in place and they're just gonna run this and it's gonna be part of their bigger portfolio. They're looking for the amount of cash of passive profit to make them larger to private equity. Is that did I get that? Or is there anything that I missed in my understanding today?

 

Brannon Moncrief (30:37)

I I I think that is very well said. That that is the difference between the perspective of a private buyer and DSO. They're they're very different. I understand how sometimes people are like, why doesn't a private buyer care about EBITDA? Like you should. You should care about profit, but it's just a different perspective if you're gonna step into the shoes of the seller and the clinician and you're gonna take home that clinical, you know, chair side

 

Kiera (30:59)

Sure.

 

Brannon Moncrief (31:00)

wage. You know, one point I I wanna make in regards to this whole discussion, like private buyer versus DSO.

 

Is you hear a lot of talking heads out there that are really pro-DSO

 

Kiera (31:11)

Just

 

Brannon Moncrief (31:12)

that are like, it's a no-brainer, like 2.8 million versus 1.8 million. You go DSO all day long. They don't even want to talk about the difference and and the nuance involved. And then you have other people, whether it's CPAs, whether it is brokers that don't do DSO deals, that are like, no, DSOs are the devil. You know, you you should only sell to a private buyer, you should never sell to a DSO. And I I think

 

You have to look at those people's perspective and their business and why they may be saying certain things, right? Because

 

Kiera (31:45)

Mm-hmm, mm-hmm.

 

Brannon Moncrief (31:47)

ultimately there is often an ulterior motive. And that is to protect

 

Kiera (31:51)

You would agree.

 

Brannon Moncrief (31:52)

their own business and their own pocketbook. And that's really where I love, where we come at this conversation is we do private deals all day long across the country.

 

Kiera (32:00)

Mm-hmm.

 

Brannon Moncrief (32:01)

We do DSO deals all day long, all across the country.

 

We excel in both of those worlds. I don't know that there's another practice brokerage firm that does, right? Most of them are siloed into either doing private deals or DSO deals. They don't excel in both worlds. They're not highly educated in both worlds. So I love that we kind of sit in that objective seat. Hey, let's talk about all of it. And I don't really care

 

Kiera (32:23)

Mm-hmm, mm-hmm.

 

Brannon Moncrief (32:24)

what path you want to go down, but get an education and then make the decision that makes the most sense for you. And then we'll help you crush the outcome, whether it's today or

 

Five years from now, whether it's private buyer or DSO.

 

Kiera (32:36)

I and I feel the same. Like in the consulting world for us, I don't care what route you go. We tell everyone like what's your life and what you want this business to do. That's our ultimate goal and end goal of what we're going to be doing. Like if you want to go to a DSO, rock on. If you want to go towards private sell, rock on. My job as your consultant and as our consulting firm is to make you the most profitable, like the most sellable business that you can possibly do. And like we're a miracle grow for practices. So I love working with people like Brannon because it's like great, you're not ready to sell or it's not quite to the level we want. Here's like

 

three or four levers that we're going to instantly push to drive that amount up for you, knowing we're headed for a seller. We want to get it there. So Brannon, I kind of want to pivot gears and do almost like our part two of today's episode. and that part two is I want to talk about the dark side of both of these because like there's elephants in the room on both. And I feel like if we can talk about that dark side, I feel like it'd be a very beneficial because I've heard the DSOs go bankrupt. And so that additional 40% that I was working my last five to eight years.

 

I actually don't cash out on that. Or they go under and then I don't even have a business. I also know with private buyers, people get annoyed because they're sitting there, sitting next to their associate. They bring on a partner, the partnership is sinking ships. So can we just like do a part two? And I want to just go a little dark. Like I think we had the light. Let's now go dark on part two of this episode.

 

Can you walk me through private buyer versus DSO? Like what is the dark? What's in the shadows? What are like the horror stories? And I don't want to freak people out. I feel like it's just a good way to educate of like what things can go wrong instead of just looking for all the things that can go right. And then we're able to make the most educated decisions.

 

Brannon, thank you for being such a wealth of knowledge in the industry. We adore you. Our clients adore you. And I'm just grateful for you today. So thank you. Yeah, likewise.

 

Brannon Moncrief (34:17)

See you. Good to see you. Bye everybody.

 

Kiera (34:19)

And for everyone listening, thank you for listening. And as always, thanks for listening. And I'll catch you next time on the Dental A Team podcast.

 

Re-releasing a favorite of Dental A-Team listeners!

Kiera chats with Chick-fil-A owner and operator George Demetriades — and it's all about applying the chain fast-food restaurant's success into your dental practice. There's a lot of gold packed into this episode, but some of the highlights include:

• Abiding by character, competence, community

• Creating realistic and attainable systems

• Hiring ideal employees

• Identifying high performers

• Acquiring a loyal fanbase

• Cultivating a consistent culture

Episode resources:

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Transcript:

Kiera Dent (00:00)

Hello, Dental A Team listeners. This is Kiera. And today we are bringing you something so special. I am so excited because this is one of our most popular episodes from the archives. Whether you're hearing this for the first time or catching it again, I am so excited because it's jam packed with a ton of takeaways that you can start using right now in your practice. We have released thousands, literally thousands of episodes. And I wanted to start bringing a few of these amazing episodes back for you. So I hope you enjoy. And as always, thanks for listening and I'll catch you next time.

 

on the Dental A Team podcast.

 

speaker-0 (00:31)

Hello, Dental A Team listeners. This is Kiera. And my gosh, I am like fangirling so hard right now. if you guys have heard, Dr. Nate Tillman, he was at Dental A Team Summit, and this year we had a really strong theme where we talked about Chick-fil-A and how much their customer service and their experience is just unmatched. So after Summit, Nate texted me and said, Kiera, I have a friend. He owns some Chick-fil-A franchises.

 

Would you be interested if I could get to him on your podcast? And my gosh, heart eyes, like gold stars galore. I have the one and only George Demetriades on today, owner of Chick-fil-A. He owns these. I am so giddy. George, welcome to the podcast. I have been so ecstatic to podcast with you.

 

speaker-1 (01:15)

Thank you so much, Kiera. I really am grateful that for the opportunity to to chat with you guys. And yes, Nate is a very, very close friend of many, many years. If I mess this up, then it then I don't know Nate. It's not Nate's fault. And we'll we'll make up a name of Sam Schmuckatelli, the dentist in Hobble or something like that that that that referred me to you. So

 

speaker-0 (01:38)

my gosh. No. Honestly, George, you're seriously so nice. And Nate is incredible. And for those of you who like can if you're just listening, be sure to snag our little snippets of this one. You literally can see George's name tag on. He is sitting in Chick-fil-A corner office right now, hanging out. He's in boots on the ground. So George, let's just kind of take it through. You and I have chatted a little bit. I have so many questions. Sure. I just I l I mean I wasn't a huge Chick-fil-A fan until I learned about their spicy deluxe sandwich. Mix it with the Chick-fil-A sauce.

 

my gosh, every Saturday Jason and I wake up and Jay says, Kiera, what's today? And I say Chick-fil-A day. Like it's every day. and so George, kind of just tell us a little bit about your background. I know you're an owner operator for eight years of Chick-fil-A, but kind of prior to that, you and I had chatted before. I just want the listeners to know who is George, and then we're diving all into Chick-fil-A today.

 

speaker-1 (02:28)

Awesome. Yeah, thank you so much again for allowing me to join the podcast. so I was born and raised in Atlanta, which is the home of Chick-fil-A, been eating it my whole life. graduated from high school, went off to Wake Forest University, which is where I know Nate from, and was commissioned into the Army as an intelligence officer. Served in the Army for a number of years, and then when I left, left active duty, some time on Capitol Hill, some time in the consulting business, and and after about 10 years of that.

 

I found my way to Chick-fil-A. I had just become kind of it was a mid midlife, I guess, or pre-midlife crisis, professional crisis, and didn't didn't find a lot of fulfillment in the consulting world anymore. Talked to a friend of mine down at our corporate headquarters about a few ideas I had and he said, Hey, if you haven't thought about a about a franchise, you should go to this website, check it up, check it out, and and holler back with questions. So did that.

 

Called him back and at some point over the next eighteen months of interviews, probably at many points during those eighteen months, my buddy down at corporate snuck into people's offices in the dark of night and took my file from trash cans back into their inboxes and I made it through the process and so took over the the Chick-fil-A in Crystal City, Virginia, just outside of DC in January of twenty fifteen. Nate and Carrie were there that day, that morning, which means a great deal to me. And

 

And then two years ago, a little bit more than two years ago, opened up my second location in Pentagon City, which is yeah, just a less than a mile from the original location that I had. And so I operate those two franchises with with a team of of well over a hundred folks that are just incredible people who inspire me every day. they really they they make my my job and my life not only easy, but it's really fulfilled.

 

so and that's me. It's it's me and a dog, a couple of nieces and a nephew and nine godchildren running around.

 

speaker-0 (04:36)

How fun. George, okay, I'm really curious. Number one, you talked about being an intelligence. So I mean I'm gonna derail from Chick-fil-A a little bit. Tell me the craziest experience in intelligence. Like you have this like very undercover life. Intelligence, Chick-fil-A, anything crazy in intelligence?

 

speaker-1 (04:52)

I

 

so I tell people I was an intelligence officer but not a very intelligent officer. And and the guys that I served with are all like, Well, he finally got one right. so I was a tactical intelligence officer, so I wasn't like James Bond. I was I was out helping commanders on the battlefield understand what the enemy was was likely to do, what capabilities they had and and how we would counter that. and you know, the army was was really, really good to me. I my my some of my closest friends in the world are

 

are from that that period in my life still today. And a lot of them are still in. A couple of them are generals now, which makes me feel very old. and but it's the army was really, really good to me. So nothing nothing crazy. It was it was it it was I was very fortunate throughout my survey.

 

speaker-0 (05:41)

Interesting. Well, I do feel like there's probably strategy trying to figure out what they're going to do, which probably helps you potentially in your Chick-fil-A franchise as well. So I need to know now how do you become a Chick-fil-A franchise owner? Like is I feel like this is a hard process because Chick-fil-A is so well known. They're so like they're across the board. Like, how long does this process to become a franchise owner? And how do even do it?

 

speaker-1 (06:02)

Yeah,

 

it's a it's a very long process. It starts with an expression of interest, which is kind of like a mini application. And and we have I think the most the number I heard most recently was last year we had around a hundred and eight thousand people express interest in becoming a Chick-fil-A operator.

 

speaker-0 (06:17)

my gosh. Okay.

 

speaker-1 (06:18)

The the opportunity is this is this is my my only job. so we are we are not looking for folks who have a collection of franchises and just want to add a Chick-fil-A to their portfolio.

 

and we are we are looking for folks who have a lot of leadership background who can use that to to really move the objectives and goals of the restaurant forward. we we kind of rely on three things when we're looking at at operator candidates and even our corporate staff candidates, which is character confidence and community. character speaks for itself. We wanna we wanna know that you're a person of character and that you've had that consistent character throughout your life.

 

We want to know that you're part of your community and that wherever you've been, that you find ways to contribute. you know, not just not just a job and and family and all those things, but ways beyond beyond what others might do in the community. And and the competence piece really is all about leadership. Chick-fil-A and and coming in from the military, a lot of the systems they use have a very they they our training systems especially

 

you can tell there was where there were folks involved in that development that had military experience, but but Chick-fil-A is exceptionally good at putting a system around as much as possible. they're even better at personalizing those systems and making sure they don't seem stale or or systemic, so to speak.

 

speaker-0 (07:51)

Like I need to know this, George. This is what I'm dying to know. Because Chick-fil-A, every experience, no matter where I'm at, and this is what we talked about. This is why I'm so giddy to talk to you. It's like I think Starbucks, I don't know how they do for their on-boarding and Chick-fil-A. Like, but Chick-fil-A has good food. I don't drink coffee, but man, Starbucks could definitely take a look no on how to make delicious hot chocolate. Like it's disgusting. Probably the worst hot chocolate I've ever had. But they have an incredible experience there. And I love to go work there. But Chick-fil-A, like you cook great food.

 

Great service. People are so happy there. And I have been so giddy to know about their system. So George, explain this more to me. And of course, I told George and I will tell all the listeners, Chick-fil-A is a special business, just like your businesses are special. So if I ask any questions that are off radar, not allowed to talk about George has every right to tell me, Kiera, that's secret sauce. that's the Chick-fil-A secret sauce, and I will definitely respect that. So, George, you have my promise.

 

but anything you can tell me about their systems. I love that you said they personalize the systems, but explain this to me 'cause I don't I didn't go to the military. But the military I think is brilliant with their systems. How tell me more about these systems in Chick-fil-A. I need

 

speaker-1 (09:00)

Yeah,

 

so I think you know, I think that that i i when we talk about competence in that in that suite of things we look for in our operators, competence is about leadership. It's not about having an MBA or being able to take a a P N L statement and squeeze every last penny out of the out of the out of the P and L statement. Make no mistake about it, we are a for profit enterprise. and and that that profit allows us to continue to grow and and all of you know, continue to to

 

compensate our people and all of those things. But I think what personalizes our systems is that we push it down to the lowest possible level, which is the restaurant, right? And so my title is owner operator. And that's because I'm expected to operate the business. This is the only active investment I have. You know, stocks are one thing. You know, all of those types of passive investments, sure. But in terms of what I do day to day, this is it.

 

So I am in my restaurants every day. and I, you know, I get to make the decisions. The all of the folks in my restaurants work for me. That's the that's true. They don't work for Chick-fil-A Corporate. Chick-fil-A Corporate has some great systems that we can employ. We have, you know, the typical ones that any small business owner like a like a dentist would would think about when it comes to employer liability insurance or health insurance, all of those types of things, payroll. you know, we have a we have a centralized systems for that.

 

but but quite frankly, you know, if my dog could speak and had opposable thumbs, he could he could do the administrative side of the business. I mean it is it it's really kinda hard to mess up. but the fact that I'm in this business every day making decisions with my leaders, if we if we make a mistake, if we make a bad decision, we just stop and pivot. And and I think in a lot of other businesses,

 

you know, a lot of other kind of chain type type restaurants and businesses. if you where that where that owner operator influence is missing, or is not in the restaurant every day, you you don't get to do that. You have managers who may be afraid to make decisions. Perhaps they're not empowered to make decisions. I took vacation earlier this year and went to Greece for two weeks for the first time and I sent Chick-fil-A an email and I said, Hey everybody, Helen is empowered to make any and all decisions on my behalf.

 

My phone will work in Greece. If you need me, call me. If I'm out in the hinterlands picking olives and you can't reach me, then Helen is empowered to make any and all decisions. I I trust her implicitly. And and I think a lot of of operators in our chain have have a Helen on their team or several Helens that are empowered to make decisions and that we rely on in in a lot of ways to ensure that our businesses operate smoothly. And and so

 

That's I think what lends the personal to the systems, right? You can put the systems in place, but if if folks aren't bought into if the systems aren't aren't realistic and attainable, the the goals that you've set, if they're not measurable, then folks are just gonna get frustrated. And and so that's that's kind of the approach that we take. and it's it's worked out well. It makes

 

really allows me to focus on the strategy of the business and where we want to be in 2030 as as a couple of restaurants that are in a very dynamic and growing area. How we want to influence the area and and take care of people. Because I've got folks like Helen and Alvin who who operate my two restaurants for me. They do the day-to-day and and they're empowered to do that. They empower their teams to do that. So systems allow us to focus on the things that only we can focus on.

 

And I think that's critically important.

 

speaker-0 (12:59)

yes. Yeah, I love that. That definitely helped. So and I definitely derailed us on this systems. So let's just quickly wrap up the last thought because I'm sure people are like, wait, wait, wait. She was on a path of how do you even become a franchise owner and then pushed into systems because I want to know. but I really do love that you one took a vacation to Greece because I think for listeners.

 

How many of you can leave your businesses for two weeks and empower an employee to make decisions all on your behalf and to be able to have it run? And for dentist, that means having another dentist in there. George, yes, he needs to be able to take care of these, but he has people in place to do that. And I love that they're personalized. I love that you empower them. But I I also hope people listened to the fact that you are thinking of 2030. Just to date, we're in 2023. So he's seven years forward thinking.

 

And you said what's the impact? Like obviously, where do we want to be financially? But you said how what's the impact we want to make within our community? And I think when people think of their communities impacting how do we want to look as a as a business and a restaurant, that was really beautiful. So back to you send in 108,000 people are interested in Chick-fil-A every year. Then you've got to look for your character, if I remember right, character, competency and community. Okay. Perfect. So we look for that. Make sure this has been a lifelong thing, not just you're a changed person.

 

It won't probably character that way. Okay. What else? How how do you become this

 

speaker-1 (14:24)

Yeah,

 

so so the it starts with that expression of interest. I I I would suspect that a a number of people are not invited to do the full application at that point simply because they may have stuff in their background or perhaps they've they've got that portfolio of franchises that I mentioned that they just want to add to and that's that's not really what we're looking for. but then you have this like forty six page application or whatever. I don't know what it is today when I went through it. Like

 

speaker-0 (14:49)

It's like buying a map.

 

speaker-1 (14:50)

it was forty eight pages long.

 

And and you go through a series of of both both virtual and in-person interviews. And in those interviews, it it I kind of employ a similar model, not as many interviews of course, but employ a similar model in my in my restaurant, which is a just a lot of experiential questions. The the interviews that you go through for Chick-fil-A, whether it's for corporate or in my restaurants, are are a lot about tell me about a time when, not

 

Well what kind of person are you? Right. So so you're really I look at it as kind of almost like we're investigating into whether this person is really gonna be a good cultural fit for our restaurant.

 

speaker-0 (15:35)

Okay, I'm gonna derail us again, George. I like on such a good path. No, it's perfect because now I want to know because that was actually one of the questions I wanted to ask is how do you guys hire an onboard? So for you specifically, George, can you tell me some very specific questions for character? Because I do believe that Chick-fil-A employs really great character people. So, what are some of the things you look for when you're interviewing people? Some of the questions you specifically ask. because I'm super intrigued by how you get such good cultures and

 

speaker-1 (16:04)

Yeah, I mean we are w so if we're looking at somebody for a supervisory type role, we're gonna ask them questions like, you know, tell me about a time you had to let someone go, or tell me about a time you had to have an uncomfortable conversation with someone. What was it about? We're not asking for names or anything like that, but what was it about? And and how did the conversation go? Were there anything that in anything that surprised you about their responses? what in their responses led you to think that that perhaps

 

this person wasn't a fit or maybe they deserved a second chance. so we're looking for everything from that that character and and consistency piece in those answers to also just kind of trying to figure out how they think and approach problems. you know so much of our business is people driven. You know, we're in the chicken business, but really we're in the people business, right? And and you can say that about a dental practice, you can say that about any enterprise out there. It

 

It rises or falls on people. That's the bottom line. When I walk into my dentist's office, he also has dogs in the lobby, which I think is pretty awesome. that is But

 

speaker-0 (17:12)

Awesome.

 

speaker-1 (17:12)

when I walk in for a dental appointment, I I fall asleep in the chair. So I'm not one of these people that's afraid of the dentist. and and and the hygienists always giggle. but think about that patient who walks in who's who's petrified, right? Well, at that moment in time when they walk into that lobby.

 

The receptionist is the most important person in the world. Because how they're greeted is gonna set the tone for that entire entire visit. It's kinda like when someone walks into my restaurant. How they see that restaurant in the instant they walk in, is there trash on the tables? are people moving quickly behind a front counter with purpose to get things done? Or are they lollygagging and and you you know, they don't seem like they're moving efficiently or

 

Or care too much about moving you through the line quickly. those folks that initially greet our guests or patients are the most important people in the world. And and they set the tone for the entire visit. And so we're looking for people who have a history of s of of kind of hum humbly serving other people. we're looking for folks who have higher emotional intelligence.

 

Because they're dealing with people. This isn't a it's not a it's not a we're not a software company. You know, we're not we're not gonna sit in cubicles. We have to interrupt interact with the public. And and in one moment we could have fifty six teenagers from Boston walk in who were here for a school tour, which happened yesterday morning all at once. In the next minute it could be Miss Sandy, who's our like our favorite guest, and she comes in every afternoon at four o'clock for unsweet tea to dri to drink on the way home.

 

And in the next minute, it could be someone who just lost their job and they don't know what's next. And they're just looking for somebody to smile and be nice. And so you have to you have to look for people who who have the experience and the ability to pivot in those types of types of conversations and types of interactions. And and so the questions that we ask are all focused on those types of things.

 

everybody interviews well, Kiera. Our schools have taught everyone to interview well.

 

speaker-0 (19:38)

George, like tell me. I

 

I would agree on that. I definitely agree on that. So that's what I'm curious. Like, how do you specifically I mean you have a hundred employees? You've got a lot. I'm sure you hire quite often. I'm sure you've become pretty good at this. Any like one, two or three key things that you're like consistently, if I find this or I I hear this, I either will hire or won't hire. Are there any things that you found in the patterns just over time hiring?

 

speaker-1 (20:03)

I

 

think the first thing that bumps everybody else or everybody up in our hiring process to to kind of a higher notch is if they are referred from someone else on the team. Your existing employees are are 99 times out of a hundred not going to refer someone that they one don't want to work with themselves, but two, someone that's gonna embarrass them, right? So so we love word of mouth referrals and we get a lot of those from our employees. We get a lot.

 

And we've we've reached this really sweet spot in the business where we have a lot of word of mouth and referrals. I think the other thing we look for are the people who just don't do anything outside of work or school. we get a lot of hey, so what what do you do in your free time? hang out with my friends. Okay, that's that's nice. I'm glad you have friends. But are you are you in the band? You know, or

 

Are if you're if you're older and you have kids, are you you know are you doing anything with your kids after school? Are you are you the t ball coach or are you helping out with the with the Girl Scouts or whatever the case may be? We're looking for those types of things that that show that they are part of a a community outside of just going to work and going home. again it it feeds into the idea that that you are

 

Y you have the ability to interact with people from all different types of backgrounds at different stages in their in their day or in their week or in their life. Mhm. And that's really important to us.

 

speaker-0 (21:37)

Interesting. That it's so fascinating. And I appreciate you sharing because that was my next question of

 

How can you guys like, okay, lovingly and bluntly, the fast food industry doesn't usually have as strong of a reputation. I did work at KFC and AW in my days, and I literally cried the day I quit because I enjoyed it so much. it was my first job out of high school, and I was the float queen, and I surely loved every minute of it. but I also know working in fast food, like it was kind of gross and there were things that I did not enjoy, and I worked late hours and

 

we had a fun time. I mean, I was young, but what do you guys do? And I wanna know from today, but also prior, what has Chick fil A done to have such happy teams? Like there is a rumor going around that it's it's faith based. But like is it more PTO? Is it that like what do you guys do to make such happy teams?

 

speaker-1 (22:33)

Yeah, so I well I think that the the first thing we do is i is we set clear expectations. We set clear expectations that are attainable. And I think we've reached this kind of strange point in society, I think, where on some level we have a group of employers out there that seem afraid to ask, or maybe society writ large feels afraid to ask people to work hard.

 

speaker-0 (22:59)

They are. So tell me how you do it. Right. And it's this illusion.

 

speaker-1 (23:02)

It's hard work. We are our our restaurants do volumes that haven't been seen anywhere else in the restaurant business per square foot, but also just in general. there's there's always a line. The lines are often, you know, the the size of the lines are often unpredictable. It's a it's a hard it's a hard business and it's a hard job.

 

speaker-0 (23:20)

They stand outside for hours. They sit there. They bring you your food. They clean up. I'm like, how do you do it? Because it's not one, how do you get your team to work hard? because so you're right. I do think that it's becoming, I feel like a millennial 2023 trend of let's work as lazy as we can and make the most that we can. And I don't believe that all of society actually enjoys that. So I'm curious, you guys do it differently.

 

speaker-1 (23:45)

And

 

I'm not convinced that much of society really enjoys that. To be very honest with you, I think it's something we've almost kind of convinced ourselves of that's just simply not true. I think people want clear expectations. I think they want goals that are attainable. And I think the leader's job is to do that, but also to make sure they're resourced appropriately to so that they can achieve those goals. And that's and that's everything from training to stuff that works. Right? When when I walk in my restaurant and one of our six friars is down.

 

It's not just that a friar's down and we'll just use the other five. It messes with the whole rhythm of of you know that the busiest day part of the of the or the busiest hour of the day. And and so I think when you when you can set those clear expectations, you set goals that are attainable and people are resourced correctly, the the last not the last, but but the other critical component is people have to feel genuinely valued and appreciated.

 

And so I think day to day it's little things like just genuinely saying thank you. I think it is ensuring that you have ways to I mean we talk about resourcing ways to to resource them and to grow them professionally, but but things that they can also take with them outside of the business. You know, we have a relationship with Point University, which is an accredited university in Georgia. It's an online university. but

 

My employees can go to college for free. you know, they have to they have to have a certain GPA and and a couple of other things, but provided they meet all of those all of that criteria, they can they can earn an associate's degree, a bachelor's degree, or a list of several certificates, professional certificates that they can carry they can they can keep in my business or they can carry other places. This helps me in my business because I have people who who who have elevated thinking, who have

 

better time management, who have more critical thinking skills. but it also helps them. They know and now look it's not Harvard, right? It's not like they're gonna go down the street

 

speaker-0 (25:53)

I still think any education is good, right? Like it teaches them discipline.

 

speaker-1 (25:57)

get out of it what you put into it. And and so I think, you know, there's the traditional ways to to to motivate, reward and invest in people like like good pay, competitive pay and benefits. And we do all of those things. For us, one of our one of our things, especially with our high school kids, hey, why do you want to work at Chick-fil-A? I just love the food. Hey man, I'm with you. You know, that is yes. but I think the other the other piece of it is that that

 

culture piece. People need to feel valued not just for what they do, but for who they are. And we work really, really hard at that. We we know our team members, we know, you know, we know their kids, we, you know, little things, they seem to be little things, but they're not. We we took our leaders last year we had a we closed my my Crystal City location for renovation and we ended up

 

Collapsed in two teams into one team. A lot of people got a lot of paid time off because we couldn't have we did just didn't have the room to have all these people in one restaurant. but it was all we were very deliberate about it, it was all very even. Everybody got the same amount, everybody got a lot. But we were bringing two teams together and and we realized very quickly that they need to know each other as human beings outside of the restaurant and outside of the business and outside of just trying to push them together. So we took all of our leaders, twenty two of them, out to

 

Linden, Virginia, which is about an hour, hour and ten minutes west of DC, near the Shenandoah Valley. And we took them horseback riding. Now look, this was seventy dollars a person. This is not an expensive entry. And then with with dinner it was a little bit more. but we s we s we I still have people asking when are we doing it again? We're probably gonna do it again in the fall. but it's one of those things. It's like I've I had a number of people come to me and say, Hey that was on my bucket list. And it's

 

You know, it's it's a very easy and simple thing to do, but we have we've exposed people to to something that they otherwise never would have had the opportunity, probably never had the opportunity to do. And it was really easy. I mean it's like this isn't this isn't that hard. and so I think I think all of those types of things are really, really important to to demonstrate to your team that I care about you as an individual, not just as

 

the person who rings up the next customer or who you know who who preps the next patient so I can come in and do and do my dental thing. Right. and so I I think all of that kind of stuff lends to a culture. You know, culture is the culture starts with the with the with the top leader. It's gonna start with the dentist in a dental office. It starts with me in my restaurant. and for me I am I've I have been around and been on this earth far too long.

 

to not have fun at work and to not you know it's I mean like and and I think that hopefully that's contagious and and yeah there are gonna be days that aren't fun. We all know that. There are gonna be days where everything just seems off. but if I can come in here every morning with with positivity, with genuine care for my for my team and my customers alike, then that that's gonna it's gonna snowball, right? That old you know what rolls downhill? Well culture roll rolls downhill too.

 

Right. And so I think that it does that piece is is really, really important.

 

speaker-0 (29:30)

It's awesome. On that same note, George, I appreciate just all the information because I think what I pulled the most from that section was to to love people and to care about them as people and as little things and giving them opportunities, experiences, really caring about them as a person. And that is that takes to me intentionality. It's very easy to give someone benefits and pay.

 

it's not easy to get to know them. Like I I would ask all of our listeners right now, like, do you know George has a hundred employees and he probably doesn't know every single one of them, but at least knows something. Do you know their families of your team? Do you know what they like and what they don't like? Do you know the things that they're striving for in their personal and professional lives? Because I do feel when you know people, they're more invested in you because you're invested in them. So that was beautiful. And I am curious, George, with all your hiring, with all these people, you've got lots of people coming and going.

 

How do you identify like those that you want to have as managers and acknowledge and reward your high performers? Like, how do you sift through hundreds of people and give them opportunities? What's some, what are some of the tips that you guys do through the Chick-fil-A experience to reward high performers and identify?

 

speaker-1 (30:41)

Yeah, so I think that it when it comes to the to the high performers, obviously we have our evaluation processes that we go through that are that that are that system, right? It's kinda like payroll and and or pay and and good pay and benefits and all those things.

 

speaker-0 (30:57)

How often do you have that, George? Just out of curiosity. Yeah.

 

speaker-1 (30:59)

And

 

and that's okay. That's one where you know, if you're if you're newer on the team at a at at a more entry level position, it's gonna be a much a much more simple process, much simpler process for for your leader above you to to to fill out. I think it's it it's a c it all becomes to about sphere of influence, right? Like yes, I have I have more than a hundred employees. I I I can't know them all as well as I would love to.

 

I think the average person, probably four to six people that, you know, having that kind of sphere of influence is is really, really important. So so I focus my efforts very intentionally on my two managing directors who who lead each restaurant, my financial return director who works across both restaurants. We have a marketing person as well, works across both restaurants. and then I've got a couple of operational managers in each restaurant that I focus very intently on.

 

And then the expectation of them is that that next level down, that next four to six people, that they're focusing just as intently. And so I'm relying and so on and so forth. And so I'm relying very much on my subordinates to identify that talent. And it's gonna start with one servant leadership. Are you willing to do what you're asking everybody else to do? And Kiera, I'm I'll I'm gonna I'm gonna test you. Here we go. I'm gonna ask I'm gonna ask the question here, young lady. All right.

 

What is the one thing in my restaurant I have never done?

 

Well no, there's one thing I've never done. I've never worn the cow suit. Now maybe everything else I've done. I have I have read a chicken, I have fried chicken, I have sold chicken, I have ordered chicken, I have put away the chicken, I have I have fixed toilets, I have cleaned toilets, I have done everything else.

 

speaker-0 (32:51)

Just not the cat.

 

speaker-1 (32:53)

Maybe maybe this will change. Well when I buy a new cow costume, maybe the first guy in the cow costume will be this guy. But

 

speaker-0 (33:01)

That's fair. I mean that would get a little over.

 

speaker-1 (33:04)

No,

 

no, I'm not doing that. I'm not doing that. I got a I got a whole host of high school kids who are more than willing to hop in the cow costume. And I've I've watched the cow costume by the way. I've taken it home and and w and literally watched it myself by hand. but cow costumes are not for me. So but I think that's really important. That servant servant leadership where you're showing folks that you're willing to do what you're asking them to do is critical. And it's and it's and it's not just that you're showing them what you're

 

That you're willing to do what they're doing. But you also do gain a true understanding of okay, what am I asking this person to do for eight hours a day? I'm asking them to stand on their feet and bread chicken. This is not an easy standing on your feet for eight hours eight hours a day alone is not is not a an easier or wonderful thing to do. but these are these are hard physical tasks in a lot of cases. and and so you need to understand how that impacts the operations, how that fatigue impacts them, impacts their safety.

 

impacts their morale, all of those types of things. And so I think we're looking for folks who are who are willing to do everything that they're asking other people to do and and do it well and have an understanding of the the challenges that other people have in those roles. The challenges they they may come into the restaurant with on a day to day basis based on what's going on at home. And and then how can they

 

How can they help them through that? How can they help them be successful at work? Right? And so that's what we're looking for in our in our leaders. We're we are we are most likely, unless you're coming from another Chick-fil-A, we're probably not gonna hire you immediately as a supervisor or at least at the same level that you were at at another business. We may hire you one level down, and and we'll be very we'll be very open about this, but hey, look, you know.

 

We we promise you you may be you may have been the best pick a franchise manager in in this last role that you had. But our restaurant is probably doing multiples of the revenue that that restaurant did. So the challenges you face here and the people you're gonna be supervising here, the numbers of people you're gonna be supervising are that much greater. So it doesn't translate exactly. So we're gonna bring you in at a lower level and and we're gonna make sure you can handle it and you can grow in the business. And then we've got

 

Throughout through through Chick-fil-A, we have really great training system called Pathways. And it's the fundamental kind of it it's online, it sets the sets the tone and the stage for all the fundamental things you need to need to know to to work in the business. got different

 

speaker-0 (35:54)

Like how does that process work? Like, do you so I'm a new hire. Is it like a month process? Do I learn the breading? Do I learn the culture first? Like w how do you guys walk through this? I've been super intrigued by this because it's consistent experience across the board. So I'm guessing there's a consistent

 

speaker-1 (36:10)

Well

 

the process is yes, I mean by and large it's it's all fundamentally the same. How operators may do it in the restaurants may vary a little bit in terms of timing and all those types of things. But for us, we bring folks in first first couple of days is orientation where we're walking through our expectations, walking through our culture and getting to know I mean that piece is really, really important. we're gonna make sure that they have people to to to be with during the that first two or three weeks of work. not just

 

Not just somebody shadowing them or them shadowing someone to make sure they know what they're doing, but also, hey, who are you gonna eat lunch with today? Right? Like we don't want you to to be lonely your first few weeks of work, right? We want you to we want you to get to know people and and and and really establish relationships with folks so that if you have a question that you might perceive as a dumb question, there are no dumb questions, but if but if you're sitting there as a new guy and you you may be afraid to ask and we want you to have someone trusted.

 

up here that you can go, hey, how many s how many squirts of strawberry is it into a strawberry milkshake? You know, we want you to to have someone to ask those questions of. And and and you may be afraid to ask a manager. So so we work very intentionally on that and we put through through part of the pathways. Now pathways is great. It's online. You're not gonna go online and learn how to make a milkshake. You've got to get your you've got to you've got to grab a cup and the spinner and and go to making a milkshake. by the way I've done that in the restaurant. They don't like it when I do that in the restaurant.

 

comparable at it and I end up making a mess. So so we're gonna we're gonna walk you through that process first on pathways and then we're gonna walk you through actually doing it in the restaurant with one of our trainers. And we've got several trainers in each restaurant. they've been in the business for a long time. It's not all that they do, but when they're doing it, that's what they're focused on. And they're gonna walk you through and make sure that you are you are trained to

 

not just our standard but to your comfort level on on how to do these tasks. and so it really the first month is an awful lot of training and and an awful lot of of familiarity and getting comfortable with with with our systems, our processes and and and our team. You know, that that part is also really, really important.

 

speaker-0 (38:36)

That's super fascinating to me, George, because I feel in dental offices, which is very ironic to me, that we might understaff in a way because I know whenever we hire somebody, it's like we needed them five days ago. So hi, welcome, super happy to have you. Good luck. And I'm like, okay, not to discredit ch fast food, but I'm like, you spend a month training these team members. And I think that that could be a different piece. Cause we talked before, there's

 

Chick-fil-A and McDonald's. You and I chatted about this before, and it was very much a you both sell chicken, you both sell chicken nuggets, you both sell strawberry milkshakes, you both sell fries, different kinds, but there's a lot of similarities between the two. Why is there a literal cult following of Chick-fil-A? I'm sure there's a McDonald's, but it's not as public, it's not as well known. and it's a very different experience. Chick-fil-A, I would never, I would, I would literally be appalled if I walked in.

 

And I had to go enter on a kiosk. Like I can go to a table and order if I want, but that's my choosing. It's not, and there's someone who's super happy and cheery, but the fact that you train for a month and you give them a buddy and you teach them culture, plus before that, because I've thought like, what do you guys do to create and cultivate a consistent culture of just happy people? And I think it's one you hire really well at the beginning. You ask for the things, you're looking for the red flags, you want people dedicated to their community. Then you spend

 

A month training these people. And I would feel if someone invests in me that much, I'm going to be comfortable, I'm going to be confident, I've made friends, I'm more bought into it before I actually have to go be like the main shebang up there. And then after that, you guys are working hard to cultivate. And you have you've got basically supervisors or leaders over four to five people. So it's a smaller group that they're over, that they're intimately knowing, that they're invested in their lives.

 

And that's how you're able to grow to scale to cultivate. So I am curious what happens when you have someone who's say an underperformer? They're not fitting the culture. They're not smiling when the guests come in. What do you think?

 

speaker-1 (40:37)

It's yeah, I'm glad you I'm glad you asked that because I think it's really, really that thirty days, there's there's obviously a method to all of this, right? And I I would imagine it's it's we're all under the gun, right? We we're all we all get overcome by the current crisis, by the current set of patients that are coming in the door, by the current set of customers that are coming in the door. The easiest thing to say, we'll get to it later is training, right? That thirty days and

 

And that time that we are spending with those new employees, and it's not just one trainer assigned to one employee for those thirty days, right? It's a number of different people that are working with that employee. That's when you identify if somebody's gonna fit. I mean, it is we know within the first two or three weeks if this person's gonna be a fit or not. And if they're not, we'll just say, Hey, they we think this isn't for you. and we know that because we're observing them very intently during that training process.

 

And so and I think it would be even probably it's probably even more difficult in the dental office where folks who are coming into the into the door to work, all of them have credentials already, right? I mean you have to be for

 

speaker-0 (41:47)

Most of the

 

speaker-1 (41:48)

the front office. You're licensed as a as a whatever. You're either the dentist or you're or you're a hygienist or or whatever the case may be, but you have presumably because you have the certification, you should know what you're doing. And so it's much easier to just go, look, they're certified, they're good. Let's But

 

I think that it really gives you the opportunity, taking that intentional time with them to show them where things are and to show them how how you want patients greeted in your in your in your chair, so to speak. I think it's really it it also gives you the opportunity to see, okay, is this is this person gonna do that? Are they gonna fit in? 'Cause it look, they're you're either gonna know that in thirty days or you're not. And so for us if it's beyond the thirty days

 

and and we've still got someone on our team and and you know, let's say they're three or four months in and they start to slip, at this point we know them well enough to sit down and go, Okay, what's going on? Is this a problem that we have with one of our systems? Is it something that can be retrained? Is it something that's going on outside that they're bringing into the business? Or is it something that we can't correct? Is it something that we're just you know, for whatever reason we're not gonna be able to to to ensure this person

 

conducts themselves to our to our standard. And and at that point we'll we'll help them help promote them to customer, so to speak. and and you know we we always want to do that in a way that honors them. I mean you know this is an individual who has spent time with us and and and and we don't we we want them to leave feeling good about their experience with us. and so we work we work hard to make sure it's also an investment, right? Any any person you bring on

 

You are investing a significant amount of time, energy and money bringing them into your business. And so you lose them and and and that money is is that's gone, right? So

 

speaker-0 (43:44)

I I heard someone tell me the biggest cost in a business is the cost of turnover. And it's

 

speaker-1 (43:48)

And that's not just financial, it's emotional.

 

This is why it takes people so long to fire someone, right? Because you are also admitting that on some level you failed too. And that is really hard for us as as leaders and as human beings to do sometimes to say, yeah, I've I've I failed, right? Now now we have people that you know that yes, on occasion someone sneaks in and you're like, no, that wasn't me, that was all them. But by and large

 

It's it's tough to let people go for a lot of reasons, but one is that you really you're you're also recognizing your own vulnerability. and so I I think that thirty min that thirty days though, I I think that initial orientation and onboarding is really, really critical to understanding if someone's gonna fit in the culture or not. And I would think it's much harder I think it's much harder in a smaller organization like a dental office where you have

 

fewer personalities, right? Fewer people, right? And fewer personalities. And so it's even more critical that that that person fit fit the culture. I can I can move people around to different shifts. I can even move people around to different restaurants if I need to, if I think, well, we got in the wrong one, let's get over there 'cause it's a different culture and and they'll and they'll thrive there. but in a in a dental office of of five or six people or, you know, eight or ten people

 

speaker-0 (45:12)

No.

 

speaker-1 (45:13)

You you

 

really you really gotta make sure that that that that person is gonna fit that that microculture sort of

 

speaker-0 (45:21)

Completely agree. I think I think the things I really took away from this were like really be intentional on my hiring. Be intentional and ask harder questions, not just tell me about your experience, tell me when. and then I also think something else I really loved was to be intentional with my onboarding. And I started thinking of like what's harder. Is it harder to throw them in and put a bandage where I think that they're going to thrive versus training them and getting them to be super excellent or letting them go if they're not going to be excellent?

 

At the beginning. as you said scheduling though, George, this is like a totally off tangent. Now I'm just gonna get like geeky on tech flip. How do you schedule all these people? Do you guys have a software? Do you have an Excel spreadsheet? Like I would imagine

 

speaker-1 (46:03)

we

 

speaker-0 (46:03)

a software of like

 

speaker-1 (46:05)

hot schedules and it and hot schedules sinks into our payroll system and all this other stuff and it sinks into our forecasting system as well which is really this is part of that you know part of that my dog if he had opposable thumbs and and and could speak could probably do a lot I say that and and scheduling's one of the hardest things in the in the business because you are putting you are putting people and what you know about our people and teams together and and it I say it and it's not as easy as I make it sound.

 

But

 

speaker-0 (46:34)

Scheduling is was a beast. That's when like I have thirty five employees and I'm like, my gosh. I'm like, I can't imagine a hundred different schedules, shifts all across the board, people coming and going, vacations.

 

speaker-1 (46:44)

The nice thing about the nice thing about hot schedules is is the schedule goes out and the employees can trade amongst themselves at certain levels. And that makes things a lot easier than having to come say, you know, may I have this day off or may I have that day off and then trying to figure out how we're gonna backfill. We basically set the schedule and tell them, Hey, cool, if you if you want if you want time off you gotta find your you gotta find your replacement for that for that shift. but it is you know, you are you are putting

 

A lot of different considerations with 60 to 70 variables in each restaurant, right? 60 to 70 people in each restaurant, and all of their considerations all in at the same time. And a lot of that is just really critical with your leadership knowing your team. You know, I'm I know this person. We have we have this huge event happening this day, and I know this person is really good at making sure those huge events happen and happen well, and this person is much better at one-on-one with.

 

customers. So let's make sure we have person A instead of person B. You know, so you've you've got to put all that stuff together. and my team my my leaders do a really exceptional job of it. And they make it they make it very personal and and it's it's they do a really nice job.

 

speaker-0 (48:00)

George, I can tell you just love the people you work with. I can tell you love your business. Like you have so much fun and that's what I think like if you're not having

 

speaker-1 (48:07)

There

 

there are days where you know, in every business there are days where you're just like, Whoa, what just happened? you know, and we get we get every once in a while get crazy folks and coming in and and into the restaurant and all that kind of stuff and and and things break and whatnot. But you know, middle of COVID I was talking to a friend of mine who's a corporate guy and and he was working from home and zooming everything and isolated and super just he was just frustrated and down.

 

And he was like, Yeah, how do you do it? And I was like, What do you mean how do I do it? And he's like, Well, how do you how do you I mean he's like, I'm really struggling and I'm like, Brother, I'm not because I I just I mean, we stayed open. I just go into my restaurant and I see my team every day and these people, they inspire me so much. I mean like they just they just have this I this just love of love of the business that it's you know, we share it and and and they they do a

 

Just they they work, they have this love of hard work and they really have this love of each other. And I think that that piece, we we really really it's just a privilege. I mean it's a privilege to lead these folks and it's a privilege to spend time with them every day. And and we we do, we have a whole lot of fun. life's too short not to. You ain't having fun, you're doing it wrong, even if even if you're in a dental office. I mean

 

speaker-0 (49:35)

The exact same way. There's so many things you have said that I'm hopeful that people while listening about Chick-fil-A, we all have this like obsession with Chick-fil-A. So many people love it. One of the girls, I asked her, I said, I told my team, I said, you know, we're I'm I'm podcasting with the Chick-fil-A owner. I'm so excited. And she wrote, she said, I'm sure it's their pleasure to podcast with you. And I laughed so hard. but I feel like so many things you said are so applicable to dental practices. So, George, as we wrap up, I just want to do a little rapid fire.

 

random questions that are not even business related, but I just think they'll be fun. So and they're just Chick-fil-A like let's just get let's just like geek on Chick-fil-A. First question as a Chick-fil-A owner operator, eating Chick-fil-A for your whole life, what is your favorite thing on the menu currently today as Chick-fil-A Chick-fil-A?

 

speaker-1 (50:20)

It is and always has

 

Yes. I just I mean I grew up with it. It's it I I I go I go back with our number one I'm forty eight. I go back with our number one meal. Oops, just dropped my phone. Sorry about that. I go back with my number with our number one meal for a a good forty six years or whenever I had enough enough teeth to chew sandwiches. and it's a number one meal preliminary.

 

speaker-0 (50:45)

Do you have like a special sauce you put on it? Like I do you love a certain sauce or you just want it like plain Jane original?

 

speaker-1 (50:51)

But I also have gotten into a one for one ratio of Polynesian and Buffalo. Yeah, it'll change the world.

 

speaker-0 (51:02)

Okay, I'm excited. I mean Saturday is Chick fil A Day. I'm not far away from this, so

 

speaker-1 (51:07)

And I'll tell you what I'll tell you the other thing that I I was

 

speaker-0 (51:09)

Understand.

 

speaker-1 (51:10)

session yesterday with a bunch of other operators and their and some of their staff and and one of our corporate corporate folks and we were talking about I think the question was if you could if you could wave a magic wand and have one thing in the restaurant, what would it be? And my thing was robots to deliver. but the other thing was and I've I've thought about doing this, I never have. I think a Polynesian milkshake

 

Could be pretty impressive. Polynesian sauce and vanilla milkshake. Now, this is don't you guys listening to the out there in the Ethernet, this is not a Chick-fil-A item. I might have received a text message last night from one of my managers who was at this training session who might have said that she tried it, who might have said it tasted a little bit like an orange green sickle. Maybe. But you didn't hear it from me.

 

speaker-0 (52:04)

No. Okay. I did not hear it from you. It's not a Chick-fil-A thing. Okay, interesting. And also on that, this is like another rapid fire. How often do Chick-fil-A owners, operators do training? Are you guys once a quarter, once a year? How often do you guys do?

 

speaker-1 (52:17)

That's hard to answer because there's a bunch of development stuff that we get to do that we can do that we can opt in and out of. we as a as a market meet once a quarter. And so there's 80 of us in the 80s or so of us in the DC market. We meet once a quarter. we meet with corporate at an annual conference where there's a lot of development that goes on. We talk very little about business. It's called Next. We talk we hear from our senior leaders in Chick-fil-A, we hear from a lot of

 

really great speakers. Everything from personal care and self care to sorry about that. To how to care for our team.

 

speaker-0 (52:56)

Okay.

 

speaker-1 (52:57)

and our teams and and then we meet our business meeting is called RPMs or regional planning meetings. And we meet once a year for those and that is that is what's the strategy for the next year and how do you build your business plan around it. but I'm glad you asked that because the other thing I would say is I

 

make it very I'm very deliberate about visiting other owner operators in the area a lot. And we're all friends is a are really but I would I would encourage and I take my leaders too. And sometimes I just send them over to see other folks. Hey so and so does this really well go over and see how they're doing it. if if I would encourage anyone on this call, you know, if you've got friends in the area who are in the same profession, go see how they do things.

 

Talk to about it, go visit their offices. Agreed. Send your folks over there. You know, they will feel when I anytime I send my team members over there to to other restaurants to see how things are getting done, they always come back. One, they come back with great ideas. Hey, they do this a little differently, let's try that. But two, they feel invested in. my gosh, George trusts me to leave the restaurant, right? You can't sell chicken outside of my restaurant. It happens inside the restaurant, right?

 

You can deliver it, but you can't sell it inside the outside the restaurant. So so George trusted me to leave the restaurant and go get good ideas from these other other businesses. Like they feel invested and they come back, they come back refreshed, they come back, they have fun doing it, and they come back, they always come back with good ideas. And so empower folks to do that. Establish those relationships and and go do it. You'll you'll be surprised what they come back with. You'll you're you just you will be, trust me.

 

speaker-0 (54:40)

Well, and I love that you don't see them as competition. You see them as like, let me go learn from them. So, okay, George, my last rapid fire question. This has been I mean, I'm just I love everything I've learned. So what are the most popular things that are not on the menu like a diet Dr. Pepper slushy? I just need to know I didn't realize that there was even a secret menu. So what are the most popular on menu?

 

speaker-1 (55:00)

Become the Polynesian.

 

And I will get calls from 5600 Buffington Road in Atlanta. But so we so you know a lot of it lately go revolves around TikTok. So the one that we're getting a lot lately is folks order mac and cheese, chicken nuggets, and fries. And then their and then their sauce du jour. And they ask for a salad bowl. And they mix it all together, they close the salad bowl, they shake it.

 

speaker-0 (55:27)

Wow.

 

speaker-1 (55:29)

And they create their own like mega entre. I have not done that yet, but I probably should. Just to see. So there's you know, we used to get a lot of requests for like spicy like a spicy biscuit and now we're we're kind of rolling all that out and a lot of stores already have it. We'll have it pretty soon. but the people would ask for a a spicy fillet on a just on a regular biscuit. So we used to get a lot of requests for that. So that that stuff is is coming out.

 

Yeah, I I'm a big fan of the crazy. I'll do a diet frosted lemonade, but I'll put two squirts of strawberry in it. And it it really is when it really turns into a a really nice almost like a like a locale strawberry shake. It's it's kinda surprising how the strawberry kind of it's a little tangy, but it's not it's not like super tangy. It kind of eclipses the the tang of a lemonade. It's

 

Yeah, you sh you may want to try that on Saturday. I know. I'm definitely You don't

 

speaker-0 (56:33)

For Saturday's Chick-fil-A day for Know.

 

speaker-1 (56:35)

have to do diet. I have to do diet 'cause I'm you know, my metabolism is shut down.

 

speaker-0 (56:39)

No, well, I mean, the lemonade's a little sweeter. So I do, I do tone it down a little bit. But George, this was such a a fulfilling podcast for me. I love Chick-fil-A, but more than that, I love you as a person and the passion that you have for business and for teams and for growing people. I am obsessed with finding business owners who love their teams, love what they're doing. And I want to just highlight one thing as we wrap this up. You and I chatted at the and you said,

 

The Marriott family and the Kathy family. So Marriott owns the Marriott hotels and the Kathy families who started Chick-fil-A. They're not just family owned, but family operated. And I think that that was one of the most cool takeaways of all of this, of the passion, the love, the investment that you have in these restaurants and your team. And I just want to say thank you for sharing all of your Chick-fil-A knowledge, for making all these dreams come true for all of us. it was truly a pleasure. It was my pleasure, actually.

 

truly. Truly. I just appreciate

 

you better believe when I come to Atlanta, I am hitting up your Chick-fil-A and we're gonna give you a huge hug. So So guys, I just appreciate George and I appreciate all of you listening.

 

Kiera Dent (58:03)

Dental A Team listeners, I hope you loved revisiting this episode as much as I did. I hope that you found the nuggets, the pearls. You can see why we re-released this one because I truly want you to take away the best of the best of the best of the best. This episode truly hopefully sparked some new excitement, gave you some new ideas. I know sometimes when I go back and I look back on things that I've learned in the past, I'm able to re-implement because like that famous quote says, no man steps into the same river twice because neither he is the same man.

 

nor is the river the same. You are not the same as you were before, nor is your practice the same as it was before. Different things, different ideas, same principles. And I really want to highlight and hopefully you took today that sometimes all we need to do is simplify and put into place or to refine things that we've already been doing really, really well. If you love this episode, don't keep it to yourself, share it with a colleague or leave us a review and help more practices find the Dental A Team podcast. As always, thanks for listening and I'll catch you next time on the Dental A Team podcast.

 

As practices grow and new people filter in, it's normal to want to measure each member of your team against your current goals versus where they were when first hired. Tiff and Nikki talk about assessing positions from a bird's eye view, working with someone who's stalled out in individual growth, differentiating emotions from the practical, and more.

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Transcript:

Tiffanie (00:00)

Hello, Dental A Team listeners. We are excited to be here with you today. I am just putting this out there. Nikki and I have tried to record this podcast now three

 

Nikki Mack (00:09)

Yeah.

 

Tiffanie (00:10)

times, and we are excited to get this information to you guys and hoping that our network works with us full time today. Nikki, thank you for being flexible, for being someone that will just jump in and for loving on Dental A Team and your clients as much as you do. I value and appreciate you so much.

 

This week and every week. How are you today?

 

Nikki Mack (00:32)

I am good. It's so good to be here. I'm hopeful for today. We've got it. I know it's gonna work. and just, you know, what a fun testament of like we're committed. We're gonna get this to you, we're gonna do what it takes. And couldn't think of anyone to be doing it with that would be better than you. So yeah, happy to be here.

 

Tiffanie (00:50)

Thank you. Thank

 

you. I think you pointed out something very special there. It's Sterilis. It's a part of our core values, right? Do the right thing. We've got the grit and the passion for excellence and

 

the results focus. We are living and breathing those this week. I completely agree. gosh, Nikki. so fun fact, we both head out for offices soon. we're both gonna be

 

Nikki Mack (01:15)

Mm-hmm.

 

Tiffanie (01:15)

on the road again. And I was looking at the weather.

 

This morning with my fiance. Have you looked yet?

 

Nikki Mack (01:23)

I have it. Now I'm nervous. It's share. Share with the class.

 

Tiffanie (01:24)

Yeah. So mm-hmm.

 

So just for everyone's knowledge base, at the time of recording this, it is mid October. We're like a week into October of twenty twenty six. And yesterday here in Phoenix, in my area of Phoenix was a hundred degrees. That was our high. Today's

 

Nikki Mack (01:44)

Mm.

 

Tiffanie (01:44)

high is ninety nine. Next week it's like high sixties and we're gone.

 

Nikki Mack (01:52)

Okay, yeah, that tracks. Got it.

 

Tiffanie (01:55)

No, so last week when Nikki

 

was gone, or the week before last when Nikki was gone, we were both traveling that week and everywhere we went we had just missed the rain. Like it was trailing right behind us, including at home. So it was beautiful at home, it was raining, the weather was gorgeous, and we get back and it's sunny and hot and we've been living sunny and hot now. And as soon as we leave, like legitimately I think Sunday, it starts cooling down. Yep.

 

Aaron said, he said, my gosh, it's gonna be so pretty next week. I Yeah, and it's literally the entire time that I'm gone. Seven days of beauty, seven days I'm gone. So I thought I'd share that with you today. I get you prepped, ready to go. It's Thursday. So, you know, here we are. It's gonna be great.

 

Nikki Mack (02:40)

Yeah.

 

It's my mind for it. I love it. You know what? Well but I will say this. At least almost everywhere we go is beautiful and green. Everywhere's

 

beautiful.

 

Tiffanie (02:50)

This is true.

 

Nikki Mack (02:51)

Walk that back. Everywhere's beautiful. Just most places are also green. And as desert girlies, like I love to see it. So there's a win.

 

Tiffanie (02:57)

Yeah, it's so true. And we should

 

get some fall colors, which they're not good, it might be beautiful here, but there's no fall colors in Phoenix. So I love that. I love that.

 

Nikki Mack (03:05)

Absolutely. my god.

 

Tiffanie (03:08)

Well, more testaments to our core values, which actually, as you said that earlier, like our our testament to getting this done, I kind of I think that actually we spoke a little bit about what we were gonna talk about today, but I think that kind of ties into today's statements as well and really talking about our core values. So

 

Today, Nikki, I'm picking your brain on team. And something it's been a very recurring theme. and I think actually, now that I say it out loud, like I think a lot of practices right now are pushing for growth. It's towards the end of the year and they've experienced some growth. For whatever reason, this year has been like a like a stale growth. It hasn't been a lot at one time. It's been kind of intermittent and a weird year for sure.

 

But practices are experiencing that growth. And within that, we hire new people, shift things shift and people shift, but we really start taking a look at the people that we have, the people that we need, et cetera. And today's topic, we really wanted to talk about your team. Like, would you rehire everyone on your team? And I love this title or this topic that our marketing team gave to us so much because it's like hard.

 

Core, right? Like it hit. It was like, wow, that's like cut into the chase. Would you rehire everyone? So, Nikki, I think this is something that comes up for a lot of practices, at least in my consulting. And I think you're seeing it. I know specifically a couple of practices you have that have onboarded new doctors and new hygienists and just this expansive growth. When it comes to looking at the actual team members, what are you helping practices work through? How are you walking them through that and really?

 

trying to decide on something like this, like would you hire this person again? How do you, how do you work that with them?

 

Nikki Mack (04:58)

So I think the first step is you have to take an honest look at the practice, yourself as a leader and kind of your expectations, right? Where are we like truly at? What's changed this year, and what do I still want to change, right? You know, like what what goalposts are we still working towards and how has that translated with my team? Because here's the thing at the end of the day, you hired everyone on your team for a reason, right?

 

Nobody, I think, wandered in off the street and was like, Can I stay for a bit? And you're like, Yeah, sounds good, right? You know, we'll teach you how to use Tentrics, it's fine. but our teams do change, right? Our office changes, and we change as leaders and kind of our goals and things we're looking for. So being able to say, like, okay, let me take a real honest look at where we're at, where I'm trying to go, and how everyone kind of fits in with that right now, not from that personal relationship standpoint.

 

not from you know past experiences with them, but just how do they fit into my team and my structure because what do I need? a good example of that, I think a lot of times when we talk about org charts with teams, right? we love an org chart. But what do

 

Tiffanie (06:08)

I do.

 

Nikki Mack (06:08)

we usually tell them, let's design an org chart for what your office needs, not for the people that you currently have in place. And then we figure out how they fit into those positions. Because we have to be honest about what we're trying to build and what team structure gets us there.

 

And I think it's that same kind of mentality, even if we have an org chart, if we're evaluating our team, what do we really have? Right? Like what is in place and what are our goals?

 

Tiffanie (06:34)

Yeah, I love that. And

 

Nikki Mack (06:35)

Mm-hmm.

 

Tiffanie (06:36)

within that like org chart and that structure and really looking at those goals, I something I notice is even just in the same position, no growth for the practice, a lot of times someone can just like get stale or stagnant, or maybe they were in a space that worked for a while and now that's that space just isn't working. Do you feel, Nikki, that once someone's a bad seed, they're always a bad seed?

 

do you feel like there's opportunity for individual growth? I've seen all of it, and I think we can walk through so many scenarios, but like when you consult a practice and when on Dental A Team consults a practice for all of the listeners, we rely heavily on a lot of information that you provide to us. And so we're the bird's eye viewpoint. and we try to see everything from that high-level kind of looking in.

 

But we really do require so much data and input from you. So Nikki, with that, when you're coming in like blind, we'll call it, right? You're just you've just got the information that you have. How are you helping a doctor to assess those people? And I'm like truly interested.

 

Nikki Mack (07:50)

Yeah. Okay, so this is possibly one of my fatal flaws. we're full transparency, right? Here on Dental A Team. I absolutely believe people are you

 

Tiffanie (08:00)

Same.

 

Nikki Mack (08:00)

rehabilitate, right? Like I know it and sometimes look guys, sometimes I've tried way too long to my detriment. But what valuable experience to know when to tell you, like, guys, cut it. We've done what

 

Tiffanie (08:13)

It's fair.

 

Nikki Mack (08:13)

we can.

 

but I do often think there's room. And I know a few of my teams right now would be listening to this and being like, Yes, we had that same conversation. I was like, This person, we've done everything, there's no hope. And I was Well, let's just try one more thing, right? Now I'm

 

Tiffanie (08:28)

Yeah.

 

Nikki Mack (08:28)

fresh, new set of eyes. Let's be for sure that we've done everything. Because it's completely fair as a leader. Sometimes we think we've done everything, and sometimes we've only responded out of frustration in the moment. And so I do think people can be

 

Saved, right? So to speak. but we have to be super intentional. And this is about really looking into okay, what are my concerns with this problem, with this person, excuse me? What are their opportunities? What are the consistent challenges? Is this something that's coachable? Or is this something that is simply not a fit? Whether it's skill set, personality, you know, something of that degree, if it truly doesn't work for what I need from that role, then we have a different conversation. Because I think it goes.

 

In two places, depending on the position. Are they still a good fit for my team, but maybe in a different seat? Or is there not somewhere in this practice that is the appropriate seat for what we're trying to do and where they're at? But

 

Tiffanie (09:28)

Yeah.

 

Nikki Mack (09:28)

ultimately, yes, I am gonna try to save you a hundred percent. I just want to be sure that I did everything I could and that we are confident if you are in the right seat and you're the right person.

 

Tiffanie (09:39)

Personally and professionally, that's me to my detriment. Yes,

 

Nikki Mack (09:41)

Yeah.

 

Tiffanie (09:45)

I think a lot of us in the dental field probably feel that way. Something I'm hearing that's really special and important to pull out is the separation that you're creating from the emotional standpoint to the black and white. Like, are they are they a good fit? And that's personality wise.

 

and capabilities, but removing those emotional pieces. Because to your point of what you said, I think a lot of decisions we make in life in general are emotionally based decisions. Like we don't go to Target, right, for just the things we need. I every time we walk into Target, the kids are like, what are are we here for? Like, did we get everything we need? And I every single time I say, listen, guys, Target doesn't, I don't always come knowing what I need from Target. Target tells me what I need.

 

And we walk around until I feel as though Target has spoken to me all that it can. And then we check out. Then it's time. Then it's time to

 

Nikki Mack (10:43)

Then it's time to check out. Okay.

 

Tiffanie (10:45)

check out. And those are just those are emotionally, you know, we're walking through the it's always the kitchen stuff, right? And I'm like, you know, and my cart's full. And sis is like, I don't think we needed that. I'm like, it's fine. Target said, but we're making those decisions.

 

not just at Target, we're also making them in the workplace, and maybe even more so in the workplace because the stress is higher. Like Target's not stressing me out. It's just getting me excited, right? But I'm still making these emotionally based decisions on if I do or don't want something. And I think at the workplace it's so much more stress evolved, right? They're involved. There's so much more stress to be had that we're like, cut it, be done. Or I'm gonna

 

continue trying until I can't try anymore. So I love that you determined those two pieces. Now, would you rehire everyone on your team is like that's honestly it's a little harsh, right? And I love it because I want to take that look. and something you mentioned too with the org chart. And then you also said like are they in the right seat? Are they right the right person? So does their personality fit our practice and then are they in the right place? Something that ties into what you said initially this morning when we started was

 

like

 

the core value. So I think it's huge for people and for practice owners to understand how to separate those two things. And Nikki, I think you do a great job at anecdotes and allowing people to see like real life examples. How would you how would you help a doctor to determine like, is this an an emotional decision that I'm making, or can I see on paper black and white that this person does or doesn't work for us?

 

Nikki Mack (12:27)

Yeah. I think it comes back to KPIs a little bit, right?

 

Tiffanie (12:31)

Mm.

 

Nikki Mack (12:31)

You know our things we love. because you have to decide if the outcome, whether that outcome is frustration, things not getting done, holes in the schedule, lack of follow up, whatever the outcome is that's causing that concern, where is that coming from? Is it a KPI issue? Is it a training issue, or is it a personality issue, right? Like kind of a fit.

 

Because we talk a lot in

 

dentistry about how fit matters a ton, right? Patients need to find the right dentist for what they're looking for. You need the right team for what you're looking for. And I think it definitely matters with team and what role they fill. Because we'll take, for example, a small office, right? We've you and I have both been there, right? I was the only girl up front running the show. So I did the phone calls, I did confirmation, I did billing. We're a hundred years old, so we didn't get to text patients to confirm.

 

Tiffanie (13:22)

Yeah,

 

fair.

 

Nikki Mack (13:23)

We were making

 

40 phone calls, right? you figure out how to do all of it and we make it work, right? And our office thrives and we grow and it's amazing. And then we bring more people on. But sometimes people are doing certain duties just because they've fallen into that place, or that's kind of where it is. But then as we grow and there's a little bit more of dedication to tasks, I might still be with a task that actually I don't love. And I can do it, but

 

It's not what fills my cup, right? And it's not what kind of gets me excited to come in every day. And that over time will impact our performance, right? Even if we're good at it. Look, my billing ladies out there, Tiffanie and I both talked about this. My AR queens, the insurance, you know, 40 minute phone call, they're gonna wait it out. Appreciate you, love you. That can't be me long term. Can I do it? Yes. Is that what I want to do for 40 hours a week? my gosh, no. I need a patient. You know what I mean?

 

You can end up in these positions and that is where that output suffers. But is it because I don't have the skills or is it because that's just not where I thrive? And so I think that's where you have to look at what's causing this gap or miss with this employee and where does it come from? Because maybe I can train them. Maybe we can figure out how to utilize them in a different way. and what the office, what does that look like? Right? Because when we're in different periods of growth, we have to

 

Take a step back just like we look at systems, look at our people. Where what seat are they in? And is that the right seat for what we need and where we want to go?

 

Tiffanie (14:56)

Yeah.

 

So you're taking out the emotions by just simply looking at black and white data. I love that you brought in the KPIs. because I think that's multifaceted too of if we're not if we're not reaching the KPIs and that's the frustration. So maybe the schedule's not full, like you said, or whatever the KPI is that they're not hitting, then you can take a step back and we're really like removing the person. Cause you think that's what happens, right? Is that we get attached to Nikki.

 

Right. And I love Nikki. And I'm like, okay, but I don't want to lose Nikki. Or maybe Nikki just frustrated the heck out of me today. And I I'm like, get out of here. But the reality is, is Nikki reaching the goals or not? And so what you're saying, I'm like visualizing this and I love it because I can see, okay, this KPI is not being hit. And if that's the frustration, not the personality.

 

Right. If that's the frustration, then we can take a step back and say, cool, what about that isn't like what's what's missing? So then we can say, do they know how to do it? Right. Like, do they know how to do it? Do they want to do it? And do they have the space for it? Because something you said there is huge that I think we miss is that want. And then caveat here, because I worked in this office where we just like

 

Decided, I don't want to do that one anymore. So we moved it to somebody else and we just like shifted responsibilities and roles all the time. A role has its responsibilities. And 90% of it you're gonna love. There might be a 10% that's like, this is a mundane task that I hate doing. You just gotta bust through it, right? That's that book, eat that frog. Okay, just do it, just get it done. But if at the core this person doesn't want this job.

 

That's what you're saying. And that might not be a would you rehire this team member to your point? It might be, is there a different role that might suit them better? I love that. So then

 

Nikki Mack (16:57)

Yeah.

 

Tiffanie (16:57)

it takes out the person. Now the person, though, I think would be more apt to the rehire question. Maybe not.

 

Nikki Mack (17:04)

Yes.

 

Tiffanie (17:05)

I think they're both fair. But I think let's pivot. Because you might think, would I have rehired this person just because they're not accomplishing the KPIs and the goals? And then you're like,

 

missing this great human. Now what if it's like her personality is driving me nuts? You know, and I think Nikki to your point of the billing, like I my personality, if you put me in a billing seat, you're gonna hate me because I'm really

 

Nikki Mack (17:31)

Yeah.

 

Tiffanie (17:32)

cranky. Like Aaron even knows he's like, I can tell when you're just like in like go mode, like you've been on calls all day because I come out like, okay, what else are we gonna do? What can we solve? What do I how do I put the dishes away? Like I'm

 

Nikki Mack (17:43)

Right.

 

Tiffanie (17:44)

just like

 

Crazy, right? And he's like, yeah, like you gotta like chill and calm down. So putting me in that position, my personality does change. So walk me through some ideas there. Like what are you what are you seeing out in the field? And how

 

do you help

 

Nikki Mack (18:00)

Yeah.

 

Tiffanie (18:01)

determine the person?

 

Nikki Mack (18:03)

So, and I think this goes to some of the like behavior leadership like key components that we talk about a lot with our clients. This is where knowing your team comes into play. This is where having those check-ins, right, those one-on-ones and understanding what's going on with them, how their position is going, but also how they're doing. Because you're totally right, the dental office is busy, right? We talk about this all the time. Sometimes even a slow day is still a crazy day, no matter what we do.

 

And we want to control that chaos as much as possible, but it is still very much go, go, go. So as a leader, being able to step back and know where your team is and check in with them, those are those things that are going to allow you to A, notice shifts, right? Like, gosh, Tiff is like cranky every day this week, right? what's going on? How do I support that? And having a relationship with your team too, where we're in that level of trust and vulnerability that they can come to you.

 

Right. And have those conversations on both ends. So there's more than just sitting down today and saying, I'm gonna evaluate my team. We have to have some strategies and practices in place that allow you to move on that like very quickly. Now, if you aren't already doing that, that's okay because hi, hello, welcome to the Dental A Team Podcast, and we talk about would you rehire your team? This is where we start. Let's evaluate our team, let's evaluate where we're at and get that information, have those conversations, right?

 

and be able to understand where people fit because at the end of the day, if your team understands where you're going and why, then it's a lot easier for them to understand how they fit into that. And then sometimes team members come to their realizations themselves. I have a crazy story I'm gonna share with you. And I promise it's true. I would swear this, you know, in a court of law. It sounds fake, but it's not. a doctor that I used to work with years ago, we were hyper focused on this. Like

 

Our team growth, our team direction, our mission values, everything was top of like the commitment order. And the team was super excited, super bought in. We were all growing together. He had a team member that he had been a little bit, you know, concerned about. Amazing person, great personality, great team player. Just we weren't sure if she fit where we were going, right? That team member actually came to him and said, Doc, I love this office and I love that I've been a part of your team.

 

I'm not the right fit for where we're going. Like I can recognize that this is not where I where I belong, right? And she removed herself from the situation. But I'll tell you what, because she had such a strong relationship, she was amazing. Like we were sad to see her go. She found the replacement. She knew someone that was looking for a new office. She knew that person's personality and she was able to bring them on.

 

train them, get them ready to go, and then doc knew someone that needed an assistant that was great too. So it worked out amazing. Yeah. Is that gonna be the case every time? No guys. Hi. I realize that.

 

Tiffanie (21:05)

Yeah. Yeah.

 

Nikki Mack (21:06)

But when you build those foundations, when you have that relationship, these things are in fact possible. We can have that open line of communication and understanding and your team knows where we're going and they're fully bought in and support it.

 

Tiffanie (21:21)

I love that story. Ideal. So it almost

 

yeah, it almost sounds like it's less of a like would you rehire this team question? And which is the question, that's fine. But it's more of a have I done everything to support my team and lead and guide them so that I can even see if I would rehire this person or not. So we have to make sure we're doing our due diligence of pouring into the people.

 

And allowing the space for them to see if they even like it here or not, and then asking that question.

 

Nikki Mack (21:58)

Yeah. And then I think we haven't gotten to this part yet, but also at the end of everything, it's okay to say no. Would I rehire this person? No. For whatever reason. If they just don't fit right with what we're doing, if maybe like you said, the skill set's not there, the want isn't there, if they're not the right fit, guys, it's absolutely okay to acknowledge that and then figure out what comes next and how do we support the team. Because at the end of the day, if it is the wrong fit,

 

It's not a win for either of you. Not the employee, not you, not your team, not your patients.

 

Tiffanie (22:32)

I love that. I actually have had myself as a manager, I've had that where I've poured into this assistant. I felt like she was doing she was good when she was good. And she was really bad when she was bad. And I remember having to make that decision. And it was one of the hardest fires I've ever done in my life because I really wanted so much more for her, personally and professionally. I just saw this life that she could create and I think

 

As a leader, that's something that we can all do really well, is we can see the the person. And then, like we said earlier, like to our detriment, sometimes we will overlook things. And I did for a little while, not even overlooked. I feel like I excused things and like tried to coach and

 

Nikki Mack (23:18)

Mm-hmm.

 

Tiffanie (23:18)

tried to help. and at the end of it all, it was.

 

Pretty mutual, like you said. She kind of she knew it was coming. She knew she wasn't the best fit. She knew she could do better. But the team when I let her go, the team that felt so supported and so loved and so seen, because they had been at the end of the day, the ones that were suffering from just not the right person. Like, and she's not a bad human. I I she's a great person.

 

She

 

just wasn't the right fit for our practice at the time that we were at. And once that space was like alleviated and the team felt truly heard and seen, the whole team rose up to the occasion. They helped hire the next person. They helped train. They helped foreign to that person because they saw not only what could be like they didn't only see what could be wrong, what could be the worst, right? But they saw we can all.

 

pour into someone like Tiff did and build someone. And when it's right, it's right. And when it's wrong, we all have a, we all have a say in that now. So to your point, like it totally changed, I feel like, the values that the team saw and the way everyone else decided to show up thereafter. And it was after one on ones, we did, you know, core value assessments. These are your action items, like core value assessments are is this person

 

meeting our core values, is it a knowledge gap? Like do they need to know more about their position? Do they want their position? And on a on a people level, how do they show up for the team? and not just for themselves or just for the doctor or just for the leadership?

 

Nikki Mack (25:01)

Will you hear you?

 

Tiffanie (25:02)

Like how are they treating the rest of their team? And really doing like you said, those one-on-ones and building that relationship made a massive difference. Cause even this gal when she had to walk into my office, we already had our relationship built.

 

Nikki Mack (25:15)

Yeah.

 

Tiffanie (25:15)

And so

 

the conversation was honestly easy. It was not an it was a hard task and it was hard as a human, but the conversation was very easy.

 

Nikki Mack (25:28)

Yeah. Ultimately at the end of the day, I feel like when we're doing our job as leaders, whether a conversation is good, bad, or in the middle, it should never be a surprise to the employee we're having it with. Because we've had those conversations, we've had support and correction in place where necessary. And then they know where it's headed, right? Because they have ownership over their ability as well. So I think you brought up such a great point. Your team will rise up, man.

 

Like it's hard to lose a good person, but when we're making it the decision for the right reasons, your team may have been I'm not gonna say suffering, because it's not always suffering, but adjusting, right? Or

 

Tiffanie (26:13)

Yeah.

 

Nikki Mack (26:14)

accounting for it in different ways. So then when you make that realization, make that change where needed, your team will usually rise up because now they've see the other side as well.

 

And the value in that. So it that it's tough. I know it's hard to hire, right? We're stressed about losing people. And that's part of why I'm a big fan of doing everything we can, knowing that I've checked every box possible to help lift them up. But if your answer is no, then what are we going to do about it? Right. And that's something that we work through. Because you know what? No office is the same, right? No situation

 

Tiffanie (26:49)

Yeah.

 

Nikki Mack (26:49)

is the same. And so we ask a lot of different questions from that point too.

 

But we have to be honest with ourselves to kind of get that yes or no, right? Would I rehire? Would I keep them where they're at? And just being truthful and not fully emotionally driven with that.

 

Tiffanie (27:06)

Yeah.

 

Yeah. Awesome. Amazing. Thank you, Nikki. Action items, I'm gonna pull for everyone based on Nikki's conversations here. And please remember like this is this is coaching, this is real life coaching. This is what Nikki, all of our consultants do with our practices when these things come up. So foundational, make sure you've got your core values. You've got something that leads and guides your team on how to show up. So they know how to show up, they know how to be a positive member of your team and your culture is driven by your core values.

 

You've got KPI measurements. That's something that Nikki mentioned. Like, can they do their job? Are they doing their job? And then evaluate. Do they understand the job that you've asked them to do? Do they want that job? Do they have the capacity to do it? Are they in the right seat? And do those one-on-ones, you guys, whether it's monthly, we love monthly, every other month, quarterly, like some of my practices are are larger. So they're doing hygiene one month, dental assistance one month.

 

front office one month and they're rotating those quarterly so every department's getting hit quarterly. So reach out to us. Nikki, thank you so much for today. This was incredible. I think there's a ton of value in here and I appreciate you so much. You guys, if you want help with this, you need any templates, you're ready to talk to us to figure out how can we help support you in your roles and with your team, please reach out. Hello@TheDentalATeam.com. We are always here to help you and we love what we do.

 

Drop us a five-star review below. Let us know how valuable this was and anything else that you feel could be added. People do read through those reviews. So it's great for you to get your comments in there as well. And as always, we will catch you next time. Thanks so much.

 

Nikki Mack (28:46)

Peace.

 

Kiera is joined by Ryan Gross, CEO of Grapevine (formerly CEOShare), to discuss the future of dentistry in terms of marketing and AI, and how practices can stay up-to-date on everything. They touch on using AI to work smarter, not harder; utilizing the patient base you have more effectively; how to balance your practice's revenue with marketing benefits; and more.

Episode resources:

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Transcript:

Kiera (00:00)

Hello, Dental A Team Listeners. This is Kiera and today is an exciting day. I have a dear friend on our podcast, Ryan Gross, who used to be part of CMO Share and has now rebranded into Grapevine, doing all things fun in the marketing world. Ryan, how are you today?

 

Ryan (00:13)

Good. I'm so excited to be on your podcast. You know, we've known each other for years and kind of both seen each other's you know, how we've grown as companies in our in our careers and our journeys. So excited to be here and chat some marketing and you know, see you catch up on on what's going on in in in the industry.

 

Kiera (00:31)

Absolutely. Well, Ryan, for those who haven't heard you or don't know anything about you, tell them a little bit about now the new renamed Grapevine. kind of like how you got into marketing. I know you worked at the zoo. kind of just some fun backgrounds, but kind how did we get from where you were to where you are today?

 

Ryan (00:46)

Yeah, so my my marketing journey you know starts fairly fresh out of college. I went to work for the Walt Disney Company while I was in college and I did recruiting for them for years and then I went into the attractions industry and other areas, worked for a couple of museums, then went back to work for Disney again, working for Disney Vacation Club, doing marketing for them, and then went to work for a zoo.

 

And so spent, you know, that that time span's about 18 years of working in the attractions industry. and then I have a a friend, a good friend, Dr. Addison Kaleen, who was saying, hey, I need some help with my marketing. And I said, Okay, let me see if I can help out. And so I just did some stuff on the side for him and decided to go out on my own and started the journey of our company was CMO Share. started that out as basically a fractional CMO for practices.

 

you know, had a had a small group that I was working with and what happened during that time was we started to realize that on a digital marketing front, the dental like basically websites and Google ads, just the strategy at that time wasn't really what what I felt could have been the best approach to it. So we got into the website business and digital marketing business, and that's really where we've kind of

 

exploded since then in terms of our ability to to acquire new patients that way. And then over time when we started to look at the company, we said, okay, well, we're more than just websites. We have a phenomenal data set. And that's really where Grapevine was grown is the fact that we're one of the largest holders of dental data and when it comes to marketing, phone data and operational data combined. And so Grapevine was grown out of that as

 

now of our AI platform which kind of runs everything that we do.

 

Kiera (02:45)

That's awesome. Yeah. So let's talk about how offices are starting to like stand out in today's era with AI. I think that'd be a fun way to kind of dig into that marketing AI. I know it's a a very unique piece. So yeah, take it away on what you're seeing of like what's the future of dentistry and marketing and AI and how practices can can stay top of mind.

 

Ryan (03:06)

Yeah, so you know, I get this question often from practices and you know from from other companies is you know what is happening in the dental space when you look at from a marketing standpoint? And the thing is that I tell people e AI is an aid to what's what's out there right now and and to help you with your marketing. It's not gonna be the you know the only way to acquire new patients. but what it does is essentially is if you have enough data sets on on

 

your market and your area and patients, what you can do is you can use that to to go after more patients who are more likely to convert and to essentially accept treatment. That's that's the goal in my opinion and how we're seeing it work the best. And so you know one interesting data point that we have is we've seen this year the amount of traffic to our practices, their sites go down, but the number of people converting through phone calls increasing.

 

Because if you're using AI properly, what you're doing is you're getting in front of again the people who are most likely to convert for your business. And so that's that's a a powerful tool because it's you know you're getting you're working smarter, not harder. And the people who are coming into the practice, if you're doing this correctly, are more likely to spend money with you and accept that treatment. And especially now if you look at how you know a patients are navigating

 

the dental space, you know, they're really cost conscious. And so if you aren't doing this correctly, you're gonna get in front of a lot of people who aren't gonna accept treatment. And that's a big issue that we're seeing across the board.

 

Kiera (04:39)

Yeah. So Ryan, break that down in a bit deeper. Like how do people find those data points on practice? I think they I think it's fascinating to like less people are clicking, but more converting. I feel like that's always like a backwards. It feels a little backwards from what we've been taught for so long. How do they find these data points? How do they laser focus in on these patients? Like what are some of the specifics? Like let's get nitty gritty go under the hood and what are some of those specifics that they can do?

 

Ryan (05:02)

Yeah, so you know, if you wanna look at from a higher level first from a number standpoint, you know, I always ask or I always say you need to know a few data points. You need know, first of all, I always start this, what is your phone call answer rate? You know, and that's that seems simple, but you know, I presented a few months ago to about five hundred practices and I asked people to raise their hand in the room and it was, you know, dozen or so op raise their hand if they know their phone call answer rate. Because if you look at the phone call data, that's gonna

 

determine or give you a baseline just how well you are performing in terms of conversions of new patients. So you need to understand your phone data, how many calls you're getting, how many you're answering, first of all. The second piece of that is how many people are attempting to convert through your website. So when I say conversions in this case, I'm looking at people who are trying to call you through your website or through Google Ads, and people then who are trying to schedule online.

 

You take those data points there and you can start to compare the numbers. you know, we we have such a large data set, you know, over ten million phone calls we've analyzed and millions of Google conversions that we can basically use our AI tool to then say, okay, here's how many new patients you should have and in your market how many you should have. but you can do this on a on a practice level too, just by looking at and start to compare those numbers and you know, use tools out there like ChatGPT or Claude or things like that to help you analyze this and then

 

You want to also start to look at what are patients accepting in terms of production and look at your current patient numbers as well. So you kind of have to look at trends because you know we'll get questions like, Well, you know, my my schedule has holes in it. And I'll say, Okay, let's let's look at

 

Kiera (06:43)

Yeah.

 

Ryan (06:44)

your numbers, and I'll say, Well, you your new patient numbers are actually you know up five percent this month. But how so they're like, well,

 

You know, what do we need to do? And I'm like that, you know, we gotta look at it from deeper than if you have holes in your schedule and your new patient numbers are strong, you know, it typically means that you're not having treatment accepted. And that's why the doctor's schedule is open or you have cancellations, things like that. So when you start to actually take and unpill the onion of these numbers, you can take a look at it and say, Okay, there's a correlation between. So like when we look at correlating marketing numbers, we we we again we go to

 

Online conversions, we do phone call, the number of calls answered, and the total number of calls, then we look at the total number of new patients in production. And those three are independent numbers that if you're analyzing correctly, you can say, okay, I should have had based on my phone call, 100 new patients. based or I'm sorry, on on based on Google and my website, I should have had a hundred new patients. on my phone call I should have had ninety and I ended up with seventy. Well you can say, Okay, why did I end up with seventy when

 

marketing and phone set I should have had ninety to a hundred and you can start to dive in and look what's going on.

 

Kiera (07:53)

Interesting. Yeah. And I think so many practices think that marketing is harder than it really is, right? But you said like how are we answering the patients that are coming through? So is it a is it a awareness? Like, do we need more people to call us? Or is it a answer? Like, let's just pick up the phone and have the people that are there. Or is it when the people actually get in our doors, are we actually maximizing them, utilizing them, following up on the treatment that we're presenting and accepting? And like, is that the area? So it's almost like it sounds there's three bench points.

 

If people are wanting more of that awareness piece, Ryan, because I think that that's what a lot of them are looking for. They feel like they need more new patients. I agree. Look to see what you already have. And is it something that we like? Are we answering our phones enough? Are we closing the cases that we actually have? but like I have a practice, they don't have a huge patient base. Like they really don't have a large base. there's not enough for two dentists to be there. It is a little bit of a decline. And so they are really concerned because, like, yes, might have holds in the schedule. They're actually doing well. I have two practices.

 

They're

 

both doing very, very well. production is great, it's high, they're they're crushing it that way, but the base of patients is actually not enough to sustain two doctors. So that then becomes a like, we need a more of a volume. How do you uptick more of that volume? If, like, hey, we are doing well in our practice, numbers do look good, but we recognize this decline of patients. Like, how many patients do you recommend per GP doctor? And then what do they do if they need to get more of those patients in their database?

 

Ryan (09:14)

Yeah, so if you're like a PPO practice, you know, we look at anywhere from thirty to fifty new patients per doctor is kind of that that number. and again, we have practices that will s doctors have seen 75 new patients, we have some we're seeing 25. So it kind of just depends. But you want to look at thirty five thirty to fifty range is what we typically would see or recommend based on the data that we have. and so that's where your starting point is. But you kinda have to

 

look at it from a you know it's not about just driving patient volume it's driving the right patients and so you know one of the things is when you're when you're when we're analyzing a practice we say okay where is your most of your opportunity and so if hygiene is booking three weeks out or a month out or whatever then your opportunity could be within emergencies and so you want to acquire the right new patients in order to have that number grow. And so again if a practice needs you know a hundred new patients to that that's kind of the goal that they have.

 

you know you could have a percent of say 60% are hygiene, 40% are limited exams, you have to be able to understand that number before you start marketing. Otherwise what you're gonna do is you're gonna market to say like patients looking for hygiene, but you're still booking three to four weeks out when it's really the limit is that you need to. And so once you've figured out what kind of patient you need in the door, you need to be very quickly or be able to adapt to that quickly when things change. So you know maybe you bring on a hygienist and with you know in two weeks now your schedule's open to 20 more new patients.

 

So you need your marketing bill to adapt quickly. So one of the tools that we we use and that we have is able to look at your schedule and say, okay, we see that your first emergency patient is five days away. Well, that's the conversion of having a you know emergency five days out is gonna be very, very low. People want in today or tomorrow. And so you need to adapt the marketing then to get that. So you know it's about driving the right patient and also at

 

Times you can increase, and this is something that just doesn't get talked about enough, I think, in dentistry, especially now again with utilizing AIs. We have practices who are increasing their revenue significantly higher than their number of new patients because their production per new patient is up. So, in the last six months, we've seen the production per new patient climb to about 18 to 20 percent than it was last year, because again, we're getting in front of better patients that are for that practice. So, I think you just

 

Kiera (11:39)

Yeah.

 

Ryan (11:39)

have to kind of

 

You gotta analyze your practice first and then build your marking around that.

 

Kiera (11:44)

Yeah, and I think like it feels like I just want the diet pill, Ryan. Like I don't want to go it like look at all this. Like I just want you to give me more new patients. I want to have enough at bats. I don't want to have to

 

Ryan (11:51)

Yeah.

 

Kiera (11:53)

go dig into that. But I think like I think Ryan's point today, and I think for a lot of practices out there is you might not actually need more new patients. You might just need to better utilize the patients you have. And they always

 

talk about like,

 

Ryan (12:02)

Mm-hmm.

 

Kiera (12:03)

how do you actually increase a practice? Well, we either increase our patient base, we increase our dollar per like our transaction value per patient.

 

or we like add more locations, right? There's not like a ton of different levers, but I think so many people just feel if I just get enough new patients on my books, we're good. Ryan, to that, what do you feel is the correct size? So I'm a GP doctor. How many patients do I need in my database? Like I hear the new patients I need 35 to 50, but how many do I need to have to be a healthy practice before I add another doctor? Because I sometimes think when we add other doctors, we don't actually have enough patient flow.

 

Or we don't have a big enough base to be splitting. And I think that can also be a cause. So what do you tend to see is the correct base for patients? Like, I need this amount as a healthy GP practice. So maybe I do need more new patients. And I'm seeing obviously looking at the attrition rate too. Are we reappointing these patients? Are we keeping these patients? Cause we could have our front door doing a good job, but our back door is wide open. What should their like base be for the last 12 to 18 months that you typically see for practices?

 

Ryan (13:02)

Yeah, that's a good question. So we advise practices a lot on hiring doctors, bringing on associates, adding op rooms, expanding, or bringing on high hy hygienists. And so I'll tell you how we look at it first and then give you some numbers with it. So what we typically do is we start to manage demand or look at demand. And so that's the very first thing is in an area, what is your demand? And so we can use some of the tools we have to say, okay, you again you're seeing 50 new patients. we believe your demand is 70 right now, so we know there's 20

 

patients out there that could feed a new doctor or hygienist or whatever that would be. and so that's the the first thing is understanding if you want to add on a doctor but your demand is you have no demand to do that, you need to build that demand up first to to be able to do that. And so we you know that that number's kind of there's numbers all over that kind of tell you that people say of how many patients I should have. It really varies between depending on the practice. From we look at from a high like a hygienist standpoint,

 

When a hygienist starts to see seven hundred patients, that's that's a a red flag and that we see right there. From a doctor standpoint and active patients, it's it's a pretty wide number. and so because it you could we have practices that are having production per patient of like per visit of three hundred dollars, and we have some that are like eight hundred dollars. And so that really

 

Kiera (14:22)

Mm-hmm. Right.

 

Ryan (14:24)

changes that number of what you should be seeing. so again, you wanna kinda look at it from a demand standpoint

 

first and then determine so you know if a practice comes to us and we'll usually advise them ahead of time say okay you are we know that you have you could see we have a our our AR program will tell us how many new what your new patient demand is versus what your new patient is so say we see the demand at 200 and you're getting 100 new patients. Well we know there's a hundred more you can get well how do you what do you do then? Do you add on a doctor? Do you add on a hygienist do you expand? Do you go get an earlocation whatever that is

 

that's how we look at it is we first look at that demand number. And now if a practice wants to grow and again their number is 100 and they're at like you know their demand's 100 and they're 100 new patients now but they want to add on you have to build that demand before you make that decision.

 

Kiera (15:18)

Yeah, which I think is a a very interesting way to look at it. And I think people just wanna know like what is my what is my space? And so it sounds like in order for them to know that if I'm doing three hundred dollars per patient, what are you tending to see? Or if I'm doing eight hundred, I think the reason I'm asking like Ryan, sorry, to like a broken record on it, is because I feel like so many people I'm just gonna speak for the general public. They're gonna be a bit more lazy and they're not gonna wanna go do this. And so they're gonna constantly be saying, like, I just need more patients.

 

And so today I was trying to educate them on like, okay, if I am getting 300 per patient, how many patients do I need to have on average? If I'm getting 800 for it, yes, I hear that they could do more per that. But I think like just speaking from dentists that I work with across the board, a lot of them, I'm not here to say my our population's lazy. I'm just here to say that they're very busy, right? And so it's it feels easier to just push the button of like hire a marketing company, just get me more new patients rather than let me go dig through the data. Of course, people can hire you.

 

but just have like general like general metrics, like I say, like overhead should be around like 50%. and your payroll

 

Ryan (16:20)

Mm-hmm.

 

Kiera (16:20)

should be around 30%. I think if people can have some simple benchmark metrics today of like, okay, if I'm doing 300 per patient or like I know I need to get 30 to 55 new patients per GP doctor, like got it. if I need to look at my patient base, I need to have I don't know, 1400 to 2000, like how many do you guys usually recommend for that for one GP doctor? Then once I like know like those are in a good spot.

 

Let's then look at our call conversion rate and let's see how we're doing. Then let's look at our diagnosis and our case acceptance. I just wanted to try to give people some data points today of like what can they do? So so yeah, they can they can answer that.

 

Ryan (16:52)

Yeah, no, that makes sense. Yeah. We don't we don't do

 

so yeah, we don't do a recommendation on active patients per doctor, because of the fact that it it's it's too

 

If if we were to do that, there's too many variables that would mess up the equation. Because if w depending on what an active patient is and how much that active patient actually has produced and things like that, we we don't that's why we go we focus off of looking at the hygienist

 

Kiera (17:19)

I see.

 

Ryan (17:19)

number and we look at the total doctor. The active patient number is the most deceptive number, I think, in a dentistry catalog. So if you use that number, you're gonna make a wrong decision, I believe. So we don't look at that one.

 

Kiera (17:31)

So you would say then for them, like, let's just do the laundry list of bullet points. I need thirty-five to fifty-five new patients per GP. What other ones would you say of like what's their healthy scorecard for them to look to see, like, all right, do I need more new patients or can I like just dig into the ones that I already have while maximizing what we're getting?

 

Ryan (17:49)

Yeah, so you know, we c we do put some benchmarks on revenue. So, you know, if we look at like a one doctor practice, eight hundred thousand minimum. That's

 

Kiera (18:03)

Mm-hmm.

 

Ryan (18:03)

that's kind of if you're below that, there's some issues there. And so unless you're growing, I mean that's a startup server story. But if you're an established practice and you're below eight hundred thousand, there's an issue. So like eight hundred thousand Yes, mm-hmm. Yep, so

 

Kiera (18:12)

And that's like year to date production, right? Like we're talking year to date production. Yeah. And that's gonna be on net,

 

not gross. So don't be going in. I it's Ryan Gross, but do not be looking at gross numbers. Be looking at the net numbers. Okay. Cause some people I had a doctor

 

Ryan (18:21)

Yes, correct. Uh-huh. Yeah. So

 

Kiera (18:24)

the other day and she's like, We're like at one point nine and our collections are at one point one. And I was like, Whoa, we either have a

 

Ryan (18:29)

That that's your clut yeah.

 

Kiera (18:31)

a collection issue or we have a write-off

 

Ryan (18:33)

Yeah.

 

Kiera (18:34)

and we need to be reporting these in net, not gross. So okay, perfect.

 

Ryan (18:37)

Yeah.

 

So then once we see a a practice get to say one point two million in collections, we we will typically tell them in advance, you know, hey, start looking at expansion or another doctor, single be another doctor, or specialty services, like move into more of a general or super GP type thing. So one point two is that next one. And then when you add on a second doctor, now you're sitting at like say one point nine to two point one, two point two million there. So then you know.

 

You kind of start to scale that when you go up. So then you know, a three doctor practice, you know, 2.8 million, three million. and so you want to start to kind of look at those. You just you can use it as a scale. So that's how I would look at it is what are you producing? But again, if you're a fee for service practice, that's going to be a completely different number. But you know, let's stick to

 

Kiera (19:30)

Yeah.

 

Ryan (19:31)

I guess a majority of these practices are are insurance PPO based. So that's what we

 

Kiera (19:34)

Totally.

 

Ryan (19:34)

would look at. and then again, number of new

 

Patients. We look at retention as well.

 

Kiera (19:40)

Mm.

 

Ryan (19:40)

that's that's a big piece there. And you know, I get that question, well, what's a good retention rate or percent? And that's all over the board because

 

Kiera (19:47)

Yeah.

 

Ryan (19:48)

it's really there's so many things. If you are a heavy emergency practice, you're gonna have less retention just because of the fact that they're one and done. But there's a lot of money to be made in the emergency business, and so you know, I have a lot of practice saying, Well, I don't like emergencies because they don't stay. The average emergency is

 

Is worth we see three times the production in the first month than the average hygiene patient. So there's a lot of revenue to be made through emergencies. So again, it kind of just looking at so a benchmark we just look at as production per appointment or collections per appointment. I want to see that above $400. That's the first thing. From a new patient, I want to see it as and the new patient we categorize in the first month would be eight to nine hundred dollars. So then in the first three months.

 

Months, we see that from $1,200 to $1,500. So there's some benchmarks there. If you are a super GP and you're doing surgical, we've seen practices at in the first three months of $25,000 to $3,000 of production per new patient. So

 

Kiera (20:52)

Well.

 

Ryan (20:52)

there's some breakdowns there. If you are below $400 per total per collections per total appointment, that's a red flag. And if you're below $800 per new patient the first month, that's a red flag.

 

Kiera (21:05)

Absolutely.

 

No, that's super helpful. And

 

I hope people were able to take that and like put it in there because I know all of us, like so many people are like, well, what should be normal? How should this be? And so I think that was a really good clarifier of how how things should look for you. And again, like Ryan said, I I feel like this is where I get annoyed with marketing. Ryan, no, no shade to you over there. but it's always like this like it feels like a black box and like a very deep rabbit hole. And I'm like, I just want patience, right? Like that's really what I'm looking for.

 

But I think Ryan brought up a lot of our areas where if practices do a little bit more digging and like, hey, what is our answer rate? What is our new patient show rate? what is our conversion rate when we do have those patients in here? You might not actually need as many patients as you think you do. And you could have a lot smaller of a practice and still be just as successful as one who has a lot of patients but has a very large back door. And like you said, retention, retention, retention, right? Like sometimes offices, they are shelling patients out the back door and I'm like, whoa, just like close that up.

 

But they might be too busy or they might not want them or they might be

 

Ryan (22:02)

Mm-hmm.

 

Kiera (22:03)

wanting to cut insurances. and so I think that it's such a like you said, it is a black hole. There are a lot of pieces, but Ryan, I love the perspective that you brought. I am curious, moving into like today, we're airing the episode. So this is stamped time marked in 2026. What would you say practices like what are the top one, two or three things like with AI coming into play, with looking at marketing that you think could set offices up for massive success within their marketing realm coming into twenty twenty seven?

 

Ryan (22:30)

Yeah, so you know, from a from a digital marketing standpoint, I think what you're gonna start to see is the transformation of how people

 

choose a practice is it's I don't think it's gonna be significant but it's gonna be pretty I think it's gonna be could be significant. So right now it takes less than five minutes for a patient to search for a practice online, typically using Google, and then choose to try to call or schedule online with that practice. So it's less than five minutes. Ninety two percent of dental patients still go to the website. So reg you know a lot of people say, well, you know, they just call, they they're not going to the website, they call me on Google Blue. So well it's not it's 92% go to the website still

 

from a new patient standpoint. And so what I think you're gonna see is the refinement of, and you're gonna already start to see this in AI, especially with like sales, online sales, making it very easy to purchase. That's what you're gonna see from a dentist standpoint is they want to go from a very quick search, whether it's in Google, Gemini, Claude, ChatGPT, getting to scheduling extremely quickly. That's already sped up

 

prior to AI, and we're seeing that is people don't want to wait. They want to schedule very quickly using online scheduling,

 

Kiera (23:44)

Mm-hmm.

 

Ryan (23:44)

chatbots. Chatbots are still not there yet, but I think they're gonna be the future. and then calls. You know, phones are not gonna go away. That's still the leading conversion point for all practices is phones, not schedule online. And so you're gonna take and be able to customize your your patient experience using AI to if someone does a

 

search or an AI search that they're going to a website that's that's almost dynamic to their experience to get them to convert. So if they're looking for say clear liners in Visa lines, it's very quickly going to get them to the opportunity to have a consultation. Rather than having to think through the the read through the information, the data is going to be presented to them in the form that they're most likely to convert with. And so I think you're going to start to see some type of dynamic websites. We actually built out our websites have a base tool that is

 

can adapt to the market of the area. So if your market changes to being more emergency-based, the website's going to adapt to that. I think that's going to speed up very quickly where what you're going to have is someone who's searching for whatever it is that they're looking for in the dentistry space. It's the site is almost going to be catered to them. And so that's where I think it's going to go in the next one to two years.

 

Kiera (25:02)

That's amazing. And Ryan, thank you for that because I don't disagree with you. I think that those are big pieces right now of how can offices stand out. Like online scheduling, I'm like, just like online payments, like those two things, guys. We are in 2026. And if you're not doing that, that is a very tricky world to be in. I do definitely agree with you. Like, we gotta get that in place. and then I love that you say that like we still have to answer phones. Like dentistry is such a human interactive piece, and so many people like you still hear them like,

 

It's AI, like I just want to talk to a real human on the other side. And so I think that that will be something that will come through. But I really, really love that you pointed those out and for people to get on board. Ryan, you guys use so much for the world of marketing. You guys do a lot for dental practices. If people are interested in you have this very data-driven approach, and I think a lot of practices are fascinated by it. It's very different. I love that you were like, we don't actually have a metric for this. Like we don't actually talk about that way. We look to see what is this, we look at the data. What does your practice actually need?

 

Which is why we have recommended you guys multiple times for different practices. And again, marketing is just like consulting and there's so many great companies out there. Who do you resonate with and who has consistently shown and proven results time and time again? Go chat with them. So Ryan, if people are interested or want to know more and like work with Grapevine, how do they connect with you? How do they learn more about you guys?

 

Ryan (26:16)

Yeah, so if you go to MyGrapeVine.ai, you can fill out a form there and get connected with us, and then we'll do an analysis of your practice just to be able to see what needs to be done. You know, what you just said, there's a lot of marketing companies out there. And I think depending on the practice are, we don't work with all you know, the practices that come to us, because there's some who are looking for an experience that is gonna be more boutique experience. And that's something that I think you find a marketing company. There's some great ones out there that you know, you and I both know a really good company out there that does.

 

That's great, and we like to recommend to them as well of these beautiful websites. If you're looking for something that's more strategic and more data-driven, and you're wanting something that is going to adapt quickly to your market and your operations, you know, that's something that we have the ability to do. And if you go to so MyGrapeVine.ai, get in touch with us and we'll do an analysis of all of your data, your numbers, and see how you're performing and how your market's performing more importantly, and what your opportunity is.

 

Kiera (27:12)

Which I love that. And like I said, Ryan, there are marketers for all different sizes and shapes. And there are same thing with consultants. And I like I think Ryan, we're in the same boat, right? We're very analytic. We're very driven. It's tactical, practical. And Ryan, that's why I adore you guys. And so if you're interested in that, guys, go check out Ryan. it was MyGrapeVine.ai. I love that you grabbed the AI URLs. It's brilliant. and definitely go check it out. Guys, there's so many nuggets in here that you don't even need to go and change much up. I love that Ryan said that.

 

Me, I love the repurpose, reuse, recycle, honestly, analogy rather than pumping more money into it. And I know the easy button can feel easy today. but long-term longevity, if you know these metrics, these stats, it will take like it's an annoying, like this is your CE in marketing for you to learn this and learn this skill. All of us had to learn it. but taking a little bit of time digging in, I think you'll feel much more confident, just like you take in a CE with air quotes on it, learning your overhead and your numbers, you then become much more confident on making data decisions.

 

rather than emotional decisions and Ryan. That's what I like about you guys. So Ryan, any last thoughts as we wrap up today?

 

Ryan (28:16)

No, I appreciate the time and w I d I do have one last thought is you know, we we work with practices you know

 

similar practices and one of the things is I think if you have somebody like your team advising and helping practices, it is instrumental right now. Even with AI out there, having the ability to someone teach and monitor your team and talk to them and and break through those problems deeper than what we can do is tremendous. So I do want to say, you know, just just to s to say, hey, if if there's anybody out listening to this who hasn't worked with you, contact because the practices that we work on together do do very well because they're

 

there's that one-two punch of marketing and operational guidance and how to actually get your front team, your front office and to to operate at the level that they need to be. And so I can't say enough about the practices that you've helped that we work with as well.

 

Kiera (29:07)

Thank you, Ryan, for that. And agreed. We have a good synergy together. we've had a great time. And it's true. A lot of times our consultants will even join the marketing calls with your team. And we're hearing it. We're able to then drive the results within the team dynamic and within the doctor. So thank you for that shout out and agreed. We we have a really good synergy working back and forth. I love to see the stats of the practices we share together. definitely, guys, go check out Ryan. He's an incredible friend, he's an incredible marketer.

 

All things data driven. Like you said, I agree. We all know these really beautiful websites, but to me, I am all about results. You guys know if you're listening to the podcast, you Dental A Team equals results. Same thing with marketing. I'm not gonna pay for marketing just to have beautiful things. Like that's not Kiera's style. I am here like you better freaking get me leads. We better have it and know why. And if we're not, what are we gonna do to pivot it? I don't wanna just keep putting money into a an empty hole thinking that I'm doing something, but I'm not actually getting the results for it. So

 

Reach out to Ryan. Ryan, thanks for joining me. It's been too long. Super happy to have you on the podcast. Always enjoy our time together.

 

Ryan (30:03)

Thanks. Thank you, Kiera, I really appreciate it and thanks for having me.

 

Kiera (30:06)

Of course. All right. And for all of you listening, don't just listen today. Go take action on something. I don't care what it is. I don't care if it's you choose to go look at one of these numbers or you decide you're going to like look at our answer rate or you're going to reach out to Ryan or you're going to add consulting. I don't care what it is, but take action because the enemy of having what you want, like you are literally one decision away from a completely different life. So make that decision today. Make your life better. And always, thanks guys for listening. And I'll catch you next time on the Dental A Team Podcast.

 

Kiera takes a spin on profit growth by talking about a tactic many people don't consider: strategic partnerships. This means looking at the community around you, those in your field and outside of it, and learning to refer and support one another. Kiera's tips will help even the most introverted person begin to utilize their network.

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Transcript:

Kiera (00:00)

Hello, Dental A Team listeners. This is Kiera. And today I want to talk about something really fun. We talk about it in our mastermind groups with our clients. and it is like your network is your net worth. And so how strategic partnerships, you might not even be thinking this is a completely different, innovative way for you to grow your practice in a very easy, effective way. And so I'm super excited about it because a lot of times we just think that like the only way for us to grow our practice is to do more, hire another team member, or

 

To like just I think it's that GSD, which I'm very grateful that you have. but sometimes it's not even about that because sometimes there are other people around you that can actually elevate you, can grow you, can grow your practice, and that's through your network. And so really it's going to be about what are maybe the some of the partnerships you've you've forgotten, or maybe some of the partnerships we could rekindle that actually might help you elevate. Now, for somebody who you guys might think is very extroverted human, I am very extroverted, but you better believe we were just talking about an event.

 

I love to speak, you guys. I love to be on stage. but I am very much somebody that doesn't always love to be a porcelain doll on stage. And I know that might come as a shock for some of you, but like when I go to events, I'm like, the happy hour networking time is like my most stressful time of all of it. Like I love to have a conversation, I love to talk to people. It also stresses me out to no end. So just hearing that I recognize that what I'm about to talk to today.

 

might be foreign for some of you. For some of you, it might be the easiest thing and you might be like, Kiera, this is a great idea. for those of you who might be a little Kiera-esque or maybe a little less Kiera and like way less extroverted, just know that you don't have to do everything. But one of these things even can help you tremendously. And I just think it's a really fun way. Again, we talk about so many things and there's so many places of like grow your practice with this, grow your practice with marketing. I thought partnerships was a really fun spin on a great way for you to possibly grow your practice, grow your net worth. And you never know

 

Who your network's gonna bring into your place. Like, truly, my next door neighbor was Shelbi. Shelbi now is my EA, and she's absolutely incredible. there's been several people that I've just happeningly randomly met that have made my life exponentially better by being connected. And there's people that are way more connected. So, this is also a podcast for Kiera Dent. So it's all for you guys, but truly, I just want you to know that strategic partnerships really can be a benefit for you. If you're new to the podcast, hi, I'm Kiera. I hope I can be your best friend in dentistry. I truly am here to help you in whatever way possible.

 

I am obsessed with all things Dental. Our team is obsessed with it. I've built a team of consultants that truly their passion is to make you successful. We believe that running a successful practice should be fun and easy. And so I'm so happy you're here. For all of you OGs who have been listening, thank you. I hope you just give yourself like a little squeeze. Like give yourself a little squeeze and know I'm giving you a giant hug and saying thank you so much for your support, for being on the journey. And hey, if you're obsessed with us like I'm obsessed with you, go leave us five stars because your reviews are what ultimately are gonna make us.

 

continue to reach more people, be one of the top podcasts in the dental industry. And I just want to say thank you for making Dental A Team that I try to provide value for you. We're here all the time for you, three days a week, giving you practical, tactical tips. And we've been doing it for shoot. Like five years, six years, so long. So thanks for being on the journey. I'm obsessed with you and I hope that you remember dentistry is the greatest profession you could ever be in. Let's continue to make it great together. with that said, I hope that you know that like number one on this is we got to build referral relationships. So that's

 

Beyond sending patients. So I know a lot of you might have relationships with specialists. So I know a lot of people listening to our GP practices, also on the specialist side. there is a doctor that works with us, one of my dear friends, and he's a periodonist, and he literally is like the mayor of our town. He knows every single dental practice. He is always at offices, he's always driving around, meeting people, taking them to dinner, knows all the best restaurants in town. And that's what specialists have to do. And I think sometimes generalists don't realize that like you connecting and knowing all of your community.

 

really can drive like I text him at any time I'm like, hey, who's got the best hands in dentistry in our area? And he's like, you want to talk to this person? You meet somebody else. They know that person. Like he's so interconnected. And I just think like how amazing is that because he is referring back and forth. He's always looking for ways to connect somebody else. And I have found that when people come to the mastermind, that's something they tell me that they're obsessed with. So like all of our clients get together and we're like, my gosh, John, you need to go talk to Kevin and Kevin, you need to go meet Jamin. And Jamin, you need to go meet

 

Susie, like all of them connecting together. That's the same thing that you should be doing. So this is when like a partnership is broken and maybe we're being a little bit more of a user rather than a a giver on it, is if we only reach out when we need something, or we only have minimal communication with that specialist when we're referring a patient there, or we have very little collaboration on patient care. When it's thriving of a successful partnership, it's building that relationship with the specialist. It's connecting when we refer offices, it's communicating about our shared patient.

 

And it's creating a mutual trust. And so that can be as much as going over and saying hello. Like I have a doctor who was trying to get sleep. And I was like, get out of your office and go say hello. And she's like, I just don't want to, Kiera. And I was like, I know. I don't want to do half of this either. You guys think I enjoy being on video for the podcast? I absolutely do not, but you're welcome. Go say hello and say thank you on Instagram. Like, I hate being on video, but guess what? This is part of the name of the game. This is what I signed up with when I became a business owner. It doesn't mean you have to do everything, but I promise you, you go start to say hi, they know who you are.

 

Think about your neighbors. Like if you know your neighbors that refer people to you. I have a neighbor, I went and met our whole neighborhood. She literally watches for my packages every single time I'm out of town. That was a great strategic partnership, if you will, that benefits my life so much. I'm able to help her out with her kids. But we want this mutually referring. It shouldn't be a one-sided space. So I will say that when I've seen doctors, especially GPs and also specialists, you've got to build this. And there was a doctor who is a specialist, he's like, Kiera.

 

Is there any way for me as a specialist not to need my GP doctors? And I was like, unfortunately, no, we work in a we work in a referring basis. And so how do you become the person? It's like the lawyers or whomever in your town, how do you become that person that when they need a dentist or they need a referral, you are the first name that comes to mind? I want my specialist to be thinking about you as a dentist, not all the 50 other ones. Remember, people like pull out of their pocket what's familiar to them. So I want you to just know that like this is a reality, this is a space.

 

I want you to be the trusted partner and having that, it really will drive new patients. Also, you could go look at your new patient referrals and see how many of those are coming from specialist or from referral partners. If you don't have very many of them, it might be a good c key indicator for you to say, Hey, I need to go make more friends. I need to go build these stronger relationships. It's over time. It's not something of like, and please know there's a book called The Go Giver by Bob Burry. We had him on the podcast. If you didn't listen to that podcast, go listen to it. I was a fangirl that day.

 

but that's a book that was what I started the company on. And the go-giver is we are always giving more value than we expect. So I'm not going to meet these people hoping that they send me referrals. I'm going to find out what value can I give them, how can I support them? How can I grow their business? And in return, it always comes back to you. So I would encourage each of you to refer reach out to like one referral partner. every single month you could even like put it in your calendar. So you just have a rotating basis. Maybe it's I meet this person, and then in three months I reach back out to them.

 

staying top of mind, doing whatever we possibly can to make their life easier. and doing it not because you need something, but because you genuinely are interested in building this amazing relationship with them. step two on this would be like surround yourself with advisors who challenge you. So it doesn't just need to be within our industry. it needs to also be within your advisory board. And so thinking about like when you make every decision alone, maybe you don't have an advisory board. Waiting until there's a crisis to ask for help or feeling isolated as an owner, that might tell you you don't have an advisory board. And so

 

Successful owners, I see, like not just within referring partners within dentistry, but they also have a nice advisory board with their CPA, their attorney, banker. Like literally one of my friends who's a multi million pushing the billion, true friend, met him on Craigslist. I kid you not. he is now dating his banker. And I was like, How do you know your banker? Like, no one in the bank knows me. I'm not in there. And he was like, yeah, Kiera, I go make relationships with all of them.

 

And I thought about that. That led him to somebody he's now dating. But I thought about all these people. This guy is hyper connected, multi-million. I will say his business is larger than any dental practice owner I have ever met. So knowing that, let's take notes from these very successful people, knows every single person. And he's not a super outgoing guy. He just knows he needs to have these strategic partnerships within his life. What about marketing experts? How are you in the marketing world? What about technology partners? Do you know any of them? Do you like I have another friend.

 

Very successful business. He's yeah, I know the like CEO of HubSpot. Let me just send their name right over to you. I need to take a note from all of my friends and say, Kiera, get your booty out there and go start meeting these people. And then also consultants. Do you have a consultant? We are hyper-connected people. I know I'm like ragging on myself here. I have a Rolodex of so many people that I know, so many people we can connect you to, whether that's a dentist in the industry or the best in the best. I'm constantly betting them. You guys hear some of them on the podcast. Others I reserve only for our internal clients, but truly.

 

Do you have these people? Because every person that you know is your bench and then they know people and they can connect you to this person. I have a really great friend who is a CPA who is billionaire family office CPA, who knows a ton of people. I had an issue with our trademark, and I just texted him and said, like, hey, who do you know that's the best in the industry for a trademark lawyer? Sent me one of the best people that I could have ever asked for and had an amazing experience. So again, don't just think about I need these people for dental patient relationships.

 

They could like a lot of these people will actually refer to you. I can tell you how many of our dentist friends are like, Hey, I have a patient, they're moving. Well, great, who's in that area? We're gonna refer them to that dentist. That's awesome. But how many of your marketing people, how many of the people locally, your banks, you become the town mayor, people know you, you know the people in dentistry. You start to then have all these people around you that can help you make the best decisions. So, with this said, I have found that like people who have a very good advisory bench.

 

is also our best performing practices. They're great with their CPA. They them. They want all their numbers dialed in. They've got a relationship with their marketer. They know it. They their stats. They know their numbers. I asked them. They're good with that. They know their financial advisors forward and backwards. They got a great relationship there. But they're talking to these people. And again, yes, you use them for tech. They also have a consultant. I forgot that one. Sorry guys. True. Hey, hi. We can be on your advisory board and help you out. but those people who have it, you're not just using them for their knowledge like you are.

 

But also, these people are gonna refer to you. It is this whole like human referrals are the transactions of great business owners. And it's doing it not because I need to, but because I want to. And I'm gonna get you connected to the best of the best. And we all know each other. It's like a connecting the dots. And so for you, I just want you to realize that isolation slows growth. Collaboration is going to accelerate it. So this might not be a direct referral to your patient base, but it is a direct referral to your network faith. And so getting that place. So I want you just to think about what's in a business relationship.

 

That you've been neglecting that you need to reconnect this quarter or add to your advisory board. I listed them off for you. If you don't have that advisory board, start working to get that advisory board for you. So you're not making every decision alone. You've got great people on it. They will refer to you, they help you out, they will connect you to the best of the best. I my CPA, he's got me connected to our insurance person. Like I'm telling you, these people are so valuable. Somebody told me that, Kiera, I love working with you because you're literally a Rolodex. Like, hey, I need help with You're like, I know the best person for this. You need people like that in your life.

 

Just like I talk to a realtor and I'm like, who do you who's the best painter or the best electrician or the best this or that? They've got a network of people. You talk to somebody building homes, that contractor, they know the best of the best of the best. But people aren't willing to just give that to you just because. Like I had a friend reach out to my brother-in-law who builds these incredible homes. He's like, Could I get your sub list of all your subs? He's like, Absolutely not. Like he knows that that's a big portion of his business that actually is what makes him so successful. He's not just gonna give it to just like I'm not gonna give you guys every one of my people that I'm gonna refer to.

 

I like you, but also I recognize that like I'm only referring these people because I want to refer good people and be a great referring partner. I like you. I just don't know if you're the right fit for them. So just know a lot of times things are also gate kept until you work with these people. And it's not intentional, it's just relationships. And I want to connect you with the best. I was at the gym, had this girl, we were talking about things. She's like, my gosh, let me connect you to this person. Like truly get to know people because that's gonna be the benefit that like that's your that's your

 

Path to success. So if you want the easier path, get your network up. and then another piece is choose partners that make your team better. So looking at this of like partnerships should truly save you time. Like these are the ones we're paying for, these are the ones we're we're having in. The best ones improve execution. So they should save you time and they should improve your execution. So when we're looking at it, like these are vendors, these are labs, these are supplies, technology. So I want you to make sure, like, are you looking at your stack? Like, are we using our vendors?

 

Not because we've always used them, but because they're the best. Do I have ongoing education? Like, am I making sure that we're continuing to grow? Do we have our technology fully implemented and are we using it? And if not, like let's get rid of it. And like, what am I doing to make sure those those vendors are truly being maximized and executed and I'm using them? Like I have some clients that don't even reach out to us and I'm like, no, no, no. You we should be hearing from you like every single week, whether we have a call or not. Like you need to be using us constantly to make sure we're elevating you and growing you. So with that said, I would

 

I would definitely look at your tech stack right now. I'd look at the vendors you're using and see, am I using the supplier up just because I've always used them? Or is it because they're the best of the best and I'm always getting the best deals? Are my supplies at 5% or not? What about my labs? Are those at 9% or less? If not, if I need to talk to other dentists, find out who the best lab person is, what are their fees? I had a financial advisor that I was paying one and a half percent. You guys might be losing your eyeballs. I was too. Got it down to point eight percent. Met another financial advisor who works with much higher net worth people.

 

0.25%, better quality, better services, better rate, but that came from talking to people. That person's not advertising themselves. They're only taking on certain clients. And this is what I found is when you get into those elite levels, they're not there massing and marketing to the masses. They are literally held back and people only refer their best of the best. Like there are certain people that I will not refer publicly anymore. But if I know you and I know this person's going to benefit you, I will refer. But again, it's because I know only a certain clientele that person will take on.

 

So I can't just say like, go meet Johnny. No, it has to be that. So again, look at your vendors, look at your platforms and see are these maximizing me? And if not, might be time to make a change. So I would really recommend you to look at your current vendors and ask who's helping us grow and who's simply providing a service. Now, simply providing service can be totally fine, but I just want you to reevaluate it. So there's three tiers of partnerships, right? Number one is our dental referring partnership. Number two is our advisory board. And number three are our vendors and our suppliers.

 

And looking at that to see of all these people who's helping us. So I want you to remember your network is your net worth. Be surrounded by people that are smarter than you. If you don't have a group of dentists that wrote grow you, inspire you, make you smarter. Like we just had a mastermind back in February. We're about to have another one in September. And it was fascinating because people took ideas from that of multi-million startups.

 

And they implemented it. And it's been crazy to hear over six months how people talk about these implementations that they learn from each other. We had another one. We have a monthly mastermind. They were talking about AI. So many people were able to get AI tips and tricks from each other by being a part of it. If you are the smartest person in your group of friends of dentists or your advisory board, you need a bigger pond to swim in. I hope you heard that. You cannot be the smartest one in the group. Go get a bigger group. If we can be that group for you, amazing. Our dentists share with each other. We meet every single month, we meet twice a year in person, and you have a consultant.

 

That literally comes to your office or works directly with your team. Like, what more could you ask for? This is what I begged for as an owner, and we've created it for you with the best of the best. People that want to give, want to make you successful. And you are not in a room where people are better or worse. Everybody's equal. Everybody has something to give, everybody has something to take, and that's what we're here for. Be in a group of people. Your network is your net worth. And I want you to always remember that. So look at who's in your corner. Are they helping you build your practice?

 

Do you need to maybe make some changes? Do you maybe need to elevate your friendship group? How can we get these partnerships? I would go look at these three areas. Get a referring partner that's in dentistry. Get an advisor and check your vendors to make sure all of them are benefiting you. And hey, if we can help you out, reach out. Hello@TheDentalATeam.com. I'm obsessed with you guys. I'm obsessed with making your life easier. We're obsessed with being the best of the best of the best for you. So reach out. I'm happy to help you in any way possible. Whether it's just a friend, maybe like Kiera, who are those referrals? Well, depending upon who you are, maybe it is.

 

And I don't say that to say I gatekeep from people. I say that because I genuinely value the relationships I have. I will not put anyone on the podcast unless I've vetted them. I do not share people unless they're the best. And I have to own that sometimes they could be the best when I first put them on the podcast and they no longer are the best. And that's just how it works. I believe that businesses every single day, we have to win our patience over, we have to win our reputation over, and we gotta continue to stay the best or we will be be out. And that is something Dental A Team is very committed to. So

 

If you don't have someone on your advisory board that you know you can bank on who will give you the no nonsense, no BS answers, I'm here for you. So reach out. Hello@TheDentalATeam.com. Go make the changes. Get your strong net worth. Get a little more brave. Like be like my friends. And I'm going to take notes from them too. All of us are here. And I want you just to be 1% better. Not perfectly better, but 1% better. You can do it. Your patients need you. You need it. And it's very helpful to have people that you know you can count on when things don't go right.

 

And you know you can have people that can celebrate you when things do go right. So get that net worth. I promise you it's worth it. Go reach out. Let us know if we can help you in any way. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.

 

So you have the basics down on practice organization and systemization, but still manage to fall short of your goals? Tiff and Kristy discuss the three most common pitfalls plaguing these offices, and how to climb out of them with clear, tactical guidance.

Episode resources:

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Transcript:

Tiffanie (00:01)

Hello, Dental A Team listeners. I am so excited to be here with you today. I say that every single time, and I really truly am. This is Tiffanie or Tiff or Spiffy Tiffy, whatever you want to call me, with the Dental A Team. And we are here to bring you some incredible tips and tools today. And I've got my girl Kristy here with me today. She is, on the day of this recording, my Monday morning spice up, is what we'll call it. Kristy, I just told you to, but thank you for being my Monday girl. I really love starting my week.

 

with you, honestly and truly. So thank you for being here, Kristy. And I hope that you're excited. You came off of a restful weekend, it sounds like, which is incredible. how is how's life?

 

DAT- Kristy (00:42)

Yeah, I love that too. Thanks for being my Monday kickoff. So it's a good week. Hey, weather's cooling off. It we got some rain. It just it felt

 

Tiffanie (00:51)

Finally. Yeah.

 

DAT- Kristy (00:53)

like a staycation kind of weekend, watch movies, spend time with family, play games. So it was it was a good weekend. Yeah.

 

Tiffanie (01:03)

I love that. It is finally

 

cooling off and it's like our fall. Arizona gets like a mini fall. It'll get warm again and the rain will

 

DAT- Kristy (01:11)

Yeah.

 

Tiffanie (01:11)

dry up. But we love it. We've got like Halloween decorations going up and it's you know early, early in the in the month right now of recording this, it'll drop sometime in October. But it's fun to see all of that stuff start churning. And then as we travel into offices, I think Kristy, this is my favorite time of year to travel.

 

Because we don't get a lot of fall in Arizona. It goes straight from hot to like probably other people's fall, but our winter are like sixty five, you know, to fifty.

 

DAT- Kristy (01:41)

Yeah.

 

Tiffanie (01:42)

so when we travel and we get to see in offices, we love being in office with our clients. We absolutely love that. And we love getting to experience that fall. I think, Kristy, do you feel the same?

 

DAT- Kristy (01:52)

Yeah, I agree with you. We don't we don't see the leaves of the trees change color like a lot of the world the rest of the country does. So yes, it's very fun and to feel the difference in the different climates. So agree with you one hundred percent.

 

Tiffanie (02:05)

Yeah. Yeah.

 

Yeah. I was in Pennsylvania last week actually and yeah, and I was so excited and I usually go in December and I get there on like their first snow and I'm freezing cold and it's chaotic. But this year we decided to do the visit in September and which was perfect. And I got there and it was beautiful, perfect weather, and then it rained all night and the next morning was like

 

fifty two degrees and I was frozen.

 

DAT- Kristy (02:38)

Pretty.

 

Tiffanie (02:38)

I could not warm up for the entire day. And all the all the ladies at the office were like, Here's Arizona. Like you're just freezing your tail off. So it was fun,

 

DAT- Kristy (02:44)

Yeah.

 

Tiffanie (02:47)

but it was cold. It gets cold real fast.

 

DAT- Kristy (02:51)

Agree, one hundred percent. Yeah. The only bad thing is sometimes we don't carve out enough time outside the offices and then we don't get to enjoy it either. But it sure is fun while you're driving in and flying

 

in to see the different colors. So

 

Tiffanie (03:01)

Yeah. Yeah.

 

I agree. I ended up there were some communication tower issues with a couple of airports and so my flight had ended up getting completely cancelled, which is a little concerning. flying and and whatever. But I was, you know, just hellbent on getting to that office. And so I found another route and I actually flew into JFK, which was like a two hour drive. So when I got there it was night, I didn't get to see anything. But then when I left on Wednesday, just seeing the countryside out there is

 

so much different than anything we have on this side of the country. So driving the two hours between Pennsylvania and JFK was pretty cool. We have a we have a cool gig over here.

 

DAT- Kristy (03:41)

gonna say I love how you found the silver lining in that.

 

Tiffanie (03:43)

Yeah.

 

Yeah. And I've got finally I found the Yankees hat that I have been searching for forever in the color that I wanted. So that and then it was at the airport. I didn't even have to leave the airport. So wins all over for last

 

DAT- Kristy (03:57)

Win win.

 

Tiffanie (03:57)

week. Yeah, it was great. and actually the content that I want to chat with you about today, Kristy, is something that came out of that visit, honestly. It was something that I've been working with as practice for a really long time. Like honestly, I think.

 

like seven years or so, almost seven years. So we've done a lot of meetings. So these meetings continue to evolve. And we've always had some team turnover. Obviously I think everybody has team turnovers. So you can go through handoffs, you can do all of the things kind of like that back to basics. You end up doing that frequently with practices that have turnover. But this team actually

 

Has been pretty stable aside from a couple of front office positions, and they've gotten really good at training the team. This is the first time I walked in. I like I told them I was Mona Cry because the new team members that had only been there like between two to six weeks knew ICRP and NDTR handoffs. And I was like, what the heck? This is incredible. I don't have to talk handoffs for the first time in seven years with this practice. so with all of that though, we had I really had to dive in and dig deep to figure out, okay.

 

How do we level up from here? When you've got the basics pretty much down, but you're still, there's still just those areas where we're trying to increase, level up, or really hit those goals without thinking about it. I took a step back with them and I I made them dig in and think, what is the root cause of why we're not hitting these things if we have the systems? Like I'm not coming in every single time. And Kristy, I know you feel the same way when you've seen a practice for so long. There's

 

Only so much you can innovate and create a new system around and create this new fun, like, okay, let's do it this way. Sometimes we've got to go backwards and say, we already have all the systems. Now we've got to figure out what is it about the system that maybe isn't helping us reach that goal. And so we kind of came up with this thought process. I came up with this thought process around it of.

 

like

 

the three maybe three key things. I feel like one to three is like easy for us to remember, right? So I thought, is it a knowledge gap? Like is this system, do we not know how to use it? Do we not know why? Do we not know the steps to it? So is it a knowledge gap? Or I think the biggest knowledge gap that I found with them actually, Kristy, was like not knowing what the end result was supposed to be. And maybe so then it tied into okay, knowledge gap tied into may is it a systems gap? So does the system

 

need more information in it. Does that need to be tailored? Does it need to be leveled up itself or does it need to be recreated? And then is it an execution and accountability gap? So maybe

 

DAT- Kristy (06:37)

Mm-hmm.

 

Tiffanie (06:38)

we know how to do it, we know why it's got all the pieces, the system's clear, it's good, but we're just not using it. And there's no one like following up and holding accountable. So it really transformed a ton. And I wanted to chat about that a little bit, Kristy, because I think both of us can see

 

How work can get so stuck. And we just we feel like maybe we're running the rat race and we're on that wheel that's just spinning. We're not actually getting anywhere. Or sometimes I describe it as I feel like I'm just like hitting my head against a wall, but still doing the thing and running the definition of insanity, not necessarily taking a look back at it. And I think a lot of our doctors, Kristy, a lot of the doctors actually that you work with that we send over to you because I think you're really good at diving into this. Thank you for that.

 

I think that's one of those three things where they're stuck and they just don't know how to push forward. What are your thoughts, Kristy?

 

DAT- Kristy (07:31)

Yeah. Yeah,

 

I agree with you. I like how you simplified that down to the the top three reasons because I I truly believe it it does stem from that. the knowledge systems and execution again. But I always like to say if we're not getting the results we want, let's take a step back and look. all of our systems are pretty much a recipe, right? And did we stop following the recipe to a T?

 

Like somewhere along the line, we just threw out this step or forgot about this step or stepped over that step,

 

Tiffanie (08:07)

Yeah.

 

DAT- Kristy (08:08)

and now we're not getting the same results. So truly simplifying it and stepping back and going, is this still our recipe? And are

 

Tiffanie (08:16)

Yeah.

 

DAT- Kristy (08:17)

we following it? And if not, why not? What got in the way? Right. And then also, if we did follow it to a T, kind of back to what you said, Tiff, sometimes we might have to get a new recipe.

 

If we followed

 

Tiffanie (08:29)

Mm-hmm.

 

DAT- Kristy (08:30)

it to T and it's not getting the results, we may have outgrown that recipe. And so coming

 

Tiffanie (08:35)

Yeah.

 

DAT- Kristy (08:35)

up and having that communication, again, just taking that step back to really look at it. And I know there's studies out there for communication. They say, like, in the high 90% of most communication is understood out of the gate. So perfecting, I mean, we do a lot of talking every day, but still.

 

We have room to perfect even that communication. So I love how you said painting the end result, especially for our leaders and doctors. Like a team needs to really understand what is that end result we're looking for. And sometimes they don't have to have every single step lined out along the way. We just got to keep pointing to that end result. But if not, let's

 

Tiffanie (09:24)

Yeah.

 

DAT- Kristy (09:24)

pull out our recipes.

 

Tiffanie (09:26)

Yeah. I love that because you made me think actually of the recipe. I made bread yesterday. I have a bread maker. I'm not like one of those I can't, I don't have time for sourdough yet. I really want to learn how to do it. And I think it's really hard in Phoenix from what I hear. So kudos to everyone in Phoenix who's making sourdough because our weather does not do well with that. So, anyways, I have a bread maker. I have had this bread maker for I ten years.

 

You know, eight years somewhere around there, I would say a long time. And I have always just used the recipes, right? I've always just used the recipes. And I always have a little extra flour. Like I'll pull it out and I'm like, gosh, there's like crumbles, you know, and the crust is like fine. And I'm like, whatever. Like it's tastes good, right? And the inside of the bread's great, but the the crust is just like okay and it's a little misshapen. I'm like, whatever. I guess this is what it is, right? So let me just tell you yesterday.

 

I thought there's gotta be a freaking better way to use this stupid bread maker for the last 10 years. I've been doing the same thing from the little booklet that comes with it. I take a picture of the bread maker, I pop it into chat chat GPT, and I'm like, how do I make French white bread? Like just tell me how to make French

 

white bread. So chat takes me through the same recipe that I've been using, but then it says, What I would do is within about 10 minutes, op like look at the at the dough, and if it looks like this, add water.

 

If it looks like like add a teaspoon of water, blah blah blah, right? One, I didn't even know you could open the bread. I thought, don't touch it. Put it in there, don't open that bread maker. Like it's gonna like, it's like race, you know? Like, don't let the steam out. Like, do not open it. So I've never opened the bread maker while it was going. Never, 10 years. And then I open it and I'm like, lo and behold, this sucker needs more water. And I added the water, the entire family, entire family, three kids.

 

Beyonce, me, we were like, what is with this bread? This is the best bread you've ever made. Are you kidding me? Ten years, Kristy. That is the definition

 

DAT- Kristy (11:26)

Ha ha

 

Tiffanie (11:27)

of insanity. And that's what it makes me think of. Like, are we not opening the lid of the bread maker and seeing, is it dry? Is it too wet? Does it need more flour? Does it need more water? Like we're we're making a system, putting it on pen and paper, typing it up and saying, This is the system, this is how we're gonna do it. So go execute and do it.

 

And

 

we execute, especially for an office, I love you, but we're really good at being like, Well, that's the system we're gonna do it because we're busy. And so we don't oftentimes like open the bread maker and be like, Well, are we getting that result? Like, is my bread lumpy? Do I have leftover flour? Like sometimes it's even like a little like flour burnt on the side, and I'm like, whatever. I guess that's how this works, right? But sometimes it's like, well, we like.

 

didn't quite get the result that we wanted and maybe even burned a couple patients with what we were doing. But this is how we're supposed to do it. So we don't open the lid and think, what if I what if I add something, take something away? Like what if I just manipulate it a little bit to get a better result? And Kristy, your your recipe definition, that's what it made me think of because this practice, one of their goals that we set up, one of their quarterly rocks we set up for them was they really wanted to increase the

 

percentage of new patients coming from referrals because they're spending a ton of money in marketing and they're still not generating the new patients that they necessarily want. And they're down internal referrals by about 5% from what we want them to be. Kristy, you know what we figured out? Their referral gift, they had this great idea. I love the idea for the referral gift, but no one, 17 people in the room, like no one would knew the exact

 

verbiage or what the gift was. There's three choices for the gift. They didn't know, some of them didn't know they had the patients had a choice. Some of them didn't know that it was on the new patient paperwork. Some of them didn't know how to talk about it. And I was like, here we go. So we've got this really cool system that at some point we created, we're not getting the result that we wanted. And they almost revamped. They were like, well, maybe we need to give a different gift. And I said, well, is

 

DAT- Kristy (13:38)

no.

 

Tiffanie (13:39)

it the gift or is it that nobody

 

Does everybody know what the gift is? Like, do you know what the options are? And most of them didn't. So we left the system, but added the knowledge to the system and the clear, tangible result. Lifted up that bread maker and we're like, there's two options here. Nobody even knew about that everyone needed clarity on. So to your point, Kristy, that recipe just needed like a couple of tweaks. And now they've moved from knowledge.

 

They gained the knowledge on what the heck the system was. They revamped the basics or they left the basics, revamped and added in the knowledge that they just gained to the system. And now they're at the execution and the accountability stage of it.

 

DAT- Kristy (14:26)

Yeah, I love that. And I love you know, we always have to take it one step further at the end and make sure we understand now, guys, now that we all are on the same page, how will we know if it's working? What will we measure and get aligned on that? And also to your point too, Tiff, sometimes it's it's well, many most times it's identifying who's gonna be responsible for which parts of the recipe too,

 

Tiffanie (14:53)

Yes.

 

DAT- Kristy (14:54)

right?

 

And I also, you know, most of anybody that's worked with me, they'll know I always talk, crawl, walk, run. We gotta crawl before we walk and then we run. So, you know, a lot of times if we're a young team that's learning to jive together, we're just learning to crawl. As we get into the deeper pieces, kind of like the team you were with, if they can probably do that stuff in their sleep almost.

 

Now how can we gamify it and tweak it to get a different outcome or get the outcome with better results? You know, because we've mastered the skill. Now how can we even make it work a little better for us? And what will we measure to to see

 

Tiffanie (15:39)

Yeah.

 

DAT- Kristy (15:39)

if it's working?

 

Tiffanie (15:41)

I agree. I love that because that was exactly what happened, right? They were like, okay, we'll do more. We'll ask for more. And I said, Cool, but what does more mean? Because a feeling

 

DAT- Kristy (15:49)

Mm-hmm.

 

Tiffanie (15:50)

of more, like if I'm exhausted today, I did more, right? I did all I could. But maybe it was none or one. The actual physical like

 

I'm gonna tally mark this on my sticky note. I told them like don't make it hard, like don't make it where everyone's gotta go in and fill in a KPI spreadsheet at the end of the day of how many patients they ask for whatever. Like don't make don't create blocks in a system that's already not being used. Create

 

DAT- Kristy (16:15)

Yeah.

 

Tiffanie (16:16)

ease.

 

And I told them just have a little sticky note. I don't care where you put it. Put it in your cupboard, put it in your pocket. And every time you ask for one, just make a little tally and then talk about it every day at the morning huddle. And once a week, we tally all of it together. And by the end of the week, you should have, as a team, asked for X amount of referrals. And then at by the end of the month, we should have gained an increase of X amount referrals. Now, then, Kristy, to your point, what that does.

 

It gives us the accountability piece, the measurable accountability, and it gives us the space to look back. So if my bread didn't turn out the way I wanted it to, if it wasn't perfect at the end yesterday, I could look back and think, okay, or ask chat, okay.

 

What did what should I have done differently? Maybe I added too much water because it was still too moist. Maybe it dried out and I added too much flour, not enough water. I could ch I could change it, right? Do the measurable pieces. The measurable was a teaspoon of water, you know, every couple, every 30 to 60 seconds and watch how it separated, right? And how it rolled into a ball. Again, I didn't even know you could open the lid. This is how wild things get. Okay. This is real life.

 

And the measurable was the teaspoon every 30 to 60 seconds. Complete as far as you think you can or should. And then what does your bread look like at the end? So I feel like that's what systems are, like asking for those referrals, right? At this at these increments, and then looking back at the end and saying, did that get us the result that we wanted? Because if it did, great, we're gonna recreate. I'm using that method every single time moving forward on my bread, right? But if it hadn't, the next time I make bread, I'm gonna tweak it.

 

So

 

at the end of the month, if it didn't if it didn't gain momentum or six weeks, we really like six weeks to see a tangible result. So at the end of the six weeks, if we didn't see that movement and momentum on internal referrals increasing in our practice, we need to go backwards and say, okay, we need to increase the number that we're asking for weekly to get a different result. And we can again add a teaspoon of water. Like, cool, increase your frequency and change the result.

 

DAT- Kristy (18:24)

Yeah, I agree with you so much on that, Tiff. And truly looking at it, we in dentistry, I think so many times we pick out the systems where we have our pain points, and that's wonderful. We need to do that, we should do that. But also, you know, maybe once a month, just pull out your ops manual and start picking other systems too. Is this still relevant or not? Right. That's how we keep them alive.

 

And I think it's also important to celebrate the ones that are working well. We again

 

Tiffanie (18:55)

Totally.

 

DAT- Kristy (18:56)

we pick out the ones where we have pain points, but celebrating the ones that are working well will also let us repeat that, you know, and make sure that we're staying aligned to the system. So

 

Tiffanie (19:07)

Yeah.

 

I completely agree. I love to start the meetings with a what's working because if production is working, if collections is working, it's like great. What are the systems that you're using? I don't want to touch those. Like I want to make sure we

 

DAT- Kristy (19:19)

Yeah.

 

Tiffanie (19:20)

celebrate those. I want to make sure those are tangibly used. And then what we can do even from there, Kristy, to your point is cool, this one's working. How can we add maybe a different element to change this result over here? So we're not creating a completely

 

new system to change something else. It's like this is working. Use what's working and layer on top of it. If your if your collections, your production is working, but your new patients aren't, your new patients are down, awesome. Let's layer onto our patient experience referrals or review requests. Like we're not changing or reinventing an entire system. We're just layering on top. I love, I love, because I love ease.

 

DAT- Kristy (20:03)

Yeah. Easy.

 

Tiffanie (20:03)

I want it to be easy.

 

I don't want, I personally do not want to sit here working really, really hard in a million different directions if I can work hard and enjoy what I'm doing on a couple and get a really cool result.

 

DAT- Kristy (20:21)

Yeah, I agree with you, Tiff. And I think so many things we make harder than than it needs

 

Tiffanie (20:25)

Yes.

 

DAT- Kristy (20:26)

to be. So yeah, look for the ease, people. And usually it's very simple. It's goes back to the very beginning and and use that as a litmus test. Do we not have the knowledge? Is it we're not executing it, right? Or

 

Tiffanie (20:41)

Yeah.

 

DAT- Kristy (20:42)

where's our accountability factor in this? So again and and evaluate the system. Did we follow it? Did it call for a cup of flour?

 

And we used

 

Tiffanie (20:51)

Mm-hmm.

 

DAT- Kristy (20:52)

something else, you know, we used a quarter cup, you know. So just make sure that we're we're true to the system and then ease, ease, ease, ease. One one small thing can

 

make a big outcome.

 

Tiffanie (21:04)

Yeah. Yeah.

 

I completely agree. Same day, two different foods. I was meal prepping yesterday for the family. I made the bread. It was literally perfect. And then I was trying to make these like apple oatmeal like quick snack things. And I was like, it looks a little wet. I'll add more just on my own. I didn't ask anyone. I added more oat and they were so bad. So I was like

 

Okay, well that didn't work. So next time we add less oat, maybe add a little honey for some like sticky quality. But to that point, it's like what's working and what what went well. And then I was like, well that one over there called for a little ad. Instead of just following this recipe, I'll get creative, right? So it's like we can just take things out of context or move too far in one direction and not pay attention to the actual system or what worked well to get us there.

 

DAT- Kristy (21:56)

Yeah.

 

Tiff, I love that you recognize that because I always like to say, you know what? All of us who have been really great at being a treatment coordinator or biller or whatever, our biggest our biggest pivotal moment was the failure, truly. Like if I always tell my OMs or admin team people, if you have not missed a missing tooth clause yet, use of learning to do because

 

Tiffanie (22:25)

So true.

 

DAT- Kristy (22:25)

Truly,

 

sometimes, and don't, you know, I know it gets upsetting when we do miss the mark, but remember to find the lesson in it. Because I guarantee you, all of us that have been in those shoes where we missed a waiting period or a missing tooth claws, it probably only happened once because we learned our lesson. So

 

Tiffanie (22:43)

Yeah, having to call that patient

 

and tell them they actually owe $600 more dollars on the crown because that crown was only a year and a half old and we probably should have caught that. That's fun. Mm-hmm. Yeah, I agree. I'm like, I'll pay it. I remember the day that it happened. I'm like, what

 

DAT- Kristy (22:52)

Oops. Yeah.

 

Tiffanie (22:59)

how do I what if I just pay it? My doctor's like, my gosh, you're wild. But

 

DAT- Kristy (23:03)

Yeah.

 

Tiffanie (23:04)

yeah, I agree. I agree. Okay, guys. Action items. Kristy, this was so much fun. Thank you.

 

DAT- Kristy (23:09)

Mm-hmm.

 

Tiffanie (23:10)

action items are first off,

 

I say do what's working. I love a what's working, what's not working test. So what's working and what's not working? I describe what's not working. And if you're any of my practices I've been in office with, you already know this. What's not working is like what's hard, what feels like you're hitting your head against that wall or running the hamster wheel and not getting the result that you want. Just what seems difficult. So what's working, what's not working, and then the not working items assess awesome. Is it a knowledge gap?

 

Do we need more information? Do we need to know what the goal is? Is it a systems gap? Does the system have all of the clarity in it that you need? And if both of those are yes, or you get through both of those, execution. Is it an execution? Are we using it? And is there accountability attached? So I'd run those tests back through and figure out where are you stuck and how can you get unstuck? I

 

DAT- Kristy (24:05)

Love it.

 

Tiffanie (24:05)

love it. Kristy, anything you want to add?

 

You always have like a last minute mic drop.

 

DAT- Kristy (24:09)

No, and I I guess,

 

yeah, just one pearl of wisdom I guess would be on the not working. It could also be what you were talking about earlier. It might be what do we want more of, right? It might not

 

Tiffanie (24:20)

Mm. Yes.

 

DAT- Kristy (24:21)

even be not the not working part of it. It could be what do we want more of. So

 

Tiffanie (24:25)

Yes, I love that. Do a third. What's not working? I told you

 

there's always a mic drop. Kristy's mic drops. What's not working? Where are you stuck? Right? What is working? Where are you stuck? What's not working? And what do we want more of? I love it. Thank you, Kristy.

 

DAT- Kristy (24:37)

Love it.

 

Tiffanie (24:38)

Awesome. Okay, guys, if you are driving, play this back and listen to it again. Take some notes. We love you. We love sharing all of our gifts with you, all of our, all of our pearls, our wisdom, all of the things. So keep listening. Share with a friend.

 

Share with a coworker, a family member. I know a lot of doctors will send these to their teams, and I know a lot of doctors still aren't doing that. So send these things over to your teams, allow them to gain this knowledge as well. And as always, drop us a five-star review and reach out Hello@TheDentalATeam.com so that we can help you live your best lives too. Thanks, guys.

 

Introducing the Dental A-Team YES Operating System — a framework created after looking at thousands of practices to help you have predictable growth, profitability, and freedom. Hear from Kiera about why this approach will change the way you do dentistry (and improve the way you live your life).

The DAT YES Operating System:

Y: You

E: Earnings

S: Systems and Teams

Episode resources:

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Transcript:

Kiera (00:01)

Hello, Dental A Team listeners. This is Kiera, and I just want to talk to you guys about how we can say yes to more things. I call it the Dental A Team Yes operating system. It's truly a blueprint for profitable practices. And we've talked about it a few times, but honestly, it is just like what's a different operating model that we can go off of to have this profitable practice, but also to feel fulfilled, to have it more easy. Like great, let's do this. So I want you to know that this is a framework we created looking at thousands of practices, coming up with it, because I don't believe they're profitable practice.

 

is created by luck. I don't. I think that you can have it and you just need the right framework, the right operating system. And then you're gonna be able to to align, to guide, and to be able to truly say yes to everything you want. So I'm gonna walk you through our YES operating system. The Y stands for You. It's all about you first. That's the very first step. E stands for Earnings and S stands for Systems and Teams. And these are three pillars that are gonna help predict have predictable growth, profitability, and freedom for you. So I hope you're excited for it. I hope you're excited to say yes to more in your life. And hey, if you're new here,

 

Hi, I'm Kiera. Super nice to meet you. I'm obsessed with all things dentistry, so much so that my last name is actually Dent. Yep, I really am Kiera Dent. I love dentistry. I've been a dental assistant, treatment coordinator, you name it, regional manager, consulted hundreds and thousands of practices across the nation and the globe. And we are so committed to helping dentists truly reach their highest potential, empower teams, and make life and running a successful practice easy and fun again. That's what we do. I'm obsessed with it. We do startup to multi-million dollar organizations, no matter the practice size.

 

Things are still the same. The YES model works for all of you. So I want you to know that a lot of times we're focused on production or marketing or this or that. But a lot of times if we just get our whole team aligned, everything falls into place. And I'm not saying that you have a vision and everything works. And we to put in the action. Like we got to put in the effort. Your practice does appreciate effort. But I want to help you build a very successful business that's going to support both profitability and lifestyle because you don't have to have one without the other. So the Y stands for You. This is your vision. This is you.

 

And I think so many people skip over this and dive right into the numbers. And I purposely put it in this model. You are not going to say yes. You might say say S-E-Y. Guess what? You're not going to get everything that you want. You won't. Because if you focus on you first, like it took me forever to come up with this acronym. I kid you not. We're going to do the SPF, then we're going to do the this or that. I was like, what is it? Like, what order do these need to And then I was like, my gosh, it's YES. You Earnings Systems. Because we got to make sure that you are dialed in. And I tell everybody when you start with us as a new client.

 

We focus on what is your vision, personally and professionally, because your business has to have it. I don't care. Like I just had a dentist I was talking to yesterday and she's like, I want to work three days a week. And I'm like, great. Let's put it on the board. Math can math. That's why Earnings comes next. But if I don't know where our North Star is, if I don't know where we're going, then we're constantly changing our goals. Growth doesn't feel fulfilling. You're running around like a crazy operator rather than running the business. This is what's happening. Like I want you to own your business, not be owned by the business. So number one is you gotta define what success looks like for you.

 

Two, what do we look like? What's our one, three, ten year vision? We work with this, like I pull off of traction. What is it? Nothing is off the table. I don't care what it is. But you also have to realize that, like, hey, if I want to cut down to three days, are we also okay to make less money? Or is like, no, I want to work three days and make the same amount. Okay, well then maybe we need to change up our procedure match. I can't just be like, I want to make two million and work two days a week. Okay, great. Like you're doing bread and butter dentistry. Like math has to still math. So let's figure out how we can get there. Maybe you gotta get some side hustles, maybe gotta get some real estate. I don't know.

 

But hey, everything's there, nothing's off the table. We do need to make sure we back it up with realistic numbers. I remember my financial advisor gave me a crazy goal and I was like, there is no way. Like, I don't know how I'm ever gonna do it. Guess what? You chip away, we chip away. We have that as our north star, guiding star. Everything will come into place. So I want you to know that like this works. If you're if you don't have a vision and you're not anchored of where you're going, and then second to that, your team knowing where we're going.

 

All of this doesn't work. We are working for nothing. We're working for ego. We're working for stress. We're working for shoulds. We're working for what everybody else is posting about that they're doing. You're not working for what you actually need to do. And so I want you to know you is number one. You being fulfilled, you being taken care of, us knowing what you actually want it to be. And then I need that like tattooed on your shoulder. I need it to be put on a mirror. You've got to look at this freaking vision every single day because where we focus our attention, we're actually going to achieve it. So we can't build the right practice unless we actually know what we're building for. So

 

I need you, if you're gonna have a profitable practice, we gotta know where our clear vision is. What does profitable mean for you? Then we're gonna back it up and make sure that it's realistic. So I want you today, if you haven't, go on a little vision building adventure with me. Let's go right. What's your one year? What's your three year? What's your ten year? Ten years from now, how old are you gonna be? Wow, that feels like a moment. Just think in 10 years, it's gonna slip by. You either can actively create it or you can passively manage it.

 

Your choice, but I'd highly recommend that you create it. Step two is Earnings. I know, I know, you're waiting for me to get to this part. You just want to talk about this part. Don't skip step one. So Earnings. This is our profitability. So revenue alone isn't going to create your wealth. Profitability does. I don't care what your top line number is. I care what your take-home pay is. I really do. I want you to all your expenses, including paying you. I want you to have 20% left over after we pay tax and everything. Okay? So if we can figure that out, great. That's our ideal. That's our benchmark. That's what we're striving for.

 

So what happens oftentimes is people are so obsessed about not looking at the numbers so they don't look at anything, or they're so obsessed about like just only focusing on their production number. Like I had a doctor tell she's like, I'm at two million, but her collections are at one million. And I was like, yay, I gotta be the person that tells you you have a $1 million practice, not a two million. Hi, I'm Kiera. Nice to meet you. the reality is, like, I know you don't want to hear this.

 

But I also know that we've got to know what our true numbers are and what we're going towards. So once I know your vision, we then break it down. This is what we do with our clients. We break down what does that actually cost us? What does it cost us to run the business? What does it cost us for you to live? What is our debt services? What's the vision we're working towards? You're not gonna be there today. We know in 10 years you wanna be making three million, fantastic. We you know you wanna be at five million, fantastic. Break this down production-wise. Now it's easy for a practice because I can just plug and play, put that in there. But if we're building your personal life too, we need to know what that has. I will also say.

 

If your business can't support that, it's not your business's fault. You either need to readjust or produce more or have another side hobby that brings income. All of it's true, but we just we gotta make sure. I had a doctor once tell like, here, I need to make more. Well, they weren't willing, like 50% of the revenue coming through they were spending on personal items. Yeah, that practice couldn't support it. Like they their lifestyle was too expensive for the practice that they were doing, and they weren't willing to do more work, they weren't willing to bring in more patients, nothing. And I was like,

 

Okay, the math doesn't math. Like I know you want to spend this much, but like you're you're out of your budget. So and you're not willing to make a bigger budget, like we either can cut or got to produce more. It's one of the two things. or we gotta collect it. So when we look at this, I really want you to dive into knowing our numbers. We're talking our our net, not our gross production. What are our collections? You should be sitting at 98%. What's our overhead? Ideal, like I said, ideal is 50% overhead, 30% doctor pay, 20% profit. That profit then pays our debt services, leaving us at the end.

 

I would love, love, love for you to have 20% profit, profit, profit at the end. Like that's our cash flow after everything's paid, all of it, have that hanging out. That's an optimal practice. Not all practices can achieve it, but that'd be optimal. What's our payroll? What is our our hygiene period production? What are those items? Like, let's look at this. What's our case acceptance? Sometimes it's not even an issue. Maybe we're just not diagnosing enough. But what does it tell us? So, like if I know that we need to build a $3 million practice, I then need to make sure that we're producing enough.

 

Create that three million and then we need to make sure we're collecting enough. So, what are my levers in that? Well, levers are case acceptance, diagnosis, hygiene, and scheduling. Like those are pretty much it. And then obviously collection. That's really yeah, I can get marketing in there, but if I don't convert my new patients and we're not converting case acceptance, whoop-dee doo, like could be an issue, but can we maximize our patient base that we already have? That's a great question for us. So focus on these items so that way when we have it, we can actually make sure that the plan is leading up to our vision.

 

You don't feel stuck. And then we also got to build in our staffing, our payroll. Like if you're doing all the pieces and you're miserable with it, well, what's it gonna cost us to hire an office manager? Or what's it gonna cost us to hire two more dental assistants or another hygienist? Let's build that into our plan. That way our practice can produce it. We can afford it. The great news is dentistry's untapped. Dentistry's untapped. So this doctor has talked to you as like, okay, your cash flow, you just need 10,000 more a month. Let's break that down. You're working four days a week, 16 days a month, that's six hundred and twenty-five dollars a day.

 

That's a night guard. That's like a couple ceilings, couple fillings. It's nothing to make ten thousand more a month. You can do it. This is what is awesome. Like, so whatever your goal is, we just break down by your daily goal, get your team rallied, look to see where we could find this amount. You're back in business. So production is super important, but profitability gives you options. And profitability, we need to make sure that you're profitable. I don't care what your top line is. If you're not profitable and you're not paying for your life, you're miserable.

 

So that's why what is your top line? And then what is our profitability? And do we like do those match? So what we do with our clients is we actually put them through, we build out an annual plan with them. So excited. So excited. It's in the beta role. We've been doing it. And now we actually have it like really there. Shout out to Britt. She's been working hard on this. but we go through, we look at all your expenses. What does it cost for you to have it? What is your practice producing? What do we need it to produce every month? Maybe we need to get our doctors to be a little bit higher, a dollar per hour. Like, great, you can do that.

 

There's a lot of options. Maybe you don't want to. Great, then let's go cut. I always do it. It's like what is it? What can we really do? What's the cut? What's the actual production? Let's go. Let's live our best life. So I want you to truly like taking away from this, get your vision, then review your profit margins every single month. Get into it. Should review it every single day. But I want you looking at the profit margins, not just your production numbers. Then this leads us to the S, the Systems and Team Development.

 

This is going to be your engine portion of this, okay? So based on our vision, then what did the numbers tell us? Now it's our systems and team. Based on whatever our numbers tell us, that's a system we're gonna go put into place. It might not need to be all the systems. Everybody's like, well, what systems do I put into place? I'm like, I don't know. What's your vision? What do the numbers tell us? Put that system into place. I know you want it. I know you want all the systems, but why? You're probably doing so many things great. If our vision is this mount, our numbers tell us this, we can fix a lot through a morning huddle, we can fix a lot through handoffs.

 

We can fix a lot through just your hygiene department. We can fix a lot through your production. We can fix a lot through your leadership meetings and how you guys are doing it. We can do a lot through hiring and onboarding. I guess those are all important, but like what does it tell us? And then also what are your pain points? This is also where we're developing the team. I found that so many people focus only on the doctor. And I'm like, cool, that's fun. But why don't we focus on you as well? Like, let's make sure that the team is elevated so you, doctor, don't have to go tell that team everything to do.

 

We literally coach your team for you. We create office managers. We build leadership teams. We teach your team how to talk about hygiene. What do we do when we got a bloody period patient? Great. What do you do when your fee schedules aren't completely entered? Fantastic. Let's teach that person. Let's help your team actually be optimized based on what the numbers tell us, based on your pain points and where the ultimate vision is. I hope you can see that all this comes together. This is why it's called the YES operating system. It helps you say yes to more in your life. It helps us see what systems are broken.

 

A lot of people come in and they focus on systems hoping to get to the top. But I'm like, no, let's focus on the top. Where are we going? What your life is. Let's look at the numbers because they're going to tell us everything. I can just look at the numbers very quickly and tell you if you're diagnosing enough, if you're producing enough, if we're collecting enough, if our case exceptions there, just by looking at your PL and your KPIs. It's all there. And then let's go fix the systems over here. Sometimes you're overwhelmed. Well, that's not going to show up in your numbers, but what it will tell me is we need to fix that. We need to add.

 

An office manager or somebody to this plate, or we need to grow your office manager into the person they need to be in order for you to have the successful life that you want to have. I really truly want you to know that like your systems and team development can happen when we know what the vision and the numbers are. You're probably doing it in the reverse order, and that's why you feel like you're trapped and stuck. Because you're trying to focus on systems, you implement the system that you heard on the podcast that doesn't get you the numbers that you want, and it doesn't ultimately get you to the vision you want. So then you're frustrated and you're like, well, the systems aren't working.

 

So then you put in another system to try to get the numbers you want, to try to get the per the vision that you want. Instead, let's rework this. I would like you to have your vision, look at your numbers. Wherever your numbers are down, let's put that system into place and see if we get closer. Teams don't want to be micromanaged. Teams don't want more systems on top of system upon system upon system. Teams want to be like why. They want to understand the why. And then they're gonna rally with you. So look at that. Look at your vision.

 

Look at the numbers and identify one system that needs to be improved. Go listen to podcast on it. I promise you, I got the how-to for every freaking system that you've ever wanted to put into place. Systems are not your issue. Your issue is that you don't have a clear vision and that you're not looking at the numbers. So you're scrambling at all your systems. This is why, if you put it in the YES success framework model, go from You to Earnings to Systems. You literally can say yes to everything you want. So, what I'd love for you to do is to focus on all three of these. Most people just focus on one, do it in that exact order.

 

You're going to be able to say yes to more. Because when your vision and your profit and your systems work together, growth becomes predictable, stress becomes less, happiness becomes more, team morale improves. This is where it's at. This is what I love to do. This is something of like, how do we help you say yes? This is what Dental A Team is built upon. This is our framework. This is our foundation. And so many people struggle because they're not willing to do the vision. They're not willing to look at the numbers. They only want to focus on the systems or the team development or say it's my team or say it's my system. Or if I just had something better, well, here is something better.

 

And I hope you take it. I hope you execute it. I hope you implement it because I know that you deserve to say yes to everything you want and more in your life. I think back to where I was six years ago. Wow, company was so small, so tiny, like so many things. And I look to where it is today. Yeah, it's so stressful. But guess what? I'm able to say yes to a lot more in my life. I've aligned my vision. I've hit pieces off of my goal board. I'm living the life that I dreamed of living like not too long ago. You can have that too.

 

So come be a part of it. Come be a part of our community. Come hang out with us. Be around people who truly say yes to more in their life. You deserve it. So the good news is this is available for all. You don't want to be a certain size practice. It's available for all. So put it into play. Align your vision and we help you. We help you identify what your vision is. We help you look at your numbers every single month. Sometimes you just need a freaking accountability partner. I need that like, hey, be my bestie. Hold me accountable. Sometimes that's all you need.

 

And also that bestie who's been there, done it, done it multiple times over and successfully grown practices. That's who we are. That's what we do. And this is what we do all day long. So let's help you say yes to more in your life. Commit to saying yes and living the life that you absolutely deserve, not just the one that you think you should have. I promise you it's there for you. Follow our yes success model, and I guarantee you you'll be so much happier. And I can't wait to help you. Reach out Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team Podcast.

 

Kiera is joined by Sean Hamel, CEO of Art of Dental Marketing, to talk about … yup, dental marketing! Sean goes through why dentists struggle so much with messaging, what the right language for patient referrals is, how to make your practice stand out from that other practice 0.2 miles away, and a ton more.

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Transcript:

Kiera (00:00)

Hello, Dental A Team listeners. This is Kiera. And today I have a very special friend back on the podcast, Sean Hamel. He and I actually worked together. He worked in Dental A Team for a hot minute. he is a CEO and founder of the Art of Dental Marketing. He is here to talk about all things of what works, what doesn't work. I shoot, guys, you guys know marketing is my Achilles heel. So I get really smart people in the industry to come on the podcast, talk about it. So, Sean, welcome to the show. How are you?

 

Sean Hamel (00:25)

Thanks, Kiera. Good, thank you. It's always good to see you. I that was when when was the Dental A Team kinda overlap? That was like four or five years ago now. Crazy how time flies.

 

Kiera (00:33)

I know. It

 

yeah, because we were doing an event. So I think it was like three, four years ago, and we were going through like

 

Sean Hamel (00:38)

Mm-hmm.

 

Kiera (00:38)

a rebrand and I still have emails from you and like campaigns that we worked on together. So it's fun

 

Sean Hamel (00:44)

cool.

 

Kiera (00:44)

that we've actually like worked together and now here we are. You work with all the dentists too. So yeah, but it's been a hot

 

Sean Hamel (00:49)

Absolutely.

 

Kiera (00:50)

minute and now here we are podcasting again together. So here we are.

 

Sean Hamel (00:54)

Absolutely, always good to see you.

 

Kiera (00:56)

Likewise. Okay, Sean, for those who don't know you, tell them a little bit of who Sean is, how did the Art of Dental Marketing come about, and w like why you we should even listen to you today. Like basically pitch yourself.

 

Sean Hamel (01:07)

Absolutely.

 

I know there are so many dental marketers. It seems like every day there's like 20 or 30 more, probably more than that. But I started dental marketing about 15 years ago. I was purely accidental. I have a degree in marketing, graduated, and in doing that, got a job it for a dental financial services company basically running their marketing and was meeting a lot of doctors and making friendships with a lot of doctors.

 

And nobody tells you when you graduate school with a marketing degree, but you suddenly become all of your friends and family's like resident marketing expert. And

 

Kiera (01:41)

Yeah.

 

Sean Hamel (01:41)

so one of my buddies was graduating from dental school, and another buddy of mine was having some issues with SEO in his practice. And so they just kind of asked me some general questions. long story short, helped them choose some solutions, wasn't really amped about any of them, but you know, tried to help them make the best decision they could, and they didn't get great results.

 

and so I started helping them and using story-based marketing, which is a big piece of what makes ADM different, we were able to get them really solid results and they gave me a lot of grace to try things. And over the course of doing that, we were able to get really good results for them. And so in doing so, other dentists that were their peers and friends and things started asking, you know, who's doing your marketing? And so I started to get more and more clients. to now, you know, 14, 15 years later, we've worked with

 

hundreds and hundreds of doctors. and I travel all over the country speaking and teaching doctors about why dental marketing largely doesn't work. most of the time here it's a messaging problem. But why dental marketing doesn't work, why no matter who you seem to hire, you can't really get results. and also just kind of talking about why the industry is tilted in a way that it's not really set up for doctors to be successful and they have to kind of learn as they go how to vet, how to properly seek out help.

 

And then even how to monitor the people they're paying to help them to actively get results. Cause that seems to be the biggest issue for doctors is I hire seven marketing companies and nobody can

 

Kiera (03:10)

Mm-hmm.

 

Sean Hamel (03:11)

get results.

 

Kiera (03:12)

Okay, so dig into it. You pitched me, well, I'll listen to you, Sean. Why doesn't cause selfishly for myself, I'm in the same boat. I'm like, my gosh. Sean, I looked at my numbers. This is gonna be fun for you. We decided to do a revamp. I've done this twice. So this is

 

Sean Hamel (03:25)

Mm.

 

Kiera (03:26)

year two that I'm trying this. Like I did it a couple of years ago and then I was like, forget that. That was a really that was a five hundred thousand dollar mistake. This year I'm up to a

 

Sean Hamel (03:32)

Mm.

 

Kiera (03:32)

seven hundred and fifty thousand dollar mistake. Like I don't know if it's

 

Sean Hamel (03:34)

Mm.

 

Kiera (03:35)

a full mistake, but it is like it just feels like this bottomless pit in marketing. It's like

 

Just keep pumping more money into it and hope and pray something works out. And then you re-pivot the strategy. And then it's like, okay, it's gonna take three more months to do it. So I am equally piqued. We have a great CRO on our team now that actually I've seen more results than I've ever seen. But it's like

 

Sean Hamel (03:52)

Mm.

 

Kiera (03:54)

that's hundreds of thousands of dollars. Like I just listed Kiera's dirty laundry on the podcast 500,000 two years ago, 750,000 this year. Our marketing expenses are up by 350,000. So enjoy that.

 

Sean Hamel (04:04)

Mm-hmm.

 

Kiera (04:04)

Like those are some big numbers. And so I don't want any of you dentists out there being like, my $50,000 marketing is expensive.

 

Listen, all y'all, I know what this is. And also don't tell me consulting's expensive. Like I've gone through, I paid 250,000 for Tony Robbins. Like there is expensive consulting and then there's also just like it is just a a good fee. So Sean, talk to us. Talk to me. Hi, I'm Kiera. I'm your I'm your client today. Tell us why doesn't marketing work and how do we actually get it fixed?

 

Sean Hamel (04:29)

Well, and and d for dentists specifically, you know, dental is so unique. your issue with which is selling two dentists is a lot of times a messaging problem too. but as far as it relates to dental practices specifically, I talk about what I call the cycle of mediocrity, but it basically is what I've kind of drilled down over over a decade of doing this, working with hundreds of offices. And I talk about it in depth. I'll kind of give you the the cliff notes because it is a very

 

long conversation. I know we're trying to stay

 

Kiera (04:59)

Okay.

 

Sean Hamel (05:00)

like under 30 minutes here. But with dental practices, largely what happens is everybody looks the same. So if you pull up, you know, five dental practices, everybody looks the same. They say the same things. They're hiring marketing companies that are selling very like generic templated things. So everybody looks the same. It's all hyperclinical. You know, everybody's trying to to chase the same people.

 

While they're all looking the same. And so because of that, Kiera, the only way the marketers know how to differentiate the businesses is with discounts. So

 

Kiera (05:30)

Mm-hmm, mm-hmm.

 

Sean Hamel (05:31)

the the practices, because everybody's so close together and they're all saying the same stuff, they get locked in these price and proximity battles. So they're fighting over how can we how much can we outdiscount the practice next to us? They're being advised by industry leaders, industry leaders to do

 

Kiera (05:46)

Mm-hmm.

 

Sean Hamel (05:47)

new new patient specials constantly.

 

And then a lot of it too is just, hey, this practice is 0.7 miles from my house. This practice is 0.9 miles from my house.

 

So

 

Kiera (05:55)

Totally.

 

Sean Hamel (05:56)

you have you have those kind of decisions happening, but you get locked in price and proximity battles, which leads to what I have kind of coined as what I call the freebie trap. But the doctors get conditioned that they have to give away what they do in order to be successful.

 

Kiera (06:09)

Totally.

 

Sean Hamel (06:09)

It's not super helpful because that means you got to do more dentistry to make up for it. And when you're battling on price, that's all you're giving people. That's the only thing they have to make a decision off of.

 

But those price and proximity battles, getting in that freebie kind of mindset and constantly giving things away, that brings in non-desirable patients. And the non-desirable

 

Kiera (06:28)

Right.

 

Sean Hamel (06:29)

patients are the one everybody's complaining about, right? They take a chair time, they don't have credit, they're not going to accept treatment, they come in for the special and they leave. And so that puts a lot of pressure on the practice because dental practices, as you know, you have to see somebody repeated times before you really start monetizing that relationship. But dentistry is a relationship business.

 

And so the one and duns put a lot of stress on the practice, and that starts to cause burnout and frustration on the team and the doctor because they're constantly chasing this new patient number, but they're still not making any money. They're busy, but they're not profitable, which is a huge problem.

 

Kiera (07:01)

Mm-hmm.

 

Sean Hamel (07:03)

So from there, the burnout starts to set in and the doctor goes out and starts throwing up Hail Marys, hoping to get help, like you are, hoping to get help. I'm spending all this money, nothing's working.

 

And this is where, Kiera, the cycle mediocrity, it's multifaceted. So the dentists are kind of their own worst enemy sometimes. The marketing

 

Kiera (07:19)

Right. Right.

 

Sean Hamel (07:20)

companies, I'm not saying marketing companies are nefarious, but a lot of people that get into dental marketing are not qualified to be here. And then the industry has kind of pitted itself in a bad spot for dentists. And the reason why I led with that is because at this point where that burnout comes in, the doctors are going out to events and study clubs and groups and they're trying to get help. And the marketers that are being put in front of them largely

 

It's not there's no vetting of their work being done. It's who bought the diamond sponsorship package. That's who's gonna get up on stage and they can say whatever they want. And there's so many conferences that I go to and I hear people say things from the stage and I'm like, that is factually incorrect. That's not how that works anymore. That's not true anymore. Don't want to get into that today, but there's no vetting going on. And so the doctors are coming out and they're trying to get help to be profitable, right? To be chairside less, make more money, not take the wear and tear on their bodies, hit their goals.

 

you know, pay for their family vacations, put their kids through school. And there's all these marketers entering the space that are promising them the world, but there's no accountability. And

 

Kiera (08:21)

Right.

 

Sean Hamel (08:22)

so because of that, the doctor hires the next marketer, hires the next marketer. And this here is where the cycle comes back around, is every marketer they hire largely is doing the same stuff. So it's the same messaging, the same websites. They're promising them the world, but they're not actually doing anything to be able to hit that goal. And if they don't hit the goal, there's there's no repercussion if they don't.

 

But they hire the next marketer, promises them the world. They go through all the change and transition. They kind of go through that high of, hey, this is gonna work. It's new, it's exciting. And then things start to slow down. The phones slow down, right? All the growth slows down because the messaging is off, and we can get to that in a second. But they start, they call the marketing company and they say, hey, we're not busy, or hey, this isn't working, or hey, these leads aren't good. And the marketing company usually will blame the front desk.

 

Or they'll

 

Kiera (09:06)

Mm.

 

Sean Hamel (09:07)

say, Hey, why don't you go you're not you're not busy? Well, let's do a thousand dollars off in in Vizaline or whatever.

 

And so they bring the discount up and it starts back over. So no differentiation leads to this race to the bottom discount mentality, which brings the patients that they don't want to see anyway. The patients put stress on the practice, the doctor starts throwing hail mares to get help, hires the next marketer who's not vetted or anything like that, comes in, promises the world doesn't do anything, aren't busy. So the marketing company decides, well, let's just do a discount. And that's the loop. And that's why practices hire seven companies and can't ever get results.

 

Kiera (09:41)

So I agree with you. And that is a good way to put it in there. And as you were saying that, I say it sometimes. I'm like, practices are like dental Tinder. Like, guys, you're just like,

 

Sean Hamel (09:49)

Yeah.

 

Kiera (09:50)

you look like everybody else and they just keep swiping. Same thing when you're placing ads out there to hire team members. I'm like, you can't be dental Tinder. You gotta like stand out somehow. Like in my mind, I was like, all right, it's all black and white. Like, how do you stand out as hot pink or how do you stand out as hot blue? Like there's gotta be something in your right. Like a lot of times it is proximity. And so I tell a lot of doctors, like,

 

Hey, when you take over a practice, they're probably not gonna wanna leave you because they don't wanna go find somebody else. Like it's much easier for them to like you and stay where they're familiar rather than going somewhere else. And that's also the tricky thing is because unless I've got more people moving into the area or I have a very disgruntled patient, they're kind of creatures of habit. Like switching dentists is not fun. And so that's another piece that we have. So you just you laid it out perfectly. What's the solve? What's the solution? Like how do people get out of that? Because I think you're not wrong. And I will say that that's something

 

Whether it's right or wrong, I got so annoyed. I went to so many conferences and I, my gosh, early, early on, I signed up with a marketing company. I spent 80,000 on that company. And I remember like almost bankrupting the company. I was it was just and they're like, just keep going, just keep going, just keep going. And I'm like, I don't have any more cash. Like, we're gonna go under. And it was the most stressful thing I'd ever done. But it does feel like like almost like gambling, like one more pull, one more pull, one more pull. Like maybe this one will be

 

Sean Hamel (11:06)

Yeah.

 

Kiera (11:06)

big money.

 

and I remember it is like

 

Sean Hamel (11:07)

Yeah, I call it I call

 

it the finding Nemo, the just keep swimming thing. But yeah. Mm-hmm.

 

Kiera (11:11)

Seriously though. Like I was like, I just felt like I was

 

just like pulling the slot machine, hoping and praying big money was coming. but it didn't. And it was that was the early on learnings. Clearly, I keep learning them. but how do people get out of it? Because like for me, you're right, for conferences, I got sick of it. I signed up with so many people, I was like, my gosh, like I should have done a little research on these people. But even research, like marketers, the thing that's stressful, Sean, and I will say this too, I'm interviewing marketers right now for our company actually, and I'm like

 

A marketer should actually be able to sell me. Like that's their job. So they are smoke and mirrors. They're like their job

 

Sean Hamel (11:43)

Yeah. Mm-hmm.

 

Kiera (11:45)

should be to put something in front of me that I want to buy. That's who I'm trying to buy. So then how do you cut through a good salesperson who's actually a good doer? Because that's what I'm really looking for in a world where their job is to sell me and to sell me well. So

 

Sean Hamel (11:58)

Yeah.

 

Kiera (11:59)

how do people get past that?

 

Sean Hamel (12:01)

Well,

 

for dental practices especially, I think the biggest thing that's missing, well, it's a I think it's a two part problem. One is anybody can be a dental marketer now. So there there literally is a whole industry of influencers that are out and they're encouraging the unqualified to do niche specialization like dentistry. So I I always say everybody can it's really easy to be expensive now, but nobody is valuable anymore. And that's why I say like market

 

Kiera (12:28)

So I say it.

 

Sean Hamel (12:29)

marketers aren't

 

Nefarious by nature. A lot of them aren't. They just don't know what they don't know. And the reason I say that Kiera is because when I started, I didn't I did everything I learned in college and none of it worked. That's why I had

 

Kiera (12:39)

Yep.

 

Sean Hamel (12:39)

to kind of relearn it and helping friends. And luckily those friends gave me grace to try things. But once we figured it out, it's all it's all emotion. Like the average person does not know who the best clinician is. And we also spend a lot of time validating things that the average consumer already gives of practice, which is that the doctor is skilled and smart and that they work on teeth.

 

And yet that's most of the messaging that's out there. And so it's no wonder it's problematic because people are afraid, largely are afraid of dentistry anyway. And so you're shoving the things that they're afraid of down their throat. And it's not marketing differentiators because the average person doesn't know anyway. When I speak and I talk about it, it'd be like if you went out to buy a car and you walked on the lot and the salesman was like, All of our cars have turn signals and brakes and transmissions, you'd be like, duh, because you expect that stuff to be there.

 

Kiera (13:29)

Right.

 

Sean Hamel (13:29)

And yet if

 

you look at the average practice, all of that wasted messaging is there. And that's why I say it's a messaging problem. But with regard to the industry itself and these marketers that are entering the space, like where we initially started before that kind of caveat, a lot of people you can get in dental and you can with AI and stuff, you can pull smoke and mirrors. And and there's a whole industry of people selling white

 

Kiera (13:50)

Mm-hmm.

 

Sean Hamel (13:52)

label products to unqualified people and encouraging them to get into dental. You can charge 3x.

 

And the doctors don't know any better. Like, have you have you seen the like 19-year-old looking kid that's in his like gamer den who's talking about I'm gonna get you 30 all-in X patients in 25 minutes? They're buying that, they're buying that

 

Kiera (14:08)

Totally. Yep. Yep.

 

Sean Hamel (14:11)

somewhere. And the doctor's like, what you're going through, there's no way to vet that. And that's where I want to encourage as I'm out speaking and stuff, where people come to organizations and associations and meetings.

 

for guidance, like do your due diligence on the other side of it, that the people you're putting on stage are worth their salt to be speaking at your event, advising your members, telling them things to

 

Kiera (14:33)

Read.

 

Sean Hamel (14:34)

do, because they're the ones that go back and stroke the giant checks and get no results. And then they come back trying to find help. And that kind of is where I think with marketing a lot of people, including you, you kind of just get burnt out on even trying to find help. And it's just like, okay, what can I do to self-maintain without bleeding money? Right.

 

And so, with that, like as far as dental practices go, and I told you this is a lot longer conversation,

 

but

 

Kiera (15:00)

Mm.

 

Sean Hamel (15:01)

most consumers with a dental practice care are afraid. Fear is a huge part, and that's what makes dentistry singular. There's not a lot of stuff that we buy that we're afraid of. And so most people are not operating from a feature and benefits mindset with dentistry. It's like self-preservation, right? It's why.

 

referrals work so well. Like if you really think about why patient referrals work so well, it's because trust and safety are immediately passed because their cousin, coworker, friend from church, whatever, is validating that you're safe and it's a nice place to go and they're not going to hurt me. And all of that is an emotional process that's happening. And so to get out of the cycle of mediocrity, you stop talking about clinical stuff all the time and you start using human emotion to connect with people. So that's patient experience. That's the differentiator, right?

 

But how do you communicate that ahead of time? You really can't. I mean, you've got Google reviews, you've got the ability to do, you know, photo tours and things. One of the biggest things that practices can do that's easy is stop wearing scrubs. Stop wearing all your

 

Kiera (16:00)

Yeah.

 

Sean Hamel (16:00)

scary gear. You don't need tools in your hands. Don't wear

 

Kiera (16:03)

Mm-hmm.

 

Sean Hamel (16:03)

white coats. White coat syndrome is real. Just take a picture. Just take a picture of you being a normal person. Talk about who you are. Talk about hobbies and interests and things people already know you're smart. They know you work on teeth. They you do all the scary stuff.

 

Why should I pick you? you play guitar, I play guitar. Cool. We have something in common that as a human being, that means I'm wired that you're safe. That's safer to go there. Standing out being memorable. In this day where we're like bombarded with advertising all the time, that's how you do it. And that's how you get off the cycle of mediocrity is you stop trying to do the same messaging as everybody else. Stop trying to chase discount patients all the time.

 

Focus on just leaning into human emotion and how people are wired and understanding that six of every ten of them is afraid of you. So it's a different relational connection than it is just like, hey, I know you're scared of this, but guess what? We do that really cheap. Like that's like the 90,000 foot view of the average dental message. It's no wonder it falls on deaf ears. And most of the time it's quality pain-free dentistry. It's a headshot of the doctor. All the marketing is all about the doctor. It needs to be about the patient, their outcome, right?

 

Hey, you're gonna look better at the family reunion because you came and saw me. Not, hey, this is everything we're gonna do to you and I'm really smart and here's my headshot. So it's those little tweaks that make all the difference.

 

Kiera (17:22)

Do you really believe that, Sean? Like here I am like

 

Sean Hamel (17:25)

What's that?

 

Kiera (17:25)

digging into that. Like, I think a lot of us feel that way, but I think a lot do put themselves out there. And I'm like, that just feels like such a slow road. Like, I want to push the easy button. I want you to just do like SEO. I want it to when they search for me, I look like a good enough dentist rather than being like, let me share my entire life out there. Let me tell people because I think that they're just spaces like business owners that like I don't really want people to know me. I've had clients use my personal life against me and tell me like

 

Well,

 

Kiera XYZ. And I was like, forget that. Like, I'm not sharing half this stuff anymore. So I'm just like, it's a I agree with you to a point. And I think that there's a space of me that's like, is that really true? Me going out there, me being my authentic self. Like, there's so much noise on TikTok. There's so much noise on Instagram. There's so much noise there that like me as just average Kiera or average Sean or average Britt or average Kevin. My story.

 

Is that really going to break through the noise of all these other people chasing that bottom line? Or do I need to get people with that hook of what everyone else is doing and then win them over when they meet me?

 

Sean Hamel (18:29)

So I I mean that's that's fair and I appreciate you being devil's advocate. I mean we see clients

 

Kiera (18:33)

I will.

 

Sean Hamel (18:34)

that have well we I mean we see clients that have tremendous success with it. Again, dentistry is singular. So what what would work for Kiera and Dental A Team isn't what's gonna work for a practice because most people aren't afraid of you. So it's a a different relationship. It's well, I mean, I I I highly doubt it. I highly doubt it. Yeah. But

 

Kiera (18:45)

I hope. Some might be. I sometimes come in a little more intense, but no. But you're right. Like

 

people people hire Dental A Team because they've met me with air quotes on the podcast.

 

Sean Hamel (18:57)

Yeah. Mm-hmm.

 

Kiera (18:59)

You feel like I'm your friend. You feel like I'm your bestie. Like, and I should. That's who it is. But you're right. Like in dentistry, they're not listening to you on a podcast getting to know you. They're looking at your website to see do I like you or do I not like you? And do your reviews say that

 

Sean Hamel (19:10)

Yeah, and it's

 

Kiera (19:11)

you're good.

 

Sean Hamel (19:12)

and it's in and it's indirect cues. The the the way that our clients have so much success with this, I mean, we have we have one office that's getting eighty X ROI using these principles

 

Kiera (19:20)

It's awesome.

 

Sean Hamel (19:20)

and leveraging these principles. And it's just it's it's not a gimmick. Like it's not me selling you anything, it's me trying to bring people back to center on just use the way human beings are wired to your benefit. So when people are afraid of something, we as different as we all are, we largely operate the same.

 

And so that's where Google reviews and all that pulls in. There are so many people that talk about the topical thing, right? You need to get Google reviews, it's good for SEO. You need to get Google reviews because it's social proof, and social proof is safety for us. That's why

 

Kiera (19:50)

Right.

 

Sean Hamel (19:50)

we hang out in packs and we always have. Even with SEO, like what you're talking about, Kiera, the best you can do is top three. It's the

 

Kiera (19:57)

Mm-hmm.

 

Sean Hamel (19:57)

best you can do. So you still only have a one in three chance that somebody's gonna pick you. So

 

Kiera (20:02)

True.

 

Sean Hamel (20:03)

33%.

 

So if I can give them emotional cues to pick you in addition to them finding you, that's where most of this falls off here is everybody's focused on being seen. Nobody talks about how do I get you chosen? How do I get you to be the one that they pick? And that's using the emotional cues. That's using neuroscience and using trust and safety. Same thing that happens with the patient referral. We're doing the same thing with messaging, with imagery. Instead of saying, hey, $99 new patient lightning special.

 

Run, hey, like in the spring, we will run you know, you bought the dress, give her the smile, prom 2026 whitening specials, 99. And it's not

 

Kiera (20:44)

Mm-hmm.

 

Sean Hamel (20:45)

that the message is different, it's just it resonates different with people because it's fitting into their life. It's not transactional where they're having like burn mental calories to figure that out. And the average person in that sequence, like, we've done this long enough. Yes, I it does work. Putting yourself out there works, but it's not just about putting yourself out there, it's doing it strategically.

 

Right. But when you do say that in the spring and graduation's coming and proms coming and all, a parent whose kid is going to prom and they see a ninety-nine dollar whitening special is not gonna have it resonate the way the other ad does. And that's

 

Kiera (21:16)

Totally.

 

Sean Hamel (21:17)

just a very high level example of how to do it. But it is a mix of doing the things that everybody's doing. But it's once you get there, how do you then get somebody to pick you? Cause you can pull the root like you're talking about pulling the lever.

 

Kiera (21:29)

Mm-hmm.

 

Sean Hamel (21:29)

You can start

 

to have control over that with the appropriate messaging and leaning into the fact that most people are afraid.

 

Kiera (21:35)

No, I think that's great, Sean. Thank you for letting me play devil's advocate because I think people

 

Sean Hamel (21:39)

Sure, yeah.

 

Kiera (21:39)

feel that like, okay, I'm gonna go do this, but then they feel like the rejection piece or that people aren't coming.

 

Sean Hamel (21:44)

Mm-hmm.

 

Kiera (21:45)

And you're right, I like I do this when we're presenting cases and talking to treatment coordinators and consultors, and it's like no one's buying that implant screwed into their head. Like just fun fact,

 

Sean Hamel (21:56)

Yeah.

 

Kiera (21:57)

no one's buying that. But what they are buying is the ability to eat steak. What they are buying is the

 

Sean Hamel (22:01)

Exactly.

 

Kiera (22:01)

ability to smile to their grandkids.

 

Like

 

it is an emotional lever that people I'm like, no person is buying. Like, I want white teeth, but why do I want white teeth? Like I want to look good. Like I had a lady who was like ninety and she went for full ortho people like, why'd offer it to her? I'm like, 'Cause she said she wanted to look good, like good in her coffin. That is a motivator for her at ninety

 

Sean Hamel (22:19)

Right. Yeah.

 

Kiera (22:20)

to get her like no one is buying, like we don't go and we don't buy certain things because we're looking for like I'm not buying like there was even a girl who talked about like we don't buy perfume for ourselves, we buy it for other people.

 

Like, yes, I want to smell good, but it's because other people are going to experience that. Like that's why we buy things is for other people, for us to feel a certain way. and I definitely think it's like you said, you can do the same tactic. It's just making sure that we're hitting it on the the zone that's gonna resonate. So I'm curious, Sean. Go ahead.

 

Sean Hamel (22:47)

See, and and you nailed

 

it really quick because that's that's what you just said is a phenomenal like follow up. That's the problem, Kiera, is you get it, you've done it, the marketers that are getting paid the big sums aren't doing it. So the

 

Kiera (23:01)

Mm-hmm.

 

Sean Hamel (23:02)

doctor will go out and do it on their social media themselves and put themselves out there. But the marketing company, if you go look at the landing pages for the implants, none of it's there. None of that's there.

 

Kiera (23:11)

Totally.

 

Sean Hamel (23:12)

And if they call and they say, Hey, I I have this patient.

 

That I wanna I wanna highlight this that, you know, they're eating steak again and they're excited. well, we don't do that. You have the bronze package here. We don't do that. We don't do we don't do custom. That's the problem. When I talk about everybody

 

Kiera (23:25)

Yeah.

 

Sean Hamel (23:26)

looks the same, the marketing companies are built to where you have a package A, B, or C. A,

 

Kiera (23:31)

Mm-hmm.

 

Sean Hamel (23:31)

B, or C doesn't work because this kind of stuff isn't in there. That's the issue with why most of it doesn't work. A lot of people get it and they understand it, they just don't know how to make it all fit together to actually get ROI.

 

And the companies

 

Kiera (23:43)

Sure.

 

Sean Hamel (23:44)

are not focused on messaging or conversion. It's all about site visits. It's all about, like you said, smoke and mirrors. That's what the metrics are about constantly. If it worked, ever like somebody at some point would get results that they are excited about. You know, if you go into a room with a hundred doctors, you say, How many of you have had a bad marketing experience? Almost all of their hands go up. And it's not that again, the marketers aren't nefarious. It's just they're charging full fees to do half the work.

 

Kiera (24:10)

Sure.

 

Sean Hamel (24:11)

Getting

 

in front of people's half the job. You gotta get them in the chair. You gotta qualify

 

Kiera (24:14)

Mm-hmm.

 

Sean Hamel (24:15)

them to make sure it's somebody the practice wants to see. And that's where the story piece starts to unlock is the conversion.

 

Kiera (24:21)

So if I'm a dentist listening today,

 

Sean Hamel (24:23)

Mm.

 

Kiera (24:24)

I'm like, Sean, I like this. I've taken notes. I like you, but you're a marketer. So of course I'm gonna like you. You're selling me on liking you. What are my tactical pieces that I can take from why marketing doesn't work and put it into action? What are some of the things that I can start doing today? whether I have a bronze, silver, gold, whatever package I've got, like I want patience. I need patience. That's why I'm listening to you guys today. I am obsessed with this, I've struggled with this.

 

I'm the person who just raised my hand. I have struggled with this in the past. What are the tactical? Because you know, Sean, I'm very tactical on every podcast. Like, people need to be able to leave here of like,

 

Sean Hamel (24:57)

Yeah.

 

Kiera (24:58)

what can they do to go make their lives and their practice better? What would you say would be like steps one, two, or three, or like one, two or three items that they could go implement that truly would start to help them in a way? I could call it like turning the Titanic. Like, how do I get

 

Sean Hamel (25:11)

Yeah.

 

Kiera (25:11)

this to actually start making a a shift rather than just continuing to do what I've always been doing?

 

Sean Hamel (25:16)

Yeah, one of the easiest ways here is you the about you page and about the practice page. Like if it's super clinical and super generic, if it's five paragraphs about how smart you are and three sentences about who you are, just flip that and start talking about who you are. You don't have to it doesn't mean you have to show pictures of your kids and all the things like you don't have to go that deep with it, but just talk about hobbies and interests. Be somebody that they can build a connection point with because again, remember that they're operating from self-preservation most of the time.

 

They're not looking at you the way that they're shopping for a TV. It's totally different when

 

Kiera (25:48)

It's true.

 

Sean Hamel (25:49)

it comes to dentistry. And so start with your bio page and talk more about who you are and understand that people already expect that you're smart and you work on teeth and you're capable. They already expect that. So just think about tail lights at a car dealership. Nobody cares, right? It's important, but they already know that you're smart and capable. You are a doctor who is practicing, they know that. So start there. And the same thing with about the practice, lean into the patient experience.

 

But lean in in a way that it makes the patients the hero of the story. I don't know if anybody's ever read Building a Story Ran by Donald Miller. It's a phenomenal book.

 

Kiera (26:20)

Mm-hmm.

 

Sean Hamel (26:21)

You can't take it though and plug it directly into dentistry. You have to tweak it a little bit. But making the patient outcome, like you said, the even the patient that's like, I want to look good my coffin, that is why she's coming in. You don't have to tell her the ins and outs of what you're gonna do to her. You don't have to sit there and try to tell her how smart you are and all the courses that you went to to be able, she's already sold.

 

All you have to do is talk to her about, hey, you are gonna look better, feel better, get more matches on Tinder, you know, look amazing at your high school graduation, whatever it is, shift your messaging to the outcome for the patient and you will start to see the marketing unlock. That's the easiest thing that you can do. And it's, you know, like you said, I have the gold, silver, bronze. The marketing companies are not gonna help you do this. So that's one of the easiest things you can start to do. The other thing here where practices can start doing this is through their social media. So stop.

 

You don't doesn't mean you have to post constantly about yourself. It doesn't mean that you have to post about like National Chocolate Chip Cookie Day or any of that stuff.

 

Kiera (27:15)

Yes.

 

Sean Hamel (27:16)

But just go out and be a member of the community. Go out and if there are restaurants or little coffee shops or anywhere that you go or the team goes or whatever, start tagging those businesses and build reciprocity, which is you know another principle of persuasion

 

Kiera (27:30)

Mm-hmm.

 

Sean Hamel (27:31)

if you read read Dr. Cialdini's book. but you can use other businesses like if you

 

If you think about a dental practice as being highly valuable in the community. So not, hey, we need to get more followers, but hey, I have 250 people that live in the community that follow us. That's valuable to other businesses.

 

Kiera (27:50)

Mm-hmm.

 

Sean Hamel (27:50)

So if there's a coffee shop that I like and I go out and I tag them in a post and say, My favorite, my favorite stop on my way into the office, and you tag that business, what is that business gonna do? Share you back, right? Well

 

Kiera (28:02)

Gonna like you. Exactly.

 

Sean Hamel (28:05)

And they're gonna share you back in their real or story if you post one of them. And so you can start to use other businesses to not only build commonality, but build out your brand. Like gyms are phenomenal for this. You have health conscious people that care about what they look like. Dentistry, like that's that's a great spot to be for dental practices. Just start being a part of the community, build that kind of commonality, leverage your community to get in front of people in an organic way and stop just trying to do what every marketer is doing.

 

Which is really generic, really clinical, you know, quality pain-free dentistry, the team's standing by the front desk, the doctor has their arms crossed. Everybody's tired of that stuff. It's not super hard to pivot this way. Just be a be a human, be a part of the community, be social, and realize that other businesses around you can l leverage benefit from you highlighting them because even if you have a small follower account, they all live in that city or that area. And you share them, they'll share you back.

 

See if you can do fun things together with them. But it's a unique way to build more of a connection. And especially in this day of day and age with AI and just the amount of you just get inundated by marketing anytime you go anywhere. If you can get somebody to go through and they see your ad and they think like you were talking about, like eating steak, if they hit if they hit that, the next time that they think about that, even if it's like ten hours later at night, they're gonna think about you. They're gonna remember

 

Kiera (29:25)

Mm-hmm.

 

Sean Hamel (29:26)

you. How many ads do you remember since you got up this morning?

 

Kiera (29:30)

The answer is none. There's too many.

 

Sean Hamel (29:31)

Right, because it's just the same stuff.

 

Right. And so as you start to leverage this stuff, and it does seem like, you know, with dentistry Kiera, it's not like monumental shifts, it's little dial turns. And like, you know, it's not just getting in front of people, it's how do I get them to remember me? Those are the kind of things that any practice can start doing is just humanize it. Talk about who you are, why they should pick you, and it's not where you went to school, it's just

 

Hey, I'm you know, this is who I am. I have kids, I work in the community, I coach little league, like whatever it may be. That's the stuff that people can resonate with. And then use your community, use social media to be social. And those are two

 

Kiera (30:09)

Yeah.

 

Sean Hamel (30:09)

things that any practice can start doing immediately and they'll start to see results.

 

Kiera (30:14)

I

 

love that, Sean. Thank you for sharing that because that does seem doable. And as you were saying that, I thought about there's a dentist that I watch. I knew I actually worked for his dad and now he's in residency. And it's interesting because he lost his wife to suicide and he's very open about talking about it. but I and that was like why I started attracting. I mean, I know this kid, I knew all the things going through and whatnot. gosh, you're old when you call like somebody in residency a kid, like shoot, that just connected. But regardless, he just posts about like

 

The dice on toothbrush just came up and he was just posting about it. He will post some things about dental. He'll also post about like, hey, like live life, or like, hey, this is me going in for like pediatric surgery today. And I actually really love following him. And I think kudos to him. He's in residency. He doesn't even have a practice. But he's building a brand of who he is as a human and he knows he's not gonna get everybody. But that's the dentist that I remember out of all the ones I see. And he's called Toothjack

 

Sean Hamel (31:06)

Mm.

 

Kiera (31:06)

Tooth Doc Jack. I his name is his name's Jackson.

 

And I thought was really clever of how he put it together. So he's branded as a dentist. but and he has scrubs and he doesn't. He's like, this is me walking home from class today. These are some of the things I thought of. And what I've noticed is people want to follow people and like see into their lives. Like I think that that's what social media is, is getting to know people as humans. And we were talking the other day and I was like, Isn't it creepy? Like the girls at the gym were showing a picture that they made by AI of them at a karaoke thing. They didn't go to it, but they were like teasing their friends and the picture looked so real.

 

And we were talking about we're like, how crazy is it that we don't know what's real or not real anymore? And I think that that's where people are craving this, like, I want to know you as a real person and I want to know that this wasn't done by AI because that's what I actually want to be paying for. I don't want to be paying for AI. I don't want to be paying for mass marketed things. I want to be paying for that. So many people have told me the reason that they choose Dental A Team or like they've listened to me on the podcast. People now applying for our company watch my video on our website and they're like, I loved your video so much. I love who you are and I want to work with you.

 

Sean Hamel (32:07)

Mm-hmm.

 

Kiera (32:07)

And so

 

I will say that even beyond just patients, it also can be a great way for you to attract team members to your practice. But I think, Sean, there are pieces and I love that you made it tactical because it felt so like a little woo-y. Like, what am I supposed to do? Like, how do I?

 

Sean Hamel (32:18)

Yeah.

 

Kiera (32:19)

But I love the I love the cross collab of your communities. Guys, you are part of the community. Do you how hard it is to be a Chonda is like when you're across the globe, I'm not really part of any community. I'm part of like your community-ish. I'm part of the dentist community, but there is no community where I'm gonna tag a local coffee shop that's gonna apply to a doctor in North Carolina.

 

But what will apply is bring on cool collaborators like Sean that you guys are all excited about that we can hear. That's what's going to drive you here. But for you, you are so lucky. You work in a community. So leverage those relationships, leverage that. I think that's a brilliant idea. And I hope people today take notes, they execute, and they realize that you as a human is what people are craving the most. They're not craving the standardized pieces. And you're right, everything does look the same. So you actually have a great opportunity right now, like pivot a little bit differently and it'll probably stand out quite quickly.

 

in

 

a really positive way. So Sean, thanks for that. Those are my like wraps. What other wraps do you have

 

Sean Hamel (33:05)

Yeah. Of course.

 

Kiera (33:08)

as we wrap up?

 

Sean Hamel (33:09)

No, I appreciate you. again, I know this is a lot to throw at people in half an hour. This is a t I do a two and a half hour presentation on this. and and

 

Kiera (33:17)

Yeah.

 

Sean Hamel (33:18)

the goal it's not to demonize anybody or anything. It's just, you know, the industry is broken. we can't help everybody. I mean, that's why I started speaking and and stuff, because this has been so successful for the offices that we work with and so many dentists largely are struggling.

 

And you know, this isn't a sales pitch. You can go do this stuff on your own. A lot of times, Kiera, when I started speaking about this, doctors would hear me talk and they would go and they would call their marketing company the next day. And that's where they'd be like, hey, we don't do that. Or hey, you know, we don't do custom. We can

 

Kiera (33:48)

Sure.

 

Sean Hamel (33:49)

why am I paying you $5,000 a month then if you're not

 

Kiera (33:52)

Ha ha ha.

 

Sean Hamel (33:52)

going to help me grow? Right. And so it's really become more of a passion for me to educate dental practitioners on here's why the messaging's off. Here's how easy it is to fix it.

 

And I love the fact that you push back and we're like, hey, does this really work? Yeah, like it does. and it it's it's well, well, and it's not

 

Kiera (34:07)

Hi, I'm Kiera. Nice to meet you.

 

Sean Hamel (34:10)

for any other reason, just that like people are never not gonna be afraid of the dentist. It's one of the things with AI too, the adoption with AI, and that's another podcast we can do, but people don't trust it. And so when you

 

Kiera (34:20)

Right. Mm-hmm.

 

Sean Hamel (34:22)

add that layer to it, it's just a recipe for disaster. But these principles work.

 

It's not a gimmick, it's not a sales pitch, it's just how human beings are wired when they're afraid of something. If you lean into that mindset and understand that the average person is at least a little like maybe they're not petrified, Kiera, but it's like the first day of school nerves where you're just kind of like, yeah, and then you go in and you meet your teacher and you find your locker and you start to calm down. Same

 

Kiera (34:47)

Mm.

 

Sean Hamel (34:48)

kind of thing. And you can replicate that by giving people emotional cues on the front side. So when you pay for SEO and you show up high, you also get the the butt in your chair.

 

Which is the big part that everybody seems to miss and nobody talks about. Hey, I rank really well, but I need patience to actually come in and spend money.

 

Kiera (35:05)

I think my takeaway from all of this today was it's not so much how do I get you seen, it's how do I get you chosen. And I think even that becomes a very different strategy. Like I'm going out onto the field, like I want to be chosen, I don't just want to be seen. that definitely was like my anchoring point. So, Sean, if people love you, they to hang out more with you, like tell them how they can connect with you guys. What do you guys specifically do? Are you a full force marketing agency? Do you build websites? Do you do social media? Do you do all that?

 

do just help them build out the strategy plan, kind of give them a little bit more and how they can connect with you.

 

Sean Hamel (35:38)

Absolutely. And this is actually called the chosen approach. That's what I call this presentation. I have a book that's coming that goes over how to do this. so yeah.

 

Kiera (35:45)

That's awesome. I'm glad I pulled out the right line.

 

Sean Hamel (35:49)

Well, hopefully, I mean that's it, you know, that is kind of the the best summation of the issue that's that's facing everybody. But you can always get in touch with me on the social media, Story Base Sean. You can find me on Instagram and Facebook. Art of Dental Marketing is just ArtOfDentalMarketing.com.

 

We have a new division of the company that's launching called ADM Express, which brings the core tenets of what we do, the wireframing, the messaging, but it's at a price point that's that's driven by our AI agent. His name is Alfred DDS, but he does

 

Kiera (36:17)

Mm-hmm.

 

Sean Hamel (36:18)

a lot of the customer service and the and ideation and things. but we do we do websites, SEO, we do all of that stuff, video, we help practices tell unique stories. We do ground marketing, we do general practice consulting, we can help with appointment setting, we can help with

 

you know, we can even help with like acquiring talent. So if practices are looking for hygienists or associates or anything, we don't do placement, but we can help them advertise for that. Really anything a dental practice needs to where the doctor

 

Kiera (36:46)

Yeah.

 

Sean Hamel (36:46)

can make more money and be chairside less and grow into the practice they've always wanted. we have a service or solution or a partner that can help them with that. And so we really are a full service growth agency. I w really wouldn't even call us a marketing agency anymore.

 

there's really not anybody like us in that, in that regard. But we just from websites and logo design and brand design to strategic messaging to hey, how do I get the gym next door to partner with us on stuff? You know, we help with literally everything necessary for a practice to grow.

 

Kiera (37:18)

Awesome. No, and Sean, thank you so much for that. So, guys, go check it out. If this resonated with you, go check it out. And I hope that you just recognize there's so many different ways for you to connect with people, connect with humans. that's what we're all about. I believe that the the human experience is about being connected to people rather than just being sold to people. So go connect, change it up, take one of these, implement it today. Reach out to Sean. If we can help you connect you in any way, we'll happily help. reach out Hello@TheDentalATeam.com.

 

Guys, go make today the best day. Sean, thank you for being on the podcast. Truly appreciate you being here. Of course.

 

Sean Hamel (37:50)

Thank you, Kiera. Appreciate you.

 

Kiera (37:52)

Of course. And for all of you listening, thank you for listening. And I'll catch you next time on the Dental A Team Podcast.

 

How great would it be, having systems that sail smoothly no matter who is sick, who changes positions, who quits, who [insert out-of-the-blue incident here]? Tiff and Dana talk about what exactly to implement in your practice so that communication flows.

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Tiffanie (00:01)

Hello, Dental A Team listeners. We are so excited to be here with you today. I say it every single time. and I have Miss Dana here with me. And Dana and I have been podcasting together for what feels like an eternity at this point. It's been a long time. she is an OG with me at this point. And if you ask Kira what OG means, please ask her next time you see her in person. Say what does OG mean? and she will tell you it's oldie but goodie. And so that is our company.

 

lingo for OG at this point. And Dana, you are my girl. You know I love podcasting with you. We have done so many podcasts. We were actually just talking about fam here. Like how many times can we take these different perspectives of these similar topics? And I'm like, gosh, yes, I agree. And it's like we we talk about such similar things, but Dana, I do think you and I do a really great job. You kind of coax a different

 

side you and I both come from different angles in so many different ways. So if my point of that is if you're here today and you hear this topic, you hear what we have to say and you're like, gosh, I I think I need a little bit more, do a quick Google search. I call it a Google search. It's just a a search on our website. on the podcast section of our website, if you type in any of the keywords that you hear today, there's gonna be more podcasts that pop up. It's maybe I think I could say like similar content, but that even feels wrong.

 

their topics you guys that we have just poured into and poured so much information out into the world because we want you to have everything that we have in our brains in your pocket. So make sure if you feel like gosh I just needed a little bit more go search it or if you like these were fantastic and what else are they talking about? What does Tiff mean? Go search on our website TheDentalATeam.com there's a whole podcast section there's a little search bar there. Go do yourself a little search and you can find just hundreds of topics. So

 

Dana, thank you for being here with me today. Thank you for always going rounds with me. and for prepping ahead of time so that we can see kind of where we want to take this, even though who knows where it'll go, you know, it could just change on the drop of a dime. But how are you this morning, Dana?

 

DAT-Dana (02:11)

Doing good. And I tip, I think that's my favorite part of podcasting with you. It's like we can come in with like best laid plans and then we just get to talking and it just starts to get natural and it goes where it needs to go. and you're right, while like maybe there's some similar topic in there, I do feel like there's always a new angle to it, there's always a new consideration in it. And so I love that you say, hey, if you want to deep dive, check out the other ones that are around the same top like topic point, because

 

It might not just be you and I, right? It might be you and someone else. It might be Kira that talks about it. And we all have just just different like skill sets and backgrounds that I think puts a little twist on everything. So I'm excited to be here with you.

 

Tiffanie (02:49)

Yeah. I

 

totally agree. I love how you said that. And I agree. And honestly, in the morning I'm like, gosh, we had a podcast. And then as soon as we get here, I'm like, I just get to hang out with Dana for an hour. So this is kind of cool. I definitely need this time with you. So thank you for being here and thank you for always having a fresh perspective. for our listeners, if you've never met Dana, please go check.

 

Her out, come to the events, come see her in person, listen to all of her podcasts. Cause Dana, you really do have an incredible mind, and I love picking it. So I'm gonna pick your brain today. And marketing gives us some really cool topics, and and I love like we talked about they'll they like put a spin on different words and you know, similar topics, but it's stated differently. The titles it's titled something really cool and catchy, and I think speaks to the fact that we do have really

 

I mean, dental is like it's dental. Like how how exciting can we get here? You know? But we really do have exciting takes on so much stuff. And something we've been working on, our our doctor's only mastermind actually tomorrow is kind of a similar topic, Dana. You mentioned this that like what if the doctor's not there? So something our company's been working on with our clients internally, and then it's transitioning now into outpouring messages here on platforms like this is really prepping the business.

 

for when something changes, when maybe a doctor's out, and that could be vacation, that could be gosh, my doctor, when I was like, gosh, Dana, I think I was twenty maybe. I remember coming in after Thanksgiving. It was it was the Monday after Thanksgiving. And my doctor is like on a scooter, like those little like what you know, his knees up scooter. And I'm like, what happened? And he had an A T V accident over Thanksgiving break and he had

 

like broken his ankle and it ended up being this whole thing. He was on that scooter for like eight months 'cause he had have multiple surgeries. It got infected. And I remember standing there at t nineteen, twenty, however old I was, looking at him and going, What if that was your hand? Like I knew in that moment how like serious this could be. So I think we think about plan for your vacations, but what about all the things that we can't plan for? Illnesses, you know, we've got

 

hygienists that have kids that have school, you know, things that they have to attend or breaks. Like we've we've got a an industry that's full of a lot of moms and a and a lot of illnesses. I know I was sick last week because we had a kid come home with something, you know. So I think Dana, to your point of our of our conversation earlier, it's really like systems that keep

 

working when plans change, but sometimes it's not even just something falling off of the schedule. Sometimes it's that we're short staffed or without an entire doctor because something has happened. So Dana, when you when I we read that topic and you you looked at it, I said it earlier. What did you think of? If you had to prep a practice, a dot a client was like, gosh, things are changing or something changed, what would be your go-to method for helping them prepare

 

for systems that can withstand change.

 

DAT-Dana (05:59)

Yeah.

 

Yeah. And I think that dentistry is still very and I love it. Some of my favorite offices, you know, I walk in and they're like, I I don't want to do dentistry without this assistant, right? Or I don't ever

 

Tiffanie (06:09)

Yeah.

 

DAT-Dana (06:09)

want to be in business without this, you know, office manager. And I think that dentistry still can be a little bit people dependent

 

Tiffanie (06:17)

For sure.

 

DAT-Dana (06:17)

versus system dependent. And I think we've had to talk about this a lot lately, because just a hiring climate.

 

a little bit of a hiring drought in some areas of dentistry and just in some areas of the country, it's been harder

 

Tiffanie (06:31)

Yeah.

 

DAT-Dana (06:31)

to I think hire and replace team members too. So I feel like getting practices to see that we have to have systems in place that no matter who is there, no matter how many team members are there, we can kind of pivot every day and and certain things continue to go on.

 

you know, especially like those patient experience things or the patient flow pieces and closing treatment, right? Those are things that have to go on, no matter how many people we have in the practice or or who is there or what the schedule looks like. And so I think that it's something we're having to work a lot with offices. And I think it's great to be able to have a platform like this to talk about how we do that.

 

Tiffanie (07:10)

Yeah, I totally agree. You said, in there like case acceptance and filling the schedule essentially, right? And I something that that makes me think of is the importance of communication. Right. We we call it handoffs. Everyone says, you know, what's your handoff or how do we do a handoff? What is you what is the verbiage we should use with a handoff? And I think if we narrow it down into like the simple word of communicate, making sure that we're all speaking to each other, it's the biggest

 

space that leaves room for error and I have I have a practice and I love them dearly and that doctor he constantly is saying like how do we how do we mitigate the chaos? How do we mitigate the chaos every day? Why is it crazy? Why are there, you know, cases are missing and schedules falling apart and phones are ringing off the hook. People are calling in and I'm like, gosh, it's so simple, it's annoying.

 

Because we want it to be this grandiose, like difficult thing, but it's so simple, it's annoying. We just need to talk to each other more. We need to say what's in our our brain to one another and prep and plan together. If everyone knew that Joanna called out this morning and that the assistance team were short staffed, everyone could pick up the pieces in their area and help. But most of the time, I feel like the hygiene department doesn't even know.

 

that there's a dental assistant missing until sterile's backed up and they're like, What is going on? And they're like, Where's Joanna? Where has she

 

DAT-Dana (08:38)

Mm.

 

Tiffanie (08:38)

been all day? It's like three hours into the workday and the assistants are running ragged, or vice versa. Like people just we're not communicating enough. What do you feel, Dana?

 

DAT-Dana (08:48)

Yeah, I agree with you and I feel like it's it you are you are it's such a silly

 

Answer, right? Because the everybody wants it to be this thing that, like, I would have never thought of that, right? Or my gosh, that's like just this so far out there idea. And you are 100% right because a team that is on the same page or a team that communicates throughout the day, it doesn't matter if you normally sit in that seat. It doesn't matter if you've just jumped in. If I'm giving you all the pieces that you need and I'm setting you up for success, it doesn't matter if it's something that you do day in and day out, or if you just are Johnny on the spot because you happen to be free in those five minutes.

 

Tiffanie (09:24)

And where do you think that the easiest space is, like, systems wise? So if we turn this into, okay, docs, you're harping on me, communication is too broad. You want systems, like what are two systems that practices could focus on every day that regardless of who's there, whatever whatever the change is, they stick

 

DAT-Dana (09:42)

Yeah, I think the two biggest tools for communication and practice are route slips. because there's just a lot of information already pre-ready there. So that like if you're a new person on the team, if you're a temp on the team, if you are covering a position you don't normally cover, pretty much a lot of the patient information to continue at least that patient flow is on the route slip plus there's space that you can write things down that you can take your own notes that you need to give to the next person. So I would say route slips and then secondary, like you already mentioned, Tiff, I think handoffs are just

 

a huge piece communication tool that just makes sure that the patient flow continues as well as every step of the way we're all on the same page and the patient feels it too.

 

Tiffanie (10:24)

Yeah. Yeah, I think that's smart. And I I love the route slips because I think makes it easy to win. Like all of the information that you need is on there. And so in the case of a hygienist being out and now we've got a temp hygienist or Joanna being out and everybody's scattered, like all the information is already written down. And a lot of practices, and I'm not knocking this if it works for you, great. They want they use messaging systems, right? And so great that works too.

 

But the handoff the paper forces that communication and the verbal communication to one another is what creates that connection, in my opinion. Right. So we've we've got to be able to connect with one another in order to bridge that gap. but as you were talking to Dana, as you were saying route slips, I also thought morning huddles. And I think you do a stellar morning huddle routine, like you really get

 

practices excited for them and I know you've got a few tricks up your sleeve, but how would you go about a practice who doesn't do morning huddles and they're like, gosh, Dana, like we are just skirting in as like on time. Like I have an office, I love them dearly, that we cannot get that associate dentist there to save our lives of ten like she's ten minutes after her patients, right? So like, but this morning huddle can help

 

I think mitigate change as well because you thought r you said route slips and I thought, I maybe we pass them out the morning. How would you help a practice in implement morning huddle?

 

DAT-Dana (12:00)

Yeah. And honestly, to be you can have a really stellar morning huddle in 10 minutes, right? So I think that that's that's a little bit of a misconception in practice. They're like, well, then we need to come in 30 minutes earlier than we typically do. No, no, no. We're looking for a window of about 10 minutes. and in that it's like we just want to celebrate what went really well the day before, right? We want to look at our schedule, patients that are on the schedule. Is there any pertinent information? I one of my biggest, I don't want to say pet peeves because I understand it, right? When I go into a practice, but I'm like, all right, it's morning.

 

huddle and I'm like super pumped and I get there and we're just like reading the schedule. Like we can all read the

 

Tiffanie (12:33)

Yeah, they're like a f Dio on number fifteen at eleven.

 

DAT-Dana (12:36)

schedule. Like this, like just to have a morning huddle as like a schedule read, I think we can all just put our eyeballs on it and

 

Tiffanie (12:43)

Mm-hmm.

 

DAT-Dana (12:43)

like see that this is what we're doing. So I think just like pertinent information would stand out. Do we have you know any concerns for the patients that are going to be in our chair anything that everybody needs to know. Like

 

Maybe that lab case in the afternoon isn't here yet, and we need to get on the phone and we need to call them, right? And we need to make sure they said noon, we need to make sure it's going to be there at noon, right? So those types of pieces. and I also like morning huddle just as like you said, Tiff. Like if Joanna's not going to be here today because she is out sick, are there any updates that are pertinent for today? We don't discuss issues in Morning Huddle. We don't, but if there's something that's affecting the schedule today, I want it discussed in Morning Huddle. And if we can, which I

 

love because I just feel like Morning Huddle is the only time in the day where we're really all together and we're really all kind of focused. I love to build in a culture piece just because I feel like again, it's the it's the point in which we are to together. And I feel like just adding that like human piece to get to know each other as humans because if we don't care about each other as humans, why the heck are we there? Right. So

 

Tiffanie (13:45)

huh.

 

DAT-Dana (13:46)

I do like those pieces in Morning Huddle, but I agree with you when when we've got a day where we do have to pivot, right? And maybe we had

 

Pivot doesn't mean a team member's out. Pivot could mean somebody called and like, we've got to get an emergency in today, right? Or we've got a plan to be able to pivot if an emergency calls. I think morning huddle is essential for those things. And I think you can do a really bang up job at a morning huddle in 10 minutes. team members just have to like be bought in to like this is our time to game plan. This is our time that if, hey, we accidentally scheduled kind of a messy afternoon, we're gonna game plan it. We're gonna make sure that it goes as smooth as possible.

 

All together.

 

Tiffanie (14:24)

Yeah. Yep. I love that. I think you hit on all the pieces I was thinking. I knew that culture piece. I was like, I know she's gonna throw some culture in there. And it's massive because the communication, we do it in our company. Something that I like to remind people or or tell people if they don't know is Dental A Team will rarely ever suggest something that we haven't ourselves used, either in practice, like in a dental practice or

 

within our own company. So when it comes to the structure of a business and the communication that's upheld, we we have all of that in our company. We do leadership meetings, we do traction style, level ten meetings every Monday. We do quarterlies, we do yearlies, we do morning huddles, we do all of the pieces that we talk about here on the podcast and within our consulting because they work and because we want to

 

make sure that they work. Like we we don't we don't test things on you typically. I'm gonna say typically. Sometimes I do. Sometimes

 

DAT-Dana (15:25)

Exactly.

 

Tiffanie (15:26)

I'm like, I don't know, try this. Like I'm just making it up. but I think the morning huddle is such a massive piece of like that camaraderie. Like you said, if we're not here for each other, what are we even what are we even doing? Right. And when I see practices falling apart at the seams or they're like, gosh, like the plans changed and everything fell apart, right?

 

Joanna was out or hygienist was out or the schedule fell apart. Like we've got I how many times, Zina, do we see the schedule completely fall apart? And the back office, I walk in and I see hygienists like at their computers, like, well, I don't know who's gonna fix this. And we've got dental assistants in sterile, like what can what else can we put away? We've got nothing to do. And we've got front office scrambling and a doctor hovering over them, like fill the schedule.

 

But nobody actually knows what anyone else is doing or how they can help the situation. They're all just in their own little worlds. And to be fair, that's where we live, right? Especially hygiene. Like you have an operatory. You're literally in in a world and you don't leave that operatory for sometimes six or eight hours, not even to eat. So

 

that morning huddle and those handoffs, those route slips, literally forcing the the departmental communication, one department to the other department and person to person increases the relationship value between every individual in that practice. And when you've got an odd man out, it shows really quickly, but even the odd man out starts to come around eventually 99% of the time. Yeah.

 

DAT-Dana (17:03)

Yeah. Yeah.

 

I agree with you.

 

Tiffanie (17:05)

And then always to our point, write them down. And I

 

DAT-Dana (17:08)

Did you

 

Tiffanie (17:09)

think I was thinking I because I know we always do operations manual. Dana's my operations manual girl. But I was thinking Dana of a great question because I think we see this a lot, especially with startups. We get quite a few startups that eat at least reach out and say, Hey, give me some tips to start when I'm, you know, up to five hundred to eight hundred to a tho to a million, I'll call you, right? So we do get a lot of that. And I think one of the biggest things we get is

 

How can I start if I don't have an operations manual? Right. And it's like, how do I how do I do a handoff if it's not written down? Well one, make it and then write it down. But Dana, how do you how do you help practices overcome that hurdle of I I guess my hurdle thought is people hold back from taking that next step because they feel like they don't have the tool. So rather than being creative and just trying something.

 

they'll kind of keep themselves where they are because the pain now has become bearable. I know what this pain feels like and I don't know what that pain feels like. So how do you help practices and doctors jump over that hurdle to be more prepared when plans do change like this?

 

DAT-Dana (18:19)

Yeah. I feel like for me, it's exactly what you said. It's try it, track it, write it down if it works, right? And if it doesn't work, then let's try something else, right? Or let's like

 

Tiffanie (18:29)

Yeah.

 

DAT-Dana (18:29)

figure out what pieces of it worked. And then we can kind of pivot from there. But I do feel like a lot of like a and and find a networking group, right? You don't have to you don't have to like come up with the idea yourself, right? But pick one thing, try it out.

 

Track it so we know if it worked or it didn't. Like what tells you that what you're trying is working or not working? So track it. And then if it's off track, then let's figure out what piece of it or do we need to scrap it and start over again and get a new idea.

 

Tiffanie (19:02)

Yep. It's all the way down to morning huddles, all the way down to handoffs, to case acceptance, right? Because these these pieces we're talking about here, they will increase metrics like treatment planning, right? Like case acceptance, diagnosis. If you're doing chair side handoffs, your assistant and your hygienist is handing off to you the doctor, your case or your case diagnosis, your diagnosis amount, the amount you're willing to diagnose on a single patient.

 

will increase just because of that communication because you are more comfortable in that room with the people who are there. You've been introduced to that patient and you naturally will diagnose more than you would have before. Meaning, it could be, it might not be, becomes a hey, I'm actually kind of concerned about this. Let's talk about it. Might not be a filling, but you're actually talking about it instead of keeping it in your head. So Dana, to your point,

 

The tracking piece sometimes I think feels hard for people because they're like, cool, we did nine out of ten handoffs today, great, but that's not what we're tracking. Like, why are we doing handoffs? We're doing handoffs to ensure that the bottom line is increasing. So how is case diagnosis, case acceptance, production, collections? I think Dana, that is a wildly misunderstood metric when it comes to communication. Your collections will increase.

 

And your AR will decrease when your team knows how to communicate. So I love that. You said try it, track it, write down if it works. And if y'all took anything, it's those three things today. Try it, track it. I was like, dang, that was it. That was the mic shop moment of this podcast right now. So if you didn't get that, listen again. Dana always comes in clutch with something. I think it's like your mom.

 

piece, right? Like you've got so many littles running around that you're coordinating. You're like, nope, we gotta simplify this. We got to make it a set of three. How do we build a song into it? How do we how do we chant this? I love

 

DAT-Dana (21:01)

Right.

 

Tiffanie (21:02)

that so much. I love it. Try it, track it, write it down if it works. So Dana, is there any I mean I feel like that was our mic job. Is there anything you would add to that or any other suggestions for those who are trying to ensure that when change happens they can pivot?

 

DAT-Dana (21:17)

No, I think honestly, Tiff, I think yes, that would might be the mic job at the end, but I think you had it from the beginning and it all comes down to the communication tools within the practice. Because if we can keep the communication strong and we can keep those tools in place, it doesn't matter who's there, it doesn't matter what patient's in our chair, it doesn't matter what our schedule looks like, right? Those communication pieces you will stay on track all day long just by simply having those standard pieces that you use all the time.

 

Tiffanie (21:46)

Yep. I completely agree. yeah. And practices come and they want a full sweep of every system in their practice and they feel like they cannot be successful until they get all of it. And it really comes down to three to five awesome systems that you repeat every single day. And that's how you get the results, just like the gym. Like you're not you're not doing sixty two different exercises when you're there.

 

you're probably doing three to five things really well, increasing your weight, increasing the resistance, and getting stronger over time. So I love it. Awesome. Thank you, Dana. Thank you, listeners. I hope you enjoyed this one. Again, if there were pieces that you thought you were gonna get or you want a little bit more, by all means take a keyword.

 

maybe not the mic drop moment that was that was a today special but take a keyword something that stuck out to you handoff ndr is what we call our handoffs there's a million morning huddle and go search on our website TheDentalATeam.com there's a podcast section there's a little search tool there we actually worked really hard to ensure that search tool was there for you so go use it and as always you can reach out anytime Hello@TheDentalATeam.com we are more than happy to help we have

 

forms and documents for just about everything that we do and we openly share them with everyone. So whether you are a client, a prospective client, someone starting a business, someone who may never work with us, but you love listening to our beautiful voices, just reach Hello@TheDentalATeam.com and as always drop us a five star review. We love to hear from you and we will catch you next time.

 

Practice success doesn't always equal personal life happiness. Kiera talks about the Yes Success Model, and how to align your business goals with your personal life goals, because they're allowed to complement each other (and should, frankly). She asks probing questions that'll get you thinking about alignment and finding the right motivating factors to keep going.

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Transcript:

 

Kiera (00:01)

Hello, Dental A Team listeners. This is Kiera. And I am so excited because I love today's topic. And I hope that it just gives you a filtering and a process of how do I like actually make like growth decisions and life goals and like what is that long-term vision clarity? Like to me, it's such an empowering topic for you. And I'm so excited because I think that so many practice owners, when I meet them or we work with them, is they actually build a successful practice that they don't want. I've done it. I built a business that I didn't freaking want to work in. And I've said, like, hey, if I

 

If I actually like didn't have to work here and I didn't own this, would I keep working here? And if I can't say yes, then we might want to rework this. and honestly, growth without direction can leave you with more stress, more responsibility, and less freedom. And so today I just want to work on like sometimes bigger isn't always better. Sometimes like we just need to be better aligned is better. So bigger isn't always better. Doesn't mean bigger is wrong, but better aligned is where we're actually trying to go. So I want you guys just to know like a lot of owners feel stuck.

 

Even after they hit success. Like I had a podcast a while of like the empty millionaire. Like I thought like if I hit a million, everybody says this and I was like, Yeah, right, I'm not gonna be that person. No, I remember being like, So this is it, huh? Like, all right, we've hit a million.

 

Cool. Do I love my life? No. Like it was this wild thing. And so, like, why do we still feel stuck after hitting success? And how to create this vision that guides a lot of your decisions to where you have a filtering process of yes or no? Like I think about Willy Wonka and the golden egg, like yes, no, good, bad, like giving you kind of that framework to know. And then like what are some questions you should be asking before your next big move? So I think it's really fascinating because when we work with a client and we get on our first call, I'm not here to say like, what do you, what do you want to produce?

 

we call it the yes success model and the why stands for you. The number one thing I want to know is like what what's the life that you're trying to build? I say it often I will say it here. Your business should serve your life, not the other way around. And I've gotten it wrong for so many years where I've given up so much of my life to serve the business. I remember being like, I think back to when I first started the company and Jason and I would be hanging out and we were literally floating down the river. I kid you not, like we're rafting tubing, and I'm on my phone answering emails. And that was an aha moment for me of like here, I think you're doing this wrong.

 

Like you need to freaking shut it off and like be present. And I'm building like that's not the life I want. I don't want to be working seven days a week. I don't want to be psycho. I don't want to be stressed out of my mind. So like I think it's really powerful. Like I call it the yes success model. You are number one pillar. Then it's earnings and then it's systems and team development, not the other way around. If I mess up on you and your life and we are building a practice and you're not fulfilled at the end, we have failed. And that is my definition of it. So I don't want you guys chasing someone else's version of success.

 

I don't want you chasing more locations or operatories or production. I want you doing this because this lights you up and this is your vision and that not because you feel like that's what you should be doing. We're gonna stop shooting on ourselves. I have a practice, they produce about four million a year. They're at a 35% overhead, they work four days a week. People are like, you need another practice, and they're like, we don't want to. This is the life we want. And I think sometimes being that stalwart in your vision is really, really critical and pivotal. So today I just want you to like.

 

realize that vision planning, like I talk to offices all the time, if your team's not following, it's because you don't have a strong enough vision. If you're not happy in your life, it's because you don't have a strong enough vision of where you actually want to go. So I want you to really have these growth decisions that move you closer to the life you actually want, not further and further away from that. So number one, what are we gonna do? Hi, we're Dental A Team. I'm obsessed with you. I'm here to help you have the dreamiest life you could ever imagine. I love, love, love helping dentists and teams come together to live their best life.

 

And I really want to empower you, CEO dentist out there, the dentist who is the CEO of their life and their practice. I call it life and business on purpose. Like let's GSD together. So step one is let's define success beyond production. And for me, this is really hard. I remember there was a dentist I was talking to, and he's like, But Kiera, production is the only thing we can compare against. It's the only actual number. You're right. There is no number of like, what's my fulfillment measure today? Am I like 10%, 20%? There's nothing in there.

 

So it's really, really hard because sometimes we're like, well, my production number is the only thing that I compare with all the other dentists. But I have a dentist who's making a million a year, like he's producing a million a year, works three days a week, and loves his life. There is no way for me to say, like, what's his success measure? I can know what his production is and like, hey, I got an office over here doing 29 million. But we got to define our success beyond production. So production's a result, it's not a vision. So I really want you to have like

 

it's hard because like setting revenue goals without lifestyle goals is a miss. Saying yes to every opportunity is another miss. Feeling successful on paper but exhausted in reality, that's another miss. So we pivot it and sometimes I feel like this is the time where like pretend I'm your fairy godmother and I'm just gonna wave my magic wand for you. Like if you had no stressors, you didn't feel like anybody was judging you, no parents, no spouse, no family, no friends, no no, I don't know, like mean girl or mean guy sitting on your shoulder, how many days do you actually want to work?

 

What kind of dentistry do I actually love doing? When do I want to retire? Or like maybe scale back a few days? What about my family to look like? How much freedom do I actually want? Notice I didn't put in there any dollars in there because if we can focus on vision first, dollars come second. If I know what your vision is and what your life is, fantastic. We can go build. You guys, dentistry is untapped. It's freaking awesome. Like, so let's just build. Like, what does that look like? And you might realize, like, I don't know, Kiera. And so I was actually working with a friend this last weekend.

 

And he's like, Kiera, what do you do when you don't know where you want to go? And I was like, Well, step one is we got to have a little guiding star. Like, let's just do five or 10 years from today. What's your age and what do you want that to look like? You could go further and you could say, when I'm 90, what do I think I'd want to be doing right now? Like when Kiera's reliving her life at 90, sitting on her rocking chair with hot pink hair, like it's actually cutting candy. Pink, you're welcome. for that visual, like, what do I want my life to look like? So, whichever one's gonna work for you.

 

Sometimes a tenure for me, I just need like a little glowing light up on the hill. That's written in pencil. It doesn't have to be permanent. But what do I want that life to look like? And most people usually do it based on one of three things. It's either going to be a dollar amount, which is totally fine. It's going to be on a fulfillment, like what's going to drive you, or it's going to be on a purpose. So, like for me, massive impact. I drive so hard because I want to impact and serve every dang dentist out there. So share this podcast with somebody. Help me on my goal. Like, I'm obsessed with helping dentists have their best lives.

 

And so like that drives me literally in the middle of every vision board, unintentionally, it says massive impact. Like, what can I do that's gonna leave a stamp and a mark on so many people's lives? And so I built the podcast for free because it was a way for us to reach more people. I hope we brighten your day. You're welcome. Go leave us a review for it and tell more people about it so more people we can serve. Like genuinely, that's what it was. But that's like in the middle of my goal board. So for me, it's impact. Like numbers are super fun and numbers drive me hard. And I'm not here to say like numbers are wrong. I am highly numbers driven.

 

But like, what's the impact? That's gonna motivate me so much more. Like serving 500 dentists and then serving a thousand dentists. Like that to me is something of like a churn. I want to make 40 millionaires in my next lifetime. Like, how do I do that? Like the next decade of my life. So, like, I look at this, but also like, what is the life that I want? What's the trade-off? They can be hand in hand. So I really want you to look at like what is it? I told you about that office that I've got this 3.5, 35% overhead.

 

They don't want another practice. They literally want to live. They don't want another associate. They have great, it's all the systems are done. They don't want to deal with the headache of that. And I'm like, fantastic. You want fewer clinical days. I've got another doctor. He's like, Kiera, I want to go play a pickleball. I used to like have a lake house and all these other things. Like, I want it simple. I want to play pickleball. And I want to be able to hang out with my family. Your lighthouse of 10 years or your motivator, it can be a little fuzzy up there. It doesn't have to be perfect.

 

But getting that vision out of you is something I'm obsessed with because your practice should support your life and not the other way around. And once you get your identity outside of success, you're gonna realize like, and hey, guess what? If that practice goes away tomorrow, are you still a human? Are you still happy? If not, we've got to figure out because you need to be a full, complete person and not just a dentist producing. So I don't want you building a practice that you want to eventually escape. I want you building a practice.

 

Of what like I'm so excited and like I love that part of my life. and it doesn't mean we have to have every day great, but we want to love this part of it. So I'd really love for you to write down what success looks like for your life first and then your practice. Also be careful because I found like for me, I used to have a definition of success that was really hard to achieve. Tony Robbins said it really well. He says, We make it really easy to feel bad about ourselves and really hard to feel good. So like for success, you might be like,

 

Have to make a million every year and I have to drive this kind of car and I have to live at this type of house and I have to do this and this and this and this and this and this and this. Well, you're never gonna hit that. You made it so impossible for you to ever feel happy and successful. And I'm not here to say like lower your goals and dreams, but like, is a million really gonna make you happy? Is living in that house really gonna drive you for your happiness and your thing, or is that just something you feel like you should do because that's what people do? Just a question to ask. I want you to write down what success looks like for you, and I want you to make it easy for you to hit success.

 

It's not your production. Success for your life. What does that look like 90 years, 10 years from now? Whatever it is, but let's write that down and let's get that going. Okay. Number two, I want you to filter every opportunity now through this vision. So this hurts. This is hard. This is the discipline side. Not every opportunity is right or a good opportunity. This year, gosh, I don't have my bracelets on. I usually wear bracelets. this year I actually have a bracelet that says no.

 

To remind myself that saying no is equally as important as saying yes. Does that actually fit and fulfill the life I'm building? Or does it not? I have a sign pointing right over here. It says she designed a life she loved. And that's the ultimate goal is we need to be designing, creating, not managing, a life we are freaking obsessed with. So when I look at this, like buying another practice because it's available, if that doesn't fit into your life vision and what you want to do and less this, like I remember I had a doctor, he would set up.

 

Everything was done. We checked every box, every tea. I was like, all right, guys, we're wrapping up. Like, I don't know what else to consult you on. Like, truly what we set out to do, we've accomplished. Like, let's let's go. And now I we have another practice. And I was like, okay, so you have a college-age student. Like just imagine like your child is college age now, like they're out of the house, they're done, and you're about to bring on a screaming baby. Are you sure you want to buy this practice? And this doctor was like, Kiera, I do.

 

Like I really am excited for the grind and the drive and the like thrill of building something else. And they've done an amazing job. It's been three years. They took them from 500,000 to 2.5 million, like crushed it. I'm so proud of them. But it wasn't just because it became available. It fit. And so really checking to make sure, like, does this fit my life? Adding services in because everyone else does. Just because everyone does implants doesn't mean you need to. It's got to fit what you love. Hiring because you're busy instead of because it's strategic. Like, why am I hiring? Why are we doing these things? So

 

I want you to like start to filter through. You got your vision, you got your 10-year plan. Like, what does your life look like? Next step is like, does this move me towards my vision or away from it? And don't be careful where I can justify my life away. Like I can justify the shenanigans out of a lot of decisions. Will this improve that my quality of life? And will this make the practice stronger or just bigger? So those are some good filtering questions for you. And so, like I said, a lot of these, like when we choose to make decisions, like maybe we're gonna have a bigger leadership team or I'm gonna improve systems or

 

We're gonna go hunker down and like focus on profitability. My doctor who wants to like got rid of the lighthouse. We simplified so much. They're like, it's profit and like less stress is what I want. But I want you to know that just because you write this vision today does not mean it's permanent. It's like very much in pencil. You're allowed to rewrite this as much as you want because when you hit this, I want you to feel fulfilled and not empty at the end of it. So looking to see how is this helping me have more freedom, have more life. Like I said, I got a doctor who's working.

 

three days a week making a million and so happy. Like sometimes I look at him and I'm like, I am jealous and so happy of your life. I've got another doctor who works six days a week and they're producing like five, six, seven million. Success comes in all shapes and sizes. And this is actually why I love bringing our doctors together. there was one doctor and she told me she's like, Kiera, I really don't like coming to the mastermind because I compare. And I was like, gosh darn, like you missed it, honey. Like there is no space that you have to compare. It's like hey I'm gonna rip off their ideas that are great ideas.

 

And I'm also going to be so proud of who I am and so confident. And that to me is when you have a very solid vision. You can walk into a room and you can hear a lot of people, but you don't walk out there feeling any less because you're like, this is my life that I'm creating. I am designing a life I'm obsessed with. And when you can say that, it just makes your decision making easier. But I would say have that locked, have it up on a board to where you're constantly focused on that, saying no, not saying yes to every opportunity just because it's there, but truly this is gonna help your decision making process become so much easier.

 

If it doesn't fit the vision, it's a distraction. And it's a no. So just say no and move on. That way you are obsessed with creating your life rather than managing it. So I want you to think about your next major decision and ask, does it support the future I'm trying to build? And if it does, rock on. If it doesn't, rock on. We just want to make sure that we're driving you forward. And then my next step is like revisit this vision every year at a minimum. I like to do my like, gosh. Are you ready to meet Kiera for real? I have been using the passion planner. Thank you, Monica. I know you listen to the podcast. This is a shout out to

 

I use the passion planner. It literally at the end of every month has reflection questions for me. It says, What was a memorable part of this past month? Describe it. What were three lessons you learned this past month? Review your planner for the past month and assess your priorities. Are you happy with how you spent your time? If not, what steps can you take next month to adjust them? What did you accomplish this past month? What are you proud of? How are you different between this past month and the month before it? What or who are you especially grateful for this past month? Name three ways you can grow this upcoming month. What concrete actions can you take to work towards these?

 

From one to one to ten, how do you feel overall about this past month? And this is supposed to you can take those same questions. I write my vision out. And a lot of times I use that reflection to also ask myself, am I getting closer or further away from the vision I set for myself? Every quarter I revisit our company's vision and my personal vision. Am I closer or further away? And what do need to do to course correct? At the end of every single year, kid you not, I literally write it. It says 2026. Like, let me just pull it up right now so you guys know.

 

That I'm not there. So 2026, my word this year is happy. and it's outcomes over so 2026, the year of happy. Kiera's the happiest version of herself. She does things that light her up. Outcomes over activity say no. This is my dream of a life that I am creating daily. And I have my purpose, I have what my goals are, I have my things on there, I have my mission statement, I have my personal important goals this year.

 

And I have my consulting goals for our company of what I want. And then I break it down into quarters of what needs to happen. And I review this monthly and I review this quarterly and I review it at the end of the year. My goal is like, what do I need to do and how do I need to drive towards this? So really it's a like review it every year at a minimum. I have a goal board. I put mine out on Canvas so I don't forget about it. To me, if it's if I'm creating my life rather than just managing it, I better be actively working towards that rather than just stumbling and hoping I make it.

 

So I want you to like when I get doctors and teams aligned on their one year, their three year, their ten year, thank you, traction for that model. They're able to all row. I have a doctor that we're working with right now. They're about a five million dollar practice. And they like we started out, we like got all the leadership team aligned about almost two months ago now. And they've been running their meetings. And today we got on our call and they were like, Kiera, we actually are rowing like.

 

The leadership highlight was we're all having better communication. We're all focusing on the same thing and we're all headed in the same direction. And to me, that lights me up because that team's lit up. But what's even cooler is on the backside of it, that doctor has their personal life goals that they're working towards in conjunction with their business goals. This doctor has never been happier. And I think about that. To me, that is the freaking success of what we're aiming for. So I encourage you, like have an annual vision day or put it in there monthly of like review my vision and see.

 

Get a passion planner. I know it sounds so silly, but like this forces me not to forget. And to me, my vision is the most important thing. Secondary is executing on it and not just having it as a hope and a wish, but something I know I'm confident I will actually have. So for you, quick wrap up on this. I hope you loved it today, is divine divine your success beyond just production. Like, what is that? And make it easier to feel good and harder to feel bad. Filter our decisions through that vision. We do the same thing for teams. If it's not aligned with our vision, we don't do it now.

 

And then revisit that vision every single month, every single year, every single quarter, whatever's right for you. Because I really want you to know that the best life and the best practice are built on purpose, not by accident. You truly are intentional by this. Like I want you to be designing a life you love, not just managing one that's given to you. When your vision is crystal clear, your decisions become much easier. So if you feel like you're being pulled in a bajillion directions, like it might be that you're not doing too much, it might just be that we don't have a clear vision of where you need to go.

 

So let's define that up. Let's help you. This is something we do with all of our offices, your personal life and your business. And they need to be married together and they need to be serving you. Life and business on purpose. You're worth it. You deserve it. You went and took the risk of becoming a business owner. Now let's reap the rewards of that. Success has two sides of the coin, the hard side and the great side. Let's get more of that great side. So that way when you reach these successful milestones, you feel freaking lit up, fulfilled, and so happy that you are actually living your dream of a life and not just managing what's coming your way. So reach out.

 

Hello@TheDentalATeam.com. Go live your best life. Do not make this just a hope and a wish. I used to write on my mirror when I was little. I said, don't just dream, do. And I encourage you to do the same. And with that, thank you guys so much for listening, and I'll catch you next time on the Dental A Team podcast.

 

It's Kiera and Britt on the pod together, with listeners getting a live look into how the Dental A-Team is thinking about the year's end — plus ideas as to what could be copied over to dental practices. There's a large emphasis on cost estimates and budgeting, including knowing when to fine-tune production or start cutting, and finding alignment as a team over those decisions.

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Transcript:

Kiera (00:00)

Hello, Dental A Team listeners. This is Kiera and today, wow, today feels like it should be written in the history books. Me and the Brittany Stone, No BS Britt coming on the podcast today. Britt, how you doing today?

 

Brittany (00:12)

Good, was just thinking it's been a minute since I've been on the podcast.

 

Kiera (00:16)

I know. I always message Britt when I need like certain topics. I'm like, hey, you want a podcast with me? And Britt's nice to say yes to me. I don't I don't bring Britt on as much as we used to. Britt doesn't actively take clients now. Britt hangs out in the background with me more often. So Britt, I think that that's like a win. I'm gonna say it's a win. Like Britt gets to be a little,

 

Brittany (00:36)

I'll take it as a win.

 

Kiera (00:38)

yeah. We work on some cool, crazy projects. We're working on a real fun one right now, getting ready for next year.

 

Britt, that spreadsheet's sexy. Spreadsheets are kind of my love language. So reviewed that

 

Brittany (00:48)

Thank you.

 

Kiera (00:48)

this last week and we're excited. There's some fun things coming up in the company for all future clients and our current clients. So Britt and I work behind the scenes, but yeah, No BS Britt. If you guys don't know her, she has been a consultant for quite a while. She has like three favorite clients that she kept when she decided to, you know, move along. And then she works in our operations in HR. And Britt is just a wealth of knowledge. She also's a hygienist. So

 

All things, but Britt and I decided we'd get on the podcast. AK I decided and asked Britt if she would join me is really how this shook out.

 

Brittany (01:16)

Yeah

 

Kiera (01:20)

we want to talk about like some of the things we're doing in Dental A Team for end of year planning. And I figured Britt and I, like these are our real everyday conversations, helping you guys plan and prepare for end of year. And Britt, maybe I'm a little psychotic on end of year planning, but I figured like let's kind of go through what we do together in our company, how we set up, and then hopefully again for offices you guys can be prepping for.

 

end of year. So that's my that's my plan for today, Britt. I hope you're on board with that.

 

Brittany (01:45)

I mean, I like it. think our company sometimes has a little bit more, has a few more variables than like dental practice

 

Kiera (01:51)

Yeah.

 

Brittany (01:52)

end of year planning. think we'll just say that on the like psychotic comment, but dental

 

Kiera (01:58)

Yeah.

 

Brittany (01:58)

practices, not to say there aren't variables involved, but you know, cost of travel and stuff like that is real fun right now.

 

Kiera (02:07)

I mean, seriously, our travel costs, we were going through all of our expenses this year and I was like, wow, we are up a lot. And a lot of them are just travel costs. Like I was shocked at how much travel has gone up. There's just a lot of things, right? Everybody's dealing with inflation. And so

 

Brittany (02:20)

Mm-hmm.

 

Kiera (02:21)

as we go through it, I think systematically Britt and I start planning our year around September time. So we'll be going through and we're gonna pull up all of our costs for last year. So we're gonna look to see.

 

We're gonna look at 2025 and then we're gonna run from 2026 from January till September. What is that? And then I don't know what the word is, Britt. Like when you just I think it's project out. That's the word I'm looking for. We're gonna project, yeah. Choose the word. We're

 

Brittany (02:43)

Protect, forecast, choose your word.

 

Kiera (02:46)

gonna project your forecast out how much we think we're gonna spend for the rest of the year. So that way we can get a good glimpse of what does everything look like? How does this work? What what are we actually doing? And then becomes my favorite part until I hate this part.

 

You then go

 

Brittany (02:59)

Zzzzz

 

Kiera (03:00)

to what we plan for next year. And so

 

Brittany (03:02)

Mm-hmm.

 

Kiera (03:03)

Literally there's a line item of like what's 2026? And then what do we think 2027 is? And man, Britt, we got our booties burned on some of the things we projected last year. Like we thought it was only gonna be 90,000 and it came in at like 120. So I definitely recommend looking at that. but also like Britt, what are some of the things you see for us and then also for offices? Like when we're projecting out for next year.

 

What are some of those costs to be planning in? Cause you've got your everyday ones. We're going need to impact for inflation. Like you said, like we're going to sell travels. Like we're going to have to need to boost that up. You still got merchant fees. You still have your rent. You still got these different pieces.

 

Brittany (03:35)

Thank

 

Kiera (03:37)

But like, what are some of the additional things that like you and I talk about in the business that I think a lot of practices might also be considering in their practices too?

 

Brittany (03:44)

Yeah, I think that the steady things are the easier things, right, to anticipate. It's when you're wanting to go and do some fun stuff like, hey,

 

Kiera (03:52)

Yeah.

 

Brittany (03:52)

let's go buy this thing or let's, you know, implement lasers across hygiene and we're going to need to go and buy lasers for everybody or things like that where there's going to be a bigger cost, bigger expense, bigger investment or like, hey, we want to build out.

 

three ops, right? What does that mean? Does that also mean we're adding in more providers if we're building out those operatories? So some of those things that are one, bigger costs, two, there's opportunity involved. So like there should be some revenue involved with that, of course, if we're investing in those types of things, but being able to plan out both sides of them. So one, what's our investment? One is that investment hitting us? What's that going to look like? And two, right, then like

 

Part of the fun is like the, are we banking on being the result of that thing? So

 

Kiera (04:43)

Yeah.

 

Brittany (04:44)

if it's provider related in a dental practice, right? What does that mean for even our revenue, our production, if we're gonna be adding on a hygienist or adding on, you know, another doctor to the practice that we didn't have there before. If it's just

 

Kiera (04:58)

Yeah.

 

Brittany (04:58)

an expense, right? Then planning for that expense and how you're gonna go about paying for it, whether it's gonna be.

 

one lump sum that's going hit us or if we're going to finance something and then that bill is going to be coming to us every month and we're going to be paying it out.

 

Kiera (05:13)

Yeah. And Brett, I think when you talk about that, like it is tricky. And I do think we have a bit more variable expenses. Like for us, it's like dental offices, you know, you got your dental assistant, hygienist. For us, we're like, shoot, when do we need to hire a consultant? Like, don't be too early,

 

Brittany (05:27)

you

 

Kiera (05:27)

don't be too late. What's their capacity that they can handle? so I do think our company does have a few more variables, but I also think, like you said, it's a okay, what is it going to cost? And then what is our projected income for next year or our revenue?

 

And I'm really excited because in our mastermind with our doctors coming person, this is mine and Britt's like little power project that we've been working on of like

 

Brittany (05:47)

Thanks

 

Kiera (05:48)

helping doctors see, like build in all the expenses that you want. Then let's see what we're gonna produce in how many days and what's your dollar per hour. And then it's like figuring out which levers we can push. And Britt, I think about you often of like, okay, do we need to produce more or do we need to cut more? Like which one are we going to be leveraging? And so when offices are looking at this, and even for us, like I love to have that wish list. Like I love to put it in of

 

I want to hire this and I want to do this. And like I think, and then when we get to the bottom of it and we're looking at our projected income, it's like, shoot. Now we get to go back through with like full blown

 

Brittany (06:16)

So she's not very happy.

 

Kiera (06:18)

razor and just cut and slice and dice. And hey, Britt, I'm just curious, how do you feel about company retreats on that budget line? Just curious how you feel. I know you just talked to an office about this the other day. It feels relevant, but how do you feel about company retreats?

 

Brittany (06:32)

I think one, build those things in for what you want

 

Kiera (06:35)

Ha ha ha.

 

Brittany (06:35)

to do, what you want to plan to do. then plan wisely. Company retreats can get wild. I think we've all heard some stories. We have great teams, but sometimes we put up in an environment and in a condition and things happen and we have to deal with things we don't want to deal with when we're trying to have fun. yeah,

 

Kiera (06:51)

Yeah.

 

Brittany (06:53)

that's what I'll say on that topic.

 

I think that owners, this is a good practice of planning things out to be able to see, if I want to do all these things, right? I love my docs that like want to go and take all the courses and buy all the things and have all the newest stuff, which is great. But what does that mean if we go get all the new stuff and go to all those courses and what do we need to do to be able to actually pay for those things? I also think it's really important for our managers out there.

 

I think it helps to bring some kind of reality to the situation. think a lot of the times if we don't know facts, we sit there and like, well, why can't we do this? Well, why can't we do that? Well, I really want to give this first than that. And I really want to do this, which we would love to do all of the things. But when it comes down to it, can we actually do it? Can we afford it? Because that's often when they're not involved in that side of it of seeing what the spend is and the reason why we need to set goals where they are. They'll be like, well, why is our goal so high? And I was like, OK.

 

There's a reason why our goal is so high and no, it's not just because we want our owners to make money. There's a lot of factors involved in that. And yes, we also want our owners to make money.

 

Kiera (08:00)

Mm-hmm. And Britt, I think that you just highlight something really important is I actually hadn't thought about it till right now when you said it. I do love that you and I work through this because I think there's an accountability side on both of ours. Like we both

 

Brittany (08:11)

No.

 

Kiera (08:12)

went and put the budget together. We both said what we thought we needed for the business. We both said,

 

Brittany (08:15)

I

 

Kiera (08:16)

hey, we think that this needs to be there. So then when we come back around and we're like, well, nuts. We gotta like figure out this amount. We gotta figure this out. Like I remember, I don't remember what it was this year. There was something you came to me and I was like,

 

I don't know, Britt. This is the budget. This is what we gotta do. Like, go figure it out. Like, we don't have the extra cash, even though we want to. But I think also I've done it. I remember last year, it wasn't this year, it was last year. I was like, Britt, I want to hire all these people. And you're like, girl, we made the budget. Like, this is what we said we could afford. And I'm like, I know, but I want all these people. And Britt was pretty much like me. And like, hey, well, what are you gonna go? Like, where can you cut, or where can you like this is how much we have agreed to allocate for it? Go go figure those things out. And so

 

I think it's really important to have doctors and OMs together where both of you guys are aligned. You can both keep each other in check and be looking and projecting forward. I think something that's hard, Britt, and I'm not sure if you've got ideas for offices, hiring people I think is one of the hardest things for me to like budget in because it's what like someone's salary, they might only get hired midway through the year. And I think something we did this year is I hired like three to four months before a lot of these people were projected in.

 

Well, that absolutely impacted our spend because we were hiring them. We met people, like, we know we want this position, but adding them in three months before they were really necessary or needed, I do think was a big like hit on us. And so I'm just curious, like,

 

Brittany (09:39)

Thanks.

 

Kiera (09:39)

how do people plan for when to hire, how to budget that in? Any thoughts you've got? Because I do think personnel is usually one of the biggest changes that a doctor office is going to do.

 

Brittany (09:49)

Yeah, and I think that it's only those one, those offices that are in a stage or like those like multiple practices that are in a stage where you're going to into some sort of like expansion, right? If not, I'd say on the year is a good time to evaluate if we want to like add a brand new role to a practice without changing any other factors like revenue that they're going to bring in.

 

And so I think that you've got to plan ahead and look at it in a little bit more detail by like, great, here's what the first six months are going to look like. Here's what the next six months are going to look like and what our expenses will be as you look and you forecast out. I'll say usually with dental practices, if you're looking at adding providers, it's a little easier because usually as long as they're hitting their production they need to hit, it's going to keep my other

 

my other numbers in line, right? If I hire a hygienist and I can keep them busy and I'm paying him the appropriate percent of their, you know, production, what they're gonna make for me, then like, I'm not really worried about that throwing my profitability way off because it's still gonna keep me in line. Associate is gonna be similar-ish. There's a lot more factors of like, how's it gonna impact owner-doctor production if I'm adding an associate. So we've got a...

 

Think about that a little bit more, but let's oversimplify it and say, hey, we've got all the patients. We know we can keep that associate busy. Then I know I can hire an appropriate level team to go with them, assistants to help support them, right? They're going to be producers if saying we have the patient base for them, then I'm not as stressed about adding them in. Still should like run it, see what it's going to look like.

 

Kiera (11:31)

Yeah.

 

Brittany (11:32)

But if they're a provider and we have the patients in order to keep them busy to where they're going to be producers.

 

then you can move a little bit more confidently than I'm adding a role that has no production side to it because that means my revenue is gonna stay the same and I'm adding costs.

 

Kiera (11:49)

Totally. And the only other one that I'd throw in, because of course this is like my role that I pitch to hire, is like a treatment coordinator because they can put quite a bit of dollars on your books for you, close more cases for you. You don't even have to have more patients for you. But I agree with you, those ones are easier versus it being like, We need an office manager or we need this person or I might need to give raises out for everybody. And there have been years where as much as I want to do raises,

 

We're in a heavy growth year and it is just a like Britt and I lock in and we say, like, all right, this is the budget. This is how much we can have. I do also think it's important to re-look at that budget because if we aren't producing as much as we thought we were, well, we might need to make some of these changes for the second half of the year that we haven't considered. So we'll dig into our like real life. So this year when Britt and I are looking, we're saying, Okay, what are we really budgeting out for next year? We know we're doing these masterminds and Britt can we just like

 

Brittany (12:38)

Yeah.

 

Kiera (12:39)

your budget that you had.

 

isn't gonna work for next year. That was literally the slack I think I got last week of like so we need to up that budget for next year.

 

Brittany (12:45)

Something to that

 

effect. We have a lot more people that are coming to those and we keep having more people each time we do them. So we know it's gonna get bigger.

 

Kiera (12:56)

Which is awesome. And I think it was fun because Britt and I like it forced us to innovate. And kudos to Britt. She went and found a really awesome venue for us. It's going to be able to facilitate the growth that we're wanting. We want these masterminds to be awesome. Our doctors love it. Hey, if you're not a part of it, join us. Like, hey, you want to be a part of it? It's very fun. It's a very fun community. Connect in with us. but I think it's a space of like, okay, we know that that's going to be a budget increase for next year. We know travel will be a budget increase for next year because going up to clients. We also like Britt and I are looking and we're looking at how much our consultants have capacity for.

 

We are looking to bring on another consultant for next year. So hey, if any of you know a great consultant or anybody who wants to be a consultant, shameless, not shameless plug. Send over any consulting friends you've got. They want to work for Dental A Team. Cause Britt and I, Britt, how fun is it to hire consultants?

 

Brittany (13:44)

You know, it's a unique set of skills, we'll put it that way. And so they are a level of a needle in a haystack. So we love good ones. So you read with Kiera, you've got the background, you've got the experience, come over to us if you know the business side of dental and want to be a consultant. But yeah, it takes us a while. It's not a quick hire. And I know I'm preaching to the choir to a degree on, for some of you, what it's like to hire even for dental practice right now.

 

Kiera (14:09)

Agreed. Yeah. So it's one of those spaces of like hiring an associate or hiring a hygienist or hiring other positions. They're tricky. that was literally not a shameless plug. If any of you do want to be a consultant, reach out. Britt and I are actively interviewing. So reach out. Hello@TheDentalATeam.com. Don't worry, doctors, we're not taking any of your office managers. Any office managers who know people in the industry, send them our way. We'd love to work with them. but we're hiring that. We also know we're hiring like we got bigger this year. We added a lot of admin to our team. I mean,

 

For Britt, her role split into three roles. Like that was a big change and a big shift that we had to make. So when you look at it, and I think for all dentists right now, as you're building out, look to see what do we do this year. Look to see, like Britt said, what are the things that are going to stay the same? And then what are the pieces that you're actually going to need to increase or change out? And then look to see at that bottom dollar amount. Britt, this is always where it like depresses me. And we just get that big number. It's like all the wants and wishes. And then I go back up and it's like, all right, what things do we really have to have? What thing I mean.

 

Last year it was over analytics. Like we get scrappy and

 

Brittany (15:09)

Yes, yes, yes, yes, yes, yes,

 

Kiera (15:10)

we're like, all right, could we get a better deal? Is there a different software? Is there AI that could replace this? Is there this? Like, I do actually, Britt, to me, you might not like that part as much. As much as I hate that like bottom line number versus what our production is. How do we like innovate to get those numbers to be in a line to where your profit margins are still where they need to be? What are the trade-offs you're going to make? And sometimes your trade-off is that you'll have less profit because it's a growth year. Other times the

 

Brittany (15:33)

Mm-hmm.

 

Kiera (15:34)

trade-off is

 

We're gonna scrap and we're gonna grind and we're gonna just figure it out. And that's the trade-off for this year. But do you have any suggestions for offices of like, okay, what happens when I'm too high over budget and I need to like figure out my production or cut? Like, how do you get those offices to be in alignment so that way they feel like they like next year we can actually afford all the things we need and we're also gonna be able to produce what we need to produce?

 

Brittany (15:57)

Yeah, this is where Karen and get into some good back and forth on some of these topics.

 

Kiera (16:02)

That's great. That's why I brought you on today.

 

Brittany (16:06)

And I think in getting it into alignment, I think there's the necessary things that we need to do. Like those are ones that no matter what, it's necessary and we need it, then we've got to find a way to produce enough and collect enough in order to get those things. That's the way we've got to tackle it. I think on some of the other ones,

 

I think you can build it in, in a dental practice to be like, all right, well, here's our necessities. But if we hit X number, right, then great, we can do this thing. Or if we hit X number, we can go and we can add this thing to our monthly cost and moving forward. it can be a little bit of a, here's our study that we know we can hit. And great, we've gotten our expenses where this is our like,

 

comfortable space, but we know we're always going to push ourselves a little bit more. And when we push ourselves, here's our reward. We hit it. We can get X, Y, Z and add those things in because we did better than we thought we did.

 

Kiera (17:08)

Yeah. No, and Br I agree. It is a good healthy back and forth. And I do think that that comes down to like, okay, we budget this much for team gifts or events or for a retreat. This is where Britt and I are like, All right, we will put it together at this point in time. Like, what are the innovative ways that we could do it? Or hey, if we hit this, like offices all the time say they want to go on these retreats. I know I'm like, We we make a joke because our team is virtual. So then you force people to travel who aren't travelers. It got a little wild for us for a few years. So Britt and I were like,

 

Screw that. We're not losing any more team members. We're not running any more retreats. Like, we're done. And it's a PL save. But that doesn't mean that like our team loves to get together. So can we do things when we get in person for the masterminds? Like that's where we got creative of like, when do people get together? What could we do that could be fun? I did love the idea. Like, again, no ideas are off limits. Someone's like, well, can't you guys like just do your retreat on Sunday after your masterminds? And I was like, hard no. I'm exhausted. The team's exhausted. We want to.

 

never see each other for six more months like just pure exhaustion because we put so much energy out for everybody. But I think it's really where you can just go back and forth and it's like, okay, well, if we want to do this type of a retreat, like, is there a way we could get the same outcome on a different budget? Or are there different ways

 

Brittany (18:20)

Mm-hmm.

 

Kiera (18:21)

too? And I really do love that Britt and I will come in and it's this back and forth. It's both of us creatively thinking, Britt pushes hard on like, is this really a must or is this like a want? And I appreciate that. But even looking at consulting, like

 

I think that there's a space, and I think Britt and I are a good example of this, which is why I wanted you guys to hear our genuine true back and forth. Me sometimes I'm going to push, like, no, Britt, we do need to hire this consultant or we do need to have this. This year, I had three great ideas. Of my three great ideas, one was good, two were not so good. Like Britt, I'll hand it to you. The last hire we made that you told me not to do, that I thought was a brilliant idea, didn't pan the way we thought it was going to. And I called it, I've admitted it, it was not a good move.

 

But I think that there's like my job is to push and innovate and try things that maybe Britt would say, like, I'm not so sure. And Britt's job is to say, like, you might want to think about this before you say it. But there are some times when I'm going to see that, like, no, bringing this person in or bringing this piece in or changing this up, it might not be right. But I will say, like, between the two dynamics of a doctor and an OM, make sure that both of you are pushing your agendas while coming together of what's in the best interest of the business. Those are my thoughts, Britt, but I'm sure you have your perspective of it too.

 

Brittany (19:31)

Yeah, and we're always going to try things and they're not always going to not everything's going to pan out, especially like technology and all the things going on and all the advancements. Like there's going to be things we try that we're like, hey, this might be a great idea. Think it will work. Let's do it. We do it. We're like, man, maybe that isn't as helpful as we thought it would be. We'll fix that one and we're going to move on. I think those things, if they're not happening, we're probably not trying enough.

 

If they're happening all the time, then maybe we could vet a little bit better before we jump into some of those things.

 

Kiera (20:03)

fair. And I think they like I think in dentistry it's a little bit easier. Britt and I are in the wild while the bus over here. Neither of us have ever built a dental consulting company. So you better believe some of my like late night grandiose great ideas, some of them have been kick A. Some of them have been awesome. Others, hmm, that one didn't pan. And I think having the humility on both sides of like that didn't work and always coming back to the table of this is in the best interest of the business.

 

what's really going to get us to where we need to go. So I think Britt, thank you for coming on and humoring me today. I really want people to hear

 

Brittany (20:33)

Thank

 

Kiera (20:34)

like what you and I do back and forth. Hopefully for doctors and OMs, I would say it's time. Like let's go run our numbers for this year. Let's project out through end of year what we think it'll be. And then let's build 2027's budget. Let's look to see what it's going to cost us. Let's look to see what we want to add in, what team members, what softwares, what consulting. Like this is where a lot of times people have also I will say on the consulting end of year, if I know we want to add this in for next year.

 

And I'm looking at my tax liability this year. Britt

 

Brittany (20:59)

Mm-hmm.

 

Kiera (20:59)

knows I am in a heavy hunt of what are the capital expenses? What are the things that I can put in now that are going to benefit us for next year? That's also going to keep our cash flow high. So if you you've got a higher tax bill this year, that's why I like to plan in September. Cause then I've got October, November, December. We have prepaid for event venues. We have prepaid for consulting. We know we're gonna have lots of our clients will pay at the end of the year for consulting. So if you've been considering that, then it's not a cost next year that I have to do. We're getting the benefits of it next year.

 

But I'm able to get the discount rates. And sometimes also Britt and I will negotiate with people, hey, if we pay in full at the end of year, can we get a discount? Like people are willing to do things because they know business owners need to get these off their books. So I'd really recommend dialing

 

Brittany (21:38)

Mm-hmm.

 

Kiera (21:39)

it in, looking to see. I can't pre-pay and hire somebody today. Like I can't do that. But software, consulting, technology, different things that I want to bring into the business. Things like if we know we're going on a trip, like we will pre-book a lot of our flights at the end of the year.

 

anything that we can do, depending upon the tax liability that we have, it's things that we're gonna do. And everyone's like, you might kick your can down the road. True. And next year might not be as profitable. We knew we were headed into a growth year this year. So we stockpiled last year. We knew this year would be a bit more of a stretch year. That's how I think business owners should look. And it gives you, I'd rather you be doing this today in September or October before the end of the year. So you have time to make those decisions. So those are my final thoughts for any for you.

 

Brittany (22:19)

And I'll come in with my

 

like conservative two senses as long as it's something that you know you're going to spend money on anyways. It's kind of like I've got I've got a friend's family that I'm like, it's like the people who are like, well, it's on sale. So I bought it. I'm like, OK, but a good deal on something you don't need is still spending money you don't need. So

 

Kiera (22:38)

Yeah.

 

Brittany (22:39)

as long as it's something that you actually need or you are actually going to spend money on anyways, 100 percent agreed. But don't go like.

 

spend money on stuff you don't actually need to spend money on.

 

Kiera (22:51)

I do agree. And this is again where you got good, like it's a good balance here.

 

Brittany (22:54)

Yeah.

 

Kiera (22:54)

agreed. I'm glad you put that caveat in because all those pieces like software, technology, consulting, we knew we were going to do it anyway. Let's just get it for a better deal because we can. Like we will bundle end

 

Brittany (23:01)

Mm-hmm. Correct.

 

Kiera (23:05)

of year. We're is looking at all of our softwares and we were hunting to see, like, hey, if we buy it now, if we do a whole year, things we know we're already going to do, can we get that a reduced price? That's also going to keep our cash flow higher next year, too, for us, which is always a benefit. So

 

That's our that's our end of year. We're, you know, having a good time with masterminds. They're growing. They're a good time. They're so fun. We're looking for consultants. but I also think, Britt, like, I think Dental A Team is it's a growing company and it's always going to be growing and it's always going to be evolving. And I think both of us have accepted that. Some dental practices aren't. And it's also okay if like your numbers are pretty consistent year over year.

 

Brittany (23:40)

Mm-hmm.

 

Kiera (23:41)

That's also okay. But look, you might be looking in like,

 

What are the raises? Or what are the CE courses we could take our team? Because just because you flatline, if you will, you're not adding more head count, you're not adding more tech, you're not adding more ops. What things can I do to innovate and push my team forward? Or how can I get more increased dollar per patient in the practice?

 

Brittany (23:57)

Mm-hmm. Mm-hmm.

 

Kiera (24:01)

Those are the areas to be looking at. So every practice should be like, this is the push, this is the innovation, this is the creation, and then lock in. And Britt, like we got to lock on that budget. Britt does a good job of being like, no, we locked on this, we stay on it.

 

reconcile it monthly and then reset usually halfway through the year to see how you're doing. Obviously look at it quarterly, but really I don't really try to make big budget changes until about mid year to let it ride for a little bit longer.

 

Brittany (24:25)

Mm hmm.

 

Yep, I agree with you. And yeah, offices, your spend may not change a whole lot each year. You should be growing to a degree each year. And yeah, costs are going to go up to a degree each year, but it won't. Some don't swing as far as some others. Now, my my practices out there, my my owners, my true entrepreneurs out there, they're like, yeah, I'm adding a practice next year. I'm doing

 

Kiera (24:50)

Mm.

 

Brittany (24:50)

this or I'm doing that. Like, yeah, there's going to be a few more variables in the mix.

 

Kiera (24:54)

Absolutely. So go guys, go start plupping pranning. If you need help with this, we're literally working on it with our doctors and our offices. It's a great time. reach out Hello@TheDentalATeam.com. Britt, thanks for being here. Thanks for being my like No BS Britt. You always love give it to me straight. You always talk to me. And I respect that so much because I think every good entrepreneur needs a great No BS Britt next to them who will make sure that both are are synced and can really do the best in the business. So thank you for being on the podcast with me today.

 

Brittany (25:23)

Thanks for having me.

 

Kiera (25:24)

Of course. And for all of you listening, go get your end of year in place. Go get your numbers dialed in. Reach out if we can help you in any way. And as always, thanks for listening. We'll catch you next time on the Dental A Team Podcast.

 

Dentistry is most important when a patient is in the practice. As soon as they leave, there are a million other parts of their life competing for priority. Tiff and Dana discuss how to talk about dental care with your patients so it doesn't get lost under the heap of everything else. 

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Transcript:

Tiffanie (00:01)

Hello, Dental A Team listeners. We are back again to podcast with you. To yeah, I loved that Dana. Dana's got some excitement in her veins today. I think it's nice out. Honestly, it's nice out. I had I had to close this window the last podcast. That's what you saw me do. and then I have another window open and I'm in Phoenix. We don't open our windows often, and I've only got like probably thirty minutes left of this window being open.

 

DAT-Dana (00:27)

Right.

 

Tiffanie (00:29)

but it's energizing. I feel like

 

I just need the fresh air and and it's just beautiful out. So I can imagine Dana where you are if it's this beautiful here and then Brodie's in he's forty five minutes south. So he's in Tempe and he sent a picture and it was more beautiful and I'm like, gosh, go another hour and a half past that towards Dana. It's gotta be just gorgeous down there right now.

 

DAT-Dana (00:51)

It is. I feel like though Phoenix can just be gorgeous and be gorgeous. Further south, and there's an as you know, Tiff, because you kind of grew up in this area.

 

Tiffanie (00:58)

Mm-hmm.

 

DAT-Dana (01:00)

if it is sunny and beautiful, then typically it's paired with wind, right? So I feel like my windows are never

 

Tiffanie (01:04)

This is

 

DAT-Dana (01:06)

open because even when in the temperature is beautiful enough to have them open, the wind is going and I don't want all

 

Tiffanie (01:12)

yeah.

 

DAT-Dana (01:13)

the desert dust you know, sitting in my living room. So

 

Tiffanie (01:17)

I love

 

what you just said. I love it. So Brodie texted me a picture and I said, Gosh, that's prettier than here. I said, This is this weather is the only thing I miss about living in Sierra Vista. And what you just said, people say, Why did you move? Like the weather was the weather is better in Sierra Vista. It literally is. The temperatures

 

DAT-Dana (01:33)

Yeah. Yes.

 

Tiffanie (01:35)

are better. You get a better winter, you get better seasonality. Like it is just better. And people say, Well, why did you move? And I say, Because of the wind. I legitimately

 

90% moved because I couldn't you just can't be in it. It whips your hair, like it hurts my hair hitting my face as a child. I remember the pain of that and the tangles and brushing my hair out at the end of the day because I had to walk home from the bus. Like legitimately, Dana, the wind. I can't handle Southern Arizona winds. Yeah. Yeah.

 

DAT-Dana (02:12)

Yep, yep, you

 

hit it. You hit it right on.

 

Tiffanie (02:15)

Spent

 

my I spent my whole childhood there. I lived in Sierra Vista till I was what, twenty? I think I moved up here when I was twenty. I can't I can't do it. So yeah, I love that you said that. And everyone listening, you just got a nice little taste of the Arizona weather history there. It's never changed. It's still windy. So if you want wind, go down south. If you want really cool honestly, it's it's beautiful down there. So if you haven't visited Southern Arizona, meaning

 

Like Phoenix is cool too. Obviously Sedona. But if you haven't been south of Phoenix, Tucson has some really cool stuff. But then you get into like Saurita, where you are, and Senoida, there's like wine country, there's Tombstone, Isbe. Like there's a lot to do down there. And I discredit it and disvalue it 'cause I grew up in it. but it is really beautiful. And

 

on to dental. Yeah. Yeah.

 

DAT-Dana (03:08)

Yeah, but my windows just stay closed. So I can look at

 

the beauty. I just Yep. Right. Yeah.

 

Tiffanie (03:13)

My windows stay closed because it's too hot. So in Arizona we just don't open windows. Okay.

 

It's just stifling in our house all the time. It's fine. So on that note, dental. Dana, we get fed podcast topics. and then you and I, I love that you and I are just like, nah, we're not gonna do that one today. I don't I didn't like the other one. So today we we already talked about kind of

 

Prepping for changes and and systems that work in the midst of change. That was a a podcast we just recorded. So if you haven't heard that one, go back, find it after this one. You don't need it beforehand. But they kinda go I think they kinda go hand in hand because one change that we oftentimes don't prep for because we don't know it's coming, is accepted treatment still like falling off of a schedule. And I think that happens a lot. I have a lot of practices that are like,

 

It's full until the day before or two days before or gosh my hygiene schedule's full six months. I can't get ab get anybody in. But then the week of it's falling apart. So we're not here to talk about hygiene. There's plenty of those podcasts. Go search it. But we are going to talk about why accepted treatment still falls off of the schedule. And Dana, right before we started this podcast, you said something and I was like, Yep, another drop mic drop moment from Dana. She'll always give them to us.

 

I would love for you to repeat what you said right before we got on this podcast because I think that it's true and I think that's where we start.

 

DAT-Dana (04:38)

Yeah. I I am known for my brutal honesty tips. So what I

 

Tiffanie (04:42)

Ha ha

 

DAT-Dana (04:44)

said before we got on is like treatment that falls up after the fact is typically for the same reasons that we hear patients give us that they don't schedule to begin with.

 

Tiffanie (04:53)

Yes, yes. And I got excited about that because I believe that oftentimes we work so hard in like the sales side of dentistry that or not that we work so hard on the sales side of dentistry to get a yes that they're just like, okay, yes, fine, I'll schedule it. Like, well, what about this hurdle? What about this hurdle? And yes, I wanna work objections and I wanna I wanna get over hurdles.

 

But I think Dana, in what you said, you said the same, they they fall off the schedule for the same reason that people don't schedule. And I wonder if not every time, but if sometimes those patients who are falling off weren't actually a yes, they were a let me out of this office right now, right? Because I I've taken a lot of

 

Communication courses, a lot of relationship style courses. I've done a lot of emotional intelligence and just like communication stuff. And something that is tried and true in every aspect of anything that I've done extracurricularly is the relationship comes first. And

 

Knowing

 

the person, knowing the why, knowing the reason, and speaking to that and overcoming, helping someone overcome an issue or a problem and seeing better on the other side is the most important factor. And oftentimes in our objections and our conversations of our hurdles, I wonder if that aspect of the communication gets missed because it's more about checking check boxes.

 

than it is about investing in the person. And maybe I'm being wild, but when you said that, that's where my brain went and I was like, gosh, it's the relationships. Dana, what are you what's your perspective? What are you seeing on your side?

 

DAT-Dana (06:47)

Yeah, I 100% agree with you. And I feel like when because we hear it all the time when we go into park, well, it falls out because life happens, right? Well, you're right.

 

Tiffanie (06:55)

Yeah.

 

DAT-Dana (06:56)

Life is going to happen. and typically we will also kind of say that like dentistry is most important when the patient is in the office. So then when life happens, right, it becomes less and less important. And I think that you're absolutely right. And to me, it tells me that like

 

I actually didn't really listen and get to the bottom of what actually was holding the patient back or what their no actually was. And so yes, I got a yes, which great, but I didn't actually get a yes that meant I'm fully committed, I fully understand, I'm fully ready to go. and so then that's kind of why we see it fall off. And I feel like

 

The biggest thing is life is going to happen for your patients when they leave the practice. So if they don't know where, when, how to prioritize the dentistry that you are talking about with them in life happening, then we didn't get it right.

 

Right, because life is gonna happen and I need to know that if my dog chews 35 Legos, like she's been doing every week and has to have an emergency vet visit, right? That

 

Tiffanie (08:00)

Yep.

 

DAT-Dana (08:01)

like I know where my dentistry needs to fall in the spectrum of the things of my dog eating 35 Legos, right? Do I need

 

Tiffanie (08:08)

Yeah.

 

DAT-Dana (08:08)

that crown or does the dog need to so life happens, absolutely.

 

Tiffanie (08:12)

Yeah.

 

DAT-Dana (08:13)

But I think our biggest tool is

 

treatment coordinators or people that talk about treatment or even the dentists, right? Tre doing the treatment planning in the back is they need to know where to prioritize the dental work that needs done with the life things that are going to happen. And I think when we just get that artificial yes, that didn't happen.

 

Because they

 

Tiffanie (08:34)

Yeah.

 

DAT-Dana (08:34)

left and something came up in their life, or they left and were just like, I do it all the time. I go to Target, I put all these things in my cart, and as I'm walking up to the thing, I'm like, I don't really need that. Or

 

Tiffanie (08:44)

Mm-hmm. Mm-hmm.

 

DAT-Dana (08:46)

you know what? I don't, I don't really need my lips moisturized. That chapstick can go. Right. And so

 

Tiffanie (08:50)

Yep. Yep.

 

DAT-Dana (08:51)

those things start to happen. And if you think about doing that and you think about, okay, well, how

 

What would make someone take the dentistry out of their cart, right, and stick it back on the shelf? It's probably because we didn't get to the bottom of what is important to them. We didn't build that relationship with them. We didn't understand who they were and how they make their decisions. And we didn't get through to them where to prioritize this decision and all the other decisions they're going to make the second they leave the office.

 

Tiffanie (09:21)

Absolutely agree. Absolutely agree. And that's not something that I think people innately know how to do, especially in the workplace, because in my opinion, we think of work as transactional, right? You go it work, the word work is transactional, right? You do something for something. you work out at the gym to get stronger, right? To get healthier. You do something for something. So it's always transactional.

 

And transactional doesn't always translate to the emotional side of it. And we miss that mark. And in in dentistry, dentistry is weird, right? Because d medical, like med they don't have to think about this very often, right? One, they've got a million people walking through the door all day. They don't it's a rare occasion that someone's really concerned if you're coming back or not. So if you have a provider like that, please by all means share it on all the platforms because we all need one.

 

In dentistry, one, it's that's not how it happens. We don't have a million people coming through the doors. And two, we actually literally are more invested in the people that are coming to our practices. Dentists in general sought out dentistry for a different reason than many medical professionals at least are practicing now, right? I think that they probably had a good reason to get into it, but throughout the years something shifted and changed for for many people. My point of that.

 

is that we discredit that emotional side of it and we become more transactional where it's like, okay, the next step in the in the flow is schedule. And so we're like, okay, great. I reviewed the estimate. You've got that estimate. No questions. Great. Let's schedule. Right. And then they're like, I'll call you. And we're like, well, what difference is let me get you on the schedule now. So that I would hate for you to forget. Let me put you on the schedule now. We'll block out the time. And then if if there's you get to work and there's a work

 

Event in the way, give me a call. Right? I've done that a million times. Like, no, no. Now I'm supposed to say, Well, let's get it on the schedule, because now it's on the schedule, it's accepted. Right? But then that patient is like laxadaisy about the appointment or what have you. Because I didn't I didn't ask what's holding you back. Like, great, tell me more about this. Tell me when I would sit patients down for a treatment plan, I've I've done this for a long time. And in the same practice I had

 

the

 

awesome opportunity of testing out a million things over the almost 13 years I was at this practice and I've watched myself evolve. I can look back now and see like how I evolved from the transactional to the they sit down in front of me and I'm like, hey, they said you need a crown. Wha how what do you think about that? And sometimes patients were like they would just cry. They're like, I don't even I don't have anything like this. Or sometimes patients are like, I knew it was coming or can't they just pull it?

 

Like now I'm in a conversation and now I can learn more about the patient, their thought process, their priorities, right? Like can't you just pull it? Well, tell me why that's where you jump. From a crown to a pull, for me, that's a massive, that's a massive jump. Let me tell you why. And then you tell me why you took that leap. What's the priority there for you so that I can understand more? But instead we're so transactional, we're like, no, that would be wild. You need a crown.

 

And it's gonna be this much. And we stick to that transactional checklist instead of being like, Well, let me be curious, like what makes you wanna just pull out the tooth? Because to me, in dentistry, you blew my mind with that statement. So tell me why you want to pull that tooth out. But we don't always think to ask those questions. So Dana, like this is all very Kiera would be like, Yes, Tiff, this is great, but like what's the track like what's the action item, right? So like

 

This is all great. How do we train? And I know you and I both work on this with practices, but how do we train a treatment coordinator or a doctor, right? A dentist diagnosing can do these things too. So what

 

DAT-Dana (13:30)

Yeah.

 

Tiffanie (13:30)

are some like tips that you give practices to say, hey, get more relational and less transactional without saying those words?

 

DAT-Dana (13:38)

Yeah. I

 

I think one, it is just just like you said, it's kind of shifting your mindset. I always teach teams at the end of the day, we want the yes, right? But we want a yes that is good for both of you, right? Like you as a treatment coordinator and them as the patient. And just getting a yes, like you said, is super transactional. So to me, how I train teams is we have to just ask more questions. We have to ask what's holding them back. We have to ask.

 

what would a budget be that they're comfortable with? We have to ask like if they feel like third party financing is an option for them. We have to ask if they even want to save the tooth. We have

 

Tiffanie (14:14)

Yeah.

 

DAT-Dana (14:14)

to just ask more questions. And I feel like

 

It's again, I like gonna highlight the podcast we did before. Please go find it. It was a good one, but like it comes down to communication and it comes down to just asking more questions because every question that you ask is going to break down a barrier in some way. And it might present a new one that we have to work through, but it's getting treatment coordinators to understand that your job is to partner with the patient and figure out a way. There is

 

always away. And I like I say this all the time. There's no financial barrier that you like really can't truly overcome. You can break down treatment, you can break down payments, you can pay ahead of time and then add third party. You can like there are you have to get super creative sometimes, absolutely. But you have to really feel in your bones that it is so important for this patient to have done what is needed to be done and you have to be willing to ask whatever question it takes.

 

to get to the point where you can both feel really good about a yes. Not just you, because you got the yes. You both have to feel really good about the yes.

 

Tiffanie (15:23)

I totally agree. Yeah, that was beautiful. And then get some pre-collect.

 

DAT-Dana (15:28)

Yes.

 

Tiffanie (15:29)

I the money mindset is far overlooked. there's a statement I wanted to remember to say. One of the things that I learned in all of the training that I've done is to be more interested than interesting. And I think about that all the time because human nature is to talk about ourselves, right? Or to be right or to have the the

 

most information and in dentistry, especially my treatment coordinators, my office managers, my billing reps. Like we I think sometimes feel like we have something to prove, right? That we're we do know what we're talking about because there isn't a formal you don't get to go to school to be a treatment coordinator and you come out with a certificate or a degree in treatment planning. Like you just don't we learn it on the job. We learn it by going to CE. We learn it because we hired a consultant, the Dental A Team and they were wonderful. Like

 

We learn these things through doing it. And so I think sometimes we wanna make sure that people know what we know what we're doing. So we can get a little transactional in it and a little dry. So making sure that we're being more interested, meaning to Dana's point, like asking more questions. Be be in the why, be in the why is it that way? What do you feel about that? Tell me more, right? So the one aspect. And then the the

 

like hurdle of the collecting in advance or something you've already paid for, right? Everybody, it's all over Instagram. You guys just look up like girl math, right? But this is one majority of your patients are probably female. I'm just gonna point that out there. Okay. So girl math works. Two, I don't think it's just women who think this way 99.9% of the time, right? Money out, money spent is already gone. You're likely not going to have someone call you and it it does happen. I'm not gonna say it won't.

 

It does happen, especially for large sums, but it is going to be very rare that someone calls and says, Hey, my dog ate 35 Legos yesterday and I need that $600 that I put towards that crown back so I can take him to the vet. They're gonna find another way to pay for the vet bill because they've already paid the $600 or whatever towards the treatment that they're getting done at your practice. So whether they're paying full in advance, they're paying partial, having some skin in the game.

 

And

 

having committed financially locks it in place. And it is a psychological proven skill that works every single time. Money is already gone. We've already accounted for that money to be gone. We've already formulated a plan to get it back. And we're we've moved forward. So Dana, do you I do you still this is a real question? Do you still find that you

 

Have pushback from teams to collect in advance. I feel like for me, it's like less and less over time. It's 2026 now, and the time of recording this, I can tell you five years ago it was much different than it is today. What are you seeing? you see more new clients than I do. I don't, I don't

 

DAT-Dana (18:38)

Do

 

Tiffanie (18:38)

take on new clients, so you're gonna have a better pool to choose from. Are you still seeing pushback from teams when it comes to pre collecting?

 

DAT-Dana (18:48)

Feel like I do still see some because it's an uncomfortable space. It's a new space. And I think anytime we're putting people in a new space, you do get a little bit of resistance, but it is nowhere near what I used to get because honestly and truly Tiff, teams are exhausted in trying to

 

Tiffanie (19:03)

Yeah.

 

DAT-Dana (19:03)

build and rebuild and refill and backfill and replace what they've already replaced in their schedule. And and I think that.

 

For so long, like yes, cancellation policies are great. Yes, all those pieces we wanna have them in place, but I think

 

Pre-collecting, I think, works wonders in that area. And I think that team members are willing to do things or try things like just to keep their schedule solid. So

 

I agree with you. I think that more and more team members are open to it. More and more team members also just understand, like I think sometimes just put your patient hat on and yeah, I'm probably not gonna miss an appointment that I've already paid for. And so I do feel like

 

A lot of my calls are around like just schedule changes and then the process of that. And then, you know, we're trying to chase down patients because they're working the same hours we're working and and all of that. And I think teams are exhausted from trying to fill and backfill their schedule. And so I do think that like pre-collecting in those pieces, because again, it's like a yes that you can be super confident is a yes.

 

Like I

 

Tiffanie (20:17)

Yeah.

 

DAT-Dana (20:18)

said before, I yes, it feels good for both of you. I think when it's yes and there's a financial commitment that feels really good for me because I know that patient is invested, is going to come. And that's probably not a spot unless there's a super rare thing that pops up that I'm gonna have to then do that extra behind the scenes work to fill. And so I

 

Tiffanie (20:39)

Yeah.

 

DAT-Dana (20:40)

agree with you. I think teams are a little bit more open to it. I think teams are a little bit

 

more willing to kind of see the benefits of it because honestly and truly schedule changes I think are still just a really big highlight in a practice. And anything that's going to lighten that load, I think is massive for teams.

 

Tiffanie (21:02)

I

 

completely agree. Thank you. I hope that the dentists who are listening today heard that. The office managers who are listening. Because I I think, Dana, from what I've seen, I agree with you. I think teams are exhausted and they're like, I'll do it, I'll try it. Right. And I think we have to we're so used to paying for things these days before we get it. It used to be like, Well, I can't get like I don't get my stuff from Target. Like I walk out and I pay for it at the same time. But now

 

It's an Amazon Prime culture. We're paying for things before it ever ships to our door. And I'm gonna tell you right now, there are times that that thing never even comes. Right? It never gets here. And I'm like, it's lost in someone's trunk and they're sending me a new one. massage therapists, right? I booked a massage for a surprise massage for Aaron a couple months ago. I had to pay online, I had to pay on the app to before I could schedule the appointment for him. So I'm like, well, he's he better freaking go because I already paid for it.

 

concert tickets, there's nothing there's not a lot right now that we pay for that we're not paying before we get the thing. And we're paying pretty far in advance for something. So it's that culture, that mindset has shifted. But I think that business owners, it's it's personal. Right? They're paying for your treatment, for your business, for you to provide them with something. So it's more personal. And I say this because to

 

To everything that Dana said, I want you to take that to heart because I think it's more often a dentist and a business owner that says, my team's not going to like that, than the team saying no, we won't do that. And so I want you to give them the chance, the shot, the opportunity to make their lives easier and get the actual yes. Because in my opinion, case acceptance is scheduled and paid for. Treatment that is scheduled and paid for.

 

Is accepted, right? And I don't hold that, I don't, that's not my like standard bar for everyone. You guys get to decide what that looks like, but to Dana's point, scheduled and paid for is less likely to fall off the schedule. So if that's where you can set your bar, you're gonna have a more full schedule. So I love that, Dana. So I would say one, I loved your ask more questions, so B

 

Be invested in the person, be interested in who they are and why they're making decisions the way that they do. And I think Dana, something you said was how are they making the decisions? Like how, what is their priority in the decision making? If you can get to that point in just asking more questions and being interested in them, you're gonna get your yes. And then I would say if you don't do some sort of prepayments, if your schedule is falling apart, even if it's not, I think it's smart. But if you're someone who's here because that title said

 

accept a treatment is still falling off your schedule, put in those pre-collects. At least collect a portion, I would say 50% to 60% down holds the appointment. Dana, thank you so much. I knew this one would go I knew it would go well. We didn't super prep for it. And I feel like the ones that we don't super prep for are the ones where our minds really start getting on a a good track. So Dana, thank you for your time today. Thank you for your nuggets as always. And

 

On behalf of everyone, Dana, thank you for your brutal honesty. Always a pleasure. Thank you. It's

 

DAT-Dana (24:25)

Anytime

 

Tiffanie (24:27)

always accepted. I love brutal honesty. and with that, that is a wrap for today's podcast. You guys go re-listen. There were some gems in here. Like Dana, thank you so much. You you dropped some massive gems, and business owners, try it, just try it out, see if it works, see how it works, see how you can manipulate it to work best for you guys. If you guys need help with it, Hello@TheDentalATeam.com.

 

Also TheDentalATeam.com, you can sign up for a live like video call session with our team, and they'll help you figure out the gaps and figure out a way to fill those gaps. And so Hello@TheDentalATeam.com and TheDentalATeam.com as always. Thank you for listening. Drop us a five-star review below. We love to hear from you. And we'll catch you next time.

 

Your key performance indicators do not have to be intimidating. In fact, with the correct frame of mind, they tell you exactly what's going on in your practice! Kiera shares the smart way to utilize KPIs, including:

1. Looking for patterns, not just numbers

2. Finding the question in each KPI

3. Understanding KPIs are team-wide, not just for the owner

Episode resources:

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Transcript:

Kiera (00:01)

Hello, Dental A Team listeners, this is Kiera, and I hope you're excited because I'm gonna talk to you about KPIs and whether you're excited about it or not, you're gonna listen to KPIs because KPIs are the vital of your practice and your KPIs are really telling you a lot more, just like your vitals on your body are probably telling you a lot more than you think they are. I have been getting and falling in love with weight training, and I had a client shout out to her. She was like, Kiera, you need a new passion to become obsessed with, and I think weight training could be there.

 

But with my history, I was anorexic for a lot of my life. And thankfully that part of my life I think is like done and over. And I love food. And so with weight training, my coach was like, you've got to track in and you gotta weigh in. So it's weighing in every day, doing your measurements, and then doing macros. And for a girl who is terrified of that, because a skill for me and eating food, like a lot of food.

 

was like no goes for a lot of years in my life. And what I found though is she was like, Kiera, you're just tracking these because they're telling you information like the food you ate yesterday, or are you like coming up on your menstrual cycle where you're bloated and you're holding more water? it's been fascinating. And I've been tracking for almost a year now. So like huge win. Thank you. Thank you. I'm sure you're all cheering for me. and if you're not, I appreciate the cheers. but what I realized is like,

 

It's just data and it's telling me information. And I re bring that up because I believe that this was what our KPIs are too. The KPIs are just data to tell us if something's working, if it's not working. I'm obsessed with tracking my metrics. Like there was a while that I was weight training and I wouldn't track what my weight was. And I never was getting stronger because like it's like, I think I was at like 10 pounds last time, versus hey, last time you were at 10 pounds, we're gonna start you at 10 on your warm-up and we're going up to 12. And now I have a really like strict UR trainer.

 

Who watches my metrics, watches the pieces, and then adjusts accordingly. I am up to PRs that I've never been hitting, but it was because I actually use the data, not just track the data, to make better decisions. And that's what your KPIs are. So I just want you to know that like look at your KPIs to look for the right messages because we're only looking to see if we won or lost most of the time with KPIs. But using these to diagnose problems before they become expensive to me is where your KPIs really start to become impactful. Similar to like, wait.

 

Right. Like we're trying to add and bulk up my calories. Like I came in at a lower calorie, no shock to anybody. but for us, it's like, okay, well, for me also, how do I know I can add this much food in? Like, guys, so much protein. If you have protein tips, please email me. Be a protein buddy out there. I am so tired of eating cottage cheese, chicken, fair life shakes, cottage cheese. Like my main thing was like cottage cheese, wheat checks, gr raspberries, and peanut butter.

 

I have eaten Built Bars, like you name it, protein powder. I shout out to Ballerina Farms. That's my favorite one. I've made an Orange Julius with vanilla protein powder. Like you guys, to get that much protein has been so hard. But I also know if I don't get enough protein and I'm lifting, I'm not gonna get my the the gains and the strength that I'm actually going for. And this is to make Kiera, 95-year-old Kiera, to be freaking ripped. I wanna be like running and beating your 20-year-old son or daughter. Like that's what I want to be doing. So

 

But if I'm not looking at this, I'm not diagnosing these problems. So like we're adding more food food, but like we got to watch to make sure the measurements aren't changing and we're not adding it too quickly or not. So it's this whole piece. Same thing with your KPI. So I hope that analogy was there. I hope that, and hey, if you want to talk to me about like protein or weight training, hi, I would love to talk to you because I was like rookie girl who didn't even know how to lift going into it, wasn't like a bodybuilding competition. There's really, I don't know how to explain it.

 

But there was this incredible photographer from Spain who does physique photo shoots. And that was like a goal I worked towards. And to be able to have that to weigh in, to do a bulk and a cut, to just like be able to turn my body into this incredible machine and see how I can fuel her. Hey, if you want to talk about that, like hey, maybe that's another podcast of like, but happy to chat with anybody and just know, like, it's really incredible. Also, exhaust the body, tame the mind. Shout out to Dan Martell.

 

It really has also made me a more powerful CEO and to navigate some of the hardest times in the business because I've been able to have that mental strength and support by working out. So total tangent, but like let's get back into KPIs because KPIs really truly are so helpful for you. It's the first thing that's going to work with you. We have a KPI dashboard for all of our clients. We use the analytics with all of our clients because this will tell you before there's truly a problem. And we can watch trends instead of being like, it was an off month or I feel this way. No more, I feels. It's either I'm gaining.

 

My weight, like and it's muscle, and I'm building muscle, or I'm just eating nonsense over here. Like it's been really fascinating. So I want you to know this, and we're gonna talk to you guys about like what your KPIs are really trying to tell you. So, as I mentioned, step one is looking for patterns, not just numbers. So, usually like we have a book of business trend for all of our consultants. So we're watching certain KPIs on every single practice, all hundreds of clients that we have, we're watching it.

 

And we look at kind of like a three-month trail. So I want to see how are these clients doing? How are they doing compared to last year? Because that's going to tell us the whole story. Looking at it just monthly isn't really going to tell you a lot. Just like me tracking my metrics every single day. Well, it's not really going to tell me a lot. But looking at it over the course of time, I'm going to be able to see, okay, when my like as a female, when girls go on their period, guess what? They actually increase their weight because our hormones shift. So then I'm going to be able to start to see. I can actually start to tell without even looking at a calendar.

 

Which men, I don't know. My husband's like, how do you just not know these dates, Kiera? And I'm like, listen, and all the ladies are giggling, I don't freaking know when this thing's gonna come. It's not like an alarm clock on the 30th of the month that shows up, gentlemen. Okay. So for a female for us to be able to track because of our metrics going up, I'm able to tell when my period's coming much better than I used to be able to predict it because I'm actually watching and trailing that. But I've been tracking it for multiple months. So now I can see the pattern of what's going to happen. So with that.

 

A lot of men are also giggling, like, well, Kiera, I could tell you beyond just weight. It's probably your mood shifts. Hey, we women are emotional creatures, and I'm okay with that. All right. I hope you guys just enjoyed my like rant between men and women. And I hope you guys all got a good giggle because I did. But back to KPIs, I'm getting tangenty on you all. A single month's not really going to tell us the whole picture. We've got to look at this of like, cause you can have high production, low production. I look in January. It's really embarrassing when I'm showing a new client like an example of a book of business and showing them like,

 

How this client's trending. January always usually has a low collection. And I know that because December is usually a lower month, which usually means my January is a lower collection. It happens almost on every single practice. So you go down the line, all those buckets for us of every client usually is red on their collection compared to their production. Usually they're producing X amount, they're collecting, but their December is usually two weeks, sometimes three if we're lucky. But that tends to happen. So if I'm saying, like, my gosh, those collections are down.

 

Well, no, I need to look over this. Or if we're panicking because we have a slow week, everything's down. No, but we need to figure out like how we can actually predict this, how we can measure it. So what I like to do, and this is what our practices are doing, we're looking over several months. So usually like a quarter. Also, I'm gonna look annually because sometimes it's cyclical. Anybody have a September or an ominous October or a dead December? You're welcome. because it's either a September or an ominous October.

 

And some of my practices just have a genuine dead December. Like my practice in Hawaii, they must aloha over there. It is dead, dead, dead December. So we have to plan and prepare for that because I know it's just gonna be dead. So we're gonna look at this and we're gonna look at the trends over several months. We're also gonna look at cyclical, what's happening annually, or even like month over month, what's going on and what are kind of the trends. We're gonna compare our KPIs against the goal. So, what should this be at? Where are we at? And then we're gonna look for consistent movement. So

 

When I'm working with a practice, I'm not gonna say, all right, hygienist, we need to get our perio up to 30%. Let's look and see where they've been for the last couple of months and then let's increase it by a couple of percentage points. I'm not going from like I got a practice right now that's an eight percent perio. Woo! We gotta talk about some bloody profies over there. It's okay. I'm not stressed about it, but we do need to change that. We set a goal this quarter to get them up to 15%. And you might be like, Kiera, they gotta be to 30%. Yes, but me going from eight to thirty is psychotic.

 

You gotta go eight to 10 to 15, and we gotta be moving those KPIs in the right direction. Just like somebody losing weight, we're not gonna be like, all right, you need to lose 50 pounds in two weeks. Like psychotic. Don't do that. Let's make these realistic so people actually get the momentum and want to grow. So when we're watching this, look at hygiene reappointment, look at our case acceptance, but not in an individual week. Look at it over a month and like if I notice there are certain weeks, what was going on? Or if I was down, let's go dig into it and find out why. Was it just an isolated incident?

 

Did we not have enough hygiene? Did we have a lot of openings? Find out why this KPI is telling you this rather than it just being a well, that's annoying. Look at it as an early warning sign rather than a complete and total drop. This is going to help you predict future better off of today's numbers. So, like, what's our future gonna be? Like, use our numbers. Let's better predict. Let's look back at trends. It's going to help you. Patterns are going to tell you the story. Numbers are where we're going to start to like look into conversations. So

 

Looking for patterns, looking for true numbers. How's this going to go? So I would recommend a quick call to action today is go look at the last six months of KPI. So we're talking production, collections, overhead, profit. we wanna look at our case acceptance, we look at our new patients, we look at our AR, we don't look at our hygiene. Those are just some off the top. There's several others you can dig into. Like you can look at your schedule capacity, you can look at your answer call rate, we can look at our marketing, we can look at our new patients, but like look at our general ones that are gonna move the practice. And what are the last six months?

 

And identify a trend that's moving in the wrong direction. Okay. And identify a trend that's moving in the right direction. We don't just want to use this as bad information, like there's good information too. So what's happening there? Go identify that. But again, not just looking at one week, because one week, one month can isolate and it actually won't work. We've got an awesome office and we've grown them so much this year. They've added over 100,000 per month to their practice, and we're talking this as a very large practice. But I love their office manager because she's like, hey, last year we had this.

 

This is what we've got going on. We need to predict and project for this because we're going to be running into these issues. That is using your freaking KPIs. And that's what I would like all of you to get to. Okay, number two, every KPI should lead to a question. So one, we're looking at patterns. Two, these are going to actually ask questions. So we're asking why. Like I said, so collections are down. End of discussion. Instead, like, why are collections down? Did K and like you've got to think of it as like a trigger tree down. Like, I don't know.

 

Don't know what it's called. Like it's like it's like a family tree almost. Okay. So it's like a decision-making matrix. Here we go. So if our collections are down, what are the pieces that make up collections? Well, we've got insurance claims. We also have case acceptance. We have production. We have AR. Like those are going to be pieces that are going to impact. I know for a while all the insurance is like all of our collections were down across the board because one of the insurance companies were holding it up. Well, guess what? That's why our collections are down. But we don't just like

 

Say collections are down, go collect more. Let's find out what the root of this problem is to see, like, what is our collection? How do we get this back up? There was one office where the collection percentage is sitting at 58%. Well, they're not putting fee schedules in. That's why their collections don't look right. So, what is the reason for it? We gotta make, we gotta be curious. We also need to dig into the root problem, and then we gotta solve the problem, not just the symptoms. So, for that one when insurance was just holding up, not really a lot I could do with an asterisk. There actually was.

 

We could then start to do like let's call our patients that are fee for service patients, bring them in. Let's call in patients and fill our schedule with patients who are not on that insurance so we can boost up our collections. Like you might say, like, it's out of my control, but if you actually use this and look at it and get creative, any KPI, you can drive that number and improve that. So I really, really, really, really want you guys to ask like why five times before creating a solution. Okay. So pick a KPI and ask why and why and why and why and why.

 

And then create a solution. Like, so why is this? Why? Like, what about this? Like, what about this? Like, dig, dig, dig, dig, dig. I sound like Snow White. Dig, dig, dig, dig, dig. You're welcome. because this is going to actually help you guys figure out what is going on. And this is why consultants were so great. Because we ask the why. We dig to find out. All right, production's down. Why? Like literally every consultant knows when I'm looking at it. I want to know why. If a client's saying X, Y, or Z, I want to know why.

 

Tell me what's going on. What are we noticing? What are the pen patterns? And not just for this month, but what's been happening for the prior three months to it? Let's figure out why. So that way we can predict and change moving forward and actually fix the problem. If you're like collections are down, great, we're just gonna fix our over the over the counter collections. Well, if we're collecting fine there, we just solved a problem we didn't actually have. It could be insurance, it could be that we're not billing out, it could be that we're getting denials left and right on things. Why? Like what's getting denied?

 

Go dig there. So I really want you guys to one, you're gonna look back six months. That's number one, let's look for pattern. Number two, I want you to pick a KPI that's down any of them and start asking why multiple times before we create the solution so you can truly get to the root of it. And then number three is like KPIs should be for the entire team accountability. It is not just for owners. And I know this is very controversial. A lot of you come on calls with us to see if you want to work with us, and I'm like, cool.

 

We never roll out KPIs fully to the full team until you're ready for it. I do not believe that I should force a practice to look at numbers if an owner doctor is not comfortable with that. What I do believe though is owner doctors, let's share at least a couple of KPIs because if everybody knows their number, it's like a scoreboard on the ball. Like, can you imagine teams like basketball, football? We're going to football season. So maybe that's the one you want to talk about. Can you imagine if they didn't have a scoreboard and every person up there didn't have a metric? Like, no, they're all talking about their passing, they're running yards, they're how many games they've won.

 

That's what we need. Our teams need to know like what is their number that's gonna push us forward to the championship. So every single team member should know their number and they should be tracking it. I have so many office managers that are just awesome. They're rocking it. But what they don't do is they don't have their team track their KPIs. So then their hygiene's down, but no one knows it other than the OM. And then they're trying to convince that hygienist to do their period. Versus if I'm a hygienist and I know my goal is 30% and I'm noticing I'm at 10%, 11%, 12%, what we track and measure improves.

 

So this is going to really help your team. Like give each team member a number. And I know this sounds so silly, but like they don't even have to know the whole production. We just have to know like this is the number that you own. A scheduler. They've got to have their goal to goal every day. Like 90% of the days, I want us hitting goal. Treatment coordinator, non negotiable. Doctors have to be at goal every day, and they have got to hit our production goals every single month. Non negotiable. That's what they do. Billing, you should never have more than one month's worth of AR in there. Period. That's what they need to do. Non negotiable. Non-negotiable. Okay. Office manager, you got to hold.

 

Hold your overhead. That is your number one KPI plus everyone else getting their KPIs. Hygienus, three times your pay. That's what it is. Okay? That's your number. And that's on net, not gross. Next thing below that is gonna be pay you at 30%. That's your number. That's your metric. That's what you're gonna have. Dental assistants, you're my trickiest ones. Dental assistants, you need to be adding one same day or not being a popcorn assistant or getting referrals. Like you choose what their number is. But every single person owns it. Billers, less than one month's worth of AR and 98% collections. Everybody needs to know. Doctors, I need you producing what.

 

Like you need to diagnose three times what you want to produce. And if you're at five hundred dollars an hour, I want you to be at five fifty. You need to know what your dollar per hour is. And we need to make sure we're tracking this. I need you also diagnosing enough that we can close it. Treatment coordinators, what's your case acceptance? Like, but notice I didn't stay like I need you at thirty-five percent or I need you at fifty-five percent or ninety percent. No, treatment coordinator, I need you to get the doctor to go every day and to hit our production goal.

 

Very different, and a lot of us will be Well, you should get case acceptance. Well, guess what? They hit your case acceptance goal and not hit the actual outcome you want. So make sure the KPIs are directed to the outcome you want, not necessarily just a metric. So, and when everybody's owning their number, everybody owns the outcome, and we all are rowing to that championship score. So I would recommend at least rolling that. I don't care if they know anything else, but at least roll that out. So to quickly put this together, remember KPIs are the vital. We're gonna look at this before there's a problem. So number one, look for patterns. Number two,

 

Ask better questions, get to the why. And number three, create ownership and give everyone a KPI number. If this feels hard for you, or you're like, I know I should do it, Kiera. I just talked to a doctor who joined us. He's like, I know I need to do this, but I need some hand holding. If you're like that doctor, join us. He just reached out, he's got a consultant now. He's gonna have his whole life change and I can't wait. Office manager has no clue how to do this or implement this. Or maybe you do know how to do it, you guys are just not executing on it. Reach out. Hello@TheDentalATeam.com. I want to help you. So let's do this because KPI should not feel overwhelming.

 

For me, I needed a coach sitting next to me to be able to start tracking my metrics, tracking my weight, tracking my gains, tracking my macros. It was really freaking hard for me. And it took me two years to get to where I am. I first started out of like, let's just get to the gym three times a week. Then let's start looking at how much I'm lifting. Then let's go into tracking macros of just protein. Then let's go into tracking the whole kit caboodle of weight and metrics every single day. That was a process that did not turn overnight.

 

Otherwise, it would have been too hard. And so for you, let's just start small. It's like, and we as consultants set this up for you. You don't even have to do it on your own. So just start. I need you watching your numbers. I need that you to use those as metrics. And not for me, but for you. Because the more you know about your KPIs, the more you're gonna be able to make better decisions. You're gonna feel more confident and you're gonna be able to feel like you actually know your practice rather than being concerned about your practice all the time. So reach out if we can help you, because the right numbers can truly become your greatest leadership tools.

 

It doesn't have to be scary, but it can actually help grow your practice and have easier conversations. So reach out. I'd love to help Hello@TheDentalATeam.com. And as always, thanks for listening. And I'll catch you next time on the Dental A Team Podcast.

 

Guest episode! Kiera is joined by Paul Edwards, CEO and co-founder of CEDR HR Solutions, which provides human resource support especially for dental practices. They go through a rapid fire of topics, such as coaching and accountability, worker classification, documentation and evidence (including AI!), and reporting policies.

Visit CEDRSolutions.com to learn more about Paul. 

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Transcript:

Kiera (00:00)

Hello, Dental A Team listeners. This is Kiera and today is a great day. I love my episodes with Paul. Paul is incredible. He is the owner and founder of CEDR. And guess what? He is somebody that I get to just pick his brain about all things HR every time he comes on the podcast. So, Paul, welcome to the show today. How are you?

 

His Paulness (00:19)

very good and I'm gonna take that introduction, that part where you said Paul is incredible. I'm gonna turn it into my ringtone and I'm gonna be insufferable for the rest of the year with that.

 

Kiera (00:25)

Yeah.

 

His Paulness (00:27)

So thank you for that.

 

Kiera (00:29)

You're welcome. I it's funny because every time people meet you and they know you're an HR, they're like, he's actually really funny and he's a good time. And he used to play in a band. And I'm like, yeah, he makes HR not feel as scary. But every time, every time I leave, everyone's like, my gosh, he scared me to death, which is good. Like I think it's a good healthy, like you're super approachable, super nice, but also like whip us into shape of like do this, don't do that. And I appreciate you continually like guiding us along the right path.

 

His Paulness (00:55)

There's

 

a lot of moving parts when you're an employer. So it all feels a little bit scary. 'Cause soon as you get figure one thing out, then there's the next thing. You're like, no, I'm doing that wrong or or I could do it better or whatever. So yeah, you know, we try

 

Kiera (01:07)

Yeah.

 

His Paulness (01:08)

to break this down so it's understandable.

 

Kiera (01:11)

Which and I appreciate. And if you guys are not subscribed to his newsletter, he's got the best newsletter out there. Like I think you guys do an incredible job. So, Paul, if they're not, how do they get connected to your guys' newsletter? 'Cause that's one of my favorite things about you guys.

 

His Paulness (01:21)

Well, I think what you want to do is just go to the website and search for almost any form on there, but there are education forms on the website. So just go to the website and join what we kind of refer to as HR Base Camp. So if you think about base camp as a place you come back to when you're on a big hike, well, you're on a big hike as an employer. And so we are constantly sending out helpful stuff, you know, two or three times a month. We send out some pretty cool stuff to all of our base campers.

 

That'll get you also an email that invites you to join the Facebook group, which is kinda cool 'cause you're in there with just managers and owners. and you know, it's about ten, I don't know, nine thousand people in there, something like that. So, yeah, that's the way to go there. you know, you can also subscribe to my podcast, which is what the hell just happened and we cover a lot of topics there that that are kinda fun, you know. So

 

Kiera (02:12)

I love it. Okay. I want to just get that right in at the beginning because you guys truly he's got the best newsletter, got an incredible podcast, and I think this is the stuff that keeps business owners up at night. So let's like not have that happen anymore. So, Paul, we're gonna just like rapid fire. There's

 

His Paulness (02:27)

Okay.

 

Kiera (02:27)

a few topics, and then I know you've got some case studies for us as well. So, and if you guys don't know Paul, CEDR, they are one of the top dental HR companies out there. most of our clients use them. He is one of our

 

I do not bring a lot of people in to speak to our private groups. And Paul is one of the people that I have hand selected to come in and speak to all of our dentists in a very intimate that's not on the podcast. So it's like no recording, it doesn't get shared. He comes in and speaks to them. So, Paul, I'm excited for today. This is stuff that we'll talk publicly, but let's talk about some of these items. Coaching and accountability. I'm sure we're all doing it wrong. I'm sure I've been coaching and telling people to do this. So tell us what we can and can't do when it comes to coaching and accountability.

 

His Paulness (03:08)

you know, the thing about coaching accountability is that it starts to feel like it starts to feel like something that's punitive, like consequences. And and when it goes into that realm, it's really hard to get somebody to listen. I I I don't know about you, but when someone starts to tell me what I'm doing wrong and that's what the focus is, I get defensive. And that's just human nature. So when we t when we talk about coaching and accountability, especially with Dennis, and I know that you're gonna I think you're gonna agree with me.

 

I while there are exceptions to the rule, and probably many of them, overwhelmingly I find that dentists do not want to have difficult conversations with their employees. They kind of avoid it. That I mean it's it's about 50% of the reason they get office managers because they're like, I want to have these conversations. I can get someone else can do it. Here's the thing that

 

Kiera (03:55)

Yeah.

 

His Paulness (03:56)

I want to say. Yes, sometimes it ends up where you have to have a really serious conversation with someone. but the

 

Better way to go about this is for you or you and your manager when you hire someone is to set the expectation with the employee, I mean literally during onboarding, that they are going to receive feedback from you, both positive and sometimes it might feel a little negative, because you're making small corrections. So if you get in the practice of making small corrections as you go forward, you don't you you have far fewer of those big conversations with someone.

 

And then the the ones that are frustrating, I mean the issues that you're facing with an employee, also become easier because when we're looking at someone who's late all the time, and you know, in a practice with you know, we ha always have just the right amount of employees. We never have a I don't know about you, but I never have an excessive amount of employees around, where everybody's important, you just start leaving no quarter for being late all the time.

 

you really have to say something about look when you're even when you're only five minutes late in the morning and you tell them what the issue is, you tell them what the impact is, you explain their role in a very positive way so that you can say, Look, when you are late, we are missing you. Not you need to be here on time because when you're on time, bad things happen. And if you don't start being on time, bad

 

Kiera (05:19)

Mm-hmm.

 

His Paulness (05:20)

things are gonna happen to you. If you start with trying to enroll them in the idea that they're playing an important role.

 

you know, part of the reason I think for goal setting is that you get to say, how are we going to get to the goal if this behavior continues? So I just want to give everybody this reminder that coaching is coaching and it doesn't always have to be corrective and it needs to you if you set an expectation and then you execute on it, you're gonna get a lot better outcomes with people when you bring them on board. And and the other the other end of coaching should always be.

 

Can you do that? And do you need anything else from me? Like is is is the issue here me? Do we need to give you more training? What can we do to help you get there? So don't forget where that's appropriate, you'll always want to insert that in.

 

Kiera (06:08)

I think Paul on that just like piggyback, what do you do when you've had that conversation like four times? Like, Perry, we've had this, we've had this, we've had this, like, I miss you at Morning Huddle. We need to be at what

 

His Paulness (06:20)

I missed you.

 

Kiera (06:21)

point, at what point is it not like cute? It's like the I feel like it's the child that keeps throwing the rock and mom's like, Okay, let's not throw the rock, like it's gonna break a window. When

 

His Paulness (06:28)

Yep. Stop it. Stop it. Stop it. Yeah.

 

Kiera (06:31)

do I actually like do something about it?

 

His Paulness (06:34)

As my mom would say, when do we get to snatch a knot in him? That's what I I was just with my mom. She's eighty eight years

 

Kiera (06:37)

Ha ha ha.

 

His Paulness (06:39)

old right now. I she actually said, Son, don't make me snatch a knot in you. 'Cause I like to take her out in public, embarrass her now, and pick on her. but anyway,

 

Kiera (06:46)

Mm-hmm, mm-hmm.

 

His Paulness (06:51)

look first things first, great question. I I would do wanna say that after you've had the same repetitive convert conversation with someone

 

After the second or third time, especially if it's in close proximity in time, you know, you've already talked to them two weeks ago about something and they're doing it again or not doing it. you also want to make sure that you're making little notes in their file. That's very important. and what I found is is that if you don't hold someone to the standard, right? The standard that you're looking for, I I you're they're never going to improve.

 

And if they're not improving, then maybe they're not the right fit for your company. And the sooner that you figure that out for them and for you, the better. And so if I'm in my third or fourth time within a month about the same thing, I'm sitting down and having a much more serious conversation with them. And in my mind, I'm I'm thinking, and sometimes I might say this to them, look, I'm not telling you that you've got to do the thing, whatever it is that we're talking about. What I'm telling you is I cannot work with someone who

 

does or doesn't do what it is that they're that they're up to. Like, you know, I just need you to know that I, you know, I can't continue to work with you if it's going to be this way. I understand you're late. I understand that you have all these issues. I get all that. I've tried everything I can to adjust here, but I I may not be able to work with you. And you always have that standard. I need you to show up on time. There's no more there's no more getting around this. But you really need to be adding notes to their file.

 

dating them, you need that, and and then we can move into written corrective coaching if we need to. And you know, that's a little more formal.

 

Kiera (08:35)

Awesome.

 

His Paulness (08:36)

That's them acknowledging the conversation. And look, four times in a month for the same thing, they're gonna get something in writing. That's just how it's gonna happen. If if I'm if I'm on your

 

Kiera (08:44)

Okay.

 

His Paulness (08:45)

HR team, that's what's gonna happen.

 

Kiera (08:47)

Okay, great. That's what I feel like so many people just like it needs to go on forever and ever. And I'm like, there's gotta be an end date to it. So,

 

all right, that was a quick teaser on coaching and accountability. Okay,

 

His Paulness (08:53)

Yeah. Yeah. Yeah, yeah.

 

Kiera (08:58)

next one worker classification. I know that's a a hot topic with dentists. They love they love this 1099. I don't want to pay taxes on them, Paul. It's a better deal for me. They're

 

His Paulness (09:07)

Yeah. It

 

Kiera (09:09)

a dentist. I don't need to have them as an associate on payroll.

 

His Paulness (09:12)

Right.

 

Kiera (09:13)

This person's just coming in to help out. I can ten ninety-nine them.

 

His Paulness (09:14)

They're only going to be here for a day. They want to be paid

 

as a as a independent contractor. so there's a couple levels of classification. And by the way, this is one of the good reasons to go sign up for our education because we're gonna do we're gonna release a really good classification guide. And you know what? you know, we're probably gonna make it exclusively available to your folks as well, just so you know. So at some point we'll pass it over to you.

 

look, classification, couple things. I'm not gonna put you to sleep

 

Kiera (09:42)

Thank you.

 

His Paulness (09:45)

on it because you do you actually need to kind of go through a checklist and do some stuff on your own. And we'll provide all of that. you gotta think of classification as a couple of things. First of all, there's that independent contractor conversation that we that we're always having. And for those of you who haven't heard me, I'm just gonna say this in a very definitive way. There is no hygienist on the face of the earth who qualifies either under the Department of Labor or under the IRS rules for employees.

 

as a as an independent contractor. It does not exist. It

 

Kiera (10:14)

Nope.

 

His Paulness (10:14)

can exist. It just can't. An independent contractor cannot open his or her own practice. They have to have a dentist attached. And that's kind of the nail in the coffin, but there's a lot more. All right. When it comes to

 

Kiera (10:25)

Yeah.

 

His Paulness (10:27)

when it comes to associate doctors, in some states that same thing is true. I'm serious. They the state has such strict rules

 

That for you to classify a general dentist and a general dental practice as a independent contractor is just wrong. It doesn't meet the Department of Labor's standards in that state. But for the most part across the country, a a a employee who's doing the main function of your business, who's performing the main function of your business, a a worker, I should have said a worker, they're an employee, not an independent contractor. So that's one part of the

 

Kiera (11:02)

Mm-hmm.

 

His Paulness (11:03)

classification.

 

The other part of the classification com conversation has to do with whether or not I can pay an employee a fixed salary and not worry about any overtime they work, or whether or not I have to track

 

Kiera (11:14)

Mm-hmm.

 

His Paulness (11:14)

their hours and pay them. And I'm just gonna say this. If your entire team is on salary, that's okay, but you still have to track their hours and you have to pay them overtime. You can have a manager who who you don't have to track their hours and you can pay them a fixed salary.

 

But not all managers qualify for that exemption. It's called an exemption to the standard to pay overtime. Not all managers qualify for that. The smaller your team is, the more in danger you are of not being able to classify someone as a salaried employee. So now that you're really confused, just

 

Kiera (11:51)

Mm-hmm.

 

His Paulness (11:51)

go join. You're gonna get this is the kind of information and the guides and stuff that we send out.

 

So the the you know, the classification's a big deal 'cause we run into it every day. I mean,

 

wh

 

Kiera (12:02)

Yeah.

 

His Paulness (12:02)

when I say run into it, we get about twelve thousand questions out of our three thousand members and every week there are four or five what we call submissions asking us about you know, they've read one of the one of our articles and they're like, I think I got this wrong. And most of the time they've gotten it wrong. and you can't rely well,

 

Kiera (12:21)

Yeah.

 

His Paulness (12:22)

you you it you gotta be careful because

 

Kiera (12:24)

It's true.

 

His Paulness (12:25)

The IRS rules for your independent contractor and the Department of Labor rules don't match up all the time. And so you have to be

 

Kiera (12:31)

Correct.

 

His Paulness (12:31)

very careful in that area.

 

Kiera (12:34)

Yeah, and Paul, I'm so glad you talked about it because like it is a while it is a full checklist. And I think sometimes we like to justify it. Sometimes we like to say like, but no, like they really do. And that's not gonna go over well. And so to I'm like, cross our T's, dot our I's, which is why Paul, we do podcasts like this and why everybody should have that checklist. Because when I learned about this, I'm like, No, they're a salaried employee. It's like you gotta you gotta check off this checklist and this checklist, and they're not like you said, they're not the exact same checklist at all.

 

His Paulness (13:02)

It it's a little complicated,

 

Kiera (13:02)

And you had to make sure both qualify for them to truly be

 

His Paulness (13:04)

but once you figure it out, you'll have all your positions and you'll know and and you'll be set. It's just that you guys and gals tend to borrow what someone else is doing.

 

Kiera (13:13)

Mm-hmm.

 

His Paulness (13:14)

Maybe it was already in the practice that you purchased, or it was in the practice that you were an associate of, so you're c you know you're copying, which is what we all do when we start a business, or you're talking to your you're talking to, you know, other other people in your industry and they're giving you HR guidance that

 

Is not sound sometimes.

 

Kiera (13:33)

Yeah. No, I love that. And definitely sign up for that checklist. That's a brilliant one. Okay, next one. Documentation and evidence. Let's talk

 

about that.

 

His Paulness (13:42)

we are going to be we are going to be actually doing some podcast on this where the internet does HR is what we're gonna call it.

 

Kiera (13:56)

Mm.

 

His Paulness (13:56)

I just want you guys to know that online HR advice is not something that you really want to participate in. well look let me let me

 

Kiera (14:08)

we're talking like AI, internet searches. Let's just talk about it.

 

His Paulness (14:11)

We're talking about AI,

 

we're talking about going on Reddit, we're talking about we're talking about going into any kind of group thing for for advice and running with that. But particularly AI is a con a concern and we'll get into this a little bit more. I think every time you see me I talk about AI. Well we now have court we

 

Kiera (14:31)

You do,

 

His Paulness (14:32)

have court cases rocking it right now and and companies are getting themselves in trouble for creating employee handbooks through AI.

 

they're getting themselves

 

Kiera (14:39)

Mm-hmm.

 

His Paulness (14:40)

in trouble for using AI to fire people. they're finding out that your chat is discoverable. and so in one case we watched the chat was really bad. The the thought process of the person who was putting the problem into the chat became exposed in court and they were basically asking it how can I break the law? I might I'm paraphrasing, but they were basically like I they were kind of telegraphing, I know what I want to do here is wrong.

 

HR wise, tell me how I can get away with it. And so just be

 

Kiera (15:11)

no.

 

His Paulness (15:12)

careful about online advice and taking something from someone without knowing who those people are. it's you know, the context here is you're making an HR decision that is has a law that impacts it. And if you get it wrong, it can be very, very expensive. And there's no reason for it. There's no reason to go out that way and try and self-help.

 

yourself. So just be very careful. you know, same thing. Same thing about the internet. I'll make this other point, maybe a little bit about AI. You know how if you're a subject matter expert and you see AI give an answer to the thing that you're an expert on, you will look

 

Kiera (15:55)

Mm-hmm.

 

His Paulness (15:56)

at it and you'll go, you what, that's pretty darn good and it's getting better. But here's these three or four little subtle places where it's not exactly wrong, but it's not correct.

 

And without context, I I would be worried about just telling someone that. Versus you're asking it a question about something that you really don't have a whole lot of subject matter expertise in it. And it gives you back that wonderful, confident, same kind of answer. It's got bullet list. it's actually, if it's your AI, it's designed to please you. So it's put a little bit of stuff in there to please you. And you'll just take that hook, line, and sinker and say, this looks so well organized

 

Kiera (16:30)

Yeah.

 

His Paulness (16:31)

and so authoritative.

 

And it look, it cited some things too, and you'll run with it, and that's what's getting people in trouble. So we just really I don't know what the word is for that. Maybe I need to make it up. but you just can't you

 

Kiera (16:43)

Mm-hmm.

 

His Paulness (16:44)

if you don't have subject matter expertise, you gotta be very careful when it involves employment law and your pocketbook. I think that's the

 

Kiera (16:52)

I think that I think it's so hard because like AI we use for so many things and like you said, it is like a little therapist over there and people

 

His Paulness (16:56)

Yeah. Mm-hmm.

 

Kiera (16:59)

enjoy it. I mean, I'm guilty of it too. I heard you talk about this six months ago and I was like, It feels annoying, Paul. Cause I'm like, I just wanna ask like what are kind of the parameters and I I

 

His Paulness (17:07)

And I want the answer. Yeah.

 

Kiera (17:09)

think of you all the time and you're like, Kiera, it's gonna come back on you and like they can pull these records on you and it's like, okay, noted. I need to just go to the proper sources and channels to make sure that we're compliant truly.

 

His Paulness (17:21)

Yeah,

 

yeah. I mean my AI is incredibly smart about HR and it still gives wrong answers occasionally when we're writing articles and stuff. So I mean, kinda gives you some perspective. Yeah.

 

Kiera (17:31)

So there you have it.

 

Do you think there will ever come a point that AI can replace HR? Not to say I want to put you out of business. I'm just genuinely

 

His Paulness (17:37)

No, no, no.

 

Kiera (17:38)

curious of like, I think about for consulting too. Like, do you think that AI will like there will be HR AI in the future?

 

His Paulness (17:44)

I think at

 

some point it's gonna you're gonna have some very strong models that are mostly available to lawyers. They're not available

 

Kiera (17:51)

Mm.

 

His Paulness (17:52)

to someone like you, you know, l someone who's not giving out guidance, because I believe that the context of the guidance alwa almost always has one or two more questions, and AI is not great at taking a left or a right hand turn. But five

 

Kiera (18:09)

Sure.

 

His Paulness (18:09)

years from now, six years, ten years from now.

 

I think, yeah, in some pla in some ways it's gonna be able to give some very good answers and prompts to get those answers. And we are as a company, we are very aware of that. We are

 

Kiera (18:23)

Mm-hmm.

 

His Paulness (18:24)

we are well, I I think the I've said this twenty years ago when we started CEDR. And I think this, you know, for the people listening, the business you're in, I think this might h head home a little bit. I believe that the next I believed then that the next greatest innovation

 

was the opposite of what was going on in the world, which was it's providing service and people and getting it getting systems right and being able to actually talk to someone instead of running them into these failed chat bots and these failed chats that you you know you put your question in, it's like, let me give you your question. And then it, you know, it it answers with one third of a cup of flour. And you're like, we were talking about my internet not working. I mean

 

Kiera (19:08)

Mm-hmm.

 

His Paulness (19:09)

So I think the greatest

 

in I think the I still think that that that innovation is there and available for us and we've been using the technology in the wrong direction. I'm using it to make us more efficient, to so that my experts can spend less time creating something from a conversation that is kind of a policy or a th or a thing, and so they can spend more time listening and and a little more time with the member.

 

And and worrying less about I have six other people who are waiting for me to get back to during that day. So that's my view

 

Kiera (19:45)

Sure.

 

His Paulness (19:46)

that's my view on AI and HR. humans are humans. As long as we're being human, I I don't think we're gonna be able to take the human out of that out of that process. Yeah.

 

Kiera (19:55)

I agree.

 

I agree. Okay. Next reporting policies. Let's talk about these.

 

His Paulness (20:04)

the the reporting policies that people okay a policy only works if it's distributed and it and it is more it becomes more powerful when the policy is distributed, it's acknowledged, and the and the employer and manager know how to use that policy. All of those things have context. So look, let's let's use AI as an example.

 

We used to say this about template handbooks. Some would say, Well, I got a template and I put it together and I said, Well ask the template how to and ask the qu ask the template any question. Templates can't answer questions. And so if you end up with a a policy and you don't know what you haven't had training and what its purpose is, what its limits are, what it's both both, you know, small and large, what it's how you're supposed to use it and where it's supposed to apply, then you're kind of missing

 

that. And so I just want to be clear that when you put together a set of policies and when you change them or you have an employee handbook, if it doesn't come with a couple hours of support and training and ongoing training, then what you have is kind of a static thing sitting there in your office and it's not really helping you when it in the ways that it can help you. and I give you guys an example.

 

If you don't have a good maternity policy and it's not complete, then when an employee s asks you a question about your maternity policy, you can't say, go to the handbook and tell me. You go read it. You tell me how much time that we give for for maternity leave. You tell me whether or not you can use your vacation time that you've accrued. you tell me whether it's paid or unpaid. You tell you know, all those things.

 

should be in the employee handbook. So it's important for owners to train their managers. It's very, very important for owners to train their managers. make sure

 

Kiera (22:03)

I love that.

 

His Paulness (22:04)

they understand and make sure you understand the policy.

 

Kiera (22:08)

Yeah. And I think Paul, you're right. Like, as companies evolve, like where you started at the beginning versus where you might be today. Like we didn't have people that were getting pregnant when I first started now. It's like we do. And so definitely I'm big on like make sure that they're updated, make sure that they're current, make sure that everybody has them. That the new ones that have changed and morphed through the business, like we've been in business for 10 years. Like what we started with versus where we are today are very different. And I like that.

 

call out that you really do need to know that. So

 

His Paulness (22:40)

Yeah, I I

 

I mean I could give you a really good example. Arizona changed about I don't know, about seven, eight years ago. We went to mandatory sick time. And all employees were entitled to it under a specific set of rules. Before then it was like it was in much of the other states, not all the states, 'cause many states have mandatory sick time now. it it was you just could give it, you could make it paid, you could make it unpaid, you could not offer it at all, you could do whatever you want to.

 

Once that changed, a new a complete new set of rules came around. and I just give you an example, and I think managers in Arizona need to know that this exists. In Arizona, if you fire an employee within I think it's sixty days of them having used it's sixty, yeah, within sixty days of them having used one of those sick days, it is presumed to be retaliation against them for using one of those sick days.

 

And so you've got to be thinking, well, h what? Wait, what? Does that mean you can't fire anybody because they can use sick days? No, the answer to w what you know, what you do about w what I just described is that you have to have documentation showing the reason why you terminated a person or took that adverse action against them. So basically we went from being in an at will state to sort of being an at will state because we've got this sick lead policy.

 

Kiera (24:00)

Mm-hmm.

 

His Paulness (24:01)

So I I again I was kind of a roundabout way.

 

but but it kinda shows you you need to understand the policy and the limitations that come the laws that affect that policy.

 

Kiera (24:12)

How often do you recommend looking at your policies like and updating? Because those rules come into effect. Paul, you read this. Like to me, this is your algorithm. You're seeing this all the time.

 

His Paulness (24:22)

Yeah, yeah.

 

Kiera (24:22)

for us, it's like a one and done, check it off the list. We think we're compliant. How often do you recommend updating your policies, double checking your state laws, having your handbook updated? What are what are your recommendations

 

for that?

 

His Paulness (24:32)

I think at

 

at least once a year and if you're in s California, Connecticut, New Jersey, Washington State, some of those states, you have to visit it more often. and I think that's the problem if you don't have a support company because how would you visit it? Like where is it that it's certainly not get f get f you know, fed to you on TikTok or Facebook or something. So, you know, at least once a near a a year you should if you have time

 

You should read your policy to see if you're following it. And I don't mean your policy should tell you what to do. I mean you may have changed something and it conflicts within your handbook now, and you just need to change the policy. That's it. That's that's that's all there is. so yeah, once a year you should check. Most states are now updating and putting in new laws about once a year. Many states are putting in new laws and making them effective two or three times a year.

 

Kiera (25:26)

Awesome.

 

Okay. All right. Let's go into payroll. Payroll I feel like is such a thing. Payroll, payroll review. I've got some questions on payroll, but what are some of like the hot things that practices deal with in the payroll realm?

 

His Paulness (25:39)

this has come up two or three times in the last three or four months. I don't know why. the employer is not reviewing their their payroll ledger. meaning they run payroll, you always get a report. If you're in gusto, you dig for it or ADP, maybe you can find it. I don't know. maybe it y y you know, somehow you find your you you you get this report every single time, but you don't pay attention to it.

 

And or you do give it a quick look and you go, yep, all their hours are right. But what you don't do is you don't review your payroll thoroughly. And what we're finding is is we've had these three instances where an employee has been paid anywhere from five to eight dollars more an hour than they were supposed to be paid. And it's been going on

 

Kiera (26:28)

Well.

 

His Paulness (26:29)

for years. And so tens of thousands of dollars in payment and salaries have been made.

 

And in all three of these instances, none of it was recoverable. In one state,

 

Kiera (26:43)

Mm.

 

His Paulness (26:43)

it was just not recoverable. You couldn't do it. The state would not allow you to recover it. In the other two instances, the there was no way they were gonna get this money back from this employee. They were not working for them anymore. they were gonna have to sue them and and there were problems with that. It was not gonna be a a a slam dunk home run to try to get the money back out of somebody.

 

So I think one of the biggest one things that we're just telling everybody right now is you need your own oversight. If you're doing your own payroll, your payroll company's not doing anything, they're not watching anything. They'll let you misclassify a hygienist. They'll let you pay somebody a salary that they're not supposed to be paid by salary. your payroll company is not reviewing your final ledger because how would they? They don't know. You they they just take what you put in. That's how they work.

 

And so I I just want you guys to be very careful and review your payroll every now and then. And then the other one that we've seen I've seen over the years, and it's more than once or twice, the the reason the payroll was wrong was because the person in charge of the payroll made it wrong for themselves. And then the other reason why the payroll was wrong and in in the most egregious cases was that they were so they were using it as embezzle as an embezzlement mechanism.

 

and they had actually put people in their family on the payroll that didn't work for the practice. and that ran for two years before they got caught stealing another way and then the full audit re revealed that they had put their family members on there. So I I

 

Kiera (28:22)

my gosh.

 

His Paulness (28:23)

think the the the moral of the story is check your darn payrolls. Yeah.

 

Kiera (28:28)

Paul, that is something ten years in I still am the final stamp off on payroll and I feel silly doing it, but I like a lot of those things happen and I catch it and like as an office manager I didn't I didn't I mean I just put in the hours and as a business owner I have very different keen eyes on that. So it's the isn't

 

His Paulness (28:44)

Yeah. Yeah you do.

 

Kiera (28:48)

I have two other questions on payroll that I didn't prep you for. One

 

His Paulness (28:50)

Sure, sure.

 

Kiera (28:52)

is how can you change like let's say we've got variable comp.

 

That's bonuses. Like I've got an office right now, they recognize the bonus structure is very, very high. It is variable comp and they're trying to figure out how do we like change that bonus system. Do you have to have like are there any laws? I obviously know it might be state specific. This one happens to be in Arizona. but like what can you do for that variable comp commission states, like pieces like that when you recognize we're we're paying more than we're supposed to, and I need to right size that and I don't want to fire an employee, but also I gotta deal with changing their comp.

 

His Paulness (29:20)

Yep. Yeah. I gotta deal with

 

changing the car. Okay, first of all, really difficult conversation. Good luck, y'all. but but let's let's talk

 

Kiera (29:29)

Seriously.

 

His Paulness (29:30)

about the rules around it. yeah, I mean this is let me sidetrack for a second. You may have to put me back on the question. This is why you when you promote someone to a manager's position, they don't get an immediate raise. they need to earn their way into it. Now it needs to happen quickly and it could be, you know, by steps over the next weeks and months.

 

But it's really hard if someone's unsuccessful and you've moved your best employee in and now you realize they're you've kind of peter principled them. They're not competent as a manager, you need to move them back down. Y the hard part would be to take the pay away from them. So so going back to your question, some states require you to provide notice in a certain amount of time before you make any pay adjustments. So you want to know if that's true or not. Arizona does not. You cannot make it retroactive in any case. so

 

If you're going to change someone's compensation, you need to change it and you know going forward. if it's a commission or it's a bonus program, I want you to keep those things outside of the employee handbook, but I want you to refer to those things. So I know you didn't ask me this. I want conditions in the handbook about how someone qualifies for the bonus program should a bonus program exist. For example, one of the things that's in our policy of many things, which, you know, one of the reasons you work with us.

 

is in order for you to earn the bonus, you must be employed for the entirety of the bonus period. Meaning that if they quit or get fired in the middle of the bonus period, they're not entitled to a portion of what's going on or what happened. So to be more direct, I I think you've gotta you really gotta work this out. I think this is a good place for AI, by the way. I don't say this very much on podcasts. I think

 

Kiera (31:14)

Mm-hmm.

 

His Paulness (31:14)

you I think you put what your bonus system is and what's going on and what your problem is in it.

 

And where you need it to go, and you help it, you you know, work with your consultant and you figure out where that pay needs to adjust. And sometimes you're adjusting the base rate of pay. and sometimes, by the way, everybody who's on a bonus or commissions needs to have a base rate of pay. or or you're, you know, you're you're moving some, you're moving something. My way of moving something is we're not hitting the goals that justify that commission or that bonus. And

 

In order to get back to it, here's the new numbers that we have to hit. And until

 

then I need to adjust this back and you you make your adjustments. are you talking about massive adjustments or yeah.

 

Kiera (32:03)

This

 

one is like so it's like an office manager who came inherited to a practice and has a bonus structure in place like on collections. Well, back in the day it was great, but now payroll is at 42% of total overhead.

 

His Paulness (32:16)

That's all hot.

 

Kiera (32:18)

is a little high. And so recognizing the base pay is great. the additional compensation does not justify, like it's just part of their job. It's not an above and beyond. And so needing to remove that bonus structure.

 

until maybe we hit a higher tier of the company and it's to right size that payroll portion.

 

His Paulness (32:35)

Yep. Yeah,

 

I think that I would just kill the bonus system in that in that case. And if it's across the if it's across the board, I'd kill it. Or I would adjust it back significantly and so that they still have the feeling that they can earn a little bit more on the bonus system and I would set goals for them to get up. I think in your case, I don't know what you would could get a manager to do to to right side a forty two percent cost labor

 

Kiera (33:02)

Yeah.

 

His Paulness (33:03)

in a dental practice.

 

what can I ask you what percentage you think it's supposed to be?

 

Kiera (33:08)

So what we typically say, like a lot of consulting companies are twenty-five percent, I tend to err on thirty percent. So it's twenty-five to thirty percent tends to be where I sit. I recognize California offices sometimes are a little bit higher than that.

 

His Paulness (33:20)

Hello, mm-hmm.

 

Kiera (33:22)

but that tends to be about what we'd recommend for a percentage.

 

His Paulness (33:23)

I'm I I'm with you. We

 

you know, we we've got several hundred close to a thousand people on payroll. So we and and and they're using our our software for their HR systems. I you're you're you're in about the the pocket right there. We see as high as thirty six percent, and as as low as twenty two percent. That twenty two percent practice is tiny and highly profit profitable.

 

Kiera (33:47)

Mm-hmm.

 

His Paulness (33:48)

That's a very specialized dentist with about four employees.

 

Kiera (33:52)

Mm-hmm.

 

His Paulness (33:52)

So yeah,

 

same place. I just was curious. I just, you know, love to

 

Kiera (33:55)

Yeah, no.

 

It's a great one. And then one other question on payroll, because I have a lot of dentists who get burned by that third payroll, right? So it comes in the month and they're like, ugh. So some dentists, and I did this early on, so I have no idea how people can do it. I know what I did and I'm not about to share because it might not have been correct. but we move to only two payrolls in a month. So I do it on the fifth and the twentieth. And I know some dentists are thinking about that, wanting to are there any rules around how to do that? Are you allowed to do two payrolls a month? Like, because then I'm not getting hit with the cash flow hits of the third payroll.

 

periodically, just some thoughts of offices are wanting to do that, are the right ways to go about it.

 

His Paulness (34:28)

Absolutely. Absolutely.

 

You need to check your again, you gotta check your state rules. There's fewer states that have these rules but you need to check your state rules. There's this pay frequency. By the time they finish their payroll period and they close the payroll, there's a certain number of days when they have to be given a check. In none of those

 

Kiera (34:47)

Mm-hmm.

 

His Paulness (34:48)

instances does it prevent you from going to two payrolls a month, th that that I can recall. It's if it is, it's it's very

 

It's one maybe one state, where you might have to add one or two payrolls to the year in order to meet the law. It's not every month. It's just to the year.

 

Kiera (35:09)

Interesting.

 

His Paulness (35:10)

Yeah.

 

Kiera (35:11)

Okay. Yeah, 'cause I know when we did it, I just I was like, We're gonna change it and they told us to float employees if they needed it. I let them know when it was coming so they could financially prepare for it and yeah.

 

His Paulness (35:20)

Yep. Give everybody thirty days and you will have met your states

 

most states' requirements too that say if you're gonna change to this model, that's what you gotta do. Yeah.

 

Kiera (35:30)

Awesome. Okay. Well, Paul, I've like we peppered you on so many questions. I know you had a couple of case studies you wanted to bring and I'm excited to like hear. I I do enjoy a good case study that freaks me out and I I feel like it's like forensic files with you. Like bum bum bum bum. Like let's hear the case studies now.

 

His Paulness (35:46)

I think I'm gonna start with a f positive one and then I'm I'll ruin y'all's days with the other one. here's the here's

 

Kiera (35:52)

Ha ha

 

His Paulness (35:52)

here's the positive one. And we have been saying this for years and we're the ones that started implementing it with our clients. It's not that we invented it, it's that not enough importance was put on it. And when we started in two thousand six, everybody was making up their own employee handbook or they were going to ADP and they were getting handbooks that didn't have anything about HIPAA in them.

 

And they didn't have anything about maternity leave. I mean, literally, payroll companies were telling employers, you don't have to give you're not required by law, so we don't put it in the handbook. And and we're like, so offices with seven women in them who

 

Kiera (36:23)

Yeah.

 

His Paulness (36:24)

are all going to get pregnant at some point in their career, you don't have a policy for what to guide them through. Anywho, the policy that we are very big on and we use it throughout the handbook in the c in the proper places.

 

is a requirement to report a problem. So it's very simple. If you re if you have a problem and it could be with payroll, it could be around harassment and and you got to define that. It could be around many other things. You have to report it to us. Here's how to report it. If you're not confident who manages you, here's a way to tell somebody else about it. If you put those reporting procedures in place and someone doesn't follow it, they get fired.

 

And they come back six months later to sue you over the problem that they never told you about, then the the judge is supposed to say, Hey, when did you tell them about this? When when when did this happen? And so we see it happen a lot in depositions, which never make a court case, so you don't see it publicly, where the lawyers got someone in deposition, they'll just say, okay, cool. so you said this was happening for the whole year, and you had four one on ones with your manager.

 

and when when did you report it to your manager and and and or or or an email to somebody, you know, that that kind of thing. Well, we recently saw a case come up, it was errors versus chemjet. I I don't know what in the world chemjet does. chemjet argued,

 

Kiera (37:54)

Mm-hmm.

 

His Paulness (37:55)

hey, we this case should not go forward. We want summary judgment, we want out, because this employee never told us about this problem. They never said a word to us. And the judge said to the and the judge granted it to him. They just said, you know,

 

It they're right. You had an opportunity to report this. You're back here. You have a multiple complaints, but you were you did sign the employee handbook, you did acknowledge it, they did distribute it to you, and you gave them no chance to cure this. Had you given them a c a chance to cure it, there's a reasonable expectation that they could have done something about it. Without knowing about it, nothing they could do. So again, when you self-make your handbook and you miss that opportunity,

 

Kiera (38:31)

No, she's not.

 

His Paulness (38:32)

you get, you know, you may not get the best result.

 

Kiera (38:36)

I think Paul, something I've learned and when I started a business, I was like, okay, I can be cheap on certain things. I can be cheap on gauze, I can be cheap on gloves, I can be cheap on what I pay for dinners, like staff gifts. Like I can be cheap those areas. The thing not to be cheap on is have my employee handbook and my policies like cross our T's, dot our I's pay there to prevent much harder future decisions.

 

His Paulness (39:02)

Well, you're speaking my love language right now. There are just a few places

 

where you just don't want to be cheap. You don't want to be cheap with your CPA. You wanna you want consultants and and good consultants cost a little bit more and so that you can get more individual attention. There's just you know, for all of us, there's just these things where it just doesn't make sense to kind of cheap out. the you know, but the entrepreneur in all of us, in

 

Kiera (39:26)

Mm-hmm.

 

His Paulness (39:27)

me too, and me as well. I mean, heaven help me,

 

AI has made it so that I can start coding my own stuff. That's probably not a good idea. But I'm doing it, Kiera, because I'm gonna I'm

 

Kiera (39:38)

I know.

 

His Paulness (39:38)

gonna save myself some money. that's

 

Kiera (39:40)

Ha ha.

 

His Paulness (39:41)

not what's gonna happen. I but anyway, that's the story, you know, that little guy in the back of your head. yeah, there's some things

 

Kiera (39:48)

Seriously.

 

His Paulness (39:49)

not to say. Money on, and I'll make this argument about policy. Most doctors will and will spend hours on creating their own employee handbook.

 

Which I mean, I don't know a doctor that doesn't value his or her time at five hundred dollars an hour. Many of you make a lot more than that. You have to generate that. That's the only way you can keep your business open. you end up with a fifteen to twenty to twenty five thousand dollar handbook that was created by somebody who doesn't understand HR law, which is you. it's just not the best way to spend your time. And I'm just I'm just like, doctor, this is

 

Kiera (40:20)

Agreed.

 

His Paulness (40:20)

a this is a fifteen thousand dollar document and it's got a bunch of evidence in it and it's not the right kind of evidence. So,

 

Yeah, thanks for letting me talk about that.

 

Kiera (40:31)

I agree. Okay. Now let's scare everybody into why they should not make their own handbooks. Like that that'll be the one that won't let us sleep tonight. Cause I'm sure has something

 

His Paulness (40:37)

That'll be the Halloween thing, yeah.

 

Kiera (40:39)

that that like just don't don't shortchange on your HR and legal. To me, I'm like, those are worth it. Just pay. I can sleep at night better. Like and cross my T's not my I's. I do want to do right by my employees. So okay, what's your other case study?

 

His Paulness (40:49)

And just like

 

I wanna add one more thing. When you're

 

Kiera (40:54)

Yeah.

 

His Paulness (40:54)

working with someone like us, you're also getting access to the experts who are taking the legal and the human side approach to it. So they've talked to thousands of practices and heard your problem probably. Every now and then somebody gets an award a an award, a monthly award for wow, we've never heard that before. but for the most part, you're talking to a a a group of experts who are there who can actually help you solve the problem too.

 

And that's where the real value is. You know, we were talking about AI giving the right legal answers. It's the human answers that are are more interesting. So the last case study is the it it it has to do with the classification conversation we had. a temporary employee who the doctor hired. she was a hygienist. she came into the practice, they hired her as a

 

ten ninety nine employee, which doesn't exist, hired as a ten ninety

 

Kiera (41:52)

Mm.

 

His Paulness (41:52)

nine, didn't put her on the payroll, didn't put her on workers' comp, didn't put her on anything. she ended up working for them for about three weeks. The person that she was supposed to set in for was supposed to come back, and that person was at the end of her pregnancy, and so she d was unable to return to work, so they kept that employee on for about three weeks. She was not great.

 

at the end of the three weeks, they she was like the the the the employee who she was replacing for for temporarily was going on maternity leave. She was expecting to stay and through that time period now. And they didn't want her to stay, and they told her, you know, no, you're you're not gonna stay. And so she went and filed unemployment. and you know, you guys are thinking, well, an independent contractor can't get unemployment. Well

 

Well, remember, she was misclassified, she was an employee, didn't matter what you called her. And this triggered the state to look

 

Kiera (42:53)

Mm.

 

His Paulness (42:54)

for her withholding and to see that she was not on the record. and then it triggered them to tell the Department of Labor in that state that this because they were working together. So UI a UI claim kicked in an entire investigation from the Department of Labor in that state. And so they wanted all the time records and

 

I think they may even requested bank records because they were looking for other instances of misclassification and paying people as an independent contractor. So that's the other horror story.

 

Kiera (43:25)

Mm-hmm.

 

His Paulness (43:25)

I don't I don't s that it doesn't usually get that bad, but it can, but I do see it blow up a lot and and I mean quite frequently people go out and make these claims. the other thing

 

Kiera (43:40)

Mm-hmm.

 

His Paulness (43:40)

that can happen in a misclassification in the domino effect.

 

Is that your associate doctor gets that that independent contractor gets audited. and in the audit they learned that they were working for you, and then that

 

Kiera (43:54)

Yeah.

 

His Paulness (43:54)

triggers an audit of you, and then you have to pay all the taxes that you didn't pay them, with with penalties.

 

Kiera (43:59)

Mm-hmm.

 

His Paulness (44:00)

That's a really happy note to end on, right?

 

Kiera (44:03)

I know. I'm like, all right. And with that, everybody, have a great day.

 

His Paulness (44:05)

Yeah, w with that, yep. Have a great day. I think we should pause to focus our way out of this somehow.

 

Kiera (44:11)

I think we should too. And I think I think the piece I take about this is I appreciate honest and real because I think so many times we were like, that's not gonna happen to me. And I would like people to like, I remember it was crazy. I actually was talking to my financial advisor this week and I was like, okay, let's just like run the tape. If me and my husband got divorced and

 

Like what would this look like? Would we both be financially taken care of? And he was like, is divorce on the table care? And I was like, no, not at all. I just want to know like what would be my worst case scenario if that ever did happen. Cause that's going to set me up better to make smarter decisions today and like make sure we're prepared if that ever came about. And he's like, You're the first client who's ever asked me that. And I thought about it and I'm like, that is actually how I think. And I feel like it applies very much to HR is why don't we know like what worst case scenarios are? Not so we don't sleep at night, but so we make better decisions.

 

His Paulness (45:00)

So we do

 

sleep at night. Yeah.

 

Kiera (45:00)

And like this can happen. Exactly.

 

Cause I'm like, I'd rather know. Like they have proven that us not knowing what happens creates more anxiety than knowing. And so I'm like, I feel like this is my like when I pay for HR or when I pay for my lawyer or when I pay for I have to learn a lesson. Like we're going through some things in our company right now. And I'm like, all right, this is just my CE and HR. So like me paying

 

His Paulness (45:18)

Yep. Exactly.

 

Kiera (45:20)

my legal fees, me paying my HR fees. Like I didn't learn this. You paid for dental school. So this is where we learn what's the absolute worst that could happen to us.

 

We pay for our CE education in this to learn from people like yourself for this. And then we do the best we possibly can. And when we learn that we were doing it wrong, we correct it, we make it better now and we keep moving forward. And that's how I think I would like put a pretty bow on this because Paul, like, to me, as much as I get creeped out every time I talk to you, I appreciate it. It's not a lie. Every time

 

His Paulness (45:48)

Okay.

 

Kiera (45:50)

you come and meet with our dentist and I'm like, my gosh, and my whole team's sitting there. And I'm like,

 

His Paulness (45:54)

Yeah.

 

Kiera (45:55)

like, please like just cover your eyes and ears and don't hear that I'm messing up. Like

 

His Paulness (45:56)

Just yeah, Toba said la la la. Yep, yep.

 

Kiera (45:59)

All the dentists get a hear and like their teams aren't even present. My whole team sitting there taking notes rapidly. And I'm like, goodness, like great and not great. but I appreciate it because it makes me better and it makes me a better business owner. And I think that's why we're all listening to this. So that's my take. You might have a happier ending, but to me, I'm like, let's learn

 

His Paulness (46:16)

I do.

 

Kiera (46:17)

it. Let's play our CE fees of learning HR and let's continue to be great employees in the industry.

 

His Paulness (46:22)

I have a very upbeat thing here

 

to end this on. it's very short. if your better half is like my better half, there's no way in hell they listen to your podcast 'cause they've heard your voice enough. And so your your

 

Kiera (46:34)

It's true.

 

His Paulness (46:34)

your spouse is never gonna hear that he's in imminent danger right now. Maybe he should hear it. Maybe we should send him a

 

Kiera (46:40)

True. Maybe to

 

I did tell him I asked the financial advisor that yesterday. I was like, I did ask this question.

 

His Paulness (46:47)

Mm-hmm.

 

Kiera (46:47)

He's like, Kiera, I like that about you. He's like, that's more probable than me dying. He's like, how many and I was like, you're right. And I was like, but guess what? I hope we ride off to the sunset forever. Like, that's my ultimate plan, but I

 

His Paulness (46:58)

Right.

 

Kiera (46:58)

would like to know. So anyway, he probably will never hear this podcast, which is probably in my favor today.

 

His Paulness (47:03)

Yeah.

 

look, I appreciate you having me on the show. I it's nice to be able to kinda talk through these things. This is like, you know, my passion, the thing I wake up thinking about every day. So it's kind of fun to share this stuff. I do appreciate.

 

Kiera (47:17)

Well, I appreciate you, Paul. Paul, you're such a resource in the industry. You're somebody that I recommend to every practice that we work with. So, Paul, if people are interested, if they loved this, if they're freaked out and they're sitting there with their stomach in knots, how do they connect with you? Or if they're like just wanting to be better. You don't have to be nervous. You can still reach out.

 

His Paulness (47:26)

Yep. yep. if they Exactly.

 

okay, so you can go to our website, which is C E D R, the word solutions with an S on the end. So that's CEDRSolutions.com You can go to our website, sign up for the education. if you want an employee handbook or you want to kind of figure out, you know, what it would take, you're like, hey, I think I maybe I should take care of this.

 

You go in the other direction,

 

Kiera (47:55)

Mm-hmm.

 

His Paulness (47:55)

just fill out a form, you'll talk to somebody here, it's all low pressure. You wanna make sure that you that you're saying, Look, I heard the podcast of Dental A Team, so we can so we know where you came from. and we'll take good care of you. We'll explain what's available to you and kinda, you know, go through the process. those are really the best two ways, you know. Best those are the best two ways.

 

Kiera (48:17)

I love it, Paul. And Paul's not going to be high pressure. I will be high pressure. Get your freaking handbooks updated and like legal. Then go do that. Like that to me is like give

 

His Paulness (48:25)

What she said.

 

Kiera (48:26)

yourself the gift of peace of mind at night. Go get that done. So, Paul, thank you for being on the show. Thank you for being a part the Dental A Team. Thank you for being someone I trust in the industry, someone I value. And I hope today everybody listen to what he says, make yourself better, become a little bit better today. And Paul, truly thank you for being on the show.

 

His Paulness (48:41)

My pleasure.

 

Kiera (48:43)

And for all of you listening, thanks for listening. And I'll catch you next time.

 

on the Dental A Team Podcast.