Episode 654: Behind the Curtain of Dentistry

Kiera is a guest on The Dental Download podcast! In this crossover episode, she talks with host Haley Schultz about the realities of the fast-paced world of dentistry, including …

• What makes a dental practice different from other work environments

• Key systems to consider if you want to own a practice someday

• Incentives for employees

• The transition from student to associate to owner

• And more!

This episode is pertinent to associates, soon-to-be associates, dental grad students, doctors looking for new grads/associates, and team members hoping to assist new associates.

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Transcript:

[music]

0:00:00.0 Kiera Dent: Hey everyone! Welcome to the Dental A Team podcast. I'm your host, Kiera Dent and I have this crazy idea that maybe I could combine a doctor and a team member's perspective because let's face it, dentistry can be a challenging profession. With those two perspectives, I've been a dental assistant treatment coordinator, scheduler, biller, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over 165 different offices, coaching teams. Yep. We don't just understand you, we are you. Our mission is to positively impact the world of dental, and I believe that this podcast is the greatest way I can help elevate teams grow VIP experiences, reduce stress, and create A teams. Welcome to the Dental A Team podcast.

0:00:51.1 KD: Hello Dental A team listeners, this is Kiera. And you guys, I did an awesome podcast today and I am so excited for you guys for us to be cross-promoting it across the two platforms. So guys, today's podcast is coming from the Dental Download podcast and the reason I wanted to share on our podcast is because I feel like I really went into a lot of things that's pertinent for associates, future Associates what it's like to be a new grad and how to accelerate that process. And I was thinking for a lot of our doctors out there who are truly looking for those new associates, looking for new grads and then also how team members can help those new associates, I feel like this would be a super valuable podcast for you guys. So I hope you enjoy it. It was a lot of fun, lots of awesome content for you guys. And as always, thanks for listening and I'll catch you next time on the Dental A Team podcast.

0:01:39.9 Haley Schultz: All right. Hi everyone, so we have a guest here today. And Kiera, if you don't mind just introducing yourself, giving us a little bit of your background.

0:01:47.0 KD: Yeah. Absolutely. I'm super honored to be here. A huge fan. My name is Kiera Dent and Dent really is my last name. It's always funny when I'm on a dental podcast and people ask if it's a stage name, but that just took me only three engagements to be able to actually get this last name. So I'm obsessed with dentistry, I love it. I've been a dental assistant, a treatment coordinator, a scheduler, a biller, an office manager, regional manager. I've owned dental practices. I worked at a dental college for three years, so shout out to the student life. Haley, I understand your life. I understand your world. I was never in that world but I felt like I just love on the dental student world. So I've actually owned some dental practices. I helped a student straight outta school. We had a practice together and took it from 500,000 to 2.4 million in nine months and opened a second location.

0:02:39.3 KD: Everyone's like, "How did you do it? That sounds so fun." And I'm like, "If you dig the 2:00 AM to 10:00 PM life then yeah, it's amazing, if you don't, I've got a lot of tips for that." And then honestly I just... I love dentists, I love helping students and so that was my thought of if I could help this one student, I bet you I could help a lot more students with this and so maybe there's a way that I could serve an even bigger population. So that's why we created Dental A team consulting, very unconventional. I believe that dentistry and having your dream life and having an amazing team and having an accountable team and having systems like that shouldn't be hard. It should be easy and, honestly, let's share those tips. So that's a little bit about me why I'm obsessed with dentistry and just super excited to share and positively impact. 'Cause honestly we're in the best profession. I don't know if you think that yet. I know you're not quite out, you're on third year coast here, but I really do think that we can change lives in dentistry and, and so why not? I wanna help the best dentist be even better and truly win.

0:03:40.4 HS: And I'm excited for everything you have to offer and share today because my audience really is mostly dental, pre-dental students. So we're getting them at an ideal time when maybe they can start thinking about some of these systems and ways that they wanna run things rather than five years into practicing when they're gonna buy an office and being clueless. So this is great information that we're gonna get out to them.

0:04:04.2 KD: For sure. Yeah.

0:04:04.9 HS: So one of the first things I wanted to ask you is, in your opinion what makes a dental team, a dental office different than other work environments that people may have been in?

0:04:15.3 KD: So dentistry's weird guys, you gotta think about it. There is no other profession where I walk up to complete strangers and put my fingers in their mouth. It's weird, it's a weird environment, it's a weird place. We're like knocking knees, dental assistant dentists, our hair is touching each other, we are in such close quarters and I don't think there are many other professions where you work that physically close with somebody else. And so I really feel because of that closeness and I bring that up, patients and our encounters and our experiences are much more intimate than I feel in other work environments. I feel with dental people, I mean we can all like pull our mouths back and like could you just look back here patient like I had my neighbor come over and she's like, oh could you look at my lip?

0:04:57.0 KD: It's weird. We work in this weird zone that we cross a bunch of boundaries that are not normal. And so I really feel like those dental teams in those dental offices are intimate, they're close-knit, there's opportunity for a lot of miscommunication, a lot of high stress. Like I do feel those dental office ops can be very intense, high pressure. Doctors are running from exam to exam, they're trying to get dentistry down. I mean like you know Haley, you're dentist, dentist in the making over there. You guys have all this stress of I've gotta have the perfect box, dropping that box, making sure I prep that tooth correctly and I've got three exams stacking up on me and I've got hygienist waiting back there and I've got all these things that I just feel it creates an opportunity for there to be really intense stress and pressure.

0:05:43.7 KD: If we're not open communicating with each other, if we don't have good systems in place, it can get bad shenanigans crazy for you guys. And so I feel like other work environments... Hospitals, my husband has it, but I'm like they're not having to set prep numb, have that waiting of the numbing time. Like most things don't have that and other procedures that do have that numb time, they're much longer procedures generally speaking. So I just think you've got a lot of elements but in doing so because you've got that closeness because you guys are working like literally knee to knee hair touching, I truly have had some dentists where their hair is touching my forehead and I'm like whoa, we're a bit too close. Like we're gonna hit heads. I think that it also creates a very strong family knit unity where we're truly changing lives of these patients, we're helping them overcome a huge fear that patients are scared, they don't love coming to the dentist.

0:06:36.6 KD: And so to be able to create a work environment that's fun, fast paced, high stressed, but we're all laughing having a good time, I just feel that that's something very unique to dentistry and something that I feel can be so fun if done correctly. But also so stressful if you don't have those systems in place and if you're not profitable, like so many dentists love to do the dentistry but when they're not collecting money, their team's not collecting money, it creates a stress like pressure cooker environment that I feel those are the different pieces. So if you are a fast-paced lover, let's move, let's roll. I literally in one of my dental offices, I wore Heelys true story. I had the wheels like I wheeled into my operatory, said hi to my patients. You don't like that fast paced dentistry's not gonna be your jam. But if you do and you thrive on it and you can find team members and build systems, I think it's one of the coolest, most like fun day job. Like your day goes by so quickly in dentistry and you're serving and changing people's lives left and right in a way that I don't think most people ever imagine that they would do.

0:07:38.7 HS: And speaking of these systems, I know an employee manual is a long book but what are some of the key types of systems that we should be thinking about when we're looking into owning an office one day?

0:07:52.3 KD: Systems, systems, systems. So on the Dental A team podcast, I actually just did a whole series of the top 12 systems that I see, that every practice needs to have and their general overarching topics. But the things that I feel really are the ones that like crux new dentists is for sure number one billing. You've gotta get a good solid billing because I don't know about you but I like to know how I'm going to get paid at the end of the day. So if you don't have that dialed in, you guys know how to do the dentistry. And working at a dental college I learned like what you don't learn at dental school. And so one of those pieces is you don't learn how to get paid. So I would have strong systems hands down around billing and doctors like you can go shadow a practice and I don't mean shadow 'cause you guys can sit back and be like, "Hmm, Kiera looks really interesting on that bill... "

0:08:38.1 KD: Like get in there and ask them like can I send a claim? Can you walk me through how we attach insurances? Can you walk me through how I submit this and how do you enter a check not to actually do it, but to understand how the money comes to you after you do a procedure. So hands down, I would get billing systems in play and just understand the process and you guys can do that while you're going to school. You can do that as students, you can do that as first year associates. I think so many dental students who graduate or wanting to graduate don't realize that just by asking questions and being intrigued you can get your hands dirty in the front office and you're gonna be saved a world of hurt. So hands down billing is probably the number one second after that.

0:09:18.7 KD: A lot of dentists don't realize and they will, I feel almost compromise their room setups. Dentists, you guys are kind of grabby when you come outta school and you like wanna grab all the instruments and I'm like whoa, I'm a really good assistant and I'm gonna hand this to you. And if you can get all your rooms to be set up and not allow for it to be sloppy and not the same from hygienist to hygienist and assistant to assistant, you dentists can be able to do so much more than you ever imagined. It's just like have a really good assistant. And one of the best things for me especially was I actually trained the new doctor. So new doctors like go work with an experienced assistant and let them train you of what an assistant should do. Dental students assist each other at school and I'm not gonna rag on the dental students, but all y'all could take a lesson in assisting like you guys sit there in your section like so you don't even know what it's like to have a really good assistant.

0:10:09.7 KD: So I think not realizing that system of having your gauze, your cotton rolls, your floss, your explorer in the same place every time you come in, not having to think about where those things are actually makes you guys much more efficient and productive as well. So I would get your room setups and your exams very standardized, that way it's easier for you. So billing exams and then I'm all big about morning huddle, office manager meetings making sure you're reviewing your... I would say you gotta look at all your reports. So again, that's gonna fall under your procedures. You're billing out the billing that you're doing, making sure that our unscheduled lists we're actually checking those lists of patients for their recare for their unscheduled treatment plans. Those types of systems, which they're not hard, they're just checklists that you just need to check in on on a consistent basis.

0:11:00.6 KD: Those are systems that I fill foundation. So if I was in your shoes, I would be thinking, all right, let me walk through the patient journey because they need systems for all of that. So number one is how do we answer the phone, patients calling in? How do we answer that phone? Then when they show up and we get their insurance information before they get there, then when they're coming into the practice taking them back into the the operatory, we gotta have all that set up. How we do our note template should also be some systems, how we dismiss the patient, how we do those handoffs, how we present the treatment plans, how we collect their payments, how we send it off to insurance, how we post those payments and then how we follow up with our patients. That is literally your system walkthrough.

0:11:42.1 KD: There's other pieces to it but I think if you can get those pieces for the patient experience and get really solid systems around that, most of the rest of it is going to be pretty easy for you. Those are are really the simple systems for you of each piece of the practice.

0:11:57.0 HS: And we're talking about how crucial having great team members are in a practice besides just the dentists doing the dentistry. There's so many assistants, front desk treatment coordinator, some people have specifically people to just deal with the insurance in their office depending how big it is. And there's a staff shortage right now and honestly who knows when that's gonna get better. [chuckle] So I was wondering what kind of incentives do you recommend for employees? Like some offices don't ever go over finances with their team and they want them to just focus on the environment and then some offices are like, no, we need to hit this. If you do this, I'm gonna give you this bonus. How do you think really gives the best payoff for the practice?

0:12:39.8 KD: Oh Haley, I'm gonna be either a loved or a not loved person and I'm okay 'cause as a consultant I found draw a line, say an opinion and people will either agree or disagree with you, but at the end of the day we're gonna make a decision. So I feel so many new grads, new owners, they're trying to increase production and so we're like well let's incentivize with bonuses. I am really anti bonuses and that's not saying I don't wanna pay team members. Well guys, I'm a team member first, you gotta remember that's who I am, that's who I'm representing. But I found that bonuses oftentimes create a lot of entitlement and a bonus really should be not when we hit our goal, but when we've gone above and beyond what is my normal job? Like you're already paying me a healthy paycheck and you're paying me well, so why are you bonusing me just to do my job?

0:13:26.0 KD: That's something that I feel is cultural. And so offices who have amazing cultures do not have to be giving these incentives. I find oftentimes that offices that are struggling with culture oftentimes might be compensating with a bonus. Now that's not to say that I don't think bonuses can work and have worked and they're very successful. I just say don't create a culture where your team is dependent on it. Like I have an office right now, they're overhead so the amount of money going out to run the business is so high that they're taking money out on their house. So they're literally taking out equity to pay for their dental bills, which I mean you guys are smart, you can do the math, that's scary. But the problem is it's because their team has so many bonuses and the practice isn't profitable. So the doctor's paying the team member all these bonuses because the team has become dependent on it, the practice is not doing well.

0:14:18.5 KD: But yet doctor can't rip away the bonuses 'cause they don't wanna lose the team members. So I feel bonuses oftentimes shackle a practice when it's not a necessary thing to do. Now in that same breath, I think that there's a lot of ways you can benefit your team. So for example, if you guys hit goal, like for our team, I take them on super fun retreats. We did Disneyland last year, this year, they don't know they're probably not gonna listen to this podcast so I can release it like we're playing Dental A team freaking survivor. Like get your buffs, I can't wait, I'm taking them whitewater rafting. They're gonna have to like survive in camp. Like I'm sure I'm going to so I'm not gonna be feeding myself rice but I can't wait to do it. I think it's just gonna be a blast. Other years we've gone to Lake Tahoe but to me like if we're all winning, let's do something that's a fun team bonding.

0:15:04.4 KD: Now some people might say, Kiera, I would hate that. I would never wanna do that. Great, you wouldn't wanna work with me. But for my team and the people I attract, we love to travel. Those are things we enjoy doing. I also do random bonuses for team members who go above and beyond. So every so often they will get an extra $500 on their check like just because they're crushing it and I tell them why. Other times you guys like I think an office who does a really incredible bonus structure is they have what's called a shoutout jar. And so people are putting in shoutouts all throughout the month. At the end of the month they pull two names. One name I think gets 250, the other name gets $500 and it's because those people went above and beyond. Then everybody gets all their shoutouts for the month to see what things people have been saying about them, how they've been an amazing team member.

0:15:47.4 KD: And that was an office who had a bonus that was hurting their overhead. They ripped it away and they went to this and their culture has radically improved. Now other people, if they really wanna implement a bonus, I say perfect, no problem. Put it on production and overhead. You have to be profitable before you can be bonusing. And bonuses come after we go above and beyond. So if our goal is to hit a hundred thousand, don't bonus when we hit a hundred thousand, it would be 105,000, 110,000 above and beyond what is standard. And then you can do profit share with them. I love to profit share, I think it's totally fun. Give a 1% of your overhead to them, split it amongst team members. And I do believe in putting hygienists on bonus. So anything above like three to 3.5 times their pay on a PPO practice, if they're producing that, I usually pay a 10 to 15% above and beyond.

0:16:35.5 KD: So if their daily goal is a thousand, they produce 110 or a 1,000-1,100 hundred, there we go. They would get bonus on that extra a hundred dollars. We could do a 10%, that would be a $10 bonus that day. So those are some different ways you can implement bonuses. But I think if you're trying to do a bonus to attract team members, make your team the place that people wanna work. And I use the example of like Chick-fil-A, people love Chick-fil-A, we are Chick-fil-A fanatics. People love Chick-fil-A, we go to Chick-fil-A... It's crazy. And yet they're not the highest paying, they're not the ones who are doing all these crazy things like they do pay well they're competitive in the industry but it's their culture and the place and the environment that people are... That they crave to work there. So make your practice a place that has raving fans, raving individuals and usually that comes from appreciation. Team members crave appreciation, especially from their doctors. And I think that can set you apart far more than any bonus will ever do.

0:17:33.5 HS: I really like that. I learned a lot from what you were saying and it sparked a few other questions in my head. A couple more things I wanna pick your brain about is kind of the transition that a lot of us are gonna go through from student to associate to owner a lot of the times. Are there any any skills you think we should really be focusing on now in a dental school setting that can benefit us later?

0:17:54.9 KD: Amen sister. I'm so glad you asked this question because students who do this are light years ahead of their other colleagues. So what I say is use dental school like your mini residency. So as much as you can do, let's think about what are gonna be your skillsets. One to be an associate or one to be an owner. Either way it's gonna serve you the same way. What's your crown prep time? You gotta get those crown preps down. And guys, I know you can do it cause I watched all of you on your practicals and I know you can prep a crown in like 10 to 30 minutes. It doesn't take you forever, but you spend the next hour and a half messing it up, nicking it, trying to make it perfect, and then fixing all those mistakes. So I would say like really learning how to do amazing dentistry in a condensed amount of time. No patient outside of the dental college is going to wanna sit there for three hours with you doing a crown prep. So push yourself in school. Patients coming to you in dental school, know that you're practicing. So practicing, get those skills up faster. Pretend that you're working in a practice and see can you scrunch that down to where a crown prep doctors are usually prepping, like between numb to prep 30 minutes is a typical standard for a crown prep.

0:19:01.4 KD: Their OT assistant comes in, we're packing cord, we're making the temps, we're scanning, creating that, cooking it and milling it and off we go. So for that, what can you guys do right now? Also, is there a way for you to go get implant or ortho? Anything you can do to expand your skillset? Because the more you can do as a general doctor, the more you're gonna be able to produce in your practice. Get your exam times down, figure out how can you do a faster hygiene exam. Because think about it, you're gonna be running two columns, most likely a production and have two hygiene columns. Treat yourself in dental school. I know you guys have checks and I know that that is like in no way, shape or form, real life, but you still can time yourself and see how long did that take you?

0:19:44.7 KD: The doctor that I shared, I mean most doctors don't come out and produce 2.4 million in a five op practice within nine months of graduating. And everyone's like, what did she do differently? How was she able to do it? And I'm like, guys, that woman, I think she had over 350 crowns that she had milled before she graduated. And that wasn't on just patients. She went and she practiced doing them on models, she was practicing. She literally acted as if I'm going to own my practice on this day and I'm gonna be able to produce X amount, check your production numbers. Like guys you need to be producing like a healthy doctor is usually producing about five grand a day. Well, figure out how many procedures and not on gross like gross will feed your ego, it will never feed your family. So it's on insurance.

0:20:30.2 KD: So that's your net, your adjusted production. How can you produce $5,000 a day and start checking yourself, timing yourself, seeing how you can do this quicker. Yes you can do it quicker with an assistant who's trained but really right now, what are the skillsets that's gonna make you a more valuable associate or a more valuable owner? What are the things you're going to need to do? How can you expand that skillset suite? How can you reduce the time it takes you? And then also I would say the next one is get really good at your injections. Patients complain all the time about painful injections. And I know typically, and this is a little stereotypical so I'm not trying to be women oftentimes don't get patients as numb. They're a little more hesitant on it and men tend to be a little more aggressive on their injections.

0:21:14.7 KD: So again, that's very stereotypical Haley. And I'm not trying to be having sexes here, but if you know that that's what's typical, a lot of female doctors, what I tend to see is they're way more hesitant to diagnose. So they're going to hold back on their diagnosing. They're not gonna give us comprehensive exams 'cause they're very nervous of rejection. And so if you know that this tends to be the stereotypes and the things I see as patterns, check yourself and say like okay am I under-diagnosing? Am I over-diagnosing? Am I presenting this in a way? And then consolidate those exams. If you could have a really solid exam where you can get it in five minutes, 10 minutes tops and time yourself, start timing yourself now see how long it's taking you, those things are going to light yours propel you forward. 'Cause usually it takes a new grad, six to 12 months to get their timing down on exams to get their preps done, to get better injections.

0:22:05.8 KD: Not like cutting someone's lip open like crazy stuff that you guys do, which is totally normal and don't think it's bad like you are learning, you're trying to figure it out. But if you can practice that in your third, fourth year of school and just start thinking like you're going to be in an office rather than in school. Get a bunch of like scan guys, all those things like implants, ortho, same day crowns, that is the new norm. So if you are not super proficient in it either take the time learning on your tuition's dime which you're already having to pay for anyway or spend the time in practice where time is money when you get to practice. And I would much rather you guys practice in school than on patients paying you that then you have to redo work 'cause you didn't practice in school.

0:22:47.5 HS: Yeah, that's so important. And I was actually talking to my roommate about that because we're studying for our national boards right now and we like paid for this test prep company whatever. And we're just like studying and so focused like man we really gotta pass this board. This is an expensive test, blah blah blah. And I'm like okay we're paying $200 a day, I don't know per school. But we don't always like wanna show up and like be really active like every day you get fatigued and drained, that's normal. But like if we can shift our mindset like we are paying so much money to be here that like make the most of 8:00 to 5:00 every day, like be there, go do something. So I'm working on that mindset.

0:23:25.3 KD: It is hard. I know students, I mean my husband went to pharmacy school, I worked with a bunch of students and I get it, I understand that there is true mental exhaustion. Like you guys are tired, you've got the stress of of your professors coming and checking your work. But guess what? You're gonna have patients judging you. You're gonna have team members sitting there judging you and be like, hmm, I don't know if I really like their prep and I'm not gonna tell this patient to come back. So like you think the judgment will go away when you get that DMD or DDS, it's not, like you've gotten out all these people looking at you judging you, looking at every one of your moves. Be okay with that in that place. And, I agree change that mindset. Think of yourself right now as a doctor.

0:24:03.5 KD: Think of yourself of having to run four, five exam rooms. How can you run that? How can you build your skillset now because $200 a day is a lot for tuition but when you can produce $5,000 a day guys like 200 to 5,000, you're gonna pay your student loans off way faster. The doctor I worked for, we had her student loans paid off her first year. Like these things are possible but that also came with a lot of discipline and dedication and commitment and I mean you guys see the fruits of those laborers and it was, it's pretty impressive of what you guys can do in school. So I think it's a good thing to change that mindset and realize like you're gonna be freaking beat tired when you're working eight hours a day doing full dentistry. So just realize like that's gonna be normal and build up that stamina now that way you can rock and roll and not have to go through that like learning curve when you're out of school as well.

0:24:54.4 HS: Definitely. And kind of the next step after school for a lot of us is working as an associate kind of getting the bearings on maybe how a practice works but really getting those skills up to a level where you can be productive and successful. But what I was wondering is how do you think an associate kind of fits into the dynamic of an office? Where is it their place to do things, not do things when they are the doctor, especially if it's they're hired into an existing team, like people don't wanna step on people's toes but you have an authority there too.

0:25:27.1 KD: For sure. And I'm so glad you said that there's an authority. Guys as a team member I don't care if you're the associate or the owner doctor, you are a doctor to me and so I'm looking to you as a leader. So a lot of associates I think make the mistake of thinking like, well I'm not the owner and I'm like No, but show up as if you were the owner 'cause your team will respect you so much more. I think the zone where a lot of associates get into a little bit of funky water is one if they're trying to be the owner and they're not respectful of what that owner did. So guys coming with that I say it's a confident humility where you are confident in your skillset but so humble and gracious of what that owner doctor did that is going to get you so far with an owner doctor because they've blood, sweat, tears to make this a place that you can come into.

0:26:11.9 KD: And so really show that but at the same time don't sell yourself short 'cause you've gotta be recognized as an expert as somebody who's very confident in that. So I would say those are some of the pieces I see with that. But I also think associates, sometimes you just come in a little lackadaisical and you're like well these are just my patients and I'm not here. Try to see what you can take off of the owner's plate like hey, I'd love to help out with the assistance, I'd love to do this. And then also listen to the team. I think sometimes where I really see associates lose credibility and not have a team follow you like I've got an office in mind right now. The hygienists are such a strong hygiene team and the doctor has been there for a long time, amazing patient base and the associate came in and decided they just wanted to run their own type of exam.

0:26:57.1 KD: They didn't care what the hygienist did and it was almost like a holier than thou like I'm the doctor, you guys listen to me. And those hygienists were like okay, they're just gonna come in and do it. And that doctor didn't produce very well because if you don't have your hygienist bought in to you as a doctor, kiss your treatment goodbye because all, guys, they talk to them for an hour, you've got five to 10 minutes. So listen to them. I think so many new grads are trying to show their confidence. So again it's this fine line of you've gotta be confident but you can't be too confident that you become arrogant. So listen to your team members. If hygienists are telling you you take a long time on your exams, listen to them. They're not out to get you. If a dental assistant's telling you like Hey the other doctor does this, don't take that as an ego blow and I know it's very easy to do.

0:27:43.5 KD: So they're really trying to help you learn things that this doctor who's been doing dentistry for so many years, how they do it faster, how they're able to do it. Because you as an associate don't go get to sit with that doctor. You don't get to hear their exams, you don't get to see how they prep. But me as the assistant, I've watched hundreds of preps, the hygienist has listened to hundreds of exams. So really listen to that team and listen to what they're telling you because they want you to succeed. They love those patients and if you can actually listen to them, you'll be so far ahead. And I'll say like associates sometimes come in and they're like, I'm just gonna do this. And I'm like, if you would just listen to that team because the teams don't lie and they know and they want you to succeed, they want to share you with the patients.

0:28:27.9 KD: I think those are pieces. So from the humble confidence to being able to take things off your owner's plate to listening to the team, I think that it's there. But I also don't wanna forget this, I think so many doctors could be owners sooner, but they just think in their mind like go to dental school than be an associate. It's Like you guys get brainwashed into thinking that that's the path and you're afraid of it. That most of the doctors that I've talked to most, not all, most of them say I could have been an owner sooner. I wish I would've just jumped in sooner. So I just wanna put that out there to like plant some seeds that I don't think you have to be an associate. I think you guys really can do it. The only benefit is you do have a mentor doctor but honestly guys, a lot of times those owner doctors don't mentor you so you're still just kind of there on your own.

0:29:14.0 KD: You guys can always reach out to your dental professors, you can reach out to each other If you're stuck on a case we surely messed up on some patients and you'll learn real fast and you'll be refunding money and that's okay, you learn real quickly. But I'd say don't just have the mindset of I need to be an associate before I can be an owner. If ownership's on your mind maybe maybe challenge that belief and and ask yourself could I do this? And if I was going straight from dental school to ownership, what would I need to know now? Because maybe you can do that moonlighting. Maybe you can go shadow some people, maybe you can talk to professors, but you're gonna jump in and it's gonna be hard and it's gonna be exciting all at the same time. So that would just be a piece of advice I'd give you guys from that associate to owner role as well.

0:29:55.3 HS: And last thing kind of once you are buying a practice, if you're not doing a startup, I think there's so many different things to consider when you're gonna do an acquisition of course and you hear all these horror stories, oh this office looked great on paper but I got there the dynamic just wasn't meshing with the staff. All the staff left, I lost some patience. Do you think people should focus more on what kind of culture of an office they're buying before they just look at the financials or do you think people can rebuild from something like that and still be okay?

0:30:29.6 KD: This is such a good one 'cause like I said, we bought a practice and then nine months later we bought a second one and I was two very different people on those. First one [0:30:36.3] ____ shmoo keep the team, second one came in like a raging bee and like the whole team quit. So it's okay you can recover from both. For me, me I'm a business person and I believe at the end of the day buying a practice is an investment and I wanna make sure that investment's protected. So I need to make sure the numbers make sense and if they don't make sense, culture can get you only so far, but numbers are going to pay the bill and that's gonna create a ton of stress if the numbers don't look right. So when I talk to people about buying a practice, number one, be in a place that you truly love to be or it's a great opportunity that you know you're gonna sell in a couple of years and you're just gonna grit and bear it, but it's a great practice and you're okay with that.

0:31:17.7 KD: So really, I mean when you guys are buying practices, that's your life, that's your future, that's your livelihood. So have it be in an area. There is someone in Chicago and they don't even like the city of Chicago and I was like then why the heck are you in a practice here? Like you're paying the premium of being in an expensive city and you don't even wanna live here. So that would be number one of like pick a spot where you really do want to be long-term. Because usually dentists tend to be at their practices for a long time. I don't think it's a bad thing. I actually have some offices and I think acquiring a practice myself and doing a couple of these we're always so scared of losing team members. But guys, it's okay to lose team members. You are going to come in and shake and rattle and roll and you're going to lose patients because they don't jive and that's okay.

0:32:05.3 KD: I wouldn't recommend losing your entire team because it is an investment and you need it. But so many people have told me that they've hung onto team members because they were afraid those team members were sabotaging, they were stuck in old ways. The new owner couldn't get things to move and it actually is really, really hard. So I say come in, I, I don't think you should be extreme Kiera on either one of them. But I would look number one at the financials, does this financially make sense? And when you're looking at it, I had a doctor almost buy a practice, I'm so grateful they didn't. Practice was super profitable, but when we dug in and looked at all the procedures this doctor was doing, like 60% of the production was from procedures this doctor didn't even do. And so I was like that even though on paper looks good, if you can't replicate that, it's not a good purchase because you are gonna be floundering.

0:32:54.2 KD: They're presenting it to you. And it's not that it was a bad practice, you just don't know how to do those procedures. So for me, for acquisitions, I love what's called sleeping practices. So a retiring doctor, you guys can put postcards out, you can create websites for them. But those retiring doctors are the ones that are the best because not intentionally, but they do under-diagnose. They're older, they're in later in their career. That's a goldmine of production for you guys. Something that you can do very easily. A lot of bread and butter dentistry, it's very simple for you and there's a lot of room for you to just like light the fire and and have this practice take off. If you're finding a practice that say is super glam glitz, they've got all the things going, that feels really good 'cause that's like dental school most likely, but there's not a lot of room for you to improve it and enhance it and make a profit.

0:33:43.9 KD: So those ones scare me. It's kind of like do you buy a fixer upper house that you know you can massively improve the equity? Yes there's some growing pains or do you go buy this brand new house that's gorgeous but there's really no, there's no wiggle room. I think that's a personal decision but especially watching new grads with your amount of debt, I've seen if you have a way to create a great profit, do that because the stress of finances is not a joke and it will keep you up at night far more than any culture will. So you can always hire new people guys, there are people out there, there are people that wanna come work for you even in a hiring shortage there's a million different things you can do. You can do assisted hygiene, you can have it, but I would say of the positions not to lose right away within your first six months, hygiene and office managers pending upon the office manager if there's a really good one, they're gonna be valuable to you.

0:34:31.3 KD: If not hire a new one. If it's like a doctor's spouse, those are always really weird because they're gonna hold the practice of what it was. So those ones I'm very cautious of. Keeping a doctor on I'm usually a no-go on those. Some people it works out but usually it's not the best thing. So help them go live their dream life so you can live yours as well. That way the team comes to you and not to them, but there's so many pieces and what I'd say is don't be afraid to ask for help. Don't be afraid to get a coach to ask for it. Like build a really good board of advisors for you. So have a good legal team, have a consultant, it costs money for sure. Build that into the the purchase price of your loan. Because having really good people on your team will help prevent a lot of those mistakes right away. But honestly don't be afraid of losing that whole team. It happens, it happens often and it should 'cause you're shifting and they're either gonna grow with you and if they don't grow with you, let them move on. So you can hire people who are die hard, your fans and not just there because they've always been there.

0:35:29.9 HS: And you've shared so much great information and I know if people head over to your podcast they can just listen to their heart's desire of all this other great information that you can share. But aside from the podcast, what are like the consulting services, can you talk a little bit more about that and what that would look like for someone most likely just getting started in dentistry?

0:35:49.0 KD: Yeah, of course. Well thank you. The podcast is truly my labor of love. I love to put out the content and on our website, the dentalateam.com, you guys can click on the podcast link and then truly any topic you wanna hear about. So if you wanna hear about associates or overhead or scheduling or billing, you type that in. And any podcast I've recorded, we've recorded over 600 episodes, any of those, you can find those topics so be sure to reach out there. But as far as consulting, we actually have a couple of things for new grads. So we have our online, virtual academy. It's about to change names, so pending upon when you're listening it might be dental university but that it's AGD accredited. So it is CE guys, but it's all of the, the pieces of the practice.

0:36:35.4 KD: We actually have courses. So like how to be an office manager, like what does that role even entail? The billing, the scheduling, the TC, how to build an operations manual. We have a 750 page templated out operations manual for you to just hit the ground running. So I think for new grads coming out, that's an amazing resource. We've made it very affordable for new grads to come in and to be able to have access to that. If you want more which most of the time it's usually new owners. We have a virtual consulting where you get that whole online library but then you also get one-on-one coaching plus you get to come to a mastermind with other doctors, which as a new doctor you live in an isolated world in your practice. And so really being able to join that network and that community and then if you really wanna go, guns or blazing, which some people do.

0:37:18.5 KD: We have our in-person consulting where we physically fly to your practice and I've had some brand new owners hire us for that. We come out, we set up so many systems that you don't even know exist, like we're little dental fairy godmothers and when people are purchasing their practices, they actually include our consulting fee into the price of the loan. So that way, and we pay for ourselves, we're usually a 30% increase in production within your first 30 to 60 days. So it's a pretty fast ROI I guarantee we'll cover ourselves. But those are the different ways. So either the online resources, which I feel would be so beneficial for you guys that virtual consulting or the in-person are the three areas that we do.

0:37:57.6 HS: Thank you so much for that. I'm excited to check out your website. I've looked through some of the podcasts but I haven't looked on the website yet, so that's awesome.

0:38:05.2 KD: Yes, Thank you.

0:38:06.7 HS: Well thank you so, so much for your time tonight. I really appreciate it. I learned a lot. You're such a bubbly, fun person to talk to as well, so that was nice as well. So thank you.

0:38:14.9 KD: You're welcome and truly Guys, if you have any questions, email me. [email protected]. I want you to feel confident. I'm just Kiera Dent from the block, I'm not a dentist, I am here as a very down to earth, Like ask me any question I want you to say like, I don't even know what a freaking P&L is. Awesome. I'm gonna explain it to you, I'll help you. So just know you've got a friend in the dental industry. That's why I built this was for dentists, for dental students. So that way you guys had a resource out there like, I don't even know what lawyers to call. I don't even know what brokers to go. Like, I don't even know what this means. Reach out. I'm happy to help. I'll share as much information as I possibly can. So Haley, anything I can do for you, for your listeners email [email protected]. Let us know that you heard about us here and we will take care of you and help you get the right resources or share anything we can.

0:39:00.3 HS: Thank you so much.

0:39:01.7 KD: You're welcome. And that wraps it up for another episode of the Dental A Team podcast. Thank you so much for listening and we'll talk to you next time.

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