Episode 814: To Expand or Not to Expand…

Kiera shares two office autopsies, each who considered practice expansion and went about it in different ways. When considering whether to sell to a DSO or move to a bigger building or simply stay where you are, make sure you’re not doing so for the wrong reasons. Kiera explains what the right reasons and wrong reasons would be, and how the two offices ultimately made their decisions.

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Transcript:

Kiera Dent (00:00.802)

Hello, Dental A Team listeners. This is Kira and welcome to the Dental A Team podcast today. I hope you're having an incredible day. I hope that you just remind yourself that you are living in the greatest time. This is the best time to be alive. There's so many cool things that make our life so easy and you get to work in my opinion, the best profession that we could ever, ever have the opportunity to do so. So I hope you just like high five. I'm giving you a high five. High five yourself. Give yourself a huge hug. Like you chose to be in the best profession that changes lives.

that makes people happy, that really gives them a gateway to success. So today I wanted to do, I know you guys are obsessed with and I'm obsessed with office autopsies. I love a good office autopsy and today's going to be kind of a fun one because this is an office that was...

to expand or not expand. And I think that this is a question that so many people struggle with and so many people wanna know. So before we get started though, you guys know I'm on a mission to get this podcast into every single dental practice across the nation to positively impact them in the best way possible. And the way to do that is I'm challenging each of you to every single month, share this podcast with at least one dentist or dental practice. So tag us, share them, invite them, welcome them.

tag them on social media because of every single one of us invites 12 people to the podcast. That's super simple. Think of how much this podcast is gonna grow and how many more offices we'll be able to impact and to change their lives. Make their life easier, more profitable, less stressful, better patient care. So please do me that favor, get on the path. And when you've done it.

Tag me on social, let me know. Hey, Kira, I invited this person and I'm gonna give them a huge welcome. I DM a lot of people personally, so I would love to welcome them to our Dental Late Team podcast family. Be sure to leave those reviews. I love to do review shout outs to you guys. So it's been a while since I've done one. So I'm just gonna pull this up. We're gonna go, cause you know, I'm reading all the new ones, but here we go. This is from my, D-Y, it's M-D-Y-M-M-1.

Kiera Dent (02:05.43)

For years, I worked in an office that used the scheduling institute for consulting. I thrive on the constant learning and constant growth. I love the growth mindset. As a leader, I strive to constantly improve my skills. As of November 1st, I am at a new office that does not use any consultation company, and I've missed it horribly. I started listening to the Dental A team, and it's filling the hole I didn't even realize I had. I listen to it every morning to start my day. This podcast is a necessity for all dental practices.

Dang, thank you so much. The fact that we're able to fulfill that for you is something that I'm so passionate about. So I just appreciate you. So leave those reviews. I will give you guys review shout outs because I appreciate you and I read those reviews. So thank you. All right, so to grow, to expand or not to expand. So this is a practice. They were doing really well. And I'm going to kind of morph two offices into this office autopsy for you. And for those of you

Every so often I will do an office autopsy where I talk about a practice That we've consulted and show you kind of their path to success that they've gone on Because I don't believe in dental a team our consulting is not one-size-fits-all It is what is that practice owners vision and their dream? What do they want to be and that's how we consult so whether it's in our virtual consulting or a one-on-one consulting It's your dream your life giving you those tools and tips for success So for this office what we did it was to expand or not to expand and so what I found was

This doctor was really struggling because they had a really profitable practice and the practice was great The systems were tight the team was there and the doctor has I don't know five ten fifteen depends on how long they want to practice Years left of practicing so I'm not brand new out of school Not super old to retire kind of in that weird like middle zone of what do I do? I've grown this great practice It's very profitable. It's very successful

They thought about selling to a DSO. So a DSO was an option. There was space to expand to add in more ops or just stay status quo. And I think so many offices come to this crossroad of what do I do? I could cash out to a DSO. Like there's a lot of money that can come from a DSO and I'm going to say a lot of money with massive air quotes because the DSO world sounds great on paper.

Kiera Dent (04:22.454)

but it doesn't always pan out the way you want. So make sure if you're planning the DSO route, do your homework, do your research to make sure it's really where you wanna go. So they did that. And honestly, I remember I coached this doctor for a long time and I had a couple of them. So I'll kind of, like I said, I'm gonna merge two stories into one, but this doctor of this first practice really truly just was like torn because...

the thought of expanding. So the thought of selling to a DSO felt like a loss of ownership and having to be like shackled to someone else's model of their practice. It's like living in your house after you sell it to someone else and being told how to live, how to run, how to have it. And then, so that was like the DSO feeling, but then expanding the practice felt like going from having all your kids grown up, everything's moving smoothly, to now I've got a brand new baby.

and I'm going to have to work more hours, like all the freedom that I worked so hard to achieve is no longer going to be a thing for me. And so it was really this like toss up and then just staying there just felt stagnation. Like we knew we were at a crossroad. We knew we probably weren't gonna stay like there. We knew we'd probably grow. Now I'm gonna pivot, cause I had another office, same type of thing. Do I sell to a DSO? Do we expand to a bigger building? Or do we just stay where we are? And that office actually chose to stay where they were because they're like,

We work four days a week. We have little kiddos. We get off work every single day at three o'clock in the afternoon. We have an insanely, insanely profitable practice. If we grow, if we sell, like we don't wanna sell this as a cash cow. Like it's doing really, really well. And if we sell to a DSO, they're just gonna get the profits. It's not hard for us. We know we still wanna practice for the next probably 20 years. And so we're just gonna have a killer life. So they went for a lifestyle change.

They just decided we're gonna have the most incredible life. We're gonna take more trips. We're gonna have more fun, but we're just gonna stay here and we're gonna have our business support our lifestyle and serve our team that way too. So that was their model. This office, they didn't have little kids at home. The other office, like I said, they still wanted to practice for a few more years. So lifestyle wasn't really a thing that they were going for. Selling to a DSO did seem very appealing, but it felt like it was shackled and they almost sold. Like they almost, almost sold.

Kiera Dent (06:37.974)

to the DSL, like almost signing down the dotted line. But then they realized that they were going, like the DSL was going to expand. So if they sold, they were going to be getting the profits of the expansion as opposed to them getting the profits of the expansion. And I think that was truly probably the deciding line because they still have a few years. Why not go for it? Why not grow this thing?

Why not make it bigger? And then if we want to sell to a DSL, we can do it at that point, but like, why don't I grow? And it was crazy because this conversation had probably been happening for about three years. And I want to paint that picture because so often on office autopsies, we think that this is overnight. But to give you a timeline of this was a three years in the making decision. Like I had many, many conversations and the other one who decided on the lifestyle, that was like three years in the making as well. So long conversations. You think I just consult on tactical systems.

No, I do more lifestyle and more your lifestyle. My background's marriage and family therapy. So there's a lot of, I feel like therapy in consulting too because I'm really passionate about you having your dream of a life. And so this doctor, I said like, I can't make that decision for you. Let's go through pros and cons. Let's go through the different things that you and I can think through and let's figure out what this is actually gonna be best for you. There is no, and I wanna point this out, there is no wrong option.

There is no wrong option. And sometimes I think that that's hard because we want a wrong option. We want it to be so clear, but there is no wrong option. I feel like it's Alice in Wonderland and there's lots of different paths. We know the Robert Frost one, like there's two paths. Both paths are gonna lead to a great place. It's just which path do you want to go on? Where do you ultimately want to end up? And sometimes like multiple paths could get you there. If this doctor would have sold to a DSO, pending upon the DSO.

We could have had it where it was great. Like I have a friend, you guys have heard Pierce on the podcast, if you missed that podcast, go listen to it. He sold his business and it was so freeing and then he built another business. There's some doctors who have sold to DSOs and it was great, it was awesome. Some sell to DSOs and they don't enjoy it. Just like some doctors work for corporate and love it. Some work for corporate and hate it. There's so many different paths you can take. And I think that that's where it's hard. It's hard to do I expand, do I not expand? But I wanna say,

Kiera Dent (08:50.71)

So many doctors that I've consulted expand for the wrong reasons. They expand because they think that that's what they need to do. They expand because they feel like, oh my gosh, I have all these different people around me that are expanding. I need to do that. And it's like the I want to grow too. I want to be with this too. But not because you actually want to, but because you think you need to. So that's the wrong reason to expand. That's the wrong reason to grow. And so you really have to check yourself of why am I doing this? Is this for me or is it for someone else?

and you really boiling that down is going to help you exponentially decide what you need to do or what you don't need to do, depending upon where you wanna go. So for this doctor, it was like I said, three years in the making, almost sold to a DSO, and then decided, nope, we're gonna knock that wall down and we're gonna expand out. And so this practice has gone through the construction, they added in.

Gosh, I want to say they've added in six more operatories. They brought on two new doctors. The doctor did go back, like they don't have nearly as much time. So there's not as much free time. And they knew that going into it, we have like a one-year plan of where they're going to go. We know how long it's gonna take. They were super strategic on who they hired for these additional doctors. There was conversations of people partnering in, not partnering in. That was a whole different piece.

Do we partner with doctors? Do we not partner with doctors? We realize we don't really want to be swapping equity right now. That just isn't the path we want to go. Maybe it's in the future and just like going through the different processes. But once the decision was made, it was crazy how calm that doctor became. Yes, there's more work. Yes, we're expanding. Yes, we're doubling the size of the practice. Yes, we're going to have to hire new team members, but they already have the systems in play and the team was so solid.

that this doctor, I think it became that like, I don't know, it's not even middle of career, but just something of growth for fun of where they know they ultimately can go. And I feel like this doctor made the best choice for them. This is a path, remember, there's like three options in front of them. And they chose the one that inspired them for them, not because of anyone else, not. And they did a lot of research. They talked to a lot of mentors. They called a bunch of people about selling, about expanding, about staying status quo. How was your experience? What did you do? How was this for you?

Kiera Dent (11:02.91)

And so for me, it's really fun because I watched the process with no agenda as a consultant. I wasn't here to say, you should expand or you should sell to a DSO. It's what do you want to do and where do we ultimately want to end up? And honestly, all three of these could get you where you ultimately want to end up. And then let's make the decision that you want to do. And so it's been fun. And there's, I feel new energy in the practice. There's new energy for them of growing and expanding and being able to serve more patients and to be able to bring so many more things in that they were able to do in the past.

And for them, the right option was to expand. It was to add on those new ops or to buy another practice for some of the other offices I've consulted. That's the right decision for them because that's where they ultimately wanna go. For the other practice, it was a lifestyle. They wanted a lifestyle. They knew that they were getting to be have the best lifestyle. And so really both are getting a very similar outcome with two different paths. And that's why I wanted to do this office autopsy because it's fun. It's fun to see the different paths that people go on.

It's fun to see the different lifestyles that they choose. It's fun to see the different stages in their life that they're in. So the practice needs to serve at a different level for the different lifestyle you're in. Do you have little kids? Do you have grown kids? Do you wanna retire in five years? Do you wanna retire in 10 years? Do you wanna retire in 20 years? Do you wanna retire in five years? All of those things are gonna play into where you go. And so being able to consult this office and to be able to help them navigate through into.

play out the different paths and this is what it could look like or this is how it could turn or this is what it could be. Let's figure out what it is and then going through and navigating through it. I mean a big thing was the cost and the risk of expanding and I think that's a true thing. You know you sell to a DSO you're going to have someone else shoulder it. You have a partner someone else shoulders this risk for you but you don't get all the reward. And for this doctor my biggest thing that I thought was great was you know you can grow a practice. You've proven yourself to do that already.

This is just making you uncomfortable, but you already have the skillset to do it. So what's the true risk in it, other than just being afraid? And oftentimes fear, I have this really cool quote right here that says, don't let the fear of losing be greater than the excitement of winning. I think oftentimes we sit there with fear, thinking that it's going to be there. When reality is, like, we let that fear talk us out of so many things, when in reality,

Kiera Dent (13:21.21)

Winning can also be exciting and we're probably going to win, especially if we have a track record where we've done it. And this doctor had a consultant, we know we're going to be able to add money to the books. I know how to grow practices. I've done it hundreds of times. Like you have the right people on your executive board to make sure you're successful. The fear should be mitigated, but I believe that fear is good because it forces us to question our decisions and make sure that we're really doing it for the right reason. But I also love this, and this one's from Thomas Edison. He says, most of life's failures

are people who did not realize how close they were to success when they gave up. And I think about that. When you're expanding or not expanding, if you're buying another location or not buying a location or choosing to have lifestyle, don't give up because you're probably so close to that success, whatever success looks like for you. And this is where you defining what success is for you, you figuring out what does success actually mean for me.

I think can really be a beautiful piece. It doesn't necessarily mean you have to have so many practices. It doesn't mean you have to make so much money or you have to have this much overhead. It's your success. I have a doctor and he doesn't care that his overhead is high because he has a lifestyle that he wants. And he's like, I have enough money and I don't care if my overhead is high because I'm living the life I want. Me as a consultant, I would love him to have a lower overhead, but that's me being egotistical, not serving his. I'm going to teach him. I'm going to coach him. And if he knows what the knowledge and he sees it and that's a conscious decision he makes,

Rock on. And as long as he doesn't get his business in trouble, he makes the decisions he wants to make. Success is not numbers in your bank account. Success is the life you're living and the happiness you have. So this one, it's fun. I'm so excited. They're now, they've expanded it. They broke down the wall. The whole practice is there. It is stunning. It's gorgeous. They figured out how to do it. They're going through the growing pains, but they're loving it.

and they're feeling so fulfilled. And the other office is not. They're loving their life. They didn't expand and they're so happy with the life and the trips and all the things they're able to do. They travel more with their family. They see different things in this world because that's where they are. And just know that each decision is not the final decision. For them to choose lifestyle today does not mean they can't expand in the future. For this doctor to expand now and choose that they wanna sell to a DSO, it doesn't mean it closes that door. We often think that opening one door means we're closing all these others. And maybe for a time and a season,

Kiera Dent (15:37.398)

but it's not permanent. And so just remember, make the decisions, move forward. It might take you a while, but hopefully this gives you some clarity on to expand or not to expand and some questions and some things that other offices have done in making that decision so it's more clear for you. If I can help you with this, this is what I obsess about doing, giving you the systems to be able to expand, helping you figure out what you really want to do. And that's what Dental-A team is about. It's a different type of consulting. It's not just numbers and metrics. Of course we do that, but it's about you.

It's about your success. It's about your passion. Like we said, it's your success, our passion. I wanna make sure that you're getting your success because that's my passion. And if we can help you with that, I'd love to serve you. So reach out hello at thedenalieteam.com or book a call on our website. I'd love to help you. And as always, thanks for listening. I'll catch you next time on the Denali Team Podcast.